Hospitals are generally places that most people choose not to frequent. I have been lucky, for apart from occasional day visits for medical checks, the only time I was hospitalised was when, aged nine, my tonsils were removed. It was a very common operation in those days – the slightest sore throat and out they came. I remained in hospital for a week, being forced to eat runny soft boiled eggs which I have never been able to stomach since without a wave of revulsion. The best thing was that they gave me ice cream regularly, supposedly to soothe the throat.
My three sons were born at home, not hospital. I had to provide the midwife with a range of essential items for the births, including ‘a pair of your husband’s socks’. I asked why his and not mine? but was never told the reason. The births were quick and efficient, being fitted in between other domestic activities.
Writing this story has made me realise just how far medicine has advanced since then. The most significant change in the UK, after World War 11, was the establishment of the National Health Service. In the field of baby care, tests became available for defects such as spina bifida and Down’s syndrome and treatments were developed for children with heart disease. In addition the contraceptive pill was launched in 1950 and the first ‘test tube’ baby was born in 1978 with IVF transforming the lives of many couples who otherwise might have remained childless.
Penicillin was used widely during WW2, then came drugs to combat TB, steroids to relieve pain and inflammation and DNA was discovered in 1962 leading to an understanding of diseases caused by defective genes. Christian Barnard’s first heart transplant in 1967 was followed by the transplant of other organs, and today the replacement of hips and knees is commonplace. I have one friend who has had three hip replacements – I am not sure where they attached the third. Many procedures are now less invasive, being carried out by micro or keyhole surgery and the range of treatments for cancer improves each year. Basically conditions that would have killed in 1950 are now mostly treatable.
This massive leap in medical technology since the 50’s was brought into sharp focus for me when I discovered that that the oldest operating theatre in Europe is located in a roof space above St Thomas’ Church, close to London Bridge. It opened in 1822 providing treatment for poor females – wealthier patients could opt for a surgeon to visit them at home, where the operation would usually be carried out on the kitchen table.
The Smallest Operation Theatre in Europe
The operations performed were mostly amputations and were seen as a last resort. Patients were tied to beds as there were no anaesthetics, only opium or alcohol to numb the pain. Speed was of the essence. One respected surgeon reportedly removed a leg in two and a half minutes flat, but in his haste also cut off the patient’s testicles. Perhaps an example of carrying professional enthusiasm too far.
This operating theatre is now a small museum. To reach it you climb a narrow, steep spiral staircase to the roof area of the church. The theatre is light and airy with standing room for about 100. The operating table is in the centre, with a box of sawdust underneath to catch the blood. When the theatre was constructed a double floor has to be installed to stop blood from the operations leaking down and staining the ceiling of the church. It might have been something of a religious experience for worshippers to see this in the middle of a service.
The Herb Garret (part of it above) adjoins the theatre and was originally used by apothecaries to store medicinal herbs. The room is crammed with medical artefacts and written reports of cases.
The term ‘operating theatre’ referred to a tiered amphitheatre where students and other spectators would watch the surgeons who covered their frock coats with aprons to protect them from bloodstains. A report at the time stated how such clothing became “stiff and stinking with pus and blood”. The sign of a good surgeon was judged by the amount of blood and stains on his clothing that he did not wash off. They operated bare handed with instruments that were re-used on other patients without sterilization. A doctor was far more likely to wash his hands after an operation than before. There was little understanding of the causes of infection and no antiseptics until the 1860’s when Joseph Lister, following the research of Louis Pasteur, confirmed that germs caused disease. He became known as the ‘father of antiseptic surgery’ and helped to reduce the 50% death rate after operations.
I found the museum utterly fascinating, but was left with a profound feeling of gratitude that I was born in the next century. As mentioned earlier, my medical history is scant. However in my 20’s I went to the local hospital to have a wart removed from my thumb. I thought it would take five minutes to dab on salicylic acid and burn it off. Instead, I was taken to a ward and told to remove my clothes. I was given a hospital gown, placed on a bed and covered with a sheet in which there was a small hole through which the thumb in question protruded. Five doctors surrounded the bed muttering in low tones. The senior doctor addressed me “You realise, my dear, that if we perform this procedure it will leave a hole in your finger – so how will you manage to type?” I replied, “No problem at all – I will call my secretary and he will type for me”. Remember this was the 1960’s.
Thirty years ago we bought a home in Jerusalem and I decided to go through the ‘aliyah’ (immigration) formalities in order to ship our furniture from England without import duty. At the Jewish Agency in London I was informed that I must have a medical. I had that morning undergone my annual check-up but that, apparently, was not acceptable. I told the Agency doctor that I was doing this solely in order to get my furniture to Israel tax free. But he insisted on examining me, then told me to get dressed. Facing me across his imposing desk, he said “I am very glad to tell you, Ruth, that your furniture is well enough to travel”.
One final addendum to this tale. There are only two operations mentioned in the Bible – castration and circumcision, which brings to mind the story of Arthur, who went to his doctor and insisted that he wanted a castration. The doctor tried to dissuade him but the patient was adamant. The operation took place. The following day Arthur awoke to see a man in the next bed. “What are you here for?” he enquired..”I had a circumcision” said the man, to which Arthur replied “Oh damn! – that’s the word I meant!”