When Jean Akehurst patrolled the floors at Johns Hopkins Hospital on the evening shift, insecure young interns felt safe. They knew that every nursing position would be staffed, every difficult patient calmed, every hard-to-find medicine located.

She was the classic head nurse, and for more than 30 years she dressed and acted the part. No one remembers a wrinkle on her starched, white uniform, or any time that she stepped outside her businesslike demeanor.

But after Akehurst died last fall at age 79, she surprised former colleagues with a bigheartedness many never knew she had. Hospital officials learned in May that she had left the institution $1.2 million.

Hopkins' treasurer, Thomas Trzcinski, used to those sorts of contributions from trustees, believes it is one of the hospital's largest donations ever from a line worker.

"I don't think she showed much affection to anyone, and I don't think she showed it in nursing," said Anna Flatley, a fellow nurse who knew Akehurst for 58 years. "But she must have had a generous heart after all."

As unusual as the gift might seem, it isn't.

In the past five years, about 10 other retired nurses have each donated amounts ranging from a quarter-million dollars to a half-million or more, in their cases to the Johns Hopkins University School of Nursing.

Another former nurse, Mildred Struve, who worked her way up to being a key nursing manager, recently left $900,000 for nursing school scholarships.

Most of these women came of age at Hopkins during World War II. They lived, learned and labored together, even stepping in to run the hospital when dozens of Hopkins nurses were shipped overseas with the troops.

'An amazing group'

"The only reason the hospital was able to retain high standards of care during that period was the cadet nursing program," said Linda Sabin, a Hopkins nursing graduate and associate professor of nursing at Northeast Louisiana University. She is working on a history of Hopkins nursing.

"They were an amazing group in that period. They just did extraordinary things."

Now, it seems, many are giving back to the institution that made them who they were.

Some saved the money from nothing more than their nurses' salaries. In Akehurst's case, she had inherited stock from her father. But she apparently rarely tapped that wealth in her personal life, where her style was as Spartan and disciplined as her hospital demeanor.

She lived for many years in a tiny two-story rowhouse in old Dundalk with her husband, Ernest C. Akehurst Jr., a firefighter. She never indulged in fine clothes or expensive vacations. She bought her sole luxury, a 1978 light blue Cadillac, the year her husband died.

"It's amazing to me because she never really did anything, never went anywhere or anything," said Flatley, 83, of Akehurst's wealth.

"Maybe this was her way of saying, 'That was the happiest time of my life.' It was for me."

A private person who revealed little of her feelings, Akehurst gave a one-sentence explanation for her act.

"Hopkins is my family," she once confided to a hospital staffer.

In a sense, the institution was in her blood: Her father, Warren Leaper, earned his medical degree there in 1911; her mother, Florence, trained as a nurse. In 1939, Akehurst followed her parents.

In those days, nursing training was as regimented as the military. The students lived together in Hampton House, a dormitory across the street from the hospital. There were impromptu room inspections.

Student nurses lined up in their spotless uniforms at 6: 50 a.m. each day for a few prayers and to get the day's assignments. Then they marched off, two abreast, in order of seniority, shouting hellos to the front doorman polishing the brass rails.

During the war, students often worked split shifts, staffing a hospital unit during the morning, attending afternoon classes, then returning for an evening shift.

Any nurse not present 10 minutes prior to the beginning of the shift was counted tardy. And certain practices were expected of every nurse: Beds were made with sheets tucked under the corner in a triangle shape, and even though the nurses bathed patients, a Hopkins nurse never got her long sleeves wet.

Akehurst graduated in 1943. At the time, Akehurst and her fellow nurses also stood up each time a doctor entered the room.

"She was a real proper, old school nurse. She would stand up and help you put your coat on," said Dr. Theodore Baramki, who remembers Akehurst from his residency days.

An associate professor of gynecology and obstetrics at Johns Hopkins School of Medicine, he is director of reproductive endocrinology at Greater Baltimore Medical Center. "She wouldn't accept mediocrity," he said of Akehurst.

Akehurst didn't worry about people's feelings. She spoke the truth as she saw it, say those who knew her, and she didn't put up with any nonsense.

"I used to laugh and say, 'I bet she was just like Nurse Ratched,' " said friend Dottie Whittle, referring to the disciplinarian nurse. "She was a strong-willed woman."

The nurses worked six days a week, earning about $60 a month. For fun, they took turns each summer riding in an old station wagon to a donated cottage on the banks of the Severn River. But only for a few days. They spent most of their time working in the hospital. It was a different world then.

Floors were segregated by race and gender. Wards consisted of rows of beds separated only by curtains. There was no air conditioning, so nurses used to push patients out onto porches in the summer. Each morning, nurses bathed the patients, and each evening, since pain medication and sleeping pills hadn't yet been developed, nurses gave every patient a back rub.

When Jean Akehurst and her colleagues started their careers at Hopkins, they weren't allowed to take a patient's blood pressure. Intravenous lines could be started only by medical students. And all the needles, bottles and other medical equipment had to be reused.

"We didn't have throwaway equipment," said Mary Louise Miller, 76, who trained and worked at Hopkins for three decades. "We boiled everything."

Even as late as the 1960s, nurses carried grindstones in their pockets to sharpen their needles, said Sabin, the historian. That's how patients and physicians could distinguish a good nurse: by the sharpness of her needles.

Over the decades Akehurst spent at the hospital, mainly as a supervisor of several floors in the women's clinic, discoveries transformed medicine.

Respirators, originally the size of a typical bed, shrank and became more efficient. Doctors pioneered coronary bypass procedures and neurosurgery. Nurses stopped wearing caps every day. They handled more IVs, and aides started giving the baths.

Akehurst's career ended in 1983, at the age of 64, when she fractured her hip while on duty, requiring a total hip replacement. But when a staffer from Hopkins worker's compensation department showed up at her bedside to get her to sign a form so she could get benefits, Akehurst refused, stating that Hopkins was her family. (She was estranged from her only sister, and it stayed that way until she died.)

"She said, 'I'm just going to leave all the money to Hopkins,' " said Pat Schammel, Hopkins' manager of worker's comp. Later, Akehurst wouldn't attend a hearing. Finally, a worker's comp commissioner was dispatched to her house, and she grudgingly agreed to accept some money.

'I did it to myself'

In the final years of her life, Akehurst struggled with asthma and a leg wound that eventually led to an amputation. She spent six years in a nursing home, futilely trying to walk with a prosthesis.

Always hoping to regain her independence, she refused to sell her Dundalk home. But finally, she had to move into a one-bedroom apartment in Owings Mills, where she could get around in her wheelchair, rolling out onto her deck to water her geraniums.

She took pride in her wavy, iron gray hair and its widow's peak. She relished Orioles games, devoured mystery novels, chain-smoked Pall Mall Golds and refused to be treated anywhere but at Hopkins. And she kept her new home and her life as uncluttered by things and people as ever.

When a doctor declared that she would die of cancer, she said without a tear, "I did it to myself."

It was then that a neighbor grew close to Akehurst and saw the heart that had been hidden. Akehurst worried about the single mother and the wheelchair-bound woman in her apartment complex. She regretted having gone so many years without talking to her sister.

"Once she said she wished she could cry because it would make her feel better," said Whittle, her neighbor. "She said, 'I don't have any friends, and I've never had any friends.'

"I told her, 'I'm your friend.' "

So in the last few weeks, through pain and a throat racked by cancer, Akehurst whispered the stories of her life, about living in the nurses' dormitory, giving immunizations to the children who lived around Hopkins, even revealing one of the rare antics in her many years -- the time she shot down the hallways of Hopkins, riding a gurney and laughing.

Pub Date: 8/06/99