36 Temporarily heavenward

Key words/phrases: anaesthetics, ether, chloroform, Valerius Cordus, W. Frobenius, Richard Pearson, Thomas Beddoes, Paracelsus, Crawford William Long of Georgia, USA, ether frolics, James Venable, Prof. James Young Simpson, Hannah Greener, Emergency Medical Service hospitals, Joyce Green Hospital theatres, Mr Catchpole, Henry David Thoreau.


No. 36

Today is the 165th anniversary of the occasion on which ether - the first anaesthetic - was first used during surgery and I found myself thinking about the use of anaesthetics at Joyce Green Hospital.

Ether (diethyl ether) is cheap to manufacture because it is often made from sugar cane using alcohol and recycled sulphuric acid but it is also very cheap because it is non-halogenated (i.e. unmixed with fluorine which would render it more stable and safer to use).

It seems that it is still used today in developing countries for several reasons. Firstly it is economical to produce and use, secondly it is relatively safe as an anaesthetic and finally because it is simple to administer either intravenously or using the inhalation method. Of course it is still as highly volatile and inflammable and as potentially explosive in the presence of oxygen as it ever was.

In terms of its disadvantages, rendering patients unconscious and recovering them was remains a slow process when ether is the used as the sole agent. It’s strong, unpleasant smell, plus its tendency to cause bronchial irritation and coughing, tends to make induction using a mask more difficult. Finally most nurses will remember having to give patients atropine pre-operatively because of the likelihood of bronchial irritation creating excess mucus secretions … and of course post-operative nausea and vomiting was a frequent event on theatre days, wasn’t it ?

Ether’s history extends back to 1540 when Herr Valerius Cordus, a German physician, discovered his revolutionary technique for synthesizing ether which involved adding sulfuric acid to ethyl alcohol, but it was another German scientist called W.G. Frobenius who changed its original name (“sweet vitriol”) to ether in 1730.

Up until then scientists and physicians had used it for other things but not as an anaesthetic agent. In 1794, two English physicians, Richard Pearson and Thomas Beddoes in Bristol were using ether in the treatment of phthisis, catarrhal fever, bladder calculus and scurvy and in 1805 American physicians were using it to treat pulmonary inflammation.

The Swiss physician and alchemist known as Paracelsus had discovered its hypnotic effects but it was Crawford Williamson Long (1815-1878) the American physician who first used ether as an anaesthetic for surgical purposes.

Apparently Long’s use of ether came from observations made at social gatherings known as “ether frolics”. Since ether produces exhilaration rather than unconsciousness when used in small amounts the inhalation of ether for fun and recreational purposes seems to have been quite common at that time. Long noticed however, when he was present at this type of party, that whenever the participants sustained twisted ankles, bumps and bruises they didn’t seem to experience any pain.

But it was on March 30, 1842, when he was 26yrs old, that Dr. Long - a rural general practitioner in Jefferson, Georgia, USA - first used ether for a surgical procedure. In the presence of several medical students and various on-lookers he administered sulfuric ether via a towel to a 21yr old patient, James Venable, for the removal of a tumour on the back of his neck.

The ‘lumpectomy’ was so successful that the patient had to be shown the specimen before he would believe that the operation had actually finished. Despite this and even though he continued to use ether in his surgical work Dr Long apparently didn’t make the effort to record his ‘first’ until 1849.

In fact not only had several American dentists pipped him to the post by using ether in a number of dental extractions prior to his innovation but several other doctors had ‘written up’ their experiences relating to the surgical use of ether long before Dr Long got round to putting pen to paper. Nonetheless C.W. Long is now generally credited with having introduced modern inhalational anaesthesia.

James Simpson, who was Professor of Midwifery at the University of Edinburgh and physician to Queen Victoria had already discovered chloroform by this time (back in 1831) and it quickly replaced ether in Great Britain.

Unfortunately, chloroform is not as safe an agent as ether, especially when administered by untrained practitioners and sadly the first fatality attributed to anaesthesia was recorded on 28 January, 1848 when Hannah Greener, a 15-year-old girl from Newcastle upon Tyne, who was undergoing the resection of a toenail on a table in her home, died when she was being operated upon. Chloroform, it seems, was being administered to her via a cloth held to her face when she suddenly became pulseless and died.

It’s not exactly clear who was involved in this young woman’s “care” but it is worth recalling that medical students, nurses and sometimes even members of the public were pressed into administering anaesthetics during this newly enlightened era - each of these groups being considered capable of participating in these newly approved 'frolics'.

But switching attention now to the many surgical procedures which we recognise as having taken place at Joyce Green Hospital I seem to have found myself with more questions than answers.

Did specific operating rooms exist during Joyce Green’s life as a smallpox hospital (1903 -1931) or were any minor surgical procedures that were necessary carried out at patient’s bedsides via either a local anaesthetic or a short ether-induced period of unconsciousness ? Then later on, when the hospital was re-opened as a Medical Emergency Service general hospital in 1939 with an increase in the number of beds available from 986 to 1,900, where exactly were the operating rooms or theatres established ?

In 1940 war casualties started to arrive from France and Belgium. Without a doubt there must have been surgical facilities but where were the theatres located ? Were they established in the same area of the hospital that most readers will recognise as the old surgical corridor and if not, when did “theatres” begin functioning in the Theatre suit between Ward Blocks 1 and 3 ?

And when was the “twin-theatre suite” opened and the Honeywell theatre suite commissioned ?

Sadly Mr. Catchpole, the Theatre Superintendent, is no longer here to provide us with any further historical information but there may be some of you reading this who will perhaps be able to provide some further detail on the evolution of the JGH theatres ?

In closing do you know what the philosopher, writer and naturalist Henry David Thoreau (1817-1862) once said about ether ? He apparently underwent a transcendental experience while having several of his teeth extracted and he said this: "If you have an inclination to travel take the ether - you go beyond the furthest star...".

Thus it appears that the enjoyment of mind-bending frolics is something that some of our predecessors also set out to experience ?

35. Home Thoughts, from Abroad

Key words/phrases: Metropolitan Asylums Board, Dr T.F. Ricketts, Dr A.F. Cameron, Harry Hopkins, Arboretum.

No 35.

If you were to ask half a dozen people on any English street to suggest a poem that refers to Spring I suspect that at least one of them would launch into those immortal lines by Robert Browning : “Oh, to be in England now that April's there …”

Is it because British Summer Time starts again this Sunday morning (when we have to turn our clocks forward) or is it because we have had enough of winter by this point in time and simply find ourselves yearning for Spring ?

Whatever the reason, if you allowed yourself to start thinking further about this magical time of the year I’m also prepared to wager that “blossom” or “flowers” would be two of the things that would also shoot into your mind were I to ask you to identify a couple of images linked to Spring.

It seems to be the case that we are inescapably ‘hard-wired’ into contemplating two specific things when we think about Spring: new life & new growth and interestingly - looking back over it’s history - Joyce Green Hospital has had more than it’s fair share of individuals interested in encouraging new life and growth in relation to the animal and plant kingdoms.

The Metropolitan Asylums Board borrowed £257,100 from the Local Government Board to build Joyce Green Hospital but when the hospital was completed in 1903 it appears that there was a lot of land “left over” including the parcels of land situated on each side of the wards.

The buildings it seems stood out like sore thumbs until 1905 when according to the records the hospital farm was formally established. This project was initiated, according to Dr Thomas F. Ricketts, the Medical Superintendent, at the behest of the M.A.B.

The existence of a farm in the middle of a smallpox hospital was obviously fairly unusual; as was the presence of sheep and cows grazing between the ward blocks but notwithstanding this the farm apparently functioned for 14 years between 1905-1919.

Apple, pear and plum orchards plus many ordinary deciduous trees soon existed - in such numbers indeed that an unnamed individual felt it necessary at one point to purchase 400 tree guards to protect the trees from the animals that were supposed to be confining their grazing to the grassed areas.

The orchards - which if they still existed would probably be blossoming as you read this - survived until 1921. And according to the hospital records a certain Mr Joyce was even retained on the payroll for an unspecified period of time to spray and care for the trees.

But apart from the orchards a certain Mr Harry Hopkins who arrived to work as the gardener at Joyce Green Hospital in 1919 described the hospital grounds as “a wilderness with a few trees” and, if the truth be known, it probably would have remained a flat, uninspiring plain had it not been for the determination of Harry Hopkins and Dr A.F. Cameron, the Medical Superintendent to develop the hospital grounds into an Arboretum.

It seems that Dr Cameron was simultaneously a member of Kew Gardens Society in London and The Royal Horticultural Society and as a result of his contacts he was able to obtain enough plants, shrubs, saplings and slightly bigger trees to begin to develop the Joyce Green site into a very respectable horticultural site.

Between 1919-1935 approximately 500 trees were planted including some very rare and exotic ones, although I particularly remember magnolias in blossom. A few conifers were also planted, plus a large number of sycamore trees and a fair number of laburnums too.

The soil in this riverside location was very alkaline and had previously only supported salt-tolerant grasses however these two men even arranged for the delivery of lorry loads of leaf mould to enable the gardeners to grow a number of rhodendrons in selected spots. The hospital’s annual report of the time also mentions the planting of a mixture of 6,000 flowering and evergreen shrubs, as well as some long stretches of hedging.

In no time at all these two men had transformed the site into a veritable Garden of Eden and the gardening staff were apparently so successful in propagating large quantities of herbaceous plants and shrubs that very soon the hospital Gardening Dept was supplying plants to many of the public institutions under the control of the London County Council.

All good things come to an end and Harry Hopkins died in the 1930s at about the same time that Dr Cameron fell due for retirement but happily the grounds of Joyce Green continued to provide untold enjoyment for hundreds of thousands of people over the years - including those who were recuperating, visiting or working within the hospital.

I don’t think that I could really be accused of “over-icing the cake” if I said that these two men really did embellish our alma mater with some very beautiful natural decorations indeed, nor do I think that could I be accused of over-stating the case either if I were to say that I think that even Browning, Wordsworth or Keats would have found a Spring visit to Joyce Green inspirational.

But what do you think ? Was your life enhanced by the surroundings that you were able to work in at Joyce Green? Or do you remember anyone else who appreciated the beauty that they discovered in the grounds ?

Oh … and by the way, what was it that Robin Williams said about Spring ? "Spring is nature's way of saying 'Let's party !'"

34. Move over St Patrick .... for our laundry workers.

Key words/phrases: St Patrick's Day, George Orwell, Catherine and Tom Cookson, the launderies of Joyce Green Hospital, South Shields Workhouse & Hospital, Hastings Workhouse & Hospital, telangiectasia, the Hastings Writers' group, Simonside Protestant School.

No. 34

“I gaze in awe at the mystic saint
who dwells in the light that rainbows paint;
but I love the saints that darn and scrub
and the tired old saint of the washing tub.” Anon

Hundreds of thousands of people around the world celebrated St Patrick’s Day yesterday. Perhaps you were one of them ? But this short poem seems to be trying to get us to re-focus our attention on those far less well known “saints” who get on with the task of turning mountains of dirty washing into clean, freshly laundered linen everyday.

George Orwell once remarked that "All people who work with their hands are partly invisible .... and the more important the work they do, the less visible they are."

This could be said of many different groups of ancillary staff who work in hospitals, including of course the domestic and the catering staff but the fact is that these latter two groups are at least partly visible, whereas laundry staff are hardly ever seen or noticed.

Out of interest for instance, how many of the laundry staff at Joyce Green Hospital did you actually know ?

Perhaps at this point someone is going to catch me out here and ask me if I know ‘for a fact’ that the hospital linen really was washed on the Joyce Green Hospital site ? Well the short answer is: I can’t actually remember, although perhaps you can ?

I certainly remember that Bexley Hospital near Dartford Heath had a large laundry and perhaps Joyce Green’s dirty linen (or at least some of it some of it) was dealt with there ? But the point I am trying to get at here is that those who work at the cutting edge of patient care often don't know very much at all about the hard work and difficulties of those who work behind the scenes.

Did you realise that the novelist Catherine Cookson was someone who had first- hand experience of working in hospital laundries ?

This famous English author was born in Tyne Dock, South Shields in 1906 and was brought up by her grandmother Rose and her step-grandfather John McMullen; her unmarried mother, Kate Fawcett, returning “to service” soon after her birth.

Catherine's first school was Simonside Protestant School but since her grandfather wanted her to have a Roman Catholic school education she was later transferred to Saint Peter and Paul's School in Tyne Dock.

At the age of 14yrs she became a servant to a lady in Harton Village, South Shields, earning a 9 shillings a week (roughly 45 pence) but at the age of 18yrs, and as the result of some help that she had from the local Roman Catholic priest, she started work in the laundry at the South Shields Workhouse.

She apparently worked for 7 years at as “checker” in the laundry there situated in the grounds of what is now the South Shields General Hospital after which time she moved to the South of England where she took on a similar role in an Essex hospital.

Next, something drove her into moving on again and in 1929 she arrived in Hastings where she worked in the local hospital workhouse laundry, finally becoming it’s manageress and earning £3.6s a week.

Once there, she set about saving every penny she could in order to buy herself a large Victorian house, at which point she started to take in “gentleman lodgers” in order to supplement her income.

In June 1940, at the age of 34 yrs, she married Tom Cookson who was a teacher at Hastings Grammar School. Their's was a happy marriage but after experiencing four miscarriages it was discovered she was suffering from a telangiectasia.

As a result of her illness and her miscarriages she suffered a mental breakdown, a problem that was to last over 10 years. At one point in her depression her G.P. suggested that she took up writing as a form of therapy and she joined the Hastings Writers’ Group.

She complete her first novel "Kate Hannigan" in 1948 at the age of 42yrs and in total wrote almost one hundred stories, many of which are set in her native region.

She and her husband continue to live in Hastings until 1976, after which she returned to live in the North-East of England with her husband. She eventually died in 1998 just prior to her 92nd birthday, having seen many of her books translated into different languages and having been made a Commander of the Britsh Empire, a Dame of the British Empire and awarded an honorary M.A.

Some laundry-women, don't you think ? Although I think that it almost goes without saying that thousands of other hospital laundry workers also deserve similar words of praise for their generally-unreported efforts ?

So maybe St Patrick won't mind us swinging the spot-light away from him for a short while on St Patrick's Day and bringing it to bear briefly on to those who worked to provide clean laundry for Joyce Green Hospital throughout it's long history - as Catherine Cookson once did in South Shields, in Essex and finally in Hastings ?

33. Too early for ... what ?

Key words/phrases: Teenage pregnancy rates, causes of, G.N.C age-related admission for training policy, Orthopaedic and Ophthalmic Nursing certficates, British Journal of Nursing, Cadet Nursing schemes, Miss Waugh, Miss Penney, N.W. Kent College of Technology.

No. 34

According to the latest statistics, teenage pregnancy rates in Dartford in 2005 were twice the national average with 10% of 15 to 17 year old girls on one housing estate being pregnant. In addition the figures for 2006 still appear to show that Britain had the highest teenage pregnancy rate in Western Europe ?

Perhaps the situation has now improved by now with the opening of some new sexual health services for teenagers in Dartford but nonetheless the question remains: Why do these high levels of youthful pregnancy exist ?

Are these figures due to lack of parental supervision, lack of self-esteem among the teenage population, boredom, high levels of unemployment, lack of education in sexual matters and/or the lack of reproductive health facilities in Dartford?

Perhaps the simple answer is that there isn’t a simple answer ! Thus health care professionals, sociologists, teachers, psychologists and politicians will no doubt continue to try to get their advice and opinions heard, if for no other reason than that each high risk sexual encounter also carries with it the danger of developing sexually transmitted infections, regardless of the ages of the parties concerned.

But what has this to do with Joyce Green Hospital, do I hear you asking ?

Well nothing directly - although I have been wondering if it could be argued that the old G.N.C. policy (The General Nursing Council for England and Wales) on the age at which young men and women were permitted to begin training as a State Registered Nurses could have had an affect on at least one career- opportunity open to young people following the change the age limit in 1952 ?

Back in the 1950s and 1960s teenagers wishing to commence training for the Orthopaedic Nursing Certificate or their Ophthalmic nursing qualification could do so at the age of 17 years, whereas for those wanting to commence State Registration training, the starting age was 18 yrs old.

“Nothing new about that” I can almost hear some of you saying. These were simply the accepted ages for the commencement of nurse training in England and Wales.

But did you realise that in 1952 when the G.N.C. set these new age limits for youngsters wishing to embark upon a career in nursing some senior members of the profession were not at all happy about this decision by its Council members.

An editorial in The British Journal of Nursing (April 1952, No. 2204, Vol. 100) had this to say :

“Why may we ask - in all humility - has the age for commencing State Registration training been set at 18 years instead of 17 yrs or 32 yrs ? Perhaps Council members are under the impression that a female is not a woman until she is 18 years old and that prior to this the strain of training would be too much for her ? If this is the case, then might not Council be mistaken in under-estimating the physical propensities of young woman?”

The writer then went on to say this:

“Surely it is common knowledge that at 15 years of age a female is no longer a child and that according to Francis Parkington-Keyes, the author, ‘a young women is capable of coping with the complete experience of love and the ordeal of maternity, which in the flesh, represents the supreme fulfilment’”.

“This time lag,” (between leaving school and commencing training) the editorial writer went on to say, “can only have dire results for our hospitals. It is, after all, a well known fact that significant numbers of young women of 15 yrs enter the professional as Nursing Cadets … but that by the time they are 17yrs of age it is difficult - when they have found jobs in industry or elsewhere and have started to forge friendships - to get them to change direction and to enter a career such as nursing”.

It appears from this that some senior members of the nursing profession were of the opinion that IF girls of 15 years of age were physically mature enough to contemplate motherhood, they were surely equally ready to take on the responsibilities of careers in nursing, either as Student Nurses or Cadet Nurses.
As you know some hospitals or groups of hospitals did establish Cadet Nursing schemes .... with Miss Waugh and Miss Penney, the Matron and Assistant Matron, respectively, of Bow Arrow Hospital bringing up the rear-guard of the one organised within the Dartford hospitals in conjunction with the N.W. Kent College of Technology.

This scheme - and many others like it – certainly provided an access-to-nursing route for many teenagers of 16yrs of age in the 60s. However when this local scheme was discontinued perhaps the Dartford hospitals authority inadvertently closed a door which had previously provided numerous young women (and a small number of young men too) with a meaningful way of occupying themselves until they were eligible to apply to start training as Pupil Nurses or Student Nurses in Dartford or elsewhere ?

As a cadet nurse myself in the Dartford scheme not only did I gain a host of invaluable insights into the functioning of different hospital departments within Joyce Green, West Hill and Bow Arrow hospitals, as well as studying too for further G.C.E. examinations at the Miskin Road College several times a week, but I was also paid a small salary for doing so.

Thus on a personal note I really do believe that these ‘earlier access’ opportunities might, for certain young people, have provided a focus of attention for them that some people might now argue today’s youngsters no longer have.

What do you think ?

32. Sticks & stones may break my bones but ....

Key words: Avian flu, epidemic, pandemic, Bukhara (Russia), Camp Funston (Kansas), flu nomenclature, nomenclature of syphilis.

No.32

Although the Avian flu outbreak on a certain well-known Norfolk turkey farm now seems to have disappeared from the British news headlines scientists are still expecting a flu epidemic or pandemic to affect the human population in due course. “It’s now a matter of when and where it will occur, not if,” they say.

Have noticed too that western governments have begun issuing guidelines to the public and to local authorities about how we should begin to prepare for any such outbreaks now in our country or locality?

“Make sure,” they advise, “that you have a two week supply of water and food at home. During a pandemic, if you cannot get to the shops, or if shops and supermarkets are out of supplies, it will be important for you to have extra supplies on hand. In order to limit the spread of germs and prevent infection teach your children to wash their hands frequently with soap and water and model the correct behaviour. Teach your children to cover coughs and sneezes with tissues, and be sure to model that behaviour. Make sure too that you have the following items on hand for use during what may become an extended period at home (the list includes: dried, canned and frozen foods but it also includes a torch and radio + batteries, a camping stove with bottled gas and a manual tin-opener)”.

Thus, although western governments are obviously trying to avoid causing panic amongst the general public they are nonetheless aware that large swathes of the population could soon become infected, or at least affected. The next influenza pandemic, it seems, is just the next communicable disease challenge that we are going to be faced with.

The first pandemic of 1510 apparently originated from Africa and then spread into Europe, after which the “Asiatic flu” epidemic of 1889-1890 began in Bukhara, Russia in May 1889. It west rapidly spread and hit North America in December 1889, South America in February-April 1890, India in February-March 1890, and Australia finally in the Spring of 1890. This latter pandemic was caused by the H2N8 type virus and it also had an extremely high mortality rate.

Next came the “Spanish flu” outbreak of 1918-1919. This was first identified in March 1918 amongst US troops training at Camp Funston, Kansas and by October 1918 it had spread to become a world-wide pandemic evident on each and every continent. This strain of flu” was particularly virulent and deadly. Fortunately it ended nearly as quickly as it began vanishing completely within 18 months; however within in six months at least 25 million people had died. An estimated 17 million died in India, 500,000 in the United States and 200,000 in the UK.

In passing - did you realise that this particular virus has recently been reconstructed by scientists at the main Centre for Disease Control in the USA who had been studying human remains preserved by the Alaskan permafrost. They identified it as a type of H1N1 virus.

After the Spanish flu tragedy the world health authorities were then faced with the “Asian flu” outbreak of 1957-58. This H2N2 sub-type was first identified in China in late February 1957 and by June 1957 it had spread to the United States, eventually causing about 70,000 deaths there.

Then, most recently the “Hong Kong flu” - so called because it was first detected in Hong Kong - threatened the world during 1968-69, causing approximately 34,000 deaths in the United States alone. This outbreak was caused by the “Influenza A” sub-strain, with these same H3N2 viruses still circulating today.

One further thing which I am sure that you must have noticed is the choice (and sometimes the range too) of names ascribed to these infections by different nations …. because influenza, has, like syphilis, had a good many different names in the past.

Did you know for example that following an outbreak of syphilis in the French army it became known as morbus gallicus (the French disease)? At the same time the Italian Girolamo Fracastoro named it the “Spanish disease” and in turn certain other French doctors called it either "la maladie anglaise" or “the English disease” and also the “Italian disease”. In turn the Russians called it the “Polish disease”, the Tahitians called it the “British disease” and the Turks called it the “Disease of the Christians”.

As far as naming these types of flu is been concerned when large numbers of French soldiers serving in the trenches France in 1918 became ill the soldiers called it the “Spanish flu”, despite the fact that there is no evidence that it originated there, whilst the Spanish called it the “French flu”.

For the moment though the latest strain of flu caused by this worrying new sub-strain, H5N2, is being referred to as Avian or bird flu … or is this just until such time as there is an epidemic in the human community in some very specific geographical location ?

However, one thing is certain. No matter how the crisis evolves neither patient admission numbers or staff sickness levels at Joyce Green Hospital will be at all affected, will they ?

31. Trying to connect you.

Key words: Hospital switchboards/operators, PABXs, PMBXs, “Hello girls”, Alexander Graham Bell.

No.31

“You want the On-call Radiographer ? I’ll get him to call you back !”
“Joyce Green Hospital. How can I help you ?”
“Sorry, there are no lines free at the moment”.
“Joyce Green Hospital. How can I help you ?”
“Are you wanting Dr Raj or Dr Dinu ... Patel ?”
“Joyce Green Hospital. How can I help you ?”
“Hold the line please - trying to connect you.”

Recognise them ? The switchboard staff. That small team of people that so many of us used to have almost daily contact with, whose voices were almost as familiar to us our colleagues and yet whose faces we wouldn’t recognise in the street ? Do you remember that friendly operator who acted as an intermediary between you the nervous student nurse, alone on a ward on night duty and the night sister that you felt you needed so urgently. Or that familiar voice that would warn us that they were putting us “through” to Nursing Administration on those rare occasions when we felt that we had no alternative but to “phone in sick”. Those synaptic links, those fountains of knowledge, those conveyors of information, bearers of news and keepers of everyone’s secrets.

Remind me, was the hospital switchboard in the central admin block or was it housed in a section of the porter’s lodge near to the main gate? May be you can remember its exact location because I am certainly struggling to do so right now. But having said that most of us have a clear mental image of a “Joyce” or a “Frank” sitting in front of a hospital switchboard fielding the dozen-and-one calls a minute that seemed to burst into those PABX exchanges throughout the day and night.

Private Automatic Branch Exchanges (PABXs) arrived on the scene for most business premises, government offices and hospitals in 1940 taking over from the old Private Manual Branch Exchanges (the PMBXs) with their bulky switchboards, a battery room and the need for the constant attendance of an operator. However we should perhaps avoid being fooled into thinking that these newer automatic versions were in any sense “hands-free liberators” of switchboard operators because they weren’t !

As far as I can understand the PABXs saw the demise of the old-fashioned boards with their jack-plugs, and their all-too-familiar “cats-cradle” mesh of crossed connection cables but these dedicated “hello-girls” (as they used to be called in the U.S.A) and ‘boys’ too of course were still kept extremely busy.

One switchboard operator recently described her work like this. “There's never a time when the switchboard isn't covered. When I arrive at 8.30 a.m. my colleague, who has been working all night, is waiting to go home.. There are also two part time operators who work from 9.30 - 1.30pm and 1 pm to 5 pm respectively. These peak-time colleagues are a great help particularly when they can relieve me to get on with some of my many administrative tasks. Our telephone network has 13 switches, with 105 lines and more than 9,000 extensions. Most of these are DDI extensions (direct dialling in) and so staff are expected to dial (or to tap out) their own outgoing numbers.

As a switchboard operator you have to be extremely up-to-date all the time particular in relation to where key staff might be (which is sometimes very different from where they are supposed to be) and we obviously try our very best to be conversant about which on-call staff who have asked colleagues “to cover for them” at short notice.

We realise, of course, just how irritating it can be for a caller to be kept holding on waiting for an answer but I can assure you that it's not because we're doing our knitting! Obviously we give priority to outside callers but we often get caught up with staff asking us for information that they could just as easily find out for themselves or with external callers who decide to treat us to their entire medical history when all they really want is to be put through to a Consultant’s secretary !”

Perhaps you have got your own favourite memory of an amusing or serious incident concerning your work at Joyce Green which is linked with an interchange with one of the switchboard operators - if so, why not share the story with the rest of us.

Meanwhile, if you want to check-out how steady your nerves might be if you were ever to find yourself ‘manning’ a telephone switchboard, why not go to this website and put on a set of operator’s headphones for a few minutes ?

http://www.connectedearth/FunandGames/Howdoesaswitchboardwork/index/html

Oh, and in closing, let’s say “Happy Birthday” to Alexander Graham Bell, who managed to produce the first intelligible telephonic conversation on 10 March 1876. It was his birthday today, 3rd March, in 1847.

“H-E-L-L-O ! Oh sorry caller, are you still holding !