The Tale of Issy Modinski
He is a sweet boy with dark hair and chocolate colored eyes. His face is always frightened with good reason to. All he has seen since he arrived is strange men and women moving him around examining him speaking in a strange tongue. He struggles to swallow and to breathe; the paralysis is steadily climbing his body until he can move almost nothing. I am one of two nurses assigned to him, one from eight o'clock am to eight o'clock pm the other (me) from eight o'clock pm to eight o'clock am. He came to the hospital on July 24, 1909 the only polio case I have seen throughout my career as a nurse. The worst part for me was the helplessness I felt, I could do nothing to ease his pain and suffering or to bring back the use of his limbs. He is very much alone, an orphan now, his parents are dead and even if they were not they were most likely very poor. Even if they were alive unless he made a full recovery he could not return home. He is in a strange place unable to understand most of the doctors or nurses who tend him. He is not allowed to see his sister, his only remaining family. His body must seem out of his control.
The day they came in was much like any other day the receiving room was extremely crowded and understaffed, but this was not at all unusual. It was a hot day at the end of July of 1909 and all the bodies crammed into that one room made it hotter still. It was a small party who came with Issy, only a friend who carried him, himself, and a sister who could not be more then 10 or 11 at most she was 12. They were a ragged bundle. The man in a worn shirt and overalls he had black curls and coffee colored eyes he could not have been much older than me but he looked as though he had lived a hundred years and more. His eyes seemed to hold a knowledge that went beyond years, it was knowledge of love and loss, that no matter our trials we must be strong in the face of overpowering evil and we can come through with hands raised in victory. His face was dirt streaked the freckles on his nose barely discernable. Yet he carried the boy so gently as if he were a father and the boy his son. He was tall, thin, and pale almost sick looking himself but he carried the boy with unfounded strength.
The girl clutched her brother's hand and stood stiff and silent. She looked as though she had never been so frightened but as the eldest must put on a brave face for her little brother so he would not be afraid. She wore a dirt stained white peasant blouse, a long black skirt with red and green bands of embroidery, a brownish pink hand embroidered head scarf over her dark braids, black stockings, scuffed black boots, and a dirty white apron. The braids curled at the ends and were tied with pieces of frayed, dirt stained black ribbons. She was, I found out later only about five months to her 12th birthday, her clothes more resembled that of a 10 year old. This elder child's body in that too short young child's dress gave her a horribly vulnerable look. She held on to her brother's pajama pant leg with one hand and clutched two carpet bags to her chest. I later found that they held everything she and her brother owned that was not on their personage.
What the Bags Held
Chaya's clothes, including: a blouse, a red striped skirt and red plaid vest, red stockings, a slip, petticoat and drawers, warm boots and coat, a sweater, a hat, scarf, and mittens, a white nightgown, a green shawl and a red shawl.
Issy's clothes, including: a pair of brown pants, a shirt, a nightshirt, a pair of long johns, a warm coat, mittens, stockings, warm boots, sweater and hat.
Toiletries: a hairbrush, two toothbrushes.
Toys: a rag doll, a wooden horse.
Bedding: a wool blanket.
A few of their parents prized possessions: a gold locket with a gold star raised on the top, her wedding ring, the wedding canopy, their fathers yarmulke, a grainy photograph of their family.
Most of their family's belongings had been in a trunk which the children had not been able to carry and was still at the boat dock waiting to be sent to family in the country.
She had dark curls the same shade as her brother's, and identical brown eyes though hers were unfocused like windows with the blinds drawn. Once we fed her up a bit she would have round rosy apples in her cheeks. Her chin seemed permanently glued to her collarbone, her eyes stared at the floor she did this if she was frightened, confused, or nervous. She was extremely intelligent with wisdom beyond her years yet with an ever-present innocence, sweetness and winsomeness of one much younger.
Finally for the sick boy, he was 10 years old with straight dark hair, and frightened chocolate colored eyes. His eyes were unfocused, concentrating on the effort of breathing and swallowing rather than solely on his surroundings. Occasionally they drift away, looking around nervously at the room around him. Softly he speaks to the young man, who is carrying him, in Yiddish,
"I don't like here."
His voice is listless, weak, and slightly breathless. The man answers in an uncommonly kind, gentle voice almost jokingly, not quite.
"You're not the only one!"
The girl speaks up now her pretty Yiddish sounding beautiful and sweet even in this gloom she tugs on the sleeve of the young man's coat.
"Will the doctor be here soon? Will they fix my brother?"
She is almost frantic; they have sat down relieving her of her small bundles and one hand is shaking violently, she is rocking back and forth in a panic. The young man is unable to calm her as the small boy cannot even sit up and so he can't let go of him, even to calm his panicking sister. I send a last patient to treatment and go to this forlorn group.
"What is your name please?" I ask the young man I assume is in control.
"Their names are Modinski," he says indicating the girl and boy.
"Mine is Landau, Saul Landau."
"And their first names?" He then addresses the two children in Yiddish and the girl answers for both.
"His name is Issy, the girls is Chaya."
"The boy is the patient?"
"Yes, he is sick, he has a fever and cannot use his legs, and he is having trouble swallowing."
"Where are their parents?"
He addresses the girl in Yiddish then answers.
"They are dead; Issy and Chaya only got here a week ago. Their parents died on the boat."
This is all I need to hear, at least for now; I call over an attendant to find him a bed in one of the Hebrew wards. A stretcher is rolled over and Mr. Landau places Issy ever so gently upon it.
"You should wait here." I tell them. The man sits and touches the girls arm as a gesture for her to sit next to him; she remains standing her hand on her brother's arm. She utters one word in English, what is strange is that her eyes remain focused on a point directly in front of her not on me or anyone else.
The word is garbled as though she is holding back tears, and her accent makes it almost undecipherable but it is loud.
I lean down and take her arm, speaking in slow precise Yiddish I ask, "Would you like to come too?"
Her answer is predictably, yes, she starts to move forward. She knocks directly into one of our doctors. I am beginning to realize something. I take her arm again,
"Can you see?" I ask.
"Not very well" is her reply. This girl is blind. The doctor would obviously need to look at both children.
I pushed the stretcher into the examination room to wait for Dr. Culpin to come in. I lifted the small boy onto the examination table. He whimpered at the movement, which seemed to cause him pain. As I lifted him his legs hung limply down. Just after I lay him down his legs moved, bending in what I soon realized was a painful spasm, he could not straighten them. Soon the muscles relaxed becoming limp and useless again. The legs remained bent, the toes remained curled. I reached out to straighten them but the child screamed in agony when I tried to move the limb. The doctor walked in then.
"Good morning Nurse Bennett, what have we here?" he asked.
"He has a fever and paralysis of the lower limbs as well as spasms in the legs."
"My goodness," he said walking over to the table and felt the boy's forehead.
"He's burning up."The tone of his voice was solemn. I take his temperature which is 103°F. In order to keep the fever down he must have liquids so I give him a glass of water, he cannot lift his head. I lift his head and tip a small amount of water into his mouth, he swallows the water, but with difficulty. Dr. Culpin then spoke lifting the boy's leg slightly off the table.
"I'm going to assess the extent of the paralysis."
He runs a probe down the boy's feet but the muscles remain limp and lifeless, he goes up the legs. Not one muscle responds. Many muscles in his arms and torso are paralyzed as well. There was nothing to do now. We would just have to wait it out in the dark.
A young doctor who luckily spoke Yiddish by the name of Dr. Goldman came in to see her. He lifted her onto his examination table. She swung her legs enjoying the metallic clang of her muddy boot knocking against the leg of the metal examination table.
"Are you going to fix my brother?" she did not seem to realize he was examining her. He chuckled and said he was not but he hoped to see him eventually. He then lit a match and held it directly in front of her face at a safe distance from her face.
"Chaya, can you tell me what you see?" She looked hard for several seconds then said,
"It's a candle flame." I was surprised that she saw so clearly. Dr. Goldman then held his watch near the side of her face,
"Don't turn your head to the sound." He said.
"It sounds like a watch but I can't see it, only hear it." She answered.
Dr. Goldman tested her with several other items, and then stopped, he seemed rather grim.
"I am not sure exactly, I'm no eye doctor, but I believe that it's either glaucoma or retinitis pigmentosa."
"Should I send for the hospital's eye specialist?"
"Yes I think that's in order."
I spoke to Chaya then telling her we were going to get a special doctor to look at her eyes. All she wanted to know was what would happen to her brother.
First came a man tall and lean, then came another man pushing a pale feverish boy on a stretcher. That was how I met Issy.
The door opened and I walked over to the group which came through it. The man spoke first
"We have been sent here by Dr. Culpin."
I could not let him in without a ticket; we were overcrowded as it was.
"And do you have a ticket?" I asked. He handed me the green slip of paper and stated firmly.
"I'm not to leave him. His parents are dead; he and his sister speak no English they've been here for one week."
I bend over the lad, remove his cap and examine his head and the back of his neck for signs of injury. His skin is burning with fever. Reassuringly I say.
"I just need to check."
As I go down his body I realize I don't even know what I am checking for, really. The man with this boy looks almost scared. His eyebrows are raised, his forehead divided into many lines. When I have finished I begin to walk toward our last empty bed.
"Come with me please." I say.
Our young friend's companion bends over and tells him not to worry, he is not leaving. Not leaving, it's a commandment not found in any scripture. A word with its meaning not found in any dictionary. It is as simple and innocent as an act of trust, but in the eyes of a child it is of greater value then a lovers vow or oath of office. To a child it means that no matter what hailstorm, blizzard, or earthquake, you will be there by their side. Until the very end, until death welcomes you into his arms, until the dying breath. The attendant pushes the stretcher over beside the bed. The boy is very small so I will need no help lifting him. But first I must put him in pajamas. I unbutton his coat and lift him to remove it. As I do so tears fill his eyes and he must bite his lip to keep from crying out. In Yiddish I ask him.
"Does that hurt you?"
He is panting as he answers,
I can't just tuck him in dressed as he is. So I continue to undress him. Each time I move his body he is in pain, and I know not what will ease it. I button the last button and prepare to lift him onto the bed, and then I realize a problem. If he is in pain when I undress him what will he feel if I lift him? To try and hide my not knowing what to do next I ask him some simple questions in Yiddish.
"What's your name?"
"Mine is Nurse Goodly." With a shadow of a smile, the hint of a dimple and a great effort he replies.
"I am very pleased to meet you Nurse Goodly."
The sister in charge of this ward must have seen my look of uncertainty and she walks over.
"What seems to be the trouble nurse?"
"He has great pain if I move him."
She seems harried but understanding.
"We'll just do it as fast as possible, alright."
She turns to Issy and says to him smilingly.
"We are going to put you on the bed as fast as we can so it won't hurt, alright. "
"Alright." He says.
I have an idea then.
"Can you count Issy?" I say, he answers yes so I go on.
"While we put you on the bed how about you count to see how fast we can go.
"Yes! One…" he continues counting as we lift him onto the bed and tuck him in.
"How was that?" I ask
"That was good, Nurse." He answers and closes his eyes. He fell asleep almost instantly. During the next few hours he slept on and off, he had frequent spasms in his legs which caused them to bend and his toes to curl. As he could not move his legs at all I straitened them for him, though they became increasingly stiff. His temperature remained at 103°F and he could not swallow solid foods. Thankfully Dr. Head would be here shortly.
For what seemed like hours I sat by the bed dipping a cloth in a basin of cold water, cooling his burning hands and face with the icy cloth.
Just in time it seemed Dr. Head walked in he talked to a nurse for a minute then came over to Issy's bed.
"Hello." He said. "I'm Dr. Head; I see you are having trouble using your legs." He sat down on a chair by the bed and took out a tongue depressor.
"Now make a big ahh, that's it."
Issy opened his mouth and gave a garbled ahh noise.
"That's good." He said comfortingly.
He felt Issy's throat, his chest, and his legs. As his examination continued he said
"I need a parent here."
This could not be good.
"He was brought in by a neighbor, his parents are dead." I say.
"Will you tell me how long he's had the fever?"
"About four days." I fill in.
"And the loss of mobility in the legs?"
"That happened yesterday."
"And he arrived only recently in England?"
"About one week."
"I suspect this child may be suffering from an endemic viral disease; there have been outbreaks recently in various parts of Europe, Vienna is one I believe." He bends down closer to the boy and speaks to him in German.
"Du kommst aus Wien?"
Issy's face seems somewhere between terror and confusion almost guilty. Dr. Head turns to me and translates his speech.
"I asked him if he came from Vienna, clearly not."
I am wondering what infection could cause such an illness in a child. I have never seen anything like it.
"What's the infection?" He answers my question quite gravely as though confirming my fears that this could kill or cripple this small boy.
"Poliomyelitis. We don't have it in this country and there won't have been time for the virus to spread, so I think we're safe."
Right then as if on cue Issy pipes up in clear, fluent German. He is breathless and scared but sure.
"Ja, ich komme aus Wien."
I look at him and Dr. Head looks at him then we both look at each other. I already know what he will say next.
"He does come from Vienna."
"Should he be in contagion?" I ask, I did not know if the boy could stand the pain of being moved again. But if he could infect other people he must be moved, even if it is painful.
"Yes he has to go into isolation immediately; I will continue my examination there."
"You said this boy's from Lithuania?"
"Bossil, his family is from my family's village, that's why they came to me."
"In what language did you speak with them?"
"The boy speaks German."
He shrugs his shoulders and shakes his head.
"The girl said they were from Lithuania because she didn't want anyone to know they were from Vienna."
"Why would they do that?"
"Where are you from?"
"That doesn't matter."
"It seems to matter, doesn't it? It seems to matter a good deal."
"Are you going to wait out here quietly?"
"Will you wait with me?"
"I have duties."
"Then I'll wait quietly until you've done them."
"We're moving the boy to the isolation block. After he's gone strip down his bed, and take all the usual precautions."
"What does he have?"
I carry the boy into isolation and set him gently on the cool white sheets. He is whimpering from the pain of it but the doctor feels any pain relief or sedative could depress his already labored breathing. Due to the contagious nature of this virus Dr. Head decided to relieve Nurse Bennett and me of our usual duties in favor of not exposing any other nurses to this disease. Nurse Bennett will take the day shift while I take the night. In the hours between we must make sure we take no contagion out of the ward.
Once the matron called me into her office I knew something must be wrong, the question of course was what. As far as I knew I had done nothing wrong. Horrible thoughts crossed my mind. She had found out about my relationship with Dr. Culpin, or my studying to be a doctor, I would be in a dreadful mess if either were the case. The truth of why she needed me turned out to be even more horrifying then either previous possibility. The little boy who had come in earlier that day with paralysis and fever turned out to be carrying a potentially fatal disease known as poliomyelitis, which was why he was paralyzed.
When I get to the isolation ward and go into the room which housed the boy I see Nurse Goodly sitting, exhausted, next to the little boy who, if anything, looked worse. He lay in a bed of clean white sheets; his face was damp with sweat and burning hot from the fever.
"I'm glad you came Nurse Bennett," came the voice of my comrade in arms.
"What do you need me to do?" I answered knowing the boy needed care.
"I need you to keep this boy alive." I knew from the way she said it that this would be no easy task.
"Oh, I have longed to hear someone say that."
"What's your full name?"
"Saul Nathanial Isaac Landau."
"The doctor needs to see you."
"Why are we doing this?"
"When did you last have a medical examination?"
"I've never had a medical examination."
"Breathe deeply please."
"We need to take a history."
"Oh you want to talk about history?"
"Take a history."
"History is something I can talk about."
"I mean you and the two children's medical history."
"I don't know the children's. I have no medical history. But I have many other kinds of history."
"I'm sure, but they're not our concern."
"Then I'll come back another time to talk about history, or take history."
"We'd like you to stay."
"You've been in contact with a contagious and potentially fatal disease."
"Only for a few hours."
"All the same."
"The lad speaks no English; he is presented with spreading paralysis, and fever. My diagnosis is that he has been infected with the poliomyelitis virus, which is endemic, but fortunately not epidemic."
"Is the paralysis confined to the legs?"
"No it is also present to in the back and slightly in the arms, and the muscles which control breathing and swallowing. Fortunately polio is very rare and you are unlikely to see much of it, if any."
He turned to Issy then and explained to him in German that he was helping some doctors learn about his disease and that this was good.
"Da wir nicht Poliomyelitis in diesem Land haben, das Sie diesen Doktoren erhalten einigen aus erster Hand bezogene Erfahrung helfen, helfen Sie medizinischer Erziehung, Ihnen sollten stolz sein."
"Fortunately my German is good enough that it has permitted me to explain to the patient that he has done medical education a service.
The small girl no more than twelve was put under my constant watch. She seemed scared almost out of her wits. I had been informed that she had very low vision which would make my job no easier, her brother had been brought in earlier today with a high fever and paralysis in both legs. It had been determined that he suffered from poliomyelitis. There was a possibility his sister had contracted it to but as far as we could see she showed no symptoms.