Chapter 18:
“Lives might have been saved, spread of infection diminished, great suffering avoided, if the known sick could have been isolated…but it was necessary to ‘carry on’ and the relentless needs of warfare justified this risk… and the associated creation of a more virulent type of disease.” Sir Arthur Newsholme, Chief Medical Officer, London Government Board 13th November 1918

Ruby had started to feel ill whilst she and Nash had been waiting for a tram outside the Lyons Corner House. By the time they had changed trams at Gardiner’s Corner Aldgate, it was clear she was going down with something. And having collapsed into bed as soon as she got home, Nash was concerned that his wife might have caught the new deadly flu.
Nash had never felt such panic in his life. He dashed to Dr Alice’s surgery, then her house, and when these trips proved fruitless, he toured the streets stopping all and sundry to ask them if they had seen the good doctor. Some had, but each line of inquiry failed to track her down. By the time he thought he must get back to attend to his wife, he had left countless messages throughout Bow asking Alice to visit Ruby as soon as possible.
But with several local doctors now down with the flu themselves, Alice had spent much of the day outside her usual jurisdiction attending patients in Mile End. She had not received Nash’s message.
Having arrived home, exhausted from a twenty hour line of duty, she had not even made it into her bedroom. She had slumped onto her kitchen chair, put her arms on the adjacent table and within a second her head was resting on them.
The next thing she was vaguely aware of was someone banging on her door.
She pulled her head up, straightened and immediately grimaced at the pain in her lower back. Her neck ached too. How long had she been asleep at the table? It was now dark outside, which answered the question. She dragged herself to her feet and sloped groggily to the door.
Her next door neighbour Bea passed on the message that Nash had left with her some hours earlier. Bea apologised that she had not passed on the message sooner, but she hadn’t noticed Alice arrive home. Perhaps she had done so whilst she had been out getting her rations. Alice reassured her that it was probably just as well. The cat nap she had just had was much needed before she saw another patient.
Five minutes later she was knocking at a front door herself. Nash answered. He was carrying a candle, and nodded for Alice to come in.
“Good of you to come Doctor.”
The formality in the greeting impressed upon Alice how worried Nashey must be. It was the first time he had ever called her anything other than Doc or Al.
“Take this here candle. I got the black-out going on in there. She just wants to sleep all the time but not before she kicked up a right fuss about there being too much light.”
He went on to tell the doctor that he was concerned Ruby’s initial symptoms of headache, drowsiness, body pains, chills, feeling giddy and lack of appetite had changed for the worse.
“She’s been coughing up green yellow puke. Reminds me of poor bastards I’ve seen coughing their guts up who’ve been invalided out the trenches ‘cause they’ve been gassed. She won’t eat nothing neither.”
The doctor examined the patient and took her temperature. It was one hundred and two.
“Has she been sneezing Nashey?”
“No, funny enough that’s something she ain’t done. It’s a rum sort of flu and make no mistake.”
“The desire for darkness is photophobia. A fear of light,” said the doctor. “Her symptoms suggest she has one of the new diseases which are cropping up. I’ve heard there are many cases of this in the trenches. It’s rather indeterminate at the moment I’m afraid. I’ve tried to get some information about it from the local medical officer of health, but he tells me the higher authorities are keeping things under wraps. Don’t want the Germans to think we’re weakening do you see. But it appears to be a form of purulent bronchitis rather than influenza as we know it. One thing I do know, it gets worse if you try to shake it off. Now I know how tough Ruby is, but if she starts to fret about needing to get to work, that sort of thing, on no account allow her to get up.”
“I’ll see to it she don’t get up, don’t you worry”, assured Nash with grim certainty.
“Good. Now I’d like to start her on steam inhalation to begin with.”
The doctor gave Nash his nursing orders and said she would try to return the next day but with the proviso that she was so busy at the moment, that she couldn’t promise anything. If Ruby’s condition worsened he should attempt to contact her immediately.