Farewell To The East End

antibiotics, some of the babies affected might have died. Certainly one or two would have developed chronic otitis media, or pink eye, or a lung infection, which could lead to something worse. But antibiotics, being new in those days, were more effective.
    Cynthia was off work for two weeks, and returned to the district with confidence. No more infections occurred amongst the babies.

    The first case Cynthia went to on returning to work was in a comfortable little house in Bow. It was a nice sort of home to be working in and everything was going well: the young mother having her fifth baby was progressing in labour; her mother was looking after the four young children downstairs; her grandmother, an experienced matriarch for whom childbirth was less alarming than a visit to the dentist, was competently helping Cynthia. She – the grandmother – was looking at the fire.
    ‘Sulky ole fire, that. Needs a bi’ of life in it afore this baby’s born. We wants a nice warm room for ve new baby, eh, nurse?’
    She picked up the poker, stirred the sluggish embers and opened the air vent. Flames leaped up the chimney. There was a rumbling from somewhere near the roof and a cascade of soot fell, completely dousing the fire. The grandmother screamed and rushed forward with a sheet of newspaper in an attempt to contain the soot in the grate. But there was a second rumble, louder than the first, and another fall of soot came rushing down the chimney, smothering the poor woman and flying all over the room. Cynthia’s sterile delivery equipment, carefully laid out on the chest of drawers, was covered in soot; the white bed linen was black; the lovingly prepared crib with its white lace and bows was black; Cynthia, aseptically prepared for delivery in a sterile white gown, cap, mask and gloves, was black; and the woman lying on the bed was black, although she was past caring – the second stage of labour was approaching and she was suffering a massive contraction prior to full dilation of the cervix. Cynthia gazed at the scene and raised her gloved hands in horror. Her first instinct was to wash them, and she rushed over to where the washing bowl stood. But a film of soot was floating on the water, and soot clung to the sticky wet soap. She tore off her gloves and was relieved to see clean hands.
    ‘Oh my Gawd,’ moaned the grandmother, ‘I never seed nuffink like it. What’s you goin’ ’a do, nurse?’
    ‘There is nothing I can do. If a baby is going to be born, no power in the world will stop it. We will have to continue like this. You go downstairs for some more hot water, and take this bowl with you and get it washed. You can also ask if there is any more clean linen in the house. I don’t think there will be time to get another sterile delivery pack from Nonnatus House, but you could try.’
    With the last contraction the waters had broken, and viscous amniotic fluid was flowing over the absorbent mattress coverings. Falling particles of soot were rapidly sticking to it.
    As Cynthia spoke particles of soot blew off her mask, so she tore the thing off. She would be better without it. The upper part of her face and eyes were black, her mouth, nose and chin were white. She looked like a comic turn.
    Poor Janet, sweating profusely from the pain and pressure of advanced labour, had soot sticking to her entire body. It had even managed to penetrate beneath her nightdress. She raised her legs and vaguely rubbed her hands down her thighs, perhaps to wipe the soot away, but it only served to make thick, slimy black streaks.
    ‘Oh Gawd, wha’ a mess,’ she moaned, beginning to pant. ‘Vere’s anuvver contraction comin’, I can feel it. Aaah …’ she groaned in agony.
    Cynthia did not need to make a vaginal examination. She could see the head descending.
    ‘Don’t push, Janet, whatever you do. Just pant, quickly, like a little dog. In, out, in, out – quick, shallow breaths. That’s right, keep panting. I need to turn you over onto your left side in order to deliver the baby.’ (We were taught, in those days, to deliver on the side.)
    In the meantime the grandmother had taken the washing bowl away and returned with clean hot water. She also had some clean towels and sheets.
    ‘We can take ’er into anuvver room, nurse.’
    ‘That would be nice, but I doubt if it will be possible. The baby might drop out on the landing! See here, I’m holding the head back as it is. Another contraction and it will be