Chapter Three

Three Flew into the Cuckoo’s Nest

“Get me a pint, quick,” pleaded Bill desperately, as he burst into the pub and plonked himself down exhaustedly in the midst of our group. “What a day I have just had, rounded off by the most bizarre lift into town!” I handed him a pint, most of which disappeared in one gulp. He had just finished a 12-hour shift, 7am to 7pm, at Rainhill Psychiatric Hospital, and had come to meet everyone in the Market Hotel in St Helens town centre.

During university holidays, all of our friends from school days would come home from university. The top priority, apart from regular sessions in the pub, was to find a temporary job. Delivering Christmas post was a regular earner, and during the summer we usually ended up working in some ‘Dante’s Inferno’ of a bottle factory, a building site or perhaps a hospital. Norma was hoping to find a job in a beauty therapy salon. Jeff, who was studying Fine Art at Newcastle University, was still unemployed and studying the bird table. I was studying Textile Design at Leeds University, and still looking for a summer job. Bill was training to be a teacher. Yes, it was the same Bill who had grabbed me in the street during his brief incarnation as a policeman. I think his change of career was more to do with the fact that he had heard that the all-female Rolle College in Exmouth in Devon was accepting male students for the first time. Our group of school mates were dispersed throughout the country, including Oxford. We hitch-hiked to visit each other and, invariably, Devon was the most popular destination.

We were just settling down around a table in the pub when Bill made his dramatic entrance.

“Because of my size, they decided to put me on the secure ward... As a member of staff, I hasten to add,” he said. Bill then stood up, and paused for dramatic effect. From his jacket pocket, he pulled something out with a flourish and banged it on the table, rattling the drinks.

“That’s the key they’ve given me,” he said theatrically, pointing to a huge black metal key. It looked like something from a medieval dungeon in a Robin Hood film.

Rainhill Hospital had always had a mysterious, eerie reputation. It was as if it was the Castle of Vlad the Impaler in Transylvania; feared by the local village peasants in Hammer Films. It was surrounded by a high brown sandstone wall, and, when travelling on the bus to Liverpool, we would often look from the upper deck to see if there was anything to behold in this other world. As kids, if anyone did or said anything slightly crazy, we would say things like you should be in Rainhill, or Rainhill Loony Bin as it was invariably known in those gloriously politically-incorrect days.

A Tall Tale

After another gulp of his next pint, Bill continued with his story.

It was his first week at the hospital, and he told us that he was working with Big Walter, who was well-known to us in Blackbrook. He was the archetypical ‘Gentle Giant’. His name was Walter Mountford, and I am not exaggerating when I tell you that he was over seven feet tall. I remember once standing next to him and, even though I am six feet tall, I only came up to his shoulder. There were stories that he had been invited for trials at St Helens Rugby League Club in the early 1960s but was rejected on the grounds that he was too big and posed a danger to other players. That must be some kind of a record, turned down by a rugby league club for being too rough. This is how Bill told us his story:

I had worked a couple of shifts and one morning I heard whispers along the corridor that Walter was on his way over, returning to work after a holiday. I looked along the tiled-corridor of the Victorian Building to see quite a few patients congregating outside their wards. The echoing sound of a heavy door being unlocked reverberated and, as it opened, the morning sunlight flooded in. However, it was quickly blotted out by an enormous silhouette which filled the door frame. “It’s Walter!” whispered the patients to each other, which spread like a wave. He didn’t need to say a word as he slowly made his way along the corridor. He was like a ‘fee, fi, fo fum’ pantomime giant. The patients disappeared into their wards left and right, like rats jumping off a sinking ship. By the time Walter reached me, the corridor was empty and silent.

He greeted me with a crushing handshake. He welcomed me warmly, and we chatted during the day. At the end of the shift, he offered me a lift into St Helens. We walked out together to the staff car park, and I couldn’t help but wonder what type of car such an enormous man must drive. Unbelievably, we stopped at the side of a Hillman Imp. As Walter put his key in the lock, he couldn’t help but smile at the incredulous look on my face. “Get in, it’s open,” he said with a nod.

I opened the door and struggled to squeeze into the passenger seat. I looked to my right and couldn’t help but notice a small detail. The car did not appear to have a driver’s seat. Walter then opened the driver’s door and started to get in. ‘Where’s he going?’ I thought with an open-mouthed gaze. He then went through what must have been a well-rehearsed routine, which, at one brief moment, brought us both face to face. I must have had an expression of bemused amazement as I looked at Walter’s broad mischievous grin. Within a couple of seconds he was in his driving position... from the back seat! The steering wheel was unlocked and extended back, and the extra-long gear lever was set at a customized angle. At that point Walter could keep a straight face no longer and he let out a huge roar of laughter, which from a seven foot, twenty-stone man inside a tiny Hillman Imp reached a decibel level higher than any car stereo.

“Your face was a picture,” he laughed as he tapped me on my right shoulder.

“Do you offer lifts to many people?”

“All the time,” laughed Walter as we set off towards the front lodge, “I love to see the look on their faces.”

If Walter thought my face was a picture, you should have seen the expressions on people next to us at traffic lights!

In the pub we all laughed at Bill’s tall story and shook our heads in amazement. “They still have vacancies at the hospital,” announced Bill, knowing that one or two of us were still looking for summer jobs.

“I don’t think they would give me a job in the high security ward,” replied Jeff, pointing at the key on the table. “I couldn’t even lift that!”

“I don’t mean in the secure block, there are lots of different types of wards,” Bill added reassuringly.

“How do we apply,” I interjected.

“Just go to the main office and they will give you a form to fill in.”

Jeff and I exchanged faintly dubious smiles, as if to say ‘a job is a job,’ and we decided to go for it. Norma was sitting next to me and she just raised her eyebrows, with an expression of dismay bordering on horror. As a child, she had lived in Edge Street, which was in the shadow of the high perimeter wall of the hospital. While growing up, Norma had heard endless stories about the asylum; most of which were, of course, grossly exaggerated in the minds of all the local children. She was often teased by her three brothers about the dangers lurking the streets. The woeful look she gave me in the pub was as if I had volunteered to spend a night at the Castle of Count Dracula.

Brad and Janet

The following morning, Jeff and I caught the bus to Rainhill, and Norma came with us for moral support; but she also had a morbid curiosity to finally venture behind the high walls. We approached the front lodge with trepidation, and were directed to the appropriate office building. After all those years of trying to catch a glimpse over the wall from the bus, we were now walking in the grounds. I don’t know what I expected to see, but my first impression was one of calm tranquillity: beautifully manicured lawns, lots of trees, colourful flower beds, and plenty of benches, most of which were occupied by patients enjoying the morning sunshine. They seemed to have an air of other-worldliness about them. We knew that they were patients because nearly everyone was wearing a dressing gown. One or two were wearing their everyday clothes, most of which were from a bygone era.

As we continued along the tarmac path to the main entrance, a man, who had been sitting alone on a bench, stood up and blocked our path. He was smartly dressed and wearing a tie, but his pin-striped de-mob suit indicated that he was a patient rather than a member of staff. We stopped a couple of feet from him, wondering whether to speak, or just to give him a wide berth. Norma squeezed my hand a little tighter. At that moment he put his hand in his jacket pocket and took out a paper flower, which he handed to Norma with a smile and slightly distant expression. He then sat down quietly on his bench.

“Thank you,” we all said together, but there was no further reaction from him, as he just looked back along the path towards the front lodge.

We explained to the receptionist that we were students looking for vacational employment, and she asked us to take a seat in the corridor. We waited for about five minutes, which gave us time to peruse our surroundings. It was very quiet, the silence broken only by the hollow sound of doors being opened and closed and the occasional distant voice echoing along the corridor. All of the tiling on the floor and walls seemed to be original and matched the Gothic-horror style Victorian building, which had the atmosphere of a place lost-in-time. We sat quietly, if slightly nervously, like waiting for a dental appointment.

Norma turned to me and whispered, “You know, I remember the man who has just given me the paper flower. When I was young, from about six to twelve years old, he used to sit near the shops making flowers and giving them away as gifts. And he is still here after all these years.”

A door along the corridor opened and a tall, dark sombre-looking man emerged and approached us.

“Good morning, I am Mr Johnson the personnel officer,” he announced in a deep voice, “I believe you are looking for employment.” His tone and delivery was reminiscent of Vincent Price on ‘Thriller.’

“I have the application forms here,” he continued, and Jeff and I stood up to take one each. Norma remained seated because, after all, she was only there to give us moral support. The last thing she wanted was a job in the dreaded Rainhill Hospital. However, he took a few steps towards her and offered her a form.

“Oh no thank you,” she said to him politely, “I haven’t come for a job.”

“But the receptionist told me on the phone that there were three of you, and I have brought out three applications,” he stated in a monotone, and continued to hold out the forms in front of her. As he didn’t look as though he was about to move, I suggested to Norma that perhaps she should just take them.

“You can complete the forms here and now,” he told us as he handed each of us a biro from his top pocket and gestured for us to sit back down on the bench.

“Just fill it in,” I whispered to Norma, “Just to keep him happy.”

“Oh, that’s him being happy is it? I wouldn’t like to see his unhappy face,” she whispered.

We spent about ten minutes completing the applications, and just as we finished the personnel officer appeared, right on cue.

“Please follow me into the office.”

We were beginning to feel like Brad and Janet in ‘The Rocky Horror Show’. The office was rather sparse, with only a couple of the office staff working at the typewriters. Mr Johnson sat behind a large wooden desk which was festooned with piles of paper, files, jars of paper clips and other office paraphernalia. We sat on old, sit-up-and-beg style uncomfortable wooden chairs. He quickly read the application forms, and started rubber-stamping. He asked us a few cursory questions and picked out relevant information. He noted that I had worked at Nutgrove Old Folks’ home, which was only half a mile away, and that Norma had experience of dealing with the public in a variety of jobs.

“Well, this all seems fine,” he announced, still expressionless, as he stood up and, with a cold, limp handshake, said, “Welcome to Rainhill Hospital.”

Jeff and I both replied with a grateful thank you. We had a job. Norma fully intended to tell him that she wasn’t interested, but was stunned into silence by the suddenness of it all, as she returned his handshake politely.

“When would you like to start?”

“As soon as possible, we need the money.”

“I presume you would all prefer to be on the same shift?” he asked as he walked over to a wall chart. After a moment’s consideration, he turned and said, “The day after tomorrow, at 7 am. Please report to the front lodge.” With that we were ushered out of the office and made our way along the corridor.

As we emerged into the sunlight, all I could say was, “7 o’clock, bloody 7 o’ clock,” as my body clock was still in student mode. I realized that Norma was still in shock at the prospect of working in a psychiatric hospital.

“Just ring him tomorrow,” I said reassuringly, “and say that you’ve changed your mind.”

“Oh, I may as well just take it... after all it’s a job. I’m just worried what mum and dad are going to say about me working at Rainhill Hospital.”

“When do they get back from holiday?” I asked.

“During our first day at work, which at least that gives me time to decide what to tell them.”

On our first morning, Jeff and I got off the bus from St Helens at quarter to seven. Norma was already waiting for us, as she lived with her parents in Rainhill and had arrived from the opposite direction. We reported to the lodge and were duly escorted to the main hospital block; where we were welcomed by a lady from personnel. Over a cup of coffee, she took us through various formalities; after which followed a brief induction course, including a tour of the hospital. We were greeted with brief smiles of acknowledgement from various staff, including nurses, doctors, cleaners, and catering staff pushing trolleys. Patients tended to fix us with a stare, sometimes a smile, as we felt eyes following us.

“Is that bacon I can smell?” I asked as we walked along a corridor

“Amongst other things,” was the personnel officer’s sardonic reply.

I think she must have meant the full English breakfast, with a hint of urine permeated by Dettol. A heady combination!

At the end of our introductory tour, we returned to the administration office to be allocated to hospital departments. Jeff and Norma were told that they would be working in the geriatric wards, and I would be at the Benedict Clinic, a new annexe in the hospital grounds which hadn’t been included in our morning tour. It was a rehabilitation centre which treated patients who were suffering from a variety of ailments including depression, various syndromes, and addiction to drugs or gambling. Norma, Jeff, and I were issued with white coats. I was tempted to ask if we would be having stethoscopes to drape casually round our necks. I decided it wasn’t the time to be flippant.

“Ok, if there are no more questions I will take you to your wards. Please follow me.”

As we walked along the corridor, the three of us were wearing our new crisp, white coats. We didn’t feel like visitors anymore. Jeff and Norma were introduced to the charge nurse, and disappeared into the ward with an apprehensive glance over their shoulders and a ‘see-you-later’ wave.

“At least they’ve got each other,” I thought as I stood there like a parent waving off children on their first day at primary school.

White Coats Not Required

I was then taken outside, and we headed towards the clinic, which was about two hundred yards down one of the tarmac pathways which criss-crossed the hospital grounds. I offered to find my own way, to which the personnel lady readily agreed. She told me to report to the charge nurse’s office, and that he was expecting me. “Oh, by the way, take off your white coat and carry it with you.” I must have shown disappointment on my face, as she quickly added, “It is a much more informal regime at the Benedict Clinic.”

As soon as I entered the clinic, I was immediately struck by how different the environment was from the rest of the hospital. It was modern, open and light. I knocked on the office door and entered, and, on seeing my white coat over my arm, the charge nurse stood up from behind his desk and said, “Ah, you must be...,” then paused for a second to glance down at his desk, “John Meadows,” as he greeted me with a welcoming handshake.

“I’m Henry Broughton, Charge Nurse. Call me Henry. Just hang your coat up, you won’t need it here,” he said, gesturing towards several white coats hanging on the rail. Henry was probably in his mid-40s and about 5ft 8 tall. ‘At least they are not all built like Walter,’ I thought.

“We just wear white coats when we are walking around the hospital,” he said, before adding with a laugh “To distinguish us from the patients.” We had a chat for a few minutes and he explained that my duties would be very flexible. First thing in a morning I was required to tour the male wards to make sure all the patients were out of bed by a certain time, to help with breakfast, lunch and afternoon tea, and to make beds. I explained that it sounded very similar to my job at the old folks’ home, and he told me that that was one of the reasons why personnel had deployed me to work at the clinic.

“Come on I’ll show you around, follow me,” Henry said as he opened the office door. We turned left along a short corridor and through a door, which opened onto an open-area, about the size of a tennis court.

“This is the social area,” explained Henry as he stretched out his arms to emphasise the space. “It is where the patients spend most of their time.”

My first impression was that it was more like a social club than a hospital. There were snooker, table tennis and pool tables, chess, draughts and other board games. Significantly, I didn’t notice any darts.

“Hello nurse,” said one middle aged man, who looked up before making his shot at snooker. He spoke in an unmistakeable ‘Scouse’ accent, more like “Hello nerse.”

“Hello Ernie,” replied Henry, “Are you winning?”

“I don’t know,” said Ernie, “you’ll have to ask nerse,” as he gestured his head towards his opponent. I quickly realized that his snooker partner was a member of staff who came over, right on cue (sorry, couldn’t resist that pun), and Henry introduced us. His name was Malcolm, and the three of us had a brief conversation in the middle of the room. In the meantime, Ernie simply stood to attention at the side of the snooker table, holding his cue as if he was a Coldstream Guard.

Malcolm saw me looking over towards him and said to me, “Oh, Ernie will just wait there patiently until I go back.”

In the room were about twenty patients, male and female, who were engaged in a range of various pastimes, games, and activities. Some were watching television or reading books and newspapers, while others were simply staring into space, gently rocking to and fro. Once the introductions and pleasantries were exchanged, Henry excused himself and returned to his office.

“What is the patient-to-staff ratio?” I asked Malcolm, trying to sound as professional as possible on my first day.

“There is no fixed rule; it depends on shifts and whether patients are elsewhere for treatment or counselling.”

“At the moment,” he continued, “there are four of us on duty, including you.”

The other nurse on duty was a lady called Anne. Malcolm pointed her out to me with a whisper and subtle gesture with his head.

“I don’t want to point,” he said quietly, “because the patients pick up on it and wonder what we are talking about. We try to maintain a low profile and generally mix in and socialize.”

“Hence the no-white-coat policy,” I replied with a nod.

“Exactly,” said Malcolm, “Anyway, I had better get back to my game of snooker with Ernie Halton. Just join in wherever you like.”

“Do you mean I just play chess or watch telly with the patients?”

“Yes, of course.”

I slowly made my way around the room, returning the occasional smile. No one seemed to give me a second glance. I felt like ‘Billy-no-Mates’ who had turned up at a party where he doesn’t know anybody. The demographic in the room was difficult to identify specifically. There was an equal mix of men and women, and the ages ranged from mid-twenties through to patients in their seventies. One or two were easy to identify by their dress sense, or, should I say, lack-of. I suddenly remembered where I had seen Ernie before. He was the man in the de-mob suit who had presented Norma with a paper flower when we first arrived at the main office a couple of days earlier.

He was quite tall and slim with thick dark hair, even though he was probably in his mid-fifties. No grey hairs. Obviously, he didn’t have a great deal to worry about. His eyebrows were dark with the texture of tangled fuse wire and they met in the middle without a break. He reminded me of someone I couldn’t quite recall, and then I thought that he looked like Rudolph Hess, the infamous Nazi held for many years in Spandau Prison. “No it can’t be,” I thought as I found myself watching him a little too closely as he played snooker. Anyway, I doubted if Hess had spoken with a broad Scouse accent. I continued to stroll around the room, and approached Anne to quietly introduce myself. She was blonde and petite with a very clear complexion, and I guessed that she was in her mid-thirties. She welcomed me with a genuine warm smile, and we had a conversation about the clinic.

Anne explained that the patients included long-term residents, some of whom had been in Rainhill Hospital for thirty to forty years, and also day patients, who lived at home and came in to hospital for treatment. This was borne out by the range of clothes being worn: from very smart designer jeans and polo tops to trousers which were too big and held up by a length of cord.

Check-mate Charlie

After a short chat with Anne, I went over to Malcolm, who was by now playing chess with a short, red-faced man who seemed to be constantly scratching his bald head. As I got closer, I noticed that his head had a few scratch marks and a few scabs which were seeping traces of blood. But still he scratched incessantly. Just as I got to the table, this bald man moved a chess piece and announced triumphantly, “Check mate, can’t be beat, can’t be beat!” and without further comment or discussion he pushed back his chair, stood up and walked away muttering constantly, while still scratching his head. His accent was definitely not Scouse, or even northern. It sounded distinctly Cockney.

Malcolm just sat there, staring at the chessboard. He rested his chin on his hand as he pondered and scrutinised. I felt that I should not break his concentration by speaking and decided to just stand and wait for him to complete his thought-process. After what seemed like ages, he eventually shook his head with an expression of exasperation and stood up.

He turned to me and, before I had chance to speak, he smiled and said, “One of these days I’m gonna beat that bugger at chess.”

“Sorry you lost your chess match,” I said sympathetically, but really as an opening line for small talk.

“Oh, I’m well used to that feeling,” he replied wistfully. “I haven’t beaten Charlie once in four years of trying, usually on a daily basis.”

“Charlie?”

“Yes, Charlie Rosewall. He was a chess champion in a former life in London. He’s been in here for years, and does nothing but play chess. In fact, many of the doctors from all over the hospital often come over when they have got a little free time and challenge Charlie to a game.”

“Do they ever win?”

“Only if Charlie makes a silly mistake, or if he is playing two or three of them at the same time.”

“Amazing.”

“Do you play chess John?” Malcolm inquired.

“I haven’t played for years, but I do quite like the game.”

“Well, while you’re working here, make the most of Charlie’s expertise. You’ll learn a lot.”

I looked around and said, “It looks as though I am going to improve my skills in a few different games.”

“By the way,” I asked as an afterthought, “why is Charlie in here?”

“He murdered his father,” whispered Malcolm out of the corner of his mouth for dramatic effect.

“Why?”

“He beat him at chess.”

As my mouth fell open, Malcolm laughed and grabbed my arm and said, “Don’t worry John, I’m only joking.”

Just as relief showed on my face he added, “Well, at least about the last part.”

At that moment the door opened and a uniformed nurse entered, pushing a large aluminium trolley. As she stopped and applied the footbrake, all of the patients stood up and formed an orderly queue which snaked through the room and round the snooker table. No-one made an announcement, not a word was spoken. The patients were so institutionalised that they knew exactly what to do and where to go at any time. The nurse unlocked the metal box trolley with a key which was attached to her waist by a metal chain. She lifted the lid and secured it in an upright position. I could see that the box was in fact a dispenser for tablets and medicines, and a list was cellotaped to the inside of the lid. Each patient collected the prescribed dose as the nurse carefully checked names against her list. I was very impressed by the fact that she knew them all and greeted each patient with their first names.

“Come and see me in a minute Charlie and I will give you something for your scabs,” she said, before scolding him with, “Stop scratching your head!”

Charlie strolled off muttering to himself in a Cockney accent, “Can’t be beat. Can’t be beat.”

One side of the social area was taken up by large sliding doors, and, from the sound of clattering pots and pans and the smells beginning to pervade the room, I sensed that it would soon be lunch time, or, should I say, dinner time. The doors were opened by the catering staff and the patients instinctively proceeded to the serving counters. They formed an orderly queue, naturally, and took their meal trays to the tables. There was no hesitation or looking around deciding where to sit, which indicated that all the patients sat at the same place for every meal. My new colleagues told me to just move around in a supervisory capacity in case anyone needed anything, and I helped to tidy everything away. I spent the afternoon chatting to various patients and, quite honestly, I couldn’t believe that some of them had been admitted to a mental hospital, because I was unable to detect any apparent disorder. I mentioned this to Henry, the charge nurse, at the end of the day, and he told me that some conditions were not immediately apparent. He suggested that I look at some of the case notes in the office, which I read with interest over subsequent weeks.

At the end of the shift at seven, I left the premises via the front lodge gates, with a cheery goodnight from the security officer. I strolled two hundred yards to the ‘Brown Edge’ pub to meet Norma and Jeff. They were already there, and, as I sauntered over to join them, I couldn’t help but notice that they looked shell-shocked.

“Is this mine?” I asked rhetorically as I picked up the pint that was obviously waiting for me.

“So how was your first day?” I asked wiping the froth from my upper lip.

They both let out a big sigh and Norma managed to reply wearily, “It’s been a long day.”

Jeff put down his pint and said, “We’ve been helping to lift old people in and out of wheelchairs, emptying bed pans, helping to feed patients who needed bibs. Get the picture?”

“Well, at least it’s a job,” I said cheerfully, but unhelpfully, repeating our motto.

“So, how has your first day been?” asked Norma, taking a sip of her wine. I hesitated for a second, not knowing how to approach a delicate situation in view of the fact that Norma and Jeff had obviously drawn the short straws.

“Oh, it’s been okay, no problems,” I added casually with a Gallic shrug.

I think I overplayed my hand by acting a little too nonchalantly, as Norma asked pointedly, “So what have you actually been doing?”

‘Have they been given inside information?’ I wondered.

So, I explained the nature of the clinic and that part of my job was to play various games like snooker, table tennis, or chess.

Jeff then chipped in with, “So, let me get this straight, while me and Norma have been slaving in the geriatric ward, you have been playing snooker all day?”

“No, of course I haven’t been playing snooker all day,” I replied trying to be light-hearted. “Sometimes it was pool.”

They put down their glasses and gave each other a woeful look. The kind you would expect from someone who had resigned from a lottery syndicate the week before a jackpot win.

“You always were a jammy bastard,” muttered Jeff, as Norma nodded in agreement.

We finished our drinks and went to the bus stop outside the pub.

“My mum and dad will be home from holiday by now,” said Norma morosely, “Wish me luck breaking the news to them about my new job.”

Are You Mad?

The following morning, as we walked towards our wards, we asked Norma about her parents’ reaction last night. I will let Norma take up the story from here.

“Well, I broke the news to them gradually. After welcoming them home and asking about their holiday I told them I had been to work.”

“Oh, did you get a job at ‘Gold’n Locks’ salon?” asked Mum.

“No, but I am working in Rainhill.”

“Are you at ‘Cutting Edge’ in the precinct?”

“No.”

“Then you must be at ‘Root 66’ Hairdressers,” said Mum, convinced that she had finally got it right.

“Nope.”

“I can’t think of any other salon luv,” Mum said, becoming increasingly intrigued.

“Mum, I didn’t say that I was working in a salon.”

At that point Dad put down his newspaper and looked at me over the top of his glasses.

“So where are you working?” he asked in a tone that suggested that the guessing games were over.

“The hospital.”

“What, Whiston hospital?”

“Er, no,” I replied, and, after a moment’s hesitation and deep breath, “Rainhill Hospital.”

There followed a moment’s silence...

“The bloody loony bin, are you mad?” he shouted, oblivious to the irony.

“You don’t have to be mad to work there... but it helps!” I joked flippantly as an opening gambit to win them ‘round. Once they had recovered from their initial shock and their holiday suntans had returned to their faces, I assured them that everything would be fine. They felt a little easier when I told them that you two and Bill were all working at Rainhill as well.

Norma and Jeff went to the geriatric block; I walked to the Benedict Clinic. Her story made me wonder why it is that almost every hairdressing and beauty business seems to find it necessary to think up an excruciating pun as the name of the salon. The best (or worst) I have ever seen was one which I guess was owned by someone who enjoyed skiing in the French Alps. Her salon was called ‘Val Does Hair’... That’s a pun to ‘Curl up and Dye’ for.

I was still smiling to myself as I arrived at the office. I greeted my colleagues with a cheery, “Good morning.” Henry and Malcolm were huddled together reading something on the desk between them.

“What’s so interesting?” I inquired as I hung up my jacket. Without looking up, the charge nurse answered,

“It’s the ‘Salmon Report’, it’s just been published.”

“Oh, are you going fishing?”

They all laughed at my perceived witticism until my slightly bemused expression betrayed the fact that it had been a serious question.

“It’s an NHS report,” said Anne, helping me out. “That’s the... National... Health... Service,” she added slowly, emphasising each word sarcastically.

“Yes, even I know that thank you,” I responded as we laughed and made our way to the wards just as the night shift staff were anxious to go home. Most of the patients were already up, and all I needed to do was to patrol the wards to make sure everything was okay. As with every other aspect of their lives the patients were self-regulating as they followed their habitual routine. A cooked breakfast was served every morning, and I noticed that a few patients had specific tasks such as serving, clearing tables, and helping to wash up. These jobs were regarded with pride by the patients, who approached their work very conscientiously. After breakfast, it was time for general socialising and the day-patients started to arrive.

“Are you going to take Charlie on?” teased Malcolm nodding over towards the chess table.

“I think I will watch and learn for a couple of weeks.”

I spent the morning joining in with table tennis and pool. After about an hour, I noticed that a white-coated doctor had entered the room and was chatting to Henry. I could tell that he was a doctor because he was wearing the obligatory stethoscope around his neck. When I saw the charge nurse point over to Charlie Rosewall I realized that a chess challenge was imminent. As the doctor walked past tables of patients he was greeted with, “Hello nerse,” by all the patients. Everyone in a white coat was called ‘nerse’, even the dinner-ladies.

He sat down at the chess board and rubbed his hands together in anticipation as Henry shouted over to Charlie, who was quietly chunnering to himself as he stood looking out of the window, scratching his head of course.

“Can’t be beat, can’t be beat,” was all that Charlie muttered in his nasally Cockney accent as he sat down. Malcolm and I gradually gravitated towards the table.

Just before they started to play, the doctor nodded to Malcolm and said, “I’m on my breakfast break for half an hour, so I thought I would come over and challenge Charlie to a game of chess.”

“Oh yeah,” joked Malcolm, “and what are you going to do for the other twenty five minutes?”

Charlie was oblivious to this banter and continued mumbling with the occasional giggle as he scratched his never-healing scabs. The doctor pondered his every move carefully and slowly, while Charlie, by contrast, made his moves instantaneously, seemingly without any thought.

I had no sooner settled down to watch and hopefully pick up some tips than Charlie moved a chess piece and announced, “Check mate. You can’t do it, can’t be beat, can’t be beat,” and, without further ado, stood up and walked away quietly laughing to himself. It was now the doctor’s turn to start muttering under his breath. Malcolm’s joke about twenty five minutes was not far short of the mark, many a true word is spoken in jest.

When I returned from the staff canteen later that day, I went over to Malcolm and told him that I had been sitting opposite a doctor who looked as though he was a keen chess player.

“How could you tell that?” he asked innocently, setting me up for the punch-line.

“It took him five minutes to pass the salt.”

Is it Tuesday Today?

As the days and weeks rolled by, I fell into a routine almost as regimented as that of the patients. Norma, Jeff, Will, and I exchanged anecdotes regularly, humour being the perfect stimulus to help us through the early starts and long hours. Very often when we arrived in the morning we were met by Ernie Halton. If he didn’t have a flower to give us, he would just pick up anything: a pebble, a feather, a piece of grass to give us a gift.

We would accept these with a thank you and, invariably, he would then whisper in my ear, “Is it Tuesday today?”

After a few days I asked Ernie, “Why do you always ask me if it is Tuesday?”

“Sister brings biscuits,” he replied as he made his way to his morning bench.

I mentioned this to my colleagues at the clinic, and they told me that his sister did indeed visit him on Tuesdays and bring him biscuits. But that was twenty years ago.

“Very sad,” was all I could say, as I shook my head.

“It is sad,” they agreed, “but he is happy enough here in his own little world.”

At that point Malcolm called Ernie over to join us.

“Who is your favourite film star?” asked Malcolm

“Boris Karloff,” was the instant reply, delivered in a ‘clipped’ way of speaking, in his thick Scouse accent.

“Anyone else...?”

“Vanessa Redgrave.”

Malcolm then pointed to anyone at random and asked Ernie

“Do you like him?”

“No.”

“Why?”

“He’s in the way,” whispered Ernie.

This was obviously a well-used routine. Malcolm informed me that that was Ernie’s full repertoire of conversation.

“Do you like him?” Malcolm asked Ernie as he pointed at me.

“Yes,” replied Ernie with a little nod as he bent to pick-up a piece of paper which he handed to me.

“Thank you Ernie,” I said as I put in my pocket.

“You are very honoured,” Malcolm said to me, “one of his chosen few.”

Even to this day, over forty years later, if Norma or I ever find ourselves asking “Is it Tuesday today?” we both nod in acknowledgement of memories of Ernie. And, of course, if ever there is a film on television starring Boris Karloff or Vanessa Redgrave, we have to pronounce their names in Ernie’s distinctive manner.

You Did Say ‘Have Another Sausage?’

At the end of a shift one evening, I was sitting in the office with the charge nurse, just winding down, when there was a knock on the door.

“Come in,” shouted Henry, and a head slowly and hesitantly came into view around the opening door.

“Can I have a word, nerse?” was a very sheepishly asked question.

“No you can’t, George!” shouted Henry, “I’ve had enough of you today.”

George entered the room anyway; arms outstretched as he approached the desk, insisting that he had come to apologize. He was a rough-looking character: about 5 feet 9 inches tall, with large hands and strong, hairy forearms. He was middle aged, but looked as though he kept himself fit. He had dark hair and a nose which gave the appearance of a face pressed up against a plate glass window. The actor Charles Bronson came to mind.

“There is no need to apologise,” said Henry in a conciliatory tone as he stood up from his desk to meet George in the middle of the office.

“But I am really sorry for being such a pest. I know I can be a nuisance,” continued George, while offering a handshake.

Henry smiled and said that it was okay, and he accepted the apology and the handshake.

I noticed that Henry very skilfully maintained the handshake as he gently manoeuvred George back towards the door while humouring him.

“Thank you,” said George as he was leaving, and went on to say, “I am really sorr-”

But his sentence was cut short by Henry saying, “That’s enough George; you’ve said sorry once, let’s leave it at that.”

“Ok, nerse,” were George’s final words as Henry closed the door.

As he walked back towards me smiling and shaking his head, I couldn’t resist asking what that was all about.

“That was George Church,” said Henry.

“Yes, I have seen him around the clinic.”

Henry then told me that George suffers from a compulsive repetitive syndrome. He went on to explain that there are many forms of this which manifest themselves in a variety of ways, such as washing hands repeatedly, obsessively straightening books on a shelf, or following an essential routine when getting dressed. He told me that George’s disorder was to keep asking the same question over and over. Some days were worse than others, and George came to apologize after harassing Henry for most of the day.

“Read his case file tomorrow,” suggested Henry as he nodded in the direction of the filing cabinets.

“You’ll find that he was a former professional middleweight boxer, which you probably guessed,” he added, while demonstrating the point by flattening his nose with his right forefinger and folding his ear with his left hand. Henry went on to tell me that, in the past, George had been sacked from numerous jobs for getting into trouble due to his condition. His colleagues and bosses thought he was trying to be funny or argumentative when he repeatedly questioned instructions or statements.

“I dare say you will see a few examples of his behaviour before long,” said Henry wearily as we wished each other goodnight. I didn’t have to wait long.

The following morning all the patients were sitting at their usual tables, quietly enjoying breakfast. I, Anne, Malcolm, and Henry supervised as usual. One of the catering staff came from behind her serving counter and approached Henry. She told him that all the bacon, eggs, and beans had been served, but she still had surplus sausages and that it would be a shame to throw them away. Henry immediately volunteered to go round with the tray from table to table.

“More sausages anyone?” he would ask cheerily.

“Thanks, nerse,” were the grateful replies.

George Church was eating heartily as Henry approached his table.

“Here you are George, have another sausage,” said Henry, as he scooped one on to George’s plate.

“Thanks, nerse,” he replied as he stuck his fork into it.

Just as the charge nurse was about to move on to another table, George held up his sausage and said, “Nerse, you did say have another sausage?”

“Yes George, have another sausage,” repeated Henry reassuringly.

George then put the sausage back on his plate but, just as he was about to cut it, he looked up again at Henry and asked, “But you did say ‘Have another sausage’?”

“Yes George,” said Henry. “Have another sausage,” raising his voice slightly.

After about two seconds came the inevitable, “But you did say ‘Have another sausage’?”

I watched from a couple of tables away. Henry caught my gaze and raised his eyebrows and rolled his eyes as if to say’ here we go’. Henry replied once more with a much quieter, almost whispered, “Yes George, have another sausage,” in an attempt to calm him down as parents often do with an unruly child.

There was a long pause, and Henry breathed a sigh of relief as he thought that his strategy had worked. It hadn’t.

“But you did say have another sausage?”

“Yes, have another bloody sausage!”

I was fascinated watching this exchange, and yet not one of the patients took the slightest notice.

“But you did say have another sausage?” asked George again, becoming increasingly animated. This went on for quite a few minutes as George followed Henry around the dining room, asking the same question incessantly. Unfortunately, George caught the corner of the tray with his arm and accidentally knocked it out of Henry’s hands. The rattling of a tin tray on the floor only inflamed the situation. A cascade of sausages landed on breakfast tables, causing a slightly confused flicker of attention from the patients. A couple of them even looked up at the ceiling to see if it was really raining sausages. Henry remained calm, but he looked as though he was about to explode. To his credit, he retained his professionalism as he announced to the staff that he was returning to his office.

“But you did say have another sausage?” were the last words he heard echoing along the corridor as he closed his door and disappeared into the sanctuary of his office. I struggled to keep a straight face as I tried to stifle a laugh. The catering ladies immediately sprang into action with a mop and bucket and a waste bin for the sausages. Ernie Halton got up from his table and picked up a sausage off the floor

‘Oh, that’s a nice gesture,’ I thought, ‘Ernie is helping to clean up’.

Except that he came over to me and offered the sausage as a present. I accepted it gratefully and surreptitiously dropped it in the bin. George continued to ask anyone who would listen, “But he did say have another sausage?”

No one was listening. He continued with this tirade until two nurses arrived and gently persuaded George to go with them. Henry had rung to report the incident, and George was taken for counselling and a review of his medication.

“You can come out now Henry,” I said popping my head inside his office, “George has been taken away by the men in white coats.”

“I think they will soon be coming to take me away,” replied Henry wearily.

We returned to the dining area as everything was being packed away, and one of the dinner ladies came over to us with the menu for the following day. She showed it to Henry and said playfully, “You did say sausages again tomorrow?!”

At the end of the day, we were sitting in the charge nurse’s office, slowly winding down. There was knock at the door and, before Henry could answer, in walked George. He gave me a slightly confused glance before saying, “Hello nerse,” to Henry, who was sitting behind his desk.

“Hello George,” replied Henry, cautiously.

“I’ve come to say sorry. I know I can be a real nuisance at times,”

“It’s me who should be apologizing this time,” said Henry magnanimously.

“So are we still friends?” asked George in an almost child-like manner.

“Of course we are. You go and have a cup of tea now, and enjoy your evening.”

“Thanks nerse,” said a relieved George, as he moved towards the office door.

“Sorry once more,” he said as he waved and closed the door behind him.

Then almost immediately the door opened again, and George’s head popped ‘round.

“But you did say have another sausage.”

George managed to get his head out of the way just as the wicker waste-paper basket flew through the air and hit the door.

Taking the Plunge

The next time I saw George was a couple of days later, when I was coming out of the charge nurse’s office and almost bumped into him. Again, he looked at me with a quizzical expression as he side-stepped me with the skill of a rugby player. He was wearing a track suit, so I asked him where he was going. At first he gave me a sort of ‘What’s it got to do with you?’ look, and then answered that he was going for a run in the hospital grounds. I later mentioned this to Malcolm, who told me that George’s doctors encouraged him to exercise regularly as it seems to help with his condition. When I said that I was a regular jogger and I played rugby league, Malcolm casually suggested that I should join George on a training session to make it more interesting for him.

“Would I be allowed to do that?” I asked, expressing surprise.

“Of course,” said Malcolm, “Remember, your job is to spend time with the patients. It would be frowned upon if members of staff spent all their time playing snooker or chess with each other. Just ‘okay it’ with Henry first.”

So the following day I took my tracksuit into work and invited myself along for a run with George. He must have been at least twenty years older than me, but he set a fair pace as we jogged along the tarmac paths. He also punched the air while bobbing and weaving in the style of a boxer, which, indeed, he used to be.

“What’s your name?” he asked me after a couple of minutes.

“John,” I replied, and then wondered why he had asked, since I had never heard any of the patients referring to Henry, Malcolm, or Anne by their first names.

We stopped on the grass at the side of the Benedict Clinic, and George started to do some push-ups and sit-ups. I had kept pace with him without a problem while running, but I must confess that I struggled to match him with these exercises. He still had the upper-body and core strength of an ex-professional boxer; which must be the hardest, toughest sport of all. As we sat together at the end of a gruelling session, I felt that George had extended himself more than usual because he had a training partner.

“I like swimming as well,” George said.

“Does the hospital have a swimming pool?” I asked, wondering if there was one for therapeutic treatments.

“No,” he said, laughing and shaking his head as if I had asked a stupid question.

“Sometimes I have been to Widnes baths.”

“Oh, I wouldn’t mind going as well next time.”

“Yeah, but we would need a nerse to go with us,” George said with a shrug.

“Well, why not me?”

“What do you mean?” George asked with a quizzical expression.

“I am a nerse; I mean, nurse.”

There was a long pause before George pointed at me for emphasis and said, “You are a nerse?”

“Yes, what did you think I was?”

After a further slight pause George just said, “I thought you were a patient.”

He then thought for a while longer before adding, “I’ve often wondered why you were always in the charge nerse’s office.”

Now I realised the reason George had always given me a puzzled look when I was in Henry’s office, and the fact that he had never once referred to me as ‘nerse’. Come to think of it... neither had any of the other patients.

Needless to say, Norma, Jeff and Bill all thought it was hilarious when I told them. All the usual jokes came out: ‘It takes one to know one’, ‘Are you mad?’, ‘Don’t be crazy’ ... ad nauseam. Even my colleagues ribbed me about it. ‘Should have worn the white coat,’ they would say. Amongst all this banter, Henry did tell me that I could take George to Widnes baths if I so wished.

A few days later, George and I set off mid-morning for our day out to the swimming pool. I carried a small ruck-sack containing towels and swimming trunks, and some sandwiches provided by the catering ladies. No, not sausages, in case you were wondering.

As part of George’s rehabilitation and integration into society, I was told by the charge nurse to encourage him to take responsibility for his own money and to buy his own bus and entrance tickets.

“Keep a close eye on him,” was Henry’s final instruction.

While waiting at the bus stop, I had coached George and advised him about paying. The buses in those days were invariably double-decker, still with a conductor. We boarded and went upstairs. I sat next to the window to enable George to speak to the conductor.

“Widnes baths please,” said George, money in hand.

“That will be 20 pence please sir,” replied the conductor, carrying a battered leather money satchel over his shoulder and a ticket machine which dispensed the tickets from a roll with the turn of a handle. George checked his coins in the palm of his hand and picked out the correct fare, which he offered as payment. I was looking out of the window, not wishing to draw attention to George by over-supervising him.

Just as the conductor was about to take the money, George pulled his hand back and asked, “You did say 20 pence?”

“Yes sir. That is the correct fare to Widnes.”

“But you did say 20 pence?” asked George again.

I must have been daydreaming momentarily as I watched the world go by, but then, just in time to avoid any confrontation, I said sharply, “George!” My admonishment seemed to jolt him, and he offered the money to the conductor without further comment.

“Same here,” I said simply as I paid my fair.

“Sorry nerse,” whispered George to me.

“That’s okay, you are doing well,” I whispered back encouragingly.

As George and I arrived at Widnes Baths, the entry prices were displayed, which meant that he could pay without asking any questions. As we approached the ticket office, I simply squeezed George’s elbow and gave him a ‘raised eyebrow’ look. He understood immediately that this was a ‘behave’ signal and he replied with a smile and a ‘Don’t worry’ thumb-up sign. Perhaps telepathy is the secret of success.

George paid for his own ticket and collected it from the lady behind the glass with a pleasant, “Thank you.” He just managed to stop himself from adding ‘nerse’. He looked towards me and his face beamed as he was obviously pleased with himself, having cleared another hurdle.

“Well done,” I whispered as we made our way to the changing rooms.

We were allocated lockers in a stark, white-tiled room which had a row of benches in the centre, with toilets and showers next door. The locker keys were on a coloured elastic band which could be worn around either your wrist or ankle while swimming. George and I spent a very pleasant hour in the pool, and did some training by swimming lengths. We also had a bit of fun jumping off the diving boards and splashing about. I occasionally had to quietly suggest to George that he didn’t shout “nerse,” to me from the other side of the pool, thereby avoiding any unwanted attention. Everything went swimmingly, so to speak, and we made our way back to the changing room, which was occupied by a few people, some just arriving and some drying off. George and I took our towels from the lockers, and I decided to go to the toilet.

“Don’t move from here,” I whispered to George, “I won’t be long.”

As I was in the loo, I started to hear the sound of raised voices reverberating off the tiled walls. At first it was difficult to distinguish between the general exuberant sounds coming from the pool and sounds coming from a different direction. I tilted my head, as if that makes the slightest difference when listening for something, and then the penny dropped. There was some sort of argument going on in the changing room and I realised I had better get there sharpish.

I then recognised George’s voice as I heard him say, “You did say that is your towel?”

I knew I had to intervene without further delay and, whatever was going on, ‘nip it in the bud’ quickly. I walked into the changing room to find an enraged member of the public practically nose-to-nose with George, who looked totally bemused.

“Yes, this is my bloody towel,” shouted an aggressive man to George. One or two members of the public were watching, slightly worried that they were going to get caught up in trouble, which looked likely to kick-off immediately. The aggressive man’s friend was trying to calm the situation by pulling him away and suggesting that George didn’t mean any offence.

Then, just at the wrong moment, George pointed and repeated, “You did say that was your towel?”

“If you are looking for trouble, mate, I think you’ve found it,” he said as he pushed George in the chest. His friend pulled him back just as I managed to jump in between them.

“Calm down, he’s with me,” I pleaded.

“George, go and sit down over there,” I instructed firmly but reasonably quietly, under the circumstances.

“He didn’t mean any harm,” I assured the man, who seemed to me like a character who was never far away from trouble.

“He is accusing me of stealing his towel by keep asking me if I am sure it’s mine,” he said, while still being held back by his much more reasonable companion.

“I didn’t accuse him of stealing the towel, nerse,” shouted George defensively.

“That’s okay,” I reassured him with a hand gesture signalling him to stay where he was.

“What did he mean when he called you nurse?”

“He is a patient of mine...at Rainhill Hospital.”

The expression on their faces must have been the same as Norma’s parents when she told them where she was working. I sensed a slight tensing of bodies amongst the watching bathers. It was as if they had been cornered by an escaped axe murderer.

We all continued to get dressed, with a distance between us maintained. As George and I were about to leave, I felt obliged to go over to the two men and offer an apology and a conciliatory handshake, which they accepted somewhat begrudgingly. As I walked away, the man who had been involved in the altercation could not resist saying, “Hey mate, it’s a good job you came along when you did, otherwise somebody might have got hurt.”

All I could do was turn to give a little smile and say tersely, “Yes... I think somebody would have got hurt.”

On the way back to the hospital I decided to pay for the bus tickets for both of us. George had had enough social integration for one day.

Drawing Together

One quiet afternoon, as the sun was streaming into the social area, I was interacting with the patients as usual when I noticed that my colleague Anne was sitting side-by-side with a female day-patient a little distance away from the general activities area.

Up until then I had played a game of snooker, table tennis and pool. I still had not summoned up enough courage to play chess with Charlie; I was building up to that. I found myself casually wandering over towards Anne; intrigued to see what they were doing but anxious not to intrude, in case Anne was conducting a counselling session. As I approached them, I noticed that the patient was drawing the scene outside, with Anne offering encouragement. The patient had a drawing board on her knee, and the art portfolio leaning against her chair suggested that she was a keen artist.

“Hello, do you mind if I watch?” I asked gently, hoping I wasn’t breaking her concentration. Anne looked up and smiled welcomingly, but the only reaction from the patient was a cursory sideways glance. Her unchanging facial expression gave me no indication at all as to whether I was welcome or not.

“You don’t mind if another nurse joins us do you, Susan?” Anne whispered to her. After an almost imperceptible shake of the head from Susan, Anne beckoned for me to join them.

“That’s very good Susan,” I said quietly, glancing at her drawing.

Again there was no reaction or acknowledgment from her as she continued to concentrate intensely.

“Do you enjoy using coloured pencils?” I inquired. Still there was no response. I looked to Anne who gestured to me to stand up. We moved away slightly as Susan continued to hunch over her drawing board, only occasionally looking up at the landscape through the window. She was one of the youngest patients, mid to late twenties, and Anne briefly and quietly outlined her case history to me. She told me that Susan suffered from depression and she had withdrawn into herself, having very little interaction with anyone else. Anne told me that she was making progress with her and art seemed to be a good avenue of expression for Susan.

“Unfortunately,” Anne said, “I have no talent for drawing, so all I can do is encourage her and try to get her to talk.”

She went on to tell me that occasionally they have had an art therapist visit the clinic, but not for a while.

“I am an art student,” I said to Anne, presuming that she already knew, but her surprised expression told me that this was not the case.

“I had no idea, nobody has ever mentioned it.”

During the rest of our conversation, it transpired that vacationing students come and go at the hospital and none of the permanent staff take much of an interest as to which particular course or college anyone is from.

“So what do you study?” Anne asked with interest.

“I have just finished my first year at Leeds University where I’m doing a BA degree in Textile Design and Art History.”

“That’s great,” said Anne, and turned to Susan to say

“This nurse is an artist; can he have a look at some of your work?”

Anne looked to me and nodded, but I must admit that I couldn’t sense any response from Susan. I picked up the portfolio, which was made of black rigid plastic and had handles for carrying, like a large, thin briefcase. I sat next to Susan and placed the portfolio on my knee, ready to peruse her drawings. I flicked through the selection which comprised mainly natural forms, such as flowers and landscapes drawn in charcoal and coloured pencils. There were a couple of Disney cartoon characters, and, interestingly, some portraits, which I thought would be a good topic to attempt to coax Susan to talk about them.

“This is very good,” I said encouragingly as I selected a drawing and held it in front of her.

“It certainly is,” Anne agreed enthusiastically, looking for signs of a response. No luck. Susan continued with her blank, almost vacant, expression as she continued drawing the landscape. I tried one or two other examples with the same tactic, and the same result. I looked at Anne and shook my head slightly, as if to admit defeat.

“John, why don’t you do a drawing so that Susan can see that you are an artist?” suggested Anne in a tone directed more towards Susan’s ear.

“What a good idea,” I responded, in the same tone, but still there was no reaction. Undeterred, I took a sheet of cartridge paper from the portfolio and Anne took a 4B pencil from Susan’s pencil case and handed it to me. I decided to draw exactly the same scene; some common ground which I hoped could possibly spark a reaction. Anne settled down to watch and I started to lay out the basic structure of the drawing by holding my pencil horizontally in front of me and then at various angles of perspective. I quickly sketched these lines in and Anne started to ask me questions about the drawing. I answered with explanations in the hope that Susan might pick up on it. She didn’t even glance sideways as she continued with her own work. At one point I closed my left eye and held up my thumb. I scrutinised it and changed angles regularly from vertical to horizontal.

“I’ve seen artists do that on the telly,” said Anne, “So why are you doing that?”

“I’m going to draw my thumb,” I joked.

We both laughed and instinctively looked to Susan, but to no avail.

I was beginning to feel like a stand-up comedian doing the first house on a Saturday night at the Glasgow Empire.

“I think I will just draw,” I whispered to Anne.

“It better be good.”

“There’s no pressure there then!”

I spent the next twenty minutes or so drawing the scene in front of me, and I was pleased when it started to take shape. I was concentrating so much that I almost forgot that Susan was still drawing next to me. Anne then gently nudged me with her elbow to gain my attention and suggested to me with a nod of her head that I should look to my left. Susan had stopped drawing and she was actually watching my drawing take shape. I felt like an angler who had just got a bite, and I decided to keep drawing rather than speak and lose the moment.

Anne leaned forward and spoke across me to ask Susan gently, “Do you like John’s drawing?”

Even as I continued looking forward and drawing, I could clearly detect from the corner of my eye that there was a slight nod of Susan’s head. It was a gesture which spoke volumes. Anne nudged me again and nodded with a broad smile. Susan continued watching until I finished the drawing. I then wrote along the bottom of the picture ‘to Susan from John Meadows’, and handed it to her without a word. She took it from me, again without a word. I then stood up ready to move on to other patients, and Anne quickly took my place sitting next to Susan.

“What do you think of the drawing?” Anne asked.

“It’s good,” answered Susan, barely audible.

As Anne and I walked away, once we were out of earshot, she told me that they were the first words that Susan had actually spoken in a while.

A couple of days later Susan came in again, portfolio under her arm, and I asked Anne to set up some flowers on one of the tables.

“No problem,” she said enthusiastically, “If there is one thing a hospital is not short of, it’s flowers.”

I went over to sit with Susan, and I like to think that there was a slight flicker of recognition and a faint smile on her lips, or perhaps it was just my imagination and wishful thinking.

She made a good start with her new subject matter: a round vase containing lilies and roses. I made a couple of observations and offered a few words of advice, with no response. I then asked her if I could show her one or two things by working on her drawing. I was pleasantly surprised not only to get a reaction, but she offered me the drawing and her pencils and shuffled her chair slightly to make room for me to sit next to her. I demonstrated a few techniques, such as how to use light and shade and to render different textures and she watched intently.

The most gratifying moment of all was when I stood up and handed back her pencil and drawing, she looked up at me and said “Thank you.” As I walked away, I felt that I had made a breakthrough and was surprised to feel a great sense of fulfilment and job satisfaction.

“Anne tells me you’re a bit of an artist, John,” said the charge nurse a few days later. “If we buy some materials, would you be interested in doing a few art classes or perhaps some art therapy with the patients?”

“I’d love to,” I replied with enthusiasm. “It would provide an extra activity for everyone.”

“Not quite everyone,” observed Henry, “I don’t think anything would lure Charlie Rosewall away from the chess board.”

Over subsequent weeks our art sessions went well and Susan joined in, sharing a table with others for the first time, which we regarded as a significant breakthrough.

I actually did a couple of portraits of some of the patients; Ernie was a good subject who sat very still, occasionally asking if it was Tuesday today. I gave up with Charlie; he couldn’t sit still long enough. I spent some time drawing George Church’s portrait, and Malcolm watched with interest over my shoulder. As soon as I had finished the drawing, Malcolm took it off my drawing board and said he was going to show it to the charge nurse.

I followed him into the office as he held it up in front of Henry and said, “Look at this, John has just drawn it.”

“That’s very good,” exclaimed Henry, and then, pointing at the drawing, said, “I like him very much.”

“Who?” said perplexed Malcolm.

“What’s-’is-name in ‘The Dirty Dozen’.”

“Why, who do you think it is supposed to be?”

“Charles Bronson!”

A New Boss Sweeps Clean

Our shift-patterns at the hospital often required us to work weekends. One morning, after leaving Norma and Jeff at the geriatric ward as usual, I was walking to the Benedict Clinic when a rhododendron bush asked me, “Is it Tuesday today?”

“No Ernie, it is Sunday,” I shouted back instinctively without even looking round or breaking stride. Perhaps I was becoming institutionalised. As I entered the office, Malcolm was glancing at the Sunday papers before starting work, and he told me that Henry would not be in as he had booked a couple of days’ holiday. Malcolm was the acting charge nurse, and he told me that he had some admin work to do in Henry’s absence. I left him to it and went into the social area to help supervise the regular breakfast routine. Anne was at the other side of the room overseeing the activity going on around her, and she waved a good morning to me.

The patients were being organised and regimented by a man whom I hadn’t seen before. He was in his mid-forties, very smartly dressed in a white shirt, tie and a pair of chinos. He spoke with great authority as he very efficiently gave instructions regarding the re-arrangement of tables and chairs. The patients followed his instructions to the letter, even though they would have carried out their individual tasks anyway, because that’s what they did every day.

“Good morning nerse,” a few would say to me as I walked past. The word had finally got round to everyone... I wasn’t a patient.

When he heard them refer to me as ‘nerse’ he came straight over to me, with a beaming smile and arm outstretched and greeted me with a cheery, “Good morning young man.” He shook my hand vigorously and continued with, “Pleased to meet you; my name is Mr. Tinsley... please call me Fred.”

“Pleased to meet you Fred,” I replied, continuing to shake his hand, “I haven’t seen you in here before.”

“I am sometimes transferred over from St Anne’s ward, usually at weekends,” he explained, and I presumed it was because Henry was on holiday. Fred then proceeded to give me detailed instructions about what he would like me to do that day, much more than Henry had ever done during previous weeks. He seemed to exude an air of importance, and I suspected that he had seniority over Henry in the hospital hierarchy. I thought I had better comply without question. ‘Thank god I didn’t work on St Ann’s ward,’ I thought as he kept me on my toes during breakfast.

During clearing-up time and setting-up for activities, I helped to move tables a little more conscientiously. ‘This could be an assessment,’ I thought. As I walked around the room my conversations and banter with the patients became a little more animated as I tried to make a good impression. I could feel Mr. Tinsley’s eyes following me around the room, like a portrait in an art gallery, but I was relieved when I saw him smile at me and nod his approval. ‘It’s going well,’ I thought.

Fred then went into a walk-in cupboard just along the corridor and wheeled out one of several vacuum cleaners which were kept in there. The patients were well into their individual activities, and, being Sunday, one or two were sitting watching television. As he was about to plug in the cleaner he saw me watching him and came over.

“I always like to help out like this at weekends,” he said and then started to hoover around, barking out orders to people to lift their feet as he approached the TV area.

‘I can take a hint,’ I thought, and then used my initiative and wheeled out a second vacuum cleaner and started at the other end of the room between the tables. After a minute or so, Malcolm emerged from the charge nurse’s office and saw me struggling to manoeuvre an industrial standard vacuum cleaner.

“What are you doing?” he shouted in my ear over the noise.

I switched off the machine and said, “What?”

“What do you think you are doing?” he repeated in a quieter voice.

I was tempted to answer ‘What does it look like?’ but I resisted because I felt that it would have sounded more disrespectful than intended, especially to the acting charge nurse. I answered his question with a question, “What do you mean?”

“Since when has it been part of your duties to hoover the floor?” he asked in slightly bemused manner.

“Well, I thought I had better show willing since Mr. Tinsley is leading by example,” I explained as I nodded in the direction of the TV area where he was still cleaning.

“You mean Fred?” asked Malcolm.

“Yes, he did ask me to call him by his first name.”

“John, please follow me to the office,” instructed Malcolm solemnly.

I thought I must have transgressed some important rule regarding use of electrical equipment without the statutory training. I also felt that Malcolm’s manner was rather officious and I put that down to his temporary elevation to the dizzy heights of Charge Nurse.

“So you have been taking instructions from Mr. Tinsley this morning, have you?” was his stern, rhetorical question.

“You mean Fred?” I replied, trying to lighten the tension. At that point I realized that Malcolm did not take kindly to someone from another ward coming into the Benedict Clinic and giving orders. This surprised me, because I was now seeing another side of his character which I hadn’t noticed before. He had always seemed such an easy-going, laid-back person and we had got on well up to that stage, particularly since we shared a similar sense of humour.

“I’m sorry Malcolm, but I wasn’t intending to undermine your authority. I just thought, being a vacation student who needs to keep his job, I had better do as I was told.”

This seemed to work as Malcolm’s tone softened. “It is true that Mr. Tinsley often comes over from St. Ann’s ward to help out at weekends,” explained Malcolm, “but John,” he continued, “and I don’t know how to break this news to you... Mr. Fred Tinsley... is a patient!!”

My face must have been a picture. After a couple of seconds of stunned silence Malcolm thundered into laughter which filled the room. By the time Anne came into the office to see what was going on, Malcolm was roaring and holding his sides in pain, with tears streaming down his face.

“Fred Tinsley is a patient? ... Well you could have fooled me!” I said loudly in order to be heard over the sound of laughter.

“He did!” Malcolm spluttered, before convulsing into further fits of mirth.

“So let me get this right,” said Anne to Malcolm, as if I wasn’t there, “John thought Fred Tinsley was a member of staff, and he has been taking orders from him all morning.”

“Yeah,” screeched Malcolm, as he dabbed his eyes with his handkerchief, “The lunatics have taken over the asylum.”

My expression remained deadpan, or was it bedpan? ... And they hadn’t finished with me yet.

Anne tilted her head towards me saying, “And is this the same John who George Church thought was a patient? ... That must be some kind of a record!”

“Stop it,” croaked Malcolm as he collapsed onto a chair. For a second I thought we might have to send for a doctor. What could I do but laugh along with them? Eventually they settled down and sanity prevailed. It’s not often you can say that in a psychiatric hospital.

“Now come on,” I eventually retorted, “you must admit that Fred doesn’t act like a mental patient. I still can’t work out what’s wrong with him.”

“Well,” said Malcolm, gradually regaining his composure, “I can’t remember the exact medical terminology because Fred’s case file is kept in St. Ann’s ward, but I do know that he suffers from a severe type of paranoia. It is a form of persecution complex and he believes that if he sees a group of people talking, or two people whispering, they are actually talking about him.”

“Really,” I commented as I sat down to hear more.

“Yes, he has been thrown out of pubs for causing trouble because he had accused complete strangers of plotting against him. It has happened in Liverpool City centre and supermarkets. He was even banned from going to rugby matches because every time the players formed a scrum he ran onto the pitch and berated them for talking about him.”

“No, unbelievable,” I exclaimed with the shake of the head.

“Okay, I admit I made the last one up,” teased Malcolm.

“But I’ll tell you what is true,” he said “Fred’s paranoia extends to people on television.”

“Is this another joke?” I asked apprehensively, suspecting that I was setting him up to deliver yet another punch-line.

“I’m perfectly serious,” said Malcolm as he went on to tell me that the television incidents were the reasons why Fred had been admitted to Rainhill Hospital.

“So what kind of things did he do?”

“Oh, he would rant and rave at the screen if he suspected that anyone was conspiring against him. He has tried to get round the back of the telly, and he has sometimes put his foot through the screen. Also, anyone speaking directly towards the camera, such as a newsreader, was speaking to him personally and he tried to hold a conversation with them.”

“Amazing.”

“Keep an eye on him today,” suggested Malcolm. “You might see something interesting.” As I was leaving the office Malcolm shouted, “Oh, by the way, John...”

“Yes?” I said as I popped my head back.

“Don’t let Fred tell you what to do!”

“Ha, ha...”

Later that day, Malcolm and I were sitting near the television area, spending time with some patients and browsing the Sunday papers. On television was an episode of the series ‘Mission Impossible.’ Fred Tinsley was sitting at a nearby table casually glancing at some magazines while half-watching the telly. A conversation was taking place on screen, and one character asked the other if he had a pen. At that point Fred pushed back his chair and walked directly towards the television while taking a biro from his shirt pocket. Malcolm’s newspaper dropped as he frantically attempted to attract my attention with a combination of loud coughs, nodding his head and rustling the paper. I looked up to see him gesticulating to me to turn towards the television. I was just in time to witness Fred Tinsley approach the screen with his outstretched hand holding a pen.

“Yes Sir, I have a pen you can borrow, here you are,” he said to the screen as he offered it to the actor on TV. Just at that point the two actors exchanged pens, and Fred simply said, “Oh, I see you have got one,” and turned away, replacing his pen in his top pocket. He returned to his table and continued flicking through his magazines. I watched him all the way and then looked back towards Malcolm, who was grinning broadly. He looked at me and tapped his chin with the back of his hand.

“Close your mouth,” he was signalling, as I sat there shaking my head incredulously.

Operation Stitch-up

One morning, during tea break in the social area, Henry casually asked Malcolm, “How did the operation go last night?”

“Oh, fine, no problems at all, a great success,” answered Malcolm.

Not wishing to intrude on what I thought could be a personal issue, I didn’t say anything, but my surprised expression seemed to speak for me. Henry sensed my curiosity and brought me into the conversation by telling me that Malcolm had been an observer in the operating theatre the previous day.

“Really, how fascinating,” I enthused.

I assumed that Malcolm had attended an operation in an official capacity as a nurse, but they told me that any staff who expressed an interest could arrange to watch an operation taking place. Henry explained further that when the Benedict Clinic had been built it incorporated a brand new ‘state-of-the-art’ operating theatre. I assumed that he meant that it was exclusively for patients at Rainhill Hospital, but I was informed that this was not the case. Patients were brought in by ambulance from other hospitals, and many specialist surgeons visited on a regular basis.

“It must be fascinating.”

“Would you like to see an operation?” Henry asked me, almost matter-of-factly.

“Would I be allowed to, being a vacation student?”

“Of course, I will arrange it if you like?”

Being a ‘why-not’ sort of person, I simply nodded and thanked him.

I didn’t think much more of it until about a week later when Henry called me into his office and asked me if I was still interested.

“Oh, yes,” I replied.

Before I could ask for further details, he simply added, “This evening after work, at quarter to eight.”

I was a little stunned by the suddenness of the arrangement. Henry told me that a team of theatre nurses would be coming over later for pre-op checks, and I would be able to meet them. I received this news mid-morning, and I spent the rest of the day wondering what I had let myself in for. How would I feel? How would I react to the sight of blood? What operation would be taking place?

At five o’clock Henry called me to his office to meet the three specialist theatre nurses: a man and two women, all in their mid-thirties. He introduced me to Frank, Linda and Janice, each of whom greeted me with a friendly handshake and warm smile. I had seen them around the hospital and in the staff canteen, but this was the first time we had actually met.

“So you want to watch an operation, do you?” said Linda.

“Yes, it should be quite an experience.”

They were on their way to the operating theatre and suggested that I accompany them, checking with Henry that he could spare me for half an hour.

“I think we can muddle through,” Henry replied light-heartedly.

The operating theatre was located in the Benedict Clinic, but I had never actually been required to go to that part of the building. We entered through heavy double doors, each of which had a maritime-style porthole at eye level. The operating theatre had about the dimensions of a squash court. Stainless steel seemed to predominate, and the various beds and trolleys seemed like modern sculptural works-of-art with all the levers, handles, wheels. There were a couple of screens, brightly coloured with flower motifs, and several trolleys, some of which were covered with green sheets. It was a very light room with a skylight. It reminded me of the studios at Art College, but without the splashes of paint. The only time I had seen similar lighting units was in the dentist’s clinic. There were a couple of stainless steel sink units, with the type of taps you would not find in your kitchen. The various dispensers and taps had the long arms which were operated by elbows after scrubbing-up. I knew that from numerous hospital dramas on telly. There was a further annexe room in which there were lockers and washing facilities.

“Okay John, let’s take you through the procedure,” said Janice, adopting a business-like tone.

She told me to arrive as soon as possible after I finish work at seven o’clock, and that they would provide me with the necessary clothing. She gestured around the room and stressed that I must not touch anything on a green trolley, as they held sterilized instruments. I assured her that I would not be touching anything.

“Just one question,” I said as I looked around the theatre, “Where is the observation section?”

She told me that I would be standing just inside the doorway, but I would be close enough to see what was going on. The surgeon, a Mr. Simpson, would be arriving at about seven thirty, and we should be ready for that time. As Janice was briefing me, Linda and Frank were going through a list on a clipboard, checking everything, including a complicated-looking piece of apparatus of gas cylinders with numerous dials.

“We need another half-an-hour in here, so we will see you just after seven,” Janice concluded, gesturing me towards the door.

I returned to the Benedict patients in the social area, and I rang the geriatric ward to let Norma and Jeff know what was happening.

I arrived back at the theatre feeling rather nervous, almost as if I was the patient undergoing the operation. Frank, Janice and Linda were already there, and I was surprised to see that they were already wearing their theatre uniforms. They were dressed in green, wearing a hat, short-sleeved top, trousers, and a pair of white wellington boots.

“So you decided to come back and go through with it?” said Frank with a welcoming smile as he beckoned me to join them.

“Wouldn’t miss it for the world,” I replied, unconvincingly.

He then took me into the annexe locker room and gave me an identical uniform to put on. I entered the theatre with a ‘Ta dah!’ as I extended my arms to show off my new outfit to the nurses.

“Very fetching,” said Linda playfully, “give us a twirl.” I spun around theatrically as if I had just come out of the changing room at ‘Burtons,’

“Yes, I think I will take it,” I joked as we all laughed.

“Okay John, we now need to get rid of your static electricity,” said Janice in a serious tone.

“Get rid of my what?”

She then told me that I must touch my toes ten times to get rid of any build-up of static. I found a space to start, and as I did the first one I sensed that I might be the victim of a wind-up.

“Is this the equivalent of sending somebody for a tin of polka-dot paint, or a jar of elbow grease?” I asked dubiously.

“Don’t know what you mean,” they replied in mock innocence.

“So when did you do your static toe touching? I’ll do it with you,” I retorted.

So we formed a circle in the middle of the operating theatre. We only counted as far as two before they all started laughing. At least the joke broke the ice and momentarily took my mind off the forthcoming operation. At that point two theatre orderlies, dressed in the same style of uniforms but only in white, came into the room. We were still standing in the circle laughing and one of the orderlies looked at me, and with a knowing smile said, “Don’t tell me... static electricity.” The flippant, jokey atmosphere then changed in an instant as I was told that the patient would be wheeled into theatre very soon. The orderlies told the theatre nurses that the surgeon, Mr. Simpson, and the anaesthetist, Dr. Rogers, had arrived and were currently changing and scrubbing up.

“Okay John, time for serious business. Listen carefully,” instructed Janice solemnly.

She now had my full attention as she told me that the operation was going to be a sterilisation of a lady who had been brought from St. Helens hospital.

“It will involve an incision here,” she said as she demonstrated by pointing at her own abdomen, “and the surgeon will tie the fallopian tubes. The procedure is called Tubal Ligation.” She told me that there will obviously be plenty of blood on view, and asked me if I would be able to cope with that. I have never been squeamish at the sight of blood, but to be honest that has only ever been a cut or a graze playing rugby. All I could do was tell Janice that I wasn’t sure. She showed me exactly where I would be standing during the operation and told me that if I felt the slightest discomfort, nausea, or sickness, just turn around and walk straight out through the double doors.

“Don’t apologise, or speak, or try to fight the feeling. Just go.” She emphasized this by pointing towards the door and then added firmly, “but Do Not come back in because you would have left a sanitised area. Everything clearly understood?”

“Absolutely.”

It was now scrubbing-up time, and we went to the sinks. I followed their example as we dispensed a blue gel by operating the elbow taps and washed our hands and forearms thoroughly, rinsing off with warm water from another elbow-operated tap. The theatre doors opened and the white-uniformed orderlies pushed in the patient on a trolley. This was accompanied by a couple of stands from which protruded a variety of tubes and a stand which carried gas cylinders and a multitude of dials and gauges. We then put on green masks which covered my mouth and nostrils, and which was secured in place by pressing a piece of white plastic into the contours of my nose. We also wore very fine, tightly fitting transparent gloves. We were now ready to go from the scrubbing room into the operating theatre.

“Good evening doctor,” they said, welcoming the anaesthetist who was seated at the operating table behind the patient’s head. He was surrounded by a collection of dials which he was scrutinizing like a pilot doing a final check before take-off. The green covered trolleys, which I had seen earlier, had been put into place besides the operating bed, and the sheets had been taken off to reveal a set of gleaming silver instruments, shining brightly under the operating lights. They were neatly laid out on a green under-sheet, and there seemed to be every conceivable type of scalpel and scissors (perhaps conceivable is the wrong word to choose, in view of the nature of the operation!) The patient was already unconscious; she lay there with tubes leading into her mouth and nose. I took up my designated position about six feet from the operating table as instructed, and Frank, Janice, and Linda took up their positions facing towards me.

“Mr. Simpson will be here in a second,” said Dr. Rogers, who up to that point hadn’t noticed me, but he put me at my ease by nodding in my direction. Although I could only see his eyes over his mask I knew that he had given me a smile. (Being an artist and a portrait artist in particular, I knew that a genuine smile can only be detected in the eyes, not the mouth). The double doors then flew open, held by another orderly, and the surgeon made a grand entrance. This was accentuated by the fact that he was holding his arms outstretched in front of him as he entered, thereby ensuring that he does not come into contact with any surface. He stopped after a couple of strides and looked around as if to familiarise himself with his surroundings. He was wearing the same uniform as the rest of us, except that he was also wearing a plastic apron.

Through his green mask he announced, “Good evening everyone, sorry I am a little late and I have not had chance to speak to you, but I believe we have all worked together before.” Everyone nodded, and just as Mr. Simpson was about to approach the operating table he looked at me and did a double-take. He didn’t say anything. As he looked directly at me, I noticed immediately that he had the most piercing blue eyes. As he stared at me it seemed as though he had Superman’s x-ray vision as I felt the almost laser-like force going straight through me.

Thoughts quickly flashed through my mind, ‘Do I look away?’ ‘Am I not supposed to be here?’ ‘Do I speak first?’ I sensed the doctor and nurses at the table watching as two masked men stared at each other. Who would blink first? It was like the ‘Gunfight at the OK Corral’. An instantaneous moment was like an eternity as I seemed to be frozen in time. I tried to follow the surgeon’s thought-process by attempting to read his facial expression around his eyes: initially raised eyebrows and open eyes of surprise, then the lowering of eyebrows in puzzlement, and finally a smile and nod of acceptance. I reciprocated with a similar nod. The whole exchange lasted two seconds maximum, but to me I felt as if my life had flashed before me.

At the operating table the surgeon stood on the side directly opposite the three nurses, and the anaesthetist sat at the head of the table to his right. He greeted each colleague warmly by their first names and his professionalism and courteousness were such that he also turned to the two orderlies, who were standing a few feet away and politely nodded to them in acknowledgement. He was like the conductor of a symphony orchestra who shakes hands with the first violinist and then acknowledges each section in turn. There was no doubt as to who was in charge. He turned to the anaesthetist and asked a few technical questions, and then made sure that the nurses were positioned exactly where he wanted them.

I settled into my position, adjusting my body stance in order to gain a good vantage point, ready to witness a totally new experience in my life. By no stretch of my imagination could I possibly expect what was to come next. The surgeon, Mr. Simpson, turned directly to me and said firmly, “Here,” as he held out his right hand towards me and then pointed to the floor next to him. I just looked at him, remaining rooted to the spot. I was glad that I was wearing a mask because at least he couldn’t see my open mouth.

“I want you here,” he instructed firmly, repeating his gesture. Before I could reply, I noticed Frank tilting his head to me and down to the operating table. He was signalling me in a similar fashion to the way Malcolm had attracted my attention to witness Fred Tinsley talking to the T.V. a couple of weeks earlier. The message that Frank was attempting to convey was ‘just do as you are told’ and Janice reinforced this. So, I did as I was told and took up my designated position at the operating table. The surgeon positioned me right next to him. In fact we could not have been closer, since his right elbow touched my left elbow and to my right sat the anaesthetist. I could have put my arms around both of them, the way a hooker does to the prop forwards in the front row of a rugby scrum. He then told me to hold the patient’s head under her chin with my left hand and under her head with my right hand and to make adjustments as instructed by the anaesthetist.

After a couple of seconds the surgeon asked, “Is that okay now?”

“Yes fine,” I replied

“I was talking to Dr. Rogers,” he said curtly.

I looked across at my colleagues who returned my glance with a combination of, ‘Good luck’ and ‘Sorry we got you into this.’ At least that’s what I would like to think they were conveying to me.

The patient was covered in green sheets, and the area to be operated on, literally right under my nose, was about the size of an A4 sheet of paper.

“Ladies and gentlemen, let us begin,” he announced, and selected a scalpel from the tray to his left. I was transfixed. With the blunt handle of the scalpel, he simply marked a line about 4 inches long on the exposed flesh. This left a visible white line, temporary for seconds but sufficient to act as a guideline for the incision. With expert speed and confidence the surgeon cut along this line to the depth of about the width of the palm of his hand. The blade was so sharp and the incision so swift that I literally watched the wound open up before my eyes. It was like slicing a Victoria sponge cake. For a split second there was no blood, and I could see the various layers of skin and fat as clearly as, well, a Victoria sponge cake or a geologist analysing the strata in an exposed section of sedimentary rock.

The blood then started to seep from the walls of the incision and quickly formed a pool in the wound. The whole team then moved into action. The surgeon removed the first blood simply with a couple of scoops of his hand onto his plastic apron. The theatre nurses moved rapidly, applying various clamps which looked like, and were handled like, scissors. At the same time, they were handing various implements to the surgeon. I have never seen anything as fascinating in my life. In fact, I was so enthralled that I didn’t even have time to think about any feelings of nausea. Janice had chance amongst all this activity to look up to me with a slight raise of the eyebrows and an encouraging nod of the head to see if I was okay. I responded with a similar expression to assure her that I was fine.

I was particularly intrigued to watch how the surgeon directed his staff not only with verbal instructions but also by tapping on the implements as they were offered. He would have a clamp in his right hand and literally knock one to one side from one nurse to take a different one from another. It sounded like a fencing tournament with metal on metal. One nurse would dab with a swab, and this would be tapped away forcibly by the surgeon when he was ready to proceed. In no time at all, about half a dozen clamps had been applied with the handles all protruding at different angles, and the bleeding was stemmed as quickly as it had first flowed. The level of skill displayed by everyone was awesome. To my untrained eye it seemed like organised chaos, and I could only try to imagine the amount of training necessary to work together in such a manner. The first stage was over and the surgeon asked the anaesthetist for technical information and asked if everything was fine. He then turned to me and asked if everything was fine. This time he really was talking to me.

“Yes, her head is at the same angle,” I answered proudly as I maintained my hold with both hands.

“We are now ready to tie the fallopian tubes,” he announced.

‘God, I hope he doesn’t ask me to put my finger on the knot,’ I thought.

This phase of the procedure was much calmer and slower, and then the clamps were removed by the theatre nurses.

“That seems fine,” concluded Mr. Simpson, stepping back from the operating table. “I think the incision can be closed up now.”

Needles and sutures were handed to him by a nurse from a sanitised tray, and he started the sewing up. Once he had started the process he handed over to Frank to finish off.

“Thank you very much everyone,” he said graciously, with a gentlemanly bow to each of us. “Will I see you all for a cup of tea?”

“Yes Mr. Simpson, in the usual room down the corridor in about half an hour,” said Janice.

“Splendid,” replied the surgeon, who left the theatre with Dr. Rogers.

Frank was busy concentrating on his sewing, while Linda and Janice disconnected the patient from various tubes and the theatre orderlies prepared to wheel her to a recovery ward.

I went into the annexe locker room and sat down. I was exhausted.

“Well done John,” said Linda and Janice. “So, what did you think of that?”

“Unbelievable,” I said, and then added, “I’m really glad I got rid of all that static electricity!”

Frank then joined us and informed us that the patient had been taken to the ward.

“I hope the sight of all that blood hasn’t spoiled your appetite,” he remarked.

“Why?”

“The hospital always provides a buffet and cup of tea after operations.”

After a quick shower and change, I followed my colleagues to a room where the catering staff had organised a buffet of sandwiches, quiche, chicken drumsticks and cakes. Thankfully, there wasn’t any Victoria sponge. We helped ourselves to a plate of food and stood together in a group.

“That has never happened before,” said Frank, referring to my inclusion in the actual operating team.

“Yes, it was a slight surprise,” I concurred with deliberate understatement.

“I think it was because Mr. Simpson was slightly late and didn’t have chance to speak personally to any of us beforehand,” suggested Linda, who then looked at me and said, “He probably assumed that you were a member of the team.”

I then had visions of me receiving my P45 the following day. Janice took a sheet of paper from her pocket and showed it to me. It was an official hospital document on headed notepaper which included a check list for the operation: patient’s details, nature of operation, surgeon, anaesthetist, and theatre staff. At the bottom, where else, was my name: John Meadows (student).

“I can see what’s happened,” said Frank taking the sheet from Janice. “It doesn’t say ‘Observer’ next to John’s name.”

“So I was included as part of your team due to an administrative error?”

My P45 was starting to look like an absolute certainty.

“I’m glad I didn’t faint or have to dash out,” I said with a sigh of relief.

“Yes,” said Janice, “I watched your face as the surgeon made the incision, but you were fine. Well done again.”

At that point the two doctors entered the room and walked over towards us. “Don’t say anything,” Frank whispered to me.

“May we join you?” asked Mr. Simpson, by far the more extrovert and demonstrative of the two doctors. “Sorry I didn’t have time to greet you beforehand,” he said as he shook hands with Frank, Linda and Janice. “It is nice to see you again.” The surgeon then turned to me and said, “We haven’t met before, I’m delighted to meet you,” as he offered me a firm handshake. Before I could reply he said, “You are Mr. Meadows, I believe.”

“That’s right Mr. Simpson, pleased to meet you.”

I fully expected the surgeon to engage the rest of the group in general small talk over a cup of tea, and I could retreat into semi-anonymity. No such luck. He continued to fix me with his intense, blue x-ray eyes and said, “I believe you are a student?”

“Yes, that’s right,” I replied, not attempting to disclose any more information than was necessary in view of Frank’s advice. As I answered him I could detect a slight shuffling of feet from my three colleagues, and I was really hoping that one of them would interject with a change of subject.

“So where are you studying?” he inquired further.

“At Leeds University,” I answered. I could feel myself beginning to act shiftily.

“Oh, terrific reputation, I know it well,” he enthused, “and when will you graduate?”

“I’ve got two more years left,” I answered, and realised that this had become a two-way conversation with no escape route.

“You must know Professor Rawlinson.”

“Well, not personally, but of course I know of him.” I was telling the truth because the names of the Professors of the various university faculties often appear in print. There followed more shuffling of feet and occasional clearing of throats from my colleagues.

“Yes, we studied at Cambridge together,” said Mr. Simpson proudly, “and he is still a very good friend of mine.”

“You probably spend some time at Jimmy’s?” was his next question. I knew that this was the nickname for St. James’s Teaching Hospital in Leeds.

“Oh, St. James’s,” I said, nodding my head in agreement, but not actually answering his question.

“So when were you last there?”

“Oh, let me see,” I said, stroking my chin looking to the ceiling. “It must have been last April.”

“Which department were you in?”

“Casualty,” I answered. By now he must be thinking that I had had a personality by-pass operation.

“Oh, really, how interesting.”

“Yes, I twisted my knee playing rugby.”

The surgeon laughed at that, and Janice, Linda and Frank followed his lead. Mr. Simpson thought I was just making a little joke.

‘When is someone going to interrupt and change the subject?’ I thought, hoping to be rescued soon. Unfortunately I realised that the surgeon was extremely eminent and carried great authority, and interrupting him was hardly an option.

“So, Mr. Meadows, when you graduate from University which particular field of specialism or areas of expertise do you think you would like to go into?”

I took a sip of tea, looked around for a second while thinking over his question. I rolled my eyes towards the ceiling and stroked my chin again as Frank, Linda and Janice looked on helplessly. I took a deep breath and looked straight at the surgeon and finally answered, “Textile Design...”

The interminable silence was only broken by the sound of shuffling feet as my colleagues closely inspected their shoes. Mr. Simpson stood there expressionless.

“I am here as a vacation student for the summer holidays.”

Still silence as I fully expected to be frog-marched off the premises by men in white coats. Mr. Simpson then burst into laughter and looked towards Dr. Rogers, who also started to laugh. My three colleagues joined in with hesitant, forced laughter. I didn’t know whether to laugh or cry.

“My dear chap,” said Mr. Simpson touching me sympathetically on my shoulder, “let me apologise most profusely. What must you think of me putting you through such an ordeal?”

I must confess that an apology from an eminent surgeon was not the outcome I had expected from our conversation.

“He did very well don’t you think?” said Janice with obvious relief in her voice.

“He did tremendously well,” agreed Mr. Simpson patting my arm. After a few more minutes of light-hearted chat, Mr. Simpson looked at his watch and started to say his farewells. As he shook my hand he said, “Let me apologise once more,” and added jokingly, “I don’t suppose you would consider switching careers from Textile Design to Medicine?”

“I don’t think so,” I agreed. “The only stitching I will be doing in future will be on cloth.”

And with a laugh he was gone, after inadvertently providing me with one of the most incredible experiences of my life.

Can You Stand the Sight of No Blood?

The following week I was back in the operating theatre. Henry had told me that an orthopaedic operation had been booked, and it was to be carried out on a lady called Helen who was forty five years of age and a long-term patient at Rainhill Hospital. Since birth, she had only been able to walk on her tip-toes with the aid of a Zimmer frame because her Achilles tendons were too short and caused her feet to point downward. She was to be operated on by a consultant orthopaedic surgeon called Mr. Habib. Incidentally, the tradition of consultants reverting back to the title of ‘Mister’ rather than ‘Doctor’ goes back to the days when the local barber also doubled-up as the doctor and dentist. In 1540 Henry VIII instigated the founding of the Barbers-Surgeons Company and this is the origin of the red and white pole outside a barber’s shop, representing bloody bandages.

Imagine walking into the barber’s shop, “Yes sir, how would you like it?”

“Just give me a short back and sides, an appendectomy, and pull out four teeth please.”

Not surprisingly, doctors who had studied for higher qualifications wished to be referred to as Mister to distinguish them from their ‘blood-and-guts’ colleagues.

When I arrived at the theatre I was greeted by two different theatre nurses, and I explained to them that I had observed an operation the previous week. I made a special point of checking the staffing list to make sure that this time I hadn’t been promoted to consultant surgeon. We got changed and scrubbed up as usual, if I may be forgiven for sounding blasé. The patient was wheeled in by the same theatre orderlies as last week, who greeted me with a cheery, “Hello luv, are you here again?”

“Yes, I’m a glutton for punishment.”

I was surprised to see that the patient was actually lying face down. She was unconscious and without all the tubing, gauges and dials of last week. The theatre nurses positioned the trolleys, and then lifted the green sheet to expose the back of the patient’s leg. It was as white as a marble sculpture by Michelangelo. “That’s because of the tourniquet,” explained one of the nurses, noticing my surprised expression.

The double doors opened, and in walked the surgeon, arms held slightly aloft in the customary manner. (There I go again, sounding like a seasoned operator).

“Good evening everyone,” said Mr Habib as he walked towards us. He had a pronounced limp, and from the echoing sound of his footsteps it was apparent that he had a false leg. An orthopaedic surgeon with a wooden leg! I couldn’t help wondering if he was a particularly clumsy orthopaedic surgeon. I was reminded of ‘Not Only, But Also’, the popular television comedy show of the 1960s and the classic sketch in which a one-legged Dudley Moore hopped around while auditioning for the role of ‘Tarzan.’ A bemused Peter Cook uttered the immortal line, “I can’t help but noticing that you seem to be deficient in the leg department, to the tune of one.”

Mr Habib was aware that I was a vacation student, there to merely observe the procedure. However, he still instructed me to stand at the operating table, but this time near to the patient’s feet.

With the team in position, he began by making an incision about six inches along the back of the patient’s lower leg and ankle. I was almost as close to this as last week’s operation. Again I was totally transfixed, but what was totally fascinating was that there wasn’t any blood, apart from the odd drop which was quickly dabbed away by the nurse using a swab held by a metal implement. It looked like a cold chicken drumstick. The surgeon then carefully probed the six inch incision with a few spatula-type instruments and skilfully separated and identified the ligaments, tendons, and nerves. He even gave us a commentary as he identified each one, using medical terminology.

It was not dissimilar to watching an electrician doing a re-wire or a telecom engineer working on a seemingly unfathomable tangle of wires and cables in a junction box. The important difference being that if an electrician or telephone engineer cuts a wrong wire it can be rectified. If a surgeon cuts a wrong ‘wire’ a patient could be crippled for life. What skill, knowledge and responsibility. I was in awe.

Mr Habib identified the Achilles tendon and explained that he was going to cut half-way through at two points a few inches apart on opposite sides. He would then split the tendon lengthwise between those two incisions, a sort of z-shape cut. This would enable him to re-adjust the angle of the foot and, at the same time, stretch the tendon. After he had made the three cuts, while wearing specialist magnifying spectacles similar to those worn by a jeweller, the surgeon said that it was time to re-adjust the foot.

“Can you just give me a hand here?” he asked me casually.

‘Here we go again,’ I thought. He asked me to support the slightly elevated leg by holding it firmly. As I held the leg, he said that he would now straighten the foot. He seemed to put his whole weight behind it as he pushed the sole of the foot up from a pointing position. The foot had been in that position for about forty years. Once it started to move it made the most dreadful crunching, cracking sounds. It sounded like footsteps on a gravel path.

Once the foot was in its new position, the surgeon sewed up the tendon and checked on the position of all the other ‘cables’ which operate the ankle. The incision was closed, sewn-up with precision, and the foot, ankle and lower calf set in a plaster cast. Exactly the same operation would be carried out on the patient’s other leg a week later.

“She should be up and about in six weeks’ time,” Mr Habib told us later over a cup of tea. Somehow the chicken drumsticks didn’t seem quite so appetizing. I never managed to find out why the surgeon was deficient in the leg department, to the tune of one.

A denouement to this particular story happened during my final week at Rainhill Hospital. One morning Henry told me that I had a visitor waiting to speak to me in his office, but he declined to tell me who it was. I felt as though I was a schoolboy on his way to the headmaster’s study. I was greeted by a nurse who I had seen around the hospital, but we had never actually met.

“Good morning John,” she enthused, greeting me with a warm smile as if we were old friends. “Do you recognise this lady?” she asked as she gestured toward her companion who was sitting on a chair next to Henry’s desk. It was a lady in her mid-40s, who was obviously a patient in view of the fact that she was wearing a dressing gown.

“Erm, let me think,” I answered with a quizzical expression. I then noticed light bandages around her ankles and realised who she was. “I know who you are. You are Helen, who had the operation on your legs.”

They both nodded, and as I started to walk towards her to shake hands, the nurse put out her hand towards me and said, “No John, you just stand there.”

At that point Helen slowly started to stand up from her chair, while steadying herself with her hand on the desk. She then gave me a beaming smile and took her first steps towards me. I felt like a parent watching a toddler take her first-ever steps. I almost instinctively adopted a pose in readiness to catch her if she stumbled forward.

“Don’t worry,” the nurse assured me. They had obviously practised this demonstration. Helen walked hesitantly and greeted me with both hands.

All I could say was, ‘Fantastic’.

Her nurse explained that Helen had been told by the theatre nurses that I had been present at her operation. They had pointed me out to Helen as I had walked past one day. It must have been during a rare time when I was wearing my white coat on my way to the canteen, because the nurse whispered to me that Helen thinks that you are the surgeon who performed her operation.

I walked outside into the bright sunshine with them and Helen gave me a big hug and whispered, “Thank you,” before setting off very slowly back to her ward, without a walking frame. I couldn’t speak. She had been disabled since birth. My insignificant contribution was to have merely held her leg, but as I watched Helen walk away I felt as proud as if I had been the surgeon.

When I returned to the office Henry said, “Wasn’t that nice.”

I had a lump in my throat and I merely nodded. Eventually I said, “How could Helen possibly think that I am a consultant orthopaedic surgeon? I’m only twenty two!”

“You should have realised by now John that many psychiatric patients have little concept of age or time.”

There was a television police series in the 1960s which always ended with the American narrator saying something like, ‘There are ten million stories in the ‘Naked City’, this has been one of them.’ To a lesser extent it also sums up my experience at Rainhill Hospital. Norma and Jeff, in the geriatric ward, and Bill, in the secure unit, provided hours of fascinating stories: funny, sad, poignant, awe-inspiring, and downright frightening. It was an amazing time for all of us, and even forty years later we all look back on a richly rewarding experience.

Just before we left to go back to our studying, Norma was called to the hospital administrator’s office. She was offered a full-time job and they asked her to train to be a fully-qualified psychiatric nurse. She had impressed them with her dedication, compassion and aptitude, but she politely declined the offer. It is ironic that Norma had been the reluctant recruit who only entered the hospital as moral support for Jeff and me.

Today in the 21st century, the site of Rainhill Hospital is occupied by residential housing, and the once-imposing high sandstone wall is now the height of a garden fence. Whenever I am passing, I cannot help but visualise the familiar faces from all those years ago: the ghostly images of Charlie, Ernie, George and all the others, and memories of the care, professionalism, and humour of former colleagues Henry, Malcolm and Anne.

Oh, by the way, I am sure you must be wondering if I ever played Charlie Rosewall at chess. Well, I did eventually pluck up the courage to take him on. Unfortunately I didn’t learn much or pick up any tips, because the games didn’t last long enough.

When the Oscar-winning movie ‘One Flew over the Cuckoo’s Nest’ was being shown at the cinema a couple of years later a friend in the pub asked us if we had seen it.

“Seen it?” answered Bill whimsically, “We’ve lived it!”