by Ian Wheeler
Not far into their training, the hospital’s psychiatrists began lectures on the current state of the profession; students had to attend in addition to their full duty days on the wards. The lectures covered the latest theories of mental illness but always with the caution that nothing could be done for the patients beyond giving them meticulous medical and professional treatment. Mary’s memories of these lectures are acute. She describes a room full of men and women still in their uniforms, busily taking notes and trying to stay awake.
With seniority came more responsibility. Back on the ward, when she was left in charge overnight, her ‘ladies’ knew this was her first night in charge and were not co-operative. Since nursing students slept in rooms adjoining the ward, Mary knew she could call for help but she wanted to deal with it herself. After one chaotic night, she installs a therapy of tea and broken biscuits. ‘Anyone willing to keep the ward quiet tonight and help in the morning, come out for a cup of tea and a biscuit,’ she calls out. It works. After that, the ward is with her and she has no more trouble. These are the tricks that only experience can teach her.
Her first day charge is just as dramatic. The patient who swallowed the cufflinks drinks Bluebell metal polish. Mary blows her emergency whistle and handles the situation as she has been trained to. When it is over, she talks severely to the student nurse assigned to watch the woman, repeating the same words the ward sister had used to her.
Mary never saw a patient mistreated at the hospital. In fact, she describes only professionalism and dedication. If cures were not available, the staff substituted meticulous care and unfailing tolerance. Popular fiction may suggest otherwise, she says, but anyone who abused patients was immediately sacked – and she saw it happen.
In fact, the nursing staff did everything they could to make the patients’ lives as happy as possible. She describes how the cheery Occupation Therapy girls collected ladies from the ward for daily work or crafts. In the summer, she took small groups out into the airing yard so that they could enjoy the lovely countryside and, a couple of times a year, escorted them down to the auditorium for a dance. With everyone dressed in their best, the administrative staff made a grand entrance and patients and staff danced with one another. It was all very innocent and great fun.
Mary describes in detail the probing and thorough examinations she had to pass for her certification. These were given at national hospitals, mostly in London. Out of a class of thirty students, twelve became qualified graduate nurses.
Mary’s RMN from the BMH was the basis of a career lasting fifty years. She transferred to Warren Road Hospital in Guildford, working on a psychiatric observation ward during the Blitz. From there she accepted a position at Borocourt Mental Hospital, working with Down’s syndrome men and boys. By then she had her daughter to consider, so she worked for a private nursing co-operative in Brighton, nursing famous, rich, and aristocratic patients until she was part of the wave of British medical staff that emigrated to Canada during the 1950s. There, she participated in the new treatments made possible by psychotropic drugs and the impetus to move patients out of the great mental hospitals and into their communities, a movement that is still ongoing. (Kindly contributed by Mary Fairbairn’s daughter, Diana M. DeLuca, PhD.)
***
The author recommends the full and highly informative version of Mary’s experiences at Fair Mile, published in 2013 by the Berkshire Medical Heritage Centre in Reading, under the title Nursing at the Fairmile Mental Hospital, Cholsey. Her complete memoir, which is essentially a history of modern mental nursing from the viewpoint of the psychiatric staff, is forthcoming under the title Affairs of the Mind: My Life as a Mental Nurse, published by Seafield House.
Lilian Talbot’s pass key and alarm whistle. (Author’s collection)
Vera Wheeler adds some further colour to the hospital’s working day:
My mother, Lilian Talbot, worked there from the age of 17 (1920) until she married my father, Leslie, who was initially an attendant but subsequently became Hall Porter. Married couples were not allowed to work at the same hospital at that time. All doors were opened with keys, which had to be handed into Father’s office as staff went off duty and left the building. They were collected when they reported for duty. The male attendants carried their keys in their pocket, attached to their trousers by a chain. To the best of my recollection the female nurses had theirs buttoned to their uniform on a fabric strip.
Male staff wore navy blue suits and peaked caps, much as the old prison officers wore. Female nursing staff wore a grey/blue dress, a white bib and apron and a nurse’s hat. I remember seeing a picture of my mother wearing her uniform at the time she became a charge nurse – the modern term would be ‘sister’ – and she was immensely proud of her ‘strings’; these were the ties that came from each side of the cap and tied under the chin in a bow.
Sisters Annie and Grace Kirk in July 1925. Grace shows off her ‘strings’, the bow beneath the chin denoting Charge Nurse status. She was promoted to Deputy Head Female Nurse in 1926 and went on to succeed Mary Ratcliffe as Head Female Nurse and Housekeeper (Matron) in 1932. Annie married Gerald Woolley, who ran the stores, while Grace married a doctor in 1938 but sadly died young. (Author’s collection)
Post-war Training
At the end of the Second World War there was a severe shortage of nurses, and interested candidates were employed from many countries, ‘female staff of continental origin’ being first mentioned in 1954. Even so, many of these required training in the specialised skills that had developed in psychiatric medicine. Although Fair Mile had long been a training hospital, it lacked facilities; there was a classroom in the basement of the original superintendent’s quarters from 1932 but the Recreation Hall or even the operating theatre sometimes had to be pressed into service.
Moulsford Manor
The answer was the creation of a residential training school just a mile towards Reading at Moulsford Manor, an elegant country house with large, panelled rooms and pleasant gardens stretching down to the Thames. The manor already had a history and was used by Winston Churchill – presumably before it was taken over by the United States Army Air Force in 1943 – as a quiet retreat from the stresses of holding the country together and beating the Axis forces.
The Moulsford Manor School of Nursing came into being in 1956 and its students came from mental hospitals far and wide and from many nations. At various times, there were intakes from Ireland, France, Spain, Germany, Holland, Italy, Portugal, the West Indies, Scandinavia and even Latvia.
Official pictures show comfortable surroundings and good facilities. Less formal views indicate that hard study was the order of the day.
The school closed in 1994, at which time the building passed into the ownership of the famous Maxwell family.
Moulsford Manor in the 1970s. (Spackman collection)
Momena Wright’s badge from the Moulsford Manor training school. (Author’s collection, courtesy of Momena Wright)
A lesson taken in the comfortable surroundings of Moulsford Manor in the 1960s. Martin Morris on the left, then Colette Reynolds and Bill Fox. Colette Dusaillent is in the other corner. (Spackman collection)
A practical session posed for the camera in the 1960s. This room was Churchill’s bedroom during the war. Trainee male nurses had green lapel flashes while female trainees would not have had a badge on the bib of their apron. Bill Fox is behind the basin. Colette Reynolds and Colette Dusaillent are to the right, with Conar MacDonald far right. (Spackman collection)
Chalk and talk at Moulsford Manor in 1972. The tutor is Alan Stirton. (Spackman collection)
This modern-looking scene is actually from 1972. Today’s students would be poring over tablet computers and smartphones. Christine Brown features on the left. (Spackman collection)
THE NIGHT RUNNER
Michael Reynolds grew up in Ferry Cottages, in Reading Road. His father, Alf, was a charge nurse and in 1956 Mike followed him into Fair Mile as a student nurse. B
ecause he already lived in staff accommodation, he was not required to live within the hospital like other trainees.
With some amusement, Mike recalled the duties of the junior member of staff on a night shift: essentially these were any lousy tasks that were going and the unofficial job title was ‘night runner’ (we would probably say ‘gopher’ today). At the start of the shift, he had to collect heavily bound report books from the office and deliver one to each of the wards. He described staggering along the winding corridors, laden down with books in an attempt to avoid making several trips. At the end of the night, the made-up and signed books had to be returned for safe keeping.
This pales into insignificance when compared with delivering the tea, which was brewed in quantity in the kitchen at night, rather than in the ward kitchens. The poor night runner was required to deliver tea to all the staff, in all parts of the hospital, in strict order of seniority. No record exists of the miles involved in first serving all the senior personnel before repeating the tour to serve their immediate subordinates, and so forth. Suffice to say that the night runner’s tea was seldom warm when he or she got it.
A lighter look at the staff regulations, found during 2010. (Bill Nicholls)
An excellent staff group of about 1951:
Rear, from left: 1st Lem White; 3rd Bert Lines; 4th Mervyn Lovegrove; 6th Bill ‘Taff’ Walker; 7th Bill Mundy; 8th Basil Mann. Far right: Arthur ‘Lofty’ Bryant.
Standing: 1st Kay Hazlewood; 2nd Ruth Green; 4th Mrs. Franks; 10th Carmel Parkinson (née Clancy); 11th Peggy Veloso (née Norris); 12th May Lehaney (later Walsh).
Seated: 3rd Arthur Perry; 4th Agnes Pilgrim; 5th John William ‘Jack’ Croxford (Head Male Attendant); 6th Mary Nicholls; 9th May O’Reilly.
Front row: 3rd ? Max-Deans; 5th Rees Hughs. Far right Irene ‘Renee’ Gorman (later Brewerton). (Bill Nicholls)
Notes
34 Some official records as early as 1911 use ‘nurse’, while former staff members claim that ‘attendant’ was current well into the 1930s.
35 These laboured under the lengthy title of Regulations and Orders for the Management and Conduct of those engaged in the Service of the Berkshire Asylum Wallingford (see also Chapter 6).
36 Women took to this title more readily than men, who apparently thought of themselves as ‘attendants’ for years afterwards.
37 Leslie Talbot held this position at the time.
38 This was almost certainly Jack Croxford.
39 More likely, no more could be found to put up with the hours and conditions.
11
TRAGEDY, DEATH
AND SPIRITUAL CARE
The Chaplains
In his tenure from 1870 to 1872, Revd George W. Oliver worked a pattern of 11 a.m. and 6 p.m. services in the chapel on Sundays, morning prayers in the dining hall on most weekdays, followed by visiting the sick and touring the wards to talk with a high proportion of the patients. Choir practice is first itemised on Saturday, 9 December 1870.
Revd D.B. Binney was the incumbent from September 1872 to June 1875, followed by Revd C.F. Thorndike until 1876. Revd W. Kirkby was another short-term holder of the chaplaincy until November 1878, when Revd A.O. Taylor filled in until April 1879. The hospital was subsequently sorry to lose the services of Revd Richard William Perry Circuitt AKC (Associate of King’s College) in 1886, after seventeen years of commendable service. He was also vicar of Cholsey.
Next was a short period in which Revd A.L. Crake was assisted by Revd F.W. Agassiz, who was curate at Cholsey and who was himself briefly Chaplain from June 1887 to October 1888. Regrettably, Agassiz was a serial philanderer and gambler, who absconded to South America.40 Revd Hayman Cummings covered most of 1889 but August of that year to the start of 1896 enjoyed continuity under Revd Augustus Edward Farrar.
From 1896, when Revd F.T. Stewart-Dyer took the chaplaincy, a typical day’s entry would read, ‘Visited the wards, except Female 1 and 6 bathing, Laundry, Airing Courts & Workshops and conversed with many of the patients individually,’ this last being perhaps linked to the customary duty of distributing library books. Failing health prompted Revd Stewart-Dyer’s resignation.
In July and August 1909, we know only that Curate H. Daman acted as locum tenens to Stewart-Dyer during his holiday but we take a little more detail from the hand of 30-year-old Revd G.L. Edwardes, who arrived from the Bucks County Asylum on 30 September 1910. Although the business of his average day was little altered from that of his predecessors, he was expected to take an active part in the social life of the asylum and appears to have done so with considerable energy, frequently singing solo in the weekly entertainments and leading the choir. On Sunday, 13 November 1910, there was a ‘Vocal & Organ Recital’ attended by 130 patients, ten attendants and three servants. The organ was played by Mr. A.G. Letts and included items by Guilmant, Lyle and Freyer. Vocal contributions were made by Edwardes himself and Miss Hilda Deacon. Edwardes was subsequently sick-listed for four days. Undaunted, he also ‘attended minstrel practice’, took solos in many other events and dutifully presented himself at at least one staff ball, in February 1911. He later took the peaceful-sounding curacy of Ottery St Mary in Devon.
Rather than a picture of Revd Raynor, who appears elsewhere, this is the steady-looking J.R.F. Davis, long-serving finance officer and amateur thespian. Perhaps he had been taking lessons in ventriloquism from the chaplain! (Miriam Pryce)
Revd Philip Edwin Raynor AKC, also vicar of Moulsford, held the post of Chaplain from 1912 until the journals cease in 1953, shortly after the loss of his wife and when he was himself not very well. Before taking holy orders, he had been on the stage as a ventriloquist and still gave ‘Tommy’, his dummy, the occasional outing. He was an accomplished academic and sportsman, featuring in some of the finest older photographs, typically of cricket teams. He became friendly with authoress Agatha Christie and would play chess with her at her home in nearby Winterbrook.
All of these gentlemen were engaged at a salary of £200 per annum, typically with lunch and beer on Sundays.
There is a gap in the records after 1953 although it is known that Revd John Hall had the post from 1983–92, succeeded by Revd Andrew Petit, the last chaplain and still vicar of St Mary’s, Cholsey, at the time of writing.
Although the chaplains were very much involved in the wellbeing of patients, their journals are incomplete and contribute little of historical interest, being suitable for inspection by the Committee of Visitors on a monthly basis and signed off as satisfactory. Morning prayers may have been discontinued when the sheer number of patients necessitated taking breakfast in the wards. Time was found for at least one service in the chapel on Sundays and the chaplain always recorded the numbers of those who attended. Sadly, the journals are dry and repetitive, with little opportunity to gauge the personalities of the writers. Even records of the many funerals at which the chaplains officiated are perfunctory, the tragedy being that there were often very few mourners present.
At various times, services were rescheduled to be more convenient for one or other of the hospital’s functions, although the underlying aim was to maximise attendance; the chapel was twice enlarged as patient numbers grew, and suffered its own tribulations over such matters as heating. Now redundant, the building stands firm under a preservation order but its construction makes future use an interesting challenge.
Other Faiths
Naturally enough, the resident chaplain was Church of England but arrangements were also made for other denominations. No arrangements would have been necessary for any of the non-European faiths until well into the NHS era.
Death and its Causes
Death was a matter of constant concern to the staff, who were charged with preserving life where this was humanly possible. In the earlier years, many deaths were a sad result of the depleted condition of patients on arrival. Senile decay, erysipelas, general paralysis, senile gangrene, ‘brain disease’ (often meaning tumours), circulatory problems and pneumonia figured lar
ge, while others succumbed to diseases contracted within the establishment and there were periods when tuberculosis, enteric fever, dysentery and even the dreaded typhoid fever claimed the lives of more patients – and occasionally staff – than any self-respecting doctor could pass as routine.
For the year 1933, the causes of 164 deaths were heart disease, forty-two; senile decay, forty-two; bronchitis, sixteen; epilepsy, nine; pneumonia, five; malignant disease, five; tuberculosis, three; and general paralysis only two, the remaining forty being due mainly to natural causes. There were six cases of TB but the Commissioners felt that the hospital was ‘singularly free from this disease’.
The death rate was regularly above the national average for asylums but was often explainable by the large numbers of elderly patients, including transferees from outside the area. Mortality statistics were scrutinised, particularly where a post-mortem examination was warranted, and successive superintendents clearly felt a sense of personal responsibility, reflected in the distressed tone of some of their journal entries.
By December 1938, the main causes of a 10 per cent mortality rate were organic brain diseases and cardiovascular or respiratory disorders. The national average of 7.5 per cent was achieved in 1940.