Ruth entered her office and placed her brown crocodile handbag next to the chaise by the window, then removed her feathered hat and hung it on the brass rack in the corner. She smoothed her dark hair, tucking a few loose strands back into her tight chignon, and took a quick glance in the looking glass. While given an uncomfortable amount of attention in college for inheriting her mother’s striking good looks, she hated to fuss with her appearance; still, she was in many ways an ambassador for the hospital and expected to look the part. Thankfully her mother’s dressmaker always sent her what she needed to stay abreast of fashion.
She had arrived early, as usual, so she would have time to make her tour of the wards before her day officially began. Without consulting her calendar or looking at the pile of files on her desk, she set off to do the part of her job that she cherished most. She typically started at the farthest ward, in continuous care. This ward housed men and women assumed to be “lifers” at the hospital, the truly hopeless cases in the eyes of most doctors and even the patients’ own families. Ruth didn’t think of them that way, though. With the exception of the criminally insane, who occupied a locked ward at a prison hospital on Blackwell’s Island, adjacent to the old Octagon （made infamous by Nellie Bly’s damning exposé）， Ruth held out hope that all the men and women could be cured, at least enough to safely return home again. This required the most comprehensive treatment program: cutting-edge medicine combined with compassionate care for all.
As much as she wished empathy and fresh air could be enough, she had seen firsthand that patients needed more to cure their suffering. Harry had enjoyed all the fresh air he desired at the pastoral Payne Whitney. He had seemed to find respite in the woodshop, making birdhouses. And, because Ruth spent a portion of nearly every day by his side and consulting with his doctors, she knew that they were as compassionate as possible. Still, none of that had stopped him from fashioning a noose out of his bedsheets. No, Ruth knew that there had to be more to treatment. And she spent every day trying to ferret out the methods that might work best.
She walked speedily and arrived at the continuous care quadrangle in less than two minutes—a feat, as it was several buildings away. She went first to the indigent dormitories. Emeraldine was one of the few hospitals large enough to accommodate every level of need. For those with means, they of course offered private rooms, but Ruth took great pride that even the quarters for the poorest patients held only a maximum of sixteen people, unlike most other public hospitals that were lined wall-to-wall with beds.
Still, as she entered the dorm, she could hardly hear herself think over the screaming, singing, and babbling of its inhabitants; she wondered how deafening the noise must be in those other hospitals. It alone would be enough to drive a person mad.
“Miss Emeraldine—you met my pet parrot?” An older woman rushed toward her, smiling broadly as she pointed to the pillowcase tied on her shoulder.
“Why, no, Miss Nellie. What is his name?” Ruth obliged kindly, bringing her face closer to inspect the imaginary bird.
“He?” Nellie cackled. “He! This is a women’s ward. You a moron or somethin’？” Nellie suddenly looked enraged as she tried to scratch at Ruth’s face with her long fingernails.
Ruth ducked Nellie’s swing as a nurse and two orderlies came to her rescue. “I’m fine,” she said firmly, while grabbing Nellie’s hands and holding them tightly in her own. “Nellie and I will just go sit on her bed and wait for you to get the straitjacket so she can calm down a bit.”
“Not the straitjacket! It will kill my parrot! You bitch! Ruth, you bitch!” Nellie shrieked and flailed as Ruth held her hands even tighter, and the other women in the room began to laugh and cheer.
Ruth had long ago convinced Mr. Hayden to eliminate the use of cage-like “cribs” and leather-belted chairs with hoods to constrain violent psychotics. At Emeraldine, when cases required restraints, they used the gentler straitjacket form.
“Nellie,” Ruth said in a loud and firm tone. She tightened her grip on the woman’s writhing arms. “We will put your pet on your bed, right next to you. If you can get yourself under control before they return with the jacket, perhaps you won’t have to put it on. But, right now, you clearly need some help to calm down. Ladies”—she looked around sternly at the other women in the room—“you all have moments when you need help controlling yourselves, so I suggest you mind your manners and give Miss Nellie a moment to collect herself.”