Letters from Alice: A tale of hardship and hope. A search for the truth.. Petrina Banfield
Alice said, her voice carrying across the hall. ‘I’ll deal with this.’
‘He’s a filthy lying hound!’ the woman yelled, spittle spilling out from the edges of her mouth.
‘Be that as it may, he’s now our patient,’ Alice returned, her voice low and steady. Behind her, the nurse handed the man, who was now coughing up blood, a handkerchief. ‘If you want to come back and see me later today, I’m happy to talk things through with you. But for now, please, I’d like you to leave.’
‘You’ll pay for this, Jimmy!’ the woman screamed over Alice’s shoulder, as the nurse led him away. ‘I hope you cough up your guts and strangle yourself with ’em,’ she added, before turning on her heel and waddling to the door.
Alice pulled down the cuffs of her blouse, straightened her hat and gave several still-gawping patients a reassuring smile. The almoner often needed to draw on every ounce of diplomacy she could muster to deal with the loud confrontations that sometimes broke out in the outpatients department.
The man was still coughing when Alice joined him in the watching room. ‘She’s agitated ’cos I’m not earning what I-I used to on account of this cough,’ he told Alice in a thick Irish accent. ‘And what with the baby soon to join us –’
Alice opened a new file and jotted down some notes while Jimmy spoke. A thirty-five-year-old labourer, Jimmy had sailed for England from Ireland a year earlier looking for work. He managed to find employment on the Wembley Park site, where work was under way preparing the ground for a new restaurant to be built near the planned new sports stadium, but had not yet managed to save enough to cover the cost of a deposit on his own lodgings.
Alice managed to elicit that he had spent most nights sleeping with three other workmen in a small shed on site, while his pregnant wife camped out on her parents’ sofa. Waking in the same damp clothes he had worked in the previous day, his health had worsened through the winter. ‘’Tis a fine place here though,’ Jimmy said, when Alice confirmed that his meagre earnings and imminent dependant qualified him for entirely free treatment at the hospital. ‘And you’re a fine woman, so you are,’ he gasped, after she told him that he’d been booked into the chest clinic. A deep hacking cough issued from his lungs. He rubbed his red-rimmed eyes, watery with the strain of coughing, and said: ‘Too fine to be wasting your time helping a vagrant like me.’
As the almoner made her way back across the atrium, Hetty Woods nudged her husband with her elbow. When she neared, Ted signalled to her. ‘We was wondering, Miss Alice. Do you think you might have the opportunity to visit our daughter, Tilda? She’s expecting but her husband won’t let us near the place. He’s got some sort of hold over her, I think. We haven’t seen her for months. But my Hetty thinks that if anyone can sort them out, you can.’
Alice glanced over to the double doors, where another line of people were waiting to file inside. When temperatures plummeted, as they had in London in the last twenty-four hours, it was difficult to impose some order on the chaos reigning in outpatients. The doctors found the crowded conditions near impossible to work in, but the worsening storm and poor visibility at least provided her with an excuse to grant the most destitute a temporary reprieve.
‘I will see what I can do in the next few days,’ Alice told the couple, after noting down their daughter’s address.
‘Don’t go after six though, duck,’ Hetty said warningly. ‘That’s when our son-in-law gets home.’
The almoner nodded. ‘I cannot promise anything, but I will try.’
Ted and Hetty watched Alice as she headed off for her meeting with Dr Harland, their rheumy eyes watery with gratitude.
The almoner is a general practitioner in social healing. It is the almoner whose job it is to deal with the personal difficulties and troubles of the patient … the constructive side of the social work done by the almoner seems to know no limits.
(The Scotsman, 1937)
From its earliest days as an apothecary, doctors from the Royal Free went out into the community to treat patients who were too ill to leave their homes, or rose in the early hours to meet them at the hospital. ‘As there were no telephones,’ explained Dr Grace de Courcy, a medical student in 1894, ‘if an emergency arose at night and the resident required assistance he would go into the street and take a hansom cab or a growler to the house of the surgeon or physician in charge of the ward to bring him back.’
Dedicated to their patients and uncomfortable with the idea of their private lives being examined, medical staff at the Royal Free had initially been reluctant to share any information with the almoners. For some, the whole idea of conducting financial assessments on the sick was repugnant. Sir E. H. Currie complained to a reporter for the London Daily News in 1904 that vetting patients using ‘special detectives’ was ‘a scandal’. Currie ‘strongly condemned’ the use of inquisitorial methods to ‘denounce’ well-off patients. ‘What possible good can one woman investigator do?’ he argued. ‘It is ridiculous.’
Mr Rogers, a secretary from the London Hospital, defended the appointment of an almoner who was to ‘watch in the receiving rooms for cases of imposition’. The secretary stated that local doctors running private practices had accused the hospital of ‘robbing their profession’ by treating patients who ‘they had personally seen … driving to hospital in their own carriages’.
Like his predecessors, Dr Peter Harland was another of those people who subscribed to the view that any sort of surveillance of the private lives of others was a disagreeable pastime. He was waiting at the top of the stairs leading to the almoners’ basement office when Alice arrived. ‘I’m so sorry, doctor. Have you been waiting long?’
‘A minute or so.’ There was no reproof in his voice, but his features were strained.
Alice led the way down the dimly lit stairs, stopping before a sturdy-looking oak door inset at eye-level with a small barred window. Dr Harland waited silently as she opened the door to the office, where arrow-slit windows high up across one wall overlooked the sodden grey pavement of Gray’s Inn Road. The window sills provided neat cubby holes for reference books and medical journals, the heavy tomes blocking much of the natural light.
Before the fires were lit by the caretaker each morning, the almoners’ office lay silent, the stillness broken only by the rumble of underground trains beneath them. Now, the room was bustling with activity. Frank was seated at the nearest desk, taking ledgers one by one from a small pile and checking them against a list of the hospital’s assets. Alexander was kneeling on the floor beside a solid leather trunk and setting a trap for the mice that emerged at night to nibble the edges of his financial reports. He fumbled with the steel mechanism with a harried air, his handsome features twisted and pink with annoyance. In the far corner, Winnie sat behind her typewriter, her habitual anguished frown in place.
At the opposite end of the office, the Lady Almoner, Bess Campbell, was busy preparing lists for a post-New Year party; a get-together for those acquaintances who had missed out on the New Year’s celebration that had taken place in her considerable residence in Kensington. Miss Campbell, a woman with a flair for combining dynamic guests with those of a quieter nature so that everyone felt at ease, had a calendar packed with social events, dances and dinner parties.
She was a slim woman in her late forties, with greying shoulder-length hair and sharp but pleasant features. An accomplished and formidable character, she had a love of fine clothes and an air of authority, but she was also possessed of a natural humility, an essential quality in someone working so closely with the poor.
Like the majority of her colleagues, she had been selected from a class superior to those she served, the appointing committee believing that only someone gifted with eloquence could suitably advocate for the working class, who were generally less able to express themselves.
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