Phyllis has thrown out her back, and the pain is great enough that she doesn’t protest when Sister Julienne sends her to the hospital. She has a trapped sciatic nerve, and will not be able to work for at least six weeks. A temporary replacement is needed to pick up her slack at Nonnatus House, so Mother Mildred herself comes to Poplar, ready to learn about the House’s operations and help out the midwives on their rounds. Given her short stature and eminent status, however, she won’t use a bicycle like everyone else; Fred’s van will do just fine, thank you.
One of her first appointments is with Trixie at the Brittall family home. Three generations of dockworkers live here, but the oldest can no longer work. Joe is dying of a respiratory disease common among older dockworkers, given all the dust that they encounter. Trixie and Mildred give him oxygen and try to ease his suffering. Before they leave, Joe’s daughter-in-law Gilda has them examine a wound on her husband Barney’s neck. It looks infected, so Trixie refers him to the clinic and Doctor Turner – but not before Mildred manages to insult Gilda by saying she had seen similar infections in Chinese slums, unintentionally likening Gilda’s home to a slum.
Doctor Turner sends Barney to the hospital for extra tests: given his work on the docks, he may have been exposed to anthrax. The hospital confirms it and confines Barney – and the docks are shut down to investigate. Luckily, no one else was exposed, but dockworkers like Gilda and Barney’s sons are indefinitely on limited paid leave. When Mildred goes to apologize to Gilda for her accidental insult, she learns how unfair the owners of the docks are. Two members of her family are suffering from life-threatening ailments that could have been prevented had their employers provided them with masks and protective clothing. Gilda is worried that her sons will also eventually get sick from working at the docks.
Mildred is appalled, and goes to talk to the owner of the dock herself. She makes no progress with him, but she does meet the union leader and learns that the workers have tried and failed to get protective clothing, or to know what sorts of cargo they are unloading so that they can treat dangerous things more delicately. The union leader will retire this year and have nothing to show for it.
But a new generation might be able to force changes. One of Gilda’s sons is considering running for union leader, despite his youth. After Mother Mildred encourages him, he’s able to convince his mother to support him by promising to make the docks a safer place. He’s seen what unsafe conditions can do: his grandfather Joe dies with the family around him, and while Barney has survived the anthrax, he could have easily succumbed.
As Mildred makes all these calls across the borough, she uses Fred as chauffeur. It’s become an extra job and expense for Fred, who has started dipping into savings to pay for fuel and is working additional hours without pay in order to complete his other tasks. He can’t say no to a nun. So Violet does it for him, bringing her case to Sister Julienne and Mildred, who is embarrassed by the realization that she has been taking advantage of Fred. Fred’s next paycheck contains some extra money to make up for his trouble.
Julienne also helps Shelagh resolve a problem. Mae is due to be adopted soon, but Shelagh is worried about the effect the change will have, even though she knows it’s the right thing for her. Mae has already lost a mother; what will she think when she loses the Turners for another family? The adoption agent tells Shelagh that Mae will be fine, but Julienne advises Shelagh to follow her instincts. So Shelagh creates a scrapbook for Mae of the loving moments she has spent in the Turner family, so she knows that they didn’t abandon her.
Lucille has abandoned Cyril, despite her fond feelings for him. He took her on a date to a West Indian social club, where people were smoking marijuana. Plus, he’s not a pastor as she was led to believe; he barely even goes to church. But it wasn’t Cyril that made her believe he was a pastor; it was Sister Monica Joan, who wanted to set Lucille up with him. Lucille can trust Cyril after all. She apologizes to him, and he admits that he doesn’t approve of marijuana but gets homesick; that’s why he likes going to the social club. Lucille suggests he try coming to her church to alleviate that nostalgia instead, and their romance is rekindled.
While Lucille may have found someone, her patient Elaine Pilkington is alone and setting off on a difficult path. Elaine arrives at the clinic in labor. When Lucille asks if she wants anyone there with her, she says no: she’s only 17, unmarried, and her parents, with whom she lives, don’t know that she’s pregnant. After Lucille delivers a healthy daughter, she asks Elaine about her history; she knows she has already given birth once before.
Elaine’s first child, whom she had at 15, was taken away from her by her parents and given up for adoption. But she’s dead-set on keeping this baby – she wants a child so much that she purposefully tried to get pregnant and doesn’t care about the father.
Elaine’s desire to keep her daughter horrifies her parents once Doctor Turner speaks to them about Elaine. Not only did Elaine once again get pregnant before marriage, she also lied to them for months in concealing her pregnancy. They refuse to let her keep the baby unless she gets married. When they visit Elaine in the clinic, they won’t even look at their granddaughter, and walk out when Elaine refuses to give her up.
The disowned Elaine decides to go it on her own. Her father at least drops off a typewriter for her as a sort of parting gift, so she can try to make a living as a typist. Between that income and national assistance, she might be able to eke by. Lucille and Miss Higgins help Elaine find a sympathetic landlady who will accept her without judgment. And that’s the best they can do.
It’s difficult and lonely getting by without a family and their love. Valerie needs to remember this: her grandmother calls, asking her to stop by with her medical kit. She has a painful boil on her rear that needs lancing – but she also misses Valerie, who hasn’t visited in a while. She’s very proud of her midwife granddaughter, and yearns for her presence and love. You have to cherish the family that you have.