Sister Anne Resigns (1931) by Josephine Elder

Book review by George Simmers:

Josephine Elder is a pseudonym of Dr Olive Potter (1895 – 1988), one of the first female doctors to be trained at the London Hospital in Whitechapel. When she became a G.P. In Surrey, patients were slow in coming, so she started writing school stories for girls under the pseudonym of Josephine Elder. Later she wrote novels for adults, mostly with a medical setting. Sister Anne Resigns was the first of these, and originally published as by Margaret Potter. Later adult novels used the Josephine Elder name, though, and Greyladies have used it for this reprint. (If you don’t know Greyladies, take a look at their website. They specialise in the  novels aimed at grown-ups by women famous as children’s writers. Noel Streatfield and Richmal Crompton are included.)

This book demonstrates some of the qualities that made the author a successful writer for girls. The language is clear and direct, the narrative moves swiftly, and the characters are clearly labelled. As a novel, it’s not  very sophisticated, but I enjoyed it a lot, mostly because of its picture of hospital life in the twenties.

The book begins with Anne Lee’s father telling her she must leave school at sixteen, because girls don’t need education. Her university hopes are dashed, and she spends five aimless years at home until her father dies suddenly, leaving the family in the financial lurch. Anne will need to get a job, but seems qualified for nothing except the grim roles of governess or companion to an old lady. When a relative suggests that she should become a nurse, this seems the least bad option. Without any particular idealism she begins her training at a teaching hospital in the east End of London.

As a probationer she is rigidly controlled by sisters and staff nurses, kept constantly busy in the ward, and bullied into the highest standards of efficiency and hygiene. A staff-nurse called Nurse Paley – ‘a thin, hard-eyed young woman’ (20) – resents Ann’s popularity and makes trouble for her. She’s the first of the book’s embittered nurses, the women who have missed their chance of romance and marriage, and are spiteful to younger women with better prospects.

It’s not just on the wards that nurses’ lives are regulated. The Nurses’ home is often compared to a convent (because of its pettiness and spite) and nurses are expected to conform to a model of absolute respectability. Contact with men is strongly discouraged, and there is a particular taboo on mixing socially with doctors. We are told that Ann

crossed the court to the nurses’ Home, averting her eyes, according to rule, from the strolling pairs of students and Resident Medical Officers who met and passed her.

Soon, however, she makes friends with an attractive young doctor, but when they go out for a bus ride together one afternoon she is spotted and reported to Matron.

I couldn’t help it, said Ann lamely, if he sat down next to me on the bus.

‘A right-minded nurse,’ Matron snapped, ‘would have instantly made an excuse to leave the bus.’

Ann is labelled a flirt, and moved to the gynaecological ward, where she is unlikely to meet men. This incident blows over and she assumes it is forgotten, but years later, when she is a candidate for promotion to Sister she is passed over for the job, and understands that it is because of rumours about her her reputation.

She applies for a Sister’s post elsewhere, and gets a job replacing a woman who has run her ward very sloppily. She is faced with the task of turning the ward around, and finds herself becoming as fearsome as  the martinets who had terrorised her when she was a probationer.  Eventually her ward gains an excellent reputation – which once more brings her up against the jealousies of the Sisters who are thwarted  spinsters. This is especially so when a young doctor begins to call in to her lounge to chat.

The relationship between nurses and doctors is one of the most interesting features of this book. At the start, nurses are expected to be subservient females, always respectful of authority, while doctors -especially surgeons – expect to be served without question. There is a strict gender divide between the two professions, though Ann cannot understand ‘why it was more feminine to wash bedpans and dirty feet than to write prescriptions and listen through a stethoscope she never could see.’ By the end of the book, there is a woman doctor in the hospital, and a subtext of the novel is that things have improved greatly since nineteenth-century days when surgeons were flamboyant figures who operated wearing old frock coats:

Filthy! Filthy isn’t the word! The more begrimed they were with blood and pus, the more they stank, the more the men liked it. It showed they were young and inexperienced to have  a clean coat.

That world has gone, and has been replaced by the rigid discipline of cleanliness and asepsis, but nurses are generally not expected to think for themselves. Josephine Elder makes it very clear that nurses can be more than drudges, and that the professions of doctor and nurse are complementary. There are cases that doctors despair of who are brought through by careful nursing. The young doctor who visits Ann’s lounge knows that he can learn from her, just as she can learn from doctors.

She is very fond of this young doctor, and they become engaged, but she is uneasy in that she is too much like a mother-figure to him. She breaks it off, and then gets a proposal from another man, not a doctor but a manly farmer. He seems to be the ideal husband for her, but if she marries she will have to give up her nursing career. It’s not exactly a spoiler to tell you the choice she makes, since it’s in the title of the book:  Sister Anne Resigns.

So this book, by a pioneering woman doctor, about a woman making a career for herself, has been heading towards the conventional marriage ending demanded by the genre (and on marriage Anne will give up her career). Even so, Josephine Elder raises questions about the nature of nursing, and about gender relations in medicine, that would have been well worth asking in 1931.