The four deans of the University of Jena met in Werner Rolfinck's office at the university. Werner was dean of the medical school. Next to him sat Johann Gerhard, the dean of Theology. In his early fifties, Dean Gerhard was conservative, thoughtful and prudent man. Werner was particularly glad he was here, as Johann was known for his ability to smooth troubled waters and had studied medicine for several years in his younger days before turning to theology. He was also someone who listened to arguments, considered carefully and then acted. Werner wasn't sure what Johann thought about the proposed merger with Grantville's medical people. He wasn't sure what he thought of it himself.
Across from Johann and Werner sat the deans of the schools of Arts and Law, Dietrich Wetzel and Karl Strom. Dietrich was about Werner's age and a good friend. He was a plump, cheerful sort of man who seemed to exist in a perpetual swirl of energetic chaos. Dietrich had incredible ideas. Making them happen was another story. He was usually off on the next idea before the first project was even halfway completed. Karl Strom was his exact opposite in some ways. A member of the minor aristocracy, Karl was meticulous and very cautious in his approach to life. He had a sunny smile but, most of the time, wore a sober face that he thought was more in keeping with his position. Werner wondered if he realized how young and earnest that sober face made him look. Or how like a young man dressing up in his father's clothes. Karl, only twenty-eight, was young for his position as law school dean and painfully aware of it. It could make him rather prickly on occasion.
Dietrich was all but bouncing in his chair with excitement. Werner stroked his dark, thick mustache to hide the grin trying to escape. "As I told you last time, the Americans want to start a joint medical education program. If we are agreeable, they would like a formal arrangement with the school of Medicine to start teaching nurses and doctors. The arrangement would be the first in a long-term partnership with us. The medical school would expand into a Health Sciences College with schools of Medicine, Nursing, Pharmacy and Allied Health."
"From what you have told us so far, the other three schools we have now may need to be involved right away as well," Johann said thoughtfully.
Karl looked startled. "The other schools? But I thought that was further in the future?"
Werner waved a hand. "You know these Americans. They have laws for everything. The have laws for who can practice, in what area and under what conditions. Fraulein Flanagan tells me they call it 'scope of practice' or some such. I would imagine that as we are setting up the new school, there will be some need to reconcile their laws and ours."
Karl's ruddy complexion blanched a bit. "Yes, I can see the need. Still. They do have a great many laws. I don't know anything about medical law, though, theirs or ours. I have been mostly looking at constitutional and national law. None of us in the law school have experience in the areas of medical law. We did but with so many students and faculty leaving because of the war..."
"You could hardly do anything about the war, Karl. We have what we have. It may be that this partnership will attract new students and we will refill the ranks of our faculty as well." Johann's calm practicality eased the anxiety from Karl's face.
"What about the arts?" Dietrich leaned toward Johann and Karl. "We've been translating a few of the books Fraulein Flanagan lent Werner. Fascinating, just fascinating! And the quality of the illustrations are amazing! We may be able to help with that, too."
"Mathematics and philosophy are other areas where we may need help, but I'm just guessing. Right now, it's too early to make many plans." Werner knew Dietrich well enough to stop that line of thought before he went to far with it. The School of Arts would be in absolute turmoil if they didn't slow Dietrich down a bit. As it was, that facile brain of his would have a dozen different projects ready to start before he left the room today anyway. "I've talked to the head of the delegation they want to send next month. Frau MacDonald will be..."
"Frau? The head of their medical delegation is a woman?" Johann looked and sounded shocked.
"Yes." Werner knew he sounded a bit defensive. "I don't know about the rest of the delegation but the leader is a woman."
"I hadn't realized they had women as physicians." Even Dietrich sounded a bit shocked. Women simply weren't university-educated physicians. Nor were they barber-surgeons or apothecaries, who were seen as lesser levels of healer. Women were usually midwives or herbwives, considered the very lowest of those caring for patients. They were necessary to care for women's mysteries but any of their other activities were not well regarded. There was simply no comparison between a physician and what amounted in their minds to an uneducated herb witch.
Werner gritted his teeth a bit. "She isn't a physician. She's a nurse." Which of course only made things worse.
The silence that followed was anything but comfortable for Werner. Intellectually, the deans had known that Americans didn't seem to care about a person's gender very much in terms of one's role in life. Most of the Americans they had each dealt with had been men however. That they understood. Thanks to his meetings with Mary Pat Flanagan, Werner was a little better prepared than the other three but it would be his department that would have to make this work. He wasn't entirely certain how his faculty or students would respond.
"A nurse?" Dietrich seemed nonplussed. "Nurses to teach doctors, to be dean?"
Werner hastily explained. "The nurses from the future know a great deal. They have university degrees and some have graduate degrees, including doctorates. Nurses are faculty at medical schools in the future."
"How will your faculty respond to teaching with women?" asked Johann.
"We've discussed it but more in theory than in fact. Now that we are actually faced with it and soon... I just don't know."
"Why aren't they sending a man for such a position?" Karl's disapproval was all too apparent.
"I doubt it even occurred to them to be a problem. Dr. Nichols assured me that Fraulein MacDonald is the best person they have to do this. She taught for more than twenty years at one of their universities." Werner carefully didn't mention that she was a midwife or that she hadn't taught doctors. It would just make things worse. "We have talked about having women as faculty this last year, even as deans. Granted, there aren't many women with university educations in our experiences but we knew that our association with the Americans would change that."
Clearly, talking about it and actually doing it were two completely different things. Judging by the look on Johann's face, he had just thought of something unpleasant. "Will they expect us to enroll women with the men as students as well? The university's prestige may suffer if we do this. I had thought this might be a way of gaining students. Now I wonder if we will lose them."
"Women as students with the men?" asked Karl, looking rather stunned by the idea. "How do you teach women?"
"We are supposed to be one of the more forward-looking universities in all of Europe. We are part of the United States now. I have seen something of what they accomplished in the medical arena. Some of their leading scholars were women. We can build something like that here. Whatever reservations I have about merging with those of Grantville, I want to be able to treat patients as they do. And I want our students to have the very best education possible, as I am sure we all do. If that means women as deans and faculty, I am willing to at least try. I think my students and faculty will as well, but how we act, how we present this to them will be critical for shaping whether they see this as a difficult but exciting opportunity or as a lessening of the university and what we have to offer."
Werner looked each of them full in the face, his tone grim. "There are many other problems to be solved in the coming months. We must discuss at least some of those today. Ultimately, the question is whether or not we wish to join with Grantville and under what conditions."
It had rained the night before. As she crossed the grass in front of the hospital's front entrance, Beulah felt her shoes getting wet and soggy. At least she didn't have to wear hose anymore. She could put the socks over a chair in her office and they'd be dry before she had to be the director of nursing.
The hospital was a source of some pride in the community. The three-story building had been finished nearly a year ago despite shortages of materials and funds, and competing construction needs. The iron grillwork over the windows glistened from the rain. The hospital had been built with security in mind given the time they were living in now but they had still tried to make it look more comforting than fortresslike. They had tried to design a hospital that could handle casualties from battles and the epidemics every member of the health care community feared were coming. Time would tell how successful they had been.
She had received a letter last week from Debbie Leek about building a hospital in Magdeburg using a similar design to the Leahy Medical Center, named after Dr. Leahy, a much loved former town physician. The Leek family's story was one of the tragedies of the Ring of Fire. Jennifer Rush, Debbie's eleven-year-old cousin, had been doing very well on chemotherapy for her leukemia before the Ring of Fire. Afterward, unable to get the treatment she needed, she had only lived a matter of months. Before the family had moved to Magdeburg, Beulah had gotten to know them all well. Most of the family had been in some kind of management position pre Ring of Fire and they saw Magdeburg as a place where their backgrounds could be put to good and profitable use. Debbie's letter indicated she was working with Mary Simpson on her educational projects with Veronica Dreeson. Long term, they wanted to found a university in Magdeburg.
That letter started Beulah thinking about something else now. Mary Simpson was working on fund raising and other aspects of getting the girls' school up and running. The new department at Jena would need funding badly. Supplies, textbooks, tuition, living expenses, teacher salaries, the list went on and on. The cost of just one handpainted, illustrated herbal had been stunning. They were going to need more funds. It was a certainty the current government didn't have any money to spare. In fact, most people didn't. All those deep pockets Mary Simpson was picking with such class could...
"Guten morgen, Frau Professorin."
"Guten morgen, Fritz. Wait up a second." Beulah waved to the young man nearing the entrance. Friedrich Joseph Hersch, also known as Fritz, was a twenty-year-old who worked in the hospital bakery. His family were local German bakers who had relocated to Grantville shortly after the Ring of Fire. Several of them worked in the hospital bakery. Fritz was a little above average height, with sandy hair and hazel eyes. The heavy work he did as a baker had given him a strong build.
"If you have a few minutes in the next week or two, come up to my office. I'd like to talk with you about working here at the hospital taking care of patients."
Fritz seemed surprised but pleased. "I shall come to see you today at lunch. Will that be convenient Frau Beulah?" Fritz's English was good but tended to be rather formal. He had spent a lot of time learning from English grammars as well as talking with people. Smart, kind, responsible and motivated, excellent characteristics for what she wanted in a future graduate from Jena. As a bonus, Fritz was just plain nice.
"Perfect. I'll have some food brought in so you don't miss your lunch. Can't have a growing boy deprived of food." With a laugh and a wink, Beulah walked toward the conservatory at the center of the hospital while Fritz headed for the kitchen. The conservatory had practical as well as ornamental uses. Medicinal and ornamental plants were grown in the glass-roofed conservatory. There were cement paths and stone benches for patients, staff and visitors to stroll or sit and rest. She had made it a habit to stop in and walk in the quiet garden for a few minutes before heading up to her office. Now, she sat on a bench sans wet shoes and deliberately set aside thoughts of all the tasks waiting for her upstairs to enjoy the fragrant stillness.
The plants had come along nicely. The aloe plant was sending out new leaves. Aloe had proven helpful in treating minor burns. It soothed the pain wonderfully and helped keep the tissue moist. The plant grew in the graveled area near the bench she was using. Nearby were Saint John's-wort and valerian, herbs that were being used to treat depression and anxiety. There had certainly been some of both the last two years.
The garden had become something of a symbol for her. The plants meant hope for treating patients and for finding future cures for the diseases they now faced. When she lost another patient that might have been saved in the twentieth century, the hospital garden reminded her they weren't entirely helpless. They were adapting. The health care situation was not quite so desperate as it had been when they first arrived now that they had the hospital, its staff and the herbal remedies. The sanitation committee was doing a great job. At the same time, the garden was not entirely benevolent. In a shady spot on the second floor was foxglove to make digitalis preparations. The plant grew four or five feet high and had lovely flowers. While good for treating congestive heart failure and some irregular heart problems, it could be deadly poison and thus was placed where curious children or adults couldn't get to it.
When she got too worried about the future, her personal faith and thinking about Mary Pat, Fritz and the other youngsters eased her mind. Fritz would make a wonderful nurse or doctor. So would a number of others. They would have to choose the first students very carefully. Possible sources of students were likely graduates of the nurse's aide, emergency medical technician, combat medic and licensed practical nurse programs as well as personal recommendations from various people. Those programs all took a year or less to complete in Garnet's program at the tech center. They were running people through the programs as quickly as possible. Now that they'd opened them to German students, they'd have an even larger pool of possible applicants from which to draw.
Beulah would be recommending Fritz for the RN program. He'd need to get into the tech program at the high school as soon as possible to be ready to go to school for his degree as a registered nurse. There were several RNs she would like to see go on for the MD program at Jena. Which would leave them even shorter of RNs for a while. Some people, like Sharon Nichols, had essentially had enough on the job experience to be functioning as RNs. Some of the Jena students already in the medical program would undoubtedly want to be admitted. That was going to be trickier. How did you tell someone that while they were about to graduate with a medical degree, they weren't qualified to work as MDs in Grantville? A possible solution came to her. Hm. Have to check with Mike Sterns and a few others first. Might work. Who knows, maybe I can handle this diplomacy stuff after all. With a lighter heart, Beulah headed for her office.
The faces around the gleaming conference table at the medical center, or Leahy as it had come to be known, were all familiar to Beulah. She was not happy to see all of them. Mara Washaw was a thorn in her side. She was one of the small number of up-time RNs available, young but still experienced. That made her important and she knew it. Beulah had tried to be more rational about her. Mara had great experience, having worked in a large hospital as a nurse in Charleston before she married Lennon, Starr's brother. Mara and Starr were about the same age, early thirties, and both had kids. Other than that, they were very different. Mara hadn't taken it well that Starr was going to be taking Beulah's place. Frankly, Beulah was glad Mara hadn't gotten the position. Most others had stepped up to the plate after the Ring of Fire and done as much as they could for their families and community. But not everyone. Mara just sort of coasted. Since she was very bright and well educated she got away with it but she did the minimum amount necessary. She knew how bright and talented she was and didn't let others forget it. Beulah could forgive that if Mara had lived up to her potential. Or even tried to. Beulah hoped she didn't have trouble with Mara being on the committee. She didn't think Mara sitting at the opposite end of the head of the table was an accident. Beulah wished Starr was in her place but Starr wasn't at the table. She had assumed Beulah's duties this week. Which left Mara as one of the senior RNs available for the forming Health Care Education committee.
"Morning everyone. Why don't we all get settled? We've got a lot to work on and not much time."
Garnet Szymanski, director of the high school nurses' aide, EMT, combat medic and LPN programs, gave an exaggerated wince. "So what else is new?" A nice way to start the meeting. Grins all around. Except for Mara. Must have been the mention of lots of work, thought Beulah.
Beulah looked around the polished wooden table as the others got settled into their chairs. Balthazar Abrabanel sat on her left. His face was very welcome. Not to mention the fact that he's far more skilled in diplomacy than I'll ever be, Beulah thought with an inner grin. That wasn't the official reason he was here, of course. He was the first down-time physician to absorb enough up-time knowledge to become a full partner with Drs. Adams and Nichols. His knowledge of the current educational practices in Europe would be important as well. If not for his heart and the amount of time he spent training their spook squad, he was up to speed enough to be the new dean. In Beulah's opinion, he'd be a better choice for a lot of reasons, not the least of which that she and most of the others knew next to nothing about medical education in this time.
Garnet was seated next to Balthazar, wearing as usual, her beloved yellow. The woman had a bright yellow house and had driven a bright yellow car. She was fifty-three and solid in more ways than just her physical appearance. Garnet was someone you could count on. She loved teaching and it showed in the ways she interacted with her students. When Garnet was around, learning was going to be fascinating. Her enthusiasm was catching and her two LPN assistants, Courtney and Marcia, were just as dedicated and competent. Any future nurses and docs who got run through the program at the high school would be getting a first rate start in their careers. Licensed practical nurses or LPNs only took about nine months to train now, since many of the things they could have done up-time were no longer possible. They didn't know as much as registered nurses but they knew more than nurse's aides. The program was going to have to expand again but at least the groundwork was all done and most of the kinks worked out.
Across from Garnet was Ann Turski, a health educator who had worked with Garnet before the Ring of Fire. Her time was now split between Garnet's program and helping put staff inservices together here at Leahy. She and Beulah worked well together, although Ann tended to get upset if things weren't organized to her satisfaction. The woman was an organizing machine. Disorder and chaos were the enemy. She had had quite a lot of both to combat during the last two years. When Beulah had told her about the committee and asked her to serve on it, Ann had been visibly relieved. "Finally, we'll be getting properly organized. There's been too much flying by the seat of our pants the last two years." Ann had light blue eyes and shoulder-length dark brown hair. When she was nervous or facing disorder, she tended to pat her hair, as if making certain that at least her person was still neat and tidy. Right now, she was patting her hair and had just smoothed her knee-length skirt. Hmmm. Probably knows I'm about to drag her off to Jena and disrupt her routine again. At least her husband Wells is off on a diplomatic mission and they don't have kids to worry about.
Next to Ann sat Raymond Little, the hospital's chief pharmacist. He was a quiet man and deliberately rather nondescript. Ray blended into the woodwork whenever possible. He knew his stuff as a pharmacist but she'd never seen him really assert himself for anything. He and Stoner worked very closely together. Beulah suspected that he loved working with the plants and in the garden. Once, she had even seen him give a plant he was cutting a tender, apologetic pat and murmur soothingly to it in his pleasant baritone. Completing the group was Mary Pat, sitting at Beulah's right hand in more than a literal sense. Hayes had been tied up with other projects and couldn't make it to the first meeting. He would be keeping track of a lot of this by minutes when he couldn't attend anyway.
Before Beulah could even get started, Mara fired the first salvo. "This is such an exciting opportunity. I'm so glad you could be here to get us started. I'm sure that with everything going on, you're very busy."
"Yes, it is very exciting. There will be times I can't be here for meetings. Fortunately, when I can't be here, Mary Pat will sit in for me. If she isn't around, Balthazar will take over." Judging by the souring of Mara's smile, that wasn't what she had expected to hear. She'd undoubtedly thought that Balthazar would be too busy, Mary Pat deployed and the other two easily managed, leaving her to take over and have all the glory with little of the work. Beulah had been on too many academic and public health committees to be taken in by that particular tactic though. Normally she would have approached the leadership roles on the committee differently. Garnet was here more in a capacity as bridge between the programs to make sure they articulated well. She was already busy. Ann and Ray would be too likely to let Mara slide if they were in charge. Neither of them liked conflict and Mara in full attack mode was something to see.
"Did you all get the handouts for today's meeting? Anything in particular you'd like added to the agenda for today's meeting?" Mary Pat helped ease past the little conflict and get back to business.
"Yes, as a matter of fact there is a problem." Mara said firmly. "We have the hospital here and the most educated staff. It makes no sense to split our resources between here and Jena. It will leave us too short staffed and take too much travel time."
Beulah sternly refused to ask if Mara's concerns were really about the program or about having to work extra and not having students around to lord it over. Unfortunately, the point was a valid one, whatever the motives of the person making it. Beulah wasn't too surprised when Ann spoke up.
"I agree. We have what we need right here. The faculty and students from Jena could easily come here and we wouldn't have to leave Grantville."
"We thought about that. There are advantages to keeping it here but the advantages are outweighed by the disadvantages both in the short term and the long term. First, we need the resources and faculty at Jena. We don't have enough personnel here. We need to spend some time learning about their resources and skills and time is short if we are going to start the first classes of new RNs and MDs in January."
Garnet nodded agreement. "At Jena," Beulah continued, "we'll have access to the botanical gardens, the faculty and the textbooks as well as their other facilities. Space is at a premium here in Grantville for everything from classrooms to housing. We plan on building a student dorm, a medical library and other facilities here but right now, we don't have the money or most of the other things we need to make that happen. Jena has everything but the hospital and our staff. We work with them and both of us win. The students can come here to the hospital for intensives early in their training. We'll have had time to get more resources in place for them here for later training when they are ready for more clinical time. I've already sent a letter to Debbie Leek about raising funds for the health education project.
"Finally, Jena is a strong university as well as being the closest one to us. We don't want to lose the university base for health care education. I know we've all had to do quite a bit of OJT the last few years. We need to be proactive now and set up an educational system capable of creating the knowledge and advances we had up-time. We need people who will be able to practice at that level as soon as possible."
Ann was nodding thoughtfully now although she still didn't look too happy. Balthazar took over and added some more information about Jena and 1630s medicine. He also spoke a little about the faculty he had been corresponding with in Jena. One area smoothed over. Beulah sighed as Mara came up with another disagreement. Time to get things back on track.
It was going to be a very, very long meeting.