Thursday, May 24, 2012

History: Laid Up at Haslar

Formalized medical treatment for service people was to a large degree pioneered by the British and by the Royal Navy in particular. In the mid-18th century, when a “hospital” amounted to nothing more than a work house for the majority of England’s population, the Royal Navy was opening impressive buildings at Plymouth and Gosport dedicated to the illnesses and injuries of sailors and marines.

The Gosport location, known as the Royal Hospital Haslar, opened in 1753 with construction continuing until 1761. The structure was large, including three stories, an attic and a basement, with wings jutting forth on either side and outbuildings to house nurses, groundskeepers, guards and cooking staff, just to name a few.

The guards may seem to stand as an unnecessary adjunct to a hospital but, in fact, Haslar was designed as much to keep invalids from running away as to cure them. The hospital was purposefully built in the middle of a murky swamp, and until the early 19th century the only reliable way in and out was by ferry. Men were divested of their clothes immediately upon arriving. After a warm, soapy bath the clean seamen were issued “Hospital Dress” which they were informed would “greatly tend to [their] recovery.” As Kevin Brown points out in his book Poxed & Scurvied, The Story of Sickness and Health at Sea, these oversized shirts were probably cleaner than the clothes the men came to the hospital wearing. They were also an excellent way to tell if a man had left without permission, essentially deserting just as he might from a ship. Men tried this trick nonetheless; Brown notes that the latrines were a particularly popular escape route. They were also used to smuggle in booze, usually by the nursing staff.

At the outset, Haslar was run by medical men. The first physician to oversee the hospital was the famed James Lind whose pioneering research on scurvy was done to a large degree at Haslar. He insisted on separating patients by illness, putting the most contagious cases on the top floor of the building. The second floor was for men recovering from fevers, STDs and the like, while the ground floor was reserved for those who were ambulatory.

The system worked rather well, and men recovered under Lind’s oversight. Unfortunately, however, discipline suffered as most of Haslar’s doctors had private practices to attend to as well. The “dispensers” and nurses began to bicker amongst themselves and the doctors could become martinets when they felt their areas of expertise had been trespassed.

Initially the nursing staff was recruited from seafaring families. Sailors’ and marines’ wives, “the most sober, careful and diligent that can be had,” were brought in to administer medicines, give baths, change bandages and take those who could get up and about on therapeutic strolls. After Dr. Lind retired in 1783, things went steadily down hill and, though there were still excellent individuals among the nursing staff, the standards in general certainly slipped.

Brown notes that the Haslar nurses “developed a reputation for stealing from patients, forging wills, and smuggling gin tied around their waists and under their stays in bladders.” Patients complained about specific women who put them in fear of their lives. In Haslar the Royal Hospital, A.L. Revel quotes invalids speaking of one Nancy Armitage:

who treated us in such a manner that we were afraid for our lives. We have neglected taking our medicine from her less she should poison us, we never thought it was in the power of any woman to so behave and shew herself in the manner as she has done to us, and we were not able to help ourselves. She strove all she could to hurt us, she broke the poker striving to kill some of us and threatened us with drawing her knife.

What became of the psychopathic Nancy is not revealed.

Meanwhile, cases of nurses trying to assist neglected patients and being reprimanded or dismissed by doctors are also on the books. The middling road included nurses who were illiterate and could not tell which medications should be given to which men. Then there were those who were too drunk or too lazy to bother with medications or bandage changing at all. Then there was Jane Brown, who was sent packing for “going to bed with four or five patients and infecting one of them with the foul disease.”

By 1795 the Royal Navy, whose legendary system of discipline could hardly tolerate such mutinous behavior, had had enough. A position of Governor of the Hospital was established, to be awarded to a seaman of at leas post captain rank. The first at Haslar was Captain Charles Craven. It would be close to 100 years before the hospital was again run by medical doctors and Haslar would remain a functioning hospital, servicing all branches of the British military, until 2007.

Header: Early 19th c engraving of the Royal Hospital Haslar via the James Lind Library online


Timmy! said...

Ahoy, Pauline! It seems like there are a few bad apples everywhere and it sounds like they definitely needed some naval discipline...

Pauline said...

Of course, that's human nature. In fairness, the shenanigans didn't stop as soon as Craven showed up, but by the mid-19th century they were considerably curtailed. Like the dog watches... (Hey! A Stephen Maturin joke to go with this post!)