This extract comes from the first chapter of House of Orphans. Thomas Eklund, a country doctor, is visiting the local orphanage one day in late winter, during an outbreak of sickness. He treats the orphans without charge and is concerned for their welfare, but he doesn’t question the orphanage matron’s view of what is best for these destitute children. Here, Thomas is treating a very sick child, and he is also about to meet Eeva for the first time.
He lifted the child’s head. Her hair was matted and it smelled of mice. It ought to have been cut, but Anna-Liisa didn’t follow the practice of shearing orphans’ hair. He pushed the child’s hair back from her face and brought the salt-spoon to her cracked lips. A little water went in, then rolled away from the corner of her mouth. Anna-Liisa was right, the child needed someone to sit with her. Without such help, she would probably die. But it wasn’t necessary for her to die.
He became aware of movement at the far end of the long room. He turned. A girl was sweeping with a broom that was too long for her. She brushed energetically, in and out of the little beds.
‘What is that girl doing in here?’
‘You know, Doctor Eklund, you told me it was important to keep everything clean -’
‘Yes, but that girl should not be here. She’ll fall sick herself.’
‘But she has already had the sickness. She was one of the first. She recovered in a couple of days. She doesn’t look it, but she’s strong.’
He looked at the girl more closely, and as if she were aware of his interest, she began to brush even more vigorously. She stooped to a dish of water, took a handful and scattered drops onto the boards to settle the dust. She seized her broom again and thrust it under one of the beds. A thin child, but she seemed unusually energetic for an orphan.
‘I haven’t seen her before, have I?’
‘Surely you have. She’s been with us a year or more, since they sent her to us from Helsinki,’ added Anna-Liisa in her significant manner, which often turned out to mean nothing.
An idea struck him.
‘Come here,’ he called to the girl. ‘Yes, you. Put down that broom.’
She propped her broom against the wall, glancing at Anna-Liisa first to be sure she was doing the right thing. She came towards him, wiping her hands on her apron. Grey skirt, rough calico apron and cap, the heavy boots that Anna-Liisa got in bulk at a special price and which never fitted properly. The orphans wrapped rags around their feet like Russian soldiers. She looked just like the rest of them, but he’d known immediately that he hadn’t seen her before. It was the way she moved, which was quick and free, as if she hadn’t learned to walk like an orphan yet.
'That’s right. Come closer. Don’t be afraid.’
But she didn’t look afraid at all. Her skin was pale, her nose and cheekbones sharp. She looked straight at him. Her eyes were pale green and without expression, as if she already knew how to mask herself against intrusion.
‘She can sit here, by the bed, and give water to this child,’ he said to Anna-Liisa. ‘Look,’ he told the girl, ‘This is what you must do.’
He lifted the sick child’s head again. ‘Hold the spoon like this. Touch her lips gently, just here. She will open her mouth. Give her a very small amount of water each time, or she’ll vomit. Can you do that? Are you patient enough?’
The girl nodded.
‘And she’s dirty. Can you change the flannel, and wash her?’
‘They’re all dirty,’ commented the girl. ‘All of them. They all need changing.’
He couldn’t tell if she meant that since all were dirty, there was no point cleaning just one, or if she was telling him that since one was to be cared for, then all should be. But he felt a power in her, as if he had to answer her.
‘I know,’ he said. ‘We’ll do what we can.’
‘They all had their flannels changed this morning,’ said Anna-Liisa defensively. ‘Sirkka is down there boiling them up in the copper. As fast as you wash their bedding, it’s dirty again.’
He nodded, pleased. He had told her last winter to boil the flannels and bedding, and she’d remembered.
‘ She’s crying because it hurts,’ observed the girl suddenly, watching the sick child. ‘It’s her stomach, that’s where the pain grips her. I know what to do.’ And she bent down and began to rub the swollen stomach with a light, circular motion. ‘You rub like this, see, and it warms her. It doesn’t hurt so much then.’
‘Yes, do that too,’ he said. It was true, the child was growing calmer. Her cries sank to a thin moan. It wasn’t the warmth that soothed her, but the girl’s touch.
‘Give her water as often as you can. Keep her clean and rub her like that if it helps. Tomorrow we’ll try a little sugar-water.’
The girl nodded. She knelt beside the little bed, with the salt spoon in her hand.
‘Is there a stool that could be brought here?’ he asked Anna-Liisa. ‘If she’s going to nurse that child, she’ll need to sit by the bed.’
He went around the room, from one bed to the next. The rest of them would do, he thought. They were sick and wretched, but they would survive it. All of them were taking water. They seemed indifferent to each other, staring at the ceiling or curled up in a stupor. The same matted hair, the same crusts of yellow around the eyes, the same yellowish pallor.
‘They’ve had their porridge this morning, those that would take it,’ said Anna-Liisa.
‘Good. I’ll get a nurse sent in. There’s more work than you can manage here. The Board will cover the cost.’
She looked at him gratefully. Maybe she guessed that he would pay for the nurse out of his own pocket, but it was better if nothing was said. Anna-Liisa preferred the idea of the Board’s approval. She liked things to be done in a proper manner. And if you started to think of where your personal duty to these children might lie, where would it end?
It would end in my not visiting them, he thought. It would end in not seeing them at all, to save my fine feelings. Anna-Liisa works with them, eats with them, sleeps with them. She does what she can.
‘And how is Mrs Eklund?’ asked Anna-Liisa respectfully, as she saw him out.
‘She’s perfectly well, thank you,’ he said mechanically, but the words scratched in his mind as he said them, because he knew they were not true. In her angry way his wife was a brave woman. She said nothing to him, but sometimes he knew she was in pain. She wrote long letters to her daughter; their daughter; and she stared at him with challenging eyes if he came into the room while she was writing.
If they’d still slept in the same bed he would have known everything. He’d have smelled the nature of her sickness on her skin and in her sweat as she slept. He’d have seen the signs and changes that he knew she was keeping from him. She’d sent her clothes to be altered, he knew that. She had lost weight, these past months. Tendons stood out on her neck, and her wrists looked big and clumsy as her flesh shrank away.
She slept in the bedroom along the corridor now, in Minna’s old room. Sometimes at night he woke and went to his bedroom door and opened it silently, to stare down the corridor towards the room where Johanna now slept. He thought he heard her walking to and fro, to and fro. But the door of Minna’s old room stayed shut.
‘Did you sleep well, my dear?’ he asked in the morning.
‘Of course. Haven’t I always slept well?’
‘You’d tell me if there was anything wrong?’
‘Of course. Why ever shouldn’t I? You’re a doctor, after all,’ she said with cold emphasis on the word ‘doctor’.
Why had he called her ‘my dear’? No wonder she looked at him like that. She was a brave woman. She had never cried out when Minna was born. He’d wanted her to cry out, to ease her suffering, but she wouldn’t. He’d never forgotten the way she glared at him when he came to stand at the bedside, impotent.
‘ Yes, she’s well,’ he said to Anna-Liisa. ‘I’ll call again tomorrow morning. That girl you’ve got - the girl who was sweeping - what’s her name?’
‘Give her a cup of coffee tonight, with plenty of sugar. She’ll need to keep awake. If that little one lasts the night, then she has a chance.’
‘They have no stamina,’ said Anna-Liisa.
‘They have no mothers,’ he said. ‘Excuse me, Anna-Liisa, that isn’t a criticism of you.’
‘We do what we can.’
‘I know. And if you’re worried tonight, send for me again.’