Some to misery are born.
Every morn and every night
Some are born to sweet delight.
Some are born to sweet delight,
Some are born to endless night.”
WILLIAM BLAKE
During these years in New York trained nurses were in great demand. Few people wanted to enter hospitals; they were afraid they might be “practiced” upon, and consented to go only in desperate emergencies. Sentiment was especially vehement in the matter of having babies. A woman’s own bedroom, no matter how inconveniently arranged, was the usual place for her lying-in. I was not sufficiently free from domestic duties to be a general nurse, but I could ordinarily manage obstetrical cases because I was notified far enough ahead to plan my schedule. And after serving my two weeks I could get home again.
Sometimes I was summoned to small apartments occupied by young clerks, insurance salesmen, or lawyers, just starting out, most of them under thirty and whose wives were having their first or second baby. They were always eager to know the best and latest method in infant care and feeding. In particular, Jewish patients, whose lives centered around the family, welcomed advice and followed it implicitly.
But more and more my calls began to come from the Lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them which did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view of her background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them.
The wives of small shopkeepers were my most frequent cases, but I had carpenters, truck drivers, dishwashers, and pushcart vendors. I admired intensely the consideration most of these people had for their own. Money to pay doctor and nurse had been carefully saved months in advance—parents-in-law, grandfathers, grandmothers, all contributing.
As soon as the neighbors learned that a nurse was in the building they came in a friendly way to visit, often carrying fruit, jellies, or gefüllter fish made after a cherished recipe. It was infinitely pathetic to me that they, so poor themselves, should bring me food. Later they drifted in again with the excuse of getting the plate, and sat down for a nice talk; there was no hurry. Always back of the little gift was the question, “I am pregnant (or my daughter, or my sister is). Tell me something to keep from having another baby. We cannot afford another yet.”
I tried to explain the only two methods I had ever heard of among the middle classes, both of which were invariably brushed aside as unacceptable. They were of no certain avail to the wife because they placed the burden of responsibility solely upon the husband—a burden which he seldom assumed. What she was seeking was self-protection she could herself use, and there was none.
Below this stratum of society was one in truly desperate circumstances. The men were sullen and unskilled, picking up odd jobs now and then, but more often unemployed, lounging in and out of the house at all hours of the day and night. The women seemed to slink on their way to market and were without neighborliness.
These submerged, untouched classes were beyond the scope of organized charity or religion. No labor union, no church, not even the Salvation Army reached them. They were apprehensive of everyone and rejected help of any kind, ordering all intruders to keep out; both birth and death they considered their own business. Social agents, who were just beginning to appear, were profoundly mistrusted because they pried into homes and lives, asking questions about wages, how many were in the family, had any of them ever been in jail. Often two or three had been there or were now under suspicion of prostitution, shoplifting, purse snatching, petty thievery, and, in consequence, passed furtively by the big blue uniforms on the corner.
The utmost depression came over me as I approached this surreptitious region. Below Fourteenth Street I seemed to be breathing a different air, to be in another world and country where the people had habits and customs alien to anything I had ever heard about.
There were then approximately ten thousand apartments in New York into which no sun ray penetrated directly; such windows as they had opened only on a narrow court from which rose fetid odors. It was seldom cleaned, though garbage and refuse often went down into it. All these dwellings were pervaded by the foul breath of poverty, that moldy, indefinable, indescribable smell which cannot be fumigated out, sickening to me but apparently unnoticed by those who lived there. When I set to work with antiseptics, their pungent sting, at least temporarily, obscured the stench.
I remember one confinement case to which I was called by the doctor of an insurance company. I climbed up the five flights and entered the airless rooms, but the baby had come with too great speed. A boy of ten had been the only assistant. Five flights was a long way; he had wrapped the placenta in a piece of newspaper and dropped it out the window into the court.
Many families took in “boarders,” as they were termed, whose small contributions paid the rent. These derelicts, wanderers, alternately working and drinking, were crowded in with the children; a single room sometimes held as many as six sleepers. Little girls were accustomed to dressing and undressing in front of the men, and were often violated, occasionally by their own fathers or brothers, before they reached the age of puberty.
Pregnancy was a chronic condition among the women of this class. Suggestions as to what to do for a girl who was “in trouble” or a married woman who was “caught” passed from mouth to mouth—herb teas, turpentine, steaming, rolling downstairs, inserting slippery elm, knitting needles, shoe-hooks. When they had word of a new remedy they hurried to the drugstore, and if the clerk were inclined to be friendly he might say, “Oh, that won’t help you, but here’s something that may.” The younger druggists usually refused to give advice because, if it were to be known, they would come under the law; midwives were even more fearful. The doomed women implored me to reveal the “secret” rich people had, offering to pay me extra to tell them; many really believed I was holding back information for money. They asked everybody and tried anything, but nothing did them any good. On Saturday nights I have seen groups of from fifty to one hundred with their shawls over their heads waiting outside the office of a five-dollar abortionist.
Each time I returned to this district, which was becoming a recurrent nightmare, I used to hear that Mrs. Cohen “had been carried to a hospital, but had never come back,” or that Mrs. Kelly “had sent the children to a neighbor and had put her head into the gas oven.” Day after day such tales were poured into my ears—a baby born dead, great relief—the death of an older child, sorrow but again relief of a sort—the story told a thousand times of death from abortion and children going into institutions. I shuddered with horror as I listened to the details and studied the reasons back of them—destitution linked with excessive childbearing. The waste of life seemed utterly senseless. One by one worried, sad, pensive, and aging faces marshaled themselves before me in my dreams, sometimes appealingly, sometimes accusingly.
These were not merely “unfortunate conditions among the poor” such as we read about. I knew the women personally. They were living, breathing, human beings, with hopes, fears, and aspirations like my own, yet their weary, misshapen bodies, “always ailing, never failing,” were destined to be thrown on the scrap heap before they were thirty-five. I could not escape from the facts of their wretchedness; neither was I able to see any way out. My own cozy and comfortable family existence was becoming a reproach to me.
Then one stifling mid-July day of 1912 I was summoned to a Grand Street tenement. My patient was a small, slight Russian Jewess, about twenty-eight years old, of the special cast of feature to which suffering lends a madonna-like expression. The cramped three-room apartment was in a sorry state of turmoil. Jake Sachs, a truck driver scarcely older than his wife, had come home to find the three children crying and her unconscious from the effects of a self-induced abortion. He had called the nearest doctor, who in turn had sent for me.