Among the number of small evils which haunt illness, the greatest, in the misery which it can cause, though the smallest in size, is crumbs. The origin of most things has been decided on, but the origin of crumbs in bed has never excited sufficient attention among the scientific world, though it is a problem which has tormented many a weary sufferer. I will forbear to give my own explanation, which would be neither scientific nor orthodox, and will merely beg that their evil existence may be recognized and, as far as human nature allows, guarded against. The torment of crumbs should be stamped out of the sick bed as if it were the Colorado beetle in a potato field. Anyone who has been ill will at once take her precautions, feeble though they will prove. She will have a napkin under her chin, stretch her neck out of bed, eat in the most uncomfortable way, and watch that no crumbs get into the folds of her nightdress or jacket. When she lies back in bed, in the vain hope that she may have baffled the enemy, he is before her: a sharp crumb is buried in her back, and grains of sand seem sticking to her toes. If the patient is able to get up and have her bed made, when she returns to it she will find the crumbs are waiting for her. The housemaid will protest that the sheets were shaken, and the nurse that she swept out the crumbs, but there they are, and there they will remain unless the nurse determines to conquer them. To do this she must first believe in them, and there are few assertions that, are met with such incredulity as the one — I have crumbs in my bed. After every meal the nurse should put her hand into the bed and feel for the crumbs. When the bed is made, the nurse and housemaid must not content themselves with shaking or sweeping. The tiny crumbs stick in the sheets, and the nurse must patiently take each crumb out; if there are many very small ones, she must even wet her fingers, and get the crumbs to stick to them. The patient’s night-clothes must be searched; crumbs lurk in each tiny fold or frill. They go up the sleeve of the night-gown, and if the patient is in bed when the search is going on, her arms should hang out of bed, so that the crumbs which are certain to be there may be induced to fall down.
Mrs. Leslie Stephen, born Julia Prinsep Duckworth, is better remembered today as the mother of Virginia Woolf. She published this little book about a year after Virginia’s birth, with the simple aim of sharing “things which have come under my actual observation, either as giving relief, or causing discomfort to the sufferer.” Notes from Sick Rooms, which has been reissued recently by Paris Press to accompany Virginia’s essay, “On Being Ill,” is also available on its own from the Internet Archive (link).
It’s a short book brimming with common sense and a certain measure of humor. “I have often wondered,” she writes at the start, “why it is considered a proof of virtue in anyone to become a nurse. The ordinary relations between the sick and the well are far easier and pleasanter than between the well and the well.” Of course, relations between care-giver and cared-for are often not easy or pleasant, but her point is well-taken: overall, the odds of both parties being accommodating are better.
When Notes from Sick Rooms was reissued back in the early 1980s, Penelope Lively wrote of it in the London Review of Books:
It is as though Mrs Ramsay had stepped out of the pages of To the Lighthouse – cool, kind, sensible and meticulous – and set out to tell us, with the minimum of fuss, how to wash an invalid, make the bed, comb the hair, give an enema, arrange the bedside lighting. The tone has that combination of humanity and practicality that ought to pervade the medical profession and so frequently does not. It makes one yearn to collapse at once between linen sheets smoothed by Mrs Stephen and give oneself up in gratitude to the calm, unhurried, reassuring presence, the therapeutic rubbings and the beef tea. The section on the removal of crumbs from the bed is a masterpiece. This is the voice of a woman for whom the unsentimental alleviation of distress in others is a way of life; hearing it, you know this is someone whose advice would always have been equally precise, rational and wise – the sort of person you would want to meet in a hospital consulting-room, or at the scene of a disaster. And you think also of the frequently-reproduced photograph of Julia Stephen – a face of unforgettable beauty. And of Mrs Ramsay: ‘Was it wisdom? Was it knowledge? Was it, once more, the deceptiveness of beauty, so that all one’s perceptions, half-way to truth, were tangled in a golden mesh? or did she lock up within her some secret which certainly Lily Briscoe believed people must have for the world to go on at all?’