Perhaps the worst decision made by Roscoe Arbuckle and whoever had his ear was to let Maude Delmont stay with Virginia Rappe in room 1227 of the St. Francis Hotel.

Although she didn’t pretend to be a real nurse, she assumed the authority of one. (Delmont’s  younger sister, with whom she lived from time to time, was indeed a registered nurse.)

When the second hotel physician, Dr. Arthur Beardslee, came to see Rappe, he realized that this wasn’t the usual patient with a stomach ache from overindulging on rich food from the hotel kitchen or alcoholic beverages—as Delmont said. What he saw was a young woman he believed needed to be taken to a hospital for immediate surgery. But Dr. Beardslee erred on the side of hospitality, being a hotel doctor, and gave Rappe morphine injections to keep her quiet.

Meanwhile, Delmont had been going back and forth between room 1227 and the reception room of Arbuckle’s suite, room 1220.

The people in that room decided against sending Rappe to the nearby St. Francis Hospital, where Dr. Beardslee was a resident. That risked “notoriety.”

Delmont never disputed this decision. She returned to room 1227 and was satisfied with the effects of the morphine. She also convinced Dr. Beardslee that the only thing wrong with Rappe was gas. She suggested having an enema bag and Dr. Beardslee ordered one.

When he was gone, Delmont gave Rappe the enema, apparently with expertise and little mess. But undoubtedly the experience for Rappe was no less excruciating than her ruptured bladder.

Only Dr. Beardslee suspected the true nature of the injury. On his last visit, in the wee hours of Tuesday, September 6, he catheterized Rappe and extracted a little urine and clotted blood. The results alarmed him but he suppressed any expression of urgency given, perhaps, the inconvenient hour.

Still deferential to Delmont, Dr. Beardslee could only advise that his patient—whose name he incredibly failed to learn—be taken by ambulance to the hospital. Delmont, exercising a kind of medical power-of-attorney before there was ever such a thing, elected not to do so. Rappe would be treated in her hotel room.

Later that Tuesday morning, Dr. Beardslee was informed by Maude Delmont that her personal friend, a famous San Francisco surgeon who had performed an operation on her in the past, Dr. Melville Rumwell, would take over the case.