By Dorothy Daniels, ©1963
Cover illustration by
Karen Carlisle thought
her frantic flight from the past was over when she boarded a luxurious ocean
liner, to become the ship’s nurse. There, among strangers—the richest and most
glamorous people in the world—she felt safe. Nobody asked why she was there.
And she could pretend she was free like the others. But when an infant was
stricken with a fatal disease which only Karen understood, her safety, her
career, the love she had learned to cherish above all else, must be sacrificed.
Though it might mean disgrace and the loss of her fiancé, Karen Carlisle
prepared to reveal the scandalous truth.
“What a bedside manner. You’ll charm the women out of their
“I suppose everyone is entitled to a ship romance. It must
even be included in the brochure of the cruise.”
“Now run along and attend to your gown and your makeup, all
the things that will make everyone appreciate you so much.”
“There’s nothing better than a pizza in Japan.”
“They want a doctor, not a fashion plate.”
Seldom do we meet a VNRN heroine as smart and as feisty as
Karen Carlysle. In truth, she should really be a physician assistant or nurse
practitioner, so focused is she on diagnosis and treatment (she had wanted to
be a doctor, but financial considerations forced her to drop that dream). This interest
surfaces right away when she is assisting society hack Dr. Radcliffe, who is
“oozing his bedside best” with a rich, demanding woman with a thyroid tumor.
The patient wants an immediate diagnosis, so Dr. Radcliffe pulls out a
Vim-Silverman needle for an on-the-spot biopsy. Karen, who had been studying up
on thyroid cancer, looks upon the doctor with horror and reminds him that a
needle biopsy of a cancerous lesion can seed tumor cells, causing metastasis.
He drags her into the corridor and, as she argues with him that the procedure
is incorrect and dangerous, declares that he will have her license revoked for
interfering with a doctor.
Fortunately, though, also present in the room was her fiancé,
Dr. David Logan, who will naturally back her up with this important but
outdated doctor. “I’m a lowly resident. I don’t know anything,” he tells her.
“A nurse should know even less, but the most important thing she should know is
to keep her mouth shut. Damn it, you’re not a doctor. You’re just an
interfering nurse who shouldn’t even wear that uniform.” Thanks, Dave. Needless
to say, when called to testify before the chief of staff that Dr. Radcliffe had
been about to perform a contraindicated biopsy, Dr. Logan “promptly” denied it.
Karen, expecting to lose her license as quickly as she lost
her fiancé, is on her way out of the hospital when she passes the room opposite
the thyroid patient’s, where she finds an elderly man in respiratory distress.
She cannot resist a patient in need, so despite her own problems, she helps him
until he is better. It turns out that he had heard the entire exchange, and now
wants to help Karen. It turns out that he is the owner of a cruise line, and
with one phone call gets her a job on the Prince
Thatcher, a luxury liner embarking on a three-month cruise through the
So off she sails … but her troubles are not exactly behind
her, because the ship physician, Dr. Lloyd Dunlop, is more concerned with
cocktail parties and bridge games than he is with medicine. You don’t have to
be a brain surgeon to see what is coming next. One patient on board, a Filipino
diplomat named Ramon Morrano, is returning to Manila with a fatal lung cancer
to die, but it looks like he won’t make it. Karen “had made it a habit of
reading all of these journals she could find.” This was how she had known so
much about papillary carcinoma of the thyroid; “the hospital library had been
at her disposal and she’d studied case histories thoroughly. It was like Karen
to do that because her interest in medicine and nursing was such that all this
hard work was of vast satisfaction to her if she understood a little more.” So
now a little paper about advanced treatments of terminal cancers is teasing her
memory. A few hours and a stack of Dr. Dunlop’s virgin medical journals later,
Karen discusses a new anabolic medication with Mr. Morrano, who would like to
try it—but a nurse can’t prescribe, only Dr. Dunlop can. Needless to say, he is
not at all impressed with his uppity nurse. “I refuse to take any
responsibility for administering a drug I know nothing about,” he shouts.
Fortunately, Karen has a new friend on board, Pete Addison.
Pete refuses to tell Karen what he does for a living and seems to be
trailing—and photographing—another passenger, Robert Nesbit, a shy recluse who
turns out to be one of the richest men in the world. Karen is upset about this,
but Pete tells her that he has given his word to keep this secret and so cannot
tell her about it, much as he’d like to. Karen believes Pete to be honorable,
and it also turns out that he’s powerful, because he has some of this drug
flown by jet from New Jersey to Los Angeles, then on a military bomber to
Hawaii. Pete also has a few words with Dr. Dunlop, and soon Mr. Morrano is well
enough to take some liquids and even go out on deck to enjoy the views. And
remember that Pete is a journalist for a very important and quite conservative
news magazine, who had interviewed him once in Washington. “You must never let
him become aware of the fact that you know who he really is and what he’s up
to,” Morrano advises. “Let him tell you himself, for then he will feel more
important and honest. Never bring a young man’s head down out of the clouds.”
And it’s not too long before Pete’s compunction to keep
secret his mission fades, and he tells Karen that he is trying to do a profile
about Mr. Nesbit, who has always refused any press in the past. But “he has no
right” to privacy, Pete states, that the public has “a right to at least know
what he looks like,” a curious assertion. And Mr. Nesbit’s six-month-old baby,
Melissa, is looking a bit blue about the lips and not taking her food. Dr.
Dunlop prescribes a change in formula, but our bold diagnostician Karen has
cardiac ideas. When she finds, after a more careful examination than Dr.
Dunlop’s, that Melissa is limp, pale, afebrile, and tachycardic, she insists
that the baby has more than a minor stomach upset, but Dr. Dunlop furiously
denies it. “See that you remember your place,” he snaps. “You are a nurse, not
Needless to say, however, the formula change makes no difference
to Melissa, and now the Nesbits are calling for Karen, not Dr. Dunlop.
“Frankly, I think you know more than he does and you apply your skill better,”
he tells her. Karen is worried, of course, that she’s just adding to her
troubles: “I guess I’m not a very good nurse. The first thing we’re taught is
to obey the doctor.” But Pete has confidence in her: “If you saw Dunlop going
off on a wrong diagnostic tangent, you’d step right in and do what you honestly
knew to be right, even if it meant more trouble. You stick by your guns, my
girl.” So she returns to the sick bay and promptly starts reading up on
pediatrics. When she discusses the case with Dr. Dunlop the next day, he
declares that the baby may have acute appendicitis, and Karen is “almost in awe
of the man’s complete ignorance.” A blood count proves him wrong, but Dr.
Dunlop is afraid to do and EKG for fear of upsetting the Nesbits. Feeling
powerless to contradict the doctor, Karen pours out her worry to Pete, who has
a talk with Mr. Nesbit. Mr. Nesbit listens to Karen’s reasoning and insists
that she do the EKG, but now Karen is in the precarious position of having
introduced the journalist to her patients.
The EKG shows ventricular hypertrophy, and Karen diagnoses
coarctation of the aorta. The baby will need immediate surgery, but again, a
medication, plus oxygen and antibiotics, will help relieve her symptoms until
she can have the surgery. She just has to go up against Dr. Dunlop again. “If
she was wrong, she was finished as a nurse. But she was certain the medical
books backed her up—if she had read them properly—and she knew she had.” In her
discussion with him, she is calm, confident, and insistent that he do the right
thing, advising that he communicate with a cardiologist by radio—which is
promptly done, and the MDs ashore confirm Karen’s diagnosis. In a meeting with
the captain, however, Dunlop brings up Karen’s insurrection with Dr. Radcliffe,
suggesting that she “has some type of complex and is possibly psychotic. If that’s
all, Captain, I’ll return to my party.” But Pete steps up and asks the doctor
if he even knows what the proper treatment for the baby is. He does not,
unsurprisingly, but Karen sure does! Her treatments are confirmed by the
cardiologist ashore, so now all we have to do is get Melissa to a hospital that
specializes in pediatric cardiology in the next 36 hours. But Pete—first
confessing his occupation to Mr. Nesbit, destroying his film, and tearing up
his story—calls on his amazing contacts with the military and arranges a
helicopter from a nearby aircraft carrier to swing by and pick up Melissa, Mrs.
Nesbit, and Karen, take them to the ship and then to Honolulu by military jet,
then by private jet to Los Angeles—the very hospital Karen was to be drawn and
quartered at. There, the baby is saved, and Karen is cleared of all wrongdoing
in the thyroid case, after sworn affidavits from the cruise ship owner, the
supply room manager, and the patient herself showed that Dr. Radcliffe had
called for a Vim-Silverman needle. Phew! All that’s left is for Karen to
receive Pete’s proposal of marriage over the telephone from Singapore, and all
I’m not really certain that Karen is going to be happy
professionally as a nurse, now that her name is cleared—she most positively
would not be content as a housewife. But I appreciated both her confidence as a
healthcare practitioner, her diligence in doing her homework, and her
assertiveness (and her doubts) in challenging the doctor. She is truly an
enjoyable heroine, one able to toss of a biting remark when necessary. The
writing is slightly above par, and the characters were, for the most part,
well-drawn. And when the first class of physician assistants matriculates at
Duke in a few years (the first four PAs graduated in 1967), we can only hope
that Karen Carlyle will apply.