Hospital of the Queen's Heart by Ileana, Princess of Romania
In the fall of 1946, Dr. Puscariu, Badillo and I were invited to visit the school of medicine at the University of Cluj.
Cluj is a beautiful little university town in northwest Transylvania, with a long and turbulent history. For centuries it was a stronghold of the Hungarians, although the rural population has always been largely Romanian, and many Romanians matriculated at the University even in the days before the liberation of Transylvania from the Hungarian yoke and its consequent union with Romania. After World War I the University developed very rapidly, and the school of medicine especially enjoyed a fine reputation, continuing as it did in the tradition of the school of Vienna, and adapting to its curriculum as well many of the French and American ideas of medicine. Its doctors and its clinics were famed all over the country, rivaling closely the excellent schools and clinics of Bucharest and Jassy.
For me, it was a great distinction to be invited to visit and inspect the school and to watch operations performed by famous surgeons in the different clinics. I stayed at the home of the Dean and his wife, a comfortable, spacious house set closely in protecting shrubbery on a hill overlooking the town. I will always remember with affection the lovely, quiet white room I occupied, with its wide picture window facing the mountains and the sunset, from which I looked down on the beautiful old town in the valley below, with its quaint, gabled roofs and winding streets, its church steeples rising above them. Clustering together under beech trees now turning russet and purple with autumn, I could see the gray stone and faded pink brick buildings of the University. From up here on the hill, the scars and still open wounds of war did not show.
Cluj suffered enormously during the Second World War when, for a time, it passed back into the hands of the Hungarians. War had been waged in the countryside all around, and consequently much of the town had been destroyed. There was ruin everywhere—some of the rubble had been cleared away, but much of it still lay where it had fallen. Like a spiritual backwash of the dreadful devastation and ravage that the city had undergone, everyone seemed to be living under great moral stress. It was like the slow and difficult recovery from a severe illness.
Although at the end of 1944 Cluj was taken back into Romania, this had been done in conjunction with the Russians who had invaded us and were occupying the country, although there was still, ostensibly, a Romanian government. The Russians, of course, had imposed their own regime upon the town. The Hungarian minority seized upon this situation as their long-awaited chance for national independence and had promptly joined the Communist party. As a result, Cluj was full of dissenting factions and very strong currents of political feeling. The National Hungarian and Communist parties were opposed to the Romanian Nationalist and Royalist parties. There were all sorts of underground movements, all sorts of shifting loyalties, resentments, suspicions and intrigues. There was tension, a sense of insecurity, distrust and oppressiveness everywhere, and feeling ran high.
The hospitals had been sacked during the battles in the town, and many of the university buildings had been severely damaged by shelling and by fire. Of course there was a desperate housing shortage, for no building had yet been done, and the students were hard put to it to find living quarters. There was the continual nagging strain of want, anxiety and apprehensiveness wherever I went. But at the same time, I became conscious of an extraordinary spirit of rebirth in the town. At the University there was a tremendous impulse toward bringing life back to normal, to its former state of well-being and intellectual richness. There was a stimulus to carry on as before, to study, to develop research, to renew and continue the activities of clinics and hospitals. It was as if the inviolate good in the city was reviving to overcome the remaining evil residue there and to restore its centuries'-old tranquil dignity.
I visited all the clinics of general surgery in the medical college and many of the other clinics as well. Everywhere I was aware of this tenacious, upthrusting spirit of determination to make the best of things as they were, and to better them. At the same time, I was appalled at the pitiable lack to be seen in the hospitals—lack of linen, lack of the most essential medicines, lack of decent food, lack of nurses. Everywhere, people seemed to be doing double their work with a minimum of material. There were no resources. Sponges and bandages were used over and over again, washed and sterilized until they fell apart. Dressings could not be changed frequently enough, and postoperative blood and discharge escaped from wounds into the beds which could not be protected since there were no rubber sheets, nor changed since there was lamentably insufficient linen, and laundry facilities were makeshift and inadequate.
Patients, after operations, could not be given extra pillows or blankets, nor any sort of comfort, because there were none to give. There were not enough pillows to go round. Some of the patients rolled up their own coats and put them under their heads. Food was restricted; university personnel and patients alike ate the least that they could get along on. Many patients, to my eyes, were frankly suffering from shock and lack of nourishment. Blankets were thin and worn; they were never clean. Fuel in the city was scanty and had to be used sparingly, so hospital rooms were never warm enough.
Despite all these deficiencies, the hospitals were full, and the medical school was enrolled to its capacity with students of both sexes and all ages from all over the country. Now that the war was over there seemed to be a gigantic urge to learn, to make up for the lost time and lost opportunities that the war years had swallowed up. Here and there amongst the medical students I was surprised to see monks and nuns, their black habits strange in those classroom surroundings. They told me that they intended to return to their various monasteries and convents when they had finished their courses, to organize hospitals and dispensaries in their villages for the care of the poor. They were all eager to share in the rehabilitation of the devastated countryside and the war-impoverished people.
I attended classes. I was impressed not only by the excellent teaching methods and lectures of the professors, but by the fine discipline in the operating theaters. I sat with the students who crowded the amphitheaters, and with them I was absorbed by the detailed demonstrations of surgical techniques that were given us.
On the other hand, I was appalled by the casual postoperative care given the patients. I quickly learned, however, that this was not the fault of the hospital administration; it was due simply to the over-all shortage of everything necessary to good essential nursing. There was another reason, too, for this lack of adequate postoperative care to supplement the extremely skilled surgery: the Communist regime did not permit nuns to serve as nurses in the wards, and there was an acute shortage of civilian nurses.
To my intense pride and great joy I was invited not only to watch operations, but to take part in several as assistant to the professor-surgeon. I cannot describe to you the sense of worth this recognition gave me, the lift to my self-confidence. I felt recompensed for all the hard work I had done in the hospital at Bran, and for the endless, unnoticed spending of myself in the service of those who needed us there.
It seemed to me that this invitation to assist in the operating theater was of much greater importance than merely the honor it conferred on me. Nurses in Romania had not yet fully achieved recognition as an important part of the medical profession. We were still pretty much relegated to the wards. By proving that I, who had had no more medical education than any other average nurse, was capable of working efficiently and in harmony with the best surgeons in the country, I felt that I was demonstrating that other women, too, were equally capable of giving the same much-needed skilled assistance at the operating table.
At first, in the Cluj operating theater, I felt terribly shy and anxious. The technique of each of the surgeons differed somewhat from the one I had become used to with Dr. Puscariu. I was nervous with the strain of adapting myself quickly to these new and various methods, and I was painfully self-conscious, for I had to perform under the watchful eyes of throngs of curious and critical students, each one—or so I thought—ready to disparage me and perhaps scornfully tear apart my way of working. Not because I was a woman—oh, no, they had long since accepted women in the clinics quite naturally; but because I was a princess and therefore could not possibly be anything but a dilettante bent upon getting attention, demanding an audience and applause.
I tried to forget this antagonism, which I have found in many places, and to lose myself in the work at hand. I managed to get through in decent fashion.
All my trepidation seemed to be before an operation started. I almost died of fright and consciousness of myself and my shortcomings while we were assembling in the operating theater, and the patient was being wheeled in and made ready. I stayed in the background as much as possible; I was thankful for the anonymity of my enveloping, disguising, sterile gown and mask. But as soon as the operation began, and the attention and minds of our little white-gowned group, as well as those of the tiers of watching students, centered upon the unconscious patient lying in our midst, I forgot myself and my fears. We became one purposeful and orderly mind, all of us with one intent—the success of our united efforts for the mending and the healing of this human being before us.
I have never realized so vividly as in the Cluj operating theater the power that is generated by several identically directed, undeviating minds. As we individually gave our concentrated best to our single purpose, I felt myself drawing almost supernormal awareness and an intense, increased ability which I certainly had never known before, from a limitless reservoir of force and knowledge we had somehow tapped. That centralized power which we shared transcended the surgeon's demonstration of intellectual skill and knowledge. His was the hand, and behind that hand was our focused sustaining intent. It was union of more than mind. To me, during those operations, our group was literally one in spirit, sharply defined, almost awesome. It was very good to feel.
I suddenly understood as in a flash of light that this, indeed, is the relation of the whole human race, one to another, although few of us ever get past our self-conscious physical and intellectual barriers, so as to see and feel for ourselves the elemental fact of our oneness in God, Who is Spirit, and our conjoined existence.
It was in the forlorn wards in Cluj that I found Rosa, who was to become the favorite patient of Spitalul Inima Reginei. Hers was a strange case of congenital deformity which was corrected by Dr. Puscariu's imaginative, courageous surgery. She became the pet and the friend of the entire hospital, personnel and patients alike.
During one of my tours of inspection of the Cluj hospitals, the doctors had brought me to her.
"Rosa is one of the horrible cases that appear sometimes," one of them said to me in preliminary explanation. "There is nothing we can do for her; we have no materials or facilities for experimental surgery, nor the exceedingly necessary—in her case—postoperative care. We've discussed a few things that might be tried, but . . ." He shrugged helplessly and hopelessly, taking for granted my understanding of their hindering lack of resources.
"I keep her here to show to my students, that's all," he went on. "Someday soon I shall have to pack her up and send her back home, just as she came."
We had walked down the corridor and into the long ward as he talked, and we approached the bed. There was instinctive friendship between Rosa and me from the moment we met. Wide, brown eyes looked up at me in a friendly way from a small, plain, peaked face. Her heavy brown hair was braided tightly into two plaits the size of my forearm, and a white cotton kerchief was tied smoothly over her head.
Those kerchiefs on women hospital bed-patients are unknown here in America. In Romania they are always used to keep the women's hair tidy and out of things. Perhaps it is because we do not have short hair there, as here, for to a peasant woman shorn locks are an indignity. Her hair is her pride.
Rosa was about twenty-two, and she had been born without a bladder. Only the posterior wall was present. The aperture on her body was continually damp and raw, and the orifices of the two ureters connecting the nonexistent bladder to the kidneys were plainly visible.
It was a miracle that the girl had lived so long, for I was told that in such cases kidney infection takes place fairly early in childhood, and death soon follows. But Rosa, with her sturdy peasant constitution, had withstood her condition.
What was her end to be, I wondered to myself as I looked down at her, listening to the doctor's speaking. Why had she been born, this extraordinary lovable girl, to be so wasted? Why did such pitiable things happen in life, over and over, apparently without reason or justice?
I smiled at her, spoke a few words and turned away with the doctors, hiding a suddenly aching heart under a matter-of-fact facade of professional interest.
Later that day I talked with Puscariu and Badillo. Was there nothing that we could do in our little hospital? Even there we had at our disposal more to do with than had any of these depleted hospitals, here in this famous, once splendidly equipped school of medicine. What did they think?
An ambitious glow came into Puscariu's eyes. "What if we could operate on her! Take me to see her, Domnitza Ileana."
So I visited Rosa again, this time with Dr. Puscariu and Badillo. Her eyes lit up when she saw me come into the ward, and she and the mild-mannered Dr. Puscariu immediately became friends, as we had done that morning. She was shy with Badillo. After the examination, when we were outside, Puscariu said:
"Shall we ask if we can take her back with us?"
I was overjoyed. The doctors seemed glad to give their permission; I think they were relieved at this solution to the problem which they themselves were helpless to solve.
So back I went to see her for the third time, and I told her our plan. She was delighted, for she had slowly come to realize that nothing could be done for her here, and she dreaded being sent back home as incapacitated and as ill as when she came.
Now the permission of her parents must be obtained, and this was pathetically easy to do. They were very poor, simple peasant folk who lived in a village outside Cluj, and this invalid daughter of theirs, while they loved her, was a liability and a burden to them in these hard days of hunger and need. They could not take care of her.
So we took Rosa back with us to Bran, and her story is part of the story of Spitalul Inima Reginei.
But I did not spend those days in Cluj visiting only the clinics and hospitals. I went to see other institutions as well. There were two large preparatory schools in Cluj, one built in honor of my mother, the Scoala Regina Maria, and the other bearing my name, the Scoala Principesea Beam..
I had seen those beautiful schools built, I had attended their openings and their ceremonies of blessing. I had known them at their best and their most promising, for they had introduced highly advanced, almost experimental educational methods, and their equipment was modern and fine. My heart was broken at what I saw.
Both schools had been sacked during the war. There had been fighting in the streets around them, and the sturdy brick walls of the buildings had been ideal protection for snipers. The children were housed, as before, in their large, well-built dormitories, but those, too, had been badly damaged inside. They had recently been repaired, just enough for students to live in them. The brick outside walls still stood firmly, but they were scarred and battered from machine gun and rifle fire, and all the windows had been broken. There was no window glass in the city to repair them, so some had been boarded up and the others left open to the weather. All the furniture had long since disappeared, and the children's beds were merely wooden boards covered with straw, with wretched, soiled and tattered bedding thrown over them.
The classrooms had been repaired and were well lighted, but there were not enough benches and chairs to go around. Many of the students sat on the floor with their books and papers balanced on their knees, their eyes on the teachers and the blackboards. They were too intent to notice or to care that no fresh paint had been put over the hastily done, rough repairs, and that no attempt had been made to contrive pleasant classroom surroundings. These were superficial things, they were incidental to the primary concern of the present moment.
The feeling here, too, was one of simple, matter-of-fact resolution that however poor they were and however difficult the handicaps, they were going to learn. These young people received me with a joyous demonstration of welcome and an affectionate loyalty that went deep into my heart. It was the same enthusiasm as in the old Royalist days. They seemed to have no fear at all of consequences from the Communists. There were speeches, there was a bouquet, not roses or great chrysanthemums as might have been once, but wild flowers quickly gathered and tied together with a scavenged bit of ribbon and love. They even managed to arrange an entertainment for me. There was a well-acted little play, they sang their national songs and wore their national dress. They showed me with pride what they had been able to accomplish in their studies despite lack of materials and textbooks, and they displayed the furniture and tools that they had salvaged from the ruin, had repaired themselves, and were using. There were no complaints. They told me very earnestly about the great things they intended to do in the future, and, wherever I went, I was offered lists of the things they needed most, with pleas that I try to obtain these things for them from the government in Bucharest. I accepted the lists and promised to do the best I could, but my heart was heavy with doubt.
Alas! there was little I could do for these boys and girls. I sat with them, I talked and listened, I shared with them what they had, I bolstered their courage, I admired what they had accomplished, and I told them over and over that I, too, believed in a better future. They needed so much, and this was all I had to give them.
Through my work with the war wounded, I had many friends among my former patients who had lost their sight. Some of these had been sent to an institution in Cluj which, before the war, had been a model center for the blind. I went to see them.
At the time of the occupation of Cluj by the Hungarians, the blind patients had been evacuated to different outlying villages and towns. The director of the institution, a man who was one of the country's great specialists in the care and training of the blind, went with them. When the war was over, the government brought them back. They found the building badly damaged and already occupied, for on one floor was a Hungarian old people's home, and on another was established the headquarters of a much-detested Communist organization, the Anti-Fascist Women's League. The Communist government promised faithfully, again and again, to repair the building and to restore it to the blind, but only essential repairs were ever made, and the other two institutions continued to occupy their cramped quarters in the once roomy and comfortable building.
To my horror and great indignation, the blind officers and soldiers were banished to the garret, and the war‑blinded children to the basement. The most tragic of all were the children. There were thirty of them, crowded together into one basement room. Their cots were placed so close together that there was no room for the children to move between them. There was very dirty, scanty linen on the unmade beds, and meager blankets. The floor was cement and cold. Rain had leaked in around the small, high windows and had run down the cement walls in long, ugly, discolored stains. Only one small, immensely cluttered table was in the room, and there were no chairs at all. I shall never forget the look of utter misery on the children's poor, pinched, little faces. They were undernourished and insufficiently clothed. They had no shoes, so when the weather was bad and they could not go out-of-doors to play in their yard, they had to stay cooped up in this one room with nothing to occupy them, no studies, few playthings and almost no supervision. No effort had been made to improve their condition, or to make life more endurable for them. They had been shunted here at the end of the war to get them out of the way, and then the world had turned its back on them.
The director was at his wits' end. He had no power of authority to change things, nor means of his own to improve them. He was in despair at the authorities' repeated refusal to do anything, and he had finally run out of hope that they ever would. There were two nurses, ignorant, simple, kind women who ineffectually did the best they could against hopeless odds.
I shall always remember the expression on the face of one of the children as the director drew him toward me and showed me the terrible state of his clothes. He wore nothing under them; they were long since outgrown, not nearly warm enough, ragged, dirty. The little boy's face mirrored the most profound disgust and disdain that I have ever seen on a human being. I felt ashamed of the decent clothes I was wearing; I felt ashamed of the good meal I had eaten that day.
When I returned to Bucharest I went to the authorities there to see what I could do about improving the situation of these unfortunate children. The reply to my plea was the cynical comment that it would be much better if they died; children who are blind are of no use to the future state. Their case was hopeless and the government saw no point in wasting time and money doing anything for them. All my pleadings were fruitless. It was only by means of a collection which I took up among my friends that I was able to relieve a fraction of the sufferings and privations of these children who lived in misery and darkness.
Wherever I went in Cluj I saw crying need and destitution. As I walked from hospital ward to hospital ward, despair and more and more sorrow seemed to fill my heart. I felt complete hopelessness coming over me, weighing me down—so much bitter poverty, so much sorrow, so much human suffering, that branch of the rampant weed, Evil. Indeed, all of us were part of it ourselves in one degree or another, and there was nothing that anyone could do to relieve it.
Those three days I spent in the once beautiful and happy town of Cluj were both heartening and terrible. Certainly I have never forgotten their impact upon me. I saw Cluj from many aspects. I assisted at a variety of operations in the theaters. I walked miles and miles of hospital corridors and wards. I visited the battered, rallying schools, and the wretched children in that dreary institution for the blind. I wandered, a tooth of misery in my heart, through parks which I had once seen gracious with wide, green lawns and well-kept flower beds, now neglected, scarred with shell holes, grown high and ragged with weeds and yellow dry grass. I sorrowed over the desolation and the widespread dearth. But rising above it all was my admiration for these intrepid people of Cluj who had no time for apathy or lamenting, and who did not know the meaning of the word defeat. They were unconquerable, and I saw reiterated in their courageous, outer misery and inner dedication to a common goal the fact that spirit is mightier than matter and circumstance, and that ideas and an ideal can carry a person or a community through catastrophe and suffering, defeat and deepest sorrow.
What Cluj is like today, I do not know, but I carry the staunch conviction for it that I carry for all the other devastated, conquered towns and cities I know, that its spirit is still alive and ascendent even though everything else may be wreckage and ashes.