Virginia Rappe was finally taken by ambulance to the Wakefield Sanitarium at 1065 Sutter Street in San Francisco on Wednesday, September 7, 1921. Her presence in the small private hospital was quickly noticed by the nursing staff.
The Wakefield Sanitarium, also known as the Wakefield Hospital, wasn’t an institution that specialized in high-risk pregnancies—and abortions for its wealthy clientele, as it has been described by others looking to dish some dirt. It admitted men, women, and children, especially accident victims who required surgery. The hospital was private though and intended for patients who wanted to avoid the populations—and diseases—of general and charity hospitals. It was staffed by top-tier doctors, and patients were often referred there by doctors who taught at Stanford University’s medical school, including Virginia Rappe’s doctor, Melville Rumwell.
Rumwell specialized in taking female surgical patients. Early in his career, he made a real name for himself in saving the life of a mother and child in a difficult birth. The mother honored him by naming her newborn son “Melville.” But Dr. Rumwell had also earned the opprobrium of tent-city dwellers in the aftermath of the 1906 earthquake, especially that of the women, when he served as a city medical officer in charge of homeless people. He was seen as uncaring and unmindful of their plight. In Rappe’s case, he dialed back the nature of her illness to alcoholism, at the time the term would have been closer to a diagnosis of alcohol abuse disorder today. That is, Rappe was still being seen as suffering from having had too much to drink—even two days later!
Rumwell had taken Rappe’s case as a favor to Maude Delmont, a former patient and Rappe’s voluntary guardian for the past three days. Apparently, when it came to his fee—as well as the cost of two private nurses and a private room at Wakefield—he had been told that someone else would cover the cost, that someone being Roscoe Arbuckle. Delmont probably didn’t reach out to the comedian about Rappe’s medical costs. She was also expecting Al Semnacher to return to San Francisco to drive her and Rappe back home and deal with the medical costs later.
Even though the St. Francis Hotel’s doctor, Arthur Beardslee, suspected a grave internal injury, indeed, a ruptured bladder, he testified that he didn’t share his suspicions or the results of his catheterization, which revealed bleeding, with Dr. Rumwell. If he had, Rumwell would have done two things in 1921: he would have attempted “heroic measures,” that is, a high-risk surgery to clean out the massive infection and close the tear in Rappe’s bladder; or palliative care since a bladder rupture, if not operated on immediately, meant certain death from peritonitis and septic shock.
The second option turned out to be deliberate or a fait accompli if Dr. Rumwell took a passive course and simply neglected his patient, knowing she was going to die anyway. In that case, any optimism he expressed was pro-forma for the sake of Delmont and Rappe’s nurses, especially the two who had grown close to her over the past two days.
Delmont may have come around to the idea that surgery was needed since Rappe’s condition only deteriorated. She called one of Rumwell’s colleagues at Stanford to get a second opinion. But she never lost faith in the doctor whom she referred to affectionately as “Rummie.” As Rappe slipped into a coma, Delmont likely interpreted this as a relief since she was no longer in distress.
Meanwhile, on the evening of September 8, Rappe’s night nurse, Vera Victoria Cumberland, had gone back on duty. Before doing so, however, Cumberland learned from Rappe’s day nurse, Jean Jameson, that the latter believed Rappe was suffering from an infection and that “microscopic tests” were in order.”
But “Dr. Rumwell failed to do this,” Cumberland said during a coroner’s inquest, “and I thought his attitude of enough importance that I left the case. I told Mrs. Delmont I thought this ought to be done and she said, ‘Oh, Rummy can’t be bothered, he had a party on tonight.’”
That Rappe’s case had “been handled negligently” wasn’t the only reason that Cumberland resigned. Her other rationale was more personal and might explain why she stood up to the physician. She believed herself to be a granddaughter of Queen Victoria, her namesake, and a countess, and, if true, had a reputation at stake.
“When I realized the circumstances of the case,” she said to the press after Rappe’s death, “I had visions of juries, judges, investigators, and policemen. It was disgusting. Finally, I determined that the fair name of Cumberland should not be dragged into the filth of actors’ misdoings, so I requested my release.”
Naturally incredulous, a reporter consulted Debrett’s Peerage and discovered that Vera Cumberland wasn’t among the issue of either Queen Victoria or her German cousin, the Duke of Brunswick, who currently held title of Duke of Cumberland.
 Associated Press, “Arbuckle Indicted: Manslaughter Grand Jury Says,” Des Moines Register, 14 September 1921, 1, 2; and “The Grand Jury: Evidence Submitted by Witnesses to Arbuckle’s Wild Party and Those Who Attended Stricken Girl,” Des Moines Tribune, 14 September 1921, 1.
 “Words of Girl on Death Bed Stir Audience . . .,” San Francisco Chronicle, 14 September 1921, 7.
 Nurse Reveals Dying Confidences,” Los Angeles Evening Post-Record, 12 September 1921, 6.