Tuesday, 6 September 2016

St Bartholomew's Hospital Museum

West Smithfield, EC1A 7BE

Thursday September 1 2016

I had wanted to visit Bart's Museum while on Jury Service at the Old Bailey but as time-keeping was key I left it to another day – and with Jo blackberry picking and not keen on medical museums this was the opportunity to pop in.

The setting is lovely: a tranquil square complete with benches, some greenery, shelter and in fact not crowded even on a sunny day. Those enjoying the sunshine clearly included patients and doctors in dialogue with a few city types on a lunch break – the same was true of the Museum, staffed by volunteers, though most whistled through rather more quickly than I did.

The visit starts with a short film explaining the origins of what is the UK’s oldest still functioning hospital. Rahere, a courtier monk in Henry I’s entourage, undertakes a pilgrimage to Rome (travel time =1 month) following the deaths of Queen Matilda and the royal children. In Rome he succumbs to malaria but following a miraculous recovery and a vision of St Bartholomew he vows to build a hospital for the sick poor in London. With the support of the King and the Bishop of London some ‘marshy’ land is identified outside the city walls (I have crossed Newgate to get here from the Old Bailey) known then as ?Smoothfield. It is a new mixed (but presumably separately accommodated) monastic order, with a hospital staffed by a master, eight brethren and four sisters.

From this short illustrated film you progress to a series of display cases explaining the artefacts – for these early days there are documents setting out the foundation and the land deeds. Little is known of the early patients – medicine had not moved on much since Roman/Arabic practitioners and by and large the sick who had self-limiting illnesses when ‘cured’ were often deemed as ‘miracles’. By 1420 the hospital had separated from the Priory; it continued to take all comers including women and children born out of wedlock.

Then along came Henry VIII and with all monasteries dissolved Bart’s was not spared and the Priory went in 1539. In 1546 the hospital was given to the City of London and funded by a complex system which sounds a bit like the Private/Public Partnership Initiative…. This included lodging, food and clothing for 100 folk and the establishment of 1 physician, 1 surgeon and 12 women. Several more cases are devoted to the ‘paperwork’ which put the hospital foundation on a firmer footing still – these include an inventory, valuation  and  plan with the large chest to hold the records proving that it is impossible to run something as complex as a hospital without some concomitant administration and record keeping.. 

From this point the museum breaks from a  more chronological display to cases devoted to the different ‘specialisms’ that have worked within and evolved alongside this foundation. Being much older than other medical museums we have visited the displays contain a wider range of records and artefacts.

We start with the apothecary – apparently the word comes from the Greek for ‘storehouse’ or helper which is as good a description as any. There are plentiful pots of balm and poison to look at – apparently the first Pharmacopeia to be named as such did not appear until 1618, though of course there had been listings of ingredients for millennia.

The Physician was no more advanced than the apothecary, dependent as they were  on Greek and Arabic teachings . Bart’s star physician was of course William Harvey who had been to Padua to study and came up with his theory of the circulation of blood. 

You can put money on the fact that every town and community will have a William Harvey clinic or hospital ward somewhere... and quite right too. The display case contains implements for bleeding and cupping, a false leg and an early syringe. However a recent visit to the ‘Mary Rose’ indicated that the ship’s doctor there travelled with syringes, pre-dating these here.

The statistics relating to the early Bart’s surgeons are interesting – three were employed on rotation to deal with accidents more than anything else.   As few as 60 operations per year are recorded with the removal of kidney stones a frequent and presumably largely successful operation seen as the main ‘planned interventions’.

There is a case display of the fabric of the hospital – candlesticks for surgeons to see by, badges for staff, lists for running the hospital and a bill for the removal of ‘night soil’ – something we learnt about last week at the Water & Steam Museum. In fact just the kind of things the current NHS are asked to make ‘savings’ on…

Of course nursing through the ages has its own proud display from the ‘helpers’ who carried out menial and laundry related tasks to the later post-Nightingale more professional nurses. Bart’s matron Manson was key in campaigning for registration which became statutory in 1919.
 – I say proud as the exam requirements for nurses were apparently harder than the national ones leading to the claim that Bart’s nurses were ‘second to none’

Nearly 200 years on from Henry’s ‘gift’ to the City it was time for a rebuild and the hospital employed  James Gibbs, a most prolific Scots architect, who came up with the large quadrangle of four wings: three for patients one for administration – that is the North Wing where the Museum is now. It was an inspired design that pleases to this day, though someone in 1937 decided the South Wing needed replacing.  

Bart’s has a long history in training doctors with John Abernethy in the early 19th century taking the initiative – in 1900 it became part of the University of London and in 1995 joined with the Royal London (also Westfield and Queen Mary’s) which is the position today.

The museum traces the rise of specialists and it is indeed to the key fields of cardiology and cancer research and treatment that Bart’s owes its survival and current position amongst the London hospitals.
Somehow, without destroying the Gibbs era heart of the hospital planners have managed to insert state of the art units on the Bart’s site. Incidentally there are still the two churches bearing the apostle’s name and the whole hospital constitutes a parish.   

There are photos of students at work and play – largely rugby and cricket for the latter, which might explain why, when the head of the Medical School, the eminent James Paget, admitted Elizabeth Blackwell as the first woman student in 1850 the males protested so much women did not gain re-entry until 1947.   There is an excellent and spirited account of Elizabeth Blackwell’s views on male doctors and female patients if you listen via the ‘telephone displays’. Having worked in a borough with an ‘Elizabeth Blackwell House’ I had no idea that though born in the UK she was in fact brought up and trained initially as a doctor in the US.

There is a plaque to Sherlock Holmes and Dr Watson who met here – the latter being a Bart’s trained doctor and apparently the latest TV series was filmed here with the staged  ‘suicide leaps’ from the rooftops of Bart’s.

From the other door of the museum you can just peep at Hogarth’s wall mural which goes up the stairs to the Grand Hall – not accessible unless by accompanied tour Friday PM.

However this, the museum for the UK's oldest still open hospital,  is worth visiting in its own right and warrants more attention than a distraction for patients and their visitors.   

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