Chapter 12 The Means Test

Delphia Orval had been sister of Bellcairn Ward for eleven years, and she had learned that a children's ward is the most honest room in any hospital, because children do not pretend to be braver than they are and their mothers do not pretend to be poorer than they are, or richer. She was forty-seven that autumn. She had come to the Marrowden as a probationer the same year as Coline Marchen and had never left, and she had nursed the children of Craddon and Brammoor and Thornby through measles and diphtheria and the scarlet fever and one long summer of polio that she did not talk about, and she had buried a husband of her own and had no children, and the ward had taken the place of the children she did not have, which is a thing that sisters in children's wards say to each other and never to anyone else. The new block at the front of the building had been opened that year and was called the Quillock, and it was for out-patients: a long room with a bench and a hatch and a clerk's desk, where the people of the city came in the morning to be looked at and given a bottle and sent home, and where in the afternoon the same people came back with their papers, because the papers were the whole of it. Under the rules the infirmary admitted the destitute sick free, and it admitted patients who could pay a weekly sum, and between those two things there was a gap the width of a city, and the gap had a name that everyone used and no one liked, which was the means test. The means test was a form. A family that wanted a free bed for a child had to answer on the form what the father earned and whether the mother took in washing and whether there was a lodger and whether the eldest son was in work, and a clerk in the Quillock added it up and compared it to a figure, and if the figure was exceeded the family was told that the child could be treated as a paying patient at nine shillings a week, which was more than the family earned in a month after the rent. The child who came that October was a boy of six called Hensley Duskin, and he was brought by his mother from a court off Lornwick Lane, and he was thin in a way that Delphia had learned to read the way a sailor reads a sky. He had been coughing for a fortnight and had a fever that came and went and a chest that whistled, and the mother had already been to the Quillock twice and had been given a bottle both times and sent home, and on the third morning she had carried him up the slope to the yard gate because she did not know where else to take him. The clerk had the form. The father was a carter and earned thirty-two shillings a week when there was work and there was not always work, and there was one lodger, an uncle, who paid four shillings, and there was a daughter of fourteen who had left school and was at the mill and brought home nine. The clerk added it up and put the boy above the line. Delphia took the form and looked at it and looked at the child on his mother's hip, whose breathing could be heard across the room, and she did a thing she had done before and had never been caught doing and would have been dismissed for if she had. She wrote on the form, in the place for the almoner's finding, that the family was destitute within the meaning of the rule, and she signed it with the almoner's initials, which she was not entitled to use, and she took the boy up to Bellcairn herself that evening. The boy lived. He had a chest that was full of something that had to come out, and it came out slowly over ten days, and his mother came every afternoon and sat by the bed and knitted and did not look at Delphia, because the two of them had a secret between them and the secret was the form. On the eleventh day the clerk came up from the Quillock with a letter in his hand and asked to see the sister, and he stood in the doorway of the office and said that the almoner had said she had not signed the form, and that there was a question about the finding. Delphia looked at the clerk, who was young and had a wife and a child of his own at home and had taken the job because there was nothing else, and she told him the truth, which was that she had signed it, and that she would sign it again, and that if he wanted to take it to the board she would go with him and stand in front of the board and say exactly why she had signed it, and that the boy would be going home well on Monday and the board could do what it did with the arithmetic afterward. The clerk did not take it to the board. He put the letter back in his pocket and went down the stairs, and the fact went into a file the way things do, and it stayed there, and Delphia went back into the ward and stood at the foot of the boy's bed and watched him breathe, which he was doing easily now, in and out, without the whistle, and it occurred to her that the whole building had been built to make that sound possible and that the form existed to make sure it happened as rarely as the figures allowed, and that a sister who understood both of them could not keep her hands clean, and that she had stopped wanting to keep them clean a long time ago.