We all keeps marching on

After an exquisite holiday away from the city, one where I enjoyed the sun and the storms and the silence in equal measure I’m now facing the inevitable task of moving hospitals. Again.
It’s the second time I’ve moved hospital buildings within a Trust. The first time I was a student in the capital, fortunate in the instance that I was able to observe the nuts and bolts of the move but at the same time not responsible for any of the logistical chaos that accompanied it. Cosseted from the managers and G grades tearing their hair out at things as tedious as bedpan-packing, although simultaneously recognising the importance of such things and having to make sure they got to where they needed to go.
Those days I was happy just to do what I was told, learn things, explore on my lunch breaks, and take snapshots of a hospital with both feet rooted firmly in the eighteenth century. I didn’t have a digital camera then, instead content to focus and shoot with a regular Minolta. An SLR but still outdated even then by the big two of Canon and Nikon. This was a hospital that was forced to straddle the 19th century with its focus on the absolutisms of religion and state and class with the new 20th. The latter an uncertain time for everyone, though few could predict the horrors to come.

Forgotten Hopsital

A monolith of stone and marble it was scorched by two World Wars, technological advances of the second bringing the very hospital into the firing line as the bombs rained during the Blitz. Moments to the lost sprang up everywhere, copper and brass detailing the names of the fallen, the missing, the maimed. Stained glass and statues all wrapped in terracotta and gunmetal brickwork, themselves the influence of the Victorian age, stark with all its stoic austerity.

I was just a student then. In the hierarchy of UK healthcare there isn’t much lower. But even then I recognised the history in the walls of the place. The chapel was its heart. Grade I listed it is the only thing to survive the eventual demolition of the site in ’07. It had the atmosphere of a Russian Orthodox Church. Icons and dark wood adorned the wood, candles blazed most days – a thing of beauty now suffocated by bureaucratic legislation – and the sense of the divine permeated the sanctuary and all who set foot upon the cool stones of the atrium. I sat there a couple of times, both before and after shifts. Although not a Christian per se I do recognise the need to take time away from the chaos of healthcare. People do it in many forms; alcohol, family, pastimes, and prayer. Nowhere does it say you only have to choose one of these.

The new hospital was sparkly. With air-con that didn’t work, elevators that gave new meaning to the word ‘temperamental’ and a sanctuary where you could switch lights on and off instead of candles. See the note above about bureaucracy. It didn’t mean much to me for the primary sense that I was out of the place at year’s end. Only undergoing my final year there meant I had more memories of the old place than the new one, as well as the glamour of it had yet to fade.

The second Trust I worked for was in the same boat. Rural rather than urban it split its hospitals in two; its first handling most of the trauma due to its location to the nearby freeways, the second in the heart of the Southside estates, with less greenery and more vertical buildings. The area has specific building regs, with the former hospital only allowed two storey structures maximum, but I digress.
The first was an air force base in the war. Well America needed somewhere to park its planes. And the twentieth century Britishness was evident everywhere. Nissan-style buildings ran parallel down one side of the site and housed everything. Their roofs constructed of thick corrugated iron and steel, moss in the guttering, brickwork chipped. Overall it was a very geometric hospital. The main corridor of the main building was lined precisely parallel to the Nissan huts. Everywhere the architecture change was obvious as units and wards and offices had been bolted on like expensive mechano throughout the decades.
The second had its foot planted firmly in the sixties, with its love of grey concrete, an antiquated heating plant and cobwebs. It also had catwalks and roof access if you knew where to look and got lucky with the security. Such things made the mundane exciting. Some of the nursing cadre in the old London hospital used to jimmy the fire door on the 5th floor ward and sneak out onto the fire escape for cigarette breaks at the end of a 13 hour shift. Was it frowned on? Yes. Did it hurt anybody? Of course not. And you got to see the London skyline illuminated in the November cold, cars and traffic and people doing what they do. Very Mary Poppins.

But these things also end. the little private coffee rooms, the designated chairs for him or her, the aspect of having everyone separate isn’t optimal when it comes to health care but it does give a stronger sense of unity to the workforce, who will in turn might care for their charges better with a sense of autonomy. Instead everyone is now clumped together like battery hens. I think the analogy is appropriate. One of my Sisters (band 6 managers, not blood relations) told me it will take time to get used to this new way of working and she’s right. But sometimes all I see are big wide corridors and teeny tiny lockers, as though the staff were the last thing on the minds of those charged with the new build. Patients come first without question, but ignoring the staff is false economy. But with a recession on I can understand the reasoning. You don’t get the same drive from comfort as you do from adversity. It’s the only way I can justify the current situation; for the inspiration in bestows during the current relocation from one site to the other.

Until then all three of these hospitals will remain. Both in my memory and in the photos I’ve managed to take over the past ten years. People, places, events, all of these are history. Not as dramatic as Florence Nightingale, the aftermath of trench warfare or the Blitz but still history. The birth of laparascopic, the birth of robotic surgery, the touch screen and the robot drones that carry our surgical gear about the hospital. You didn’t have this in 1929.
I won’t see the end of this hospital. In all likelihood no one currently working there will. More likely it will see the end of a fair number of us, a thought I can gladly discard in this essay of happiness and fond memories. So to be at the breakpoint of both states is a privilege. And for all our moaning and all the problems and the stress this is historic. We can all say we were there. And probably be in attendance when one member of the Royal Family (I really hope it’s not Kate!) turns up to cut the ribbon on the thing.
Terrible, but memorable.
“Be a tomorrow person” as Chuck Noll used to preach to his players. And I try to be, but that doesn’t stop me making light of some of the good points tomorrow brings us.



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