RI supplement latest copy:Layout 1
12/2/07
14:28
Page 1
PULL-OUT SECTION
T H E R A D C L I F F E I N F I R M A RY O C TO B E R 1 7 7 0 t o JA N UA RY 2 0 0 7
Behind the scenes at the Radcliffe Infirmary: Fifty years ago Terence J Ryan (with help from Alan Todd, Glenys Davies and Iris Wastie) ehind the scenes at the Radcliffe Infirmary fifty years ago relies on the memory of people who worked there, Tynchwyke Pantomime Scripts, The Oxford Medical Gazette and "Unity in Diversity" by EJR Burroughs. What is learned sounds like one hundred years ago. That is because having been built in the 18th Century much of its structure was of that era with replacements and enlargements always superimposed on an infra structure that was ancient. The 1956 pantomime opened with the lines, said with much emphasis of sickly verse by a very good fairy, “As summer wafts his last kiss on the air, To bold virile winter with the wind blown hair Over everything the Radcliffe scaffolding is there. " and the laughter which greeted it was an indication of how heartfelt was the effect of maintenance on the lives of the audience.
B
In the Operating Scene of the 1956 pantomime "Handsome and Dettol" a builder walks through. “Who is that?" says the Surgeon. "One of the builders Sir! We've strict instructions not to interfere with their work" is the reply. The constant building repairs, demolition and building kept the corridors wards and theatres anything but dust free. The domestic supervisors, whose job it was to keep the place clean in collaboration with porters and ward staff, never knew the exact site and timing of the next project. ”Only if we read it in the papers as they were always chopping about" senior administrators knew but their soothing words were mostly post hoc."
EJR (Jumbo) Burroughs the Hospital Administrator was also referred to in the1956 pantomime. "The voices of the birds at break of day Courting the Administrators thoughts, upheld His soft suggestive promises of bliss Uttered aloud with subtle overlay." He wrote about the supporting staff but only of the top people, truly an officer class, since most had served with distinction as "high ups" during the Second World War. He had had begun his hospital administration at the London Hospital in 1934 but during the war he was an administrator at the Dreadnought Seaman’s Hospital, Greenwich. The privately printed blurb on the cover of his book possibly written by himself states "···he was brought up in and practised the traditional enabling process of hospital administration with its old-fashioned emphasis on the benevolent squirearchy". Not surprisingly at this time the actual support at all levels in the hospital was from the military and navy of both wars as well as the RAF of the second war. The Assistant Domestic Supervisor was an ex high school girl and later a local historian. Those who remember the period will also remember that Mrs Burrough played a commanding and concerned role not always appropriately directed ... She 'interrupted one meeting in the Administrators Office to complain that the elevators in the London underground were decorated by too many sexual images’. At that time all complained of regulations but by today's standards they were trivial~ like not whistling in the corridor or having the correct length of skirt. Especially missing was Health and Safety. As medical
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 2
2 / T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7
students we marvelled at the one Gynaecologist who never wore gloves. But this was not for health and safety reasons! Yards, even miles of piping had recently been insulated with buckets of asbestos and glue and then painted over with white paint as a seal. Underneath this ancient structure were corridors 4ft wide from the boiler house to the hutted wards along which people crawled. Above them, the quarter mile walk from casualty to the wards had one advantage that one met simply everybody during this sometimes hourly stretch. But passing a colleague below ground was rare.
Not only were nurses under her domain but so was the laundry
The main meeting rooms for "staff' were small cupboards close to the tools of the trade, housing boiler men, painters, electricians, pipemen, cutters and welders and two lots of carpenters and many others. They had their chiefs and deputies; not quite still in top hats, but an apprentice had to dress well. Ties had to be worn at a formal job interview or at a disciplinary proceeding for being on duty a little late, shown up by punch card clocking in system. The different professions saw the other in a special light. The electricians constantly on the move saw the painters as a different breed, "There is Fiddly Tyson the chief painter I actually saw him move one arm!" The Chief Electrician lived in The Old Parsonage supervising, as a "scout", a number of students and initiating its role as a restaurant. Electricians were dressed in blue dungarees, and theatre porters in a white tunic. The fitting was always initially four times too big a size because the laundry would soon shrink them. However if the trousers were still too long at the end of a few weeks, it was wise to have a girl friend in the Laundry to turn them up. The domestic staff relied on the sewing room for fitting their uniforms. There was an hierarchical dating system. The upper echelons would disapprove when a nurse was dated by supporting staff but formal contacts were common as no patient would go to another department without a nurse and a male porter. Both would accept responsibility for the return of the patient even if the time for going off duty was past. This business of girl friends "below stairs" always had the figure head of the Matron to contend with. Not only were nurses under her domain but so was the laundry. An electrician might aspire to going out with a nurse but going out with a girl from the laundry was more likely. As an apprentice the earnings were 23shillings and ten pence per a five and a half day week. There were some supporting staff in the domestic scenario who earned ÂŁ75 per annum. If one did not live
in and one was expected to visit the family in outlying villages all of this went on bus fares. Occasionally there were surprise perks. When the original DC cables of the hospital were unexpectedly located they were found to be a rich resource of copper. A quarter of a mile of such cut into lengths that could be carried on a bicycle to be sold down town at Warburtons meant that every electrician made several such journeys and earned more than just a few pence. One could earn more, but utilizing more energy, by helping to shovel coal in the boiler house which was a 24hr job in three eight hour shifts. The chief boiler man Harry Morris was known to be "a lad for the ladies" Going out at all was usually an expense of sixpence at the cinema and the high point might be a kiss on the cheek and very rarely on the lips. A nurse had to be in before curfew time which left little time to enjoy a girls company after the cinema. Both had stood to attention for a cooling period of "God save the King or Queen� at the end of a performance. This was still a post war period of patriotic sensitivity. The Coronation was fully celebrated and the electricians had to be on duty to maintain ERII in a large device on the front of the Infirmary. The carp in the fountain also had to put up with flood lighting at night. Or at least those that had survived the idea that bubbles would enhance the effect of the fountain. Most nurses and some domestic staff lived in one of the Nurses Home under the observation of a "home" superintendent. The windows all had locks. However an electrician had a chance to get in to the Home because most "experienced" nurses had their own iron for the compulsory ironing of the starch cap. The Ironing room at the end of each corridor in the Home would have a queue, while junior nurses late out of bed speedily had to get well dressed. An iron could always be said to be not working and in need of emergency repair. The screws that locked the windows could be made easily replaceable on the same visit. Sisters had some greater comforts. The first daily duty of the Domestic Supervise was to take them a cup of tea in bed at 6am. There were 150 rooms to keep clean and to spring clean every time there was a change in the "blocks" of nurses or new domestics. The keys were kept under close supervision shared by a porter at night and by Domestic Supervisors during the day. The assistant Domestic supervisor remembers all too well the arrival of the first girls from Scandinavia who came to learn English in the early days of the North Oxford Language schools and she remembers the first Ghananian nurses (three with law degrees) whose attempts to straighten their hair left strange odours in the Ironing rooms. Also the one without a law degree who carried the dispensary basket on her head in style down the corridor.
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 3
T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7 / 3
Elsewhere Medical students would also have a nursing interest. Knowing that their jobs would ultimately be secure only if they were unmarried, most of their relationships by today's standards would be regarded as platonic. It was thought unwise fifty years ago for any of the rather few clinical students (eight in the author's intake) to get married and very risky indeed was the behaviour of one who disappeared upstairs during a party. The hierarchy of nurses for medical students was substituted by "blondes for electricians" as glamorous Swedish trolley pushers were employed in the early fifties. The description from the Assistant Domestic Supervisor of that time of the Spanish girls with hot tempers and awful in a fight, is reminiscent of the cigarette girls brawl in Bizet's "Carmen'. Mostly these were housed in the Radcliffe Infirmary attics looked after by an aged supervisor called "Annie". One of the most specialised jobs was changing light bulbs, not because it was skilled but it needed a specialised knowledge of where every pair of steps in the hospital could be found. In the high ceiling Art Deco Nurses Recreation Hall, not only were the bulbs fitted while supporting heavy brass wear but the highest 14ft steps in the Radcliffe Infirmary were not high enough for the bulbs to be changed without standing on the top of wobbly steps with arms extended. If changing the bulbs did not enlighten, short circuits had to be looked for. A cumbersome system not unlike charging a battery with the leads from another car provided evidence if and when a light bulb incorporated in the testing system shone brightly or if, as happened frequently, the electrician's hair stood on end. Keeping the hospital going was proudly done by all. The Administrators knew how to appoint reliable workers even if not all were intelligent. Shovelling granulated coal for twenty four hours needed ex navy stokers who understood chains of command. When, like steam trains, chimney smoke became less acceptable as it swept across to the open windows and the beds of Marlborough Ward built for chesty patients (The Empyema Balcony) 50 years ago a draught fan was at last installed to divert the smoke. Cleaning of the wards was the job of ward cleaners who were supervised by the Ward Sister. The corridors and the floors of the wards were kept spick and span by a polisher brigade of Porters under different management. There were Trades Unions and lines of demarcation. Matron said on no account should the domestics clean beyond the Ward's inner door. The Porters would not venture beyond the outer door for sweeping up but could enter for polishing. So much debris collected in between doors and in porches that the Assistant
Domestic Supervisor would secretly clean up to prevent leaves and other debris being blown into the wards. She was fiercely reprimanded for agreeing to speak to a doctor who had called on her to get a replacement bath mat in the Woodstock Road habitat opposite the RLA request that should have been received by Miss Batten the Senior Domestic Supervisor. In emergencies no one let the hospital down. The porters in the lodge with a well lit list of addresses had their bicycles always at the ready to cycle to staff homes. Doctors on duty and sleeping in the Rotunda were woken up by a visit from Night sister. Travel to this or along corridors to the Hutted Wards was exposed to all weather conditions. Nurses wore capes but these had to be taken off before entry to a ward. Patients on the journey were protected by special red coloured Witney blankets donated by Mr Early. The doctor’s rooms in the Rotunda had very large curtains still lined with blackout material and great at collecting spiders and needing much maintenance. Only the theatres had generators. A power cut or fuse could endanger the heating system especially. It was steam driven and over long distances, unless pumped by the electrical devices, steam pressure could quickly build up and burst the pipe anywhere on the site. There was no time to lose for a deputy electrician to cycle in and turn the wheel that diverted the steam away from its outlet to the hospital from the boiler room. Easier jobs were given to the most junior. One might be sent to mend a fuse of the ancient lift jolting its way from mortuary to the chapel but if the lift went one flight higher it opened into the post mortem room. One electrician, Ginger Jones, had to be rescued from a dead faint having come across it for the first time. Burst pipes were rare but the damage done by a careless experiment with a water bath in one of the Nuffield Professors' Labs was considerable to an underlying ward. Every drawer of patient’s bedside lockers was filled with water. It was the Physiotherapy room looked after by Miss Green that had most electrical gadgetry. One example was a wicker seat with a copper bottom on which one sat having had ones trousers sprayed with water to improve contact. The warts on ones fingers were then electrocuted. This was probably no more a risk than the early micro wave systems for heating arthritic joints. A minor but more frequent problem was a failure of ball bearings in electric motors pumping the steam to local venues. The ball bearings had to knocked out and replaced. Another job was the maintenance of the lift by Nuffield III
Keeping the hospital going was proudly done by all.
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 4
4 / T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7
All these jobs were messy but there were only wash basins, and no showers or baths, available for the many grease coal and paint covered faces and limbs. Bodies such as those of nurses living outside the Radcliffe were not supposed to use up water for bathing purposes before changing into "Glad Rags" to go to a party after a busy day
Christmas on the ward
Oxford's water is so sterile, run it under the tap
In the laundry, clothing for washing was unrestricted, and the electricians attended to gigantic centrifuges and steam heated rollers which were used for spin drying and for ironing sheets in endless demand by overcrowded wards. This was not the time of the central sterile supply centre. Sterilisation of instruments was either in the theatre or on the wards. There was little that was disposable. It was the junior nurse who tested the rubber gloves for holes and patched them up with glove pieces and glue. Although it took time to boil up catheters and syringes it was less time consuming than undoing all today's packaging. Well scrubbed hands and arms was all that was required for removing stitches, If a proctoscope was not quite sterilised, "no matter Oxford's water is so sterile, run it under the tap" said the surgeon, Ted Maloney. Even syringe and transfusion needles were sent for sharpening. The sterilizers themselves quickly silted up with Oxford's hard water and leaks were also quite common. Junior nurses also took care of glass thermometers and had to report to Matrons office for a severe tick off when more than three were broken in a week. Disposal of dead bodies was discreetly done. Always ‘laid out’ on the ward, no nurse went off duty until the body of patient had been laid at rest for one hour. It was always assumed that journeying along the 400 yards or so of the main corridor with a trolley with a lid would not be recognised by the visitors. The lids did not always fit too well. Using sheets with purple edges was thought to be enough to disguise the identification of the dead on whom post mortems had been done. One houseman thought he was being helpful by shifting one dead body in his car at Christmas but had to bring it back when it was pointed out that he had crossed a County boundary and this was a crime that could lead to imprisonment. Fifty years ago disposal of body parts was virtually unregulated. The huge dustbins lining the wall of Somerville College emptied into well exposed dustbin collecting lorries ‘mostly’ avoided any complaint. The pathology laboratories were more easily accessed and they were the pride of the Pathologist Alaistair RobbSmith who delighted in the annual take-off by the Tynchwyke pantomime. Tours by members of the public, loosely described as “First Aiders”, would be shown the spare parts of "Mrs so and so who choked
on a beetroot", or a stomach’s bizarre contents, or “the spinal cord disrupted by what ever”. Some of us used to "manage" the First Aid Tent of St Giles's Fair and borrow trolleys to take the wounded to the Radcliffe. This was the time when Siamese twins were on show in bottles next to the fattest lady in the world to whom if one was the solitary visitor one would have to find something to say like "well done" or "congratulations". There were bare fisted displays of boxing to watch, and wasps regularly inhaled on toffee apples found their way into larynxes. A ninety year old owner of one stall had to be treated for a headache because of the noise, which is minimal compared to today. Her father had been a solo violinist for penny a dance. Thinking of spare parts, and one canteen meal, in which a finger turned up in a fruit salad, the complaint led to a quick investigation and reassuring statement to the effect "It's alright it's not one of ours". It was still post-war and possible to eat rather better in "British Restaurants” with their massed produced nutritious food in the then Oxford market (Now the Bus Station). Best of all was to be friends with the diet kitchen in the hospital who also cooked for Private Block, known to young doctors for its cucumber sandwiches. Special diets of a simple kind like broth or scrambled eggs were cooked on ward kitchens. The Pantomime each year was put on to entertain the nurses after their Christmas Dinner. The supporting staff often appreciated the jokes more than some of the doctors and Miss Preddy the Matron. A letter would go out at the end of November from the building Supervisor to enquire "what you might need in the way of props as he would like to get his men organised in good time. He also asks with respect if you could keep your requirements down to a minimum as he is rather heavily committed at the moment with sundry hospital jobs." The order for props inevitably came late but the lighting was installed without complaint, as well as much of the carpentry, including a traditional gigantic steam omitting anaesthetic machine. The Sewing room also did an invaluable job on dresses lent from a collection belonging to Mrs Hobson a consultant physician's wife living in St Giles. At Christmas there was always a risk of fusing the whole electrical system of the hospital. It occurred at least three times in 1956. Probably this could be attributed to the increasingly competitive ward decorating and Christmas tree lighting. Much money and supporting staff effort was put into this event. Precautions were few. Leopold ward turned into a fishing harbour, required long nails into every wall and ceiling to support the fishing nets. Sister Tatters on Alexandra Ward which had a rather special curved staircase had candles and hymn books everywhere, and these were not days of fire regulations requiring non inflammable bedding night cloths or party decorations.
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 5
T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7 / 5
The whole staging of the pantomime had to be dismounted on the last night after a party and there was a traditional rag that was not always too funny. The presence of scaffolding, bricks and cement everywhere, offered opportunities for placing a car on the roof of the Infirmary, walling up the main entrance, unseen by Ted Maloney (described in a Tynchewyke pantomime as "operating as quickly as he eat") in a Bentley swinging, as usual, speedily into the car park. He proudly hung a framed photo of the wall given to him by the Society. The Canteen rather shamefully was the focus of some destruction costing £ 14 2s 10d by a student rag fifty years ago. It cooked "for all", but doctors and Nurses had their own dining rooms and even at night were fed separately. Only one or two "left wing" physicians joined the mob in the main Canteen that included medical students. Cabbage and mince were especially unappetizing. After the destruction of some of the equipment and redistribution of some of the mince by some from the Tynchewyke party “His Serenity” returned and stood outside from 6am, because as Secretary of the Tynchwyke Society, he accepted responsibility. A queue of senior administrators and shocked Governors of the hospital had to receive apologies, but a letter from Jumbo Burrough apologised for having called the police. The Regius Professor imposed an enormous fine of £20. This was secretly paid by Ted Maloney a senior surgeon. The removal of the painting of a Latin proverb on the front of the Radcliffe, referring to sadness after coitus, was also the job of the painters in an era much less scarred by graffiti than now. The painter had foolishly thought that the Press would photograph the Graffiti not understanding Latin: but this was the Oxford Times in a city where at this time Latin was still a familiar tongue... Jumbo Burrough after the canteen episode put it politely in a letter "I am all for a bit of a party but unfortunately this one showed lack of originality or humour and got itself beyond the pale". The Rag was eventually disbanded once women were permitted into the Society.
behaved girls were welcome as they ate little. In Sister’s office there was usually abundant gifts of mince pies, nuts and chocolates. One patient who had a stroke and who had never spoken for many months, noticed nevertheless one medical student partial to chocolates and shouted out loudly "Feeding yourself again! " This was the time of the Welfare State so donations to wards were forbidden except at Christmas when for one week relatives could be charged a penny for a cup of tea. Alcohol and smoking were not greatly inhibited in the hospital. Many patients were prescribed a bottle of Stout. There was sherry in the surgeon's room and in the cupboards of most of the ward sisters. As medical students it was possible to meet on the wards for a cook up and a little drink between night Sister's thrice nightly visits at fixed times... The distances she covered were greater than a traffic wardens beat and as predictable. "If you go down to the wards today, You're sure of a big surprise. If you go own to the wards today. You'll never believe your eyes, For every ward is a den of vice And every nurse so thoroughly spliced That they can't tell the drunk from the recently dead or dying"
“The first year nurses are finding it hard To standardize their drink. They practice hard without regard On uraemic Mr Spink. They give him rum his thirst to quench And a bladder wash out with gin and French He's down in the records as having delerium tremens”
Another twenty years were to go by before the habit of admitting patients because it was Christmas was discouraged. Many patients had no where to go and it was accepted policy that in spite of beds sometimes put up in the centre of the ward none should be refused a bed at Christmas.
Patrick Ryan was admitted with kidney problems and noted to have an aberrant radial artery. His priest joined him on leave from the ward for a visit to Lourdes. On the way back, in a drunken stupor Patrick was found to be pulseless by his priest unable to rouse him but feeling for his pulse. On receiving an emergency call we arranged an ambulance to pick him up from London airport... He had woken up by the time he returned to the ward. It was the priest that was given a stiff drink to revive him in Sister's office.
Christmas day traditionally produced a Christmas meal for each ward and the Turkey was carved by a Senior doctor. Nurses and ward cleaners would have the leftovers, but one surgeon was overgenerous to young male members of his own large family accompanying him. Most surgical wards would hope it was not their turn to host him because the nurses and ward maids were left without a turkey lunch. Mr Till's family of well
Drunks were less of a problem than today. One night porter on duty was enough to manage the occasional alcoholic, although occasionally staff in the small casualty were chased along corridors. If one was foolish enough to escape up some stairs towards "records", poorly lit at night, it could be difficult to exit without injury: as occurred to one medical student on one night when an over excited sailor recovering from an epileptic fit, took
Many patients were prescribed a bottle of Stout. There was sherry in the surgeon's room and in the cupboards of most of the ward sisters.
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 6
6 / T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7
fright at being approached with a large syringe of paraldehyde and swung a bucket of plaster of Paris as he chased four students down the corridor and up the stairs. The casualty department was often quiet at night. 'A cushy job' stated one nurse interviewed. Nursing staff would be switched to other parts of the hospital because there was so little to do… BID "Brought in dead" meant no need to enter casualty; GPs visited home at night; suicides were rare and many injuries “would wait to the morning to avoid causing the hospital any worry”. In spite of having time to record events in long hand in some detail, abbreviations were in vogue. Alex Cook gave a popular lecture on the abuse of abbreviations in patient notes. ENT with terms such as BAPWO headed the list of miscreants (bilateral antral
puncture and washout) but in practice every discipline had its own coded language…"WOC” meant "words of comfort”, but one day a patient with a nose bleed that had stopped by the time he had entered casualty, came back after a few days to return his walking aids. "Walk on Crutches" had been the interpretation. These were days too when safety and anaesthesia were still primitive. Ethyl chloride spray sprayed onto a Gauze mask was not always speedily sleep-making and cries of children, usually twelve in a one hour tonsil guillotine session were unheard because Mrs Dale's Diary was turned on fully from 4pm. Children were bound up in green hospital sheets and sat on the floor outside the operating theatre. This radio also was over worked and needed high maintenance often within few minutes of the start of a session.
It Must Be Said…by Seymour Spencer There were no retinues of junior staff in those days. You were lucky to have one qualified houseman on a firm containing seven or eight students
t was wonderful to be a clinical medical student in Oxford during the period of the initiation of penicillin at the Radcliffe Infirmary. As a member of only the second intake of medical students I started clinical work in 1941 qualifying in 1943. The Radcliffe Infirmary was still an elaborated cottage hospital, embellished with Nuffield Professors and that wonderful teacher, Alex Cooke. They were reinforced, after retirement from London teaching hospitals, by the rather deaf, quite eccentric, but delightful Sir Arthur Hurst for medicine and the less charismatic, but sound and charming Professor George Gask for surgery. There were no retinues of junior staff in those days. You were lucky to have one qualified houseman on a firm containing seven or eight students.
I
At that time the only antibacterials were sulphonamides, particularly sulphathiazole in this country, the basic, sulphapyridine, being often toxic. Within a matter of weeks of the introduction of penicillin, sulphonamides disappeared. However until America took over production on a large scale, the availability of penicillin was highly limited. The usual dose was 10,000 units by injection, with recycling of the penicillin out of the patient's urine: oral penicillin appeared much later. Nevertheless the effects were miraculous. I recall in particular a boy in his teens who was obviously dying of septicaemia, secondary to osteomyelitis, with numerous purulent sinuses emerging from one of his legs. Forty eight hours after starting penicillin the purulation stopped, the sinus wounds came clear, then healed; and the boy's 'general condition started to improve wonderfully, leading to full recovery. Lady Florey, Howard's then wife (the marriage was soon to break up) carried out
clinical research wearing what looked like horns, but which were in fact high-powered deaf aids, whilst the modest Norman Heatley did much of the basic elaboration of the penicillin. After a comparatively calm medical firm under Alexander Gibson, which was old fashioned even in those days with “cupping” still being practiced, we all moved to surgery under Arthur Elliot-Smith. On our first day the house surgeon, Sylvia Lucas, blond and delightful, assembled us. She informed us that she was going to London to do her MB BS as she was only qualified in Conjoint. There was a large list for surgery the next day and we would have to assist. Sylvia looked down her list and said that the first operation was total gastrectomy for carcinoma. One of us would have to take it — she pointed to me… luckily Arthur was equal to any potential staff problems. He had operated for years before he came to the Radcliffe with just a theatre nurse. Meanwhile it was my first meeting with forceps, Alice's and Spencer-Wells. I had little to do except hold them while Arthur sutured around them. I came through the ordeal, but the operation proved purely palliative: the patient lived for only a further ten days. At that time we students did all the routine things like cutting out ganglions in A&E, lumbar puncturing, assisting with plastering for fractures. Naturally moronic mechanically, I did seem to improve as time went on but was never in easy touch with the spinal cord. We were later allowed to apply, if we wished, to be dressers on Nuffield 1 ward. To my joy, Ian Neill, later to be my GP, and I were selected. Charles Whitty was already operating as a consultant neurologist together
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 7
T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7 / 7
with Sir Hugh Cairns, Nuffield Professor of Surgery and Joe Pennybacker. All were wonderful neurologists as well as neurosurgeons. Again we students were allowed to do everything from detailed examinations and lumbar punctures to mapping visual fields on a huge black screen, dressed fully in black. We were delightfully treated by the surgeons and, especially, Ward Sister Day, who was known as Daisy when in her good books — luckily we both were — she was splendid support. It was a huge experience. After the final exams to my surprise, I was offered the post of junior house surgeon in obstetrics and gynaecology. The firm consisted of Chassar Moir, Nuffield Professor of Obstetrics & Gynaecology, his first assistant Scott Russell, brother of Ritchie and shortly to be Professor of Obstetrics & Gynaecology in Sheffield — and me. I assisted at all the operations. John Stallworthy, the dynamic consultant on the other firm,
was so inundated with patients with so few qualified assistants that I had to help his only — qualified — house surgeon, Mary Richardson. We dealt with a gamut of patients with no assistance, however one day John called the two of us to him: he was happy with our work, he said; but a GP had asked if his patients might be drawn, momentarily at least, to his attention. We tried; he was not well pleased at the distraction from his own work, became increasingly perfunctory over the supervision, until, before the huge clinic was over, the status quo was resumed. Though I knew I could never specialise in any form of surgery, this job was a wonderful experience in which I was unceasingly affirmed by both Chassar and Scott. Knowing that John Badenoch and Gerald Swyer were bound to get the only two medical jobs I wanted, I moved before army service to Newcastle, to become House Physician to Cardinal Hume's father.
Enhancing the memory of Sir William Osler in Oxford he timing of the purchase of 13 Norham Gardens by Green College coincided with the foundation of Oxford Medical Alumni as an alumni organisation for the Division of Medical Sciences at Oxford. This has been followed by the closure of the Radcliffe Infirmary. Together these three notable events have a common nostalgia for the history of Oxford Medicine.
a book of photographs, and a DVD of interviews, the old building, the original façade, and the chapel will be preserved: but quite how well the interior, the gold leaf list of donors to the hospital painted on the walls of the Boardroom, the portraits of it founders, in particular the Peter Greenham portrait of Bevers, will fare, is unpredictable.
13 Norham Gardens is a typical ‘north Oxford’ house, originally built for the Public Orator, and placed in the archives of the history of European architecture in the mid 19th century as a fine example of Victorian city architecture. However by virtue of housing the Connybeares, William Osler, George Pickering, Richard Doll and Lord Walton its links with the history of 20th Century medicine are even more extraordinary and worth preserving.
At 13 Norham Gardens changes in the last year have included an enhanced academic role and potential for the Reuter Foundation as a University Institute. The Newcomers Club continues the traditions of hospitality for which the Oslers made 13 Norham Gardens so well known, in its valued role hosting the partners of academics. In the midst of all this is the OslerMcGovern Centre, with its Seminar Room and the well preserved Osler Library. Both rooms contain some of Osler’s furniture; the Seminar Room has the fireplace that Lady Osler brought from her home in Philadelphia.
T
Although traditionally Oxford ‘s links with its old members were mostly through the Colleges the Oxford Medical Graduates Club had a long history of serving the need to keep medical men, and later women, in touch with their medical school. Oxford Medical Alumni continues to strive to record and preserve the history of medicine at Oxford and is always keen to record the lives, careers and achievements of the men and women who have studied, taught and worked in Oxford over the past 700 years. The Radcliffe Infirmary has a most unusual history of many generations of contributions to medicine. Many of us regret that its managers have done only little to see that its past is well celebrated as it closes. There will be
Sir William Osler left his own library of books to McGill. To enhance the value of the Osler Library for Osler visitors and for visiting researchers Lord Walton began to collect some excellent souvenirs, the Pickerings and the Dolls too donated Osler mementos they had acquired. The shelves began to be filled by various collections but when Lord Walton left Green College taking his personal library with him the Osler Library shelves needed filling with replacements. One source was Larry Bachmann, a Visiting Fellow of Green College who had been the European Director of MGM. He left for California and after Sotheby’s and his relatives had taken away any books they wanted I
We want the library to be looked at with interest and to differ from the main Osler collection housed in McGill
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 8
8 / T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7
had two hours to collect the books Green College might want. I estimated there was 70 feet of bookshelves to fill and that 700 books would be enough. I was 10 books in excess. However not all of these books were “academic’ enough for a college library or in any way relevant to Osler. Since receiving these books, more appropriate books for an Osler library have gradually been acquired and in the last weeks of 2006 the proceeds of a book sale of the less relevant items have been used for re-binding some of the more interesting but damaged material.
One of the reasons for writing this article is to ask that no one ever throws anything away without first letting me know
The main source of books and archives has been the large archive left by Alasdair Robb-Smith, to whom we owe so many accounts of places and people. Nicholas Dewey has too added his own collection for which we are most grateful. When Peggy Pickles, Alasdair’s wife, died in 2006, their house in Woodstock which in itself has early links with the brother of Chaucer, was emptied of everything except for two shelves. These shelves had a scribbled note pinned to them donating the contents to Green College. Had this not been done then it is possible that the solicitors would, I suspect, have placed it in a bag for the incinerator. Upon investigation the shelves contained not only some useful archives about the Radcliffe Infirmary but also the deeds of the house and about £5000 worth of National Savings certificates. The Wellcome Unit for the History of Medicine in Oxford hosts the International Archive of the History of Leprosy. The archive of the history of this disease is particularly comprehensive because its early documentation as LEPRA was an interest of Alasdair Robb-Smith who handed on several 17th to 20th century texts. The future of the Osler Library is to be based upon an idea that came to me while reading through some of the Osler collection. We want the library to be looked at with interest and to differ from the main Osler collection housed in McGill. We will therefore focus on the History of Oxford Medicine and collect material by and about Osler which is especially relevant to his time in Oxford. A special theme relating to his small interest of Oriental Medicine will be “Public Health before and after Osler”. There will also be a focus on Other Systems of Medicine which is of special interest to current medical students when they elect to study special subjects. It was while looking through the Osler Library holdings that it occurred to me that as Osler material we should perhaps collect writers who were contemporary and preceding Osler as a comparison for anyone investigating
Osler’s own publications. Was Osler really the best? In the context of other writers of the time I have therefore accepted from Dr Grahame Johnstone his father’s collection of history of medicine that includes the histories of many British hospitals. The Osler Library will house the main medical texts of the late 19th century and 20th century especially those that were originally in the library of physicians such as Sir Thomas Lewis. In the context of public health the library begins with Acland’s account of the Oxford Cholera epidemic and Florence Nightingale’s notes on nursing. Finally my own contribution to archiving is to record ‘below stairs’ at the Radcliffe Infirmary and to try to make sure that we know as much about the boiler room as about the emphysema ward. In addition to books we are lucky to have recently acquired original cine film of some of the physicians and surgeons around in Oxford in the 1960s including footage of Witts, Ritchie Russell, Pennybacker, Chasser Moir, this has been put onto DVD. There is also a very excellent scrap book from the Radcliffe Infirmary laboratories post 1939. A little while ago I rescued from the Sir William Dunn School some items relating to the penicillin story from many years ago, and so that story too is enlivened by not just being books. One of the reasons for writing this article is to ask that no one ever throws anything away without first letting me know. We would particularly like additional complete editions of The Oxford Medical School Gazette from 1949, The Radcliffe Guild of Nurses Reports from 1925 and the United Oxford Hospitals Chronicle from 1965–1974. However photographs, autobiographies — published or not, Tyngewyck programmes, student notes, menu cards, postcards, drawings, cartoons, and text books in fact anything is of interest to us. Do let us know.
Terence Ryan. Vice President and Archivist of Oxford Medical Alumni can be contacted via Jayne Todd at Oxford Medical Alumni.
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 9
OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7 / 9
Some Reminiscences of Starting a Career in Medicine had the good fortune to be the third generation of my family to attend Bradford Grammar School where, at the beginning of the 1960s, we were told that there was a shortage of doctors. Therefore in anticipation of job security, and with an altruistic desire to do my little bit to relieve human suffering, I found myself in Oxford intending to write the Hastings scholarship exams. Instead I found myself in the Slade Isolation Hospital suffering from chicken pox! “Don’t worry, Mr. Craven,” said some kindly gentleman in academic dress, “Come back next month and try again.” That caring attitude and personal attention, characteristic of the tutorial system, continued throughout my four years at Oxford.
I
I did return the following month for a week’s intensive written and practical exams, and interviews, and found myself the following September at Brasenose assigned to George Gordon for moral and academic supervision. Not that we needed any moral guidance; we medical students were far too busy with lectures, dissection, laboratory work, essay writing, tutorials and library reading to wander off the straight and narrow. We did not have that much time to take advantage of the innumerable social and sporting activities which were available, and the one and only private society I was able to join was the Osler Medical Society. The great advantage of Oxford, which I exploited to the full, was the 16 week summer vacations, coupled with the bucket shop airline tickets which were available in those days; I was able to obtain temporary employment in distant parts of the world. My first
such job was in the Anatomy Department at Emory University in the USA — arranged through the good offices of Graham Weddell of the Anatomy Department. Next year I found myself digging holes in the roads of Victoria, Australia. After the BA animal physiology exams I went nursing in the Old Transvaal — good practical experience — and hitch-hiked as far north as what was then Elizabethville before flying home. Indeed, my ‘golden thumb’ meant I could hitch-hike between home and Oxford faster than the railway company could transport me. After finishing the pre-clinical course I went to India to teach science making connections which I have maintained ever since. That was arranged through the good offices of an old boy and Rhodes Scholar, Chandu Bardhan. He subsequently became consultant gastro-enterologist in Rotherham. I went north for clinical training at Leeds, and discovered that the long holidays no longer existed. All we were allowed was a few days between attachments to the various clinical firms. But I was awarded a Nuffield Travelling Scholarship which took me to New Delhi for three months. Instead of flying home I cashed in my return ticket and traveled overland by public transport. After graduation I worked the customary 6-month house jobs, and then went to Iran as medical officer with a speleological expedition to the Zagros Mountains. On returning to England I was appointed assistant in general practice in Harrogate.
S.A. Craven, Brasenose 1962.
From the archives … (1950)
Required — a Gardener for the Medical School
Sir Henry Acland Regius Professor of Medicine 1858–1894
During the first six months you will receive £4.10s a week, after 6 months of satisfactory service this will rise to no more than £5 a week. You will also receive free unfurnished accommodation at Osler House and your electricity, gas and coal bills will be paid. In addition you will also receive a wife allowance. You will be entitled to all public holidays plus two weeks in the summer.
we medical students were far too busy with lectures, dissection, laboratory work, essay writing, tutorials and library reading to wander off the straight and narrow
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 10
10 / OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7
Resident Pathologist — 1965 y arrival in the Pathology Department in early 1965 did not follow the conventional route. During my second house job in 1964, on considering career alternatives which included some pathology research I wrote to Dr Robb-Smith enquiring if there were likely to be any SHO posts available in his department in the near future. The answer came back ‘no’, they had recently been filled. But about two weeks later an unsolicited letter arrived saying that someone had dropped out of the rota and would I come for immediate interview and when could I start? I had by then been offered a job with the ICI Industrial Hygiene Research Laboratory in Alderley Edge, Cheshire, near to my birthplace. However the decision to stay with the NHS, especially in Oxford, was not a difficult one.
M
“…you enjoy a secure post in one of the best universities in the world in one of the most beautiful cities in the world. Your quality of life is second to none.”
I was duly appointed to the vacant post and arrived (with a newly acquired wife) in Oxford at the end of January 1965. It turned out that Resident Pathologist was really a euphemism for ‘cheap labour at night’. There were just two of us on the rota and we were on call alternate nights for emergency pathology services. This consisted largely of cross matching blood for surgery but occasionally included a wide range of biochemical and bacteriological tests and even exchange transfusions for severely affected rhesus babies. A crude estimate is that we were called out of bed on alternate nights that we were on call; that is, about twice a week. There was no suggestion that a bad night should be followed by a day off duty. Although the night call might just be for a couple of bottles of blood — ‘in case’, on a few occasions most of the night was spent at the bench. The most notorious being when I cross matched over 60 pints of blood, most of it for three major operations by Alf Gunning all through the night. One might ask what is the point of cross matching the blood of patients who have already been transfused 15 pints? At first I was expected to be on call in a room in a hospital house on the Woodstock Rd just across from the main entrance of the RI. However since I lived in a flat less than 100 yds from the hospital gates, I eventually persuaded the ‘powers that be’ (I can’t now remember who that was) to allow me to be on call from ‘home’. Interestingly home was a second floor flat over what was Twinings grocers (now Maison Blanc) and Turners garage (now Browns restaurant). Initiation into the job was rather a surprise. One was given an intensive, one week course in the most important techniques such as grouping and crossmatching blood, Coombes tests, inspection and culture of CSF, Hb and blood counts, blood sugar, bilirubin,
urea etc. and then pitched in at the deep end. The first night on call was, like so many firsts as a junior doctor, a bit ‘hairy’ but one survived as one does. My senior colleague, Ann Paxton was an old hand by the time I started and was very supportive and helpful. Indeed my memories are that we worked well as a team and never had major disagreements. Ann’s subsequent career was in haematology in London and I now see that she has retired to Somerset. Later in the year, after Ann’s elevation to registrar, my new colleague was Angus MacIver with whom, again I was fortunate to enjoy a good relationship. Angus sadly died some years ago after a successful career as a histopathologist at Southmead in Bristol. Inevitably ones strongest memories are now of the characters and events that shaped ones career. In my case that event probably was the early allocation of the next registrar post (the one that I might have hoped to be appointed to) to a more senior colleague, David Speller, who was already a medical registrar but decided to pursue a career in Pathology: he later became Professor of Bacteriology in Bristol. I was then advised by haematologist Alan Sharp and Bacteriologist Joe Smith to transfer to the University Dunn School of Pathology and study for a DPhil. I was lucky enough to be accepted by the then new professor, Henry Harris, and awarded a Philip Walker studentship for financial support. Thus began my academic career and the beginning of the rest of my life in Oxford; not a bad fate! On occasions when I have moaned a little about how little I was earning as a university lecturer compared with my NHS consultant or professorial colleagues I cannot escape recalling the admonition of a very large Colombian-US gynaecological pathologist, Hernado Salazar, who was spending a sabbatical term in my lab. I was told very firmly ‘to shut up — you enjoy a secure post in one of the best universities in the world in one of the most beautiful cities in the world. Your quality of life is second to none”. The memory always makes me feel better and humbler. Nevertheless one can’t entirely resist the temptation to speculate on what might have been ones fate if that registrar post had been available and one had stayed within the NHS. But to return to the Radcliffe Infirmary in 1965; life during the daytime in the Gibson laboratories was generally rather pleasant; one had few responsibilities — it was very clear that one was employed principally as night cover, and of course, to learn the trade of pathologist. The support to do this was excellent; not
RI supplement latest copy:Layout 1
12/2/07
14:28
Page 11
OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7 / 11
only was there a set of distinguished consultants around to apprentice oneself to but there was a large body of very experienced technicians who were usually willing to spend time explaining the intricacies of their subject. There was also a healthy research culture in the department which was particularly important for me since I was convinced I wanted to be a researcher. This culture was perhaps led by Professor Glyn Macfarlane who by then was close to retirement as Director of the MRC Blood Coagulation Unit and Professor of Clinical Pathology but was regularly seen in the haematology department at coffee time when he would gather his ‘disciples’ around him and discourse on almost anything. Also Alan Sharp and Joe Smith were always ready to advise on any suggestions for research projects, however impractical they might have been. I have memories of investigating the ultrasound fragility of red cells from patients with haemolytic anaemias and machines to measure the clumping of platelets. One surprise was that the SHO training rotation didn’t include any morbid anatomy or histopathology and one consequence of this was that contact with Dr Robb-Smith was rather minimal — unlike that with his wife, usually known as Peggy Pickles. Peggy was in charge of Serology and Blood Transfusion and since this department was generally regarded as the ‘Residents’ base (after all, all the night-time crossmatching was done here), she became the Residents’ de facto ‘boss’ and in some ways, the one to be most feared. She had an uncanny knack of finding out about anything that had gone vaguely wrong, even though she was apparently nowhere around. The senior technician in the department, Nesta Dean, was the one who really provided the basic training for our night-time vigils. I seem to remember that this department was not sited physically in the Gibson building but next to Willis ward, the territory of the Nuffield Professor of Medicine, then Leslie Witts, soon to be succeeded by Paul Beeson. If the emergency was bacteriological rather than blood based, then a trip to the ground floor of the Gibson building was called for and this, in the dead of night, could be a rather spooky trip involving encounters with large numbers of scampering cockroaches. And if CSF, possibly infected, was involved then the spectre of Roy Vollum loomed large. He was to be informed and he gave the impression that he did not trust any junior to be competent in handling these specimens. The image gained of Roy, first from the Dunn School practical classroom, where again his presence always seemed threatening, and from the hospital laboratory, was strangely at odds with that presented in his obituary where he was described by Robb-Smith as “the kindest of men…a generous colleague... a delightful companion — a
man of wide interests and an unfailing sense of humour“. One of the joys of the department was the research laboratory run by John Morton. This was usually a haven of peace and quiet and friendship and, not least, of sound scientific advice. After a bad night it was just the place to pass a few hours. John seemed to know all relevant clinical and research techniques and though extremely modest himself he was good at passing on his knowledge. John was a keen photographer and has left behind catalogues of photographs now in the archives. Like John a number of long-serving technicians in the department had done PhDs or DPhils and were valuable sources of advice to us novices. Notable amongst these was Mick Allington, the lab’s head technician and George Higgins, who ran Biochemistry with a rod of iron. The lab was a sociable place and it was common at the end of the day for numbers of the staff to retire across the Woodstock Road to the Royal Oak where one could meet new colleagues informally. In this way I became good friends with two senior registrars, Jim Strong and Michael Severn. Jim emigrated with his dentist wife and four children to Canada soon after I left the Radcliffe but we have remained in close touch and a few years ago my own family enjoyed a wonderful holiday in his up-country retreat on Manitoulin Island (where he now lives in active retirement).
If the emergency was bacteriological rather than blood based, then a trip to the ground floor of the
Looking back over 40 years I now see 1965 as a valuable and largely enjoyable time in the evolution of my unplanned career. My one regret is that although I have remained in touch with several of the staff of the John Radcliffe Hospital Pathology department neither I, nor anyone else has managed to achieve any real integration between the two departments. I think that the legacy of Florey, who was apparently rather contemptuous of ‘clinical research’, has been too strong. Eric Sidebottom
Gibson building was called for
RI supplement latest copy:Layout 1
12/2/07
14:29
Page 12
12 / OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7
Memories of the Radcliffe Infirmary arrived at Magdalen College in 1958 intending to read PPE and become a barrister. Philosophy was my main interest and I quickly changed to PPP, reading philosophy and psychology as my options. Through psychology I came to find biology much more interesting than what I gleaned of the law from eating dinners at the Middle Temple. In the summer of 1961 I wrote to my senior tutor (the late Sir Geoffrey Warnock) and asked if I could remain in residence after completing my B.A., to read medicine. As I recall I got a two-line reply confirming that I could. That was the full extent of my application and acceptance to read medicine in Oxford.
I
I felt extremely faint and have a hazy recollection of fantasising that the patient was about to be cut completely in half
Thanks to the extreme flexibility of the university statutes, the fact that courses in basic physics, chemistry and biology were available and the support of all those around me, I managed to complete studies in basic sciences and the examinations in physiology, anatomy and biochemistry in two years. In the course of those two years I have memories of twice attending the Radcliffe Infirmary. On one occasion I went with a group of pre-clinical students to see an operation. I have no recollection of being told beforehand what operation we were going to see. I have no recollection of putting on much in the way of special clothing. The operation appeared to be taking place in some kind of shed / outhouse with a bare floor and doors which opened to the outside, as I recall. Predictably, when the first incision was made for what turned out to be a nephrectomy, I felt extremely faint and have a hazy recollection of fantasising that the patient was about to be cut completely in half. The experience did not reaffirm my wish to become a doctor. My second visit was to a clinical demonstration by an august neurologist who had asked a patient with myasthenia gravis not to take his neostigmine that day until the demonstration had taken place. We were
Radcliffe Infirmary, rear view
told briefly about myasthenia gravis and the patient was then given his medication and, before our eyes, lost his spreading paralysis. This left me with a totally wrong impression that neurologists generally had wonderful cures for all their diseases. I was able to combine three years of clinical study with studies for the pathology, bacteriology and pharmacology examinations which ordinarily took up another two academic terms so that with general support and statute flexibility I was able to complete the whole study of medicine from basic science through to graduation in 4 years and 9 months. Or that was the plan until I encountered my finals in June 1966. I was due to see a particular surgical examiner at the Radcliffe Infirmary for my viva on surgical instruments. I now recall him he as at least 10 feet high, and there he was with a bag full of instruments which, quite possibly, had not seen service since the Crimean War. I was shown a long black rod, rounded at one end. I had never seen anything like it before and hoped that no fellow human being would ever be required to use it or have it used upon them. He demanded to know its clinical purpose. It was clearly too long for paediatric use without fatal consequences. Struggling, and noting its diameter and curved end, I suggested it might be some kind of dilator. This got a nod of approval and I was asked to think of some passage in the human body down which it might usefully be passed. It was clearly not of sufficiently generous proportion for any use on the respiratory or gastro-intestinal tract or the female genital tract and by elimination I plumped for the male urethra, not without feelings of acute physical discomfort. Clearly I had taken rather a long time to reach this conclusion and my interrogator was becoming impatient. He now demanded to know what it was made for. After making me feel very small indeed he demanded that I recite the full title of this rare instrument and I finally managed to stammer out that it must be a ‘gum elastic urethral dilator’. This was followed by my clinical examination in obstetrics where, there appearing to be nothing wrong with the mother at all, the only observation of any possible originality which I had to make to my examiner was that the mother wanted her baby. This gained a great deal of approval and may have well helped to mould my future career choice of psychiatry. I enlisted for the conjoint examination and, as I recall, did become qualified within my target of five years, having returned to Oxford and managed to satisfy a more affable surgeon about my knowledge of surgical instruments, thereby gained my Oxford degrees.
Christopher Howard
RI supplement latest copy:Layout 1
12/2/07
14:29
Page 13
OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7 / 13
Farewell to The Radcliffe he last Saturday in January 2007, a rather special event took place marking the closure of the Radcliffe Infirmary and celebrating its remarkable life over some two and a third centuries. Although none of the original staff were quite able to make it, a fair sprinkling of their successors did manage to come along and mingle with the great and good, and even perhaps some of the not quite so good, over tea. Soothing words were spoken from the platform, and relayed from the Chapel Service into the Marquee, surreally covering the entire car park, fountain and all, for once strangely devoid of cars.
T
Then there was the chance to tread those old, cold stone stairs and corridors just one more time, have a final peep around that splendid original boardroom, and let the individual memories come flooding back. For that, I rather suspect, is largely what it was all about for most of us. A last opportunity to reflect, either privately or shared with other fellow travellers, what the old Radcliffe had meant to each of us and how it had touched all our lives.
Radcliffe Infirmary, Ward 3
However, we must all move on and surely the spirit of John Radcliffe is alive and now flourishing up the hill. But I couldn't help thinking as I walked away, imagining the Bull-dozers soon closing in, I somehow doubt that Oxford Medicine will ever be quite the same again without the Rad. Richard Maxwell
Pageant at the Radcliffe Infirmary
Her Majesty Queen Elizabeth and Lord Nuffield
RI supplement latest copy:Layout 1
12/2/07
14:29
Page 14
14 / T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7
Brief Histories of the Triton Fountain, the Boardroom and St Luke’s Chapel at the Radcliffe Infirmary pon the death in 1724 of John Radcliffe, physician to Queen Anne and a graduate of Oxford University, the residue of his estate of £140,000 was divided between University College and his trustees, who subsequently used the money to build the Radcliffe Camera Library, the Radcliffe Infirmary and the Radcliffe Observatory in Oxford. The Radcliffe Infirmary admitted its first seven patients on 18th October 1770, St Luke’s Day.
U
The Fountain
The figure of Triton blowing on a shell is the work of John Bell, a distinguished sculptor of the Victorian era
It was not until 1857, at a time of major building work that the fountain was suggested as part of an overall plan to improve the front courtyard of the hospital. The minutes of the weekly Board of Governors record that in a meeting on 10th June 1857 ‘permission was given to place a fountain in the centre bed of the Grassplat provided none of the expense falls upon the funds of the Infirmary’. The minutes of the 17th June meeting deferred a decision on this ‘recommendation’ to the Quarterly Court and on 1st July approval was given. ‘The Weekly Board was requested to superintend the Execution of the Work’. At the same time the front wall was to be reduced to its present height with iron railings on top — these were removed during the scrap iron collection in the Second World War. At the Board meeting on 8th July the Fountain Committee was appointed, ‘to consist of Mr Slatter, Mr Briscoe and Mr Vincent’. The design for the fountain was presented to the Board on 5th August and was accepted. The execution of the plan was implemented with equal speed and the Annual Report of 1857 reports that, ‘A great improvement has been effected in the external appearance of the Infirmary by the erection of a Fountain and the substitution of iron railings for the dead wall in front. The increased cheerfulness of the place has already been felt by patients.’ The full list of contributors to the Front Quad refurbishment appears in the Board minutes of 17th February 1858. The 64 entries total £94.5s.0d. Thomas Briscoe appears twice, as the largest single contributor — £20 — and again alongside — ‘The Balance’. There is no indication of the total cost of the scheme. Nor is any information given about how the Triton design was chosen for the fountain. The figure of Triton blowing on a shell is the work of John Bell, a distinguished sculptor of the Victorian era, who received numerous commissions for Royal and
other official works. His best know pieces include the Wellington memorial (1856) and the America group finished in 1878 as part of the Albert memorial both in London. The fountain was executed in terracotta before being cast and set in its location at the front of the Infirmary.
The Boardroom The main entrance to the hospital was originally on the first floor approached by a pair of curved staircase from the forecourt, though these were removed. On the first floor opposite the then entrance hall was the Committee Room which was renamed the Board Room. The present Board Room was at the centre of the building and contained a set of mahogany chairs purchased for the room and still in use up to the closure of the hospital in 2007. The walls record in gilt the names of the numerous benefactors over the centuries, which often served to relieve the tedium of lengthy meetings.
Extracts from the Board Minutes: 3rd March 1866 — Resolved that a sub committee be appointed with power, after communication with Dr Acland, to arrange the position of the Clock, and notice Tablets in the Committee Room. 3rd June 1891 — Proposal for entire demolition of the Old Block and the building of a new Front Block’. 17th July 1907 — It was resolved that the list of benefactions and legacies be brought up to date — and only legacies of £20 and over, and benefactions of £25 and over to be recorded in future.
On the walls: 1761 Richard Frewin MD, Camden Professor of History, in trust that the annual interest on a sum of £2000.0s.0d be paid to the physicians of the Infirmary From 1774 until 1959 a sum of about £60 was shared between the senior physicians each year. However the practice stopped in 1960 when the Ministry of Health informed the Governors that they were in breach of NHS regulations. The sum was used to pay for the annual Frewin Prize given annually for the best memoir submitted by a registrar. 1796 Mrs Elizabeth Wickham, widow of Mr William Wickham, mercer, £1000.0s.0d 1800 A fine of 100 marks received by the University £66.13s. 4d. 1807 Sir Robert Newdigate, Bart £100.0s.0d. 1814 Alderman John Parsons £1000.0s.0d. This is probably a member of the Parsons family of bankers who were at the Old Bank, High Street, Oxford
RI supplement latest copy:Layout 1
12/2/07
14:29
Page 15
T H E R A D C L I F F E I N F I R M A RY . F E B RUA RY 2 0 0 7 / 15
from 1771 until 1900. 1816 Timothy Steevans, manservant to Miss Longhams £10.0s.0d. This sum was the lower limit for recording on these boards and is therefore likely to indicate that for this person this was a very generous amount at a time when the annual pay for a butler to a member of the nobility would only be in the order of £50 a year. 1835 Her Majesty Queen Victoria £50.0s.0d 1839 Grand Duke Alexander, hereditary prince of Russia, later Tsar Alexander II £100.0s.0d 1870 Harmoniacs Society £30.0s.0d 1875 Great Western Railway given in response to the Infirmary’s handling of the Shipton railway accident in which 34 people were killed and over 100 injured. 1878 Bath and West Agricultural Society 1881 Oxford Races proceeds from the races on Port Meadow. 1883 C Morrell Esq. London £450.0s.0d One from a number of entries recording bequests made by family members of Morrell’s Brewery, or the solicitors Morrell, Peel and Gamlen, both of which were established in the late 1700s. 1898 Farmers Oratorio Choir 1899 Mrs and Mrs GH Morrell in commemoration of Silver Wedding £250.0s.0d 1900 HRH the Crown Prince of Siam £10.10s.0d. The future purpose and function of the Boardroom with these historic records painted upon its walls is as yet unknown.
St Luke’s Chapel In October 1861, the Radcliffe Infirmary Chapel was in the room immediately above the Board Room and, the altar being in the west window, the worshippers had to turn completely around to face the east on the recitation of the Creed. The Quarterly Court of Governors acting upon an observation from the House Visitors that ‘there were no sermons on Sunday afternoons’, and that a ‘more judicial arrangement of the seats in the Chapel might have a good effect’, decided to appoint a Chapel sub-committee. The sub-committee reported on 9th April 1862 that the Chapel ‘is so unworthy of the Institution...cannot provision be made for supplying this need...’ . In response Thomas Combe, a governor, offered to build a Chapel, on a site to be provided by the Governors. This generous offer was accepted, and the Rector of Exeter College, the Mayor of Oxford and the Treasurer of the Infirmary were appointed to find a site. Mr AW Bloomfield (later Sir Arthur), the architect chosen by Thomas Combe, was also the son of the Bishop of London, and at that time was beginning to make his reputation as an ecclesiastical architect.
Bloomfield proposed that the most convenient and artistically appropriate site would be at first floor level between the front entrance and the Triton Fountain, with space for a crypt or lecture rooms below. At that time of course the main entrance to the Infirmary was at first floor level, approached via external stairs either side of the door way. An alternative was to place the Chapel on the North side of the site adjoining the Observatory gardens. The Court of Governors decided on the latter plan, and the required strip of land was given by the Radcliffe Trustees. From the start Combe took great interest in the design and furnishings, which together cost £3000. The Chapel is in a simple Early English Gothic style with a bell turret, the sculpture work believed to be the work of a Mr Earp. The means of joining the Chapel to the main hospital proved to be a major problem, one idea was a tunnel which was rejected because it would be ‘reminiscent of passenger tunnels under the railway at Didcot’. Bloomfield favoured a cloister giving free access to the rear and to the garden ‘even for a man with a barrow’. The discussions rumbled on and even though Bloomfield’s idea was accepted it was still a source of trouble and was really only resolved in 1995 when a new bereavement service led to major refurbishment and carpeting of that area.
The Chapel is in a simple Early
The Chapel was consecrated on 7th June 1865 and the sermon given by Bishop Wilberforce. Combe was appointed Chapel warden and the Revd RH Charsley one of the joint chaplains under the college scheme was appointed and held the office until 1899. From 1900 the chaplaincy has been held by the Bishop of Oxford with a deputy taking responsibility for the Infirmary Chapel. Thomas Combe was Superintendent of the Clarendon Press and lived in Oxford with his wife, Martha. His charitable works included the building of St Barnabas Church in Jericho, another Bloomfield design. He died in 1872 and left his fortune to his wife. In 1874 there was a major fire in the Children’s Ward and Martha Combe offered to donate a complete Children’s Block to be designed by Sir Arthur Bloomfield. At the same time Blomfield was also asked to design the fever block, now the Eye Hospital. In 1885 when the Infirmary received its charter, Mrs Combe was elected the first woman Vice President. The Chapel will be deconsecrated in 2007. Its future purpose is as yet uncertain.
English Gothic style designed by Sir Arthur Bloomfield
RI supplement latest copy:Layout 1
12/2/07
14:29
Page 16
16 / OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7
Original caption stated: The Oxford Eye Hospital, built in 1880 as a Fever Hospital by the Radcliffe Infirmary, structurally altered in 1903 and again altered and added to on five separate occasions to cope with the growth of work. No further alterations can be made. The buildings are obsolete and all Departments are overcrowded.
Clinical intake, 1948 Back row: B.R.S. Mainwaring; R.M. Acheson; A.W. Beard. Front Row: G.R. Webster; A.D. Gardner (Regius Professor of Medicine); G.B. Batchelor.
Picture credits throughout this supplement courtesy of: Oxfordshire Health Archives, Oxford Medical Illustration, the Oxford Mail and Times.