Hospital of the Queen's Heart by Ileana, Princess of Romania
It now was plain to me that we must make arrangements to take care of women patients. Therefore, I sat down to think about adding a woman's ward to the hospital, because this complicated business of operating on women in the hospital and then trundling them across the river to the house on the other side, which we were using as a women's annex, was impractical and a nuisance. It disorganized the nursing schedule; getting meals over to them was awkward—the food couldn't possibly stay hot —and the care was doubled. It was makeshift and inefficient, however hard we worked at it. It seemed to me that two wards for women were more than we needed, yet I could not assign only one to them because, as you remember, two wards had to share one bathroom. However there was nothing else to be done, so we turned two of the wards with their communicating bathroom into a women's section, leaving four wards with their two adjacent bathrooms for the men. In the end, this really proved to be less inconvenient than I had expected, because by this time the war was over, we had fewer wounded, and my soldiers could easily be accommodated in those four wards.
And so, in the summer of 1945, another phase of the hospital's life began—the care of women. Immediately there appeared complications, chiefly the eternal one of finances! The soldiers were quartered with us on military funds since the Red Cross hospital in Brasov was still responsible for them, even while they were with us. But the section for women had to have special equipment, and its operation had to be provided for. This I could not do wholly out of my own money, and I knew that the small fees my women patients could pay would certainly not cover the cost of their care.
It was clear that I must seek official help. I knew I wouldn't get any from the mayor of the town because I was cutting in upon his practice and his income. So I took my courage in both hands and went straight to the Ministry of Health in Bucharest. This needed courage, for since early spring we had been under Communist rule.
On March 6, 1945, the Communist party, consisting at that time of only 750 members in a population of 18,000,000 people, ousted the Radescu coalition government and installed themselves with no other right than le droit du plus fort—the right of the strongest—their strength being the thinly veiled Russian bayonets and machine guns. (see I Live Again page 239)
It was not easy to go to these people, who stood against everything that I stood for, and appeal for their help. I wanted no contact with the Communist government. I would have preferred to carry my own financial load indefinitely, but that was not possible. I had done so as long as I could.
To my happy surprise, I was met with unexpected sympathy and understanding from the first secretary who was second in command of the Ministry. I will call him Dr. X, because I do not want to mark him as having been associated with my hospital and with me—he may be still alive in Romania today. This tall, pudgy, unhealthy-looking man was an excellent doctor and had become a Communist while still in high school. He was one of those enthusiastic, inspired people who are fired with an idea, and now, finding himself at the head of a Communist Ministry of Health, he was convinced that he was helping to bring about Utopia—a completely harmonious Communist world in which, of course, medicine would play a most important part. It was this ideal of his, this passion for his calling, which bridged the great distance between us and our widely opposed ideologies. We sincerely had one cause in common—our love of medicine.
When I had finished my story of the hospital and our needs, Dr. X was ready, even eager, to help me. He had extraordinary understanding of my problems and aided me from the time I first talked with him until I left the hospital and Romania, three years later. He gave me carte blanche to demand from the Ministry anything I desired for the efficiency of my hospital. As time passed, and especially during the typhoid epidemic, which I shall tell about later, he entrusted me with increasingly important responsibilities.
But now, at this first appeal of mine, he provided me with the medical supplies which I needed so much and the surgical instruments I lacked. And what made me even more elated, he saw our urgent need of a permanent resident doctor and more nurses, for with our increasing patients and the serious cases that were coming to us more and more, our very small original staff had become discouragingly inadequate. The military hospital in Brasov, as I have said, sent us surgeons when we had operations to be performed, and at this time we had four nurses, more or less permanently. The Ministry, through Dr. X, assigned the hospital two doctors and four more nurses. These additional hands and brains gave our bogged-down, overworked staff a tremendous lift, and we surged ahead, more able than ever to cope with the work that was growing so fast, and my lively, renewed enthusiasm spread through the entire staff.
Dr. Radu Puscariu, chief of staff, whose emergency operation summoned me from my bed as my story opened, came to us about this time.
Dr. Dragomir, my first chief of staff, had been with me for a year while under military orders, but his military service was up in the summer of 1945, and he was going to return to the University of Jassy to finish his specialization in surgery. I was dismayed to have him go for we had worked together in excellent professional and personal unity, and he, too, regretted leaving for he had become very much attached to the hospital. He offered, through the influence of his uncle, Vasiliu-Rascanu, the "pink" general, to have appointed to us a substitute for himself, who would be a man of my own selection. In this way, we could both be sure that the same ideals of service and fine efficiency which we shared would be continued in the hospital.
After various inquiries amongst medical circles in Brasov, my choice fell upon Dr. Puscariu, of whom I continually heard very good things. He was serving with the army on the German front in Hungary, but when he returned I was able to have him assigned to me officially by General Vasiliu-Rascanu, who was in favor with the Communists. This was my protection.
You see, it was important for the hospital that I should ostensibly have nothing to do with the selection of my new chief of staff; it must appear that I had accepted obediently whomever the authorities chose to send me, for the suspicions of the newly established Communist government were so intense and so alert that they saw in the most innocent action a dangerous coalition against them. Had I made my choice openly, I might have been accused of sheltering a former member of a forbidden political faction, or of fomenting a small revolt.
Dr. Puscariu was of peasant stock and came from Bran. His father was Professor Sextil Puscariu, well-known in Romanian letters, a member of the Romanian Academy, who was compiling a Romanian dictionary and linguistic atlas. The doctor was a mild man, tall and thin, an excellent surgeon, as I have said, a man widely gifted in the arts—he was a sculptor, he wrote amusing verse, he did exquisitely fine surgical drawings and he was musical. He was later to organize the hospital's Glee Club which was one of our means of entertaining ourselves through the long winters when we were thoroughly snowed in and had to provide our own amusement.
He was a very relaxed person and easy to work with in the operating room, quiet, and considerate of his assistant and nurses. But he lacked authority in the hospital administration, and he was too gentle and reticent to be any sort of disciplinarian. All the unpleasantness of reprimand of staff, of reconciling dissenting doctors, of dealing with difficult patients, was left to me. It was I who had to announce to the assembled family of a peasant that an operation—or worse, an amputation—must be done. It was I who had to break the bad news to patients' families of death or our inability to cure a condition. Dr. Puscariu was a charming person, skilled and kindly and gracious, but, though well-meaning, he left me the whole load of administration and authority to carry alone.
It was as well. We say in Romanian, dupa voia Domnului—as God wills—and what I was forced to learn then I have been grateful to know and to be able to use, since, in even more difficult times.
Two other doctors, internists, became members of our staff at this time through Dr. X and the Ministry of Health. They were young people, husband and wife, and since they are still working in Romania, I shall call them simply Dr. John and Dr. Lucy so they may not be identified and perhaps punished.
Dr. John was extremely tall and as thin as a paper knife. One felt that there was no fullface about him: he was all profile. He had a long, narrow horselike face, with an extended nose, sparkling, blue, close-set eyes and heavy, though well-cut, lips. It seemed impossible that anyone so ugly could be such an absolutely enchanting, lovable person as indeed he was upon acquaintance.
He was from an intellectual family in Bucharest; his father was a professor at the University there. Dr. John was a poet and a gifted draftsman; he was one of the most loyal persons I have ever known. He was instinctively a good doctor and an uncannily accurate diagnostician. Like the old Chinese doctors, he seemed to know by a sixth sense what a patient's trouble was.
I doubt that alone he could have accomplished the excellent work he did, because he lacked a certain thoroughness, a certain ability to carry through. But he was wonderfully seconded by his wife, Lucy. She was a dark, sweet-faced girl, tall and graceful, shy and almost painfully self-effacing. She always seemed to be excusing herself for existing at all.
But her knowledge and perseverance were things I always wondered at and, in my heart, admired her for. She was indefatigable; she would work day and night. She possessed a thoroughness and persistence that her husband lacked. She was excellent in laboratory research, and at the bedside as well. She was always reluctant to give up her fight for a patient's life and would work tenaciously and tenderly over a patient even after the rest of us had given up hope. More than once I have seen Dr. Lucy win her fight with death and bring a patient safely through to convalescence and grateful discharge.
These two were one of the most striking couples I have ever met. Their teamwork was so entirely perfect that one always thought of them as a unit--indeed, as one person and not two. They entirely complemented each other in their work, and in their love and understanding of each other.
About this time, Max was obliged to return to Bucharest to resume his studies. Noelle, also, had to leave me to return to her home in Bran-Poarta, since her family needed her. However, I knew that if I needed her at the hospital I could count on her to help me; or she would take the outpatients when no one else had time to.
We had an outpatient clinic in our tiny dispensary daily from eleven to one o'clock, and all day long on Wednesday, which was market day in the village. People came from great distances, afoot, or riding on donkeys or in oxcarts, and it was an opportunity for many to visit the hospital for medical attention who could not otherwise leave their farms. Market day was also visiting day at the hospital, and we were always extremely busy and full of confusion then. Many people came fifteen and twenty miles to visit friends or relations who were ill.
In the afternoon through the week, treatments were given to outpatients—diathermy, massage, sun-lamp treatments and the like. Times when our staff was depleted, or when emergencies in the operating room demanded all our attention, it was a relief to know that I could depend upon Noelle, and she never failed me. But she could not come regularly, and I constantly missed her orderly mind and capable hands, as well as her companionship.
One day an arresting young man appeared in our midst and presented to me a letter of recommendation from the head surgeon of the medical school at the University of Jassy, a great friend of mine. He had added a personal postscript, urging me to take this excellent young man into my hospital and let him work for me. He was temporarily under a political cloud, and he had had to abandon his work at the Jassy hospital and his university classes and go into hiding.
I was delighted, because we needed help very badly in the operating room, and as I warmly shook hands with him and welcomed him I looked keenly at this new member of our staff, who was to be, in the years to come, such an important member of our hospital family, and my staunch good friend in future grim trials, which I did not then dream of.
He was tall and comfortably plump, full of cheerfulness and vitality. His dark thick hair was short and stiff, like a plush fabric, and I couldn't help looking at his ears! They were startlingly large and right-angled in contrast to the smallest mouth I ever saw on a man.
Badillo was a wonderful person. Even after so long, I still think of him with zest and affection. Time will never dim that man's memory! He had skill and compassion, and he worked with such enthusiasm, and with such passion and conviction that he and I almost quarreled sometimes when cases appeared which we both wanted to treat or assist in the surgery. Sometimes he won, sometimes I did; sometimes we shared the case. He was tremendously jealous of anyone's doing more than he. I discovered that, handled wisely, this possessiveness and egotism was an advantage to the hospital, although for a while he did tread, unknowingly and unmercifully, on assorted toes, and I was called upon repeatedly to smooth things out.
This was our little company. We were extraordinarily congenial, which was fortunate, for we were cut off from the world outside; we lived, so to speak, quite to ourselves on a little island of our own. We had an enormous amount of never-ending work to do, and for a long while this kept us free from the unhappy tensions that were springing up around us. That Bran was cut off from the outside by bad communications proved to be greatly to our advantage. We knew almost nothing of the advance of the Communist regime in the country. We were a group of people who were too busy and too devoted to our work to notice the political upheavals, although these affected us eventually much more deeply than seemed possible at first.
Although we appeared to be an isolated island in the upheaval around us, we were always aware of its repercussions, like tremors radiating from the center of an earthquake. These tremors occasionally appeared in the flesh, in the sudden arrival in the village of heavily armed bands of Russian soldiers who came to arrest one or another of the inhabitants for no reason that anyone knew of. Some of these unfortunate victims came back, perhaps after months in prison during which they were never questioned; some disappeared without trace.
The Russians are past masters of the art of instilling fear. You didn't know, when you left your home to go to a neighbor's house, if you would ever get there—or ever return home again. You didn't know if you'd find your family when you got home. You did not know if the sudden knock on the door was that of a friend, or of the NKVD (the Russian secret police) coming to search—for what?—to question you, or carry you off to Siberia.
We lived under this terror always; it was an ever-lurking shadow. Yet the extraordinary thing about it all, is that after a while we got used to this form of existence and went about our everyday business as casually and as busily as we had before.
Romania had a form of socialized medicine. The country was organized into districts, each one headed by a Doctor Prima de Judetz—literally, a head doctor of that district—who appointed doctors to the towns and villages within his area. They were paid by the state, and each had his own private practice as well. Bran was within the Brasov district, which consisted of thirteen villages, and Dr. Popinescu was the Doctor Prima de Judetz in Brasov with whom I had many dealings. Dr. Stoian, the mayor of Bran, was one of the district doctors appointed by Dr. Popinescu.
Many of these district doctors worked with me very closely, and as the hospital became established and proved itself, they were glad and eager to bring their patients to us. 'We never took the patients out of their doctors' hands —the patient-physician relationship was never interfered with while they were under our care at Spitalul Inima Reginei. The doctors came and went as they wished, watching their patients' progress and conferring with us.
These district doctors were invaluable to us, for they could reach people at a distance in a way that we never could, and bring them in to the hospital for treatment when they needed to come. Most of the doctors were friendly and co-operative, for they realized that we were there to help them care for their people, who were our people also. Gradually the district doctors together with the hospital became a loose, far-flung unit, they in the distant villages and countryside, we in the busy little wards and the operating room of Spitalul Inima Reginei, all doing the same work together, and each depending upon the other.
One of these doctors remains especially clear in my mind. He was Dr. Martin, a Saxon, a stalwart young man in his early thirties. For two years he had had his own dispensary in the Carpathians at the very top of the Bran pass, in a tiny, remote hamlet called Strunga. Strunga was on the ancient frontier between the old kingdom of Romania and Transylvania, before the two were united. It was a primitive place. It consisted of only a handful of rough sod-and-clay houses, and the inhabitants were reticent sheep farmers and woodsmen. Dr. Martin lived amongst them and covered an enormous amount of mountain territory afoot or on horseback, and in the winter, on skis, visiting isolated houses and villages.
He brought many mountain people to the hospital. We liked him immensely, and we all worked wonderfully well together. We were always delighted to see him suddenly appear in the hospital courtyard, hatless, sunburnt, broad-shouldered and sturdy, striding across the graveled open space with the same purposefulness with which he forced his way across mountains and along valley trails. In a way, I should have liked to have Dr. Martin on my staff, for he was a man whose knowledge and independence I respected. Yet at Strunga he was of far more value to the purpose of the hospital. Strunga and its environs was our farthest outpost, and an intrepid man was needed there, skilled and tough and single-minded, as was Dr. Martin. He loved the freedom of the mountains and his work with the little known peasants there. I always felt that there was a story in this young man, but if there was, it is one which I shall never know, now.
The district doctor in the village of Simon, five miles away, was quite the opposite. He was apathetic and entirely nonco-operative. I called upon him; I tried to make friends with him; I tried to interest him in the hospital and its value to him. But he didn't approve of me, and he didn't care about the hospital. It had no value to him whatsoever.
However, one day his little daughter fell ill of anemia. He promptly brought her to us and made a nuisance of himself hanging over her, fussing and distracted in a thoroughly unprofessional, fatherly way. Dr. John took care of the child and, in a manner of speaking, of the father, also, for he was kindness and reassurance itself, while at the same time he discussed the case and deferred to him courteously on a professional level. The child recovered, and the father, fear of losing his daughter removed and his faith in us solidly cemented, became our firm friend and co-worker. He brought us many patients of his own and during the typhoid epidemic, later, was one of our bulwarks.
The growing civilian section of my hospital did not lessen my interest in my wounded soldiers. After the Red Cross hospital in Brasov, of which we had been a part, was discontinued as no longer necessary, I still kept my contact with the military hospital there because I did not want to sever my association with the army. Our association with Brasov gave the hospital military protection, and to a certain degree kept us out of the way of political upheavals.
Also, in memory of my mother, who had dearly loved the soldiers, I felt it was right that special cases should find the care they needed in Spitalul Inima Reginei. To the end, I kept a ward for soldiers and it was always filled. They were such nice boys, and, like Mummy, I had an especial affection for them. They were always so grateful and pleased with everything that we could do for them. Not all, of course, were wounded. Many were ill; principally we had cases of jaundice, malaria, and pneumonia. But generally Brasov sent us serious surgical cases which needed particularly careful nursing and building up. Since we were in the country, I could more easily provide the extra food they needed to augment the customary military rations, which certainly were insufficient and inappropriate for invalids.
A dreadful anxiety about food hung over my head constantly; I had approximately 125 mouths to feed and at any time my supplies might cease. Sometimes that did happen, and meals had to be eked out. The eternal dried beans in all their various guises got to be dreadfully dull, no matter how ingenious Maria was in disguising them. The patients and the personnel complained and found fault, so added to my anxiety and despair about not feeding them adequately—let alone interestingly—was my acute and uncommunicable distress at their protests, which were natural enough and for which I could not blame them too severely. For we were all living under great tension, and food is instinctively of great importance and comfort to the human animal.
I had a farm beyond Brasov, more than twenty miles away, which supplied us with most of our food. We even grew beets for beet sugar, and wheat which we took to a mill to be ground for flour. One of our trucks drove there once or twice a week and returned with vegetables, eggs, bacon, sometimes milk and occasional chickens, and fruit in season. The truck had to travel over the one main road and pass through the city of Brasov, but never once was it stopped and pillaged by the Russians. This seems as unbelievable as the fact that the hospital was never molested, for the Soviets were predatory thieves, beasts who made the countryside and all therein their own. It seemed that the hand of God was continually guiding us, protecting us.
As time went on, I depended more and more upon that sense of guidance. Surely, if I had depended upon myself, and tried to trust in my own wits and feeble strength, I would have been mad with anxiety and hopelessness. My hospital would certainly have gone under the inexorable Russian tide, and my small span of service to the countryside would have been considerably smaller.
I lived for four years with a door between me and the Russian Army, and with no right of appeal. I honestly believe that my denial of fear, my conscious dependence upon God for safety and supply, made possible His care and protection. I believe with all my heart that if I had raised a barrier of fear He couldn't have helped me as He did so continually.
Our income came partly from the army, since we were taking care of the soldiers, partly from the Ministry of Health which contributed to the hospital's running expenses, and also, for our civilian workmen patients, from the state social insurance companies, into which the workmen had paid compulsory fees from their wages for years. But now, although we were under a Communist government which continually and with fanfare proclaimed itself to be the friend of the "oppressed" lower classes, the workers were less well off than they had been before. Their situation steadily worsened under the Communist regime, for the benefits allowed them through their social insurance became less and less, to the bewilderment and indignation—of necessity, carefully voiced—of the workmen.
"But Domnitza," they protested to me. "We have paid the state for our illnesses—why do we need to pay again? Where did our money go? Why will the company not pay you for us, as they said they would do if we were sick?"
The fees the company paid us barely covered the food we gave them. They did not begin to pay for nursing care, doctors' fees, medicine, and the many other necessities. I had to pay for these myself out of my own pocket, for if I did not, I would be immediately denounced and accused of class favoritism, of neglecting and withholding care from the "working class."
From the beginning, we lacked almost completely that first essential of hospital equipment, rubber goods. They could not be obtained for love or money. Finally, in the summer of 1945, in desperation I went to Bucharest to visit a large hospital supply house to see what I could get there. It was a very famous concern; their illustrated catalogue was like a textbook, and the single worn copy I owned was one of the hospital's valued possessions.
To my dismay, when I arrived there, I found that the store had just been bombed out and the place was a shambles. After a moment's disappointed hesitation on the littered sidewalk in front of it, I impulsively went in, picking my way through the debris. I found the owner and one or two clerks there contemplating the ruin, trying to rescue and set aside what they could find of the undamaged stock.
To our mutual surprise, the owner and I recognized each other as co-workers in the past. He had been a pharmacist on a hospital train on which I had also worked, which ran from Vienna to Bucharest transporting wounded Romanian soldiers from the German front back to their homeland. They had been fighting with the German Army all along the wide front as far as Stalingrad. These hospital trains collected them behind the lines and brought them to Vienna; thence they were taken to Bucharest, and from there they were sent to hospitals or to their homes.
We exchanged warm greetings and I told him my plight: I had a hospital and no essential rubber sheeting, rubber gloves, rubber tubes, rubber hot water bottles—nothing. Had he anything he could sell me?
He spread wide his arms, indicating his ruined store.
"Highness," he said. "I have nothing to sell—especially to you. I have only the remains of a stock that the Russians will come and take. Help yourself—it is all yours. But take it away quickly, before the Russians do."
I was incoherent with delight and gratitude. He would not accept my thanks, for he said that he was making no sacrifice since he had so little left that he couldn't sell it, anyway.
Besides the small supply of rubber goods left undamaged, he gave me, for our little laboratory, some valuable chemical supplies and a small amount of glassware that had escaped ruin. The few things we salvaged were of inestimable value to the hospital. For two years thereafter we had only one large rubber sheet which we cherished and used over and over. There were a few pairs of rubber gloves which were necessary for the operating room, and when these began to deteriorate, we used sterile cotton gloves, saving the rubber ones for deep abdominal surgery. Later, lacking any gloves at all, we scrubbed, then disinfected our hands, painting them with iodine. As a result, of course, eventually we acquired all sorts of skin troubles.
We made our own liquid soap in the sterilizing room, using lye, grease and disinfectant as ingredients, and sterilizing it ourselves. Brushes were hard to find at first, and, as time went on, it became practically impossible to get them. 'We made them last as long as we could and discovered that they deteriorated quicker when they were boiled than when we kept them in a disinfecting solution. Even then they worried us by dropping apart—every so often there was one less of the precious objects, and we all took sad and anxious notice of each demise.
We had few thermometers and could obtain none. A single thermometer had to do for an entire ward, and taking morning and afternoon temperatures was a long, long process.
But we managed somehow, and we continued to save lives. It is extraordinary what great resistance the human organism is capable of. We took every precaution against infection that was possible within our limited resources, and when we could take none further, we still went ahead, operating under what now seems to me, and surely must to you, the most primitive and risky conditions. Yet our patients recovered, and they lived.
One other cherished thing was donated to the hospital, again with the plea that we take it quickly or the Russians would come and get it.
The wooden walls of our operating room were spotless with whitewash, repeatedly applied. When the Russians seized control of the government, the Ministry of War telephoned me from Bucharest.
"We have a large quantity of white tiles on hand," I was told. "If you want them, you can have them, but we must get them to you immediately because everything has got to be declared. Can you use them at once?"
"Oh, yes, yes indeed I can!" I exclaimed gratefully.
Next day several workmen arrived with the tiles, and in a miraculous matter of hours our operating room was tiled—the floor and the walls to the ceiling, shimmering white, very easy to clean, thoroughly aseptic, professional, and oh, most beautiful! I used to love to step inside the door and just stand and look at it for a moment, empty and waiting. To me still, in memory, the operating room is the dearest spot in the hospital.
We had a miscellaneous assortment of beds at first. Then one day the Ministry of Health found itself with 100 unwanted beds on its hands, which the Russians had ordered and refused on their arrival because they were too low. Dr. X telephoned me and offered them to the hospital. I nearly fell into the telephone in my eager and excited acceptance of them; high beds or low, it didn't matter—we needed beds desperately.
They were regulation height, which is indeed low for hospital use, but they were uniform in appearance and handsomely chromium plated. How smart we all felt when they were ranged side by side in our wards, and the whole staff assembled to gaze and admire!
Our mattresses were not very grand, but they were adequate. When the hospital started, the director of the Tohan ammunition factory gave us huge surplus quantities of felting which they used for packing and shipping the high explosives manufactured there. We shredded this, and stuffed mattress tickings with it, the tickings having been given us by the kindly textile manufacturer who sent us our famous sheets and provided our colorful uniform material.
The mattresses were quite comfortable, and when they got lumpy from use, as was inevitable, one of the men "serviced" them—he opened the tickings, pulled the felt apart into shreds again, restuffed the tickings and sewed them up.