INTERLUDE THE FIRST - EARLY LIFE

My early life was what many people would call privileged. Born during World War II my mother Iris had moved to Wales to be with her family away from the bombing so I was actually born in Penarth although I always think of myself as a Londoner. My parents had met during the blitz – my father working for Intelligence was in England throughout the war and my mother was driving ambulances. I don’t know the circumstances of their meeting but do know that my father loved my mother deeply for all of his life even after they broke up when I was seven or eight.
My mother’s marriage to my father was her fourth marriage in a string of spectacularly unhappy relationships. Her first marriage was when she was aged eighteen. She and her husband had gone to Brighton on the South Coast for their honeymoon and were staying in a small boarding house. One morning her husband went out to buy a newspaper and was killed by a passing bus. They had been married less than a week. My mother describes her feelings of loss and loneliness and isolation. An unsophisticated young girl, barely a woman, a long way from home, poor communications and as she describes it an unhelpful seaside landlady. Somehow she managed to return her husband’s body home and arrange the funeral. In later years she said that few would have had a marriage and a funeral within a fortnight and although phlegmatic her reluctance to really discuss this whole episode showed that the feelings were still very much with her. My mother’s reticence about her early life always remained and much I managed to glean from other members of our small family or from the occasional times when she would open up.
By 1939 what was later described as the phony war or the calm before the storm was a time when recruitment and war preparations suddenly saw large numbers of men in uniform. My mother met and fell in love with a young man who flew spitfires and within a year or two was part of the so-called ‘Battle of Britain’. He was shot down over the channel and his body never recovered. Marriage number two. Within a very short period of time my mother married again; this time to a pilot of a Lancaster bomber. This marriage lasted exactly three weeks until he was shot down on a night raid over Germany. Marriage number three.

I asked my mother why she married but the reply was that in those times life was precious and sweet, but also potentially short. Marriage was almost a gift to men who may not live long and it also legitimised a relationship so that a couple could live together and not be seen as ‘living in sin’ – a major issue then. So having coped with the loss of three important men my mother took to driving ambulances during the Blitz and here, somehow I don’t know, she met the man who was to become my father. My mother said later that Willoughby was the first man she really felt deeply for and that he was the man for whom love meant everything. They didn’t marry until after the War although it wasn’t very long until I was on the way.

At this time my father was a senior officer in an obscure unit of intelligence where he was responsible for helping with the establishment of a home underground resistance as it was felt that the Germans could easily cross the channel. He was mostly in civilian clothes and carried a stick to appear slightly lame or maybe injured (he wasn’t) so that questions wouldn’t be asked as to why he was not in uniform. Willoughby came from minor landed gentry and had a successful career as a concert pianist often playing solo recitals at the Albert Hall or playing Vidor at St Pauls. He was undoubtedly one of the great pianists of his generation and played regularly almost until he died.

Immediately after I was born my mother moved to South Wales to live with her family and to be away from the bombing. That she moved to Cardiff wasn’t necessarily a good idea as the Germans also liked to unload onto the docks and that became almost as dangerous as London. Nevertheless we both survived the war and returned in 1945 to live at my father’s grand house at Hampton Court.

I have strong memories of this time although I was only there until I was about seven or eight years old. The house was called ‘High Elms’ from the elm trees that surrounded it. It was a double fronted four story Georgian property with two acres of gardens sweeping down to the river Thames. The hundred yard river frontage was marked by a small jetty from which we fished and by what was always known as the ‘helicopter house’ a wooden gazebo that could be rotated to face into or away from the sun. A great copper beech tree hung over the river that was the most wonderful climbing tree even if we were constantly scolded by Cookie not to go too high. In later years I have visited the house and its seems smaller than my memories but then I guess my perspective has changed to slightly moderate the vision of my childhood.

High Elms was an adventure playground. There was the walled kitchen garden presided over by our gardener/handyman Len, Cookie’s husband. Cookie herself who cooked the most wonderful cakes and biscuits and of course all the meals. The kitchen was in the lower part of the house and you entered off a yard that was surrounded by the original stables but now housed the cars. Over the stables was the apartment where Cookie and Len lived and the sable yard was cobbled in dark blue-black stones. Entry to the yard was by a large steel gate that was always opened and closed very ceremoniously by Len and Cookie’s slightly simple boy, Jack. Jack was probably about 18 but helped around the house and the garden. When we were going out he would put on a smart uniform of dark blue, wear a peaked hat and salute the car as it was leaving or returning. Even if we returned home very late Jack would still be sitting in the gatehouse, keeping warm over a small paraffin burner, until he could leap out and open the gates for the car. The last staff member was Sally who was known as a ‘tweenie’ as she could be found anywhere between the kitchen and the bedrooms, making beds, cleaning and dusting, polishing the woodwork until it gleamed and setting the fires in winter. We didn’t have a Butler, it was far too small an establishment for that but the fact that we had servants was never anything I thought about as all the people we knew also had them. Cookie though was s second mother and I spent many hours in and around the kitchen, ‘helping’ with the baking and always trying to be the one to lick out the bowl after the cake mix had been scraped into the baking dish.

Not on the staff but occupying a special role in my life was our nanny, Valerie. Valerie was only about sixteen I think and her early life is shrouded from me. All I remember of my time with Valerie was that she always seemed to be there, helping us (my brother Paul arrived very soon after I returned to High Elms) dress and being involved in the long complicated war games we played with myriad toy soldiers and cannons that shot matchsticks!

I saw little of my father. He was a mysterious figure mostly seen in evening dress tails and white tie on his way to perform at a concert or to his Masonic Lodge. He was a tall, elegant man, very upright in his carriage and with long thin fingers that were so suited to playing his beloved Liszt. Dinner for the children was mostly taken in the huge kitchen where it was warm and cosy and where Len would regale us with terrifying stories of his years in the war. We would sit in the warmth from the stove and have long happy meals. My parents on the other hand would eat in the formal dining room that I remember had a long central table in dark mahogany and a frieze running round the top of the room like Wedgewood pottery; pale blue with white figures of Greeks fighting each other, pouring water endlessly from long amphorae; and small cupids peering from stylised trees. My parents would always be dressed formally and my brother Paul, three years my junior, would be presented to our parents by Valerie while they were at dinner and we were on our way to bed.

My room was at the top of the house off the big playroom. It had windows that opened onto the roof and I could watch the boats going up and down the river, the weir in the distance and the changing seasons. After a while my father would come into the room and read me a story and this would be one of the most important parts of the day and also one of the few times when I would have him to myself. At one stage I had a disaster in the kitchen. I was standing on a bentwood chair with a straw seat alongside the large coal range while Cookie was taking a rice pudding from the oven. As she placed it on the floor to close the heavy door my feet went through the base of the chair and I fell face first into the steaming pudding. The local doctor was called and came immediately. Fortunately he had worked with Archie McIndoe during the war patching up the faces of pilots who had been burned. He knew what to do, spread some mysterious salve on my face and bandaged me up like an Egyptian mummy. Perhaps not the best thing to do in today’s enlightened times but it did prevent any scarring at all. I remember vividly the fall and the pain but the lasting memory is of my father sitting by the bed singing, at my request, ‘Three blind mice ...’ over and over again. Apparently he was in tears as he thought I might actually have lost my sight but anyway he stayed with me all night and didn’t leave home until the bandages were removed and we all knew there was no damage.

Down the road was Hampton Court Palace and we had a distant cousin, Bertie, who was a retired diplomat and who lived in a Grace and Favour apartment at the Palace. I would occasionally visit ‘Uncle’ Bertie and we talked endlessly about his adventures in India and other exotic places he had served. His dark apartment was full of ancient weapons, shrunken heads and other memorabilia that never ceased to fascinate me. Every object had its own unique story and Bertie, I am sure, would exaggerate these into a sort of King Solomon’s Mines adventure so that in my young eyes he was Alan Quartermaine embodied. During these visits I got to know Sam who was the Head Gardener’s son at the Palace. As our friendship grew we spent longer and longer together exploring the Wilderness and other parts of the Palace and its grounds as though we were the natural Princes – which of course we thought we were. Sam showed me the secret of the famous Maze and we would earn the odd penny from visitors who were lost by showing them to the seats in the middle or back to the entrance. The ‘secret’ still works in virtually any maze but I’ll keep that to myself as I promised Sam I’d never tell. Sam was later killed in Northern Ireland serving with the Parachute Regiment and I lost an old and special friend.
I have many memories of this start to my life, catching herring from a boat out of Pentewan where we went for holidays, then a deserted beach and now one of the gross holiday caravan parks that only the English seem to create. We ate winkles off the rocks picked carefully out of the shell with a pin, paddled in tide pools and chased crabs from under the rocks.

I remember launching a rubber band powered aircraft from my window and watching it stall into the tall pine tree at the top of the garden where it could not be retrieved until it eventually fell down a few weeks later after a gust of wind. Undamaged and still flyable. We were indeed privileged and so my life went on as many other successful middle class families of the time. I was spared from the rigours of post-war rationing, my home was warm in winter, cool in summer and full of interesting nooks and crannies to explore. I had friends a-plenty, a river to fish and a growing collection of butterflies.

I also recall a time when my father and Len were replacing the crazy paving on the river side of the house and how Len with a barrowfull of paving slabs suddenly began to sink into the ground where his combined weight with the barrow had broken through the roof of an ancient tunnel that led all the way to the Palace. I was told it had been built to enable King Henry to scuttle to his Mistress's house that used to be past our house. The tunnel was several hundred yards long and lined with bricks but I never knew what eventually happened, whether it was filled in or is still buried beneath the waterfront houses and quietly people with the ghosts of its mysterious past.

An early idyll that came crashing down around me when I was about seven or eight ....

Pictures of Long Grove - 1995

The above image is taken looking across the semi-circular corridor at H & I wards. Typical of Long Grove was the band of black brickwork that seemed to accentuate its institutional feeling. (This picture courtesy of Urbex)

Another picture showing the yard area of one of the wards. Now very overgorwn the once immacuate lawns are run to seed. The bay widows marked the line of the gallery and at the end one can just see the jutting of the ground floor lounge area. Immediately behind the photographer would have been the walls of the adjacent ward forming the second side of a large traingular space. The central gazebo is now either gone or hidden by the trees.

Both of these pictures were taken several years after the hospital closed.

PART 5 - TREATMENT AND TRAUMA

Much has been written about the treatments meted out to some of the more unfortunate who occupied the mental hospitals of the past. Usually such writing seem to come from two directions – first the angry diatribes of ex-patients who have suffered and been abused and second from the contrary point of view of psychiatry trying to justify itself. I have seen little written from the point of view of staff working in the system and even less from those who have seen the system from both sides – as staff and also as patient. Nevertheless the treatments available to people of my generation (and let’s face it, within the span of a single career so we’re not talking of a hundred years ago) were the best available or the worst available but most driven from a genuine desire to make a difference. ECT, or electro convulsive therapy has been around for over 60 years and it had a peculiar ancestry, but for those for whom it worked it was literally a life-saver. Nevertheless like many treatments it was abused and overused or used simply to control and intimidate. But that wasn’t the fault of ECT per se; it was the abuse of what is potentially an effective treatment by people who profess to know better.

Long Grove had its fair share of physical and chemical treatments and I suppose I witnessed or delivered many of them. But although sometimes horrific it is my lasting impression that most of us did the best we could with what we had.

Our materia medica or available list of drugs was very small and could possibly be counted on the fingers of your hands. There was of course the ubiquitous paraldehyde that was used liberally to sedate. Paraldehyde was so caustic that it would melt plastic syringes so most wards carried a small supply of glass syringes that were sterilised in old fashioned stainless steel sterilisers that were little more than a square boiler kept on the bench of the clinic. Other drugs included chlorpromazine and thioridazine as our major tranquilisers or anti-psychotics with the newly introduced Stelazine being also liberally used as an anti-psychotic. Antidepressants were limited to a choice of a drug called tofranil; our anxiolytic (anxiety reducing) was Librium and for night sedations we had supplies of barbiturates and chloral hydrate. There were a small number of drugs used to reduce the side effects of the primary drugs such as stemetil and phenergan but apart from that not a lot else. As many of the patients also had serious physical conditions including tuberculosis we were also treating that as best we could but with little success overall.

From time to time a new ‘experimental’ drug would arrive – this was well before ethics committees were established and the drug companies were easily able to run trials with very little in the way of informed consent. One I remember in particular was an appalling anti-psychotic called majeptyl or thioproperazine. This caused the most gross side effects including drooling, semi-catatonic states and severe rolling up into the head of the eyes. We tried to counter the side effects with injections of phenergan but to little avail. I remember one patient, Ian, who when a young fourth year medical student had developed schizophrenia. He had the misfortune to be placed on the drug and had the greater misfortune to understand exactly why he was suffering the side effects, he would stagger to the office asking in a broken voice for phenergan being barely able to say the word he was so badly affected by the drug. Mostly he seemed to be left to his own devices mainly curled up in a chair with long strings of saliva soaking his clothes. After a while the drug simply stopped being used and the enthusiastic drug reps stopped calling on the ward. I cannot recall what happened to Ian but I am sure that once off majeptyl he would have been much better off.

The use and or abuse of medication was mainly a product of the paucity of sophisticated drugs available. Nowadays there are improved anti-psychotics that have few of the side effects of the early ones and so people on them have a much better life. The early anti-psychotics certainly made a difference in terms of symptom reduction but this was offset by the side effects that were, at best, poorly controlled. People who have suffered these treatments feel rightly angry about how they were treated but their anger is often about the side effects they suffered rather than the treatment proper. I felt particularly helpless when I saw how the patients struggled with the medication but was powerless to do much about it as I was simply a dispensing tool. When I did try to remonstrate with the doctors about the effect the drugs had on the patients I was treated to a patronising address about my inexperience (true) and the wisdom of the psychiatrists (dubious) who knew what was best for the patients (definitely untrue). So I simply did the drug rounds handing out the tablets, emulsion or elixir as prescribed and feeling quite guilty at the effect I knew it would have.

One of the more obvious abuses such as dispensing paraldehyde “of the top” so that it was not diluted by the buffer solution that had settled to the bottom of the bottle, I have already referred to but there were other abuses in particular the use of PRN medication – medication dispensed as needed. Some of the older charge nurses kept old stocks of medication that belonged to people who had ceased a course or left the ward. Thus they kept in their desk their own private supply of major tranquilisers that they would dispense to anyone they thought was ‘causing trouble’ rather than bother the doctor. After all, they knew better than most of the medical staff anyway as they lived in the real world and had to manage ‘that lot’ on a daily basis!

Drugs then were pretty much ubiquitously used and often in greater quantities than those prescribed. This was mainly because the nursing staff always believed the doctors prescribed too low a dose anyway and that as they had to manage the patients on a daily basis knew what was needed to keep people settled. In fairness this was possibly a reasonable response by the nurses as often the patients became quite violent and agitated and with the small numbers of staff to each ward there was a temptation to do what one could to reduce the risk to staff. No doubt the doctors in their turn were puzzled by the extent of sedation or extra-pyramidal side effects and then further reduced medication which the staff then increased the minute the doctor left the ward.

Note too that I refer to doctors, not psychiatrists. The latter were few in number and so most ward cover was by medical officers – doctors who were interested in psychiatric medicine but who had not completed, or did not intend to complete, their DPM (Diploma of Psychiatric Medicine). Mostly this group of doctors ended up covering the ‘back’ wards as the long-term wards were called, while the psychiatrists tended to cover the villas where patients were largely suffering from minor psychotic issues, mood or personality disorders. Here they could practice whatever treatment fad they were interested in so that some of the villas were notorious for being run as encounter groups or therapeutic communities, others were a hotbed of hypnosis, analysis, group therapies, individual psychotherapies, drug induced abreaction (often using LSD) and other vagaries that were in favour at the time. Certainly these villas were fun to work in as one never knew from week to week what would happen and there was considerably less risk than working on the back wards. The treatments were, to the untutored eye of us student nurses, exciting and interesting and allowed us deep insights into the human psyche as exposed by some harrowing psychotherapeutic sessions. Or at least we thought we did but then to our shame we were as caught up in the trendiness of the day as everyone else.

So if you were lucky enough to be a patent in the villas and were young, intelligent and attractive to boot, you’d have good access to psychiatry, psychology, psychiatric social workers (who acted as quasi-psychiatrists anyway and were probably the most enthusiastic adopters of the various psychotherapies) all in reasonable surroundings. On the other hand if you resided on the back wards you may be lucky to see a doctor twice a year for a physical and mental examination.

Electroconvulsive therapy was of course used regularly and an ECT clinic was held in one of the Villas three times a week, Monday, Wednesday and Friday. The patients for ECT were placed in gowns and then lay on gurneys in one area of the unit. Here they would often chat away to each other while awaiting treatment often being quite blasé and jocular about what was to happen. One by one they would be wheeled behind a screen and ECT would be administered by first anaesthetising the patient, administering a muscle relaxant, placing an airway in place and then applying electrodes to the temples for long enough to administer a brief, low voltage shock to the frontal area of the brain. If done properly the patient moved very little and the convulsion manifested itself merely by a grimace and perhaps the toes turning up for a few seconds. Following ECT we would use a resuscitator to ensure breathing occurred until the muscle relaxant wore off (only a few minutes) and then rolled the patient on their side. After this the patient would be wheeled to the recovery area where recovery would be indicated when they tried to retch out the airway. We would then sit them up and give them tea and biscuits before they went back to their ward or back home if they were out-patients. Mostly they recovered well with a small memory loss in that for a few minutes they couldn’t remember having treatment.

ECT was usually prescribed for people who were seriously depressed and who may not be responding well to antidepressants and was given in courses of six. If there was no apparent response a further course of six treatments was administered and that was usually as far as it went. There were a few people who had intractable depression who came in for a bi-weekly treatment for months on end, clocking up several hundred treatments but these were indeed very few.

ECT was sadly also used as a threat for ‘behaviour’ problems by some of the more recalcitrant patients I which case there was no clinic and ECT was usually administered ‘straight’, that is without anaesthetic or muscle relaxant. This procedure was usually when a patient had become violent and was being held down by several nurses. The ECT machine would be quickly plugged in and the patient shocked while still fully conscious. This produced a violent convulsion unmodified by muscle relaxant and we had to lie across the patient’s legs and chest to stop them having such a violent convulsion that they would break bones. Patients were rendered unconscious and woke after about twenty minutes with violent headaches and disinclined to continue their aggression whether motivated by their illness or by their anger. Usually they were placed in a PR (padded room) to recover with a nervous junior nurse watching them until they were awake when they would exit the room and slam the door on the patient for the next six hours or so, or until the next morning if late in the day.

The sixties were also the time when lobotomies ceased being used regularly as a means of controlling behaviour. A lobotomy was a crude operation where holes were bored into the temples and the frontal fibres of the brain cut through. The idea was to reduce agitated or obsessional behaviour but there were examples when it was used simply because a particular patient was seen as a troublemaker – much like the character of Randle Patrick McMurphy in Cuckoos Nest. More crude still was the practice of the trans-orbital leucotomy of which I probably witnessed some of the last to be done – or I hope I did. This was a leucotomy performed by the simple expedient of inducing unconsciousness by ECT, then pushing a device called a leucotome through the thin bone of the orbital socket (where the eye sits) and the wiggling it through the frontal fibres to achieve the same results as surgical lobotomy. On recovery patients sported the most terrible black eyes for weeks with their faces swollen and unrecognisable. Whether either of these procedures did any good at all is moot. Certainly patients treated this way were more tractable but then they were virtual shadows of their former selves and showed little initiative. I think lobotomy was as much a management tool as a treatment and I saw little evidence of a carefully planned, discussed and clinical approach. Rather the decision to lobotomise seemed to be made in a blasé and offhand way and was predicated as much on the perceived unpleasantness of the patient than for any obvious clinical reason.

There were a range of other treatments in fairly common practice. Prolonged drug induced narcosis (PDIN) was used frequently and patients would be subjected to large doses of major tranquilisers and left in a sedated state for sometimes months on end. In theory PDIN was not supposed to continue beyond twenty eight days but often this was stretched into much longer periods for no particular reason that I could gather. I am unsure whether this treatment made any difference and there certainly was no obvious indication as to why it should be used on one and not another. Our job was to ensure the patients were turned regularly so that they wouldn’t develop pressure sores, clean them when wet and dirty and somehow get liquid food into them which was particularly difficult in their semi-comatose state. Pressure sores were a real issue and happen for no other reason than poor nursing care in that people were not moved often enough and areas liable to pressure sores such as hips, heels and spine were not massaged regularly to make sure circulation is maintained. Pressure sores occur because the constant lying in one position excludes blood from pressure areas and they literally die. I have seen and treated people with deep sores as big as dinner plates in which bones and tissue were clearly discernable surrounded by the necrotic blackness of dead and dying flesh. We did what we could but that wasn’t much and usually included washing with a foaming solution of hydrogen peroxide, paraffin gauze dressings or sometimes honey which did seem to promote healing. So there is truth in some of the old wives’ tales after all.

Much of the above sounds brutal and horrific and in retrospect it was. My dilemma is that at the time I don’t think I saw it as such for I rapidly became as inured to the institutional excesses as anyone else who worked in that grim and grey place. Partly I switched off because it was so difficult to speak out against the system and partly it was because none of us really knew any better. What happened simply happened and the ineluctable pressure to conform and be as others became a survival mechanism and a barrier between us and madness. I think there were very few people who were deliberately brutal or violent to the patients, although there were examples of that. Mostly we simply conformed and did the best we could under the circumstances. The old school nursing staff had their own shortcuts and for some time I wondered why some of them always carried a damp tea towel in the pocket of their uniform jacket. I was to see this device used with great effect on a violent patient who would have the cloth rapidly wrapped around their neck and quickly tightened to produce almost instant unconsciousness as the carotids were compressed. Others would always have a small bottle of ‘useful’ pills in their pocket to dish out to anyone they felt needed calming down, a collection of valium, tranquilisers, or anything else they could just slip a patient they felt was getting out of hand.

The most overarching ‘treatment’ of all was of course the institution itself. Institutional life strips all sense of initiative and social skill from people who reside there in a process called institutionalisation. This is common in any closed system whether it be prison, long term hospital or rest home. What seems to happen is that people reduce to the lowest common denominator and become dependent on the organisation for their survival. Meals turn up at a certain time, they get up and go to bed in routine and everything they do is usually governed by someone else. Thus they become apathetic, listless and lack confidence. The regime plays on this by ensuring that activities are kept to a minimum (especially on the back wards) and so the residents become increasingly devoid of any social skills as they have to communicate with very few people. I was always surprised at how quiet the long term wards were and how often the only sound came from the television or the occasional mutterings of a patient talking to his or her voices. There was little spontaneous conversation and the patients did not converse freely with each other as one would expect from people who had lived together often for many years. Institutionalisation was a great weapon in the treatment armamentarium as it led to patients being quiet and easy to manage. What activities there were, were also routinised and even in the workshops and the garden crews much of the work was carried out with little interaction between patients.

Institutionalisation is insidious but can also occur very quickly. One only has to talk with people who have been hospitalised for a few months following an accident to realise that apart from physical rehabilitation they also have to make a huge step in readjusting to life back home where they have to manage their own lives. And this is people who are ‘normal’ and have good relationships and friendships to sustain them. Home quickly becomes an alien territory where it may take several days or even weeks to readjust. How much harder for people who are already damaged by mental illness and have been in hospital for long periods of time. We nurses didn’t really recognise this aspect of the hospital as we had another life, a social club, friends and relationships. The concept of institutionalisation was not taught at the school, nor was it discussed on the wards. Institutionalisation was something that was just there; patients who had been in the hospital a long time were rarely violent, were calm, quiet and bored. They were therefore easy to manage. How this state had been achieved I suppose we attributed to medication and the ‘calm’ of a long period of hospital care. In this we were perhaps partially correct but we failed to understand the subtleties and the changes that were often irrevocably wrought on our charges.

Mostly I think that in the early sixties people ‘recovered’ from mental illness as much by good luck than from the effects of treatment. Most treatments, especially those directed at psychosis provided some amelioration of psychotic symptoms but did little to relieve the disease. Drug therapies were like a sledgehammer cracking a walnut – too much, too brutal and too imprecise. Anti-psychotic medications produced significant and uncomfortable side effects that in turn required further medication to reduce. Most of the side effects involved lethargy, dry mouth or drooling, rolling upwards of the eyes, tremor, discolouration of the face, repeated movements. Long term use of antipsychotics led to what is called tardive dyskinesia, a condition characterised by repetitive involuntary movements including grimacing, tongue protrusion, lip smacking, rapid eye blinking and rapid movements of the arms and legs. There was no real cure for tardive dyskinesia and symptoms often persisted long after medication was discontinued.

Antidepressants were also in their early development and were mostly a group of what are called tricyclics that also produced significant side effects including dry mouth, constipation, loss of libido and tiredness. Again one wonders whether the cure was worth the effort or whether left to its own devices diseases such as depression would run a course. Such cynical thinking was common. Those of us who saw the debilitating effects of medication began to have sympathy with the anti-psychiatry movement in which the very process of psychiatric diagnosis was questioned. The anti-psychiatrists suggested that diagnosis was an artefact to explain our own failings and social disapprobation rather than to provide a useful treatment tool. When one has worked for four decades in the psychiatric system there is certainly a real sympathy with that idea and the general failings of the medical model.

Other physical treatments, prolonged narcosis, drug induced convulsions, lobotomy, leucotomy and such also had very dubious outcomes and looking back I can recall no instance where such treatment produced any benefit for the patient. Benefits certainly accrued for the staff in that people became easier to ‘manage’ and maybe that was the only reason such brutality continued for so long. I think most of us convinced ourselves that what we were doing was for the greater good of the patient but looking back I believe that we were more concerned with making life a bit easier on the wards. The other and perhaps most controversial treatment was ECT but here I have mixed feelings. Used appropriately ECT is a life saver and can quickly relieve otherwise intractable depression. I have received a course of ECT when in a profound and suicidal depression and have no doubt that it truly saved my life so maybe I am biased. I am sure that most criticism against ECT is about times when it was abused or simply overused. This was, and is, all too frequent but would hate to see ECT dropped from the treatment armamentarium simply because there is an emotionally charged confusion about the nature of the treatment and its abuse.

By the end of my time at Long Grove I had been privileged to work in the closing days of the asylums. And in spite of everything it was a privilege as it gave me an insight into a world that was based on the flimsiest of evidence and had little right to exist. Most of us had good intentions but then the road to hell is paved with those.

So that brings me back to the beginning and my decision to move on. It had been a formative few years and I was now qualified in nursing but the thought of a career following the footsteps of Chalky White and others filled me with disquiet. These places had to go as I was passionate in my belief that the patients deserved better and that somehow, somewhere there was a better answer.

PART 4 - SCENES FROM INSTITUTIONAL LIFE

The institution gives to the inadequate what they crave most … power


I could write about the years at Long Grove in some detail but the narrative would to a large extent become repetitious. After I had adjusted to working at the hospital, which was after a surprisingly short time, so the days drifted into each other and to some extent I developed the same tolerance for the bizarre that we all needed to successfully work there. Most days the staff saw more extraordinary behaviour than most people would see in a lifetime yet by and large it rolled off our backs as we became inured and routinised.

The hospital acted as its own village, for the staff at least, with a social club and swimming pool; the inevitable monthly magazine (of which I was editor for some time) called Brain Dead, football team, cricket team, silver band and drinking team. The latter was an important part of hospital life and involved a changeable group that regularly tried to drink the staff of the adjacent hospitals under the table at the local pubs. This was somewhat before breath-testing and I recall with horror the number of times I must have weaved my Ariel motor bike back along the lanes to the nurses home far worse for wear than was good for me – or anyone else for that matter. I didn’t fall off, well not too often, and didn’t cause major damage so I guess I was lucky. Adding to the village mentality of the hospital was the fact that many of the staff had worked there for generations, son following father, daughter following mother, many marrying colleagues and producing offspring to fulfil their inevitable destiny on the wards. It was said that male staff at least were picked for a combination of their size and/or their ability to either play in the hospital football or cricket teams or the hospital band. We students, who held ourselves a cut above the long term staff, felt the women had been picked according to the same criteria although of course this was most unfair.

The hospital as I have said, sat in its own private grounds set apart from the surrounding countryside by hedges and walls. It was dominated by the water tower but overall softened by the many trees, lawns, and generally very well landscaped and maintained gardens. Away from the D-shaped main hospital there were a number of large two-story villas that were primarily where voluntary patients, that is patients who to a certain extent were free to come and go resided. Most of the villas were built post the Second War as admission to a psychiatric hospital was expanded to include people who actually volunteered to stay there. The Villas were well laid out and most had their own kitchens so the food didn’t arrive half-cold in a large stainless trolley. They were popular to work on as they were light and airy and the patients better able to hold conversations, look after themselves and be pleasant. Most importantly though, these were the wards where some quite exciting things happened that were fascinating for our unsophisticated minds. This was the middle of the 1960s and a time of great experiment in understanding of the human condition. The villa wards provided a readymade population for the bright young psychiatrists and psychologists to try the latest therapies described in the journals. Psychotherapy of course, in all its many forms, group therapies, hypnotherapy and drug induced abreaction, electroshock therapy or ECT and of course trial after trial of the drugs that began to flood the psychiatric market in those days. All in all a fascinating place to work as long as you left your mind in neutral, discarded professionalism to the winds and there wasn’t an Ethics Committee in sight. The main block wasn’t immune from experiment either but here the experiments were more brutal; lobotomies and habit training, malarial therapy, prolonged narcosis, new ‘improved’ anti-psychotics that would leave patients drooling and comatose, insulin shock treatment and of course ECT. The main block wards still had padded rooms and straightjackets although on the whole the latter weren’t used very often as in spite of what you see in films or read in books they are fearfully difficult to get on to an agitated or violent patient.

I have thought at length how to summarise my four years at Long Grove and in the end decided to break things down into a series of scenes that are each representative of the culture that prevailed at the time. I have neither exaggerated nor minimised; nor have I drawn conclusions, those you can draw for yourself.

Jenner One Breakfasts

Jenner One was Long Grove’s Refractory Ward - the ward that held the most difficult patients or those who needed the highest level of security. In layout it was much the same as any other ward except that the side rooms in the gallery were a combination of full-pads or half-pads. Full-pads were padded rooms that were lined with padded leather to the ceiling. The floor was similarly padded so although not soft, it was hard for anyone to harm themselves and the leather made the surfaces impossible to damage with bare hands. Where the floor met the wall was a gutter that led to a drain in one corner and what light entered the room came from a small window high in the wall and just out of reach. These rooms had two doors. An inner padded door with a peephole and large, polished brass bolts that opened against a spring so that if the door was slammed shut they would snick into place. There was a gap of about 12 inches between the inner door and the outer door. The outer door was solid but otherwise conventional enough and secured with a ubiquitous asylum lock recessed in its small brass cup. Half-pads were similar in that they had the high window and two doors but in these rooms the padding was on the floor and only about half way up the walls. Padded rooms were for people who were overtly violent and in danger of hurting themselves or the staff and the half-pads were for people who were usually so medicated that they were incapacitated an the padding was there to prevent them rolling into the wall. Both types of room had no furniture and bedding usually comprised two to three blankets that were stitched together in a narrow quilting patter so that they could not be torn.

Jenner One was staffed more than the other wards but only with the addition of one or two extra nurses – medication did much to calm things down in those days. But to get back to breakfast as this was legendary, not only at Long Grove but throughout the whole asylum system as I heard stories about them in many other hospitals. “Oh, you worked at Long Grove did you? Ever work on Jenner One, I believe the breakfasts were amazing …” or some such.

The principality of Jenner one was presided over by Richard (Dicky) Birdd, a charge nurse of the very, very old school. He was a surprisingly small man, barely above my shoulder, but he ruled the ward with a rod of iron.

I have mentioned that each ward had a storeroom and it is here that the Jenner One breakfasts were held. In the middle of the room was a large wooden table that sat about eight people in comfort. The famous Breakfast began after the patient’s breakfast and things were quiet. The ward was left in charge of the two most junior students and the remaining staff retired to the store. The key ingredient was Hartley who was a long term patient of Jenner 1. He had worked as a butler for some moneyed family until for some unknown reason he had taken a shotgun from the gun room and shot not only his master but the cook and the stablehand. (Yes indeed, the butler in this case really did do it!) All three fortunately survived although it was very much touch and go for the stablehand. Hartley was found guilty but insane and committed to Long Grove’s Jenner One where after a period of time he once again resumed his butlering duties.

First he would carefully iron two white sheets and drape them over the table as a tablecloth. He would then bring from its special box in the store the staff cutlery that over the years he had lovingly polished to a gleaming shine. This would be laid carefully for each member of staff with the main place setting of course being reserved for Dicky Birdd at the head of the table.

Next to arrive would be several boxes of cereals. Two large milk jugs were filled to the brim with the cream off the top of all of the milk bottles that had been sent to the ward for the patients. Usually there were also tinned grapefruit served in small glass bowls and a glass of juice at every place. The staff would arrive and take their places while Hartley would hover around pouring tea or coffee and making sure the first course was all that was required. The table would then be cleared to make way for toast and jam and the main event which was the cooked breakfast. Even after all these years I cannot recall a breakfast to meet the standard of those served by Hartley and although I have some tinges of regret for my acceptance of this at the time, it was simply part of the milieu and the essential fabric of Jenner 1.

The main course was magnificent. Hartley had carefully saved potatoes from the previous night’s dinner and these were fried to a crisp, golden brown. In addition there was bacon, eggs, sausages, baked beans and tomatoes. Most of the food was originally intended for the patients but Hartley had intercepted the very best and kept it aside for the staff. If fish had been on the ward menu the previous day Hartley would make kedgeree or fish pie with potato and eggs and peas, sprinkled with cheese and grilled to perfection. The cereals eaten, the cooked course cleared away and in would come coffee and croissants that Hartley had baked himself in the ward kitchen. By this time we were replete but undaunted and the croissants went down with as much enthusiasm as everything else. Following the eating part of breakfast would come the yarns and the gossip with Dicky Birdd a mine of information and a fount of stories of his years in ‘The Bin’ as he referred to the hospital. I am sure many were exaggerated for effect, or at least I was when merely a first year student, but as time went on I found that my experiences although different, echoed Birdd’s.

Then after about an hour or so, Dicky would look at his watch, mutter something about getting back to loony-land and he would saunter back to his office and we would resume ward duties. Hartley would clear the table, carefully wash the cutlery by hand, pouring boiling water over the knives and forks as instructed by the fastidious Dicky Birdd who was always worried that somehow the staff would end up using the same utensils as the patients.

While on the subject of breakfast and noting the largesse the staff enjoyed I also recall one Christmas Day when I was on morning shift on Jenner 1. The main kitchen had the temerity to send up to the ward a choice of food for the patients – a large pot of porridge and a bowl of tinned grapefruit. Such items never came together but being Christmas the kitchen obviously was feeling generous. Dicky Birdd wandered into the ward kitchen where I had been dishing grapefruit and porridge out according to the preference of the patients. He elbowed me aside, picked up the grapefruit and poured it into the pot of porridge saying quite simply that “ … they don’t have a choice on my ward, Laddie.” He walked back to his office full of indignation and I was left to serve the mess to the patients who in the end didn’t seem to care anyway; they knew Dicky Birdd of old I suppose. Should I have said something? Maybe. But this was so typical of the environment that it is surprising how quickly one came to accept such situations with a mental shrug and mark it up as one more point to the institution, one less for the patients.

On the whole though, Christmas was a good day to work even if it did mean being away from family or friends. The wards were decorated enthusiastically by the student nurses, grudgingly by the more senior nurses. A Christmas tree, some small presents so that each patient had something to open on the day even if only a bar of soap or some such. The staff smuggled in large amounts of booze – the hospital was supposed to be dry on the wards but of course it never was – and we tended to while away most of the day when not exactly involved in essential duties either in the store or the office. Jenner breakfasts on Christmas Day surpassed even their usual grandiloquence and Hartley would find all sorts of treats, mince pies, Christmas Cake and other goodies so that breakfast was a sort of continuous feast lasting much of the day with minor interruptions for medication rounds or lunch.

I think Jenner One breakfasts lasted long after I left Long Grove. I did hear that one day a visiting Inspector of Hospitals called unexpectedly and put an end to them but the whole ceremonial was so entrenched that probably they ended because Dicky Birdd retired or Hartley died. But when I left they were firmly established as part of the routine and ultimately the mythology of Long Grove.


Crime and crime again

I was at Long Grove during the early sixties. Gang warfare existed on the streets of the East End and notorious among the criminal elite were the brothers Andy and Johnny Park. Andy was, in the words of Dicky Birdd “... as mad as a snake” and had been committed as a Special patient to Long Grove following his abortive attempt to knife to death a rival gang leader following an argument in a public house in Bow Road. Andy was certainly odd. I cannot recall his diagnosis but it must have been something to do with a paranoid psychosis as he would pace the ward looking around furtively and constantly complaining that the KGB were spying on him with microphones hidden in the ventilation grills near the ceiling. He was of middle height, around forty years old, well built and had a pugilistic look enhanced by the broken nose and cauliflowered right ear. We kept a weather eye on him as he was quick to violence and this propensity had been useful in his role as an enforcer on the streets and in the Clubs of London’s East End. Yet for all his brute strength and presence Andy was putty in the hands of his ageing mother, a tiny woman who ruled both Andy and Johnny with the lightest of words. Like many in such positions it did seem that their mother had an inordinate role in their lives and they always seem to have a soft spot for older people; indeed Andy and Johnny’s empire included a significant role in supporting the ‘old folk’ on their manor and there were always the Christmas parcels, coal during the winter, repairs to the plumbing and other small things that made a real difference. A strange contrast; on the one hand a violent and brutal empire built largely on racketeering, protection and prostitution and on the other an informal welfare system. One only had to give one of the brothers the nod about an elderly person in strife and matters were quietly and discretely managed. On the other hand a similar nod about a ‘grass’ or ‘snout’, to use the argot of the day for informers, saw more than one poor individual disappear, so rumour had it, into the foundations of the nearest Motorway.

Andy and his brother Johnny were alike as two peas in a pod, even down to the broken nose and the cauliflower ear. They had both been bare-knuckle boxers in the illegal fights n some of the less reputable gyms and wore their scars proudly. Andy used to say that if one didn’t like the look of his face then you should see the other guy. Johnny, although physically a close model of his brother, was the smart one of the two. He ran the rackets, Andy did the enforcing and it seemed to be an arrangement that worked to their advantage. After Andy was admitted to Long Grove Johnny would visit each Sunday driven to the hospital in his white Jag. Summer or winter he would wear a snap-brim hat tipped jauntily over one eye and a tailored camel coat with beaver collar. He would be accompanied by two of his minders, usually giants of men who would stand either side of him with their hands clasped in front of them and jumpily looking around to protect their master from any real or imagined threat.

Each visit followed the same routine. The ward doorbell would ring and Johnny and his minders would be escorted to wherever Andy was in the ward. If the weather was fine they would go into the yard where Dicky Birdd would make sure there were no other patients or visitors so they could have it to themselves. If not, they would sit in Andy’s side room and smoke while the minders stood outside the door like sentries. When he left Johnny would stick his head into Dicky Birdd’s office, thank him for looking after his boy and discretely pass across a folder five pound note that just as discretely seemed to vanish into Dicky Birdd’s pocket. Johnny and his retinue would then leave the ward almost like visiting royalty, nodding at the staff, waving at Andy and closing the door behind them to an audible sigh of relief from the staff.

On one particular Sunday the routine was much the same. Johnny arrived in his white Jag with his minders. As it was raining quite hard he spent the usual hour with his brother in the side room and then with the usual ceremony left the ward, passed the five pound note to Dicky Birdd in the office and sauntered out puffing a cigar.

About ten minutes later Andy walked into Dicky Birdd’s office and announced that he was off then. Dicky told him not to be stupid and to get back down the ward at which Andy announced smugly

“You’ve got it wrong Dicky me lad, I’m not Andy, I’m Johnny. What’re yer going ter do abaht it then?”

Dicky Birdd, it was reported later was a model of composure. What had happened of course was that Johnny had simply swapped his coat and hat with his brother, waited ten minutes until his brother was safely off the property and then turned up at the office. Naturally Johnny wasn’t a Special patient so couldn’t be held. Dicky Birdd looked thoughtful for a moment and replied,

“Why, nothing at all, Johnny …” and personally escorted him off the ward from whence neither Andy nor Johnny were seen again; well not at Long Grove that is.

To my surprise nothing at all happened. The Police weren’t that interested in picking yet another fight with the brothers and Andy more or less behaved himself for all of a month until he was once again arrested for another violent attack. This time there was no soft option and he was sent to a secure psychiatric facility where he remained until he died some years later. A couple of years went by and Johnny was arrested and sent to jail. That was really not only the end of their empire but also to a large extent the end of organised crime in London for many years. To many the brothers were a great paradox. Quick to anger and unrelenting when it came to violence against those who crossed them, yet on the other hand quite genuine tears and sadness when someone under their wing was ill or dying. I remember Andy as a man to be watched very carefully and we all trod on eggshells in his vicinity so I wasn’t too dismayed at his leaving, however unusual the events. Types like Andy and Johnny no longer exist and have been overtaken by organised gangs of immigrant mafia who deal in drugs; the brothers wouldn’t touch such stuff for in their own funny way they had certain lines over which even they wouldn’t step.

In my travels around London’s East End where I later worked for a while I would occasionally see Johnny sitting in the back of his large white Jag, smoking a cigar and waving at passers by of his acquaintance a bit like a dangerous version of Arthur Daly. He was certainly no loss when he was finally removed from circulation but his flamboyant life-style and the myths and legends that abounded about the brothers have left a lasting legacy and even some small affection. Andy remained a further ten or so years in the secure hospital until he died of cancer. The funeral was attended by many hundreds of people including one or two politicians, a scattering of well known actors and Johnny who attended under escort form prison. The cortege stretched for at least a mile through the London Streets to the Bethnell Green Cemetery and I remember the coffin with its huge bouquet spelling out the words ANDY in yellow daffodils. Johnny stood at the graveside a shadow of his former self, thin and hunched against the wind and wearing a suit that would have once fitted but was now a few sizes too large. He tossed a handful of earth on the coffin as it was lowered into the ground and following the simple ceremony he pulled his shoulders proudly back and looking neither to right or left was led back to the waiting Police car and out of my life for ever.



The Repair Shop

I think it was in my third year at Long Grove and I was working nights on one of the ground floor wards, Hunter One. This was one of the long term wards for people who on the whole were fairly easy going and needed only minimal supervision. There were the usual smattering of post-lobotomy patients, perhaps twenty or so Poles (I will return to them later), an old sea captain called of all things Jonah T----, several people with long term melancholia or more correctly intractable depression and a number of people who had simply grown old there. It was an easy job for one nurse. The patients usually began to take themselves off to bed around nine after I had wheeled round a trolley of cocoa that I poured into large china mugs from a white enamel jug. One or two would be quietly snoring in their chairs and I would wake them up and prod them gently to their beds but apart from that I had little to do. I enjoyed nights as I used the quiet hours to write assignments and generally catch up on study and I was something of a night owl anyway, possibly a delicate prodrome to the depressions I suffered later in my life.

After the patients were settled I would either watch television in the lounge or retire to the office and my text books. The night would pass with little incident; there were always one or two patients who I had to rouse out of bed two or three times throughout the night and take them to the toilet so they wouldn’t be incontinent but that was all. From time to time the Night Supervisor would call in making sure she rattled her keys noisily in the lock so as to wake up any nurse who may have, horror of horrors, been asleep on duty.

The night in question was interrupted at about midnight when Sam the nurse on the upstairs ward knocked on the door of my ward and asked if I would give him a hand to fit his motor bike into the lift as he was planning to strip down the motor and do some repairs while on duty. We struggled the heavy machine into the lift and I left him to it once we had manhandled the bike out of the lift and wheeled it into the gallery of Hunter Two.

Round about midnight and if the ward was settled I would usually wander upstairs and for about twenty minutes share a coffee and a yarn with the nurse on duty. This I did that night and there was Sam sitting on the floor of the gallery with his bike in bits carefully spread out on a sheet that was now well marked with oil. We chatted quietly and I finished my coffee, returning downstairs thinking that it was a bit strange but overall in keeping with the madness of my environment. Sam would have fitted the category of a chronic old school nurse. He was an attendant rather than a registered nurse but had worked at Long Grove for nearly thirty years. He was an easy going if somewhat lazy man and would always be the first off for his break and the last to return. He was generally well liked and seen as a bit of a rogue always quick with a joke or some other outrageous tale of life in the hospital. So to see him quietly striping and rebuilding his motor bike was as much in character as his habit of bringing in his dirty underwear, throwing it in the ward linen basket and helping himself to clean from the store. He reasoned that he was not actually stealing it as he always returned it for washing thus it was merely borrowed!

I was woken from a shallow doze by an unusual rumbling sound and as I struggled awake I realised that it was a motor bike revving up above me. Sam had obviously got the bike together and was running the engine to make sure everything worked. I looked at my watch; half past four in the morning. I thought this was hardly fair and picked up the phone to call upstairs. By this time I could hear the bike trundling slowly up and down the upstairs gallery no doubt on a test run. Then a loud crash and the bike engine stopped. From upstairs there came some scraping sounds, furniture being moved and other indeterminate noises. Then silence.

After a couple of minutes the phone rang. It was Sam. He was agitated and muddling his words but the gist of it was that he’d had an accident and could I pop up and deal with a cut. So I went upstairs to find Sam’s bike back together and on its stand outside the office. Sam seemed OK but he pulled me urgently down the ward to one of the side rooms where a patient sat on the edge of the bed with blood oozing from a deep gash over his right eye. Apparently he had been woken by Sam’s bike and stepped out of his room where he had encountered Sam and his bike and had come off somewhat the worse for wear. I cleaned up the cut, put in a couple of stitches as I had only recently been taught to do and helped settle the poor guy back into bed.

Shaking my head in despair I helped an apologetic Sam to get his bike downstairs and parked in the yard. He kept asking that I wouldn’t tell anyone would I … more than his job was worth and all that. I assured him I would not, went back to my ward and eventually finished the shift.

And that should have been the end of a rather bizarre incident in a series of bizarre incidents but it was not to be. I finished my stint of nights and a few days later was back on day shift, coincidentally on Hunter Two. The ward physician, Dr Swan, was running through the routine P & M (physical and mental) examinations that were supposed to happen for long term patients at about six monthly intervals. It was usually a quick once over with an MSQ (Mental State Questionnaire – a series of ten common knowledge questions such as who is the Prime Minister to determine contact with reality). Are the meds OK? Any other problems? Anything we need to do? By chance the first person on the day’s list was the patient I had recently stitched up after the motor bike incident.

“Hello Jim,” aid Dr Swan in his kindly way, “you seem to have cut your eye, how did that happen?”

“Well,” said Jim in his nasally voice, “I got run’d over by a motor bike.”

“Oh dear,” replied Dr Swan, “where did this happen, in Epsom?”

“No doctor – in the gallery”

Dr Swan looked puzzled and tried to elicit more information but Jim stuck to his story. He had woken up at night, stepped out of his room and been run over by a large red motor bike. I said nothing but did feel acutely embarrassed as I did not want to add anything in case Sam was compromised. To my eternal shame however Dr Swan just checked the stitching, said they were quite tidy and asked me to make sure they were removed. Jim left the office and Dr Swan wrote in Jim’s file “Physical state NAD (no abnormality detected), mental state somewhat delusional and appears to be deteriorating.” Dr Swan was all for increasing poor Jim’s medication but I at least said we’d just keep an eye on him and let’s only change it if he becomes more unwell to which fortunately Dr Swan agreed.

I ran into Sam some time later and told him about the examination but Sam only laughed thinking it a huge joke. I don’t think it did any lasting harm to Jim; he remained at Long Grove for a few more years until eventually being discharged into one of the new community care houses where I believe he did quite well. At least his nocturnal perambulations would have been less fraught with risk.


The Darkest Fear

Phobias are all too common, not only among the residents of psychiatric hospitals but within all of us. We each have our secret or not so secret fears. Our room 116. Some of us fear spiders and at its extreme this fear is called arachnophobia; others the dark, achluophobia; and still others fear crowds, agoraphobia. If the fear was crippling enough it could, in the early sixties at least, lead to admission into the dubious treatment regimen of a psychiatric hospital. Long Grove was no different and most wards had their smattering of patients who were paralysed with some fear or another.

Jonah the sea captain I have already mentioned was one such. His abiding fear was of anything to do with switches or buttons. He was incapable of switching on a light or any electrical appliance and if you think about it this would be very inhibiting in today’s world. He was also beset by the most bizarre hallucinations often seeing himself back on the deck of his destroyer ploughing through the North Atlantic. He would roll his way along the gallery swaying from side to side as though staggering on the bridge of a ship at sea and call to his imaginary crew to “Man the forrard guns for God’s sake, they’re at us again …” and then duck down behind a table to peer suspiciously at some imagined foe. He was quite harmless and apart from this little eccentricity was a delight to talk with. In his more lucid moments he would tell of his war, of the long convoy patrols in the freezing northern waters, of the constant fear of U-boats, of the despair at watching ship after ship go down and seeing some of the most terrible sights imaginable. He talked of men in the water, incinerated alive in the inferno of burning oil from an exploding tanker, of watching me jump into the water from sinking ships and knowing they wouldn’t last more than a few minutes in the freezing water so there was no point even trying to rescue them.

Jonah had no family, or if he did they never came near, and apart from an occasional outing to Epsom in the company of one of the nurses he would spend his days in the ward pacing up and down and dreaming his nightmarish dreams. One of the female nursing assistants took an especial shine to Jonah and they seemed to have a real friendship. His eyes would light up when she came on duty and he appeared a different man pulling his shoulders back and replacing his stagger with more of a nautical swagger. Jonah had been a good looking man once and one of his proudest possessions was a photo of him on the bridge of his destroyer, duffle coat pulled tight against the wind, his cap at a jaunty angle. It was hard to reconcile this young, vibrant and obviously intelligent fighting man in the photo with the sad caricature of his former self that walked the wards.

Jonah’s diagnosis was uncertain and he seemed to have one of those indeterminate psychotic conditions that could have been brought on by the stress of convoy patrol, organic change or schizophrenia. His history made him popular with each new psych registrar who came onto the ward and each tried to outdo their previous colleague with a new slant on his diagnosis so that it would swing between bi-polar disorder, disassociative state, paranoia and paranoid schizophrenia. I’m not sure any of them were right but this multiplicity of diagnoses was common for many of the patients. Psychiatry was, and possibly still is, somewhere between art and science so that interpretations of behaviour are subjective at best.

His fear of switches made his life complicated and at night one of us would have to go to his room to turn off the light, to turn it on again in the morning. We even had to turn on and off his shower as his fear seemed to extend to faucets as well. Working at the hospital at that time was a doctor Tom Heinz, who was particularly interested in hypnosis and he and I teamed up as we shared a mutual interest and I had been training in Eriksonian hypnotherapy at the Tavistock Institute. Tom and I often worked together with me being mentored into some crude level of competency. Naturally we became interested in the development of phobias and for some time attempted to use hypno-analysis to improve our understanding and then follow this up with hypnotic desensitisation In other words placing patients into a hypnotic state and then talking them through increasingly ‘risky’ situations associated with their phobia. A person phobic about spiders, for example, would be given the suggestion while hypnotised that they could see a cobweb in the far corner of a room. When comfortable with this suggestion they would be told they could see a spider in the web and so on until they were comfortable with the suggestion that they could hold a spider in their hand. I’m not sure if there were lasting effects but we had some success in the short term at least.

Jonah was one of our patients and for a long time we endeavoured to establish the cause of his phobia of switches by taking a convoluted journey back through his life during increasingly deep hypnotic trance states. The answer, when it eventually came was simple but shocking.

In one session Jonah was recounting convoy escort duty in the northern reaches of the Atlantic. Mid-winter, water so cold that a man in the sea would die in minutes. A calm, icy night with stars gleaming like a million unflickering torches. Jonah was asleep in his cabin when the action stations siren went as a submarine periscope had been briefly spotted by a lookout moving through the limpid waters. Arising from his bed, still groggy from his constantly interrupted sleep he reached for the light switch and turned it on. At that very same moment the ship shuddered with an enormous explosion as it was hit by a torpedo. His ship rapidly foundered and Jonah spent nearly forty minutes in the sea miraculously being picked up by another ship more dead than alive.

He never fully recovered from his ordeal and was left with a phobia of switches that seemed to stem from the juxtaposition of the torpedo strike and his turning on the light. On his eventual return to England Jonah was a broken man and eventually found his way from military hospital to Long Grove where his fear of switches incapacitated him and his now distorted view of reality saw him constantly pacing the swaying deck of his destroyer facing down an eternal enemy.

Whether our new understanding of the cause of his phobia was any use apart from academic interest I remain uncertain. I know that for a long time we tried to desensitise him but with no success. Tom felt that the psychotic overlay inhibited our treatment but maybe there are areas where for all our skill we are helpless in face of the complexities of the human condition.


The Poles

The Poles as we called them were an interesting and sorry bunch of people. Many of them had limited English and so conversation was difficult. Occasionally a harassed looking interpreter would accompany the patient in an interview with the doctor but somehow this only seemed to confuse things more. Medication and other treatments were thus as much as by guess or by God and so the Poles featured as having some of the most flamboyant and bizarre behaviour of any of the patients. Some of this we put down to a racial personality type of the excited and excitable eastern European. But it was probably as much our attempts to treat and the terrible situations that many of them had experienced during the then recent World War.

One I remember in particular as his English was quite good and he would spend long hours with me when I was on nights whiling away the small hours when he couldn’t sleep with some of the most harrowing tales. His name was Petrus Zzy*** And among other things as he had so many Zs and Ys in his name was known for having the last name in the telephone book and at one time featured in the Guinness Book of Records. But that aside Petrus had spent the period after the invasion of Poland firstly as a Captain in the Polish Army and when that was defeated as a partisan fighting a dark and bitter guerrilla war in the forests of southern Poland. He saw sights that would ‘harrow up your soul’ and fought against incredible odds with poor equipment, ragged clothing but a dogged determination. In time the Germans took to killing fifty civilians for every German soldier killed by the partisans and to some extent this took some of the enthusiasm from the fight and gradually the partisans disbanded or were captured or killed or both. Petrus was eventually caught and sent to one of the more notorious concentration camps where he survived for three more years.

Eventually Petrus and a number of his skeletal colleagues from the camp were packed into trucks and driven into the forest where they were lined up alongside a trench that had been dug by a bulldozer and already was lined several deep with bodies of other unfortunates. The SS then opened fire on the prisoners and they dropped dead and wounded into the trench. Petrus was miraculously wounded with a shallow injury across his scalp but which bled profusely. Falling into the trench he lay motionless and waited for what he thought would be the inevitable coup de gras but the SS troops simply sat down and smoked. The trucks left, presumably to get more prisoners and then the heavens opened and it began to pour with rain. This forced the SS troops into the tree line to take shelter and covered by the falling rain and in the by now gloomy afternoon, Petrus dragged himself from the pit and lay under some bushes where he could watch what was happening but not be seen. During the course of the day four more trucks with probably a hundred more prisoners arrived at the awful scene and all were gunned down into the pit. The bulldozer then started up and pushed the soil over the sprawled bodies even though some were clearly still alive.

Petrus watched from his hiding place until the troops eventually left, laughing and joking as though they had been at a social function and completely unaffected by what they had done that day. As the night drew in Petrus eased himself from his hiding place and staggered into the depths of the woods. One has to remember that this man had somehow survived three years in a concentration camp; he was skin and bone, infested with lice, covered with sores and a shadow of his former self. Emaciated, malnourished and exhausted he staggered and fell across some miles of countryside over the next months living on scraps of turnips and potatoes found in the waterlogged fields. He kept himself warm by wrapping himself in a rotting horse blanket he found in a ruined barn and sheltered at night under the dripping hedgerows or in the occasional ruined house that he found. He was constantly evading German patrols and even local peasants in the fear that he would be turned in. Eventually his wanderings took him all the way into Slovakia and in the mountains, more dead than alive he was found by a small band of Slovak partisans. Petrus gradually recovered his strength living in a cave with the partisans and in due course was well enough to handle a gun and join in their raids as they harassed the by now demoralised and fragmented German troops.

However for all his incredible tale of survival Petrus was left badly scarred by the experience and increasingly took to spending long hours outside the warmth of the cave and lying under bushes or just standing on the skyline talking loudly to whatever daemons were invading his increasingly disjointed mind. This was not useful behaviour and could have attracted unwelcome attention from the occupying forces and so eventually he was held more or less captive in the cave.

With the eventual liberation Petrus was once more on the move and to escape the Russians this time, he and a number of the partisans made their way to Austria where Petrus’ by now very frank and overt madness was beginning to be a real problem. As an ex-Polish Army Officer he was placed in a British Military Hospital and for some bureaucratic reason eventually transferred to England, ending up with several hundred others of his countrymen in Long Grove.

It is easy to write this tale some sixty years after it happened and in the warmth and civilisation of my library but one has to remember that this was very real and that many people like Petrus didn’t survive. It is hard to imagine how he crawled and staggered across so many miles of cold, bleak countryside living on scraps and in constant fear of capture. It is hard to imagine how any of us would have coped in the same situation. But Petrus was a survivor an in spite of his psychosis he showed a determination and strength of human spirit in the face of adversity that few of us could match.

By the time I met him he had been in Long Grove for about fifteen years and was settled into a quiet routine. His hallucinations were constant and from time to time he would burst into Polish, shouting and gesticulating to the world. While terrible I am sure that Petrus’ tale would have been representative of many of the Poles at the hospital but few of them communicated as their English was generally very poor. I do know that many were orphans of the concentration camps and had been sent to England after the liberation simply because no-one really knew what to do with them. Many of course were so traumatised that they were incapable of living a normal life and it is probably moot whether one could say they had a frank psychiatric illness or simply lacked the skills and confidence to make a life for themselves. Either way they had settled into the routine of the institution and when I left there was little hope on the horizon for any of them. No doubt over time they became part of the great experiment called deinstitutionalisation but after all of the years they had spent in the camps and then the hospital one cannot but help wondering how they eventually fared. Not very well I suspect.

PART 3 - THE LONG GROVE YEARS

It is important to once again stress that much of this is composite and the people described here are representative of the people I met. No single person, or very few, are taken exactly from life but I am sure everyone is recognisable to anyone at all who has worked in an institution.


The Hospital wards were alphabetically named after leading medical figures of the past beginning with Adams – A1 and A2 for example were Adams 1 and Adams 2, with A1 being on the ground floor and A2 being the upper ward. For some reason there were four ‘H’ wards – Hunter One and Two and Harvey One and Two. Harvey One, where I reported for duty housed seventy two patients with sixty of them sleeping in a single large dormitory with four rows of beds. These were arranged as fifteen down each wall of the long room and thirty more in two rows of fifteen set headboard to headboard down the centre. Each bed was separated by a single hospital locker about eighteen inches across. The iron framed windows were all set high in the walls with the sills at head height and the glass covered with corrugated wire mesh. The dormitory was off a large lounge room and leading to the lounge was the ‘Gallery’ that had a row of single rooms and two padded rooms. Immediately inside the entrance to the ward was the Charge Nurse’s office, a store room, a small kitchen and a clinic where the medication and various nursing impedimenta were stored. The gallery part of the ward also doubled as the dining area and opposite the single rooms were large, heavy tables where meals were served. Opening off the gallery, doors led to a courtyard that had a roofed veranda close to the ward. As the courtyard comprised the large roughly triangular plot between the ward buildings it was enclosed on two sides by the adjacent wards. The end was once marked by a high steel fence but this had been taken down during the war to make tanks or other materiel and replaced with a wire mesh fence strung between tall metal frames. The concrete base of the original fence was still there with short nubs of steel still showing where the original nineteenth century fence had stood.

Each of the courtyards had a large wooden, octagonal gazebo in the middle providing an outside area for the patients (and staff) to sit and smoke and somewhere for staff to store cycles and motor bikes out of the rain while on their shift. No non-smoking rules in those days and one of my most evocative memories of the time was the smell of the wards. A mixture of cigarette smoke, the bitter-sweet smell of paraldehyde (used in copious quantities as a sedative) and the stale smell of urine that came from centuries of poor hygiene, wet beds and overflowing urinals.

I have a very clear memory of riding in the dark through the narrow Surrey lanes and leaving my Lambretta parked against a wall. Then making my way along the curving corridor to Harvey One and for the first time, turning my large Chubb key (that I still have) in the lock. It was just before seven in the morning. As I have described, the charge nurse, Chalky White, had his office immediately inside the door so naturally I self-consciously entered his office to report for duty. Chalky was of the old school of nursing. In fact as time went on I learned the local argot that described the nursing staff that had been there many years. There were two types – COS and VCOS. COS stood for chronic old school and VCOS stood for very chronic old school. Chalky was of the latter having spent over thirty years at the hospital, the last ten ruling his small kingdom in Harvey One. He was a tall man, well over six feet and ex-Army having been a prisoner in Burma, an experience many felt had left him a little addled. Chalky was sitting behind his desk leaning back in his chair and reading the morning paper. To my surprise there was a silver tea service on the desk and a cup of the most delicate china brimming with strong dark tea close to hand. He looked up from the papers, quickly established I was ‘his’ new student nurse and spoke the words I will remember for the rest of my life.

“Get ‘em up lad”

I stood there puzzled at this and was still puzzled when all I could elicit from behind the newspaper was a repetition of the same short phrase. I was rescued by another nurse who came into the room and interpreted for me that I was expected to go down to the large dormitory and get the patients out of bed. I also had to have them dressed, showered and the beds made before breakfast was served in an hour’s time.

The new arrival turned out to be another student nurse with whom I eventually had a long friendship that lasted until his untimely death from cancer when he was in his late fifties. Ray, for that was his name had worked at the hospital for all of week and was better acquainted with the routine than me so could give me the benefit of his vastly superior knowledge as we both faced the daunting prospect of getting sixty people up, washed and dressed in an hour. You have to remember too that this was my first experience of institutional life and I was dealing with a mixture of the new reality and the images I had formed from common mythology about what I was to find locked up in the grey buildings. Who would I be getting up, would they be dangerous, gibbering madmen who would attack me if I disturbed them, how would they react to a new face? My thoughts tumbled over and over but Ray seemed quite relaxed and so I thought that if it was simply a job for the two of us maybe it wasn’t too bad. After all I had been shot at from time to time in the jungles of Borneo, climbed steep cliffs and not fallen off so had had my share of peril. This couldn’t be nearly as bad.

Anyway Ray handed me a reddish coloured rubberised apron that I slipped on over the front of my new uniform jacket and trousers and we waded (literally) into the first job of the day.

Picture if you will a long room with four rows of beds filled with snoring, moaning men. The room flooded with light as we turned on the main lights and the lumps under the covers heaved slowly awake. Ray got them out of bed by walking down the line of beds and heaving the bedding onto the floor. His charges simply lay there blinking. The next part of the job was to swing the patient’s legs off the bed and onto the floor so taking my cue from Ray I did the same thing on my side of the ward – two rows, thirty beds, thirty sleepy patients. I quickly found that once the beds were stripped they were occupied by far more than the patients themselves and were variously wet with urine or worse. Having disturbed everyone, some began shuffling of their own volition in the direction of the large communal shower off the word, others sat there stuperose and these were often the ones who had fouled themselves in the night. So I had to slip off their pyjamas or nightgowns as the case may have been and leave them in wet piles on the floor. My now naked charges were guided into the shower where a dozen or so shower jets poured steaming water. Ray showed me to manoeuvre my charges into the shower and to use the hand held warm water hose to clean the mess from those who were particular fouled with ordure.

It was a scene from Heironymous Bosch. Naked middle aged and older men milling around under the shower heads. Some standing stock still with their heads down, others wring their hands with agitation, still others pacing back and forth as we tried to clean the issues of the night from them. My feet and lower trousers were soaked and I saw that Ray had wisely slipped on a pair of gum boots – I later discovered that most of the nurses invested in gum boots for this part of the day’s duties, something I rectified immediately when I got off duty. Ray and I struggled to wash our sixty patients and then help dry those who couldn’t dry themselves, which was most of them, with increasing sodden towels; we had five towels for the morning shower to be used between the sixty patients so by the time the last ones came to be dried we probably just moved the damp around with the by now sodden towels. The ordeal was far from over as we then had to shepherd the patients back to the dormitory, find out which was their bed locker and take out their clothes and help them dress. This was also far from easy. Few seemed to know where there beds were and fewer still seemed to know their names. Or if they did they failed to communicate it clearly. We did have a board with the bed plan on it and so we worked on a process of elimination, dressing those we were sure of and then making a best guess at the others. In the end we had them more or less dressed. Some made their own way to the day room, others slumped down on the beds and tried to go back to sleep, others just stood there and would have done so for ever if we didn’t move them gently on to the day room. After about an hour of this bedlam we had them all more or less dressed and in the day room where they continued to pace around or slump passively into the large vinyl armchairs that lined the walls.

Chalky White wandered down from his office, looked around and said that this was all very well but why hadn’t we made the beds already? So it was back to the ward. Wet bedding went into a blue canvas basket, foul bedding went into a yellow one and dry bedding went into the white one. That left sixty waterproof mattresses on sixty beds, and sixty piles of grey blankets scattered around the floor. Ray and I began at the first bed. Clean sheets, blankets and covered with a pale green candlewick cover. On the bottom sheet went a red rubberised waterproof and on that went a half sheet. Every layer had to be finished with envelope or ‘hospital’ corners and the pillows had to be carefully placed with the open end of the cover away from the door. This particular way of making beds was old army stuff so no problem but it must have made a lasting impression as I still make beds that way even at home. After the first ten or so beds we got into a rhythm and could usually make each bed in a minute flat. Nevertheless we weren’t going to finish in time for breakfast so when the bell for the first meal of the day then back into the dayroom to help the patients to their seats at the tables in the gallery. By this time virtually everyone was out of bed and things became much easier as the patients in the single rooms had a type of ‘trustee’ status and were busy sitting other patients down, serving the meal from the large steel food trolley and generally being helpful. Ray and I did what we could to help, fed those who needed feeding, made sure people were eating their porridge, not spreading it over themselves, their neighbours and the general area around them; cleared the dirty plates away and then helping people back to the dayroom where most would spend their day staring listlessly at the television and for the more able or alert, a trip to the OT (Occupational Therapy) department where they did whatever it was that the OTs of the day gave them to do or assembled small metal toy cars in the IT (industrial training section). Interestingly and to digress a moment these toy cars, each about a few inches long came to the IT department in five or six parts that were deftly assembled by a large number of patients sitting around long tables. Usually they had two axles with wheels mounted, a steel body, plastic chassis and a clear plastic moulding that formed the windows. The patients first put the window into the body shell, clipped the axles to the chassis and placed the chassis onto the body where the whole was kept together by two rivets that some of the more able patients secured in a small jig. The assembled vehicles were very popular with staff and there were few staff that didn’t have a large collection of them at home for their children. The wastage must have been huge but as thousands of cars came in parts and left assembled I don’t suppose stock control was that effective. Certainly the Manufacturer never stopped sending bits for assembly and as far as I know continued this practice for many years.

Back to the ward. After breakfast was cleared away the drug trolley was trundled from the clinic and as Ray had been at work for a week he was told to dish out the medication. To this day I recall the paucity of medications we had available. The drug trolley had a row of small bottles for people who had specific medications but mostly it was a case of doling out of three or four large stock bottles of liquid an appropriate does of medication. We had three medication cups that first we used as a measure, second the patient drank from and third we wiped clean with a towel so it could be used for the next patient. Most of the patients were on liquid Chlorpromazine or Thioridazine (major tranquilisers) or liquid paraldehyde. This latter drug was so caustic it dissolved plastic so had to be measured in a small glass measuring cup kept for the purpose. I recall that at least sixty percent of patients would have been on paraldehyde. The drug came as an emulsion and the bottle had to be shaken hard to ensure the paraldehyde was well mixed with the buffering agent. Nevertheless, if someone was particularly agitated the charge nurse would usually say to give them an ounce “…off the top,” which meant that one did not shake the bottle but simply measured the neat paraldehyde that had settled out at the top of the bottle. Without the buffering agent the effects were dramatic and would render some patients comatose for many hours.

So the medication round was done by two people, neither of whom was trained, one of whom had a week’s experience and for the other, their first day at work. To assist though we had Charley, a patient who had been on the ward many years. Charley told us who was who so that we could check on the chart what they were to get otherwise we wouldn’t have had any idea who would have what. We struggled with this for a while and eventually had everyone medicated who needed medicating (we hoped). The time by now would have been half-nine so it was back to the dormitory to finish the beds and mop the floor. This we achieved in about another hour at which time all staff retired to the ward store for morning tea.

The store room was important in the life of the ward. It was a large room lined with shelves and clothes racks. The shelves held a great variety of things such as clean bedding, underclothes and shirts. The racks held trousers and jackets (of such good quality that most of the staff sported tweed jackets courtesy of the hospital storerooms. The clothing was of course for the patients as in those days the hospital provided everything they needed but mostly they got the second hand stuff while the staff had the pick of the new. In the middle of the room between the racks were a number of comfortable armchairs for the four staff who ran the ward under the somewhat less than watchful eye of Chalky White. On my first day of duty there were four nurses, one being off sick. Chalky, Ray, me and Andy – a bluff Yorkshireman who was also a registered or ‘staff’ nurse. I didn’t know where he had been during the medication round but later ascertained that Danny and Ray spent the first few hours in the ward office doing such noble things as reading the paper cover to cover, finishing the crosswords (Chalky could do the Telegraph crossword in about five minutes flat), catching up with gossip and, of course planning the day. When I was a more senior student and was involved with such esoteric matters, day planning usually meant having a quick check to see if any patients were physically sick and needed to see the doctor or had to have some medication adjustment, which also meant getting the doctor onto the ward. They would also make sure they had studied the form at the local races, placed the odd bet or so, smoked several cigarettes and done those things that their privileged position allowed.

So by the time we were joined for morning tea Andy and Chalky were well into their day and needed a break along with the rest of us. In spite of my cynicism though, morning tea was often the most interesting and instructional part of the day. Chalky would regale us with scenes from institutional life and in his way provided us with a hands-on nursing education that was a polyglot mixture of science and anecdote that in many ways was the most useful introduction to the world of the asylum anyone could have wished for. Morning tea lasted through most of the rest of the morning with occasional forays into the ward to answer the phone and have a quick look at the patients. As the trustee patients did most of the supervision we had little to do and so soon joined into the leisurely way of working following the morning breakfast and pre-breakfast rush.

Lunch came and went. Patients helped to the tables and then back to the day room where they again stared at the antics on television that were usually programmes such as Play School or other children’s programmes. None of it registered I am sure so in many ways the TV was simply moving wallpaper. Some of the patients would be restless and pace up and down, up and down. Others would stare fixedly at a spot on the wall, giggling and muttering to themselves in response to their voices. Still others walked zombie-like around the ward unresponsive to anyone. These were often patients who had had a lobotomy or other brain invasion and were left as shadows of their former selves to be ‘habit trained’ by the nurses, or in other words to have an inflexible routine that would see them carrying out their lives according to created habits – always getting up at the same time, wearing the same colour clothing, eating at the same time each day and so on. Their temples were marked by small circular indentations where their skin had sunk into the hole left by the lobotomy. They were often incontinent and would simply go where they stood if they had failed to toilet when taken there at hourly intervals by either a nurse or a trustee patient. The least liked of the patients were those with General Paralysis of the Insane (GPI) and commonly referred to as ‘Geeps’. This group of mainly older patients were the tail end of people with untreated tertiary syphilis and are rarely seen today as antibiotics now available would have changed the course of their lives by curing the disease in its early stages. Patients in whom syphilis progressed to the tertiary stage seemed to be stubborn and intractable, rigid in movement, were completely out of touch with reality as the disease had by this time done enormous damage to the central nervous system. The bridge of their noses were sunken and they constantly snuffled and staggered around the ward. They were of course extremely infectious and so most care was done with barrier techniques and we did all we could not to touch them unless we had to. Unfortunately this was often as they were frequently incontinent of urine and faeces and needed constant care including feeding and assistance with the most basic functions. No-one was keen to work with this area of unpleasantness and I think we all shared a common horror of what these people had become following some indiscretion many years before. Harvey One had four of five people with GPI and the lot of caring for them was usually delegated down the chain of command to the most junior person on the shift.

Looking back on my Long Grove years I wonder if I became as callous as those I worked with. There seemed to be a dismissive, matter of fact approach to the conditions in which we worked but I suppose we were simply trying to make the best of what we had. The whole asylum concept was predicated on the ‘out of sight, out of mind’ philosophy that society at that time had adopted. That we may have been off hand was as much a defence mechanism in dealing with what we saw every day –mostly experiences that are so far outside other people’s circle of reference that their imaginings of what went on in places like Long Grove although extreme, didn’t nearly reach the reality of our daily lives on the wards. In the end of course we all became inured to what we saw and did and as time went on our frame of reference altered so that we became increasingly tolerant of what we saw. This passivity led to outright brutality among some colleagues but fortunately this was rare. Mostly we tried to make the asylum as homely and as safe as we could bearing in mind the physical surroundings of the bleak wards.

To some extent this desire was seen in our obsession with keeping the ward as clean as possible. On alternate days we junior nurses would be given control of the bumpers and told to polish the gleaming wooden floors of the gallery. The bumpers were simply a short brush attached beneath large metal blocks about the size of four house bricks attached through a swivel joint to the end of a long pole. The technique was to place a soft cloth beneath the head of the bumper and then swing them back and forth over the floor to bring it back to a shine. With practice this could become quite easy as the weight of the block, once it began moving did much of the work. We would become adept at swinging the bumpers up and down over the floor and when electric polishers were brought in towards the end of my time at Long Grove many of us still preferred the bumpers as they produced a better shine and didn’t leave on the polished floor the circular patterns of the big polishers. Having brought the wooden floors up to scratch we would then walk across it wearing polishing cloths wrapped round our boots so that it would not be marked. Naturally this posed a problem for people who wanted to cross the floor so we would use the floor as a sort of skating rink to wipe out other people’s footprints.

Once the floor was polished the patients had to stay in the day room and not enter the gallery and the senior nurses stayed in their office. We junior staff had control of the long gallery and we polished and dusted with the same diligence as we would if the Queen was coming to visit. Chalky was also obsessional about dirt and from time to time he would do a ward inspection wearing white cotton gloves. He would rub his gloved fingers individually along the architrave over a door and then look at his glove marked with minute specks of dirt on each finger. He would stand and stare at this for some time and then would bellow about the state of the ward and out inattention to detail – “Four fingers of dust…” he would shout and then storm muttering back to his office and the paper or the latest novel he was reading. It certainly kept us on our toes. On the day we weren’t required to polish the floors we swept them with brooms with long brush heads. The yard was also swept each day and we usually tossed a coin to see who would sweep the yards with one of the bulky bass brooms or stay in the warm and sweep the wards. If we were lucky we might get one of the patients to do the sweeping but more often than not we did it ourselves as in spite of everything we were proud of the standard of cleanliness and our part in it. I doubt that would go down that well today when hospitals employ cleaning staff but in those years the cleaning was done by the nurses and the few aides usually sorted laundry, brought stuff to and from the store or helped with very basic ward chores. The aides were often people who had worked at the hospital many years and reported to the Head Porter or one of his minions. They were a mine of useful information and their position on the hierarchy and their separate reporting structure meant that they were very much a law to themselves and tended to treat the student nurses with the bemused tolerance that comes from working for so long in a place that you become part of it. Our abrupt entry to the scene made us very much the lower end of the hierarchy until the day we graduated and were able to wear the blue epaulettes of a staff nurse. Nevertheless the aides were generous with their advice and one of the first things I learned from Hilary, the Harvey One aide, was how to bend a tea spoon into a tight ‘S’ shape so that the bowl of the spoon would sit snugly behind my belt and the handle was bent over the front of the belt to make a neat hook on which to hang my keys. This was somewhat better than the long chains that the charge nurses sported to secure their keys but that badge of rank was anyway not approved for the lowly students.

So my first two or three weeks passed until I was sent to the School of Nursing that was housed in a low brick building in the hospital grounds. In the time before my introduction into formal learning I learned to strip and remake a bed in less than a minute, polish floors to perfection, the names of most of the patients on Harvey One, how to shave, wash and dress someone and myriad gossip about the goings on among the staff of the hospital. That I was ex-military helped as it meant I had some common ground with so many of the staff who had either completed National Service or, if older, had seen active service during the War.

Life in the Nurses Home (or as it was designated Building ‘T’ and known to all as the T-shop) quickly became routine; after all I had spent most of my formative years in one sort of institution or another and there was little between the T-shop and a boarding school or a Mess. I settled in, quickly arranging my room to my liking, adding a bookshelf, buying a radio and generally adding a few personal touches to improve the surroundings. I found a radiator key so that I could turn off the radiator if it became too overpowering; it was far too large a radiator for the small room but when the T-shop was built there was little consideration about power conservation. I also learned to unscrew the blocks on the window so that it could be opened beyond just six inches. The nurses ate in the hospital canteen alongside other staff, clerical, orderlies, support and administration. We seemed to have our designated areas and the ‘newbies’ as we were called sat around a long table close to the door. The hierarchy was quite strict and for nurses anyway we were marked by the colour of our epaulettes. Newbies who had not been through the first intake of the School (or Prelim as it was called) wore plain red epaulettes; once we had been through the first intake we were issued new red epaulettes with a single white stripe and then we added extra stripes for each of the next three years of service. A forth stripe could be added in the final year (before exams) for those exalted few who were Acting Staff Nurses. Staff Nurses, those who had passed finals and become Registered Mental Nurses, wore blue epaulettes again with a band to signify the number of years post-qualifying. Plain blue for the first year then up to three bands with a fourth being added when appointed to the role of Senior Staff Nurse. Charge Nurses wore no epaulettes but were given an engraved maroon coloured badge with their name and designation. These marks of the hierarchy not only told others where we were in the pecking order, they also fitted us into an unwritten rule about where one sat in the canteen, who one shared a table with and so on. It was therefore quite difficult to strike up friendships with people who had more stripes than you although of course one could deign to mix with those below you in the pecking order if you so chose. This led to intakes becoming quite close and enduring friendships were often made among one’s immediate peers rather than with people outside of your group. I know that once I had finished the first intake at the school and was given an epaulette with a single white band I was as proud as a junior officer with his first pip. I was no longer a newbie but was now officially a First Year Student.

The two weeks of preliminary training were supposed to be an introduction to the wards and our responsibilities. The theory was that the student nurses would complete prelim before they went onto the wards, however it was more usual for the hospital to employ people when they could in order to staff the wards and hope they could cope. This sorted out the wheat from the chaff as it were so by the time I arrived at the school for prelim most of us had completed several weeks on the wards and were already old hands. Prelim was something of a let down from a clinical perspective but a mine of useful information nevertheless. The course was run by a kindly female nurse tutor of indeterminate middle age who had worked at Long Grove for many years and whose knowledge of mental illness was more practical than any textbook. In retrospect this was possibly a wise introduction as Miss Hartwell was a matronly and gentle woman who quickly dispelled any lingering anxieties we may have had. She somewhat over-filled her pale green tutor’s uniform and filled the pockets with an assortment of pens, whiteboard dusters and notes on scrappy paper that she would pull out and peer at when she seemed at a loss for words which was unusual. Her practical and earthy approach was sprinkled with anecdotes and we hung on her every word as she introduced us to the mysteries of institutional life.

The intake was an odd mixture of about twenty people, roughly half men and half women. We had a variety of backgrounds and I seem to recall there seemed to be no common pathway to entering this new career. Some had come from the prison service; one was an ex-policeman. Two of the girls were recent immigrants from Spain. I remember particularly one rather aggressive man called Sam Mather who was very full of himself and had a mission to ‘sort out’ these places as he referred to Long Grove and its ilk. On the whole though I think we were all of us fascinated but somewhat uncertain as to why we were there, but having got there we were determined to make the best of it.

The two weeks of Prelim went quickly and by the end of that time and proudly wearing the first white bar on my epaulette it was back to the wards with a head full of useful information and a very basic understanding of madness. Basic indeed. Few drugs to learn, few techniques other than restraint, a history of the hospital, a few basic tray and trolley layouts, some barrier nursing training (for infectious ‘geeps’ mainly) and a smattering of anatomy and physiology. A month into my career then and I had some hands on experience in the wards and a head hardly filled with technical knowledge. Well I suppose it was a start.