THE CORPS IS OFFERED A HOSPITAL IN LONDON
The hospital at Wimereux was lighter than it had been for many weeks,
for the winter weather had caused a lull in the fighting. In February
it was evident that the constant rains and the state of the ground at
the Front would make any advance impossible for weeks to come. The
patients coming down to the base were chiefly medical cases or had
slight injuries, which made their early transfer to England possible;
and the work assumed more and more the character of a clearing station.
In conversation with the Assistant Director of Medical Services, it was
learnt that fifty thousand additional hospital beds were to be set up
in England that spring, and that the supply of doctors--especially of
doctors who could organise--was far short of the Army’s requirements.
The organisers had now to consider whether the Corps could be of
greater service in England than in France. General W----, with whom
this question was discussed, stated that the pressure of work would
probably lie in England, and that the services of the Women’s Hospital
Corps would certainly be acceptable there.
‘You must not give up military work,’ he said to Dr. Garrett Anderson
and Dr. Flora Murray. And with real kindness he sent a despatch to
the Director General about their work, and advised them to ask for an
interview with him at the War Office.
Preceded by General W--’s despatch and their letter enclosing various
introductions and asking for an appointment, Dr. Garrett Anderson and
Dr. Flora Murray arrived in London. Here rumour met them with reports
of the intentions of the Director General and of his favourable
disposition towards them, and it was with a not unnatural thrill of
anticipation that they entered the War Office.
Surgeon-General Sir Alfred Keogh, G.C.V.O., G.C.B., opened the
interview by saying that he had heard a great deal about their
hospitals, that he had heard nothing but good, and that he expected
them to manage a larger formation than a hundred beds.
‘Who is running you?’ he asked.
‘Nobody. We run ourselves.’
‘Yes! but who is behind you? What lady?’
‘There is no lady.’
‘Who gets your money?’
‘We get it ourselves.’
‘Well, but who is your committee?
‘We are the committee.’
‘Ah then,’ he said, with a twinkling eye, ‘then we can talk.’
It was a very pleasant talk, in the course of which the Director
General said that he required large units, for small ones were no good
to him at that time. And he arranged to take the women doctors on ‘in
the usual way’ and to give them charge of a hospital of five hundred
or a thousand beds. The staff was to consist of women, with as few
R.A.M.C. men as possible. The task of finding doctors and nurses was to
rest with the organisers. In the meantime, he asked them to close the
hospital in France and to bring the Unit over to London.
Dr. Garrett Anderson and Dr. Flora Murray returned to France next day,
and the business of closing the hospital in the Château Mauricien began
at once. A number of the nursing sisters who had done arduous and
devoted work in Paris and Wimereux expressed their intention of joining
the Corps in its new hospital, and were consequently hurried off to
England, so that they might have a rest and recuperate before the next
demand was made upon their health and energy. The quartermaster and
orderlies, full of delightful enthusiasm for the future, made short
work of the packing and all the winding up of affairs. A large part
of the equipment, especially such things as coloured blankets, linen
and extras which add to the comfort of wards, were reserved for use in
London. The rest was taken over by the Ordnance, to the annoyance of
the quartermaster who had to receive it, because it was not according
to the scheduled pattern.
Dr. Garrett Anderson and Dr. Flora Murray took an early opportunity of
calling upon the Assistant Director of Medical Services, who greeted
them with his usual kindness.
‘Come and tell us how you got on with the Director General--what is he
going to give you?’ he asked.
‘He is going to put us in charge of a hospital of five hundred and
twenty beds in London,’ replied Dr. Garrett Anderson.
‘Good God! he isn’t?’ gasped the colonel, falling back in his chair
with surprise. Then, recovering from his astonishment, he added kindly:
‘Well, when I think of it, I expect you’ll be able to do it.’
His congratulations and advice were most friendly.
‘You must insist upon one thing,’ he said. ‘They must give you good
warrant officers. Otherwise you’ll have awful trouble with your
discipline.’
‘We never have had any trouble,’ said Dr. Flora Murray.
‘I know you haven’t,’ he answered. ‘We have often spoken of it, and
wondered how you managed; for you have never come to us for help. But
now it will be different. You’ve always been ladies; now you’ll both be
colonels, and you’ll see what a difference it makes.’
There remained only the final arrangements to be made. The
requisitioned articles were returned and the house was handed over to
the _maire_, who remarked regretfully that he had never made so little
out of any one before! The farewell calls were paid, a farewell dinner
was given, and the Belgian staff was paid off and disposed elsewhere.
On the day when they were ready to cross the morning boat was not
running; for the Germans had just announced their submarine campaign
in the Channel. The night boat, however, was sailing; and quite late,
with the connivance of the purser, the little party, which included
Dr. Garrett Anderson, Dr. Flora Murray and two others, managed to get
on board, and lay very low in a corner. But at 11.30 the Transport
Officer came stamping through the saloons, shouting that all civilians
and ladies were to go ashore, and they were hastily turned out on
to the muddy quay in the pouring rain. After a delay of forty-eight
hours places on board a hospital ship were courteously placed at their
disposal, and they finally arrived at Dover on the 19th of February
1915.
On reaching London they learnt that Sir Alfred Keogh had made public
his intentions with regard to the future of the Women’s Hospital Corps
the day before. Speaking at a meeting at Sunderland House, in favour of
the extension of the London School of Medicine for Women, on the 18th
of February 1915, he said:
‘He had received numbers of unsolicited letters from Paris and
Boulogne, which stated that the work of women doctors at the
Front was beyond all praise; it was an example of how such work
ought to be done. So impressed had he been that he had asked
two of the staff from Paris and Boulogne to come here and do
bigger work. He had asked them to take charge of a hospital
of 500 beds and, if they pleased, of a hospital of 1000 beds.
(Cheers).’--_The Times_, 19th February 1915.
The audience, which was composed largely of people interested in the
development of the work of medical women, received this announcement
with every sign of pleasure and approbation. Sir Alfred Keogh was
cordially congratulated by the other speakers upon the wisdom and
courage with which he had made himself responsible for an innovation
of such magnitude and importance. His action was destined to lead
subsequently to that extensive development of Women’s Services which
proved so valuable and so necessary in the conduct of the war.
[Illustration: THE GATE OF THE MILITARY HOSPITAL, ENDELL STREET, AND
THE TRANSPORT OFFICER--MISS M. E. HODGSON
(Page 122)
(_Photo, Alfieri_)
]
[Illustration: AN AUGUST BANK HOLIDAY
(Page 123)
(_Photo, Alfieri_)
]
PART II
THE WOMEN’S HOSPITAL CORPS IN LONDON
CHAPTER I
ORGANISATION OF THE MILITARY HOSPITAL ENDELL STREET
The old workhouse of St. Giles, Bloomsbury, had been taken over by the
War Office for hospital purposes, and it was there that the Director
General decided to station the Women’s Hospital Corps.
The group of buildings rises, grey and sombre-looking, at the upper end
of Endell Street, on ground which was granted by Queen Matilda for a
lepers’ hospital. It abuts on Shorts Gardens, where the leper colony
lingered long after Henry VIII. had absorbed the original foundation.
Some months before the war, the Guardians had evacuated these premises
for grander and more commodious quarters elsewhere, and during 1914
the buildings had been occupied by Belgian refugees. In the spring of
1915 an army of workmen took possession, and the work of renovating and
adapting them for a hospital was already advancing. A narrow entrance,
partially hidden by Christ’s Church, led into a square, formed by
three large hospital blocks, the church and a long administrative
building. A glass-covered passage ran down the centre of the square and
across to either block. It was fenced in with high iron railings, and
the free space on either side was divided by more railings into little
pens. The little pens had padlocked gates and were labelled: ‘Old
Males,’ ‘Young Males,’ ‘Old Females,’ ‘Young Females;’ and it was in
these cages that the inmates of the workhouse had sought fresh air and
recreation. There was a little gate office next to the mortuary, where
a set of pigeon holes, constructed out of slate slabs, was designed
to receive coffins, and where the gas meter took up most of the room.
Behind the main buildings were the children’s home--modern and well
built--and the Guardians’ offices, opening on to Broad Street. Part of
the administrative block bore the date 1727, and St. Giles was said to
have been the workhouse described by Dickens in _Oliver Twist_. A long
room, with a fireplace at either end, still exists in the oldest part,
where Oliver is supposed to have been interviewed by the Guardians;
and the cellars or basements under this section of the building are of
the most ancient and grimy description. The hospital blocks were five
stories high, with good air space and large wards. There were windows
on both sides of these wards, and more sunshine and fresh air were
available than was expected in that locality. The warehouses next door
were in the hands of the A.S.C.M.T., and all round lay the teeming,
crowded streets of Soho and Drury Lane.
Extensive structural alterations were necessary. Lifts capable
of carrying stretchers were put in; the sanitation was renewed,
and electric light and modern cooking apparatus were installed.
The building was cleaned and painted throughout, but there was an
extraordinary amount of old furniture and disused apparatus which
the Guardians had left behind, and the presence of piles of lumber
was embarrassing. The fittings of padded rooms and curious pieces of
furniture, designed to restrain the insane, came out of the lunacy
block; antique baths and obsolete drain-pipes were cast out by the
builders, and in their place ward kitchens and bathrooms were arranged
on every floor; and operating theatres, X-ray room, laboratories,
dispensaries and store-rooms were completed.
Acting upon instructions from the Director General, Dr. Garrett
Anderson and Dr. Flora Murray, since their return, had been engaged in
finding staff and in drawing up a scheme for the future establishment.
Their final destination was not decided until early in March, when they
were summoned to the War Office to discuss the suitability of Endell
Street. On the way to keep their appointment, they stepped inside the
gate and surveyed with a rapid glance the lie of the buildings and
the piles of rubbish and dirt massed among the iron railings in the
square. They saw enough to enable them to say that it would do, before
the gate-keeper turned them out as being unauthorised persons upon
government premises.
The feeling of the Army Medical Department towards women doctors could
be gauged by the atmosphere in the various offices with which business
had to be done. In one there was disapproval; in another curiosity and
amusement; in a third obstinate hostility, which was not dissipated by
an unassuming manner. But in the Director General’s own office a most
cordial desire to assist was met with, and nothing was left undone to
that end. He himself put the doctors in touch with a young major in the
department, instructing him to give them every possible assistance and
telling them to go to him in any difficulty. Further, he sent them to
see the Deputy Director of Medical Services for the London District,
and so launched them on the War Office tide.
The young major--who shortly became a colonel--was obviously nervous of
being seen in such company, and in the manner of a sheepish schoolboy
secluded them in his own little den. There the limit of his knowledge
was soon reached, but he was able to indicate the rooms of several
colonels who ought to be seen. Fearful of making a public appearance
in the corridors again, he telephoned through to these gentlemen, and
with relief despatched the ladies, under the guidance of an N.C.O.
A few days later, when he was approached with regard to some small
difficulty, he said that he knew nothing about hospitals and that it
was no good coming to him--a plain truth which was already becoming
apparent both where he and other officers were concerned.
By the light of experience gained in the years which followed, the
doctors realised how much these War Office officials could and should
have done to help them in those early days, and how they did as
little as possible. Thus they created on the minds of these women an
impression, which may or may not have been correct, of incompetence
and want of intelligence. Advice and assistance were withheld, lest
the officer who gave it might in some way become responsible for the
women’s affairs; and in addition, their path was often obstructed. It
was not understood at the time that obstruction was due to hostility:
it was taken for stupidity, or the way in which things were done at
the War Office; and after two or three fruitless visits to the branch
offices of the Army Medical Department no further time was wasted on
these gentlemen. Other sources of information or other ways of getting
things through were discovered.
The Director General had arranged for the senior medical officers and
the quartermaster to take a course of instruction in administration
under the Officer-in-Charge of the Queen Alexandra Military Hospital,
Millbank; and this officer and his staff showed them much kindness and
gave them, with many hints as to procedure, a valuable insight into the
working of a well-directed military hospital.
In due course an appointment was made with the officer then in charge
of the alterations at Endell Street, in order that he might take the
doctors round the premises and give them information which would enable
them to complete their scheme of establishment.
[Illustration: THE OPHTHALMIC SURGEON--DR. AMY SHEPPARD, O.B.E.
(Page 134)
(_Photo, Russell_)
]
[Illustration: A SURGEON--DR. WINIFRED BUCKLEY, O.B.E
(Page 135)
(_Photo, A. Basil_)
]
Two officers, a quartermaster, an N.C.O. and six
privates--R.A.M.C.--were living in the buildings and were engaged
in making preparations; but owing to the state of the works and the
mess in the place, they were--so the colonel said--‘marking time.’
The colonel was what the soldiers call ‘a real R.A.M.C. colonel.’ The
idea of women doctors in a military hospital was very distasteful to
him. The proposal filled him with disgust and apprehension, and he was
firmly convinced it was not feasible.
‘Good God! _Women!_’ he ejaculated. ‘God bless my soul, _Women_!’
He writhed on his chair and, perspiring heavily, spoke for an hour
(with frequent ejaculations about ‘Women!’) in an endeavour to prove
that the idea was ridiculous and impossible in any hospital, but
especially so in that particular one. Being reminded that the matter
had been settled and that the doctors desired to go over the buildings,
he questioned the sanity of the War Office, and finding himself unable
to stay any longer in the vicinity of such ‘indelicate females,’ he
firmly declared that he was going out, and he marched off, exclaiming:
‘Oh, good God! what difficulties you will have.’
The second officer followed him silently. The quartermaster-sergeant,
who had been present all the time, pretended that he did not know
his way round the building, so Dr. Garrett Anderson and Dr. Flora
Murray set out alone on a tour of inspection. From what they saw
they concluded that, if the hospital were to open in May, ‘marking
time’ must cease, and they therefore wrote to the Director General,
requesting that they might be put in charge at once. By return of post
came their instructions, and on the 22nd of March 1915 the Military
Hospital, Endell Street, was handed over to them by the chastened and
protesting colonel. There remained, to superintend the structural
alterations, a captain in the R.E. and the contractor’s clerk of works,
Mr. Cook. The latter was a civilian and a real patriot. He was destined
to become a great ally and, incidentally, a staunch feminist. The rapid
progress made in the work was due to his energy and devotion.
The premises were encumbered by the presence of much worn-out and
obsolete furniture--the discarded property of the Guardians. A certain
portion of it could be made use of, and this was picked out and cleaned
for the wards or the quarters of the staff; but a great deal of it was
useless, and urgent requests were made for its immediate removal. It
included several hundred old flock mattresses; and these, by direction
of the above-mentioned colonel, had been stored in the laundry. This
was a fine, large room, and it was filled up to the door with dirty
and somewhat damp bedding. The danger of heating was obvious, and in
addition the laundry itself was the only available place for a linen
store. The colonel and the R.E. captain had decided that the hospital
would not require this room, and the cleaning of it had been cut out
of the estimates. As an alternative they suggested that linen, bedding
and clothing for six hundred men should be kept in a little basement
store. After much opposition and delay, it was sanctioned that the
laundry should be used, and renewed efforts were made to induce the
Guardians to remove their material. More than one visit was made to
the Clerk of the Guardians before the name of the official who was
really responsible was elicited. It slipped out quite inadvertently
in conversation one morning. The Clerk had no sooner said it than he
regretted it, for he was promptly required to telephone and see if this
gentleman was available.
It was Saturday morning and though he was in his office, he was leaving
early to catch a train. As the doctors hastily left the room, they
heard the Clerk, in accents of dismay, saying down the telephone,
‘They have started!’ Arrived at the other office, it was clear that
the hall-porter and secretaries were anxious to prevent an interview
with their chief; but the doctors, instead of sitting down in the
waiting-room with a closed door, as they were invited to do, followed
closely on the heels of the distressed porter and were so close behind
him that they could not be refused entrance to the office and the
presence of the Chairman. He had his hat on, his bag in his hand, and
in another second he would have been gone.
‘I have a train to catch,’ he cried.
‘We won’t keep you a moment: just give orders to have all that
furniture and bedding removed.’
‘I will attend to it on Monday, certainly.’
‘Monday is too late. A telephone message now, please.’
He hesitated, looked at them standing between him and the door, laughed
and capitulated.
‘All right, ring them up,’ he said to his secretary, and fled to catch
his train. But the women remained to hear the order sent through.
By the end of the month Dr. Garrett Anderson and Dr. Flora Murray had
moved into the quarters at Endell Street, which they continued to
occupy until April 1919. And the work of preparation was progressing
rapidly. Under Mr. Cook’s influence, the workmen gave up their Easter
holiday, and every one pressed forward eagerly. Indents were drawn
up and sent in for the furniture and medical stores required, and
gradually the supplies were delivered. Several years later, Major B----
told Dr. Flora Murray with what interest the first indents from Endell
Street had been scanned at the Horse Guards, and how surprising it had
been to find that they were right.
The furniture arrived before the lifts were ready and in quantities
which the small R.A.M.C. contingent could not deal with. Fatigue
parties, therefore, from the various regiments stationed in London were
obtained, and the furniture and equipment were distributed through the
buildings.
At this stage, a very kind old gentleman--not in uniform--came into
the square and inquired how we were getting on. He said that he was
the Officer in Charge of Barracks, and that the indents for furniture,
linen, etc., went through his office. In conversation he stated that
he was in his eightieth year, and he showed a friendly interest in the
plans for the hospital. He had two daughters who were both suffragists.
‘One,’ he said, ‘belongs to a most respectable society,’ then dropping
his voice, ‘but the other--she goes with Mrs. Pankhurst’s lot.’
Perhaps his hearers, who had also gone with ‘Mrs. Pankhurst’s lot’ in
the suffrage days, did not look as shocked as he expected; for he added
kindly:
‘I daresay you may not have heard of Mrs. Pankhurst.’
One morning, as he watched a fatigue party fall in in the square, he
asked:
‘Now, do you get any work out of these fellows?’
‘Yes,’ answered Dr. Garrett Anderson, ‘there is a woman placed at the
bottom of the stairs to send them up, and another at the top to send
them down again, and they get quite a lot done.’
‘Poor fellows, poor fellows,’ said the major. ‘Very energetic ladies!
Oh! we are not accustomed to that in the Army.’
The Corps required to be largely supplemented to enable it to cope
with the work before it, but fortunately it was able to fall back
upon a number of its original members, and these formed the nucleus
of the new staff. Dr. Woodcock became the physician to the hospital.
Dr. Gertrude Gazdar and Dr. Rosalie Jobson, who had worked in France,
accepted posts as assistant surgeons. Dr. Amy Sheppard, O.B.E., was
appointed ophthalmic surgeon; Dr. Helen Chambers, C.B.E., pathologist;
Dr. Eva Handley-Read, dental surgeon; and Dr. E. M. Magill, O.B.E.,
radiologist (in 1916); while Dr. Winifred Buckley, O.B.E., who served
from the opening of the hospital to its closure, and three other
doctors, completed the surgical staff. Dr. Louisa Garrett Anderson,
C.B.E., was the Chief Surgeon, and the administrative work, with title
of ‘Doctor-in-Charge,’ fell to Dr. Flora Murray, C.B.E.
Miss Hale, R.R.C., who was then matron of the Elizabeth Garrett
Anderson Hospital and a member of the Territorial Force Nursing
Service, was working at the 1st London General Hospital at the time.
Dr. Flora Murray represented to Sir Alfred Keogh that she was the right
person to take up the work of matron, and by his wish, and with the
cordial consent of Dame Sidney Browne, D.B.E., R.R.C., Matron-in-Chief,
Territorial Force Nursing Service, she was seconded for service under
the War Office. She held the office of matron with success from April
1915 till October 1919. Some of the Sisters from the French hospitals,
Miss Breen, Miss Pearson, Mrs. Lawrence, R.R.C., Miss Clemow, R.R.C.,
and Miss Belton, continued as members of the Corps. The schedule of
establishment sanctioned only thirty-six trained nurses for the
entire hospital. Words cannot measure or describe the value of their
service to the sick and wounded. Some of them, including Sister May,
Sister Beales and Sister Moore remained from the opening date until its
closure. They worked at high pressure, often under difficulties, and
with untrained subordinates, while surgeons and patients learnt to rely
more and more upon their constant care and devotion.
Quartermaster Campbell expanded her staff to meet requirements, and the
former orderlies, Miss M. E. Hodgson and Miss Isabel Lowe, were called
up early to help in organising. A hundred picked young women joined up
as orderlies, some for nursing and some for administrative work; while
the clerical section was organised by Miss Jarvis, who had also served
with the Corps in France, and by Miss Esther Hatten. The R.A.M.C.
detachment numbered one N.C.O. and twenty men, fourteen of whom were
later replaced by women. Thus a staff of approximately one hundred and
eighty persons was ready when the hospital opened in May.
[Illustration: THE PATHOLOGIST--DR. HELEN CHAMBERS, C.B.E.
(Page 138)
(_Photo, Reginald Haines_)
]
[Illustration: SEARCHING FOR PROTOZOA IN THE LABORATORY
(Page 139)
(_Photo, Alfieri_)
]
CHAPTER II
FIRST DAYS OF THE MILITARY HOSPITAL ENDELL STREET
The hospital was designed to accommodate five hundred and twenty cases,
but it had not been open long before orders were received to put up as
many extra beds as possible; and from 1916 onwards the number of beds
was five hundred and seventy-three. Several auxiliary V.A.D. hospitals
were attached to it at a later date, supplying another hundred and
fifty beds. At times of pressure, when billeting of convalescent men
was allowed, the numbers on the register approximated to eight hundred.
Once the extra beds went up, they were not taken down again, and it was
not until the summer of 1919 that any reduction was made.
There were seventeen wards, of which the three smaller ones in the
south block were reserved for severe cases. They all had ample window
space, and though the beds were closer than is usual or desirable in
civilian hospitals, there was plenty of fresh air and light. The chilly
whitewashed walls and gloomy brown blankets of Army hospitals seen
in France were not forgotten, and great trouble was taken to make the
Endell Street Hospital look gay and comfortable. Every ward had its
flowers and its red and blue or scarlet blankets to give it colour, and
its table and screen covers to give it an air of comfort. The electric
lighting, as carried out by the R.E. in spite of demonstration and
remonstrance, was hopeless; with only three or four single drop lights
in the centre of a ward for thirty or forty men, no one in bed could
see to read or play cards. An application for standard lights produced,
after long correspondence and delay, only the scheduled number of
thirty; and the lighting was not arranged satisfactorily until the St.
Leonard’s School stepped in and sent one hundred and eighty standards
for ward use. This generous gift made every one comfortable, and the
necessity for drafting report after report, to support applications for
more than the scheduled number of lamps, ceased.
The lifts were large enough to carry beds, and in fine weather it was
usual to find rows of beds and wheel chairs in the square, which had
been cleared of all the impedimenta and railings belonging to its
workhouse past, and which made a pleasant general meeting ground. A
large recreation room was available for wet days. At one end there was
a small green-room and stage, which the Corps out of its own funds
supplied with electric batons and curtains. The drop curtain was of
saxe blue, with monogram ‘W.H.C.’ in black and orange, and the motto of
the Corps, ‘Deeds not Words,’ was proudly mounted above the proscenium.
This room also housed the library and billiard table.
The patients’ dining room was a somewhat gloomy place on the ground
floor in the neighbourhood of the kitchen; but only the very
convalescent descended to it at midday and spent there the few minutes
which a soldier man requires for consuming a hearty meal. The more
experienced Sisters had an ineradicable objection to not knowing
what and how ‘their men’ ate, and persistently discountenanced the
dining-hall.
On the ground floor of the south block the large windows of the
pathological laboratory and the dispensary afforded those who worked
inside a fine view of the square and prevented them from feeling cut
off or isolated from the general life of the place. On the top were
found two operating rooms and the X-ray room with its appurtenances,
as well as accommodation for the dental surgeon. The ophthalmic
surgeon worked up there too, in default of better quarters, adapting a
passage and a corner of the dark room for the needs of her patients.
In a building where there was not a corner to spare, and where people
were constantly asking for ‘a room of my own,’ her uncomplaining
consideration was much appreciated.
In every spare corner of the basements and ground floors, offices and
store-rooms were crowded in. Above the quartermaster’s office and
steward’s stores, three floors of cubicles were arranged as sleeping
quarters for women orderlies; and for some unknown reason this part
of the building was called the ‘Barracks.’ The Children’s Home housed
the nursing sisters, and the Barracks and Guardians’ Offices were
full to overflowing with girls. The old Receiving House near the
gate was occupied by the R.A.M.C. The Master’s house, which had been
built so as to command a good view of the square, provided offices
and doctors’ room on the first floor and living rooms above for the
resident doctors, the orderly officer, the matron and several other
people. Every corner was occupied, and as the work or the needs of the
hospital expanded, it was a puzzle to find room. As the years went on,
it became necessary for additional quarters to be found outside for
the nursing staff, and two houses in the neighbourhood were eventually
rented and adapted for the use of the hospital. It is noteworthy
that although the first report and request for further accommodation
described this need as ‘very pressing,’ it took an entire year to get
the first of these houses passed by the military authorities and the
necessary business completed for opening it.
In naming the wards, it was convenient to follow the alphabetical
order, and in the desire to call them after women the names of saints,
with a few others, were chosen. Thus Ward ‘A’ was known as ‘St. Anne.’
‘St. Barbara’ and ‘St. Catherine’ followed; and, with one or two
omissions, the sequence continued down to ‘St. Veronica.’ ‘St. Ursula,’
the patron saint of young women, was included, and in order to cover
the letter ‘O,’ ‘St. Onorio’ was invoked. She was afterwards found to
be, not very appropriately, the patron saint of wet-nurses! But she
served her ward well, for it was one of the happiest in the hospital.
‘St. Mary’ was unfortunate, and the ward never had very good luck until
her name was changed to ‘St. Margaret.’ Rachel, in those tragic days of
war, could not be omitted. Hildegarde, the famous medicine woman of
the third century, and the martyred St. Felicitas were grouped with St.
Geneviève of Paris and St. Isabella of Spain. The idea was picturesque,
and the nomenclature pleased the staff, if it did not appeal much to
the men. A bare little room in the basement was entitled the ‘Johnny
Walker Ward,’ and was used as a place of recovery by his patrons and
slaves.
Early in May the first return of available beds was made; for two
blocks were ready for occupation and the third was nearly so. The
delivery of certain things, such as dinner tins, wagons and knives
and forks, was delayed, and promised to be delayed for months. With
activity increasing in France, the opening of the hospital could not
be postponed for such trifles, and the resourceful quartermaster
arranged to hire what was needful for a month. The staff was called
up and settled down in its quarters; the rows of beds were got ready;
the stock bottles and cupboards were filled; the instruments and
apparatus were issued on charge to the Sisters; the kitchen plant was
in order. Though not yet completely equipped, it was possible to inform
Headquarters that Endell Street was ready to open.
The Army way of opening a hospital is to transfer to it convalescent
cases from other hospitals. When asked at a later date why this custom
prevailed, since it did not make things easier for the receiving
hospital, a senior officer said that there was nothing to recommend
the custom, but that that was the way they did it. In every hospital
there were cases which, for some reason or another, the staff was more
or less glad to pass on; and an order to transfer twenty-five or fifty
walking cases meant that the troublesome, the idle, the grousing, or
those who were unsatisfactory for some reason, were collected and
moved on. On the 12th of May 1915 Endell Street received a hundred
convalescent cases from various hospitals in the London District. That
night, the convoys from France began to arrive, and a letter written on
the 14th to hasten the supply of knives and forks states that on that
date there were two hundred and forty-six men in the hospital. It was
open just as a spell of heavy fighting began, and within a week all its
beds were available and all were full.
The first month was a difficult one. The work poured into the hospital,
making new and heavy demands upon every one. Equipment was short, and
the women had everything to learn and no one to advise or help them.
They had to find things out for themselves, and some months later much
time was spent in correcting, by the light of experience, entries in
registers and returns which had been incorrectly made in those early
days. Gradually order was evolved. The women adapted themselves to the
conditions, and the wheels of the establishment went round more easily
each week. The strain of those first days was severe; the staff was
weary in mind and body; but the general eagerness to make things go
right triumphed, and the organisation developed and established itself.
It soon became evident that Endell Street was a favourably situated
hospital, and that it would not lack for work. It was near to the
railway stations, and through all the years that followed its beds were
kept very full and the proportion of cot cases--as against sitting
cases--coming into its wards was a high one. It had a busy casualty
room, too, where men from neighbouring stations reported sick in the
mornings, and into which men on leave, or men absent without leave,
would wander for more or less severe ailments. Men suffering from
accidents or fits or drunkenness were liable to arrive in ambulances
at all hours of the day and night, and more serious cases, from
billets, from hotels or from the St. Albans military district were
constantly received there. In 1917 to 1919 numbers of pensioners came
for treatment, and hundreds of men were examined and certified before
demobilisation, or else attended after demobilisation to have the Army
form relating to disabilities and assessments made up. The average
number of attendances in the casualty room totalled not less than five
thousand each year.
[Illustration: THE CHIEF SURGEON WITH GARRETT AND WILLIAM
(Page 148)
(_Photo, Reginald Haines_)
]
[Illustration: THE DOCTOR-IN-CHARGE SEES MEN IN HER OFFICE
(Page 149)
(_Photo, Reginald Haines_)
]
Twice, perhaps, a lull occurred in the convoys coming from overseas,
and the return of empty beds rose to two hundred or so. The nursing
staff would begin to complain of being slack, but such periods of quiet
were followed by rushes of work, when two or three or four convoys
would arrive in twenty-four hours, and every effort had to be made to
discharge or transfer convalescents and make room for new-comers. As
a rule, at busy times every bed emptied during the day was filled at
night. On one such night, when four beds were returned, four fractured
spines were sent in a few hours later.
A big bell hung in the square, and the arrival of a convoy was notified
to the staff by two blows on it. This brought out those whose duty
it was to assist in taking in. Doctors, women stretcher-bearers and
R.A.M.C. assembled without delay; for it was necessary to hasten and
let the ambulances get back to the station for a second journey. The
staff of men orderlies being small, the women were all trained as
bearers. The men would unload the stretcher and hold it, while women
stepped between the handles and carried it to the lift and so to
the bedside. Stretcher bearing was a popular occupation, and if the
bell rang during the day, volunteers would run out of the stores and
offices and laboratories and fall in with the R.A.M.C. The man on the
stretcher was often speechless with astonishment when he realised that
two ‘flappers’ were carrying him; but they were very steady, gentle
bearers, and earned high praise for the way in which they performed
their duties.
Out of twenty-six thousand patients who passed through the wards, the
greater number were British, with a fair proportion of Dominion and
Colonial troops. Two thousand two hundred and seven Canadians and more
than two thousand Australian and New Zealand men and about two hundred
U.S.A. troops made up this proportion. They had the same cheerful
spirit as the men in Paris and Wimereux. They settled down to enjoy the
amenities of the hospital with apparently little thought for the past
or the future, entering into the hospital life with zest and pleasure;
and their contentment and gaiety were pleasant to see. Within an hour
of coming in, new-comers learnt that it was ‘a good home’ and that the
doctors were women. They showed no surprise, but were wont to develop
amazing confidence in the ward doctors and to discuss the merits of
the various surgeons in the square. Each man thought his ward the best
ward in the hospital, and his doctor the best doctor on the staff; and
many boasted to visitors and at tea-parties that the worst cases in the
hospital were in their ward and under their doctor. The dental surgeon,
whose skill in extraction was considered marvellous, never failed to
thrill the men, and she was eagerly pointed out to friends or visitors.
The ophthalmic surgeon excited interest too, for she was the victim of
a false report, which supposed her to have broken more windows than any
other suffragist!
Only once did a man ask to be transferred on the ground that he did not
wish to be under a woman surgeon, but he repented of his decision and
sent his mother to ask that he might remain. More than once, a transfer
was offered in certain cases, in order that the patient might be
treated by a man; but this was invariably refused, the patient feeling
perfectly satisfied where he was. Their confidence in the Chief Surgeon
was unbounded. She never operated without telling the patient what she
was going to do, and she never omitted to see him afterwards and talk
over the operation. Between the hours of 5 and 7 P.M. was a quiet and
very useful time in the wards, when she would visit all the more severe
cases and give them time to talk about themselves. She would explain
clearly the surgical situation and what she advised and why. She never
hurried a man in his decision, unless it were urgent; but waited,
gentle and reassuring, until he would say, ‘I leave it to you, Doctor;
if you think it’s best, I’ll have it done.’
The men were reticent and inarticulate, but they trusted her. They
wrote to her afterwards for advice; and pensioners were known to travel
from Scotland and other distant places to get her opinion. In the same
way, they believed in and trusted the ward surgeons and the Sisters,
and realised that every one in the building desired their welfare
and happiness. There was a homeliness in the wards and in the men’s
relations with the nursing staff which was soothing and welcome to them
after their experiences.
Racial characteristics were very evident. The English were slow and
phlegmatic, satisfied with theatres, billiards and the football news.
The Scots were friends with the librarian and always pushing to get
well enough to see London. The Irish brought grace and charm into the
ward, but each one was the Irish question intact. Their grievances
were as unexpected as they were incomprehensible. As a rule, they were
anxious to be transferred to Irish hospitals, and the necessary steps
having been taken, Pte. Doolan would receive instructions to draw his
kit and prepare himself. Then he would go grumbling up and down the
ward.
‘But I thought you wanted to go to Ireland,’ said an astonished orderly.
‘So I do,’ he replied. ‘But I think this is very hard.’ And in response
to further probing, ‘Well, I did ask to go, but I wasn’t expecting to
go--not this week.’
Or one would present himself in the C.O.’s office.
‘I wish to mak’ a complaint. There’s a lot of men in the ward gone to
the theatre and the Sister kep’ me back.’
Under discussion, it transpired that he was not so well, and being kept
in bed, he had risen and dressed to come down and make his complaint.
‘It’s true the doctor said I was not to leave my bed, me being with a
temperature again.’
When asked whether he would have wished the other men to stay in,
since he could not go out, he replied with dignity that he was not ‘an
onreasonable man’; and on being advised to return to his bed and take
care of himself, he said:
‘Would ye say a wurrrd to the Sister?’
Then with a ‘Thank ye kindly, lady,’ he retired to bed again all smiles!
With all their difficulties, they were the most grateful of people.
It was the Irish who stood up in the ward and made speeches to the
nurses before the Irish convoy left; and it took an Irishman to say
that if he had been all the time in this hospital, he never would have
had the heart to leave it, and then to confound the doctor by a bitter
complaint at a fancied delay in procuring his transfer.
Australians and New Zealanders began to arrive from Gallipoli in August
1915. They were gaunt and grey after their terrible experiences. The
wounded had suffered much during the voyage home, and all of them were
wasted with disease. They were big, fine men, reduced by three or more
stone below their usual weight, and so weakened by long illness that
they lay silent and apathetic in their beds, thankful to be at rest
at last. The sick were collected in special wards, and it was not
long before they began to put on weight and lift up their heads. The
pathologist concentrated on them, and the laboratory had a fine exhibit
of lamblia and tetramites and kindred organisms, which excited the
interest of the staff. Whenever special diseases were admitted, every
one was invited to see the specimens and listen to brief lectures, even
the cooks and the librarian’s charlady availing themselves of such
opportunities!
These men were better educated than the British soldiers. Mentally
they were more formed, and were accustomed to independence of thought.
Their attitude towards the women, among whom they had been thrown so
unexpectedly, was friendly and chivalrous. They enjoyed the hospital
and they appreciated the work which was being done there; but they
could not understand why the vote was withheld from women, and in face
of their eager questioning the medical staff was unable to adhere
completely to its rule of avoiding propaganda talk on the subject
of women’s suffrage. They were almost the only men who wished to
discuss this subject and other political subjects with the doctors and
sisters. As they got better, they were able to go about, and they
were greatly interested in London. A party which went to the House of
Commons included Pte. King, a keen politician. At the House, various
members were introduced to the Australian soldiers, and Mr. Ramsay
MacDonald asked the politician what hospital he came from. Hearing
that it was Endell Street, he could not resist saying what a great
suffragist he was, and how much he had helped the women’s cause.
‘That may be, sir,’ replied Pte. King cautiously, ‘but these ladies
have records of every M.P.’s career, and they know exactly what each
one has done and how he has voted.’
Relating the interview in his ward that night, the politician inquired
what this M.P. had done to help; for, he said, ‘he seemed properly put
about.’
During these weeks, when about two hundred beds were occupied by
Australian troops, officers from their headquarters used to call, full
of anxiety as to the conduct of their men. The reason of this anxiety
was not understood till afterwards, when reports were circulated
that there had been difficulty and outbreaks in other hospitals and
that Australians were considered ‘very wild.’ Many Australians were
admitted to Endell Street Hospital, but they never gave any trouble.
On the contrary, they showed a consideration and courtesy towards the
staff which was only equalled by the attitude of the New Zealanders.
Eventually, the hospital became one of those to which New Zealand
soldiers were sent, and the wards--especially the medical wards--had
many serious cases among them. In the spring of 1917, and again in
1918, a great many cases of pneumonia occurred among New Zealanders,
and some of them made marvellous recoveries. These troops were very
much liked in the hospital; for they had gentle, refined manners and a
wide outlook, especially where women were concerned. The organisation
of the New Zealand Headquarters was one of the most efficient. It
gave no unnecessary trouble to the hospital, and took a great deal of
care of its men. In marked contrast was the Canadian organisation,
which duplicated and triplicated the work of the offices, and sent
innumerable letters of inquiry, instead of filing and referring to
hospital returns. With a few exceptions, their men were brusque and
somewhat rough, and the medical staff learnt to dislike the manners of
Canadian staff officers thoroughly. Among their ranks were men of all
nationalities--Russians, Greeks and Japanese, with whom communication
was difficult, as they did not know English, and many Frenchmen, who
spoke a _patois_ only. These latter would have been very friendless,
if Monsieur and Madame de Bry had not been available close at hand in
their chocolate shop, and a message to them was never sent in vain. On
visiting days the French soldiers were sure of seeing either Madame de
Bry or one of the charming young ladies who sold so many sweets to the
orderlies at Endell Street.
In 1919, when men were evacuated from Russia by Archangel and England,
a party of French infantrymen arrived in an ambulance, with a large dog
on a very stout rope. He was very gentle with people, but as he had
lived in the forest camps and been trained to kill bears, he was not to
be trusted with other dogs, and there was a hectic moment in Tottenham
Court Road when he met a bull terrier, and two men and the rope were
required to hold him. A party of Greeks and another of Serbians also
came from Russia, the latter rejoicing in the sights and shops of
London.
In that year, too, numbers of cases came from the East and from India,
and it was not unusual to meet a monkey or a parrot or a strange
reptile harbouring in the wards for a few days.
In August 1917 sixty beds were set aside for women, and were available
for Q.M.A.A.C. and other women’s units until January 1919. Ladies who
had been working abroad with the Y.M.C.A. or canteens found hospitality
at Endell Street, and the wives of officers and N.C.O.’s, with children
and little babies and their governesses and their nurses, returning
from the East, spent a few days there. In all, two thousand women
passed through those wards.
Comparatively few Americans were admitted as patients, but in the
summer of 1919 orders were sent to accommodate a hundred and fifty
U.S.A. troops, not sick, on their way home from Russia. These men,
to judge by their names, were mostly of Russian origin. The U.S.A.
Headquarters telephoned to the hospital to keep the men in for
inspection, but consented to letting them go out the second day. The
men were inclined to paint the town red, and straggled back, drunk and
sorry, up till 1 A.M. The Headquarters said they must stay in next day,
as they might leave at any moment. But no orders for departure came
through, and the men became restless and rebellious and would have
broken hospital but for the persuasive feminine tongue, which led them
back to their wards. They were granted leave to go out the next day and
were started off for U.S.A. on the following morning, less half-a-dozen
who did not return in time, and two who were in the hands of the police
for firing revolvers in the streets.
The critics and the sceptics prophesied that women would fail in
keeping discipline, and certainly the War Office did nothing to
strengthen their hands. It denied the women commissions or honorary
rank, and refused to let them wear the badges of rank which soldiers
recognise as symbols of authority. Thus there was nothing except her
bearing to distinguish a senior from a junior officer. It would have
been helpful if an experienced warrant officer had been appointed
to the hospital, but instead a newly promoted corporal was put in
charge of the R.A.M.C. detachment. Having thus made it as difficult
as possible, the authorities left the women to sink or swim. But
discipline came of itself. Until 1919 no conscious effort was made to
maintain it, and in that year it only became necessary to take definite
trouble about it owing to the very large numbers of men transferred
to the hospital from others which were closing and in which a certain
laxity had prevailed.
It was very rare for a man to be reported for a small offence and
brought before the C.O., and in the early days the embarrassment was
mutual. The sergeant (afterwards the sergeant-major) was often asked to
leave the offender alone with her, so that she could speak more freely;
and an appeal to the feelings of the sinner generally reduced him to
tears. Then he had to be detained in the office with more pleasant
conversation, till he regained his composure sufficiently to meet the
public eye. After such an interview, one young fellow retired to his
bed, and drawing the blankets over his head, refused to answer the
inquiries of his much concerned friends. In the evening, when hunger
drew him from his lair, they gathered round him with solicitude.
‘I’ve been up before men and up before women,’ he said, ‘and God save
us from the women!’
The conduct of the hospital was based upon the Army rules for men in
military hospitals; and now and then, when things were not going quite
well in a ward, the N.C.O. patients would be paraded in the office
and the Doctor-in-Charge would read to them the rule making N.C.O.’s
responsible for ward discipline. With a few words about the hospital
and the staff who cared so much for its reputation, she would enlist
their interest and help. As they themselves expressed it, ‘After that,
there was nothing more to be done.’
In 1915 to 1916 the Army rule which did not permit men to go out
unconducted was in force, and walks and drives were extensively
organised. Many friends came several times a week to take men out,
thereby helping to keep them happy and contented. Foremost among these
was Mrs. Cobden Hirst, who with the help of a group of hostesses
organised hundreds of outings and gave immense pleasure to several
thousand patients. This rule was subsequently rescinded, and the order
to let men out till 5 P.M., and later till sundown, was welcomed by all
concerned.
It was rare for a man to be late in coming in or to stay out all
night; for such offences meant that the privilege of going out would
be suspended for his whole ward next day, and he would have an
uncomfortable time with his fellows. On days of public rejoicing, such
as Armistice Day or Peace Day, extended privileges were freely given,
but they were not abused. On Peace night every man was in by 10 P.M.;
not one was absent. This punctuality was perhaps due to a large tea,
with sausages and tomatoes and cake in the afternoon, and to a meal
of cocoa and eggs at 10 P.M. These luxuries having been advertised in
the wards the day before, the men knew where comfort was to be found.
In any case, things went smoothly. The life of the hospital was not
dull. Festivities and Bank Holidays were observed. There was an endless
succession of outings--drives, teas and theatres; within, the library
was an important interest, the needlework a constant pleasure; and
the two or three entertainments given every week were eagerly looked
forward to. There was always something going on, or something coming
on, which kept the men interested and expectant.
CHAPTER III
MEDICAL AND SURGICAL WORK
From the professional point of view, the work which came into the
hospital was excellent: it was varied and full of interest, and it
gave women an exceptional opportunity in the field of surgery. The
responsibility for finding the medical and surgical staff rested with
the Doctor-in-Charge, the War Office confirming the appointments
on her recommendation. By a special arrangement these appointments
were binding for six months at a time, and could then be renewed or
terminated as desired. The medical officers were not commissioned, but
they were graded as lieutenants, captains, majors or lieut.-colonel,
and each one drew the pay and allowances, under Royal Pay Warrant, of
her respective rank. They also drew uniform allowance and specialist
pay, as well as the bonus and new rates of pay when these were
introduced. On the termination of their service they were granted a
gratuity.
Among the graduates who served at Endell Street were representatives
of the Universities of England, Scotland, Canada and Australia. Some
of them spent one year or two years there. Others continued for the
whole period that the hospital was open. The general knowledge which
all the doctors were able to have of all the work in the hospital,
and especially of all the serious cases, was a great advantage. The
ward officers acted as orderly officer in rotation--that is, they
took casualties and night work for twenty-four hours in rotation--and
had the supervision of the wards on their nights on duty. In civil
hospitals members of the staff may not meet for weeks at a time; but in
a military hospital surgeons and physicians attended daily, and at the
morning meeting the orderly officer’s report for the previous night was
read, and it was possible to talk over the various cases. A great deal
of good team work was done, the surgeons, physician and pathologist
concentrating on the worst cases. The pathological laboratory, which
was situated in the centre of the square, was the scene of many useful
consultations.
Of the five hundred and seventy-three beds, sixty were reserved for
medical cases, and the other five hundred and thirteen were under
the supervision of the Chief Surgeon. Each of her assistants had
charge of sixty or seventy beds, and one ward was generally given
to the Doctor-in-Charge, who refused to be excluded altogether from
professional work.
The surgeons spent all their mornings in the wards, and most of their
afternoons in the operating theatre, where it was not unusual to have a
list of twenty or thirty cases on each operating day.
In 1915 large numbers of wounds of head, presenting many interesting
features, were admitted. From the surgeon’s point of view they were
fine cases, for they did well. One lad, who had a bullet removed 1¼
inches deep from the brain, was found sitting up sewing at his badge
four days afterwards, and greatly pleased with himself.
After steel helmets came into use these injuries decreased in number,
and other kinds of wounds took their place. There were always an
immense number of compound fractures, for three hundred of the
surgical beds were returned as orthopædic. And in 1917 one hundred
and fifty-four compound fractured thighs were in the wards at the
same time. These were exacting cases: a good result depended on the
excellence of the nursing and the most unremitting surgical care and
watchfulness. The latest forms of apparatus were manufactured by the
carpenter, Mr. J. A. Campbell of Arduaine, and the masseuses toiled
over the patients without ceasing. The results were very satisfactory,
and it was disappointing to be told, in 1918, that in future fractures
of thigh were to be grouped in special hospitals. However, that same
year brought in a series of wounds of knee-joint which exercised the
ingenuity and skill of all concerned. In addition, there was valuable
experience with fractures of the upper arm.
The wounded owed much to the inventive genius of Mrs. Banks. She
began work in the hospital mending room, and then became famous over
_papier mâché_. No one could construct splints for the upper arm so
comfortably and so effectively as she did, and her abdominal belts and
other appliances were greatly appreciated. One notable case had the
humerus smashed into a hundred pieces, but it ultimately united and
the patient left hospital with a useful arm and some X-ray photographs
which thrilled him. There were men with divided or injured nerves,
and several hundreds with acute appendicitis, both interesting and
satisfactory to the surgeon; besides all the more ordinary gunshot
injuries, many of them with fractures, for which the operations of
wiring and plating the bones were constantly undertaken.
The number of operations performed in the theatres was seven thousand,
but the minor ones done in the wards or casualty room were unrecorded,
and are not included in this figure.
When the wards were full of men, the actual work of dressing their
wounds occupied a great deal of time; and as it was often necessary
that a large number should be dressed twice a day, or even every four
hours, the work was never finished.
In July 1916, at a time when the hospital was very crowded and dressing
was going on practically all day, Professor R. Morrison, of Newcastle
on Tyne, wrote to the pathologist, asking that his method of using
‘Bipp’ might have a trial. Doctors, nurses and patients alike were
finding the constant changing of dressings exhausting, and suggestions
were welcome. ‘Bipp’ was a paste which, after being rubbed into the
wound, could be left untouched for ten or even twenty-one days. A
chemical reaction kept up an antiseptic effect, and the undisturbed
tissues healed rapidly. The first results were so romantic that
an extended trial was given to the method; and before long ‘Bipp’
came into general use in the hospital and held its position first
amongst all other disinfectants. The work in the wards at once became
manageable; the number of dressings fell 80 per cent, and the results
were splendid. The men appreciated the rest and relief from painful
dressings and were also proud of their rapid progress. New-comers might
look doubtful when they heard that their wounds would be left alone for
ten days, and would murmur that in the last hospital they were dressed
every day; but their neighbours had learnt to comment on old-fashioned
ways, and laughed them out of their fears. ‘Bipp’ metamorphosed the
work of the hospital. The surgeons relied on it so confidently that
they never hesitated to operate on septic fractures or joints; and on
one occasion a scalp abscess was evacuated, the skull trephined and a
bullet extracted from the brain, in the complete assurance that ‘Bipp’
would save the situation, as it did.
In the autumn of the year 1916 Sir Alfred Keogh paid his first and only
visit to Endell Street. He came, accompanied by the Deputy Director of
Medical Services for the London District, to see the results obtained
by the use of ‘Bipp’; for the War Office had heard of the method and
was considering introducing it into the Army hospitals and casualty
clearing stations abroad. Endell Street was the only hospital in London
which had given it an extensive trial, and it was a proud moment
when the Chief Surgeon led the Director General from ward to ward,
displaying one good surgical result after another, showing normal
temperature charts and healed wounds, with conservation of tissues
and good movements. At last he said that he had seen enough and was
convinced, and when he took his leave, he congratulated the staff upon
the success of the hospital.
‘I knew you could do it,’ he said. ‘We were watched, but you have
silenced all critics.’
In his busy life, Sir Alfred Keogh had not time to see the hospital
again, but he kept himself informed of its progress, and when the time
came that he left the War Office, he wrote as follows:
DEAR DR. GARRETT ANDERSON--I appreciate very highly the very
charming message you and Doctor Flora Murray have sent me in
your letter. I shall go down to see you and say good-bye before
I actually leave the War Office.
I should have liked to have seen you and your work very often,
but you will know that with six foreign campaigns on hand,
and an immense amount of work in addition in connection with
home affairs--which perhaps were even more difficult than the
foreign ones--it has not been possible for me to visit you
more than I have done. I have not been unmindful of you I can
assure you. I have often talked of you and heard your work
discussed, and it has always been to me a great pride to know
how successful you have been.
I was subjected to great pressure adverse to your movement
when we started to establish your Hospital, but I had every
confidence that the new idea would justify itself, as it has
abundantly done. Let me, therefore, thank you and Doctor Flora
Murray--not only for what you have done for the country, but
for what you have done for me personally. I should have been
an object of scorn and ridicule if you had failed, but I never
for a moment contemplated failure, and I think we can now
congratulate ourselves on having established a record of a new
kind.
I think your success has probably done more for the cause
of women than anything else I know of, and if that cause
flourishes, you and I can feel that we have been sufficiently
rewarded for our courage.--Yours sincerely,
ALFRED KEOGH.
_19th January 1918._
It was characteristic of the Women’s Hospital Corps that, when the
Director General had left the hospital--or, indeed, after any official
visitor had left--various members of the staff would come to the
office, one after the other, to ask how the inspection had gone, and to
rejoice over any little word of praise or appreciation which might have
been given to their hospital.
About three weeks after the hospital opened two severe cases of acute
mania were admitted. As there was no ground-floor ward and no window
with any protection, they were a source of anxiety to the medical
staff. One of them was blasphemous and homicidal, the other deeply
religious and suicidal; both were violent and noisy and had to be
detained in a small room by themselves, with several R.A.M.C. men in
constant attendance. The hospital telephoned to the Horse Guards,
reporting the matter and asking instructions as to their disposal, and
was told that instructions would be sent. The next day the hospital
telephoned again for instructions, and the reply was that the men must
not be certified. On the third day the hospital telephoned urgently
and inquired about disposal. It was told that the question was under
consideration and that information would be sent. On the fourth day the
hospital telephoned still more urgently and received the same reply.
It telephoned again the same afternoon, and this time was told that
Colonel H---- would come and see the Doctor-in-Charge.
Towards five o’clock, a gentle and very elderly colonel arrived.
Evidently, he was under the impression that women doctors were
unaccustomed to lunatics and were unduly alarmed.
[Illustration: IN THE OPERATING THEATRE
(Page 170)
(_Photo, Reginald Haines_)
]
[Illustration: AN INSPECTION IN THE DENTAL ROOM
(Page 171)
(_Photo, Reginald Haines_)
]
‘Yes, mental cases,’ he said, ‘rather worry you, don’t they? Yes, yes,
not nice cases for ladies. I will just go up and say a soothing word to
them--poor fellows.’
The Doctor-in-Charge and Chief Surgeon looked at each other and then
led the colonel upstairs.
Pte. T---- was sitting up in bed, cadaverous and morose, and behind the
screen the orderlies were struggling to prevent Pte. W---- from choking
himself while he recited his prayers. The colonel spoke soothingly
to Pte. T----, but obtained no response. Pte. T---- only continued
to glare fiercely. So he passed round the screen to see Pte. W----.
Immediately, Pte. T----, stealthily and rapidly, got out of bed, and
prowling after the colonel, seized him from behind! The orderlies
interfered and a regular scrimmage ensued, until the doctors, who
were almost helpless with laughter, seeing that the officer was being
roughly used, called in further help, and a dishevelled, flustered
colonel was assisted out of the room.
‘Dear me, they are indeed dangerous fellows,’ he said. ‘We had no idea
they were so bad.’
He went straight back to the Horse Guards. And very promptly orders
were sent for the removal of the patients to safer quarters without
delay.
The work in the medical wards was perhaps less dramatic than on the
surgical side, but it was not less severe. Many cases of rheumatism,
gastric ulcer and cardiac disease spent weeks in the hospital, and
pleurisy and empyema were constantly admitted. There were painful cases
of gas poisoning and malaria, and others of mental disturbance; but
pneumonia dominated the wards in numbers and in severity. They were
anxious cases, occurring constantly among New Zealand and Australian
men, whose distance from their homes made a further claim on the
sympathies of the staff. Recovery depended largely upon the nursing,
and many of them owed their lives to the devoted work of Sister Hughes
and Sister Exell, who were in charge of St. Felicitas and St. Geneviève
wards.
During the first two years the physician in charge of the medical
side was Dr. Louisa Woodcock. When she died in February 1917, the
staff lost one of its most brilliant and successful members. She was a
woman of high professional attainment, of scientific mind and of noble
character. Her influence in the hospital was always helpful, and her
friendship was greatly valued and greatly missed by her colleagues.
She was succeeded by Dr. Margaret Thackrah, who was appointed in May,
and when the number of medical beds was increased in 1919, Dr. Ellen
Pickard also joined the staff.
The women’s wards, at the top of the East Block, were the best in the
hospital, and as the women were less destructive than men, it was easy
to make them homelike and comfortable. The arrangement to take women
was initiated as a temporary measure, but it continued for more than
two years. The work was both surgical and medical. The recruiting for
the women’s units had not always been prudent, and many women were
sent home unfit, as the result of illnesses or operations occurring
before enlistment. Most of these came before Invaliding Boards and
were discharged. But the greater number of the patients sent home from
France were debilitated, or anæmic and fatigued by long hours and an
unaccustomed diet, and needed rest and good conditions to make them
ready for service again. A rather large proportion of mental cases, all
of whom had had previous attacks, and some serious injuries owing to
accidents and to the bombing of camps, were received. The women’s wards
were the most responsive wards in the hospital. They were credulous of
rumours and false reports, susceptible to the influence of a ‘grouser’
or a change of Sister, but on the other hand they responded readily
to wise handling, and were led and guided by their ward visitor, Mrs.
Prior.
During the influenza epidemics of 1918 and 1919 men and women suffering
from the disease trooped into the casualty room or sent messages
for ambulances to fetch them. The extra beds were all full, and the
number of men seriously ill with pneumonia might be fifty or sixty
each day. The staff slaved over them. Extra nurses were procured;
the doctors knew no rest. But the mortality was tremendous. In the
months of November and December 1918 twenty-four men and women died;
and in February 1919 thirty died. The hospital was accustomed to a
death rate of eight per thousand per annum, and was aghast over three
deaths in one day. Sorrowing and anxious relatives sat in the square
and passages, watching the doctors’ faces as they went in and out of
the wards, and patiently accepting the issue. Old people who had never
been out of Ireland came over, and would not venture in the streets in
case they should be lost or run over. Grey-haired fathers and mothers
came from Scotland to sit, silent and enduring, beside the beds. The
habitual gaiety of the place was hidden under the cloud. The staff
could only work and wait. A dear old uncle and aunt arrived from the
country to see a precious nephew, whose life hung in the balance for
some days. One morning the doctor met them in the square and told them
that their boy was better and should do well now. They both burst into
tears, and presently the old lady, through her sobs, begged the doctor
to excuse ‘Uncle,’ for ‘he was always so silly and took on so.’
Pte. B----, a Scottish shepherd, had wounds of hip and knee, and was
so ill that his wife was sent for. She travelled all night, and for
twenty-four hours sat steadily beside his bed. When it was suggested to
her that she was tired and should lie down, Pte. B---- opened his eyes
to say, ‘Och! the wife’s enjoying herself fine, sitting beside me here.’
The relatives were very brave and very pathetic. The men clung to their
mothers, and many a careworn, weary woman sat night after night by the
side of her son, grateful because she was allowed to be there.
* * * * *
The hospital had its share of malingerers and self-inflicted injuries,
and one or two cases of fraud. The cleverest of these was a man
admitted for some slight ailment, who had only one arm, and who
stated that he was awaiting admission to a limbless hospital. He was
in the ward for ten days, and might have left undetected but for the
thoroughness of the Chief Surgeon, who insisted upon seeing whether the
stump was in a good condition before he left. The Sister said he was a
very modest man and did not like to show his arm to ladies.
‘Surely he need not be modest about an arm,’ said the Surgeon. And the
Sister unfastened his jacket.
‘Which arm did you say, Sister?’ she continued. ‘He seems to have the
usual number.’
And so he had. He stood abashed before a half-fainting Sister, while
Dr. Garrett Anderson and the orderlies pealed with laughter, and the
whole ward joined in the joke.
The amount of clerical work required of the doctors was no light
matter. They had to keep all the notes for their own beds, and as
the turn-over was generally fairly rapid, the writing was incessant.
Convalescent men reported to the office of the Doctor-in-Charge for
discharge on two days a week, and history sheets had to be made up for
every one who left or was transferred. The monthly turn-over varied
between four hundred and eight hundred cases, and each admission and
each discharge or transfer entailed the preparation and despatch of
several forms. Invaliding Boards were held regularly, and thirty-nine
different forms had to be filled up and signed for each man who came
before the Board. As time went on, the work of these Boards became
heavier; for the Army Council was clever at inventing new forms. But
when once the Ministry of Pensions got into its stride, these were
triplicated and amplified, and the hospital’s responsibilities in
clothing, equipping and providing for the men were largely increased.
The War Office had a habit of issuing numbers of circular instructions
to hospitals, many of which dealt with medical subjects. These were
known at Endell Street as ‘purple papers,’ from the colour of their
ink, and it was usual to post them in the Staff Room, where they
sometimes gave rise to amusement. One circular warned surgeons against
using syringes without sterilising them first, and suggested that for
this purpose ‘a little warm oil’ should be used; another pointed out
that they should not make a practice of amputating the right arm,
unless it were absolutely necessary to do so; while a third informed
them that ‘death under an anæsthetic’ should in future be regarded as
part of the treatment.
The Army has a wonderful way of having an official name and number for
each disease. These are to be found in the official ‘Nomenclature of
Diseases,’ and no patient may have any disease not mentioned in the
book. For instance, the Army does not recognise rheumatism, and many
soldiers had to have ‘37 Rheumatic Fever’ or ‘931 Myalgia’ instead. On
the other hand, the book had some nice comprehensive diagnoses, such
as ‘952 I.C.T. (inflammation of connective tissue)’ and ‘21 P.U.O.
(Pyrexia of uncertain origin),’ which were very useful in haste. The
proper nomenclature and numbers were much insisted upon by the Medical
Statistical Department, and tired doctors sometimes felt that the extra
work which had to be done for this department was almost the last straw.
Three auxiliary V.A.D. hospitals--at Dollis Hill, under the Commandant,
Mrs. Richardson, O.B.E., and at Highgate, under the Commandant, Lady
Crosfield, R.R.C.--were a great source of pleasure and benefit to
the men. When fully expanded, these hospitals provided, under fine
conditions, a hundred and fifty beds for the more convalescent cases.
They were very popular with the men, who were well cared for and very
happy in them; and as an important factor in recovery they were greatly
appreciated by the medical staff.
CHAPTER IV
THE VISITORS--THE ENTERTAINMENTS--THE LIBRARY
The Deputy Director of Medical Services for the London District was the
official head of the hospital, and Endell Street knew three officers
in succession in that capacity. The first of these was remarkable for
his length of limb and the brevity of his tongue. His frigid attitude
might have been misunderstood at the preliminary interview, if he had
not been accepted as ‘very Scotch’ and ‘obviously East Coast.’ On his
rare visits to the hospital he would stride silently through the wards,
making his round, without saying more than ‘Uch ha!’ and a curt ‘Good
morning’ on leaving. Time led to a slightly better acquaintance, and on
one occasion he even made a joke about misappropriation, and the wintry
smile that crossed his face was like a gleam of sunshine in February.
His efficiency was liked, and his habit of returning applications
(although generally marked ‘inadmissible’) was very convenient. His
successors were less tall and had more to say, and relations with them
were easy and pleasant.
Visitors were nearly as numerous in London as they had been in Paris.
The King and Queen honoured the hospital with a visit, and went through
the wards giving great pleasure to the patients. More often, Queen
Alexandra and Princess Victoria would arrive, either to see the men
or to be present at some entertainment. And it was on one of these
occasions that an Irishman begged to be allowed to go down to the
recreation room.
‘For,’ said he, ‘the only member of the Royal Family that I have seen
is Sir Edward Carson, and I would like to see the Queen.’
When Her Majesty heard this, she asked to be taken to his bedside, so
that she might speak to him. She was full of kindness and sympathy for
the sick, and would give them little books, or smelling-salts from her
own reticule, and once she handed her handkerchief to a dying man with
which to wipe his face. This handkerchief he gave to his sister, who
preserves it as one of the great treasures of Lancashire. After her
visits, Queen Alexandra would send gifts for distribution to the men.
Among these valued mementos were ash walking-sticks, with silver bands
engraved with ‘A.’ One severely wounded man was found awake at night
with his ‘Queen’s stick’ in his bed. He had refused the morphia which
had been ordered for him, as he was afraid to go to sleep lest some one
should take his stick. It was only when safe custody had been promised
for the stick that he consented to rest.
The Princess Royal, the Duke of Connaught and Princess Arthur of
Connaught also came to the hospital, and Lord French paid a visit one
afternoon, and had many things to say to the patients.
More frequent and very welcome visitors were Lieut.-General Sir Francis
Lloyd, G.C.V.O., K.C.B., D.S.O., and Lady Lloyd. The men enjoyed seeing
them, especially when the General Officer Commanding made speeches, and
the staff of the hospital much appreciated his kindness and courtesy.
His successor, Major-General Sir Geoffrey Fielding, K.C.B., C.M.G.,
D.S.O., and Lieut.-General Sir T. H. Goodwin, K.C.B., C.M.G., D.S.O.,
who succeeded Sir Alfred Keogh as Director General, were also among
those who inspected the hospital.
The news that the Chief Magistrate, Sir John Dickinson, had called,
and would return next day, was disturbing, for relations between
magistrates and suffragists had not always run smoothly. The
Doctor-in-Charge questioned the quartermaster: ‘What do you think the
Chief Magistrate can be coming about?’
‘I don’t know,’ she answered, ‘unless it is about that kitchen-maid.’
And she told how one of the kitchen staff had been to a dance in her
brother’s uniform, and, coming home through the streets, had been
warned by a policeman.
With this crime on their consciences Sir John’s visit was awaited
uneasily. But he came in friendship, with outstretched hand and kind
congratulations upon the womanly work which his former acquaintances
had found to do.
With Endell Street before it as a demonstration, the War Office could
not fail to perceive that ward duties and the general administrative
work of hospitals came easily within the scope of women. Towards
the end of 1915 instructions were circulated to officers in charge
of hospitals, requiring them to set free men so employed and to
replace them with women. Those in command of military and of naval
hospitals began to arrive at the women’s hospital, anxious to learn
how this might be done. They were given opportunities of seeing women
stretcher-bearing, handling bags of sugar and potatoes, or doing
fire-drill. Armed with notebooks and pencils, they would make notes
of all they saw and sadly discuss what they used to describe as ‘the
hopeless difficulty of the situation.’
During 1916 and 1917 one staff officer called periodically to see
whether every possible man had been replaced by a woman. His time
was spent in inspecting hospitals and trying to persuade those in
authority to replace their men; and naturally Endell Street was his
example. Again and again he came to say that he was assured that it was
impossible to use women for certain services, and to ask how it was
done. Amongst other things, he had been told that to use women in the
X-ray room was ‘indelicate.’ The Doctor-in-Charge reminded him that
skiagrams were made through clothing and in a dark room.
‘I never thought of telling them that,’ he said.
Talking over his experiences elsewhere, he remarked: ‘As soon as I
say, “But at Endell Street----” I see a nauseated expression come
over their faces.’ And his tales of the obstruction he met with among
old-fashioned officers and N.C.O.’s were amusing.
Acting on these general orders, the Doctor-in-Charge applied in
September 1916 for authority to replace fourteen men by fourteen women.
Referring to the R.A.M.C. personnel, she wrote:
The greater number of these men (nineteen) are physically
unfit. Their physique is very poor and their work is not
satisfactory. I find that able-bodied women are capable of
performing practically all the duties which these men perform.
In March 1917 a return showed that three women had replaced four men as
dining-hall attendants, one woman had replaced one sergeant as cook,
and fourteen women had replaced fourteen men on general duties. Later,
the Doctor-in-Charge stated that ‘no additional women can be employed
in substitution for men in this hospital.’ The staff of men had been
reduced to two N.C.O.’s and six men, and fourteen young women had been
attached to the R.A.M.C. detachment to act under the orders of the
sergeant-major.
There was no difficulty about the arrangement. The girls were splendid.
They emptied the ward bins, managed the incinerator, removed soiled
linen and took up the clean, distributed the dinner wagons, swept
and hosed the square, carried stretchers, conducted patients to the
stations or travelled with them to Brighton and other places, as
required. They rose at night when the convoy bell rang or air-raid
warnings came through; they manned the fire hose and took their turn of
night duty and gate duty, with marked efficiency. The sergeant-major
praised them highly; for they were sober, disciplined and industrious.
The men and women paraded together, but messed separately; and the
mixed company, which had at first been tried as an experiment, was one
of the great successes.
* * * * *
Experience in France had shown that though visitors in the wards were
a great help and pleasure, the number and the kind of visitor might
easily be harmful, and a decision was taken to regulate the visiting,
so as to reserve certain days and hours when quietness might prevail
in the wards and when the nurses might be able to give extra care and
attention to those who needed it. These regulations were found to be
fully justified; for the many very sick men constantly distributed
through the hospital would have suffered more than was right if
unlimited visiting had been allowed. In order that there might be
dependable visitors, a lady was appointed as official ward visitor
to each ward. She became an honorary member of the corps and devoted
herself to the interests and welfare of the men in her ward.
‘I want to ask you a question,’ said a rather dour sort of man to his
ward visitor when she came to his bedside.
‘Yes, what is it?’ she asked, sitting down beside him.
‘I want to know what you come for. You come and sit by my bed and talk,
and you never talk about religion nor about politics. Now, what do you
do it for?’
When she explained that she did it in the hope of giving him a little
change and pleasure, he said: ‘Well, I say that it’s wonderful.’
Men confined to bed for long periods looked forward to their visitor’s
days, and missed them when they were out of town. And many still write
to the ladies who gave so much time to this work and who had such a
sympathetic understanding of their needs.
The hospital was overwhelmed by visitors of all sorts and conditions,
who came at all hours for any purpose and who were all determined
to ‘speak one word of kindness to the poor fellows,’ or, as one
lady wrote, ‘to bring one ray of pleasure into the lives of the
poor mutilated darlings.’ There were scores of people representing
regimental associations and other societies, who were sure that no
one except themselves would say ‘a kind word’ or convey ‘a little
brightness’ into the wards. All of them expected and demanded nominal
rolls of men in hospital from the overworked clerks, and they did not
accept it amiably if the ‘one man they wanted to see’ was out. It was
difficult to make people realise that wards must close at 5 P.M., since
there were nursing and dressing to do.
‘Oh, I am not at all upset by painful sights,’ they would say.
And it was still more difficult to make them understand that the men
could not be disturbed late in the evening. Officers, Members of
Parliament, countesses, ladies who claimed to have been ‘born and bred
in the Army,’ ladies with husbands ‘in the Blues’ or the War Office,
colonels’ wives and V.A.D. commandants, were apt to arrive at 8 P.M. or
even later, expecting to be admitted. All these people had to be seen
and dealt with--reasoned with, cajoled and smoothed down, or otherwise
they did not hesitate to write and worry the War Office about their
grievances. The staff stood as buffers between the helpless and sick
men and those who did not understand; and the buffer gets most of the
jar.
Impartial witnesses have marvelled at the patience and self-control of
the girls in charge of the gate. Their post was difficult and onerous.
They were constantly receiving parcels, answering inquiries, taking
telephone calls or running messages, obtaining reports for relatives,
bringing walking cases down at odd hours to see odd callers in the
square, admitting, directing, checking; they had to convince callers
that the man they wanted to see was not in this hospital, or that it
was true that another whom they were seeking had been discharged.
But most difficult of all tasks was that of tracing men on quite
insufficient data.
‘I have come to see my father’s footman,’ said one lady.
‘Yes, what is his name?’ asked the gate-keeper.
‘David.’
‘Is that his surname?’
‘I don’t know. We always called him David.’
‘What is his regiment?’
‘Oh! a Highland regiment.’
‘We have some Black Watch men in. Do you think he is in that?’
‘Yes, I think he is perhaps.’
And somehow they found him for her.
The patients’ friends came on three days a week, and on fine summer
afternoons, when many men were out in the square, there was often an
orchestra playing, and fruit and ices were on sale at the canteen in
the corner. The blue suits and red or blue umbrellas suspended over
those in bed gave an air of gaiety to the scene which had an almost
continental aspect.
Amusements were regarded as of special importance, and Miss Bessie
Hatton was asked to be the Honorary Organiser and Secretary of this
department, a post which she held until the hospital closed. The
hospital was fortunate in securing her help, for she was in touch with
the theatrical world, and her delightful gifts as a writer of charming
little plays and as an actress of exceptional power made her advice and
her experience invaluable. She formed a committee of experts, which was
joined by Dame May Whitty, Miss Lilian Braithwaite, Miss Inez Bensusan,
Miss Waldegrave and Mrs. J. T. Grein. The latter wrote plays and
pantomimes for the hospital and took infinite pains over rehearsals and
over the training of a ‘troupe’ of gifted girls, whose performances as
the ‘Endell Street Follies’ were immensely popular. This committee was
responsible for the entertainments and music on the stage and in the
wards, for Christmas festivities and Bank holiday parties, and for the
organisation of the ‘Endell Street Orchestra’ under its conductor, Mrs.
Salaman.
On summer evenings crowds assembled in the square to listen to the
band playing. The patients were equally appreciative of the beautiful
singing of the Temple Church choir, of conjurers, reciters or Miss
Italia Conti’s pretty dancing children. And performances held in the
open-air had the added advantage that every one in the wards could
hear and enjoy the music and singing, and that the whole hospital
participated in the pleasure.
St. George’s Day, St. Patrick’s Day, St. Andrew’s Day and Hallowe’en
were all celebrated with special and appropriate features.