“Watch that man!” said the nurse to her volunteer aid, nodding toward a bed that had been tilted at an angle by means of wooden blocks inserted under the legs, so that its occupant, a wounded Frenchman, lay downhill, his feet higher than his head. He looked as if he were past the need of watching and were dead already, that rigid, immobile, white-draped figure. His face was a livid mask, with heavy shadows beneath the closed lids, pinched nostrils, deep carved lines of pain round the bluish mouth, and a black unkempt bristle of beard that showed up startlingly against the white of the pillows. Not a movement, not a stir or visible breath or touch of warm living color. He was a fresh arrival, thirty-six hours from Verdun, and in the morning—if he lasted that long!—he was going up for operation. Both of his legs were broken above the knees.

“Watch that man!” warned the nurse again from the door. “I’m going off duty for two hours. Lord, I’m tired!”

“Oh, I’ll watch him all right,” promised the young aid confidently. “That’s what I’m here for,” she added with dreamy sweetness.

The nurse walked over to the bed, bent down and took the soldier’s pulse.

“He seems all right,” she murmured dubiously. “Pretty weak. Well, keep an eye on him.” She sighed a sigh of pure fatigue and departed.

Left to herself, the auxiliary fussed about the ward for a few minutes, after which she, too, crossed to the bedside of the man on whom she had been commanded to keep an eye. For a space she stood staring down watchfully upon him. That was what she had been told to do, and she did it conscientiously.

Then, her duty performed, she returned to her seat at the table and commenced a letter to a girl friend. And while she is thus engaged, and the stage is set for action—and probably tragic action—let me give a brief thumbnail sketch of her.

It was a big war hospital in France, and the volunteer aid was a girl from the Middle West who, in a fine white flame of enthusiasm for the Allied cause, had come all the way from her native town as fast as train and ship could bear her in order to nurse the fine, brave, glorious and magnificent French soldiers. For it was with such glowing adjectives that she described them, and she could not even think of them without springing tears. The dear, rugged, war-torn heroes, flat upon beds of pain, with romantic white bandages bound about their brows, gazing up at her with unutterable gratitude in their dying eyes. For it was thus, movie-wise, she pictured them; and she pictured herself as a nurse, a sort of ministering-angel-of-mercy ingénue cast, divinely compassionate, dressed for the part in pure spotless white garments, on her head that very becoming French coif—it had looked so attractive in the pictures; she really must have one of them—bending over a dying poilu, soothing his fevered brow with cool white fingers, murmuring gentle words of hope, promising to write to his mother, and finally kissing him good-by into Heaven. She had read of nurses doing that, of soldiers whispering faintly, “Kiss me good-by for my mother!” And she knew—she had a sure instinct—that she would be good in that part. For, as she told her girl friend, she had so much sympathy and tenderness in her nature!

So great had been her zeal to help along the above lines that she had not tarried to take any tiresome, humdrum courses in nursing. For the war might be over any time, she argued, and she couldn’t bear to lose a single precious instant. And so she had come right on. She had come right on, and with fool’s luck she had arrived in Paris at an opportune moment—for her. A mighty drive was on on the Western Front, and the backwash of French wounded was pouring in—a vast, unending, sanguinary tide. It was the tail end of summer, a terrific, heart-breaking summer, on top of a terrific heart-breaking spring, and no let-up in sight. Doctors and nurses and aids were exhausted, pegged out, at the end of their tethers. Some of the workers had collapsed under the abnormal tension, and the rest toiled on, showing their fatigue by curt crisp orders, by quick bursts of irritation or sudden explosions of savage temper. It was into this dynamic atmosphere that romantic little Miss Greenhorn walked one day, utterly incompetent technically and spiritually, but self-confident, unabashed, full of her dream of those fine, splendid French soldiers—poor, wounded darlings!—and strong in the belief of her own divine function to succor and save—in that very attractive coif: And they gave her a place. Such was the stern necessity of the hour. Here was another pair of hands, another pair of feet; certainly they could scrub tables, carry slops, run errands, and thus divert fatigue from the more important trained members of the corps. And so Miss Greenhorn donned her coif—her premonition concerning it was right; it was, indeed, very fetching—and prepared blithely to materialize her Florence-Nightingale-Mary-Pickford dream.

They assigned her to a small ward of ten. The orderly had not arrived, which is a salient characteristic of orderlies, and the nurse bade her take a pail of slops to the lavabo. It was a heavy pail, too heavy for her slight shoulders. After that she carried piles of blood-stained linen to the same destination, and following hard upon that several morning bedpans. It was not distinguished work, and dainty little Miss Greenhorn performed these lowly duties with a disdainful nose in air. ’Twas not for this she had traveled all the way to France! The ward doctor, noting the contemptuous, gingerly fashion in which she held her burdens at arm’s length from her immaculate linen costume, murmured ironically to the nurse:

“We’ve got a queen in disguise among us. Look out!”

Presently she was set to make a bed. Now in the course of all her fair young life Miss Greenhorn had not made half a dozen beds, and, moreover, she did not deem it a matter of grave importance. Still she was willing to oblige.

“Poor man!” she breathed, hanging above him tenderly. “How grateful he must feel toward me!” And, smiling her Florence-Nightingale-Mary-Pickford smile, she began pulling away a sheet at random. The soldier let out a yell of fury:

“Imbecile! Are you trying to kill me? Oh, mon Dieu! Get out!”

The nurse dropped her work and came running. It appeared that, instead of the bed sheet proper, the novice had got hold of another which, quadruple-folded, formed part of the padding of a wooden fracture-box that held the soldier’s broken leg; and with the first tug she had all but capsized the entire apparatus and spilled fracture-box, leg and soldier out upon the floor.

Miss Greenhorn backed off from the scene, deeply mortified. Her sensitive feelings were hurt. The man had called her an imbecile! The very first words a French soldier had addressed to her—to her who had traveled five thousand miles to nurse him—had been not “You are heavenly kind, miss!” or “Kiss me, for I am dying!” but a brutal “Imbecile! Get out!” It was a rude jolt to her rosy dream. In addition, the nurse reprimanded her sharply, and for the next two back-breaking hours she made beds under a dragon eye of supervision, made and remade them.

Everything she did was wrong, clumsy, maladroit, and had to be altered twice, thrice, while the men turned pale under the prolonged strain and sweated or muttered nervously “Let be, mees! Enough! Oh, good God!” After her first mishap they were deadly afraid of her. And so sensitive spots went unbathed, uneased; temperatures shot up, and infected wounds began to throb, while little Miss Greenhorn took her first lesson in nursing. It was hard upon her, for everyone within the circle of her inexpert activities became irritated and vented their irritation freely; but it was even harder on her victims, the soldiers of France she had come so far to serve.

After two hours of constant stooping, kneeling and lifting heavy and helpless men, little red lightnings of pain began to play up and down her spine, her shoulder muscles ached cruelly, and there was a dull roaring in her ears. Her feet, too, already swollen in their fashionable white buckskin pumps, began to hurt atrociously and to show a congested purple beneath the transparent white-silken hose. Above all things on earth, she desired to sit down five minutes and rest. Instead of this the nurse bade her disinfect a bed. Another unwieldy mattress to tug and haul about!

“Do I have to put this strong stuff into the water?” she demanded plaintively, holding up the disinfecting fluid. “It’ll spoil my hands!”

She was proud of those hands. They were delicate and cool and white. And, besides, they were part of the stage property of her movie dream.

“If you intend to disinfect the bed, do so,” returned the nurse dryly. “The case in that bed died of gas gangrene, and I shouldn’t care to expose another patient to the microbes, even at the risk of spoiling your hands.”

“May I have a pair of rubber gloves then?”

“We’re short of rubber gloves just now. What we have are needed in the operating room.”

Miss Greenhorn bent to her task in silence. Her cheeks were burning and her eyes were blurred with tears of rage and fatigue. As she stooped, dabbing futilely here and there with her cloth, the blunt voice of the nurse came to her:

“Don’t shirk your work that way. That isn’t half disinfected. Here, give me the rag.” And, squatting comfortably, she proceeded to give a thorough demonstration. “Don’t be afraid to use a little elbow grease,” she concluded ironically.

Miss Greenhorn bit back an angry retort. She had not come over to France to do low, menial, scrubby, grubby work and then be treated like a servant. At home she gave orders instead of receiving them. But aloud she only said “Thank you!” so low that the nurse glanced at her keenly and added: “Never mind. You’ll learn some day. Now suppose you wash all the bedside tables. Remove everything from them first. And after that, if there’s time, scrub the big table. Then the men’s déjeuner will be coming along. Have you got the hot drinks from the diet kitchen? Ah, but I told you to do that always before eleven o’clock! The kitchen’s closed now and the poor chaps have lost their nourishment for the morning. Try not to fail on that again. Oh, before you begin on the tables, please make me a hot compress for Number Two. You don’t know how? Very well!” And with a smothered exclamation of impatience she hurried off to make it herself.

Somewhat subdued, Miss Greenhorn began on her tables. A few minutes later a peculiar sound from the adjacent bed caused her to look up and then cry hastily:

“Oh, nurse! That poor man—Number Six—he’s vomiting.”

But the nurse, with the hot compress and a patient’s broken arm in her hands, could not disengage herself instantly. Moreover, her patience for the moment had gone into complete eclipse.

“When a man vomits, don’t call me!” she barked savagely. “Hold something!”

But unfortunately little Miss Greenhorn could find nothing to hold. Terribly disconcerted, she flew round wildly in a circle, like a kitten chasing its tail, seeking a suitable vessel. But nothing seemed to present itself to her distracted gaze. The pail? Obviously too large! The bedside wine cup? Obviously too small! Oh, where—— But by this time the nurse had caught up a basin and was supporting the sick man’s head.

“He’s gone through everything,” she said wearily. “We’ll have to change the entire bed. Fetch some linen. And next time use a little horse sense, if you’ve such a thing concealed about your person.”

During the change the patient groaned horribly. The sweat of exhaustion poured from his face. His flesh was clammy.

“Get some hot-water bottles,” the nurse ordered tersely. “No, never mind, I’ll do it. You’d probably scald him!”

Miss Greenhorn returned to her tables, the corners of her mouth dipping like those of a baby whose hands have been slapped. And during the rest of the morning Number Six’s white face reproached her mutely.

In the afternoon she left another wide swath of errors behind her. The men thanked her politely, but declined her kind offers to shake up their pillows. When she took the temperatures she broke three thermometers hand-running, and French thermometers were rare commodities.

“I think they must have been cracked,” she apologized. “They snapped so easily.”

Later, marking up the temperature charts, she made atrocious blunders. Normal patients suddenly exhibited fever peaks high as the Himalayas. The astounded ward doctor, discovering such a one and its source, swore fervently and voted her a pest, with a double-barreled profane adjective attached. That night her feet ached so that she cried when she removed her shoes. And for that night and many nights thereafter she had her dinner in bed and fell to sleep immediately from sheer exhaustion.

And now, the résumé complete, let us skip a week and return to Miss Greenhorn as she sat writing a letter to her friend. Every few minutes, true to her orders, she had risen for a look at the patient she had been set to watch. She watched him dutifully, ignorantly. She was still Miss Greenhorn, with one short week of experience. Not once did it occur to her to query: What am I to watch this man for? What is likely to happen? What shall I do if it does? And yet she was not a particularly stupid girl. She was rather above the average in intelligence and eagerness; but so firmly had she riveted her gaze upon the romantic, the false, the pseudo-æsthetic aspects of her job, that she was temporarily blinded to its actual features. But that the unriveting process had already begun and was somewhat painful was evidenced by her letter to her friend. And as the man she was set to watch seems quiet, ominously quiet, let us peep a moment over her shoulder:

At this point Miss Greenhorn’s pen trailed off and she sat bolt upright, staring before her into space. A sudden thought had smitten her, almost with the force of a blow. Why was he so pale? Why was he still? Why, in short, had she been set to watch him? She rose rather hurriedly and went to his bedside. She would ask him what was the matter. Really it was an inspiration!

“How are you?” she questioned gently.

“J’ai froid,” came the faint murmur from rigid lips.

“Ah! Cold, are you? Then I’ll get you some hot-water bottles and they’ll make you warm. Nice and warm!” And Miss Greenhorn sped away on her mission, delighted to be of service. “Voilà!” she cooed soothingly a few minutes later, slipping the heated bags into the foot of the bed. “Now you’ll soon be warm! Nice and warm and cozy!” And she leaned above him solicitously, still vaguely troubled. Certainly he was ghastly pale!

It was at this juncture that the ward doctor, a busy, brusque, discerning young gentleman, blew into the room with a—

“Hullo, Miss—— How’s that fellow——” A single glance at the fellow in question stopped the words as if a sudden hand had been clapped over his mouth. He sprang forward and threw down the covers. The soldier lay in a pool of blood. “My God! Hemorrhaging! Why didn’t you call me?”

He wheeled on her savagely. But Miss Greenhorn’s face had blanched almost as white as the counterpane. Her hand went up to her trembling lips.

“I—I—I didn’t know!” she whispered. “He complained of feeling cold, and so I—I gave him hot-water bottles.”

“Yah! In case of hemorrhage, when a man’s bleeding to death, for first-aid apply hot-water bottles! Fine! Where’s that tourniquet? I tied it onto the foot of the bed myself.”

“The—what?” stammered Miss Greenhorn, immeasurably terrified. She quailed before the look in his eye.

“Tourniquet! That piece of rubber tubing.”

“O-o-oh! That terra-cotta rubber thing, you mean! It made the bed look untidy and so I undid it. Let me see. Where——”

But the door had already slammed upon the doctor, who returned immediately with a tourniquet from the adjacent ward. Fortunately it was not an arterial, but a slow, oozing hemorrhage, and so the man did not die; but that was not Miss Greenhorn’s fault. And the doctor did not spare her:

“Why did you suppose his bed was tilted up so that his feet were higher than his head? Don’t you know that in itself is a sign of hemorrhage? Why did you suppose that tourniquet was tied to the foot of this particular bed? Do you see it on any of the other beds? That’s another sign! And what did you suppose you were set to watch him for anyhow? Zeppelins? You’ve been here a week now. Tell me, are you solid ivory from the neck up?”

I am not going to repeat the remainder of his scathing remarks, for he was angry and his nerves were none of the best. In justice to Miss Greenhorn it must be said that she took her whaling like a gentleman. She did not once glance at the doctor, but kept her eyes fixed on the French soldier whose life she had jeopardized by her criminal ignorance. And in that moment she jettisoned the last fragments of her ministering-angel dream. Cool hands, fevered brows, the kiss-me-for-I-am-dying business—all the false, sentimental rubbish with which she had stuffed her romantic young head she let go by the board forever.

And that, for us, is the end of Miss Greenhorn, save to mention that she is a real person. She told me the tale herself six months later, with tears only half of laughter in her eyes. And then she affixed the moral, which in brief is this: That not all of France’s enemies are behind the German guns.

From this solitary episode one may deduce most of the qualifications, both natural and acquired, that a volunteer nurse’s aid should possess before ever she sets foot inside a war hospital. First of all she must have health. She must have the kind of health that does not break or crack or crock or show signs of wear in bad weather; the kind of health that can pile one hard day on top of another hard day, and one hard week on top of another hard week, and one hard month on top of another hard month, and keep right on without flagging or asking the captain to stop the ship so she can get off and walk. Every auxiliary signs on for a period of at least three months, preferably six months; and in some hospitals abroad they sign on for the remainder of the war. The work is too severe for a delicate constitution; it has been known to put a crimp in a tough one; and it is unfair both to the soldier and to the hospital plant to have human machinery that is apt to break down any minute. This implies youth, resiliency, reservoirs of stored strength, the unspent increment of physical endurance; and, therefore, anyone outside the ages from twenty to forty should ponder deeply before entering this most exacting branch of the service.

Aside from good general health, the volunteer aid should possess what physicians term a high threshold to disease. She should not catch things readily. Microbes should be unable to obtain a foothold. In this respect even healthy people vary widely. One person will take the mumps if there is a case in the next county; another may sleep in the same bed with the victim and go unscathed. There was a young woman in our ward who caught everything. Every little pirate microbe that sailed the invisible seas of air with his jolly skull-and-crossbones flag knew her for a friendly island, had her marked down in his log book, and put in for food and repairs, sure of safe harborage.

Tonsillitis, grippe, infected finger, swollen glands, infected eye, tonsillitis again—she had them one after another as fast as she could, and she finally came home with the jaundice!

But let us suppose that the candidate has passed her physical examination with flying colors; that her back is strong; that her feet have not the slightest tendency to fallen arch; that she can eat stewed horse without a regretful pang; that she sleeps like the traditional top at night, and rises from her slumbers fresh as the traditional daisy. There are still other natural qualifications to reckon with: She must be able to subordinate herself to the will of others, to take orders, to take hard, disagreeable, and often what she may consider unjust orders from her superiors without opening her mouth to complain.

In the first year of the war the hospitals were nearly swamped by the sudden rush into them of grand ladies who were naught but little Miss Greenhorns in more arrogant guise. These women had not the faintest notion of subordination, or of the mental and spiritual discipline involved in nursing. Their conception, in a word, was the unreal conception of Miss Greenhorn. They, too, were devotees of the Florence-Nightingale-Mary-Pickford canned brand of dream. They had not left their beautifully appointed homes to carry slops, et cetera, but to nurse the gallant British and French lads! And for a time doctors and nurses were driven almost to insanity under the double pressure of caring for the wounded, and training—or quietly assassinating and smuggling down a well some dark night!—these ignorant ladies who descended on the hospitals like an Egyptian plague. Nor were all of the untrained, emotional incompetents of English origin. America sent her quota—women who from infancy had never obeyed anything outside of their own vagrant fancies, who were congenitally incapable of sinking their own personalities and becoming privates for the good of the cause. They wanted to be colonels at the very least or they wouldn’t play, and a field-marshal’s baton was even more to their taste. Boss was the middle name of every one of them. They had elephantiasis of the mind. Such a person in the minor position of nurse’s aid can disrupt the entire ward of a hospital, which, more than any other branch of service, resembles the army in its authorities, its hierarchies and gradations of rank, and the severe monotony of the daily routine.

For a time there was such a Great Person in our ward at the American Ambulance, the sort who “my-good-man’s” the soldiers. As for the rest, she blandly did what she pleased, and set the nerves of all of us on edge in consequence. For what she didn’t please to do, we had to, you see!

One afternoon the head nurse said to her:

“Mrs. X, will you disinfect that bed?” And it was none the less a command even though it was issued mildly in the interrogative form.

Mrs. X responded in her best drawing-room drawl:

“Oh, my deah Miss C., I am so sorry! But it is my tea time! And besides, really that is not my bed, you know!” With which piece of insolence she drifted languidly off to tea.

“What am I to do with her?” exclaimed the head nurse despairingly to the ward doctor, who had witnessed the insubordination.

“Shoot her at sunrise,” he suggested jovially. “This is a military organization. Shoot her at sunrise, and put over her grave: ‘Here lies a deserter. Shot for refusing to obey a superior officer in action.’”

Of course he was right. That is precisely what should have been done to her. And I would have joined the firing squad with pleasure—for I had to disinfect that bed!

To be strong, healthy, adaptable, able to sink one’s identity and to take orders—these are some of the natural qualifications of a successful volunteer aid. In addition she must be prepared for disagreeable tasks. The sight of blood, of poor fellows smashed to pieces, the hideous stench of gangrenous wounds, the screams of the dressing hour—these are the inevitable concomitants of a surgical ward in war-mangled Europe to-day, and are sufficiently disagreeable. But these are not what I mean. I mean the monotonous, prosaic, inglorious tasks that everybody loathes but somebody has to perform. And that somebody, eleven cases out of ten, is the nurse’s volunteer aid. For you have not read thus far without discovering that the position of an auxiliary resembles closely that of a printer’s devil. Not his the high responsibility of getting out the paper or deciding the politics of the editorial page; his not to reason why, his but to be on the living, red-hot jump every second of the time or get sacked by his irate boss. In one respect, however, the printer’s devil has the haul over the nurse’s assistant, for he receives a weekly envelope, while she labors for love.

As a specimen of these monotonous tasks, an English volunteer aid confessed to me that for two months in an English base hospital, three miles behind the lines, she did nothing all day save carry heavily loaded trays of food from the diet kitchen to a certain table in the corridor. Day after day, from eight in the morning until seven at night, back and forth, back and forth, remote, solitary, with aching shoulders, this plucky young private drudged. Never a wounded soldier did she see. At times the hospital shook under German bombardment; but so far as romance and illusion were concerned, she might as well have been a slavey in a twilight basement restaurant beneath the dull roar of the Sixth-Avenue elevated trains. Another young woman told me that for six weeks she carried nothing but bedpans. And at the American Ambulance, the auxiliaire who roomed next to me had a job of which I did not envy her the possession. Every evening she used to offer to trade it in even barter for mine. And every evening I refused to take a cowardly advantage of her generosity. The position which my friend was so generous with was up in the operating room. And it was her particular duty to carry off the amputated members in a basket.

The points thus far in the natural qualifications of a nurse’s aid are health, resiliency, ability to take orders and to stick at mean, disagreeable jobs. Let us add a final one that is really the keystone of the entire arch. For without it the others are as sounding brass and tinkling cymbals. Nor is it acquirable: it is a grace, a gift. Some successful doctors and nurses possess it to a high degree; others, lacking it, turn into dried-up turnips. There was a certain young surgeon in the hospital who undoubtedly possessed this qualification. Whether he was an expert technician I do not know, for he left the hospital before I arrived and it was only the soldiers’ memory of him, the reflected echo of his personality, that I received. But that was sufficient. They loved him. “Ah, mees,” they would exclaim, “do you know Docteur James d’Amérique? Non?” And they made me feel that not to have known him was a profound personal loss. “Ah, how he was kind! How he was good!” they would murmur fondly, and they would drag forth a tiny snapshot of him for me to look at, and laugh with delight at beholding his face. “See, mees! Here he is! Aha! Bonjour, Docteur James!” They wished me to share with them the fragrance of that memory. One could not ask for a better epitaph than the tribute paid by these poilus to the unknown Docteur James d’Amérique! Another did not possess this gift. Brusque, impatient of address, he would pull away the gauze sticking to an infected wound with an abruptness that invariably raised a howl; and exclamations of “Brutal!” “Imbécile!” “Sale cochon!” followed his ministrations down the ward. “Oh, shut up! Shut up! Shut up!” the doctor would retort in English. Now the soldiers did not know exactly what “Shut up” signified; without doubt in their minds it was some extremely naughty English profanity. But they had their revenge. They nicknamed him “Docteur Shut Up.” That was his epitaph.

A nurse who failed in this one respect they dubbed the old mitrailleuse. I have seen them sham sleep when she approached their bedsides for a chat. There was one, however, whom they loved. She was a slim, gold-haired Scotch miss, not much higher than the bedposts, but a grenadier for all that, and the quality I am speaking about rayed out from her in an almost visible aura. Not that she was “soft” or easy with the men. On the contrary, she cracked a whip over them and made them walk a chalk line of discipline, which they did with an open, unabashed delight in her. They would feign all sorts of ailments to lure her to their bed for a chat and massage.

“I suffer bad here, mees!” they would begin. “No, not there—higher up. No, chère mees, not there. No—yes! Voilà! Parfaitement! A-ah! Mais, continuez, continuez!” And not a thing the matter with the frauds! But they sunned themselves in her presence and all but fought for her smiles. That little Scotch miss had a way with her. Moreover, she loved her job. She loved it from the ground up, over and under and beyond and through. She loved it in all of its aspects and ramifications; she loved it in all the hours. She had the faculty, the gift I have been attempting to describe. She had a vocation. And unless one possesses in some degree this natural delight in humanity, in sick, diseased and often dirty humanity, the hour soon strikes when nursing begins to pall.

Thus far I have dealt only with the natural qualifications that a young woman should possess if she desires to do volunteer nursing in this war. All those who, after searching their inmost hearts with sincerity, cannot pass on the above-mentioned points with an all-round grade of at least seventy-five per cent, need waste no further time on this article. They may get out of the procession right now and go round next door and sign in for canteen cooking, or join the hoe brigade. Step lively, please!

At the present moment there does not exist in the Red Cross organization any course of instruction that has for its direct and primary object the training of volunteer nurses’ aids for work in surgical hospitals here or abroad. There does not exist in the Red Cross curriculum, as it is now constituted, any course that is adequate for the present crisis. The teaching manuals are the same that were in use before the war, unrevised, unchanged. They were not written with war in mind. Their purpose and goal is not our purpose and goal. And, as the textbooks have remained unaltered, it is inevitable that the various courses of instruction based upon them should be more or less beside the point, congested with material that is useless or irrelevant, and barren of certain fundamental facts which every volunteer aid should know. Sometimes when these lessons are given by nurses or doctors who have seen actual war service they are of more value, but these are exceptional, random cases; and in general the courses, instead of hitting the bull’s-eye of to-day’s grim necessity, are faced off in another direction and shooting at an imaginary mark.

There are four courses of instruction in the Red Cross curriculum that have a bearing, more or less indirect, on the subject of volunteer nursing in surgical hospitals during the present war. Let us glance at each in turn.

Most popular of all is the course in First Aid. This is the course that nearly every woman in the land flew at and swallowed down whole at the outset of the European conflict, and, it is safe to say, with very slight benefit. This is not surprising, for First Aid was not the proper choice. To teach nursing is not its object. The punishment, so to speak, does not fit the crime. Almost purely educational in character, it is designed for the accidents and emergencies of our ante-bellum, peaceful past rather than for the precise, up-to-the-minute scientific requirements of our belligerent present.

And from the point of view of the nurse’s assistant there are entire chapters that should be ruthlessly scrapped. Methods of resuscitating a drowning man; cures for snake bite; the way to tell an intoxicated gentleman from one who has merely fallen down in the street in a fit—these matters are interesting and valuable in their place; but their place is not in a manual used to instruct in the art of nursing under present conditions. It would seem advisable that the First-Aid manual be taken in hand by some eminent surgeon who has seen war-hospital service during the present year—for example, Dr. George W. Crile, head of the Cleveland Hospital Unit, that was recently ordered to France—and blue-penciled unsparingly with actual conditions in mind. The residue, plus a chapter on the recent discoveries and improved methods in caring for wounds, such as the treatment of burns from liquid gas, and the Carrel-Dakin system of antiseptic irrigation of infected wounds, to mention but two examples, would form an invaluable nucleus of instruction.

The second course in the Red Cross curriculum is that known as Elementary Hygiene and Home Care of the Sick. “The primary object of this course,” according to the pamphlet, “is to teach women personal and household hygiene in order that they may acquire habits of right living which will aid in the prevention of sickness and the upbuilding of a strong and vigorous people, and to give them simple instruction in the care of the sick of their own homes which will fit them to render intelligently such service as may be safely entrusted to them.” Admirable three years ago in peace times, but not at all what we are after now. Here again, so far as the purpose of the volunteer nurse is concerned, the emphasis, as in First Aid, is on the wrong foot from the start-off. There are entire chapters that might be omitted with profit, such as the house, the care of the house and the laundry, the household medicine closet, the hygiene of infancy and childhood. They should be dropped, and a more thorough, intensive and leisurely training be given in actual conditions prevailing in war hospitals of to-day.

In addition to these courses there are two others of minor importance. One in Home Dietetics is entirely too elaborate for the simple requirements of the nurse’s aid, who needs to know only the general food values and the compounding of invalids’ drinks. Three or four lessons in connection with the nursing course should amply cover this field. The fourth course, the Surgical Dressings, is practical but limited.

These are the popular courses given under the auspices of the Red Cross to-day. Each, taken by itself, has grave defects; and even when all four are combined there is such a ponderous dead weight of irrelevant material, pre-war nursing and medical junk, that for practical purposes it would seem better to throw them all out of the window and devise another course, a course compounded of the valuable elements of all four, but thorough, scientific, modern, and above all specifically adapted to the actual conditions of the present fight.

It may be argued that the necessary eliminations will be made by each individual. But to let the immature, embryo nurse decide what she will and what she won’t eliminate is a dangerous business in practice. It would be all right in peacetime, when she does not have to try it out on the dog. But she might elect to eliminate the wrong detail, and then find herself in the quandary of Miss Greenhorn, with a human life hanging in the scales. For though in theory an auxiliary has no authority and no responsibility, in actual practice that is far from being the truth. There are hours, even days, in the absence of the nurse, when the entire care of the ward falls on the shoulders of the assistant, with the head nurse looking in at rare intervals. In textbooks untrained persons are not supposed to be in positions of responsibility. In this or that emergency “Call the doctor!” or “Call the nurse!” they say. But suppose the doctor is up in the operating room, blocks away. Suppose the nurse is off duty. Suppose also that the nurses in the adjacent wards are down at lunch. For such precisely was the stage setting of a mishap that occurred in the jaw ward of the American Ambulance. The auxiliary was alone in the room. Suddenly, without warning, one of the jaw cases began to hemorrhage from the mouth and nostrils. Bright arterial blood spurted high as the ceiling and stained adjoining beds. In less than ten minutes the man was dead. What should the auxiliary have done? The event proved that in that particular case not a whole regiment of doctors could have saved the patient; but the responsibility was there. And it is for just such tight corners of actuality that a volunteer nurse should be prepared. And for such preparedness the teaching manuals and the lectures based upon them should deal, not with the diffuse and general matters of health, but exclusively and incisively with the realities of the present crisis. In addition, it should be noted that the Red Cross, in connection with its nursing course, “hopes that a limited number of hours of practical experience will be provided by the base hospitals”; but such practical experience is not deemed essential to a certificate.

Aside from these courses, there is a course given by the Young Women’s Christian Association of New York City, which for practical purposes covers the requirements of the present situation in an almost ideal fashion. It is, in fact, the most admirable course of instruction on the market—scientific, modern, intensive, complete. It is called the Trained Attendant Course, and is given by Johns Hopkins nurses of the highest standards of excellence, who are trained teachers as well. The course covers eleven weeks of daily instruction and practice, with an obligatory companion course in invalid cookery.

With the natural and technical qualifications of the volunteer nurse’s aid thus disposed of, one may look about and query where suitable material is to be found. The answer is at hand: In the colleges. College women of the two upper classes form a compact body, already listed, easy to mobilize. Young, supple, adaptable, mentally and physically fit, with a background of discipline behind them, they are excellent instruments for the purpose. Sharpen them to a point by an adequate course of instruction, and three months should produce a corps of workers sufficient for a year. These might then be registered and called upon at need.

It is a feature of the present disaster that no one can gauge the future. One man’s guess is as good as another’s. It is safe to say that two years ago no one foresaw that to-day the United States would be in the arena as the protagonist of democracy. Nor can anyone predict with assurance what the next two years will hold: Whether we shall have a big expeditionary force in France; whether by that time we may not be fighting on our own soil; or whether the whole infernal business may not burst like a bubble before the month is out. But this much seems certain—American surgery and American hospitals are counted the best in the world both in the preventive and in the follow-up field. And since our entry into the war the governments of the United States, Great Britain and France have had under consideration a proposition for placing the entire French ambulance service, and later on the entire British ambulance service, under the United States army medical corps.

So there you are, dear procession, right up against your job! I hope you like its dimensions. As the darky says, “You done chawed off a mouthful!” And that is all for this time, except—God bless you, girls! Go to it! And remember, it’s our own men this time!