54. Bridge over troubled water at Joyce Green Hospital

Key words/phrases: The Bridge Project, George Wimpey plc, First Time Buyer’s Initiative, Wayne Hemingway, The Bluewater Shopping Centre, Darent Valley Hospital, The Crossways Business Park, Temple Hill, Dartford Station

No. 54

In view of the fact that large parts of England are severely flooded at the moment - an almost unprecedented situation - and with the threat of further flooding still hanging precariously over swathes of countryside near to other rivers, including the Thames, it is perhaps encouraging to hear some good news about some progress relating to “The Bridge Project” on the old Joyce Green Hospital and Littlebrook lakes sites ?

However, with this “new English Lake District” peering out at us from our television screens and national newspapers, one cannot helping wondering how safe from flooding “The Bridge Project” site will be, given the history of flooding in this area in the past.

Ex-members of Joyce Green staff, ex-patients and anyone else with an interest in the area and for those who might be contemplating purchasing property alongside that part of the river, may be interested to hear that the first batch of houses has been completed and are currently on sale with one-bedroom apartments starting at £175,000.

To help first-time buyers to purchase homes on “The Bridge” estate, George Wimpey plc. has teamed up with English Partnerships to offer properties via the new First Time Buyer’s Initiative that will allow first time buyers to obtain an equity loan for up to half a property’s value - thus enabling them to get on to the U.K. property ladder when otherwise they might not have been able to afford to do so.

During the next seven years the 264 acre site is scheduled to see the appearance of 1,100 new homes within an existing environment of mature trees and water features and Wayne Hemingway, one of the housing designers involved who seems committed to ensuring that landscaping and green spaces are a major part of the various residential segments was quoted recently as saying "that green spaces have been ignored in the overall design of large housing developments for far too long”.

“We believe, "he continued "that not only is such landscaping important in environmental terms but that it can also help in the creation of a caring society”. "I also believe,” he said, “that house builders and urban designers have positive roles to play in combating our 21st century ‘couch potato culture' which can result in health and behavioural problems”.

“But the economic value of landscaping is also significant,” he says, “because green spaces can add value to a property with recent studies in Chicago, Amsterdam and the UK showing that properties overlooking green open spaces often attract significantly higher prices”.

In terms of communication links there is to be a new fast-track transport system connecting hubs such as Dartford and Gravesend town centres, the nearby Bluewater Shopping Centre, Darent Valley Hospital and the Crossways Business Park and in addition a new bridge is going to be constructed over the M25 to provide to connect “The Bridge” estate and the Crossways Business Park with Temple Hill and Dartford Station.

How different the old Joyce Green Hospital and Littlebrook areas is going to look in 2012 or 2013 when the development is completed, although in view of the flooding that is currently affecting many people in parts of southern England one can only hope that global warming and climatic changes will not cause havoc on “The Bridge” estate in years to come !

53. Ophthalmic care at Joyce Green Hospital

Key phrases/words : Horatio Nelson, HMS Agamemnon, Corsica & Calvi, Lord Hood, the ophthalmic ward at Joyce Green Hospital, cranial immobilisation with sandbags, Mr. Owen - ophthalmic surgeon,

No. 53

This week, 213 years ago, must have been a very uncomfortable week for Horatio Nelson, the famous British naval officer from Norfolk.

In 1793, once Britain had entered the French Revolutionary Wars, Nelson and his ship H.M.S Agamemnon found themselves serving in the Mediterranean off the small northern Corsican town of Calvi.

Earlier on the British navy had been holding this garrison town under siege but on the 12th July 1794 the time had arrived for the British to press home their attack against the enemy.

Nelson and his men reached the local shore in a number of small boats carrying a number of small cannons with them but while some of his men were in the process of setting up a gun battery, with Nelson directing the way that some of these should be pointing, a French shot struck the battery rampart immediately in front of him sending a shower of earth, sand and pebbles into his face, lacerating it and badly damaging his right eye at the same time.

It seems that he made light of the incident in his letters home and to Lord Hood his commander-in-chief however a recently discovered letter has revealed that Nelson had to be carried away from the battery to his tent, suggesting that his injuries were much more disabling than he initially admitted.

The lacerations apparently healed leaving nothing more than a partially-erased eyebrow but his eye never recovered. Modern-day ophthalmologists have tried to reconstruct exactly what caused his subsequent partial-sightedness and the most likely causes suggested have been a severe internal haemorrhage or a detached retina.

What is certain however is that eye itself remained intact and that it looked undamaged. But to the end of his life he could only distinguish light from dark with it and so although not technically blind this eye was virtually useless to him for the remaining 11 years of his life.

Who knows though - perhaps if he had been treated in modern times and in a modern ophthalmic unit such as the one at Joyce Green Hospital perhaps his sight reduction could have been minimised ?

Do you remember the ophthalmic ward at Joyce Green ? I can certainly remember working on that small-but-perfectly formed unit, complete with its own integral operating theatre and headed-up at the time by Mr. Owen, the ophthalmic surgeon.

But I suppose the one thing that sticks in my mind most clearly is the high degree of attention that was paid to the regime of “complete bed-rest” following the type of surgery that was carried out there.

I particularly remember sand-bags being used to maintain patient’s heads absolutely still post-operatively and having to spoon feed patients with semi-liquid food that didn’t require them to masticate.

Oh yes, bedrest meant bedrest and neither were the patients allowed to get out of bed to use a commode until much later on following their surgery. A far cry from contemporary ophthalmic practice these days I suspect ?

Perhaps you have memories of that ward, the staff who worked on it or recollections of some of the patients that were cared for on it ?

In closing, who can say what type of intervention and care Horatio Nelson would have received if he had been admitted to Joyce Green Hospital ophthalmic unit with that particular injury -all those years later ?

52. Image & Joyce Green Hospital

Key words/phrases: The Royal Ballet Company of London, Edward Watson -Principal Male Dancer, Mary Clarke -Editor of The Dancing Times, The Royal Opera House, Great Ormond St Children's Hospital, Peter Pan, George Bush Jnr., Tony Blair,

No. 52

The Royal Ballet Company in London has been accused this week of “sexing up” its advertising material and as a consequence of this Dartford’s name has been thrust into the limelight once again.

How ? Well rather than using a traditional image of a female ballet dancer in a tutu, underscored by a plain slogan of the: “Why not come to the ballet”, the Royal Opera House has launched a new poster depicting it’s principal male dancer gazing into the camera’s lens with his lips forming a gentle pout. Then underneath the image there is a caption that reads : "Meet Ed. Fact: When he's dancing, pound for pound, he's stronger than a rhino. Superheroes really do wear tights".

So how and why is Dartford associated with this controversial advertising campaign ? Well because Edward Watson, the 31yr old red-headed male principal dancer is a Dartford lad who was born and bred in Longfield and is someone who still counts Dartford as his home town.

Mary Clarke, the editor of the Dancing Times, has deemed such treatment of a serious artist as “appalling” and as “a tacky advertising ploy that will cheapen the image of the company”. The Royal Opera House however has described its advertising campaign as “up close and personal” and “something that seeks to celebrate the physicality of its performers as well as challenging people's perceptions of ballet dancers as distant figures in tutus”.

Their director of marketing is quoted in a number of English newspapers as saying: “Whilst I have an imperative to sell seats, an even bigger imperative is to have the right image for the organisation and to change people's perceptions of it so that they realise that we are not intimidating but engaging and welcoming”.

It was this disagreement involving such a well-known company that made me begin to think about the images which hospitals have and sometimes seek to project.

If I were to ask you to name a well-known London children’s hospital you are more than likely to reply: “Great Ormond Street”. Equally, if YOU were to ask a member of the British public to name a “heart hospital”, you wouldn’t be at all surprised would you if they answered: “Harefield”.

What actually happens - clinically - in any hospital does seem to be one of the keys to shaping the image that it has in the public’s eye. In turn this led me on to thinking about the image that Joyce Green used to have and how that image was nurtured and maintained.

The name of a hospital, its historical background, its crest and its motto may all be important. (“The child first and always", being Gt. Ormond Street’s motto and the facts relating to it’s possession of the “Peter Pan” royalty-rights legacy being known to most people) but in fact it’s usually the good work that has gone on in any hospital over the years that is most effective in building up the reputation of the hospital.

So here’s a question that is perhaps worth re-asking :Did Joyce Green Hospital have a good reputation for the treatment, the care and the services that it provided and if so, on what was that reputation based ?

Do you remember particular wards or departments and their associated teams of staff who won reputations as providers of excellent treatment ? Or at a simpler level can you remember teams of people within the hospital who came to be known for the quality of the patient care that they provided ?

When “The Great Book of World Politics” comes to be written although George Bush Jnr and Tony Blair are most likely to remembered as key figures in “sexing up” the case for war against Iraq at least the consequences of their manipulations have now caused many top class leaders to re-think just how wise it is to “sex up” political, business and management evidence as a means of achieving their objectives.

Perhaps at the end of the day what really matters when it comes to providing what the public wants are … skills before sound-bites, integrity before artificially inflamed descriptions and results, reliability before razzmatazz and hope before hype ?

So even though Joyce Green Hospital never achieved 1st Division status in the world of well-known hospitals, I remain convinced that - in the main - it provided a standard of care that many patients and their families truly appreciated.

51. The Hospital Library at Joyce Green.

Key words/phrases: Joyce Green library, Charlotte Berry (née Dobbs), Clarice & F.L Dodds, Bow Arrow & Darenth Park Hospitals, Garrison Keillor, Charles Medawar, “Toohey’s Medicine for Nurses”, Preliminary Training School (P.T.S.), Henoch-Schonlein’s purpura, Ward 9A, Norman Cousins, Jesse Boot, “Chalkie” White.

No.51

Do you remember the library at Joyce Green Hospital ? Situated north of the large courtyard behind the Nursing Administration block on one of the corridors that led away from the administrative hub of the hospital and leading towards the wards ?

Charlotte Berry (née Dobbs) - who now lives in Greymouth, New Zealand - and I trained together as student nurses in the late 60s and because Charlotte is the stepdaughter of Clarice, the librarian, I have been able to talk to her recently about Clarice and the Joyce Green library.

In passing - you might remember Charlotte’s father, Fred Lesley Dobbs, too? At one time he was Finance officer for the Dartford Group of Hospitals based at Bow Arrow Hospital and later on he became the Finance Officer for the Darenth Park Group of Hospitals. He married Clarice in 1968.

But if you worked at Joyce Green during the 60s and beyond you’ll almost certainly remember Clarice and her cross-bred spaniel Toby ?

Referring to librarians in his book ‘Lives of the Cowboys’, Garrison Keillor once said “that librarians possess a vast store of politeness. They regularly get asked the dumbest questions on God's green earth and they tolerate every kind of crank, eccentric and mouth-breather there is”, whereas Charles Medawar once said: “Whilst librarians are almost always very helpful and absurdly knowledgeable, their skills are very underestimated and largely under-employed”.

Did this cap fit in Clarice’s case ? Yes, I believe it does.

Student nurses who were about to enter the Preliminary Training School (P.T.S.) at Joyce Green each had to purchase their own copy of a medical and a surgical nursing text book for use during the course. “Toohey’s Medicine for Nurses” was the name of the medical nursing textbook although I can’t remember what the surgical nursing textbook was called.

However it was to the hospital library - so expertly run by Clarice - that most of us went to in order to read up on all the other material that we needed access to during our studies since web-searching and the internet hadn’t been heard of then, at least not in Dartford. I certainly have memories of wading through material on Henoch-Schonlein’s purpura in the library in order to bolster the content of a case study relating to a little boy that was being nursed on Ward 9A at the time and valuing the help of the library staff.

The library at Joyce Green was a mixed library containing medical and paramedical texts & journals plus fiction and non-fiction for both patients and staff . In addition a library trolley was pushed around the wards once a week for the benefit of bed-bound patients.

The library itself had one large room containing nursing textbooks and recreational reading material books and then there was a medical-orientated library off of the this main room with Clarice's office off of that.

In addition Charlotte Charlotte has reminded me that Clarice also used to go up to London occasionally to select and borrow paintings that would subsequently be hung in strategic positions around the hospital. Do ever remember, for instance, having an after-lunch cup of coffee in the nurses’ sitting room - above the main dining room - and glancing at one of the pictures that Clarice had selected or seeing pictures elsewhere in the hospital ?

The American writer, editor, citizen-diplomat and unflagging optimist Norman Cousins (1915-1990) once said “that a one of the roles of a library should be … as a delivery room for the birth of ideas …”.

Since he was also very passionate about promoting health and wholeness and was an advocate of holistic healing who would be better perhaps, were we to decide to select a cheer-leader for hospital libraries, than him ?

Later on during his life Cousins was diagnosed with a form of arthritis but he refused to become an invalid to his condition and in addition to the standard treatment regimes of the time he experimented with high doses of Vitamin C and the regular use of what he referred to as “laughter therapy”. Later on he suffered a myocardial infarction but subsequently he went on to chronicle his views in his best-seller : “Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration” (1979).

In conclusion - and following on from the piece I wrote a couple weeks ago about Jesse Boot and Chalkie White, the Joyce Green pharmacist - did you realise that Jessie’s wife, Florence was responsible for setting up the Boot’s Book-Lover’s Libraries in her husband’s chemist shops ?

She charged borrowers 2d per book which obviously helped to boost the trade of Boots, The Chemists, but her motives were far from simply financial and she became a staunch advocate of higher education for women ... particularly in Nottingham where she financed the building of a Hall of Residence for women at Nottingham University in 1928.

I’m sure that Florence Boot and Clarice Dobbs would have had a lot to talk about together ?