The conduct of the hospital was based upon the Army rules for men in military hospitals; and now and then, when things were not going quite well in a ward, the N.C.O. patients would be paraded in the office and the Doctor-in-Charge would read to them the rule making N.C.O.’s responsible for ward discipline. With a few words about the hospital and the staff who cared so much for its reputation, she would enlist their interest and help. As they themselves expressed it, ‘After that, there was nothing more to be done.’

In 1915 to 1916 the Army rule which did not permit men to go out unconducted was in force, and walks and drives were extensively organised. Many friends came several times a week to take men out, thereby helping to keep them happy and contented. Foremost among these was Mrs. Cobden Hirst, who with the help of a group of hostesses organised hundreds of outings and gave immense pleasure to several thousand patients. This rule was subsequently rescinded, and the order to let men out till 5 P.M., and later till sundown, was welcomed by all concerned.

It was rare for a man to be late in coming in or to stay out all night; for such offences meant that the privilege of going out would be suspended for his whole ward next day, and he would have an uncomfortable time with his fellows. On days of public rejoicing, such as Armistice Day or Peace Day, extended privileges were freely given, but they were not abused. On Peace night every man was in by 10 P.M.; not one was absent. This punctuality was perhaps due to a large tea, with sausages and tomatoes and cake in the afternoon, and to a meal of cocoa and eggs at 10 P.M. These luxuries having been advertised in the wards the day before, the men knew where comfort was to be found. In any case, things went smoothly. The life of the hospital was not dull. Festivities and Bank Holidays were observed. There was an endless succession of outings—drives, teas and theatres; within, the library was an important interest, the needlework a constant pleasure; and the two or three entertainments given every week were eagerly looked forward to. There was always something going on, or something coming on, which kept the men interested and expectant.

CHAPTER III
MEDICAL AND SURGICAL WORK

From the professional point of view, the work which came into the hospital was excellent: it was varied and full of interest, and it gave women an exceptional opportunity in the field of surgery. The responsibility for finding the medical and surgical staff rested with the Doctor-in-Charge, the War Office confirming the appointments on her recommendation. By a special arrangement these appointments were binding for six months at a time, and could then be renewed or terminated as desired. The medical officers were not commissioned, but they were graded as lieutenants, captains, majors or lieut.-colonel, and each one drew the pay and allowances, under Royal Pay Warrant, of her respective rank. They also drew uniform allowance and specialist pay, as well as the bonus and new rates of pay when these were introduced. On the termination of their service they were granted a gratuity.

Among the graduates who served at Endell Street were representatives of the Universities of England, Scotland, Canada and Australia. Some of them spent one year or two years there. Others continued for the whole period that the hospital was open. The general knowledge which all the doctors were able to have of all the work in the hospital, and especially of all the serious cases, was a great advantage. The ward officers acted as orderly officer in rotation—that is, they took casualties and night work for twenty-four hours in rotation—and had the supervision of the wards on their nights on duty. In civil hospitals members of the staff may not meet for weeks at a time; but in a military hospital surgeons and physicians attended daily, and at the morning meeting the orderly officer’s report for the previous night was read, and it was possible to talk over the various cases. A great deal of good team work was done, the surgeons, physician and pathologist concentrating on the worst cases. The pathological laboratory, which was situated in the centre of the square, was the scene of many useful consultations.

Of the five hundred and seventy-three beds, sixty were reserved for medical cases, and the other five hundred and thirteen were under the supervision of the Chief Surgeon. Each of her assistants had charge of sixty or seventy beds, and one ward was generally given to the Doctor-in-Charge, who refused to be excluded altogether from professional work.

The surgeons spent all their mornings in the wards, and most of their afternoons in the operating theatre, where it was not unusual to have a list of twenty or thirty cases on each operating day.

In 1915 large numbers of wounds of head, presenting many interesting features, were admitted. From the surgeon’s point of view they were fine cases, for they did well. One lad, who had a bullet removed 1¼ inches deep from the brain, was found sitting up sewing at his badge four days afterwards, and greatly pleased with himself.

After steel helmets came into use these injuries decreased in number, and other kinds of wounds took their place. There were always an immense number of compound fractures, for three hundred of the surgical beds were returned as orthopædic. And in 1917 one hundred and fifty-four compound fractured thighs were in the wards at the same time. These were exacting cases: a good result depended on the excellence of the nursing and the most unremitting surgical care and watchfulness. The latest forms of apparatus were manufactured by the carpenter, Mr. J. A. Campbell of Arduaine, and the masseuses toiled over the patients without ceasing. The results were very satisfactory, and it was disappointing to be told, in 1918, that in future fractures of thigh were to be grouped in special hospitals. However, that same year brought in a series of wounds of knee-joint which exercised the ingenuity and skill of all concerned. In addition, there was valuable experience with fractures of the upper arm.