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.