Richard Gordon - SURGEON AT ARMS

First Published in 1968

He couldn't believe it.

It was outrageous, ridiculous, but frightening, like finding the Houses of Parliament in the middle of Salisbury Plain, stumbling into St Peter's Square round a corner in Wimbledon, or coming across the Taj Mahal amid the alleys of the City. The front was magnificent. The portico presented a decorated frieze, four stout pale columns of Portland stone, and all the exuberant self-confidence of a Victorian London railway terminus. Behind rose a flattish dome, topped by four minarets, two of them emitting smoke. Then the building seriously got down to business. Its slate-roofed, double-storied, mean-windowed blocks spread in a fan, sticking their ugly fingers into an empty countryside wearing the ragged robes of autumn. All round ran an eight-foot-high wall, topped with unfriendly-looking broken glass. Everything was in yellow brick, which in the pale afternoon sunshine gave the place the look of being constructed from a million bars of Sunlight soap.

But the grounds were magnificent. Lawns, shrubberies, orchards, flowerbeds, and kitchen gardens were laid out neatly on each side of the long winding driveway, all tended with care befitting a palace. He supposed they must have had an embarrassing surplus of labour. There was a Gothic chapel, with a magnificent clock which had scattered unnecessary hours for a century. There were more modern outbuildings with larger windows, and even more modern corrugated iron Nissen huts with no windows at all. There were signs everywhere. One directed CASUALTIES to some more workmanlike entrance in the rear, another SHELTER directly into the earth, a smart new blue-and-gold board where he parked his car announced

MINISTRY OF HEALTH-EMERGENCY MEDICAL SERVICE-SMITHERS BOTHAM SECTOR HOSPITAL.

It still struck him as a most peculiar name.

The entrance hall beyond the portico was a disappointment, dark and poky, painted in official spinach green and mustard yellow. Behind a small counter sat an old man with a blue uniform and sadly drooping moustaches, to whom he announced himself, 'I'm Mr Graham Trevose. I'd like to see Captain Pile, please.'

The old man looked at Graham Trevose wearily. For ten years he had sat behind that counter, hardly molested from morning to night, contemplating his pension. But now there were changes everywhere, he'd hardly time to get through his _Daily Mirror._ 'From Blackfriars Hospital, sir?' he asked.

Graham nodded.

'Have you an appointment?'

'For two o'clock.'

As the doorman turned to a small switchboard beside him Graham unbuttoned his fawn overcoat, felt for his gold case, and lit a cigarette. He noticed the hall led to a dim, narrow concrete corridor, stretching apparently to infinity. His eye fell on two doors with big brass keyholes and bolts but no handles. A terrible place to find yourself in, mad or sane. He shuddered.

Smithers Botham was a mental hospital, 'The Asylum' to the villagers, despite the term having been tactfully dropped about the time alienists mysteriously turned themselves into psychiatrists. It sprawled across the sunward slopes of the Downs south of London, which in that autumn of 1939 had lost to the safety of the countryside everything the nation held most precious-the schoolchildren, the expectant mothers, the contents of the National Gallery, the B.B.C., and the Admiralty.

The moment which had dominated British politics for five years-the arrival of the German Air Force to bomb the capital-seemed most regrettably at last about to occur. The Government confidently expected half a million air-raid casualties in the first week of the war, and something had to be done about patching them up. So the great London hospitals, too, rose stiffly from sites they had occupied for centuries, and shifted to the Home Counties in fleets of converted Green Line buses, doctors, nurses, students, instruments, beds, bed-pans, and all. Blackfriars Hospital, which had tended the sick beside the Thames since the Great Plague, was displaced to Smithers Botham, the others found secure homes in similar nineteenth-century mental institutions scattered so conveniently round the metropolis. The Government could never have kept Londoners healthy through the blitz without these vast and ugly buildings. The bread cast on the broad waters of Victorian compassion was washed ashore in the nick of time.

The Smithers Botham mental doctors, themselves dispatched with the rightful inmates to Scotland, had watched the war approach more bitterly than even Mr Chamberlain. The upper reaches of prewar medicine had many agreeable backwaters, none pleasanter than a job in such a place. They enjoyed free houses in the grounds, free vegetables piled daily on their kitchen tables, even free laundry-which was always beautifully turned out, laundrywork being thought a useful occupation for madwomen. Their main vexations were their own colleagues, who could be difficult, many doctors of unreliable personality choosing to escape from the harsh world behind the same walls as their patients. But their duties were delightfully light, the treatment of mental illness at the time being as passive as the treatment of criminals, consisting mainly in keeping both classes locked well away from public view.

Now the Smithers Botham gymnasium was partitioned into a row of operating theatres, where long-established cats snoozed in the warmth of the sterilizers or disported themselves among the beams above. New laboratories were fashioned from damp little outhouses, where sometimes toads came hopping round the test-tubes. The long bleak wards, re-equipped and refilled with rows of empty beds, after ten weeks of war still yawned hungrily for the half-million casualties, while bats flicked up and down the corridors at dusk, scaring the night nurses. The evacuated Blackfriars staff fitted in as best they could, the matron numbering among the first horrors of war her charges having to sleep without their usual collective chastity belt of spiked railings. But there were unlooked-for rural compensations-fresh air, a croquet lawn, tennis courts, even a cricket pitch, where the more athletic housemen took their exercise in the mornings and the more amorous ones took their girl-friends at night. And everyone agreed the flap would be over by Christmas, in spring they'd be home again in London.

Graham Trevose looked at his wristwatch. Ten past two. 'I suppose Captain Pile knows I'm waiting?'

'He's very busy just now, sir.'

'My own time's not exactly valueless, you know,' Graham told him, not as unkindly as he might.

The old man looked wearier than ever. 'There's a war on, sir.'

Graham winced. He always did at the expression which had come to excuse any incompetence or incivility. Instead of replying he sat resignedly on a short wooden bench, eyeing a red-and-white poster telling him his cheerfulness, his courage, and his resolution would give them victory. In a spot like Smithers Botham, he felt he was going to need all three.

Graham Trevose was odd man out, as usual.

The Second World War found the British Government prepared to take a more tolerant view of many things than during the First. Conscientious objectors were allowed to fight fires in preference to the enemy, soldiers' mistresses (if reasonably permanent) were given an allowance, and where the cure for hysteria in British soldiers at Ypres was a British bullet, by Dunkirk 'psychological exhaustion' had become entirely respectable. The Government had a particular new enthusiasm for plastic surgery. Men with faces smashed on the Somme were, if lucky, returned home looking grotesque, and if unlucky, either died or recovered so splendidly they were sent back to present another target. Then Harold Gillies created with the basic elements of surgery and the penetrating eye of an artist his brand-new science of facial repair, though until the Armistice his notion of returning casualties to the world looking roughly like human beings attracted derision from many senior officers, to whom it was a matter of supreme indifference if a man got his face shot off or his backside.