Colleague or Patient

Lilacs in bloom in Regent's park. Photo by WSM

Lilacs in bloom in Regent’s park. Photo by WSM

On a beautiful spring morning my husband and I walked hand in hand through Regent’s Park.

Crossing the Marylebone Road we turned onto Harley Street to be met by our memories.

Could this be the same building that we entered over fifty years ago? Though many times repainted and re-carpeted and now with a lift beside the stairs and we felt a shivering echo of remembrance.

Harley Street W1

Student Nurse Slater 1962

In the mid 1960’s, contraception was not readily available to young unmarried nursing students. Those who became pregnant had to choose between pregnancy, possible marriage and leaving nursing school or terminating the pregnancy to continue training. At our hospital the choices were stark; a tryst with Reg the long-fingered maintenance super, several patient escorts to the Radiology lab or a visit to a discrete gynecologist on Harley Street. I remember a smooth, urbane, gentle young man who was used to caring for the young nurses who had fallen too quickly into the arms of his lustful colleagues. I only saw him one time and had no need to go further into his suite.

Today we took the lift to the third floor and entered a compact, neat office to wait at the reception desk – for the receptionist.

Another young man is pacing. He is shyly courteous and assures me someone will be with me shortly. He is, again, urbane, handsome and impeccably dressed but in this space he seems caged and nervous. The receptionist arrives and I fill in identical forms to those I filled out ten days ago at the doctor’s office. I return the forms to her and handed over a credit card, keeping my fingers crossed that our U.S. health insurance will kick in and help us out.

The young man is still pacing. Trying to put him at his ease I turn and ask: “And what do you do here young man?” Maybe this was not the most comforting of questions but it was the best I could come up with, for, I too, was nervous this morning.
“I’m a plastic surgeon. Are you a colleague or a patient?” He bats the question back at me in defense of himself. He is taken aback by my question, and I by his reply, so we laugh together as I gather my answer.
“I’m both. A nurse and, today, a patient.” I make a quick prayer that he is not on standby for my procedure. We laugh again as I gently ask, “Do you still get nervous?”
“Yes. Always, but I try not to show it.” He knows this is the answer I want to hear. Now our conversation is over and we part, I to sit down and wait, he to pace where he cannot be seen.

Brenda, the nurse who welcomes me, is Irish, old school and cheerful. I expect she greets all her patients as sweetly as she does me. She settles me into a waiting -recovery room and I gown-up with added pale blue socks before Dr Dobbs strides in.

He is a big man, tall and more than a touch over-weight. After a long weekend his nose is sunburnt and his cheeks are ruddy. This is not a man who follows his own doctoral advice. He introduces me to the histology pathologist who will be checking over my bits after they are dug out.

He applies a little light numbing to my lip before I am led into the OR suite. Two more nurses, one from Slovenia, the other from Romania are waiting. Between them they settle me onto the table. The room is air-conditioned cold which is great for them but I need a blanket.

The local anesthetic is given and soon it is: lights, camera and action as Dr. Dobbs begins. I am aware of blood being swabbed from my face and, from time to time, the smell of burning flesh as he cauterizes bleeding vessels. Brenda has a hand on my thigh, softly stroking me as if calming a stalled horse. When she moves around the table she constantly reaches and touches me. She is steady. My eyes are closed as I ponder the difference between numbness and pain.

Dr Dobbs is focused and I can feel when the work is easy and when it is hard. He has entered the sea surrounding the tip of an iceberg, the only visibility sign for two and a half months that something was wrong. This is a tricky, not so little, intrusion in my body and I can feel he is straining hard to get underneath it all. His stomach leans up agains my side and presses into me. His belly is as comforting as Brenda’s touch. I am reassured by his efforts and silence when working and his good manners to his nurses when he calls them.

Stage one is done. I return with my blanket and socks to the waiting – recovery room. Dr. Dobbs takes my bits to the lab while I’m surprised at how shaken I feel. Brenda sits with me a while, popping in and out to give me sips of water from a paper cup.

The pause is over and it is back to surgery for another round. Dr. Dobbs repeats his scraping, as if cleaning all the fruit-flesh from a melon skin, until he is satisfied he has enough and it is time for final closure. Luckily there is no sign of the young plastic surgeon and Dr. Dobbs is relaxing as we come down this home stretch together.
Eight sutures later, a dental pad dressing and I return to recovery.

“You’ll have a sort of hockey-stick scar. It will do very nicely in the skin crease in your face.” He kindly refrains from saying “wrinkle” but I am grateful to have aged in my own skin.

“How long do you want to keep her?” Brenda asks. I want to go home and let my husband get back to work so post-operative instructions and prescriptions are given before Dr. Dobbs sums up this morning, as if to himself, “You were good to be so relaxed. It makes a big difference.” And it felt so, a team effort between doctor, nurses and patient. It was collegial. I hugged each of the nurses as we said good-bye.

Taxis turn onto Harley Street

A black cab turned onto Harley Street as we came out of the building. We climbed in and the taxi driver took us quickly home.

I was laid out and down to begin a week of advanced Sofa-thenics while the next member of the team, my husband as colleague, bent down to caress and take care of me.

Advanced sofa- thenics

Lassie, Monkey and Memories

Banner and Bea

Bea’s banner goes up at the Botanical Gardens

Each morning at 7.30 a.m. David runs across the terrace, knocks on, and then opens the door and calls out, “Granny”! For there is book reading to be done or green play-dough dinosaurs (dinosaurs are green at the moment) to be made before breakfast. But today David came early only to help Granny with her morning yoga and then left. He took his Mama off to Palermo, to his music class and then for Bea to hang the banner for her show that opens on Saturday at the Botanical Gardens by Plaza Italia.

So I’ve not felt this morning stillness since arriving in Buenos Aires two and half weeks ago. The early delivery of food crates for the restaurant down below have been stacked and we won’t hear more until later this afternoon when it is time to chop vegetables for the evening meals.

Lassie and Monkey

My Monkey – and sofa too

Lassie has come to join me as he (yes he) does everyday now. The ‘Abuela Dome’, as we have named the little studio, is a quiet place where he can rest his tired old body on the sofa, paws wrapped firmly around monkey.

This morning after laying my breakfast carefully out on the little table, I looked at every piece of china and food and saw memories alongside of breakfast.

Breakfast

Breakfast for one in the Abuela Dome

There is honey from our bees in Bolinas, and homemade strawberry jam made by Bea. The stewed apple are in one of two Johnson Bros, Indie bowls that I found at the street market at Plaza Dorrego one Sunday.

We got the money honey.

“It is an antique.” No, I first had that set in London thirty-five years ago. Does that make an ‘antique’? The petal-pink teapot came from the San Telmo Market when we first knew we would make a little home here. On it is the tea cosy I knit for the tea pot in the work kitchen of Tetro when the film crew were based in San Telmo in 2008. The bright and cheery butter dish was bought as a souvenir from our overnight visit to Uruguay last year. A surprise storm kept us there where we were lucky to be able to return to our hotel and ‘if’ we could find cash, still get a good deal.

The French Jacques Cout un Jandin …en plus milk jug came from a small village shop in Corsica. We went to visit old friends for the weekend and stayed on in their villa for ten days after their return to Paris, celebrating our 25th wedding anniversary. One afternoon a big thunder storm came across the bay and we stood naked, watching from the tall glass veranda doors, mesmerized as the darkening clouds and rain came closer and closer to finally wash over us and leave a calming stillness in its wake.

The Heirloom Royal Albert tea cup and plate belonged to my mother-in-law Katharine. I remember her at the end of a long day in New York City, sipping her tea while often smoking a cigarette. If my husband’s memory is correct this tea-set would have been from her mother, Mary Elizabeth Scott and probably sent as a wedding present from England to Mary Elizabeth MacCallum on her marriage to Thomas Beckett Scott in Canada. The tea-set was soon packed up carefully and taken to Ceylon in 1893 where she and her husband worked as medical missionaries, directing the Green Memorial Hospital and starting a nursing school. In 1913 Mary and Thomas retired and returned to the States where, until 1925, they ran the Walker Missionary Home at Auburndale, Mass, caring for the children left behind from other missionary workers.

Tea time, on another continent, with another generation

How much of the set made it back from Ceylon, now Sri Lanka? Did Mary Elizabeth sit at the end of her day and draw comfort from the delicate china as well as the tea, as did her daughter Katharine? After Mary died in 1941 was the tea-set divided up between her four daughters? Who got the tea pot, milk jug and sugar bowl?

This day began with old memories and ends with new. Lassie has returned to the sofa to hug his monkey. Beatrice joins me in our quiet catch-up ritual, sipping our late afternoon tea in San Telmo, Buenos Aires.

The little tea-set has traveled many miles over many years, bringing comfort along with tea to four generations of women. We have been blessed and are grateful.

Derby and Joan

In the top drawer of the tiny kitchen in our London cottage lies the cutlery. A divided wire basket holds the bright, shiny new knives, forks and spoons bought for the life we are making together in England. Beside them lie a jumble of old utensils culled from my mother’s three homes in Hampshire, each house smaller than the last, and all within two miles of each other. The utensils were scooped up from the collection that she could not bear to let go, I remembered, and still can’t abandon. Prominent among them are the knives: old breakfast knives, a small kitchen knife, the knife sharpener, and her old bread knife.

The bread knife has a stained and cracked bone handle and tightly grooved serrated blades. Even knowing that it struggles with the modern artesian breads of the day, I still cannot bring myself to let it loose in a charity shop where it might linger, like a homely girl at a village dance, waiting unclaimed on the shelf. So I kept it and wonder from time to time how old it really is. It does struggle so with today’s artisan breads, tearing the oblong French baguettes and rounded Italian soughdoughs. German breads with their dense rye flour fair better. The multi-grain wheat breads even better yet. But the bread knife and I struggle on, cutting and slicing on the beach-wood cutting board, grateful for each other. It knows it is safe with me and I have no thoughts to abandon it. In fact, I feel safer and enjoy a duller bladed knife.

One year at Christmas, in despair, one of our daughters gave us a new serrated bread knife for the farm kitchen. It is sharp, German and created to march through any loaf that is placed before it. And it does that with the utmost efficiency, taking no prisoners. Before the New Year had arrived it had also taken a piece of my forefinger along with a crusty slice of local artisan bread. When back on the farm I still use that knife – but – with great caution.

This Saturday afternoon as my husband was going out he asked it I needed anything.
“Yes please. A loaf. We are out of bread.” I was expecting him to pick up his favorite Italian bread from Anthony’s Deli on the high street in the village. But he lingered around the weekend stalls set out on the high-street and was gone a long time. When he did successfully return from the hunt, he opened up the bag and brought out a large English Tin Loaf, unsliced.

Derby and Joan

Tin Loaf comes home

It was a big white loaf, just like we used to get from the baker, Mr. Wright, whose wife and family made fresh bread in their shop every day in Fleet. Daily the queues outside of ‘Wright’s the Baker,’ went out the door from nine a.m. through to noon by which time every loaf of bread was sold and all that was left were the tea time cream-cakes. Every variety they made and placed out on their shelves could make and hold chunky sandwiches with a smear of butter before a good chunk of cheddar cheese, and some Branson Pickle without falling apart. They held together and were ready to eat in the van, on the lunch break or in the fields. The sort of loaf – freshly baked – and on the shelf – that immediately made one hungry for a slice.

And that is how we felt when my husband came home on this Saturday afternoon with his trophy which he unwrapped and laid out on the beach-wood cutting board. The tin loaf sat happily on the bread-board while I opened up the drawer and took out Granny’s old bread knife now long married to the cutting board. I swear the knife quivered in recognition and pulled my right hand towards the loaf, as if reaching for an old remembered friend.

Sliced and ready

Sliced and ready

The loaf of bread held steady under my left hand and seemed to sigh in relief as the blade stroked the crust and then bit deep into the first slice, letting the heel of the bread fall gently onto the breadboard. I cut another slice, and another, clean, even slices of bread. I put the knife down and it rested on the counter as if in a swoon of remembered happiness.

The English Tin loaf was rewrapped and put away for tomorrow’s breakfast. Next we put the kettle on.

Tea time memories

Tea time memories

The fallen slices of bread were firm and smooth and lay flat ready to receive a smothering of butter and honey. It was time for afternoon tea which we enjoyed sitting out on the terrace. Once more grateful for those things found, remembered, and not forgotten.

From Wards to Words and Back Again

It was 1995 when Between the Heartbeats Poetry and Prose for Nurses was first published by the University of Iowa State Press. Conceived and edited by Cortney Davis and Judy Schaefer, this was the first Anthology of Creative Writing by Nurses, gathered from around the world.

Heartbeats at Chapters Bookstore DC

Between the Heartbeats writers at Chapters Book Store, Washington DC, 1995

 For many nurses it was the first time our medical writing had been accepted for publication. That summer as many of us who could, maybe twenty out of fifty contributors, came to Chapters Book Store in Washington DC for our first ever reading. This coincided – not unintentionally – with the annual general convention of the American Nurses Association. The evening was exciting, scary and thrilling. Scary because we were reading our own work and thrilling because we were hearing the words and work of other nurses. All of us facing the same direction, our voices so different and yet so deeply in tune with each another. There was an audience, listening, applauding and asking questions. One man spoke up, “Wow, this is amazing. Can’t wait for when you present this to the ANA”. We were all silent before Cortney, in her calmest most diplomatic way, (her speciality) replied, “Actually we won’t be at the convention. They don’t want us and won’t let us present the book there.” Among the audience were nurses who would be at the convention. We were all stunned, silenced and sobered that those nurses for whom we wrote did not deem our words necessary or supportive of their work.

As nurse writers we came together for that weekend forming a tight union of sorts, loosely knit, tendrils of thought, vision, each of us seeing and transforming through words, our patients in the wards, clinics and communities we serve. Since those early years we have continued to write, sending each other our books, reviewing and commenting for each other, hosting nurses writers on the radio and spoke of our work to audiences wherever we could.

Coming together was always a chancy affair but we get our moments. Two years ago The Medical University of North Carolina held its first “Narrative Bridge Conference”. Five of us, Jeanne Bryner, Cortney Davis, Veneta Masson, Judy Schaefer and myself, made it there for the long weekend;. We were billed as “The Nurse Poets” and that is what we have become. Through the years more books of poetry, prose, creative non-fiction and novels have been written and published and within the ‘about the author’ description the word “Nurse” always leads. This is who we are, this is where we speak from, whenever and wherever we can.

It was Lisa Kerr from the MUSC school of nursing who again called us together this year. Lisa wrote asking if we could come, not only to speak to the faculty and students of the nursing school but that there could be an opportunity to perform as The Nurse Poets in the annual Piccolo Spoleto Arts Festival at the Dock Street Theatre. New books had been published, among them, Jeanne Bryner’s poetry Smoke, Cortney Davis’ When the Nurse Becomes a Patient, which won an American Journal of Nursing Book Award for 2015 and my 2016 The Bell Lap Stories for Compassionate Nursing Care were all hot off the press and we were eager to share our work. I was ending a roll-out with The Bell Lap, coming down from New York and a launch at the National Arts Club with the great cartoonist, and tonight – host – Roz Chast whose book about the final years of her parent’s lives Can’t we Talk about Something More Pleasant, remains a best seller.

A little help with the night before prep.

A little help with the night before prep.

It was – is – fun to be on the other side of the microphone. This was a first for Roz who is more used to being questioned about her work, and almost a first for me, being more used to asking those questions. With her questions and comments, memories surprised me and in the quickness of the moment words did not always take the long route – through my brain – as they rushed from my heart to my mouth. Maybe it was not the smartest thing to recall ‘my first leg,’ after Roz’s question about my failed operating room experiences. And so we learn. Beloved friends were there and I was more than grateful to see nurses in the audience, plus a doctor or two. Paul Gross and Dianne Guernsey who co-edit Pulse Magazine “Voices from the Heart of Medicine” came in on the train, Cousin Tom rode the bus from Cap Cod and nurse colleague Gerry Colburn traveled in from New Hampshire.

Tony and Peter and MAM

A Hug from Tony and Peter After it is all over.

It was a great evening and gave me the needed boost and courage to fly down to Charleston and join the band – not yet a rock band – The Nurse Poets.

Four of us had made it and it was grand to be together. Jeanne had driven for two days from Ohio. Cortney flew from Connecticut, Veneta from Washington DC and I from London, via New York. At breakfast we celebrated with coffee and grits. We quickly shared our stories, families, the agonies of book promotions and knowing as all women of a certain age do, that we will continue to balance these lives until illness, infirmity or death claim us.

At noon, under Lisa’s guidance, we spoke at MUSC nursing school for more faculty than students but how eager they all were, how they knew the importance of story, the lives led before and beyond the illness of the patient. Then an afternoon break before being driven past the Emanuel Church where flowers are still laid out daily in remembrance of last years tragedy to an early supper of fine southern food. (Where oh where do I get the real recipe for Green Fried Tomatoes?)

Then we walked to the Dock Street Theater where the audience was already gathering for our evening performance. The theatre is nestled in a small courtyard, intimate and perfect for poetry readings. The seats filled quickly and chairs were added along-side the cloisters until there was standing room only. We sat, warm but not hot, under the evening sky. Our time was tight, and so were we. Introductions by Barbara, the organizer of the festival. then Lisa, organizer of us and then, following each other in alphabetical order, we were on. Each of us brought our full-to-overflowing hearts to the mics and poured out our words. Jeanne watching family, Cortney and Veneta their clinics, and I from the wards and communities before returning to nursing school with an excerpt from The Bell Lap.

Veneta Masson, Cortney Davis, Muriel Murch, Jeanne Bryner

Veneta Masson, Cortney Davis, Muriel Murch, Jeanne Bryner

The audience rose to applaud these words that came from our hearts and our memories. Why did they love us so? We were good 🙂 yes but was it just the words, or was it the knowledge that with these words they know we have seen them, as people before patients. We have marked and held them in our hearts and returned them to themselves, thus received and healed, if not cured. Giving this audience an understanding that as these words have come from the wards to them they may also return to the new young nurses of today.

Jeanne, Miriam from L.A., Venetta and Muriel

Jeanne, Miriam (The next generation), Veneta and Muriel enjoy the reception for The Nurse Poets.

The Bell Lap event in New York City

INVITE to The Bell Lap at the NACOn Wednesday May 25, Roz Chast author of “Can’t We Talk About Something More Pleasant,” will join me in discussion, talking about “The Bell Lap,” and some of the moments in-between. We will be in the Sculpture Court at The National Arts Club from 6:30 p.m. – 8 p.m. If you are in New York and interested in joining us, please RSVP to: murielmurch@gmail.com

Shopping Baskets are Back

Morning Coffee at the Parlour

At the Fortnum and Mason’s Parlour Cafe service continues at the place of a sedate, unhurried butler coming up from downstairs.
I have ordered an Americano Coffee with hot milk on the side to sip while I wait for parcels from gift-wrap. Already I know that the parcels will be done in the same stately pace as it takes for my cup of coffee to be served. When the coffee does arrive, with the little chocolate ice-cream cone, it is about as perfect a treat as can be.

The Summer Sales are in progress in London. Much as they might like to, Fortnum and Mason’s cannot ignore them. But F&M resent all that mid-season sales imply and it is impressive how they manage to keep the allure around their brand. So the sales tables that are sprinkled through all of the floors are small, and layered with just a little of this and that. On one table lie a few scarves, half a dozen summer hats and clutch bags as if at a summer charity fête. At the kitchen table I weakened to a delicate light green and white stripped mug. It is perfect for those mornings when I do not go out, but boil the kettle at home for a mid-morning Nescafe.nescafe - Version 2

On The Parlour Cafe floor, after the sale table, my eye is quickly drawn to the display of baskets. The wicker picnic hamper is back in fashion. We still have our one from Harrods bought over seventy years ago. Though the real knives and forks have disappeared the then new plastic containers and plates are still alive. These new wicker hampers also have ‘real’ knives, forks, plates and, of course, crystal glasses.

Picnic time

The hamper display is surrounded by shopping baskets in all guises.

All of them are bigger than my mother’s shopping basket which she carried into Fleet every weekday morning.

It would be close to ten-thirty in the morning before she was able to leave the house and drive to town with only a lip-stick and a small change purse in her basket. Once in town she would join friends for a coffee At Mrs. Max’s Café, before walking the high street to shop though she didn’t actually buy very much.

What did my mother do taking those precious morning hours in town? The ladies met at Mrs. Max’s Café, taking an hour or so to pretend they had nothing to discuss, but between sipping their coffee, smoking a cigarette or two, maybe even sampling one of Mrs. Max’s homemade croissants, they chose what secret heartaches to share among the gossip and laughter of friends. Mrs. Max’s pastries were reputedly not only the best in town but in Hampshire. She was French and in some way a refugee from the war. What caused her to be here was a question far too advanced for a child to ask. Did Lady Pechall, with her understanding of many things foreign know Mrs. Max’s story? Had she perhaps been instrumental in helping Mrs. Max get ‘settled‘ in the town? There is no recollection of a Mr. Max. After finishing their coffees and loosening their hearts the ladies got up to leave, saying that they had to ‘get on with it or I will be late.’ Each would stop in this shop and that as they walked the length and back along the High Street, placing orders and possibly putting one or two things in their baskets.

What did my mother buy in our small Hampshire town? Maybe some cooking staples, flour, sugar and raisins. Spices remembered from her years in Africa and still scarce in this immediate post-war period? These she could find in Canes Corner ‘Up to Date Stores’ at the far end of town or maybe at Ernest Oakley’s General Store, situated closer to the center of town. If she has a large list it would be boxed up in an orange crate to be delivered to the house. Mr. James Oakley himself might drive up to the back kitchen door, put the box on the kitchen table and, if Mrs. P was in a good mood and he not too busy, share a cup of tea while chatting, as one does, binding community together. Daily deliveries were still common in the countryside. Milk from Rose Farm Dairy was brought by the milk man on his way home to the dairy farm next door. Late morning would often find me waiting for the milk cart to return and be hoisted onto the back of the old piebald cart-horse to ride the few yards to the farm driveway. Gordon then lifted me back off and I would scamper home again, believing, as children do, that no-one saw me. Bread was delivered three times a week from Jessett’s Store. If he saw me the delivery man would slip me fresh still-warm roll from his basket. Even the butcher, Mr Percy Harden, would drive up with meat and game, considered to big or messy for my mother to carry. It was a time of transition. A time to change, to be more in tune with the new post-war society. For a large Edwardian household such as ours, outdated even then, this was a challenge. My mother had only the beloved Mrs. P. to help her each day. There was no housekeeper to rule the kitchen though my father kept three gardeners for as long as he could afford it.
Today deliver service is offered to the online shoppers of Tesco and Waitrose. Every evening one of their trucks comes down our little street and unload crates of groceries which fit into American sized refrigerators.

Basket for Today

But for some baskets are now the smart midmorning accessory while we become super conscious of our plastic consumption and the need to buy fresh and organic produce.

 

The trolly is permissible on Camden High street though rarely seen on Regent’s Park Road. I bought my basket in Paris, where nearly everyone still shops with a basket.

Basket from France

 

 

But sometimes, when it is full, for I buy most things in our small village, it gets heavy.

 

 

This last week I pulled out from behind the washing machine my mother’s old basket.

photo

She had long ago relegated it to carrying cleaning products up and down her stairs. Somehow she needed to honour its devoted service and hold onto the memories it carried for her.

I too had not let it go and for fifteen years it has held ‘extras’ in the back of a cupboard. But out it came, shaking off the under-stairs dust and, after a spray of furniture oil, it felt perky enough to fit on my arm and come into town. It holds more than I thought. It is well designed and alongside the bigger french basket it has it’s place once more.

Granny's basket can carry

Baskets are for the markets and for those of us who are older, who need the exercise and the daily connection with others. Walking into the village and coming home with our basket full is a good mornings work.

Permission to Touch: ¿Permiso?

We laugh when AARP first shows up in our mail box on our fiftieth birthday. But over the years we come to read more articles until devouring the magazine from cover to cover. This April’s bulletin issue features Jessica Migala’s article High-Tech Ways to Stay Healthy which looks at the new world of medical app options for both patients and doctors.

In Stuck in the Past: Why are Doctors still using the Stethoscope and Manila Folder? Michael R. Splinter, Executive Chairman, Applied Materials, Inc., asks ‘Why Physicians haven’t adopted more modern Technology?’ He suggests that physicians should get rid of the Stethoscope and the Manila Folder. But I would ask him, along with Medscape Editor, Dr. Eric Topol and others, in the interest of good physicianship, for want of a better word, to hold steady and reconsider, first the sturdy stethoscope with all its uses and then, memory.

Mike Newall’s 2007 film Love in the Time of Cholera opens in the year 1880. Early in the film, Fermine Urbino, having rejected her suitor Florentino Ariza, suddenly, mysteriously falls sick. Her anguished father calls for the young doctor, Juvenal Urbino, who hurries to the bedside of his friend’s daughter. A lady’s maid hovers nervously in the background. Approaching the bed Dr. Urbino takes in Fermine’s glistening, feverish forehead. His hand reaches down to check her pulse. Then, bending low over the bed, and in haste for a rapid diagnosis (and screen drama), rips open Ferimine’s bodice to reveal her breasts, which rise, quivering under such an assault. Putting his ear close to her heart he leans low to hear its rapid, beating pulse while struggling to contain his emotions. But we all know what is going on and – because the film is a little slow and predictable, and most viewers have read the book – what will happen.

We may miss these dramatic bodice ripping moments but it is an undeniable fact that the invention of the stethoscope in the early 1800s made diagnosis of certain illnesses better, and faster.

In 1816, while studying medicine in Paris under Dupuytren and Jean-Nicholas Corvisart-Desmarets, René Laennec began to experiment with ways in which to hear the body better. His first instrument was a plain wooden monaural tube.

This early stethoscope belonged to Laennec (Science Museum, London).

This early stethoscope belonged to Laennec (Science Museum, London).

By 1851 it had evolved to a binaural instrument with flexible tubing. He named his instrument the stethoscope from the Greek words Stethos (chest) and Skopos (examination). Laennecs’ new invention was far more accurate in hearing heart and lung sounds than the old method demonstrated in Love in the Time of Cholera. But it had its detractors. Christopher McManus writes in his Right Hand, Left Hand, that Thomas Watson MD, was known for not only using his new stethoscope but sitting and watching the patient and saying he found the stethoscope ‘more of a hindrance than a help and that although he could not do without it, he did without it as much as he could.’

A young Scottish physician, John Forbes, moved to London in 1840 while his old friend James Clark was the young Queen Victoria’s physician. Queen Victoria loved all things Scottish and was fascinated with modern medicine. So it was not surprising that in 1841 she chose this studious doctor for her family and the Royal Household. Scottish physician or not, Forbes brought with him the new French instrument, the stethoscope.

Not until almost a hundred years later, in the 1940s, did Rappaport and Spraugue design the stethoscope with two sides, one for the respiratory system and the other for the cardiovascular system which remains the basic design used today.

The most basic work horse stethoscope used today.

The most basic work horse stethoscope used today.

What the Stethoscope does now, beyond listening to the regular or irregular trills and lub-dubs of the heart, and searching through the dull silence or fretful peristalsis of the abdomen for the calm gurglings of a bubbling stream, is to permit the physician to bend low, in homage to the body. His other hand may search to feel for a pulse away from the apex beat, ‘the Watson Pulse,’ of the heart’s aortic pounding, catching the dance of the two partnered beats. Maybe his fingers brush the abdomen before he takes courage and palpates the flesh, quadrant by quadrant.

In Argentina it is customary to ask permission, ¿Permiso? before crossing the threshold and entering a home. Today the physician needs an excuse to touch the body and the stethoscope gives that permission and allows the patient to accept this touch. Then he can slip the scope into his pocket and bending closer again percuss the lungs, tapping and listening over and around each lobe that embraces the heart.

As nurses we have permission to touch the patient, and time to be intimate. Washing, turning and tending the body are among our arts. They hold their place as skills alongside checking monitors and charting observations. Touch can comfort and bring safety, relaxation, even healing, and healing can pave the way to curing. Maybe nurses used touch more when we moved from bed to bed in the large open wards of long ago where patients saw and connected with the suffering of one another and were helped by that sharing. In our efforts to incorporate ‘individuality’ and privatization into every aspect of our lives, illness has become shuttered away in lonely single and semi-private rooms, where patients lie secreted and alone.

In Buenos Aires, I have had occasion to see a few physicians over the years I have visited. Nothing big, just mindful checking in and up. The office of Doctor Garavaglia, the General Practitioner, is typical of them all. His big desk faces out from the back wall and the two chairs sitting comfortably in front of it are inviting rather than intimidating. There are two bookcases holding literature as well as medical texts and a screen in the corner to give privacy for undressing and the examination couch if the patient should need it.

In each office, the visits begin with conversation, discussion about our mutual families, for that is but courtesy. Before Doctor Garavaglia asks what brought me to him, what he can do for me, he pulls out a card – no bigger than the old Kardex cards we once used. My name is written on the top, my passport and phone numbers also. And there, in cryptic hand, go a few notes. But then he puts down his pen, and listens as I talk, occasionally nudging me this way or that. For as he listens and watches me, how I talk is as meaningful to him as what I say. I speak of our daughter and he reaches into a drawer, pulls out her card and glances at it. In a moment he has her relevant history in his recall, which he – naturally – shares with me. When, a year later, I return he pulls my card from the same drawer. ‘Ah yes, I remember’ updates are made on the card, then it is put aside. ‘¿Cómo estás? Estas bien, verdad?’ He means it. It is good to see you. And we talk once more.

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