by Mary Hazard
I remember there were operations then that were quite barbaric and that now would take no time at all, or wouldn’t even happen, as they have largely gone out of fashion. In the early 1950s tonsillectomies were all the rage, as King George had had one, and everyone wanted to follow the king and his family. It was believed back then that the removal of the tonsils got rid of all sorts of upper respiratory tract problems, so children, and even adults, had them all the time, especially after endless bouts of laryngitis or bronchitis. To be honest, when I got to Putney I was aghast when I first experienced an English pea-souper fog, or smog, in the winter, and it was absolutely impossible to see any further than my nose (not even that far when it was bad). I thought the smog was probably the cause of all the coughing, spluttering and sore throats that were prevalent at the time (along with the Woodbines and other rough cigarettes we all seemed to smoke). The air was so much cleaner and fresher back in Ireland, or so it seemed. Anyway, people came into Putney Hospital for their tonsillectomies, and then they would have to lie in bed for about two weeks at least to be nursed afterwards. It was a fairly tough operation, where the surgeon used a ‘tonsil snare’ like a cheese cutter to remove the tonsils, and the adenoids (which were behind the tonsils), and there would be masses and masses of blood from the procedure. I remember one patient, a woman in her forties, Mrs Baker, had swallowed loads of blood during the operation, and then she was vomiting it all up for ages afterwards back on the ward. It was quite disconcerting to see all this blood coming out of her mouth – it reminded me of the TB I had seen back home, which involved a lot of vomiting of blood. And it seemed incredibly painful for her to be sick after having her throat cut on the inside; she was groaning in pain and looked terrible. Poor Mrs Baker couldn’t speak, poor thing, or swallow easily, so I had to spoon-feed her, tiny teaspoons of gruel (thin porridge), or jelly or soup, bit by bit. It took ages to get anything down her, but it was what we nurses did. There was also a high risk of post-operative infection, so we would be taking her temperature and pulse all the time. Today, these operations have largely gone out of fashion, I know, as the tonsils are thought to be quite useful in stopping bacteria going down into the lungs. Also, their removal is thought to be quite an unnecessary operation (and there is always a risk from anaesthetic). But if the operation is done, it’s in and out in a day, or just one night in hospital, but no more than that. Plus, nurses don’t seem to have time to give their patients a drink of water (let alone sit and feed them), if what I read in the paper is right. But back then nursing meant nursing, care meant care.
The other operation that was just coming in on the NHS, and was also quite challenging, was the cataract operation. I didn’t see many of these, as it was quite experimental then, but a patient would be in a side room, off the main ward, and would have to be in complete darkness, lying down, flat on their backs, for at least a week after the operation, which used general anaesthetic, not local. We would have to ‘black out’ the room, just like in the wartime, and make sure no light came in at all. Then they would be forced to lie down, flat out, with no pillows, and simply not move. This was so utterly boring for them, but it was essential. They had real stitches in their corneas back then which had to be taken out by the surgeon after the operation by hand, so they were not allowed to move their eyes, or react to light or move their heads. We had to bed-bath them, and feed them very gently, by lifting their heads slightly off the bed, and keep them hydrated. We also had to lift them onto bedpans, their bodies still largely flat, so it took a nurse each side of the bed. It was intensive nursing, and quite a to-do. Amazingly today having a cataract done is like going to the dentist: you are in and out in an hour and half, spit-spot, just like that. But back then it was a very risky operation, and quite experimental, and it took a lot of intensive caring from nurses to deal just with one patient.
When patients needed to be ‘isolated’ they were often put out on the balconies, outside the huge, tall windows that lined the wards. This was called ‘barrier nursing’, as we sometimes had to make sure the patients did not come into any contact with other patients. It could be pretty grim for the patients. Other patients, who might be near death, would be put in side rooms, but there was a limited number of these rooms available on each ward. The idea of ‘barrier nursing’ was to try to prevent disease, and to try to isolate infection, so that it would fail to spread. The use of penicillin had really revolutionised nursing in the post-war years, but it was still in fairly limited supply. There were some diseases that were still rife and that were deemed incurable. Venereal disease was widespread after the war, as the men came back from all the far-flung corners of the world, having had all sorts of exotic and erotic experiences. Of course, it wasn’t something that was spoken about openly, but I got to see some things on the men’s medical ward that really opened my eyes and shocked me. Syphilis, a horrible venereal disease, seldom talked about or acknowledged, was incurable back then. There was a lot of it about, but as the 1950s progressed the antibiotic treatments got better and the fatalities started to decrease. But when I started, in 1952, it was still rife and common for men to die of what was then a shameful and really nasty illness.
A Mr Jones was brought in to be barrier nursed and I soon discovered he was in the third stage of syphilis. This meant he had gone through the first stage, of having a painless sore on his private parts; and then the second stage, which was more flu-like symptoms, with rashes and headaches, and with weight and hair loss. The third stage was the most dangerous, and fatal, with the nastiest symptoms, affecting the nervous system, the eyes, heart, skin, blood vessels. Basically, by the third stage, which could be long and painful, the body was beginning to shut down and the patient on their way to an inevitable death. All we could do was give Mr Jones Streptomycin, and nurse him well and hope for the best. It wasn’t going to cure him, as it was all too little, too late. Quite often these kinds of patients left their symptoms to develop for far too long, often due to being ashamed of how they got the disease in the first place, or, as in the case of many men, they failed to go to their GP, and just put up with the symptoms until the illness was firmly embedded and sadly untreatable. It was tragic, as it was socially unacceptable and a source of shame to really acknowledge you were sick this way, so many men died unnecessarily at the time.
Mr Jones was a nice, good-looking man in his forties. He was polite, and clearly educated, and he told me he’d been in the army during the war. He read books all the time, but as I nursed him I saw his body slowly rot; it was becoming hardened and black. I’d never seen anything like it. I had to change his dressings one day, and I was unwrapping his feet to re-bandage them. I was horrified when I got down to his skin, which was like black, lifeless cardboard. As I unwrapped the bandages a couple of his toes came off in my hands. I was utterly aghast, and felt sick, although I tried hard not to show it. He didn’t say, or seemingly feel, anything, as he had already lost sensation in his feet – there was no circulation or nerve endings any more. It was terrible. I watched Mr Jones endure a long, slow, painful death with extreme fortitude. He absolutely didn’t complain, and said ‘Thank you, nurse,’ politely, for everything I did. I would wash him, feed him and try to cheer him up. He liked doing crosswords and he’d ask me for help with the answers to two across or fifteen down. He knew it was hopeless, yet he endured the unendurable with quiet dignity, and also he had virtually no visitors. I wondered if his wife had left him when she found out, as he didn’t seem to have a wife. I felt, in a way, relieved as I wondered what wives did when their husbands got these kinds of terrible diseases. Did they know? Did they get it as well? How would a couple talk about it, especially if the man had been away during the war, and the woman didn’t know what he’d really been up to? I had never nursed a woman with syphilis; it was nearly always the men. But I guess women must have got it, obviously, especially the poor old street girls or ‘prossies’. I was very disturbed as I watched Mr Jones fade away, painfully and slowly, and it made m
e feel very cautious about taking risks myself sexually (not that I was anywhere near that yet, even in my late teens). Anyway, Mr Jones bore his disease bravely and with dignity until I came in one morning and found his bed was empty and being hosed down with loads of disinfectant; it had taken him about nine weeks to die a long, horrible and painful death.
On a lighter note, we were learning all the time ‘at school’ more detail about the nursing profession and practice. Sister Tutor was a great teacher, a really kind and lovely woman, and we had regular hourly ‘chalk and talk’ lectures, with pictures that she pointed to with a wooden stick, and pickled specimens, to examine. She had practical sessions of dissection (frogs and mice mainly), and her talks were always lively and informative. We sat in formal rows at little desks, so it was like school all over again; I was often at the back of the class, larking about, and she would fix me with her eye, and give me the occasional sharp ‘Powell!’ remonstration. I always seemed to play the fool – old habits hanging over from my repressive schooldays, I suppose. But I liked Sister Tutor, and I respected her, so I learned a great deal from her. Then we would pore over heavy medical books, and spend hours learning anatomy and physiology names by heart: there was absolutely masses to absorb. It was all very technical and scientific, and I loved it. This was mixed with the ‘hands-on’ learning on the wards, which was, at first, observation, and a lot of scrubbing and cleaning. Then, gradually, we were unleashed on the unsuspecting patients, and were allowed to do more ourselves. We were instructed first, given measurements and quantities, but once we got on the ward, with real, live people, we were largely on our own, and it was quite terrifying – especially at first.
One day, during the first six months, I had to learn to give an enema. This was another job, along with my first injection, that I felt very anxious about administering to real, live patients, properly. Enemas were somehow incredibly personal, and intimate, and I hoped to put it off as long as possible. However, the day eventually came when I could avoid giving enemas no longer. I was on night duty and Sister came up and told me to give Mr Brown an enema as he had not ‘been’ for a week. Nurses and doctors were always concerned with patients ‘going’ because being ‘regular’ meant that everything was in working order. Because people were stuck in bed for so long, being static and not active, ‘going’ became very important and bowel movements were monitored daily, along with temperatures and pulses. Sister would stand at the bottom of a patient’s bed with her clipboard, and say, ‘Have you gone today, Mr Potter?’ as if she was saying ‘Pass the finger sandwiches’ at a bridge club. She would write down the gruff ‘yes’ or ‘nah’ that followed on her clipboard, and then smartly move on to the next bed without any expression on her face.
I obviously knew the importance of regular bowel movement for health, as it had been drummed into me by Sister Tutor, so I went along to see Mr Brown, who was in his sixties and very constipated indeed. I had no idea really how to give an enema, as this was during my first few months on the wards. It had been explained to us, in detail, by Sister Tutor, but actually administering an enema for real was a completely different thing. I knew we had to boil up all the leftover bits of soap with water, and make them into an enema liquid. This was then put into a long, cylindrical glass bottle, and pumped through a long rubber tube into the backside of some unwilling patient. If I had had to do this to a woman it would have been bad enough, but to a man, and an old man, to boot, who was the age of my father, well, it was the worst job I could think of having to do.
Anyway, Sister had issued her edict, so I got all the equipment together and took it over to the bedside of Mr Brown, who was deep in his Sporting Life. He took one look at me, and at the long rubber hosing and the cylinder of liquid, and he knew exactly what it was for. He was a real old rough diamond, from the East End, a balding, rotund man, and he just said, ‘You ain’t gonna put that in me bum, nurse, not on your Nellie.’ I realised straight away that I had a fight on my hands: I was public enema number one. So I started explaining to him that it was very important that he ‘went’, that this was a normal procedure and that it would help him. Mr Brown refused, point blank. ‘I ain’t having it, nurse, and that’s that.’ I tried all the health and common sense avenues, to no avail, so then I went the sympathy route, and told him I was always in trouble one way or another, and this would only make things worse for me. ‘Sorry, dear,’ he said, hardly seeming sorry at all, ‘no can do.’ And he went back to reading his newspaper. End of.
Suddenly Sister arrived. Luckily it wasn’t the Beetle, but it was another day sister, Grainger, who was middle class and very strict. I was wringing my hands and was so worried now about failing at the task, I thought I was for it, yet again. Sister swished back the curtains and stood there for a moment, eyeballing Mr Brown. He carried on reading his paper, nice as pie. ‘Mr Brown,’ Sister said loudly, and he lowered his paper and looked at her over the top. ‘Mr Brown, you need to roll over,’ is all Sister said. ‘Wotcha gonna do, Sister?’ said Mr Brown, innocently. I thought it was like watching a prize fight between two champions and I wasn’t sure who I was going to put my money on, at this point. Sister watched Mr Brown for a moment, and then she leant forward and said to him, in her posh, cut-glass, English voice: ‘I’m going to shove this up your arse, Mr Brown, and I don’t want any nonsense.’ Well, I could have fallen through the floor at this extraordinary pronouncement, and Mr Brown’s jaw dropped with utter surprise. Such ‘common’ language coming from a sister, and in such polished tones, was a revelation. I wanted to giggle helplessly and I stored it up for the girls later, while biting my lip. However, without further ado, Mr Brown, like a lamb to the slaughter, rolled over and presented his bum. I was utterly astounded. We pulled his pyjamas down and Sister stood as I fumbled about with the hose and liquid, and inserted the tube into poor old Mr Brown’s rear end. He grimaced as the tube hit his rectum, but complained not a word. He took it like a man. Sister watched me, critically, and then disappeared, leaving me to administer the enema as best I could. It was not an easy job to do, and certainly not a pleasant one, but once Mr Brown had succumbed he sort of went with it, thank goodness.
It was customary for Matron to do her rounds of the wards twice a day, morning and late afternoon. She would arrive, just like clockwork, and in the half an hour before her inspection was due we would all be ushered out to clean and sweep, tidy and organise, and make sure everything was just tickety-boo for Matron’s visit. A couple of days after I had administered Mr Brown’s enema I remember being on the ward when Matron visited. She was a small, neat, bustling woman and she marched up to the bottom of Mr Brown’s bed, accompanied by Sister and me, that day, and took hold of his clipboard attached to the bottom of his bed to read the notes. I remember her being all smart and tidy, with her little hat tied perfectly under her chin with a bow, and her pleated skirt and black shiny shoes: all just so. I explained to her that Mr Brown had had an enema to deal with his chronic constipation. ‘Well, how are you now, Mr Brown?’ asked Matron, as if she was at a dainty ladies’ afternoon tea party. Mr Brown answered Matron, without looking at me, and said: ‘I’m all right now, Matron – I’ve had a bloody good clear-out.’ I thought I was going to burst into fits, but Matron didn’t blink; she just said, incredibly politely, ‘Oh, I’m so pleased, Mr Brown. I’m so glad you’re feeling better.’
There were always plenty of characters on the wards. I remember a dear old man called Mr Poysner, a Cockney who had big pebble glasses and who smoked a pipe all day. He probably had something like prostate cancer, although we didn’t call it that then. He’d say ‘I can’t piss’ if someone asked him what was wrong with him. ‘It’s me old waterworks,’ he’d say simply. Mr Poysner had a tube going into his bladder (at least I knew what a catheter was now, and, more importantly, how to get one out), and it leaked all the time, so his bed was always getting wet, poor old fella. I was constantly changing his sheets, and had to put a rubber sheet under him, in order to preserve the
mattress. I also gave him blanket baths, which was a way of washing a patient in bed, from head to toe, without getting them out of bed. I had to bring along a bowl of warm water, a flannel, soap and towels, and it would be a meticulous daily wash, including a close wet shave with a Sweeney Todd style of cut-throat razor. His bed-baths were important as poor old Mr Poysner was constantly having his ‘wee’ accidents.
He was a sweet old geezer who called all the nurses ‘Gladys’. I think he’d probably worked on a street market or something. ‘Morning, Gladys,’ he’d say to me, and I’d laugh. I wouldn’t correct him, as I knew it was his little joke. Or he’d say, ‘Can you pass me baccy, Gladys?’ And, of course, I would. He kept a stash of sweets and tobacco under his pillow, which we were constantly putting back in his locker, only to find it under his pillow again. Then, when his catheter leaked, the wee would seep towards his pillow and he’d be desperate to save his sweets and baccy: his little pleasures were very important to him, and I guess, being as sick as he was, he knew he needed to keep himself going somehow. I didn’t begrudge it to him, at all. Anyway, one Sunday his grandson, Joey, also a Cockney, came to visit. Mr Poysner had been in hospital several weeks by then, and was slowly deteriorating. Joey had brought a pint of whelks, which was Mr Poysner’s favourite treat. These were strictly forbidden by Sister, however, for some unknown reason. Possibly it was the smell, or maybe simply a class difference as it was traditional Cockney fare, not smoked salmon sandwiches. Mr Poysner had asked Sister if Joey could bring his whelks up, but she explained, in no uncertain terms, that it was not possible and rules were rules. I had no idea why he couldn’t have his whelks – what did it matter, really?
