DOWN EAST - CHAPTER VI
THE LONDON HOSPITAL
HAVING resolved to include among my sketches some description of a leading metropolitan hospital, I was not long in deciding to which one I should direct my attention. I chose the London Hospital, and I will give my reasons--I always like to do so--for my selection.
There is a greater variety of people admitted into this hospital than into any other in London. Moreover, its district contains my old Courts of Thames and Worship Street. The magistrates presiding there hear of no other hospital, and from time to time they have occasion to visit it to take a dying deposition.
I would preface my remarks by saying that I do not believe there is another institution of the kind conducted so admirably in the whole of England--not to say the whole of the civilised world.
The hospital consists of a large building facing the White-chapel Road, from which it is divided by a courtyard, which serves as a carriage way. The main entrance leads into the receiving-room, which, if I am not much mistaken, was opened as recently as last June. One side of the building runs down Turner Street, and the other down East Mount Street, while the rear looks out into Oxford Street and Philpott Street.
The institution was founded in 1740, and greatly enlarged in 1859. The Alexandra wing was added in 1866, and the Grocers' Company's wing was opened by the Queen in 1876.
[-48-] His Royal Highness the Duke of Cambridge is the president, and the establishment is conducted by a house committee, of which Mr. Edward Murray Ind is the present chairman. A quarterly court of governors is held on the first Wednesdays in March, June, September, and December. There is a matron; and there are nearly thirty sisters, and over two hundred nurses. Some ten physicians, and an equal number of surgeons, are aided by a large staff of junior surgeons and dressers.
Four separate rooms constitute a ward, and each room contains either fifty-two or fifty-six beds. On an emergency seven hundred and seventy-six beds can be made up. As a rule between six and seven hundred are occupied. On each floor there are some thirteen or fifteen nurses and one sister.
There is an entire building, practically detached, set apart for the use of the nurses. It contains a large dining-hall for all, and each nurse has a separate bedroom, with her name and a number written on the door. The nurses are allowed two hours' leisure every day, and they have one day's rest every month. They all have to serve two years as probationers, and. if, at the end of that period, they decide to remain on, and the authorities are willing, they are permitted to take a month's vacation before resuming their duties. From that time forward they have three weeks' holiday every year. These rules, I believe, are similar to those in force in other large hospitals.
The modus operandi of the admission of patients is very simple. In the receiving-room a porter is stationed night and day, and when patients are brought in by the police or others, he promptly admits them, and hands them over to the nurses. To the right and left are two rooms, one for the reception of women, and the other for the reception of men. Here the patients are examined by the nurses, with a view to seeing whether the cases are medical or surgical, and whether they are of a pressing nature. The nurses of course afterwards report to the surgeons and physicians.
That the hospital is by far the most important in the metropolis is proved by the extent and character of the district serves. This district comprises Bethnal Green, Spitalfields, Whitechapel, Shadwell, Mile End, Commercial Road, Commercial Street, Limehouse, and all the surrounding neighbour-hoods, including the Docks. A heterogeneous mass of humanity, representing nearly every nationality on earth, is brought together within its walls.
[-49-] Communications between the doctors and nurses on the one hand, and the patients on the other, have very largely to be conducted by signs and symbols, and having regard to the sufferings of many of the patients, it is marvellous that they succeed so well in making themselves understood.
A great many foreign Jews enter the hospital, and this is not to be wondered at considering the number living in this part of London.
Two of the wards are specially endowed by the Rothschild family for the use of Jews. They are in every way distinct from the rest of the establishment, and have their own kitchens and cooks. In these wards the Jewish Sabbath is kept, the Passover is celebrated with the greatest solemnity, and all the fasts and feasts of this ancient race are duly observed.
To judge by the accounts given me, the occupants of these wards are not for the most part very courageous. They frequently make a considerable uproar when asked to uncover and show their wounds, the noise of their bellowing being, I am assured, in inverse proportion to the severity .of their injuries. They are always very loth to leave the hospital, and any of them would, I am sure, like to remain there to the end of their days.
These Hebrew patients are, as a rule, very well-conducted people. Though the race to which they belong is notoriously slow to part with money, it invariably happens that, when anybody is dying in these wards, some one is found to defray the cost of a "watcher." This individual remains by the bedside until death takes place, and performs the necessary offices afterwards. Christian nurses are not permitted to touch the body; everything is left to the "watcher."
Another peculiarity of this most peculiar people is that they will not eat from a plate that has been previously used by Christians. What is more, it is insisted that no plate from which a Jew has eaten shall leave the ward until it has been washed. The strangest part of the business is that the nurses themselves are Christians. The patients would not on any account permit one of their own race to give them their draughts and otherwise minister to them.
The inmates of these wards are allowed to receive visitors on Tuesday and Friday from four till five, and on Saturday (their Sabbath) from three to five. The friends of those who are on the dangerous list, however, have a right of entry at all hours.
[-50-] As they speak nothing but " Yiddish," they find it very difficult to make themselves understood, but by hook or by crook they manage to express the grateful feelings they almost invariably entertain towards their nurses. Sometimes very singular scenes result from the patients' ignorance of the language that is being spoken around them.
Once there was a little boy in one of these wards suffering from a serious complaint, and suddenly he died. A fatal termination to the illness had not been anticipated, and it happened that neither a "watcher" nor any of the family were present when the end came. The mother was sent for, and promptly arrived. She would not believe that her little one was dead, and proceeded to blow into his mouth. While she was thus engaged, the father put in an appearance and called upon his wife to desist. She took no heed, whereupon he endeavoured to force her from the bedside, and there ensued a most unseemly scuffle between them. A nurse tried to quell the disturbance, but this only led to further friction, and matters were beginning to assume a very serious aspect when the "watcher" fortunately arrived, and succeeded in throwing oil on the troubled waters.
When a Hebrew who is known in the neighbourhood dies in the hospital, all his or her friends and relatives -- men, women, and children--flock into the institution and congregate and wail around the bed, with the result that the medical and nursing staff are greatly inconvenienced and hindered in their work.
On Saturday nights and Bank holidays there are so many applicants for admission into all parts of the hospital that the resources of the institution are taxed to the utmost.
If any one has any doubts as to the brutalities practised on women by men, let him visit the London Hospital on a Saturday night. Very terrible sights will meet his eye. Sometimes as many as twelve or fourteen women may be seen seated in the receiving-room, waiting for their bruised and bleeding faces and bodies to be attended to. In nine cases out of ten the injuries have been inflicted by brutal and perhaps drunken husbands. The nurses tell me, however, that any remarks they may make reflecting on the aggressors are received with great indignation by the wretched sufferers. They positively will not hear a single word against the cowardly ruffians.
"Sometimes," said a nurse to me, "when I have told a woman that her husband is a brute, she has drawn herself up [-51-] and replied: 'You mind your own business, miss. We find the rates and taxes, and the likes of you are paid out of 'em to wait on us."'
One day a German woman, who could not have been more than twenty years of age, was introduced into the general ward to be treated for a broken jaw. On the following day several friends came to see her, and among them her reputed husband, who had inflicted the injury. As soon as she saw him she burst into tears, and begged the nurse to allow her to return home with him at once. Upon being told that her removal from the hospital would be attended with danger, she reluctantly consented to remain there for the time being; but she left two days afterwards. As she was taking her departure, the nurse warned her that the slightest additional violence on her husband's part must be fatal, whereupon she exclaimed impatiently
"Ah, ma'am, you don't know anything about it. You see, I love him with all my heart."
And at this time the jaw had not even been set.
The nurses as a body possess great amiability, patience, and gentleness; but it is often useful if to these qualities is added that Of muscular strength. It sometimes happens, indeed, that the nurses have to combine the functions of ministering angels with those of police constables, as the following experience of one of them will show.
"One day," she said, "a woman who had been very much maltreated by her husband was brought into the hospital. She was too tipsy for the doctors to examine her, and so she was sent up to the general ward, where she refused to undress, and began to scream and utter the most fiendish noises. I and another nurse tried to take her in hand, but it was of no use. She wrenched off my apron, and tore my dress terribly. It was, in fact, impossible to do anything with her, and so, after we had, with a lot of trouble, removed her skirt and bodice, we let her go to sleep. Two hours afterwards, when we awoke her, it took three of us to remove her things. She was a foreign Jewess--a Pole, I think."
Every afternoon some five or six hundred out-patients are treated at the London Hospital. When they arrive, if the inspector is satisfied, they are passed through at once; if he is not satisfied, enquiries are made. On passing the barrier, they are presented with numbered books for the prescriptions, and they then proceed to interview the physician or surgeon.
[-52-] There are separate departments for the different classes of disease, one entire ward being devoted to ophthalmic cases. The out-patients, most of whom attend between the hours of nine a.m. and six-thirty p.m., are for the most part wretchedly poor.
The daily routine in each ward may be briefly described. The majority of the patients are called by the night nurse at a quarter to six in the morning. Those who are able to wash themselves do so; the nurse washes the others. Between six and half-past breakfast is served. Everything is then made ready for the day nurse, who enters the ward punctually at seven. The beds are then made, and the floors swept. The probationary nurse does the dusting, while the regular nurse cleans the tables, etc. At nine the patients have bread and milk, and after that the day nurse makes ready for the doctors. They usually appear a little after ten, and remain with the patients till about twelve.
Then comes the patients' dinner, which--save of course in special cases--consists of meat from the joint, vegetables, and pudding, the different quantities of each being carefully weighed out by the nurse. After dinner the ward is kept very quiet, unless a visiting physician or surgeon comes in. If one makes his appearance he is accompanied by a whole army of students. The beds are all visited in turn, and he lectures on those cases that are worthy of remark. Sometimes his harangue will occupy twenty minutes or half an hour. One would imagine that the patients themselves would find this very galling and obnoxious. The very reverse, however, is the case. There is a great deal of jealousy on the subject, and if A's case is lectured on and B's is not, B passes the rest of the day in the highest possible dudgeon.
Tea is served at four, and when this has been cleared away, the day nurse makes the beds for the second time, does the evening dressing, and tidies up - the ward for the night. At seven the saucepans are put on for the soup and beef-tea, and soon afterwards supper is served. At eight the lights are turned down, and a cup of milk is placed by the bedside of every patient. Between eight and ten the doctors come round again, and at twenty minutes past nine the day nurse is relieved by the night nurse.
Before concluding this paper, I think I may appropriately describe the experience of a friend of mine. On leaving my court one morning I repaired to one of my [-53-] clubs, as is my custom, for luncheon.
On enquiring for a friend who usually sat at the same table as myself, I was informed that he had met with an accident and was in --Hospital.
Though very anxious to learn the nature of his injuries, I had no leisure to make any enquiries that day. Subsequently I learnt that my friend, while outside Ludgate Hill Station, slipped on a piece of orange peel and fell to the ground, fracturing his thigh. He was picked up, put into a fourwheeler, and taken to ----, where he arrived at about one o'clock in the afternoon. He was placed in the ---- ward, where some eleven other patients were being treated.
As soon as I learnt what had taken place, I was all anxiety to go and see my friend, and on the day following that on which I had first heard the news, I took a cab from Worship Street for the purpose of doing so. I had no order of admission, and knew nothing about the visiting regulations.
In the gateway stood a good-looking old pensioner, and as I was hurrying past him, he exclaimed:
"Hullo! where are you going?"
"Well," I replied, stopping short and confronting him, "I'm not quite sure. Perhaps you can assist me. I understand that there's a friend of mine in the hospital, and I'm going to see him. Mr. -- fractured thigh. Perhaps you can direct me."
"Oh," said he good-naturedly, "we don't do things in that sort of way here. I know the case; but you haven't come at the right time ; besides, he's seen one visitor already to--day."
"Well," I replied, "that's awkward, though I don't see any just cause or impediment why he shouldn't see another."
"No," he replied with composure; "only that it's agin the rules."
"Is the principal in, or any one I can refer to?"
"Well, you see, it's just about dinner-time."
This was true enough, for I had driven round immediately after adjourning the court for luncheon. The gate-keeper's remark served to remind me that I had no time to spare, so I observed:
"Come, come, you can make a difference with me. Don't you know me? I'm your magistrate."
"Lor bless me !" he exclaimed; "why, it's Mr. Montagu! Oh, sir, o! course you can go in when you like. Go through that door, sir."
[-54-] I entered, and two minutes later was standing by the bedside of my friend. He was very cheery, and, as he explained, wonderfully comfortable considering the circumstances: He spoke with enthusiasm and gratitude of the way in which he was being treated.
I visited him several times, and was greatly impressed by the quiet and order that prevailed in the hospital, and by the excellence of the arrangements generally.
Pleasant as it was to see my friend from time to time, I was anything but happy while in the hospital. Terrible sights necessarily meet the eye there. For example, in the bed next that of my friend lay a little boy who was deaf and dumb, and, as if these afflictions were not sufficient in themselves, he was suffering and dying from a contraction of the limbs. One day I saw the nurse dressing him for bed-sores, and never before in my life had I set eyes on so pitiable an object. As I was taking leave of my friend on this occasion, I said:
"You will be out, the doctor tells me, in a fortnight. Forgive me if I don't come again. I can't bear these terrible sights."
When the fortnight had elapsed, and he was once more out and about, we talked over his hospital experiences.
"A night or two after I was taken in," he said, "a man was admitted who had fallen off the flies at the Britannia Theatre. What with this poor fellow on one side of me and the little dumb boy on the other, the experience was one I am never likely to forget. The Britannia man died next day, and the lad was suffering still when I came out. But," added my friend, with a smile, "things, even in a place like that, sometimes have their comic side," and he went on to describe an incident that greatly amused me.
It appeared that, during the last week of his stay in the hospital, two new patients were introduced into the ward, and placed in opposite beds. By a remarkable coincidence both were suffering from the same malady--delirium tremens. They were of different social status, they came from different districts, and they were--as was most conclusively established--utter strangers to one another.
When admitted--the one at nine o'clock in the evening, and the other at half-past ten--they were not then drunk, but recovering from the effects of drink. Each fell sound asleep immediately he was put to bed.
The night passed, and the morning found them somewhat [-55-] restless. All that day they took very little food, and, of course, no stimulants. Night again came on, the candles were put out, the patients for the most part fell asleep, and quiet and stillness reigned--for a little while.
Suddenly a bed creaked, and the next moment a terrible oath was uttered in a guttural whisper. One of the men was sitting up in bed; my friend could just descry him in the semidarkness.
"Now," said the man, leaning forward and speaking in the direction of his fellow-sufferer, "we ain't going to stand this sort of thing any longer. We'll make our escape from this place, and I'll tell yer 'ow we'll do it."
My friend turned his head, and, behold! the other man was sitting up in bed. He, too, muttered a fearful oath. Then he said:
"Right you are. The Home Secretary is the boy for us. We'll make these minions tremble. Not one single drop all day!"
The two spectral forms in night-shirts proceeded with one accord to scramble out of bed.
My friend had a stick beside him, and with it he drummed on the floor as hard as he could. The nurse ran in from the adjoining ward, assistance was procured, and the two delinquents were removed and placed in separate parts of the building.
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