Adam Mars-Jones - Pilcrow

On the cortisone question, as it happens, I think Duckett (I can’t get used to ‘Ducat’) was absolutely right. Cortisone betrayed my generation of Still’s Disease patients. It stole their minds while it was supposed to be helping their bodies. One of the girls on the ward had a lively intelligence, a mental age of ten before she reached that birthday. Cortisone wore her away inside and out. When she was thirty she still had a mental age of ten, and she died before she got to thirty-one.

I don’t regret my distinction, among Still’s patients of my age, in being free of steroids except for those two hallucinatory weeks. I had a lucky escape. On that basis I have to be grateful, too, for the misdiagnosis of rheumatic fever, without which I would have been put on cortisone as a matter of course, to keep my bones soft. Nowadays the wisdom is to administer steroids for short periods only. They relieve symptoms without getting involved with underlying causes.

If I’d been prescribed the stuff at three, I’d have been on it for the duration, and I think cortisone would have done to me what it was doing to so many of the children on Wards One and Two at the Canadian Red Cross Memorial Hospital. It was giving them moon faces and weakening their resistance to other infections. By affecting the pituitary gland, which regulates growth, it kept them small and I’m convinced it stunted their mental growth also.

The same thief

You’ll never read it stated in black and white that cortisone was the guilty party. I know because I’ve looked in all the right places. To me, though, it doesn’t seem to be a coincidence that John Cromer, the one who missed out on the wonder drug, was the one who did some definite growing, and didn’t have his mental age stolen by the same thief that took the pain away.

So I have every reason to thank Dr Duckett for his withdrawing of the wonder drug, whether his cavils were amplified by a mystical principle or not. Yes, I know, I hardly seem worth God’s trouble. There has always been a small voice, when I think along these lines, asking the question internally, where on earth do you get the nerve to assume you qualify for divine intervention? Luckily there’s also always been an internal voice, somewhat louder, asking me where on earth I would get the nerve to assume I don’t.

At Taplow Dr Ansell became part of my daily, or at least my weekly life. She was strict, but then no one in hospitals was anything else in those days. She didn’t tolerate nonsense, but there was no one there who did, and most of the things which excited my imagination received the label of nonsense. Still, Ansell was a definite force for good. She would say quite cheerfully, ‘I know they all say “Here comes Old Bossyboots” when I come onto the ward,’ which was perfectly true, though she wasn’t old, not much older than Mum. And she was loved as well as feared.

I’m sure that if Ansell had witnessed my bedpan torments she might have come up with a solution, but of course I wouldn’t be bed-panned while she was doing her rounds. I suppose I could even have told her about it, but I didn’t think of that.

The only thing I didn’t like about Ansell was the way she would talk nicely to me, asking how I felt and being completely friendly, and then she turned to the other members of the medical staff and started murmuring long words to them. I wanted to hear what the words were, and what they meant. If they were long and hard to pronounce, if they bristled with ‘æ’ and ‘œ’s, then all the better as far as I was concerned. Difficulty was an enticement not an obstacle. The easy things in life were hard for me, so why shouldn’t the hard ones be easy? I longed to be an initiate. An initiate of what? That was less important at the time. The need precedes the object it selects.

Nose-blood petition

It was my bad luck that it was a point of principle back then, in medical circles, not to listen to the patient. It was virtually a sub-clause of the Hippocratic Oath.

I had the most violent nosebleeds in those early days at Taplow, abrupt cataracts of the vital essence. I connected them in my mind with the pills I was given, and asked the doctors if they might be the cause. They just laughed and said, ‘Don’t be so silly, John, it’s only aspirin!’

This didn’t stop me feeling that my body was registering objections on the cellular level every time I had a dose of aspirin. When enough signatures had been gathered, those objections issued as a petition, in the form of blood from my nose. And still nobody paid the blindest bit of notice.

Nowadays the rare reaction to aspirin in childhood is an acknowledged fact. It’s called Reye’s Syndrome. Back then its only name was ‘John being silly’. Eventually they stopped giving me aspirin and the nosebleeds stopped also, but either nobody made the connection, or they didn’t want me to know I had been cheeky enough to be right all along about what was going on in my body.

The nurse in charge of Ward One, including the side ward where I was kept for the time being, was Sister Heel. She had introduced herself to me, and I had noticed that her skin was creased and cracked like worn leather, like the brown shoes that Mum didn’t wear for best. I hadn’t really met her, though, in the sense of becoming acquainted with her personality. I didn’t meet her in her essential form until she was out of the room, and I heard her giving a thorough scolding to one of her underlings.

In fact what I heard was a series of crashing noises, and Sister Heel’s voice baying over everything. At first I thought that some poor trainee nurse was so terrified of Sister that she had simply dropped a tray of tea things, but it wasn’t that at all. It was Sister Heel doing the smashing, with a fierce relish. The noise it all made would make a wedding party in a Greek restaurant seem quite muted in comparison. After a bit I could make out the words. What she was saying was, ‘I’ve told you TIME and TIME and TIME AGAIN!’ and each emphasised word coincided with a loud ceramic smash.

She was telling them that cracked cups were worse than useless and should be broken outright. ‘A crack in a cup’, she crowed, ‘is an open invitation to germs.’ Not that germs would dare to multiply in her presence, her very voice would sterilise them. ‘If you wish to drink from unhygienic crockery, then you will do so in your own time and from your own dirty cups. No patient of mine will be exposed to infection because of the laxness of the staff. Is that understood?’

A voice hardly audible. ‘Yes, Sister.’

‘I couldn’t hear that.’

‘Yes, Sister!’

‘Now clear up this mess and know better in future.’

The country might be on its knees after a heroic, self-sacrificial war, the National Health Service still struggling to be born out of the ashes of a vanished prosperity, but there was no excuse for a hospital cup having a crack in it.

In fact the economic aspects of the place were oddly unpredictable. We slept between linen sheets as a matter of course, like royalty, sheets washed and ironed in the hospital’s own laundry. Ansell insisted on this extravagance — we were children, after all, who spent more than the usual amount of time in bed. The linen even had a wholesome taste against the tongue.

The discrepancy between the smoothness of the sheets we slept between and the roughness of the ones that were scraped against our tender little bums was part of the mystery of the place. In an institution where we had to have our bottoms wiped for us, by nurses whose tenderness was very variable, soft tissue would have made quite a difference, taking the abrasion factor out of the brusquer wipings.

Somehow Sister Heel was so terrifying she shot off the scale and blew back in at the other end, as a hurricane of reassurance. It made me feel better to know that she had the staff running round in small circles. She didn’t have anything that corresponded to the modern term ‘people skills’. She just shouted at the world until it fell into line, usually sooner rather than later.