Charlotte began to weep, the heels of her feet still grinding up and down against the wall. A small whimper emerged from beneath the bundle of blankets, a tiny head just visible above. ‘The other day,’ she said slowly, her swollen eyes still fixed on Alice, ‘the day you came round to ours, I thought you might help us. That’s why I followed you upstairs; I felt like –’ she stopped, her voice cracking. She looked down at the baby in her arms and when she looked up again, fresh tears were rolling down her cheeks. ‘But I was wrong. You’re just as bad as all the rest of them.’
Alice stared at her. ‘What does that mean? Who are you talking about?’
‘All of them,’ she wailed, releasing one of her arms and waving it in a sweeping gesture that made the baby’s head wobble. ‘They’re all the same. There ain’t no one I can trust.’
‘You can trust me and believe what I say, Charlotte,’ Alice said soothingly. She shot a warning glance at the doctor, who was beginning to move towards the girl. ‘Everything will be all right, but we must stabilise you first.’
‘I don’t wanna go there!’ Charlotte said in a sort of strangled gargle. ‘I’ve heard, you see. First, Molly, then the others. And they all say the same.’
‘Molly? You mean Molly Rainham?’ Alice demanded sharply, but Charlotte’s eyes were fixed on the doctor. ‘Charlotte?’ she persisted. ‘You knew Molly?’
The teenager turned back and gave a small nod. ‘She’s delusional,’ Peter Harland snapped. ‘Can’t you see?’
‘How did you know Molly? What was your connection?’ Charlotte blinked rapidly, then her eyes glazed over. ‘Charlotte, are you listening? What about Molly? And the others? What do you mean by “the others”?’
Charlotte shivered, her teeth chattering. ‘I ain’t going there, I won’t.’
Alice stared at her. ‘Where do you mean? The asylum?’
‘No!’ Charlotte wailed, closing her eyes and letting out an ear-piercing scream.
Peter Harland whisked the air with broad hands. ‘For pity’s sake, Miss Hudson, let’s stop sentimentalising and procrastinating. The girl is insensible. Beyond reason. She belongs in the asylum.’
Across the room, Elizabeth got to her feet. ‘This is dreadful. Can nothing be done to help the girl?’
‘I’m going to summon a taxicab,’ Alice said calmly, moving towards the door.
When she returned ten minutes later, her eyebrows shot up in surprise. Inside the room, Charlotte was sitting on the sofa, calmly breastfeeding her baby, Elizabeth fastidiously tucking a muslin cloth beneath the baby’s chin and another over the cushions beside her. ‘We’ve reached an agreement,’ Dr Harland said flatly. ‘Charlotte will go to Banstead Asylum voluntarily, and the infant will stay here, with Elizabeth, until she is recovered.’
Alice opened her mouth to speak, but the doctor cut in: ‘Charlotte hasn’t the means to pay for foster care for the –’
‘Daisy,’ Charlotte piped up, looking up from her baby for the first time since the almoner reappeared. ‘Her name’s Daisy.’
‘Charlotte, you are in agreement with this?’
The teenager nodded, the glassiness absent from her eyes for the first time since she had woken. ‘I’ll go to Banstead to get well, but then I have to get home.’
Alice gave her a thoughtful look, then turned to the doctor’s sister. ‘Elizabeth?’
The older woman looked up at her and nodded. ‘I’ll do what is necessary, for now.’
The almoner’s face fell slack and then she gave a small nod. ‘Very well.’
There was a pause, and then Dr Harland said: ‘Charlotte has asked that we say nothing about the birth of her second child for now. Our reports of the evening will record the birth of a stillborn child, and nothing more.’
‘We cannot do that!’ Alice said. ‘We have a legal obligation to report the birth –’
‘It’s been agreed,’ the doctor snapped. ‘For now.’
Alice stared at him. ‘This is most irregular. I cannot understand why you would agree to such a thing.’
‘Must you bring drama to every interaction? We’ve spoken to the girl. She wants the opportunity to repair her relationship with her parents before complicating the issue with a child, and for now our priority is making sure that she gets the treatment she needs. There will be time to register the birth when she recovers. Or would you prefer to drag a hysterical youth gnashing her teeth and spitting through the streets all the way to the hospital?’
Alice sighed. There was a pause, and then she gave a small nod. And so it was with an agreement that the night’s events would be discussed with no one, that Charlotte, escorted by Dr Harland and Alice, left the house twenty minutes later, clouds moving briskly across the dark sky above them. As they climbed into the waiting taxicab, Elizabeth stood watching at the window, Charlotte’s surviving infant in her arms.
The small party drew up to the gates of Banstead Mental Hospital just after 8 a.m. on Tuesday, 3 January. The rain had passed, leaving a chalky white sky in its wake, one that mirrored Charlotte’s sallow cheeks as Alice guided her across a stone track illuminated by lanterns, and over to the gatekeeper’s lodge.
The hospital was surrounded by walls ten feet high, designed to protect ‘chronic and quiet lunatics’ from the harshness of the outside world. A patchwork of outbuildings, the farm manned by patients and a number of workshops were hidden from view, the austere central clock tower above the main entrance perhaps reflective of the torment raging in the minds of those contained within its walls. Female patients like Charlotte who required medical treatment as well as psychiatric care were admitted to the infirmary in Block A, where a view of Banstead Downs could be seen from the wrought-iron bars at the windows.
Peter Harland pulled up the collar of his jacket and held it there with one hand as the porter came out to speak to him. Alice stood next to Charlotte as the young girl chewed her nails, her face creased with concern.
After scribbling his signature in the porter’s file, Dr Harland conveyed Charlotte into the grounds, the clang of the gates behind them a signal to other patients that another lost soul had joined their ranks.
Chapter Seven
No class of the community has a stronger claim than this on public sympathy. These poor girls, enticed from their country homes, seduced, diseased, abandoned, distant from all early and better influences, have no shelter or refuge left to them save within the walls of institutions similar to the Royal Free. It has been objected that this institution receives large masses of the casual poor of this great metropolis; it has done so, and persons who reflect deeply and judge fairly will consider this a recommendation to it and not a drawback from its utility … While it has accommodation, it takes all it can, and the more wretched they are, and the more diseased, the greater is their claim on this charity.
(Royal Free Hospital Annual Report, 1846)
Nestled beside King’s Cross Road, Gray’s Inn Road was so named after Gray’s Inn, one of the four Inns of Court where barristers lodged and learned their trade. The road stretched away from the hospital to the north and the district of Camden, with Holborn and Chancery Lane tube stations laying to the south.
‘Gray’s Inn Lane is not the most salubrious, cleanly or pleasantly populated thoroughfare in London,’ commented The Illustrated London News in 1856.
‘The shops are small, filthy and close-smelling – generally devoted to the retail of bad greengrocery, adulterated liquors, vicious newspapers and cagmag-looking meat … All day long [the women] are either shuffling in and out of the courts or standing listlessly at the entrances – unkempt, slipshod, dirty women, clad apparently but in one garment, and even that in most cases unfastened and ragged. The faces of these women are worn and macerated by famine and gin; the bones on their necks and hands seem almost protruding through their skin; their eyes are glassy, their whole demeanour utterly listless and weary. A visit to the gin-palace or the pawn shop, a thrashing from a drunken husband, the wail of a neighbour’
s child – these are all that ever break the monotony of their lives.’
It was against this harsh backdrop that the almoners conducted their work.
Slick with damp leaves, rainwater and a spill of cabbage leaves from a greengrocer’s barrow, the pavements of Gray’s Inn Road glittered in the weak morning sunlight as Alice and Dr Harland arrived back at the hospital on the morning of Tuesday, 3 January.
As soon as they left the cab it pulled swiftly away to the north and King’s Cross, a sign, perhaps, that the journey from Banstead had been heavy in mood and light on conversation. It would have been a rare feat indeed; stunning one of London’s chatty cab drivers into gloomy, reflective silence.
Falling into step, they passed silently beneath the British Lion mounted over the grand central arched entrance, and into the building. The doctor gave Alice a curt nod at the foot of the stairs leading to the chest clinic. He paused briefly as she walked away, giving her a sidelong glance. The almoner passed through the double doors leading to the nurses’ quarters without turning around, then disappeared from view.
Alice left her soiled cape to soak in her room and descended the stairs to the basement just after 9.30 a.m. that morning. She was wearing fresh, dry clothes, hair pins holding her bun securely in place. In the smoky office, Frank glanced up from one of the financial folders he was examining when she walked in. ‘Did everything go to plan last night?’ he asked.
There was a slight hesitation before the almoner tilted her head. ‘Perfectly, thank you,’ she said, sitting at her desk and drawing ink into her pen. After writing up a modified version of the previous night’s events, she blotted her pad dry, pulled off the top page and stared at it.
Officially, the records of any child that had been boarded out, as it became known in the nineteenth century, belonged in the box marked ‘UNWANTED’ on one of the high shelves in front of the arrow slit windows in the almoners’ basement office.
It wasn’t unusual for almoners, doctors or hospital matrons at the hospital to match ‘friendless’ young patients with foster carers or adopters without any consultation with the authorities. Other adoptions were arranged by family members and shrouded in secrecy, with babies farmed out to obliging distant relatives, friends of the family, even neighbours. Even adoption societies rarely interviewed adoptive parents; advertisements were placed in local newspapers, interested parties turned up to view the children available and, if both parties were happy, they took the child home. The children were usually placed ‘on approval’ for the first eighteen months, so might be returned at any time.
There had been a number of concerning deaths of infants placed in foster care over the years. While the majority of children were well taken care of, with their lives transformed by the care and kindness of their foster parents, a small number were shut away in attics to starve, quietened with opiates or deliberately drowned, so that another paying ‘customer’ could take their place.
Advertisements regularly appeared in local newspapers placed by women offering to take in unwanted children for a one-off lump sum, but mortality rates were high. Alice was particular about the homes she placed children in, but foster care was a costly business. In the early to mid-1920s, a weekly payment of at least twelve shillings and sixpence was expected; an amount way beyond the means of most of Alice’s patients, and especially a teenager like Charlotte.
‘You’re in a brown study, dear,’ Winnie said after a time. ‘Is everything alright?’
‘All is well, thank you, Winnie,’ Alice answered briskly.
The typist made a noise in her throat that suggested she believed otherwise. ‘You haven’t forgotten about our trip to the zoo on Friday, have you, dear?’ Winnie was a long-time member of the Women of Westminster Book Club. As well as analysing novels – their latest being P. G. Wodehouse’s Indiscretions of Archie – they got involved in a variety of projects to improve the lives of disadvantaged children. In partnership with fundraiser Alexander Hargreaves, the club had organised a trip to London Zoo for some of the children identified as vulnerable by the hospital almoners. The trip was one of a number of projects aimed at improving the lives of children in need.
‘No, I have it noted, thank you.’ The almoner nodded and snatched up some of her post and a sharp letter opener.
Winnie pulled off her glasses and rubbed the inner corners of her eyes with finger and thumb. ‘Good, because we don’t want to keep them waiting, do we?’
Alice jabbed at an envelope with the sharp instrument. ‘I have it firmly fixed in my schedule, Winnie.’
Winnie drew her chin in. Alice sighed and got to her feet. ‘I need the key to the records office, Winnie. Do you have it?’
The typist produced a key from a small pot on her desk and handed it to Alice. ‘Anything I can help you with?’ There was a gleam of interest in her eyes.
‘No.’ Alice took the key with a curt thank you and crossed to the far side of the basement and the door, partially concealed from view of the main office by a filing cabinet, leading to the medical records store.
There was no electric light in the tunnel leading to the rear entrance of the store, which was usually accessed by a back staircase in the east wing of the hospital. Alice held an oil lamp aloft as she made her way through the narrow passageway, finally emerging into the cavernous store about a minute or so later.
Alice located the main entrance to the store and ran her hand along the stone wall until she reached the light switch. Row upon row of floor-to-ceiling wooden shelves flooded into view under the artificial light. She rested her lantern on the nearest shelf and moved between the sprawling rows, stopping when she reached the register of girls and women receiving treatment for venereal disease at the hospital.
With the advent of penicillin still two decades away into the future, syphilis was one of the venereal diseases most dreaded and feared. An intimate chancre (ulcer) was the first sign of sickness; a lump that appeared a few weeks after exposure. Small and painless, it was a symptom easy to dismiss by those with a strong desire to turn a blind eye. Up to three months after the chancre had healed, the next phase of the infection brought with it blotchy red rashes (over any part of body but usually the soles of feet and the palms of hands), swollen glands and flu-like symptoms, skin growths in the genital area, and, sometimes, hair loss. Symptoms usually cleared with or without treatment within a few weeks, and for a fortunate two-thirds of sufferers the worst was over.
For the remaining third, what had passed was merely an unpleasant warm-up for the main event. Third-stage syphilis could explode any time between three and thirty years after initial infection and once it arrived, the eruption of pustules and foul abscesses meant it was impossible to ignore. A body-eating pathogen, it worked its way through the body voraciously, devouring bones and nerve cells and destroying noses, lips, eyes, mouths and throats.
Since many of the women and young girls suffering from VD lived chaotic lifestyles, the almoners maintained a register to ensure that each and every one of them completed their treatment. From its earliest days the Royal Free Hospital had led the way in treating venereal disease, refusing to stigmatise sufferers who found themselves turned away from other hospitals. A number of the VD clinic’s patients were prostitutes; girls who had sought to escape one crisis – the prospect of destitution – by diving headfirst into another.
The almoners tried to seize the small window of opportunity offered by the shock of diagnosis to steer their patients towards more meaningful lives. Whenever a new sufferer turned up at the hospital, the almoners got in touch with rescue and welfare officers, the Sally Army and the clergy, so that action could be taken before desperation turned the girls back to the life from which disease had removed them.
By keeping a close eye on working girls and making sure they completed their treatment, Alice and her colleagues could satisfy themselves that, if all efforts to rehabilitate them failed, at least they would no longer be a source of infection when they returned to their
‘work’.
Alice updated the register with details of the patients she had referred to the clinic in the last few days, then moved further into the dimly lit space.
The files relating to the Redbournes were located halfway around the room, on one of the highest shelves in the store. Alice rested a wooden ladder against one of the damp walls, bunched her skirt into one hand, then climbed up and retrieved a manila folder marked ‘CHARLOTTE REDBOURNE, DOB 02/10/1906’.
The uppermost page chronicled Charlotte’s personal details; her address and next of kin, etc. Alice flicked to the back of the file, where the girl’s earliest treatment in the hospital was documented. There was nothing out of the ordinary recorded that mightn’t appear in countless other files relating to a child; Charlotte had sustained a gash to the head following a fall downstairs in 1908, which had been repaired by stitches, and had dislocated a toe in 1916 after falling from the wooden bars in the gymnasium at school.
Towards the front of the file was a record relating to an appearance by the teenager in outpatients in December 1920. According to the notes, Charlotte had been brought in by a member of the public after collapsing in the street. Under ‘SYMPTOMS’, the triage nurse noted that the girl had complained of difficulty breathing and light-headedness. Under the heading ‘TREATMENT PLAN’, however, the space was blank.
Alice frowned, narrowed her eyes and brought the file closer. She flicked forward and back through the thin file, but there was no other mention of the visit; no referral noted, and no obvious treatment trail. The almoner tapped her fingers on the front of the file thoughtfully. A minute later, the record was back in its place and the oil lamp aloft in front of her. Alice’s hand hovered over the light switch at the main entrance, but instead of turning it off, she lowered the lamp to the floor and walked quickly back along the rows of shelves.
Letters from Alice Page 8