大象传媒

This contribution is submitted on behalf of Margaret Chadd by Roger Wood.

Presentation by Margaret Chadd MBE to Norfolk and General Hospital in 1987. (Part 1)
QUEEN VICTORIA HOSPITAL, EAST GRINSTEAD, 1941-1945
Thank you for inviting me to share with you some of my memories of the famous Plastic Surgery and Burns Unit, which during the war years, pioneered the way for today's more modern forms of treatment for intensive burns or disfigurement, whether due to accident, illness, or a congenital deformity and requiring repair. Our minds have been directed to think about these matters recently, due to the widespread publicity given to the victims in the unfortunate King's Cross Disaster. The general public have been made aware of what it means to have to live a life with a physical abnormality, however skilled the surgeons of today maybe. Focus has also been given to only to the physical scarring but to the psychological traumatic and long lasting effects on an injured person. The deformity of anyone's face or hands, naturally presents a human problem because as human beings, these are our very means of identification and communication between one person and another. Our appearance is important to each of us for our self esteem. Any abnormality can contribute to lack of self confidence, making you feel down graded, ugly or ashamed. Any form of loss involves reconstruction and readjustment, and leaves a person with the crucial need to be treated normally by his fellow human beings, plus a greater understanding and compassion. Why do so many people find this difficult today?
In 1939, the quiet market town of East Grinstead, Sussex, some 30 miles from London, there was a recently modernised Cottage Hospital, serving the needs of the people in that locality. The original hospital had been rebuilt in 1931 on a site of land given by the then Sir Robert Kindersley (Later Lord Kindersley) It had 12 male wards, 12 female wards and 6 children鈥檚 wards in addition to 6 private wards, where it cost the princely sum of 拢5 per week and you were treated royally and could experience gracious living in complete comfort, together with 100% attention. The Emergency Medical Service envisaged that with the outbreak of war, there would be immediate air raids on a colossal scale and they anticipated many wounded arriving on a massive scale from the Continent in great numbers from the Forces in France. A plan was therefore put into operation to establish special centres for specific injuries; one of these being a Plastic Surgery Burns Unit, situation at East Grinstead. Around the hospital, there was plenty of land where additional wooden army huts could be erected to accommodate 120 extra patients and which had interconnecting corridors - open to the weather at the side but just covered overhead. Three main wards were so constructed, Ward I for dental and jaw injuries with a separate Dental hut as a base for surgery and treatment, Ward II for women and children, most of whom were either air raid casualties who had lost all their possessions and members of their families too. Others had serious congenital defects that required immediate plastic surgery, which the London hospitals could not provide because of the air raids. Ward III was for officers and the most severely burned and injured service personnel. In addition there was near by a special Saline bath hut, 3 recreation rooms, a physiotherapy and occupational therapy unit. In the main hospital, the children's ward was converted into a large double operating theatre. At a later date in 1944, with money raised by the people of Canada a new wing was built by the Royal Canadian Engineers, giving additional facilities and this was followed in 1946 by a completely new surgical unit with 5 operating theatres, wards and nurses home. Over the years the hospital, which was managed by a local Hospital Management Committee under the formidable Captain Banham, was visited by several members of the Royal Family. I well remember the day in 1941 when the Duke of Kent came in his RAF uniform, en-route for his flight to Scotland tragically meeting his death, when his plane crashed. My own photographs of his visit were subsequently given to his son, now Duke of Kent, in 1987 when George and I played host at Richard's shipyard in Lowestoft for the launching of Richard Branson's boat. In 1946, the then Queen Elizabeth (now known as our
Queen Mother) paid a visit to the hospital to officially open the new buildings and she returned again in 1963.

In 1966 the Princess Marina paid an official visit. Throughout the years, many dignities and service chiefs would include a visit to the hospital to see for themselves all that had been achieved.

The person selected to be in charge of the Surgical organisation was a man of medium height, a thick set jaw-line, horned rimmed spectacles with the name of Archie McIndoe. He was a New Zealander by birth, who had experience in the States, worked at Basingstoke with the late Sir Harold Gillies and eventually succeeded him to be Consultant in Plastic Surgery to the RAF. He was a man of vision. He realised, even all those years ago, that any rehabilitation must include the total personality of the patient. This involved a whole team of specialists, working with him, who took the responsibility for the "whole patient" and in the course of treatment would often include a total re-education for living and coming to terms with the acceptance of any disfigurement and disability.
His team included some of the finest plastic surgeons the available in the world. They called McIndoe, "The Boss" or "Maestro". Amongst them was a Canadian Wing Commander Ross Tilley. It was some forty years later when working on my Collett family pedigree that I found he was the descendant of one of the Colletts who went to Canada. By 1990 he had just died, but I was able to make contact with his widow - if only I had known more in 1941. Another was Gerry Moore, who excelled in cases of cleft lips and palates. Terence Ward specialised in jaw and mouth injuries and Benjamin Ryecroft in the grafting of corneas and founded the Cornea Plastic Unit. The resident House Surgeon was from St. Bartholomew's hospital, Percy Jeyes. All these specialists worked with the Anaesthetist, John Hunter, a very large jovial man, superb at his job and who whilst at Barts in the 1920s had anaesthetised George Chadd for the removal of his appendix. Russell Davis was his fellow theatre colleague, with the theatre sister in charge, the elegant Jill Mullins, (always clad in total green from head to foot). She could anticipate every move that her boss would make in the theatre, so close was their teamwork - words were not needed - it was amazing to watch. A patient would be moved from their wards to the slab in the theatre on a trolley along the outside open covered passageways by Cyril, the RAF Theatre Orderly, who was a great person in keeping everyone cheerful and giving the right encouragement before an operation.
The nursing Staff was under the jurisdiction of Matron Hall, a warm lovable and approachable Irish lady of middle age, who tried so hard to keep a firm hand on the "lads". This often proved difficult as the hospital was not like a normal cottage hospital, once the service personnel arrived. She had great difficulty in keeping control when they got up to the pranks; more often than not in high spirits having been down to the local pub in the evening. If she made any comment to McIndoe, his reply would be "These men have had to put up with a hell of a lot, so surely, you and your staff can put up with a little of their nonsense.鈥� It depended on how you interpreted 鈥榣ittle and nonsense'. If you saw one of the ward sisters, loudly shrieking and being carried in the arms of a pyjama clad patient towards a cold bath, would you intervene or punish? What could you say to patients returning late at night, after a visit to the local pub, having collected up all the roadwork lanterns and on returning to their ward singing, cheering, waving the lanterns-up and down and waking everyone who was asleep? I remember one occasion when the patients returned from a very late night at a club in London and walking back into their ward at 5 a.m, very much the worse for wear, the nurse on duty tactfully asked them "Are you boys up early or are you now going somewhere?"
Matron Hall was backed up by three super Irish ward sisters, one of them being her own sister, known as Sister Hall, and the others Sisters Mealey and Harrington. It was they who supervised the nurses, mostly young V.A.Ds who were utterly dedicated to their role but all known by their Christian names, doing their 'bit' for the war and playing their part, not only as a 'tonic' for the patients but providing the necessary female attraction, which helped those badly burned in their rehabilitation and convalescence.
Others in the team were the Physiotherapists, Occupational Therapist, and RAF Welfare Officer, known to all as Blackie. It was he who dealt with the problems of the Service Personnel until they were discharged from the Service. He also ensured that they got the maximum possible pension from the Ministry of Pensions, according to the degree of their disability and provided endless ideas for their rehabilitation and therapeutic convalescence.
Many of the patients attended the hospital for over 5 years, coming back for improvements to their plastic surgery and all their notes and records included photographs of each stage, before and after each operation and on admission and discharge.
In 1940 the hospital had no Lady Almoner and it was at the suggestion of the resident surgeon, Percy Jeyes, who was an old personal friend of mine from Bromley that I should join the staff and start the department there. My own career had been interrupted because of the war. I had decided at the age of 16 that I wanted to do this work and chosen to gain practical experience in various hospitals, with a view to going back to University after the cessation of hostilities to become fully qualified. The job was a challenging and one I thoroughly enjoyed from 1941 until just after the end of the war when I was able to return to college. The hospital wanted me to resume my post with them but although I did return to East Sussex from London, it was to become the County Almoner dealing with the heart and chest patients in Sussex, until I married in 1950 and moved to Suffolk.
My role in 1941 at the hospital then was to be responsible for all the civilian patients, children, outpatients and all those who were invalided out of the services. This covered a multitude of other duties, such as tracing lost relatives for those that were bombed, working closely with the W.R.V.S to obtain clothes for those who had only the garments in which they had arrived at the hospital. (Remember we were on clothing coupons), helping with transport and fares for visitors, often finding night accommodation for those who had come from afar, arranging schooling for long term stay children (usually cleft palates and lips) who were often in hospital for several months. I worked closely with the local Disabled Resettlement Officer and for the Ministry of Labour as well as with Blackie, helping to ensure that those who were entitled to receive an allowance or pension got the maximum amount possible. My work included liaising closely with McIndoe's team, as well as many other agencies on behalf of my patients, many of whom had been transferred for specialist treatment from other hospitals in the S.E Hospital Region and were thus far from their homes. In addition we all helped out as and when necessary with any role we could within the hospital, when there was a crisis or emergency as we were all part of a team.
The reconstruction of damaged parts of a human body is a long and tedious business and it takes even longer to achieve full physical and emotional rehabilitation. Today the word used is counselling but that was never in our vocabulary in dealing with these badly burned patients. The support provided by McIndoe's team enabled most of the patients to survive, recover and make a new chapter in their lives. Many of them endured as many as 30 operations and the surgery itself is no more miraculous than any other branch of surgery, but it does have to be carried out the 'nth' degree of painstaking attention and to be carefully planned, designed and combined with a neatness of execution to the rival the 'finest embroiderer.'
From 1939 until April 1943 there was a sort of phoney war when nothing very serious happened but then the storm broke with Dunkirk, and there were constant air battles over the continent and the south counties of England. Many planes crashed or were shot down, the aircrew often were lucky and able to escape by parachute but not always before their plane had burst into flames. Some airmen were lucky enough to be rescued from the North Sea, suffering from frostbite as well as severe burns.
After the Battle of Britain, the Blitz against London swelled our numbers of service personnel and as well as many women and children, civilians from all walks of life were to be found amongst our hospital patients. On arrival at East Grinstead, many patients had scar tissue which had developed and this first had to be allowed to heal before it could be cut away and replaced with healthy new skin from another part of the patient's own body. In many instances, bone structure was also destroyed; this too had to be removed and pieces of bone from the hip or shin, i.e. another part of the body, shaped and moulded by the surgeon's hammer and chisel, had to be finally grafted into the bone gap. Large areas of skin loss and missing skin were often repaired by tubes of skin, taken from the patient's abdomen or chest; these were called pedicles. Replacement noses, lost through burns, bullets or bombs could need 5 or more operations before a new nose was achieved. Thus without the use of photographic records, the task of record taking could never have done justice to the progress made. The photographic department was to be congratulated on the comprehensive pictorial record for each patient.
During the war years, the main method of dealing with severe burns was by immersing the patient into a saline bath. Penicillin was only just being discovered. We relied on M and B powder, prontosil and a dressing of tulle gras, which was a Vaseline like substance fixed onto a gauze dressing, thus covering the wound. When it was pulled off it did not tear the tissue or skin and a dressing could be renewed. Today with new drugs, skin banks etc. the problems of grafts being rejected are not so likely and the breaking down of the immunological barrier has been achieved so that skin can be taken from one person and used on another.
After an operation, the convalescent period was considered as important as the operation itself, so that by just remaining in the hospital for too long a period could have a demoralizing effect. Part of McIndoe's plan involved the local community and its residents. Many kindly people in the area were in a position to offer hospitality. McIndoe certainly never missed a chance to fight for what he believed was right for his patients and he was adept at obtaining money on their behalf. The Laskey family lived nearby and were connected with Marks and Spencer and provided much practical generosity and hospitality too. Likewise, the Dewar family, of whisky fame, with their convalescent home and young Barbara Dewar working in hospital as a secretary to McIndoe, very much part of the scene. Lady Dorothy McMillan would arrive regularly with garden fruit and produce at my office and many others provided alternatives to the hospital confines with trips to places of interest, parties, and dances.

Entertainments were arranged within the hospital, by visiting celebrities of E.N.S.A coming down from London to perform. Books, radio, games, P.T, squash, tennis, swimming, classes for shorthand, typing, accounting and book-keeping all helped to maintain a high standard of morale within the hospital.

Schemes were devised to liaise with the Ministry of Aircraft Production, so that those who were fit enough, and able, could have a work experience during a period of convalescence between operations. Thus proving their worth and abilities. For the women patients and the men too, the services of a professional beautician was available to help them to learn the correct method of make up, covering any remaining scars and making the most and best of what was left of their faces.

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