Call the Midwife: A True Story of the East End in the 1950S

systolic was over 200 and diastolic 190. Her temperature was 104 degrees Fahrenheit and her pulse was 140. A catheter specimen of urine was obtained and tested. So heavy was the deposit of albumen that upon boiling the urine turned solid like the white of an egg. There was no doubt of the diagnosis.
     
    Eclampsia was, and still is, a rare and mysterious condition of pregnancy, with no known cause. Usually there are warning signs before onset known as pre-eclampsia, which responds to treatment, but if untreated may progress to eclampsia. Rarely, very rarely, it occurs with no warning in a perfectly healthy woman, and in the space of a few hours it can develop to convulsion stage. When this stage is reached, the pregnancy is unstable, and the foetus unlikely to survive. The only treatment is immediate delivery of the baby by Caesarean section.
     
    Theatre had been alerted and was ready to receive Margaret. The baby was dead on delivery, and Margaret returned to the ward. She never regained consciousness. She was kept under heavy sedation in a darkened room, but even then she had repeated convulsions that were terrifying to see. A slight twitching was followed by vigorous contractions of all the muscles of the body. Her whole body became rigid, and the muscular spasm bent her body backwards, so that for about twenty seconds only her head and heels rested on the bed. Respiration ceased, and she became blue with asphyxia. Quite quickly, the rigidity passed, followed by violent convulsive movements and spasms of all her limbs. It was hard to keep her from hurling herself on to the floor, and quite impossible to keep a tongue wedge in place. With the violent movements of the jaw she bit her tongue to pieces. She salivated profusely, and foamed at the mouth, which mingled with the blood from her lacerated tongue. Her face was congested and horribly distorted. Then the convulsion subsided, and a deep coma would follow, lasting for an hour or so and followed by another convulsion.
     
    These terrible fits occured repeatedly for a little over thirty-six hours, and on the evening of the second day, she died in her husband’s arms.
     
    All this flooded into my mind in the few seconds that I stood at the sink, looking at the sample of Sally’s urine. David. What had happened to that poor man? He had staggered out of the hospital half blind, half mad, dumb with shock and grief. Sadly, in nursing, and particularly in hospital nursing, you meet people during some of the most profound moments in their lives, and then they are gone from you for ever. There was no way that David would be hanging around the maternity hospital where his wife had died, just to reassure the nurses. And equally, hospital staff could not go chasing after him to find out how he was coping. I remembered with gratitude what he said to me just after she died, and the words of some great writer (I cannot recall who), came to mind:
    He who loves knows it. He who loves not, knows it not.
I pity him, and make him no answer.
     
     
     
    There was no time to mope. I had to see Sister and report on Sally’s condition.
     
    Sister Bernadette was in charge on that day. She listened to my report, looked at the urine sample, and said, “There may be contamination from a vaginal discharge, so we will take a catheter specimen of urine. Could you just get things ready for catheterisation, please, while I go over to Sally and examine her.”
     
    When I took the tray over to the couch Sister had already made a full examination, and confirmed everything I had reported.
     
    She said to Sally, “We are going to insert a small tube into your bladder to drain off some urine for testing in path. lab.”
     
    Sally protested, but eventually submitted, and I catheterised her. Then Sister said to her, “We think there is a problem with this pregnancy that requires absolute rest, and a special diet, and certain drugs to be administered daily. For this, you must go to hospital.”
     
    Sally and her mother were alarmed.
     
    “What’s up? I feels all right. Just a bit of a headache, that’s all.”
     
    Her mother butted in, “If there’s anything wrong with our Sal I can look after ’er. She can take it easy at home, like.”
     
    Sister was very firm. “It’s not just a question of taking it easy and staying in bed some of the time. Sally has to have absolute bed rest, twenty-four hours a day, for the next four to six weeks. She will have to have a special no-salt