Chapter 10 The Cuts

The year the trade fell off, the board met in the long room and did the thing that boards do when the rates are short and the wards are full, which is to ask the matron how many of her staff she could spare. Hespera Selvine was sixty-two that winter and had been matron of the Marrowden for twenty-two years, and she came to the meeting with a list in her hand and gave it up without a word. She had spent the morning over the establishment book, and she knew, to the shilling, what every nurse in the building cost and what the building would lose if she went, and the arithmetic of it was not the arithmetic the board wanted. The board wanted a number. She gave them a number. Six nurses. One sister. The probationers who were due to qualify in the spring would not be kept on. The free beds in Letham and Dunmarch would be reduced from twenty to fifteen, and the five beds so saved would be filled with patients who could pay, and the waiting list would be told that there was no room, and the means of telling them that would be Selvine's, because the board did not speak to the poor; it spoke to the matron, and the matron spoke to the poor, and the poor did not know that they had been refused by a room in the town hall and not by the woman in the grey dress. She went back up the slope through the rain and did the work. She wrote to the six nurses, one letter each, in her own hand, because a discharge is a letter and a letter is a face, and she told each of them what she thought of her work and that the board had decided and that she was sorry. Two of them were children of the city and had nowhere else to go. One of them was a woman named Brackley who had been in the building eighteen years and had risen from probationer to sister of Ostmere, and who had, that autumn, told Selvine that she was going to marry a widower with a shop in Ashenby, and who therefore stood outside the rule that a nurse must be unmarried, and who therefore was the first name on the list. "It is not because you are marrying," Selvine told her, when she came to the office to hear it. "It is because you are marrying and the board is short, and a married nurse is the only nurse the board is allowed to lose without a pension, and I have chosen to lose the ones the board can lose and keep the ones the board cannot, because I have to keep a building running with fewer people than it takes to run it, and you would do the same in my chair." "I would not," Brackley said. "You would," Selvine said. "You would do it and hate it and call it a duty, and that is exactly what I am doing, and it is the worst thing about a matron that she can call the worst thing a duty and be believed." She did the rest of the work and kept one thing for herself, which the board had not asked for and did not know about. She would not reduce the diet. The food in the wards was thin already and the board's economy list had a line in it about the meat and the milk, and Selvine read the line and wrote beneath it that in her judgment the patients' diet could not be reduced without increasing the mortality, and that if the board wanted the diet reduced it would have to reduce it in a minute with her name against it. The board let the diet stand. It cost them two hundred pounds a year, which was less than the cost of one extra death written up in a newspaper, and Selvine knew that this, and not her arguments, was why the line had been drawn where she drew it. The five beds filled with paying patients by the end of the month. For the first week there was a woman who came every morning to the yard gate with a child on her hip and asked whether there was a bed, and there was not, and Selvine saw her from the window of her room and did not go down, because going down would have meant explaining the arithmetic to a woman who did not want arithmetic, and Selvine had promised herself long ago that she would not stand at the gate and explain the world to people as though the world were reasonable. On the fifth morning she sent the porter down with a shilling for the tram and a note with the name of a doctor at the dispensary who would see the child for nothing. Yarrell brought the note back up at noon and stood in the doorway of her room with his cap in his hand. "She says she does not want the shilling," he said. "She says she wants the bed." "Yes." "I told her as much as I could." "Yes." Yarrell did not leave. He stood in the doorway with his cap in his hand, and Selvine looked at him for a long moment, and neither of them said the thing that was between them, which was that the two of them had spent their working lives keeping the gate and keeping the ward, and that the building had just told them in a minute what their keeping had been for, and that it was not for the woman at the gate. "Shut the door," Selvine said at last, and he shut it, and she sat alone in the small room with the photograph of her sister and the child on the shelf, and she opened the ledger of admissions and turned to the page of the month and read down the names, and she found that she could not remember the faces that went with half of them, and that the half she could remember were the ones she had refused. Later that year the board's annual report was printed, and it said that the infirmary had treated twenty-nine hundred patients, which was true, and that the cost of each bed had fallen, which was also true, and that the establishment had been adjusted to the needs of the time, which was the kind of sentence a matron reads twice and then reads no more. Selvine kept her copy in the drawer of her desk, and once or twice, at the end of a long day, she took it out and read the two columns of figures, which were the only part of it she believed, and put it back. ---