" on without anesthesia. In a letter he describes: “I suffered agonies, as they related all to me, and did violence to myself in keeping to my seat. I could scarcely bear it.” Surgery on the penis, the rectum or the anus would have been a terrifying torture, especially if the patient was a five-year-old foreigner who couldn’t have possessed the coping skills, the insight or perhaps sufficient fluency in English to understand what was happening to him. It’s awful to consider what he might have imagined when a nurse changed his dressings, administered his medicines or appeared at his bedside with a supply of leeches if he had an inflammation believed to be due to an excess of blood. The nurse may have had a sweet bedside manner. She may have been strict and humorless. A typical requirement in those days was that she was single or widowed, ensuring that all her time could be devoted to the hospital. Nurses were underpaid. They worked long, grueling hours and were exposed to extraordinarily unpleasant conditions "

― Patricia Cornwell , Ripper: The Secret Life of Walter Sickert [Kindle in Motion]