by Ian Wheeler
The Second World War saw these patterns repeated, with clear records of patients moving in from Hill End Hospital in St Albans and Brookwood Hospital in Woking, Surrey, both having been taken over as Emergency Medical Service hospitals. Hill End added 300 to the BMH’s patient numbers in November 1939, leading to serious overcrowding, the worst aspect being a surplus of 200 on the Female side during the day. Efforts were made to board out some patients, usually at Hungerford Public Assistance Institution (the former Poor Law Institute or workhouse, where this practice had been going on since about 1929), but the move was delayed while a reconstruction scheme at Hungerford remained unfinished. The year 1940 saw a further influx of seventy servicemen30 from the Royal Naval Hospital at Great Yarmouth, Norfolk, by which time seventy-two men and forty-eight women had been found accommodation at Hungerford. The ex-Brookwood intake of 100 women arrived in 1941, moving into Male wards 2 and 3 and necessitating the division of the Villa into two wards.
The war undoubtedly saw the hospital’s peak number of patients but the ‘headline’ maximum is not altogether clear, as the statistics are a little fragmentary and open to interpretation. The highest number in residence that is readily apparent from the Commissioners’ annual reports is the 1,274 of the year 1939. By 1942, those in residence were recorded as just 1,154 but, by adding sixty-five absent on leave or trial release, plus 138 boarded out, the total of 1,357 at least approaches the figure of 1,400 claimed by the BRO.
On the staffing front, the Second World War was characterised by the seemingly hopeless task of finding enough nurses. Whilst men were few enough as a result of being called up or taking other war work (even being recalled to the mines), the shortage of women became nothing less than critical. At the outbreak of war, the hospital had sixty male nurses and sixty-four female, the latter already twenty-two under strength. To make matters worse, although their competence was not questioned, most had yet to qualify. In 1941, female nurses numbered just fifty-three, although there was a recovery after that before a post-war decline described by the Commissioners as ‘very grave’.
AIR RAIDS AND MOTHERLY LOVE
Being a large target, there was understandable concern that the BMH would be bombed. Give or take a trailer pump for the hospital’s fire brigade, air-raid precautions were considered adequate in 1940 and only one incident received much attention.
The first air-raid warning occurred in the early morning of 4 September 1940, whereupon Lilian Talbot hurried her daughter and son away from the hospital to Bow Bridge, a quiet place close to the Thames. Nothing whatever happened and, after enjoying the sights and sounds of serene nature until the ‘all clear’ sounded, they went home.
One night not long after, perhaps early in 1941, a German bomber dropped a ‘stick’ of bombs in a long line that cut across the roads linking Cholsey with Wallingford. The bombs penetrated deep into marshy ground and didn’t go off. When all this was discovered, both roads were closed as a precaution and Vera and John Talbot, who had meanwhile gone to school in Wallingford, were effectively stuck there. Lilian bravely cycled forth to deliver money so that they could return on the branch-line train. Halted at the roadblock, she remonstrated with the policeman in charge and made it quite clear that she was going along the road to Wallingford no matter what. She was allowed to proceed at her own risk and later said that she had never pedalled so fast in her life!
It soon became clear that some of the bombs had fallen almost exactly where the Talbots had taken shelter in September and many believe they are still down there somewhere.
The wartime shortage of men meant that women took secretarial and clerical positions that were previously male preserves. In 1942, Dr Sylvia Reid was temporarily assisting Dr Astley Cooper and from 1945 a female doctor joined the permanent staff for the first time.
Supplies and Rationing
Fears of a German invasion were real enough that, in 1941, supplies such as bags of cereals and a ‘rescue’ drug supply were dispersed to some old cellars near the main store in case of enemy attack, with other such measures under consideration.
Also in 1941, with rationing in force, some bright spark came up with the idea – as practiced in other hospitals – of putting a supply of sugar on the wards for use in ‘hot beverages’ by those who took it. Although this seems blindingly obvious, it was actually to save sugar since tea was always made in bulk, ready-sweetened regardless of patients’ preferences.
Rationing affected the hospital as it did the civilian population. Despite this, official observations of the patients’ diet remained favourable, although it is tempting to suppose that special efforts would have been made to coincide with the dates of the Commissioners’ inspections. There were several expressions of approval at the varied nature of the meal planning and efforts to avoid predictability.
From 22 October 1942:
With the exception of cheese, bacon and eggs, the full civilian ration of rationed foods is issued, and full use is made of the available ‘points’. Cheese, bacon and eggs are however very important articles of diet, and we strongly urge that the present issue (1 to 2oz bacon, 3oz cheese – working patients get the full ration – and no eggs) should be brought up to the amount of the full civilian ration. The daily issue of milk a head to patients on ordinary diet is very small, 1/4 pint, and every effort should be made to increase this. The allowance of milk for staff is 1/2 pint daily.
Vera Wheeler recalls that, perhaps due to ministry control, there were no chickens at the hospital during the war, which might explain the absence of eggs. But, considering that the BMH had its own dairy herd, the Commissioners had previously made a slightly surprising comment in 1939 when it observed that the supply of 56 gallons of fresh milk per day was too little for 1,203 patients31 (it works out to just over 1/3 pint) and that too much use was made of condensed milk. By late 1940, the milk supply had been augmented but there was the surprise discovery that there was no milk cooler in the dairy.
July 1943 brought guarded optimism:
Recently a statistical analysis has been made of the patients’ dietary at this hospital. We were glad to find that no time has been lost in rectifying the deficiencies indicated by this analysis. The issue in bulk of food stuffs with the right proportion of various ingredients does not necessarily ensure that each meal is satisfactory.
The patients’ dinner yesterday consisted of fish-cakes (containing much potato), potatoes, haricot beans and a baked sponge pudding sweetened with jam. It did not appear to us to be a well-balanced meal. Doubtless the uncertain delivery of food-stuffs at the time they are required render catering very difficult at present: but we hope this aspect of the dietary will be kept in mind in the planning of each day’s meals.
Also:
We discussed with the Medical Superintendent and the Clerk and Steward the desirability of giving supper to all patients. At present only a few of the male workers have this meal. The chief difficulty arises from the nurses’ hours of duty and whilst the present scarcity of nurses lasts, there is no prospect of reorganising their duties.
Regardless of staff shortages, and while such concern is clearly laudable, it is hard to see how this could be achieved with rationing the way it was.
Natural Instincts
With the country crammed with men in uniform, a hospital full of young nurses was like a magnet to servicemen from nearby RAF Benson and the American airfield at Mount Farm (Berinsfield). They were barred from the hospital grounds but waited en masse at the main gate, vying to attract a nurse’s favour, while the girls always dressed up to look their best. Some of the romantic antics that took place at the end of the evening on the same spot – or, indeed, illicitly inside the grounds – are better not related, but were long imprinted on the memories of the family living at the Lodge.
8
OCCUPATIONAL THERAPY AND WORK THERAPY
The asylum’s Victorian ethos put much emphasis on providing the patients with useful occupations, to give their lives form and p
urpose and a measure of self-respect. Many of these have already been mentioned.
In January 1930, referring to the success seen in other hospitals, Commissioner Rollisham proposed the appointment of ‘a female occupation officer whose duty would be to teach and interest those patients who now sit about all day doing nothing’.
The Commissioners’ report of 1931 makes the earliest known recommendation of ‘occupation therapy’ (OT), although nothing had been put in place up to that time. The following year, we hear that Dr Read had proposed an OT room in the Bungalow, although nothing indicates that this came to pass. At the same time, some women were said to be doing OT and it was thought that men might soon join in. By 1933, despite the Commissioners’ continued advocacy, only modest progress had been made, with nine or ten men working on rug making, fretwork and raffia work. It was suggested that the Matron and Head Male Nurse visit one or two hospitals where such a programme was valued!
With the impending opening of the Villa, 1935 saw the Commissioners hoping ‘that opportunity will be taken to develop occupations in this building, which would encourage an atmosphere of interest and activity’. Suffice to say that this aspiration was not fulfilled but the report was able to add:
In the wards of the main building & elsewhere we saw some attractive embroidery and were glad to hear that competitions are held and prizes given. For the men, the room mentioned at last visit is in use, for about 12 patients, who do rug making, envelope making and one or two other handicrafts, but there is still scope for extension in the wards.
The story was much the same in 1936, although tinged with optimism:
… there is still scope for extension of this form of activity. Such articles as rugs, coat hangers, fretwork etc. are made in the wards and many of them are of good design and finish. In the sewing room, such of the female patients as are able are allowed to make their own frocks, a privilege which we are quite sure is much appreciated.
Yet by December 1938, OT had still not been formally established, leading to suggestions that nurses obtain some knowledge of the subject. Mrs Astley Cooper, wife of the new superintendent, was meanwhile leading sessions on three days weekly. Working in the divided sewing room, the good lady struggled valiantly through 1939 but lacked trained assistance. As a result, many patients sat around doing nothing.
Finally, in 1940, a Miss Taylor was appointed Occupational Therapist. Both Male and Female sides were covered and she had plans to expand the scope of OT, starting with the Male side which, by the end of 1941, offered basket weaving, reed weaving, cabinet work and joinery. The war hampered her work, as it did many aspects of the hospital’s activities, but late 1942 saw her coping with 100-plus women and twenty men; however, there remained an unhelpful lack of enthusiasm for the function in the wards.
The term occupational therapy first appears in July 1943, at which time classes were held daily for fifty-two women and eighteen men. The repeated call for extra space for this function had gone unanswered for yet another year.
The Commissioners commented in 1943:
Large groups of patients are employed in the utility departments – sewing room, laundry, kitchen and gardens more especially. Some of the male workers have liberal issues of tobacco, but no corresponding inducement is given to the women workers. We hope the Committee will give further consideration to the issuing of tokens that can be exchanged for articles, tobacco or sweets at the Canteen – a department that continues to function actively in spite of war-time restrictions.
This is an interesting observation on the unequal treatment sometimes meted out to women and on the general principle that effort should be rewarded. Happily, women were given cigarettes for their efforts from 1944.
The remaining war years saw little change in circumstances or the numbers of patients using OT, although records indicate that larger accommodation was eventually found for the men. The OT room was still within the hospital and almost certainly in part of the women’s sewing room.
Starting her training at the BMH in 1921, Lilian Brignall won her RMN32, left the hospital’s employ in 1926 to marry Hall Porter Leslie Talbot and, by 1949, had raised two children in the Lodge. She then retrained and returned to what was now Fair Mile in the role of Occupational Therapist. She was a capable, no-nonsense woman, daughter of Stoker Ernest Brignall, and her upbringing in a large village family, followed by a period in domestic service, had equipped her with a range of practical skills. She put these to good use, teaching sewing, knitting, weaving, embroidery, rug-making and cane work to her female charges. Male patients, usually supervised by male staff, were offered some of these options but could also do carpentry, printing, basket making and other ‘male-orientated’ crafts.
Lilian Brignall’s RMN badge. (David Talbot)
Lilian Talbot’s Association of Occupational Therapists badge. (David Talbot)
A posed but busy scene in Female Occupational Therapy in about 1957. Patients are sewing, weaving and making rugs and soft toys. The lady seated left at the nearest table appears to be painting plaster of Paris figures. Mrs Talbot (standing, left) presides, with Pamela Bunker at the far end of the room. (Spackman collection)
Male patients busy in their OT hut in about 1957. The man leaning on the table is Taff Jones, Charge Nurse. (Spackman collection)
Occupational therapy staff and nurses outside the OT huts in October 1958. From left: Mrs Lambert; Francisco ‘Frank’ Plazas (Spanish); Vi Perry; Albert Kennedy; Lilian Talbot; ‘Taff’ Jones; Joyce Sherwood; Colette Dusaillent (French); Michael Truba (Latvian); Beatrice West. Male 8 (Hermitage) ward is behind on the ground floor, with 9 (Ilsley) ward above. Frank Plazas came to Fair Mile in 1956 and is father of opera star Mary Plazas. He was assigned to OT when this photo was taken. (Frank Plazas)
From 1950, OT was based in two wooden huts33 – one Male, one Female – beyond the service road at the rear of the Victorian buildings, a stone’s throw from the Recreation Hall. The unit had two qualified female therapists, backed up by OT assistants and assigned student nurses. In the group photo of 1958, two of the four men are students from the overseas intakes that followed the war.
An impressive range of craft items was produced by OT in the 1950s under Mrs Talbot’s guidance. Soft toys were a particular speciality, alongside artificial flowers (in these pre-plastic days, artfully constructed from wire and dyed nylon stockings), lampshades, plaster figurines, dolls’ houses, model boats, baskets and stools, many of which did yeoman service in local households.
Lilian retired in 1962. A matter of a year or so later, the nature of occupational therapy changed significantly, especially with the advent of the new Work Therapy building, where OT relocated, and craft-based activities gave way to unskilled tasks, such as clipping together plastic toys. These were supposed to generate an income for the patients, although the rate was small. Needless to say, given her range of abilities, Lilian had a pretty low opinion of this turn of events.
By the end of the twentieth century, OT was again teaching creative skills and facilities: a number of fashionable activities such as potting, batik, music and computing were on offer, assisted by well-qualified staff.
Work therapy, as an identified discipline, appears to be a distinctly post-war arrival. The activities seem to have centred around ‘outsourced’ tasks under Remploy or similar organisations. A rather unnerving undertaking of 1957 was the manufacture of fireworks, by both men and women, in the cricket pavilion. The pavilion survived – perhaps because the scheme did not run for very long. In 1960, we are told that only men were involved in work therapy, although this may refer to the accommodation then available; the need for a dedicated space had been pointed out. In that year, old telephones were being dismantled for their parts.
George Herring (left), an accomplished basket maker, with Lilian Talbot in about 1950. (Vera Wheeler)
Occupational Therapy handicrafts on display about 1955. The venue may be Reading Town Hall. Lilian Talbot and Taff Jones are presiding. (Autho
r’s collection)
Creative occupational therapy was back in fashion and in the main hospital by 2000. Occupational Therapist Sarah Childs demonstrates. (Spackman collection)
Practical skills were also taught in the closing years of Fair Mile. (Spackman collection)
We will leave the subject with a story that may be apocryphal but which still has its supporters. At the time when there was an embargo on imports from South Africa, tinned fruit from that country was supposedly brought to Fair Mile to be re-labelled as Rhodesian. The tale has been strenuously denied but, whether true or not, makes an interesting commentary on the general character of work therapy in what was, perhaps, an isolated ‘dark’ period.
9
SOCIAL ACTIVITIES
AND RECREATION
From the asylum’s earliest years, the authorities were fully aware that recreation and entertainment assisted a patient’s rehabilitation and this was part of the accepted order; besides indoor and outdoor games, the superintendent’s reports often mention entertainments of one type or another, sometimes procured from outside and often making use of resident talent.
