‘I Shall be Ready’: The Life and Nursing Career of Anne Larkin (1875 – 1946)

Gavin Wilk

 

On the evening of Saturday 29 July 1899 at Kings Park State Hospital in Long Island, New York, twenty-two student nurses from the hospital’s training school were in a celebratory mood.ⁱ For the previous two years, these nurses had attended lectures, partaken in clinical instruction, performed recitations and completed practical demonstrations, all of which centred on learning the subjects of anatomy, physiology, hygiene, dietetics, administration of medicine, hydrotherapy, massage, and care of the insane.ⁱⁱ Now, after successfully completing their final examinations, it was time to graduate and to listen to ‘an enjoyable address … delivered by Dr. Truman J. Backus, president of the board of managers’.ⁱⁱⁱ Among these newly qualified nurses was Anne Larkin, who only five years earlier had arrived in the US from Ireland. Born in Coolycasey, county Clare in September 1875 to Nora and Patrick Larkin, she had trained as a teacher at St. Mary’s Convent School in Limerick city. In 1894, Larkin set her sights on the United States and on 27 September, boarded the steamship Southwark at Queenstown, in county Cork bound for Philadelphia. ^iv After a nine-day crossing, Larkin disembarked on the city’s Washington Avenue waterfront pier and subsequently headed northward, settling in Brooklyn, New York.^v Within three years, she began a nursing career, enrolling in the training school at Kings Park State Hospital.^vi This decision made at around the age of twenty two was set amidst a crossroads of perceived immigrant social stereotypes and new social perspectives. Although young Irish women were still referred to as ‘rosy cheeked’ in the press, newer perspectives were slowly developing.^vii And as Larkin would soon see for herself, society was ‘just beginning to know and appreciate the trained nurse.’^viii

As will be described over the following pages, Larkin’s nursing career would be far from stereotypical. The early twentieth century in the US was defined by the arrival of European immigrants seeking new beginnings. Larkin, who was only a few years removed from her own emigration from Ireland, would work closely with these newcomers at the hospital in Ellis Island and in the local ethnic communities of New York City. Embracing the role of a public health nurse for the larger part of her career brought Larkin into touch with disadvantaged individuals and communities in the local and national spheres. During the First World War, she would expand her reach to a transnational dynamic, while serving with the American Red Cross (ARC) in Italy. ‘The modern public health nurse’ as described by Elizabeth Stringer in a 1914 article for the American Journal of Nursing ‘must be a sort of general practitioner, who enters into the whole life of her patient and her community as a guide, philosopher and friend.’^ix The lives and careers of nurses like Larkin, who framed their career around this ethos, are still emerging in the historical record. The recent study by Michelle Hehman and Arlene Keeling, which offers important details about the nurses who worked at Ellis Island has opened an important window into the ‘enduring nature of … immigration, public health, and the role of nurses in society.’^x Much more though has to be explored when broadening this conversation to a transnational scope. The role of Larkin and the at least 100 other ARC female volunteers who participated in the Italian theatre during the First World War is an experience that has still not been properly assessed. According to Daniela Rossini, the ‘women’s contribution to the ARC campaign in Italy was crucial, but much of the necessary historical research into it remains to be done.’^xi This article intends to provide a glimpse into one such nurse whose time in Italy and overall nursing career has been overlooked.

In the immediate years after graduation from training school, Larkin worked as a private nurse.^xii Equipped with a broad array of acquired knowledge and hands-on training, she would have carried out directions from physicians and cared for patients seven days a week, twenty four hours a day.^xiii On 25 April 1902, Larkin became a naturalised US citizen.^xiv By this time, she had returned to Kings Park where she worked in the Hospital, which cared mainly for patients diagnosed as ‘insane’. She would remain here through to October 1904.^xv

Upon leaving Kings Park, Larkin nursed at Ellis Island Immigrant Hospital.^xvi Only two years earlier, the General Hospital Building on the grounds of the island had opened for the care of immigrants. For a nurse to even be considered for a position here, a candidate had to be between the ages of twenty six and thirty eight, unmarried, and a graduate from a training school. And as noted by Hehman and Keeling, ‘the harsh reality of hospital nursing at the time … challenged a woman’s strength of character almost as much as the strength of her body.’^xvii Working at the island’s immigrant hospital was indeed an all-encompassing job. Required to live on-site and work seven days a week, the only proper break in every weekly shift was a half day off, and this was not always guaranteed, considering the small number of nurses who cared for nearly 7,000 patients every year.^xviii

With the constant flow of immigrant patients, logistical challenges were ever present. One of the most problematic issues centred on caring for patients with contagious diseases.^xix Adequate space did not exist on the grounds to care for these patients, and many were transferred to outlying hospitals in the vicinity. For example, in July 1908, after the North German Lloyd steamship Barbarossa arrived in New York, it was discovered that a child was afflicted with smallpox. Ninety two passengers who shared the same steerage compartment as the child were transferred to the quarantine station at adjacent Hoffman Island. The ill child was in turn sent to Kingston Avenue Hospital in Brooklyn which specialised in contagious diseases.^xx

In about the same year as this incident, Larkin herself moved to Kingston Avenue Hospital and would remain there until around 1912.^xxi Working in a facility that cared for patients with highly transmissible infections posed constant risks. In July 1911, a dance held in the Hospital for doctors and nurses of both Kingston Avenue and the neighbouring Kings County Hospital was interrupted during one intermission: ‘while the doctors and nurses were chatting in the corridors a smallpox patient was brought in on a stretcher and carried through the hall to a room which he was assigned’. Although ‘practically every doctor and nurse at the dance had been vaccinated for smallpox’, it was decided ‘to vaccinate everybody again’. The ‘dancing continued’ and ‘an enjoyable evening’ was had for all, but one intern suffered ‘a serious condition as a result of his vaccination’ in the form of blood poisoning.^xxii Thankfully the intern recovered, but any further social events were viewed with trepidation. As noted sarcastically by the press, it was said ‘at the Kings County Hospital that hereafter invitations to dances or other entertainments at the Contagious Diseases Hospital will be ignored.’^xxiii

The efforts on the part of officials to stem a smallpox outbreak at this dance was a microcosm of an effort in New York City to implement careful and energetic public health measures. Larkin’s career, too, continued to evolve and she transitioned to become a District Health nurse. Her experiences at both Ellis Island and Kingston Avenue Hospital set the foundation for the diverse and challenging work that a District Nurse would need. In 1914, Florence Gibbs, a nurse from Chicago described succinctly in the American Journal of Nursing what the ‘well-defined and indispensable qualities’ of a District Nurse were:

‘… she should be well trained professionally; she should be strong and well, physically; she should have a splendid mentality; and, above all, infinite patience and discernment and tact. She sees poverty as the result of disease, and disease as the result of poverty, and drink and dirt and despair and death, and she goes among it all because of her love of men and her belief in them, and her hope for them.’^xxiv

Based on available documentation, it appears that Larkin was based around Walker Street in lower Manhattan.^xxv This area was a destination for many immigrants, and especially those from Italy.^xxvi For Larkin, this work would in many ways provide a precursor for her next experience.

After the US entered the First World War in April 1917, the ARC moved forward to ‘meet all exigencies of war’ for American purposes. The Bureau of Nursing Service which was under the direction of Jane Delano had, since the conflict started three years earlier, enrolled upwards of 8,000 trained nurses ‘to be ready on call in case of war.’^xxvii On 30 April, Eliot Wadsworth, the chairman of the ARC addressed a national convention of nursing organisations in Philadelphia and noted, ‘As the war develops this corps of Red Cross nurses will win the gratitude, affection, and admiration of every American citizen.’^xxviii Over the following months, the ARC continued to recruit nurses to join its ranks.^xxix

In December 1917, Larkin applied to enter the ARC, and a few weeks later, she was accepted.^xxx It appears that she was guided by Della De Graw of New York City’s Department of Health who was a leading nurse at Kingston Avenue Hospital. Based on De Graw’s correspondence with Jane Delano at the time, it is evident that De Graw was interested in leading a group of nurses to serve in Europe. Larkin was described as a candidate for her contingent.^xxxi Although De Graw reminded Delano that Larkin joined with a view toward serving overseas, it was clear that nursing duties on the American home front had taken immediate precedence. ^xxxii According to Delano, Larkin was under serious consideration for being sent to Camp Bureaugard in Alexandria, Louisiana to work at the meningitis hospital.^xxxiii An ‘epidemic’ had broken out and nurses were ‘urgently needed.’^xxxiv However, Delano did not realise she had already received a direct response from Larkin. After sending her a telegram on 7 January, noting that ‘there was a great need for nurses in the various cantonment hospitals’ and requesting that she ‘wire … earliest date’ in order to ‘call upon you for this service’, Larkin asked ‘to be excused’ until 1 March. She further revealed that ‘After that date I shall be very glad to respond at any time you desire to call me.’^xxxv

On 4 March, Larkin reached out to Clara Noyes, the Director of the Bureau of Field Nursing Service for the ARC, noting ‘I shall be ready’ for service ‘any time after March Tenth’.^xxxvi Five days later, Noyes, replied confirming that her ‘name had been forwarded for service with the American Expeditionary Forces.’ However, instead of caring for troops on the front lines of western Europe, Noyes believed Larkin would better be better utilised in Italy, where she could work with Sarah De Long, who was shortly going to Italy to set up a training hospital in Milan. Noyes described Larkin’s future duties as ‘largely educational and would follow the lines of the work that you have been doing’. She felt that Larkin ‘would find a greater field of usefulness’ focused on this type of nursing instead of ‘serving as a ward nurse in one of the military hospitals’. The initial plan for De Graw to lead a nursing unit in Europe had also been shelved. Noyes noted that ‘As far as possible we endeavor to consult the wishes of the individual nurse, but the time has come and the need for nurses is so great that we feel that it is necessary to request of Red Cross nurses to serve wherever they are needed.’^xxxvii

Four days later, Larkin sent a telegram to Noyes confirming that she would ‘go with Miss De Long or any unit you designate.’^xxxviii Upon receiving the message, Noyes was ‘exceedingly glad’ and passed on initial instructions regarding preparation meetings and equipment timelines and noted that the monthly payment would be sixty dollars per month. Noyes noted that De Graw had been asked to ‘go also with this Unit’ and would be ‘selected as head nurse to have charge of the group until they reach Italy and report to Miss De Long.’^xxxix In the days leading up to the departure, uniforms were distributed and overall administrative preparations were made. ^xl On 25 March, Larkin completed a witness statement for De Graw’s passport application, stating that she had ‘known’ De Graw for the previous seven years.^xli The fact that Larkin endorsed the application of De Graw who was essentially in a position of seniority is interesting, and in many ways demonstrates the collective efforts that occurred in order to quickly mobilise one specific ARC nursing Unit. Similar acts of comradery were playing out across New York City, which according to one official, had by the spring ‘nearly one thousand nurses housed in twenty different hotels’ awaiting to head to Europe. Not only were they ‘All … so truly eager to be of service’, but ‘Units prided themselves on the correct wearing of the uniform and on proper drilling and a spirit of friendly rivalry existed’.^xlii On 16 April, Larkin and De Graw sailed from New York bound for France. Although further research is necessary to delve into possible other ARC acquaintances aboard their ship, it is evident that the two nurses arrived at the ARC headquarters at 4 Place De La Concorde in Paris together.^xliii

After being properly processed, Larkin along with De Graw travelled south to join the work undertaken by the ARC Italian Commission. In September 1918, both were noted in in the American Journal of Nursingas serving in the ‘Italian Unit … under the direction of Katherine C. DeLong, who had been for a number of years the nurse in charge of the residence at the Bellevue Hospital for Nurses’. The Unit’s ‘purpose’ was ‘to open a teaching center in Milan where the Italian women may come for classes of all kinds, and to render such social and public health service as may develop.’^xliv This snapshot into the daily activities of this particular team of ARC nurses provides a clear example of how as Julia Irwin notes, an effort was made in Italy to assist the local people as well as to educate Italian public health nurses about American methods.^xlvThe centre was very successful from the outset. For example, after the Children’s Health Bureau was formed in August, local Italian women were invited to attend a course in the centre for three weeks that consisted of lectures delivered by nurses, doctors and social workers focusing on hygienic methods, feeding and the ‘value of play’. After completion, these local Italian women now empowered with knowledge and leadership skills were sent to various facilities in the surrounding areas to practice their work under the continued guidance of the ARC.^xlvi As described by Oliva Fiorilli, ‘Public health nursing emerged’ in Italy during this period set within the realms of ‘local aspirations’ and ‘an international standardization of public health methods interpreted by new or renewed transnational institutions and agencies.’^xlvii

After the armistice was signed in November 1918, effectively ending the First World War, efforts on the part of the ARC to lead health campaigns in Italy centred around children’s health and overall welfare continued. However, by March, ARC-led civilian relief had concluded with the official closure of the Italian Commission and centres began closing. As described by Charles Bakewell, the ‘disbanding of the organization was well under way.’^xlviii On 14 May, Larkin sailed from Genoa, Italy aboard the SS Guisseppe Verde bound for New York. Also sailing with her was Sarah Shaw, who was the overall Director of Nurses of the ARC in Italy.^xlix

Upon returning home, Larkin resumed nursing in New York.^l Records show that she once again worked at the hospital at Ellis Island for a period in the early 1920s.^li Larkin remained in New York for the rest of her life and it is clear from her questionnaire responses to the ARC during the 1920s and up to her retirement in the early 1930s, that she remained dedicated to serving as a public health nurse.^lii Even on 7 December 1941, the day that Japan bombed Pearl Harbor, Larkin stated patriotically in an ARC document that she ‘would be glad serve if physically able’. However, now in her late sixties, her health had been ‘poor for one and half years’.^liii On Sunday 21 July 1946, Larkin passed away after a brief illness. Her obituary, appearing two days later in the Brooklyn Eagle noted that she was the ‘daughter of Patrick and Nora Larkin’ who ‘came from Ireland to the United States as a young woman’. A ‘registered nurse’, she had ‘served with the Red Cross in Italy during World War I’ and subsequently ‘retired about 15 years ago’ after serving with the ‘City Health Department’.^liv

When assessing Larkin’s career, it is evident that her training as a teacher at St. Mary’s Convent School in Limerick city, Ireland formed a deep foundation for her subsequent nursing work. She clearly viewed nursing as her life’s duty and was fully committed to educating and caring for those less fortunate in society. Larkin’s career in public health nursing from Ellis Island, Kingston Avenue Hospital, the ethnic conclaves of New York, and in Milan, Italy during the First World War offered direct insight into those seeking better lives in environments that could be bureaucratically harsh, socially stigmatising, and dangerous. Larkin was not afraid to test her limits and experience new and distinct life chapters. Her decision to enter a nursing training school after arriving in New York was courageous and rare for an Irish female immigrant. And the varied and unique nursing experiences both in New York and with the ARC in Italy offered innumerable challenges that she overcame. Larkin dedicated her life to nursing and bettering society, and in the process many individual lives she touched would have been positively transformed.

Endnotes