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Reviewer Francene Cosman won the Queen’s Platinum Jubilee Medal and is the author of Nurse! A Memoir, which documents her career as a nurse in Atlantic Canada.

Spit and Polish by DA Brown is a work of fiction and fact, based on the experience of student nursing in the 1940s. Meticulous research into the treatment of patients with tuberculosis provides the reader with the gruesome details about the ravages of disease. Several chapters are introduced with excerpts from Florence Nightingale’s classic book Nightingale Notes on Nursing. This it is an additional bonus as it provides a moral and philosophical look back at how nursing began. There are important historic references about Armistice Day and the Nuremburg trials.

I was pulled into the push and pull of the story from the beginning pages and could not put the book down. The setting of the story was decades earlier than my own nursing education, and what a difference a decade or two made.

This is a coming-of-age story about Ruth, a young woman desperate to have a different life than that expected of her. Is there some way for her to have more in her life? Education? Escape small town living and poor prospects? Yes. The answer is nursing.

Nursing in the 1940s was riddled with rules, male dominance of the medical profession, and back-breaking labour. With a domineering minister father, and an ever-pregnant mother in an age before birth control, Ruth is expected to stay at home, help raise her siblings, cook, clean, work hard, and keep everyone happy – except herself. From those pressures, our young woman convinces her father to allow her to enter the school of nursing in Kingston, Ont. His formidable control is replaced by the rigorous demands of the hospital environment, and so her journey begins. Her doubts start almost the moment she walks through the doors of the nursing school. Her controlling father threads through this story from beginning to end. Ruth develops friendships and the reader observes her maturing attitude as her two closest friends falter with behaviour that can put their careers on the chopping block.

Follow along the rocky road of her attempts to do everything right, while the opposite occurs. “You are slow with your assigned duties, and you are risking making serious mistakes,” she is told. The hammer drops on her dreams as challenges ensue and the director of nursing decides that Ruth is not ready to be a student. Despite good marks, her skills are not up to the task. She is told to leave her place in the school and to transfer to the nearby veteran’s hospital on the TB ward, where she will be doing more grunge work as a nursing assistant. Her supportive friends are left behind as she makes the move. Can she make it through this next round?

‘Slipping into evil ways’

She is assigned the mentor from hell who is intent on getting a doctor to date and marry, thus entangling Ruth to be forever told to stay out of her way. A deliberate attempt to sabotage Ruth ensues. Her inability to defend herself shapes the flow of this story as she is beset on all sides with fear of failure, fear of being forced home to her controlling father who impresses on her that “a dutiful daughter serves her family” and fear of accepting a suitor who needs a farm wife.

I sympathized with her inability to see her way forward, but felt conflicted at times when I wanted Ruth to stand up for herself. One of her challenges is to learn to speak her truth and find her strength. Can she do that? Ruth is prone to jumping in with both feet before her skills are developed. The inevitable reprimands follow. Can she change her ways? It is a slow struggle to believe in herself.

The descriptions about tuberculosis treatment are spelled out in detail. This is what nurses dealt with: hemorrhages, spit, infections, dressings, odours, death. Gruesome to be sure and not for a queasy reader. The harsh reality is tempered by jokes between the men, mild flirtations with their nurses whose own health is threatened, and the grim camaraderie of facing death brought on by disease and the barbaric treatments in a time before antibiotics. Ruth experiences it all, as she finds a sense of happiness in doing the job right and providing comfort when it is needed most.

A surprise visit from her father results in him accusing her of “slipping into evil ways.” She has six months to prove herself or be forced to return home.

The story moves along with good pacing and excellent telling, as it fuels the readers imagination. Spit and Polish is of specific interest to anyone interested in nursing. Its wider readership is with folks interested in history. I’m ready for a continuing book about Ruth and her career.

You can read our feature on Francene Cosman’s book Nurse! A Memoir here.