The wife and daughter, in response to their post-Downton Abbey withdrawal symptoms, have started watching on Sunday nights the BBC adaptation of Jennifer Worth’s memoirs, Call the Midwife. This is based on her experiences in the East End of London in the 1950’s.
I watched last night’s episode with them, but then wished I hadn’t because of the memories it evoked. It featured Jennie, working as a district nurse, visiting an elderly man who was housebound with leg ulcers and living alone in a tenement flat. He was dirty, smelly and the flat was foul and infested with vermin and insects. The heroine was appropriately disgusted, but her innate goodness allowed her to overcome her middle-class feelings of revulsion and she became his friend.
Television always sanitises things, but the episode brought back the memory of events when I was a medical student at The London Hospital in the late 60’s, admittedly nearly a couple of decades later than the story, so things had started to change.
The first event was a request from a social worker to see if a group of us would volunteer to clean up the flat that belonged to a couple in their fifties. The man had summoned an ambulance to his partner and they found her cold dead in the bed, probably for several days, with a fungating untreated breast cancer. He was lousy with infected ulcers and was taken into hospital for treatment.
The one room they inhabited stank, and even after 40 years the memory of it makes my gorge rise! It was a scene far worse than any horror movie. Their four cats had been removed by the RSPCA, but the floor was covered with cat excreta. Electricity had long since been cut off and we used candles and torches for light. There was utter filth everywhere with greasy unwashed dishes strewn around the room and old rotten food on the table. None of us dared go near the bed which was a festering pile of verminous rags.
It was really a job for environmental health, not a bunch of naïve medical students. We did our best but made little realistic difference to the place. I came away mystified as to how a couple could descend to such utter degradation in the second half of the twentieth century. What had happened in their lives to render them so incapable of either caring for themselves or seeking help from others? What was their story; there would be one? Surely something could have been done to prevent that lady dying in such total darkness and despair?
The second event occurred the same year as some of us were wandering round the derelict areas of Stepney in the East End one warm summer’s evening. We came across an old building with boarded up windows but which had obviously been an institution of some sort. Above the door was engraved the words, “Dr Barnardo’s Home for Children. No Destitute Child Ever Refused Admission”.
Converted to Christianity at the age of 16, Thomas Barnardo believed he had a calling to be a missionary doctor in China. However when he began his studies at my alma mater in 1866 he discovered that his mission was on his own doorstep. The rest is history.
I learned a number of important things that warm summer so long ago. That compassion is more than just sentimentality, it frequently requires rolling up your sleeves and getting very dirty. That to be an empathic doctor requires at least some attempt to understand the complexities and perversities which govern people’s lives. And that one person with vision and commitment can make a difference to lives that seem blighted beyond hope.
These days the press is full of stories about indifferent doctors, uncaring nurses and neglected patients. Sadly many of these stories are true. We, in the modern NHS, would do well to reflect on the life of such people as Dr Barnardo, and many other similar pioneers whose love, faith and commitment helped so many.
Perhaps we will regain our soul!