Queen Victoria Hospital Archive Project: a day in the life of a Preservation and Digitisation Assistant

 

My name is Lucy Maguire, and I worked on the Queen Victoria Hospital Archive Project as a Preservation and Digitisation Assistant between August 2016 and September 2017. As the title suggests, my job was broken up into two main parts but within each there was a wealth of surprises, which made every day its own unique challenge.

Lucy at work

When I began working in the Record Office’s conservation workshop, my first task was the digitisation of the patient files of QVH’s ‘Guinea Pig Club’. I had of course been aware of the famous group before I came to the project, along with their pioneering ‘Maestro’ Sir Archibald McIndoe, and it was a privilege to work with their medical histories in such detail. In total I captured over 25000 images as part of the digitisation process, but this was only the first step – each photograph was edited, assigned a unique reference code and stored safely on an external hard-drive. This kind of post-production is a vital part of the digitisation process, as it ensures that an image will be identifiable and useful to the researchers that wish to use it.

Alongside the Guinea Pig Club patient case files, I also worked on digitising East Grinstead Museum’s collection of drawings by VAD nurse Mollie Lentaigne. As the Museum’s ‘Rebuilding Bodies and Souls’ exhibition explains, Lentaigne was drafted by McIndoe to illustrate the ground-breaking procedures he was undertaking in the hospital’s theatres. The resulting art is a fascinating and visually striking window into the surgical advances made during the war-time period.

Preservation equipment and materials

Once the camera was packed away, work began on the other aspect of my role – conducting preservation work on all of the patient case files in our collection. With around 15,000 files to work on this is no small task, and it’s difficult not to get distracted by the stories of the patients and staff! I removed paperclips, staples and treasury tags, interleaf pages of photographs with Silversafe paper, and store x-rays and photographic slides in specially crafted Melinex pockets.

Sometimes, however, items required more specialist attention, like a collection of x-rays displayed in the shape of a mouth. We had to remove the staples that attached them to the card, but were able to retain their orientation by ‘sewing’ them back into place with archive-friendly thread. Working through these kinds of preservation puzzles is one of the most rewarding parts of my job – improving the lifespan of a record, whilst maintaining its unique character, is always a delicate balance.

The Queen Victoria Hospital Archive is full of remarkable stories, and working on the technical aspects of this Wellcome Trust project has been a very exciting journey. Although many of these processes happen behind the scenes, they help to ensure that the collection remains legible and accessible, meaning that these stories can educate and inspire us for years to come.

Lucy Maguire, Queen Victoria Hospital Project Preservation and Digitisation Assistant

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Queen Victoria Hospital Archive Project: ‘Women in the Wings’

The history of Queen Victoria Hospital and the Guinea Pigs can often seem a very male-dominated narrative. McIndoe and the other star plastic surgeons of the day were all men; the Guinea Pig Club was unquestionably a ‘boys’ club.’ Yet often behind the scenes women were making vital – and memorable – contributions to the work and success of the hospital. Honourable mention should go to the many nurses who worked relentlessly to care for patients in the often highly demanding and challenging environment of Ward III. Here great resilience and compassion (and sometimes forbearance) were needed to deal with the severity of the patients’ disfiguring injuries and the intensive regime of nursing care required, as well as the often rowdy and ‘laddish’ antics indulged and encouraged by McIndoe.

This post seeks to highlight three other women who, in very different ways, were uniquely important to Queen Victoria Hospital.

VAD nurse and artist Mollie Lentaigne at work

Mollie Lentaigne was aged only 17 when the Second World War broke out in 1939. Her association with Queen Victoria Hospital and the Guinea Pigs began by chance in 1941 when she attended a cocktail party held in honour of Archibald McIndoe at the home of family friends. Lentaigne caught McIndoe’s attention when he noticed her drawing a sketch of him from a distance. It so happened that McIndoe was on the lookout for an artist to work with him in the operating theatre to create illustrations of his surgeries. Photography in the theatre had not been a success due, apparently, to shadows thrown from various surgical instruments. McIndoe had also ‘auditioned’ two other artists already, both of whom, he said, had fainted at the sight of blood. Impressed with both the quality and the speed of Lentaigne’s drawing, McIndoe invited her to come to QVH and try out the role.

Illustration of an eye injury by Mollie Lentaigne

Lentaigne began work at QVH as a Voluntary Aid Detachment nurse, and despite her inexperience, became a great success as McIndoe’s medical artist, remaining at the hospital until the end of the war, when the intense workload began to give her trouble with her eyesight and doctors ordered her to take a year off drawing. Lentaigne travelled to India as a nurse and later to South Africa and Zimbabwe, which became her adopted home. Lentaigne’s striking artwork is now held at East Grinstead Museum and was digitised as part of the WSRO’s Wellcome Trust project. It provides a detailed – and beautiful – visual record of the pioneering operations carried out by McIndoe and his team.

The indomitable Elaine Blond was one of the most important supporters and benefactors of Queen Victoria Hospital for over 40 years. The daughter of Sir Michael Marks, the founder of Marks and Spencer, Blond and her second husband, industrialist Neville Blond, became close friends with Sir Archibald McIndoe when they were living in East Grinstead during the war. Blond had already been a supporter of the hospital prior to her second marriage (in 1944) and famously opened up her home, Saint Hill Manor, as a place for the Guinea Pigs to convalesce, as well as organising dinners, social events and entertainments for them.

Elaine Blond

In 1959, Elaine and Neville provided funding for the building of a block of laboratories in the hospital grounds, where vital research into such areas as tissue transplantation could be undertaken. The Blond McIndoe Medical Research Centre was opened in 1961. Both Elaine* and Neville sat on the committee of the newly formed East Grinstead Research Trust who organised the finances and policy of the centre. The Blonds also provided further funds a year or two later to cover the expansion of the centre, and their generosity also enabled the founding of a much needed modern, specialised burns unit, named the McIndoe Burns Unit, which opened in 1965.

Blond’s active involvement in many aspects of the life of the hospital is well documented in the QVH archive. She took a huge interest in the Guinea Pigs, and participated in the running of the Welfare Committee alongside McIndoe as well as sitting on the House Committee of the hospital and becoming President of the hospital’s League of Friends. A set of report books for nurses’ homes shows Blond (together with Lady McIndoe) carefully inspecting the accommodation provided for the nurses and making recommendations for improvements. After the death of her husband Neville in 1970, Elaine took on his role as Chairman of the East Grinstead Research Trust and threw herself wholeheartedly into the task. In 1984, Elaine Blond became only the third woman ever to receive the honour of being made a Member of the Court of Patrons of the Royal College of Surgeons.

Theatre sister Jill Mullins

Theatre sister Jill Mullins was for many years a key member of McIndoe’s team in the operating theatre. She first met McIndoe in 1931 when both were working at St Bartholomew’s Hospital in London, where Mullins (at the age of only 21) was already in charge of one of the operating theatres. In 1935 she joined McIndoe in his Harley Street practice alongside anaesthetist John Hunter and the formidable team later known to the Guinea Pig Club as ‘The Immortal Trio’ was born. When war broke out in 1939, Mullins accompanied McIndoe to East Grinstead and worked alongside him in treating the Guinea Pigs. She was much-loved by the patients and known for her great competence and efficiency as a theatre sister, her exceptional post-operative patient care – and for her perfect professional ‘chemistry’ with McIndoe. In the operating theatre, the two worked in complete, instinctive synchronisation, with Mullins always seeming to know exactly which instrument McIndoe required, and when. Her knowledge and understanding of surgery came to the fore when she took a leading role in designing the theatres for the new American Wing of the hospital which opened in 1946, and introduced many innovations which filtered down to operating theatres elsewhere.

McIndoe and Mullins in theatre, 1940s

Jill Mullins remained as McIndoe’s surgical assistant until 1957, when she moved to South Africa due to her husband’s business. Tragically she died of a stroke whilst travelling on board ship to Johannesburg in 1959, aged only 49. McIndoe was devastated by her death and praised her many remarkable qualities in a touching tribute in the Guinea Pig magazine, perhaps summing up his feelings most clearly when he wrote: ‘Sometimes I had to operate without her. To me it was hell.’

*Elaine Blond took up the place on the committee of the East Grinstead Research Trust left open following the death of Sir Archibald McIndoe in April 1960.

Joanna McConville, Project Archivist

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Queen Victoria Hospital Archive Project: Beyond McIndoe – staff at QVH

 

The name of Sir Archibald McIndoe comes – deservedly – to the fore in any retelling of the history of Queen Victoria Hospital. As this series of blogs has highlighted, there can be no doubt of his influence in transforming the fortunes of both the hospital and of a multitude of patients through his pioneering surgical work and sheer force of personality. On the other hand it should also be remembered that McIndoe was not working in isolation; the achievements at QVH both during, and following the war, were very much a collective endeavour, and so many others – nurses, orderlies, anaesthetists, as well as McIndoe’s surgical colleagues and trainees – all had crucial parts to play. Whilst there is not space here to tell the stories of all of those who participated in this great work, it seems worthwhile to highlight just a small number of those individuals – a little less celebrated than McIndoe himself, perhaps – who made a real impact both at QVH and beyond.

Sir William Kelsey Fry © The British Journal of Plastic Surgery

Sir William Kelsey Fry was a distinguished dental surgeon whose formative experience in his field was gained during the First World War where he worked as part of a team treating facial and jaw injuries first at the Cambridge Hospital at Aldershot and then at St Mary’s Hospital, Sidcup. The team included not only the surgeon and war artist Henry Tonks, but also a young Harold Gillies (who of course was later McIndoe’s mentor), then an Ear, Nose and Throat specialist. Kelsey Fry and Gillies worked closely together, each learning and gaining from an increased understanding of the other’s specialism (Gillies in surgery and Kelsey Fry in dentistry), and their highly productive working relationship continued in the years following the end of the war.

Gillies and Kelsey Fry were pioneers of the discipline of maxillo-facial surgery and in 1932, the two were appointed by the Army Council to a committee reporting on these types of injuries. In 1935 they published a report making recommendations for treatment, and advising on the organisation of centres for this to take place which became extremely influential in the selection of maxillo-facial units prior to the outbreak of WW2. According to various sources, Kelsey Fry and Gillies were responsible for the choice of Queen Victoria Hospital as one of the the units; Kelsey Fry’s son was at the local Brambletye School and, anticipating the wartime rationing of petrol, he needed a reason to visit the area (whilst East Grinstead was conveniently situated for Gillies between London and his favourite gold club at Rye!).

Kelsey Fry played a crucial role in the work of QVH’s maxillo-facial unit during the war years and dedicated great attention to training those from the armed forces in the treatment of facial injuries, establishing QVH as a centre of excellence in the field.

Ross Tilley being presented with the air raid siren from East Grinstead (Tilley is on the left) © East Grinstead Museum, reproduced with their kind permission

Group Captain Ross Tilley arrived at QVH in 1941. As Principal Medical Officer (overseas) to the Royal Canadian Air Force, he was sent to treat the high proportion of Canadian airmen who had been injured in action and found themselves at East Grinstead.  Tilley, who had previously trained with plastic surgeons in Canada, quickly became one of Archibald McIndoe’s most trusted colleagues and the two were of the same mind in matters of treatment and their personal dedication to the care of their patients.

Tilley was influential in securing the backing of the Canadian government to build the Canadian Wing at QVH. This purpose-built facility was reserved during the war for the treatment of Canadian casualties, under the care of Tilley and his own team of specialists, but was subsequently given over fully to Queen Victoria Hospital for their own use, and formally handed over in a ceremony in September 1945.

Interior and exterior of the Canadian Wing © East Grinstead Museum, reproduced with their kind permission

Tilley returned to Canada after the war where he continued to have an illustrious career in plastic surgery. His memory lives on at Queen Victoria Hospital, where there is a ward named in his honour.

Sir Benjamin Rycroft © East Grinstead Museum, reproduced with their kind permission

Ophthalmologist Benjamin Rycroft arrived at Queen Victoria Hospital at the end of the Second World War to establish a new corneo-plastic department. The field of corneal surgery was one which was developing and growing in prominence but Rycroft’s progress in his work was initially hampered by a shortage of donor eyes, mostly because at that time in the United Kingdom it was actually illegal to donate body parts to the medical profession.  Rycroft (along with McIndoe) played a leading role in a national campaign to educate the public on the urgent need for donor eyes to enable sight-saving corneal grafts to be carried out. In 1952 the Corneal Grafting Act was passed by Parliament and became law, and the country’s first Eye Bank was established at Queen Victoria Hospital. Many hundreds of the QVH case files document the treatments and procedures undergone by patients who were able to benefit from Rycroft’s pioneering efforts in this field.

Joanna McConville, Project Archivist

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Queen Victoria Hospital Archive Project: the Guinea Pig Club and the people of East Grinstead

 

 

 

 

Today’s post is a guest blog from Katie Kettle, a volunteer at East Grinstead Museum, who provides us with a special insight into the relationship between the Guinea Pig Club and the town of East Grinstead.

Archibald McIndoe was one of Britain’s few plastic surgeons at the beginning of the Second World War. Over the course of the war, the work he performed on airmen with severe burn or crush injuries made him famous. His patients created the Guinea Pig Club, one of the world’s most exclusive clubs, so named because McIndoe was often trying out entirely new techniques and operations as part of the process of returning them to ordinary life. East Grinstead became the home of the Guinea Pig Club, and the townspeople formed close and important ties with both McIndoe and his patients. This relationship earned East Grinstead the nickname of ‘The Town That Didn’t Stare’.

Interior of the Whitehall, set up for a dance © East Grinstead Museum, reproduced with their kind permission

McIndoe took over what is now Queen Victoria Hospital on 4 September 1939, a day after war was announced. From the beginning he raised the importance of the psychological recovery of his patients, not just the physical recovery. Many of his patient received “Airmen’s Burns”, full thickness burns to the face and hands, some of whom had been burnt to the point of being unrecognisable. He was determined that his patients should not be excluded from society and asked for the help of the townspeople – he talked about the work of the hospital and the situations of his patients to the townspeople he met, encouraged donations and gained the cooperation of the local police and publicans, the latter of which would play a large part in the recovery process. He encouraged the town to invite the airmen to local events – meals, dances, sporting fixtures – and visited all the shops in town to persuade the shop assistants not to react with horror at the first sight of his patients; to treat them as ordinary young men with temporary problems. His efforts to familiarise the townspeople with the work the hospital was doing meant that it was probably much easier for them to accept the patients into the local community.

Surviving members of the Guinea Pig Club at their last official reunion, 2007 © East Grinstead Museum, reproduced with their kind permission

The attitude of McIndoe and his staff at the hospital started the physical and mental recovery of the patients, while the camaraderie from the Guinea Pig Club meant they felt that they were not facing the consequences of their injuries alone. Combined this gave them the confidence to leave the hospital, but it was the acceptance into the town community, which encouraged the belief that they would be able to return to the outside world without being outcasts. This acceptance retained its importance even well after the war ended – many Guinea Pigs gladly returned to East Grinstead every September for the Annual Dinner until the last was held in 2007.

Exterior of the Whitehall, c1949 © East Grinstead Museum, reproduced with their kind permission

The acceptance of the townspeople was, unsurprisingly, not immediate, but swiftly developed over the first couple of weeks of exposure as the patients ventured out of the hospital and the trips into town helped build up the confidence of the airmen. In particular, the Whitehall complex on London Road became a haven for the Guinea Pigs. Bill Gardiner, the manager, gave pride of place to the Guinea Pigs when they came in to the Restaurant and was very quick to deal with protests from other customers. He became a member of the Royal Society for the Prevention of Cruelty to Guinea Pigs (part of the Club made up of those who aided the welfare of the Guinea Pigs), and, for many patients, as soon as they were mobile, the first step to recovery was a trip to the Whitehall. Seats were reserved for them in the cinema, and there was a standing invitation for Club members to take part in the dances at the Rainbow Ballroom.

The relationship between the townspeople and the Guinea Pigs only grew closer following the bombing of the town in July 1943. The cinema, with a full audience for the afternoon matinee, took a direct hit, resulting in 108 deaths. McIndoe and the other hospital staff finished operating on casualties at eleven the next morning, and continued to deal with injuries days later. This event tightened the bond between the hospital and the town further as they worked together to deal with the aftermath.

In addition, the owners of large houses in the area opened their properties as convalescent homes, giving another place for the Guinea Pigs to meet the townspeople. McIndoe also encouraged the townspeople to come to the hospital, visit the wards and talk to the patients there, aided by the lack of formal visiting hours that were in place in other hospitals. Local ladies in particular were encouraged to visit the patients often and to bring fresh flowers to decorate the ward.

A Reader’s Digest article in November 1943 wrote that ‘’His face is the job of the hospital, but his will to live is a job that is in the hands of the townfolk’. The relationship between the patients and the people of East Grinstead was a lifeline to the patients, and enabled them to begin to reintegrate back into the society of the home front.

Katie Kettle, East Grinstead Museum volunteer

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Queen Victoria Hospital Archive Project: psychological rehabilitation

McIndoe and his team at QVH unquestionably accomplished great things in the treatment of severe burns, and in the subsequent surgical reconstruction of disfigured faces, hands and other parts of the body. Yet the achievements of McIndoe’s regime at the hospital extended far beyond physical repair. Many previous posts in this series, including the recent guest piece by consultant plastic surgeon Tom Cochrane, have alluded to the fact that a vital part of the Guinea Pigs’ recovery was determined by the much wider-ranging systems of support which came into play during – and beyond their time at East Grinstead.  Of these, the Guinea Pig Club was of course hugely significant, as, too, was the role played by the townspeople of East Grinstead – a topic which will be the subject of a forthcoming post.  Underpinning all of this was McIndoe’s belief in the importance of psychological – as much as physical – rehabilitation.

Memorandum relating to the importance of rehabilitation, 1949

 

Of course these two aspects of recovery were in many ways inextricably linked. In part, McIndoe’s concern with the mental well-being of his patients was very much connected with the effect that this had on the success of surgical repair. This was emphasised in his 1958 lecture, ‘Total Reconstruction of the Burned Face’ in which McIndoe pointed to the importance of ensuring the patient’s morale was ‘of the highest order’[1] when embarking on the long and exacting series of operations necessary for facial reconstruction.  At the same time, McIndoe was not simply being pragmatic; accounts make it clear that he had a very genuine and personal empathy for his Guinea Pigs, these young energetic men who had suffered such traumatic and life-altering injuries. He had a strong awareness of just how devastating must be the psychological impact of their sudden transformation into a ‘burned cinder’,[2] and saw that this had to be addressed in and of itself in order to facilitate the patient’s return to a ‘normal’ and productive life.

The piano was one of the diversions provided for patients in Ward III

McIndoe’s morale-boosting efforts on behalf of the patients took various forms. As Emily Mayhew has discussed, much focus lay in creating the right kind of ‘therapeutic environment’.[3] This began with the hospital surroundings in which the patients were to spend so much of their time. McIndoe arranged for Ward III, (whose original décor was described as resembling that of ‘a dimly lit Victorian public lavatory’[4]) to be repainted in soothing pastel shades, with new curtains and bedspreads, and filled with fresh flowers. Diversions for the patients included a piano and famously a barrel of beer on tap – although it should be added that this was well watered down and served the important medical purpose of encouraging the patients to stay hydrated.  Another significant area was the appointment of the right staff. It is widely recorded that McIndoe favoured employing nurses who were physically attractive, but even more important was that they were temperamentally suited to the uniquely demanding workload of Ward III and that they were well-prepared to interact with the Guinea Pigs without displaying any negative reaction to their disfigured appearance. Here, much of McIndoe’s influence lay in managing other people’s reactions to his patients and overcoming the natural instinct ‘…to be repelled, to turn away, to ignore.’[5] This was also famously exemplified in his success in prevailing on the East Grinstead community to accept and welcome the Guinea Pigs.

McIndoe recognised the importance of entertainment and a home-like atmosphere for his patients

Providing entertainment, lifting spirits and staving off boredom were all desirable outcomes, but there was also a longer-term goal. What was recognised in all of these initiatives was the importance of bringing the burn patients back to a place (in the emotional sense) where they could feel hopeful and optimistic about the future, and conceive of a life ahead of them which was worth living. Positive human interaction and social acceptance – amongst fellow patients, staff, and in the wider community was vital in helping the men to come to terms with their changed appearance and rebuild their image of themselves.

McIndoe was also mindful of the practical issues which arose for the Guinea Pigs in returning to everyday life. Being well aware of the wretched circumstances in which many of the First World War veterans had found themselves, McIndoe was determined that his patients must be well-looked after. Perhaps some of the most interesting records in the QVH archive are McIndoe’s files relating to the Welfare Committee, formed in October 1941. Based on McIndoe’s philosophy that ‘…the surgeon’s responsibility to the patient extended from the moment of injury until and beyond his resettlement into normal civilian life’, this committee, chaired by McIndoe himself, was concerned with the improvement of the patients’ quality of life outside of the operating theatre. Various initiatives involved providing facilities or equipment for the diversion of the patients whilst in the hospital, but a large part of the committee’s work also lay in ‘resettlement’ – ensuring that the Guinea Pigs had the necessary resources to create a fulfilling and sustainable life for themselves in the future.  This might be in the form of further education and training, assistance in finding employment, or even providing money or physical items where needed. The committee minutes in McIndoe’s files offer striking insight into the extent of the hospital’s involvement in this aspect of the patients’ rehabilitation.

Joanna McConville, Project Archivist

[1] Archibald McIndoe, ‘Total reconstruction of the burned face’ (The Bradshaw Lecture 1958), British Journal of Plastic Surgery 36 (1983): p. 143

[2] Leonard Mosley, Faces from the Fire, (London: Weidenfeld & Nicolson, 1962), p. 95

[3] Emily Mayhew, The Reconstruction of Warriors: Archibald McIndoe, The Royal Air Force and the Guinea Pig Club, (Greenhill Books, 2004), p. 202

[4] Geoffrey Page, Shot Down in Flames (originally published as Tale of a Guinea Pig, 1999), (London: Grub Street, 2011), p. 139

[5] Emily Mayhew, The Reconstruction of Warriors, p. 156

Queen Victoria Hospital Archive Project: treatment of burns

We’re very pleased to introduce this guest post which has been written by distinguished plastic surgeon, Mr Tom Cochrane, who was not only consultant plastic surgeon at Queen Victoria Hospital for many years, but also honorary plastic surgeon to the Guinea Pig Club. Throughout this time, he has supported the Guinea Pigs in many other ways, giving his time selflessly towards advice on medical, social and pension problems for over 50 years.

The disregard with which our skin is often treated remains a lasting curiosity to those engaged in its repair when it has been severely damaged. It is no exaggeration to say that it is probably the most important structure of our body, having a multitude of functions, all of which are crucial to our survival. It is, too, the most difficult organ to replace, the most allergenic and thus the least available for transfer from one individual to another. Until relatively recently, a burn injury affecting greater than 30% of the body surface of an adult and 15% in a child was expected to prove fatal, either in the early post-burn period during which precious vital fluids are lost, or subsequently through the loss of its irreplaceable role in the prevention of infection.

Even now that we have learned to overcome some of the challenges, severe burn injuries remain a very real threat to life. Recovery is virtually always associated with prolonged disability. If skin is lost and not adequately and immediately replaced the body responds by attempting to close the open wound through the deposition of scar tissue which shrinks in its attempt to close the defect resulting in contractures, the formation of which cause loss of function and disfigurement.

Prior to World War Two, major burn injuries were largely cared for by general surgeons, few of whom had the expertise to manage the gross physiological changes occurring in the initial ‘shock phase’ and even fewer in techniques of skin replacement in quantities sufficient to heal extensive areas of loss. There were but four Plastic Surgeons in the United Kingdom and precious few worldwide. Of these, Archibald McIndoe as Consultant to the RAF was landed with the responsibility to care for men from this service, victims of severe burn injuries. Aged under forty he faced the task of establishing a specialist unit, admittedly in a brand new hospital but it was a ‘cottage’ hospital designed to fulfil the needs of a local community. He needed an immediate expansion of surgeons capable of treating an unknown, possibly and as it turned out, large number of cases. Support staff was urgently required, nurses prepared to face the noxious smells of burned flesh yet anxious to boost the sagging morale of virile young men during a lengthy recovery. Nurses capable and willing to spend nights on duty engaged in threading fine surgical needles, repairing punctures in rubber gloves, cutting up gauze to pack sterilising drums with dressing materials, all in a restricted space normally provided with large windows, now blacked out and protected from blast; thus an atmosphere of poor ventilation; and all this beneath skies full of dog-fighting aircraft.

Instruments for this type of work were in short supply. McIndoe was already skilled in harvesting sheets of tissue paper thin skin grafts using an open razor with a ten inch blade which had to be stropped and re-sterilised for each case. He demanded that his new recruits to the specialty should achieve similar skills for, after a relatively short introduction, they were to be dispersed to RAF hospitals throughout the country wherein immediate care was available. It was to these units that McIndoe later made regular trips and where he selected cases for transfer to East Grinstead. Ever conscious of the fundamental role of our faces and our hands in our interpersonal communication, (especially between a young man and his sweetheart!) and dexterity in employment (just those structures mutilated in the typical ‘airman’s burn’) he concentrated much of his effort on repair of these.

At the time there was but one commonly applied dressing, a gel containing tannic acid. This often produced disastrous consequences and its popularity had to be tackled. McIndoe designed and his nurses manufactured an alternative, a non-stick combination of curtain gauze and Vaseline – in various forms still in use today! His invention of the saline bath together with this ‘non-stick’ material contributed hugely to pain relief during dressing changes. Remember, there were no antibiotics and precious few anti-bacterial agents then!

Many of the surgical techniques employed came from the past, particularly from World War One. Some required adaptation. New procedures were designed but perhaps by far the most important innovation lay in the approach adopted to social and psychological support.

It was in the nature of the fighter squadrons and later in bomber crews to form ‘bands of brothers’ that cared deeply for one another. It is hardly surprising then that a similar formation developed amongst an enlarging number, all of whom had experienced ‘trial by fire’ and all of whom were facing a prolonged period of reconstruction through multiple operations. Thus the foundation of the Guinea Pig Club which McIndoe and his team thoroughly endorsed. They always willingly joined the boys in a drink and a sing song. He encouraged them to witness the treatment of fellow Guinea Pigs taking camaraderie into the realms of mutual support, building confidence in an ultimate victory over adversity.

He, McIndoe, realised that this mutual support that was developing between his patients was a powerful tool in the restoration of self confidence too, even amongst those who had suffered the most disastrous disfigurement and crippling hand injuries. He pursued this ‘therapy’ with the utmost vigour and much of his success is down to his skill in involving (often reluctant) ‘authorities’ together with the remarkably generous people of East Grinstead. His efforts in this regard were prodigious and he quite clearly, almost single handed, managed to alter the mindset of officialdom.

Post-war, rehabilitation at Headley Court and Chessington grew from this, the former becoming the renowned tri-service establishment that it now is.

Sadly, the records of this achievement were to be buried beneath those of his reputation for surgical excellence. Perhaps the moment has arrived to rethink history and link this fundamental part of the story to the careful preservation of the Guinea Pig’s medical archive.

Mr Tom Cochrane, FRCS

Queen Victoria Hospital Archive Project: Guinea Pigs for life

This is the second of two posts about the Guinea Pig club.

Guinea Pigs enjoy drinks with McIndoe, Christmas 1948

As discussed in our previous post (see ‘Introducing the Guinea Pig Club’), the Guinea Pig Club began its existence as a social and drinking club. However, it was not long before it became much more than that. Archibald McIndoe was quick to recognise the potential of the club in helping to enact his own holistic philosophy of patient care. The foundation of the Guinea Pig Club helped to consolidate and maintain bonds of friendship and the environment of mutual support and camaraderie which existed amongst the patients of Ward III, and which McIndoe considered to be such an important aspect of their rehabilitation and recovery.

There were also other very practical benefits. The raison d’être of the annual reunion dinners, the first of which was held in 1942, was of course to provide an occasion for old friends and comrades to re-connect. These events, which often extended over a day or two and were referred to by the Guinea Pig club members as ‘The Lost Weekend’*, were a chance both to share old memories and create new ones and played a crucial part in helping to establish a sense of belonging and shared identity amongst the Guinea Pigs. At the same time, however, they also became an extremely useful opportunity, with Guinea Pigs all congregating together, for McIndoe (and later his successors) to check on the Guinea Pigs’ physical recovery and identify where patients needed further treatment or surgery.

Account of the 1963 Lost Weekend, which 200 people attended

As a formal organisation, which became a registered charity in 1945, the Guinea Pig Club became a source of advice, support and advocacy for its members as they sought to re-adjust to life in the world outside of Queen Victoria Hospital and East Grinstead. McIndoe and others such as Welfare Officer Edward Blacksell, and anaesthetist Russell Davies, who took up honorary positions on the club’s committee alongside a number of the Guinea Pigs, worked with dedication, liaising with the RAF, with employers and others to assist and promote the interests of the Guinea Pigs and provide for the security of their future in the long term.

The Guinea Pig Club also launched its own magazine, known as the Guinea Pig, the first issue of which was published in April 1944, and this became an invaluable means by which members of the club continued to maintain contact and share news years after they had left the hospital and dispersed around the world.

Guinea Pig Club magazine

It is a tribute to the determination of the Guinea Pigs, and to the success of the support network fostered by the club that so many of its members went on to lead full, active lives after the war, challenging contemporary expectations of disability and disfigurement. A number of Guinea Pigs went on to fly again, some working for civilian airlines after the war. Some Guinea Pig Club members, such as Sandy Saunders and Bertram Owen-Smith, were so inspired by the transformative work of the team at Queen Victoria Hospital that they went on to pursue careers in medicine. Owen-Smith who had been an insurance clerk before the war, ended up training to become a plastic surgeon. Others, such as Sam Gallop, became vocal advocates for disability rights, and many more used their experience to inspire new generations of burns victims. The story of the Guinea Pig Club is one which shows what can be achieved when people are prepared to act as, in the words of McIndoe, ‘the trustees of each other’.

*A typically irreverent reference to the copious amounts of alcohol enjoyed on the occasion by some of the Guinea Pigs.

Joanna McConville, Project Archivist

Queen Victoria Hospital Archive Project: Introduction to the Guinea Pig Club

It has been described as the most exclusive club in the world, but the entrance fee is something most men would not care to pay and the conditions of membership are arduous in the extreme.’

Archibald McIndoe on the Guinea Pig Club

One of the most remarkable legacies of the war years at Queen Victoria Hospital was the formation of an organisation with which the hospital – and East Grinstead – have since become inextricably linked: the Guinea Pig Club. It seems particularly apt to talk about the club at the time when the Royal Air Force is celebrating its centenary as of course the club was comprised in large part of servicemen from the RAF, (in addition to a number of Alllied aircrew) who were treated in Ward III* at QVH for burn injuries sustained in active service. Although it is sometimes assumed that the club was devised by plastic surgeon Archibald McIndoe as part of his programme of patient rehabilitation, it was in fact initiated independently by a group of these patients themselves.

The process of treatment and recovery from severe burns was long and demanding, involving multiple operations which took place over many months and even years. Lengthy periods of hospitalisation with time to fill, together with the sense of connection created through shared experiences quickly helped to create strong bonds between many of the injured airmen of Ward III. These were enhanced further by the informal, sociable atmosphere which McIndoe very deliberately cultivated in the ward.

Cartoon of Ward III, nicknamed ‘The Sty’

The normal strict rules and rigid daily routine which prevailed in the rest of QVH (in common with other hospitals of the period) were entirely dispensed with. Formal relationships between patients and staff were relaxed, there were no set mealtimes, and patients were given a considerable amount of freedom. A large part of McIndoe’s therapeutic model, which will be discussed in more detail in later posts, meant helping to boost his patients’ morale by allowing these still active, energetic young men to amuse themselves and let off steam to a large extent as they wished; drinking, practical jokes and ribald humour often being the order of the day.

Founding members of the Guinea Pig Club – standing from left to right are Tom Gleave, Dr Russell Davies (an anaesthetist at QVH), John Hughes, Michael Coote, and at the right hand side, Archibald McIndoe. Seated are Geoffrey Page and Peter Weekes.

 

It was in such an environment that, on a Sunday morning in June or July 1941 (accounts differ on which), a group of the airmen, sharing a bottle of sherry in a hut in the hospital grounds set aside as an entertainment space, concocted the idea of forming a ‘grogging club’. Those present drew up a set of rules, settled on a subscription and shortly afterwards wrote a letter to McIndoe asking him to be their President. The patients’ characteristic dark sense of humour was evident in the roles which different club members were assigned; Pilot Officer Peter Weekes, for example, confined to a wheelchair due to the severity of the burns to his legs, deliberately being chosen as treasurer as he could not escape with the funds. The club was originally called ‘The Maxillonians’, in reference to the maxillo-facial unit at QVH in which the members received their treatment, and the club’s founding is recorded in the 1941 annual report of the unit, which reads that:

Its object was to promote good fellowship and to cement the many friendships which were formed not only between the patients themselves but with the Medical Staff.’

Excerpt from the QVH annual report for 1941 recording the founding of the Maxillonian Club

Membership of the club was confined to those who had been ‘mashed, boiled or fried’ on service in the air force and subsequently operated on at QVH, in addition to many of the surgical and medical staff who treated them (although not including the women). By the time of the club’s first reunion dinner in January 1942 (which was to become an annual event, continuing every year until 2007), the club members had renamed themselves the Guinea Pig Club in reference to the pioneering nature of many of the surgeries they had undergone.

A Guinea Pig receiving treatment in saline bath – many of the Guinea Pigs underwent numerous procedures and support from their comrades in the Club was essential.

This is the first of two posts on the Guinea Pig club, and will focus on the background and circumstances of its formation. The second post, which will go online on 13th April, will cover its long-term role in providing a support network for the injured aircrew of Queen Victoria Hospital.

*Ward III at QVH was the ward set aside for treating burns patients, primarily from the RAF and Allied air forces, and was presided over by Archibald McIndoe.

Joanna McConville, Project Archivist

Queen Victoria Hospital Archive Project: McIndoe ‘The Maestro’

 

 

This post will provide a general overview of McIndoe’s life and work. Later posts will examine different aspects of his work at Queen Victoria Hospital in more depth.

Sir Archibald McIndoe, 1940s

The man who became known as ‘the Maestro’ of Queen Victoria Hospital was born in Dunedin in the South Island of New Zealand on 4th May 1900 to parents John McIndoe, a printer, and Mabel, an artist. He attended Otago Boys’ High School where he excelled scholastically as well as in music, shooting and gymnastics. In 1919, having made the decision to become a doctor, he entered the Medical School of Otago University on a scholarship, where he developed an early fascination with surgery, gaining the senior clinical surgery medal in his final year.

In 1924, McIndoe was recommended for a scholarship to the famous Mayo Clinic in Rochester, Minnesota and by the end of that year had left his home country behind for good and moved to the States. It was a formative time for McIndoe. The Mayo Clinic was a place of innovation and a hub for all the latest developments in surgery and medicine. Here McIndoe was encouraged to experiment and developed a particular interest and skill in abdominal surgery and diseases of the liver.

This work brought McIndoe to the attention of Lord Moynihan, then President of the Royal College of Surgeons in England. At a surgical convention in Chicago, Moynihan was amongst of a group of medical specialists who observed McIndoe’s demonstration of his new technique for operating on a carcinoma of the liver. An impressed Moynihan encouraged McIndoe to bring his talents to England, suggesting there would be a job for him in a new hospital he was building.  On the strength of this McIndoe bid goodbye to the Mayo Clinic and moved his family to London – only to discover on arrival that neither the hospital nor the job yet existed.

Letterhead showing the partnership of Gillies, McIndoe and Mowlem

Despite this inauspicious start, McIndoe’s career soon took a dramatic turn through his discovery that the distinguished surgeon Sir Harold Gillies was in fact a distant cousin. Gillies’ ground-breaking work rebuilding the faces of First World War soldiers damaged and disfigured by gunshot wounds, shrapnel and the like had led him to be regarded as the father of modern plastic surgery. Gillies became a mentor to McIndoe, and as McIndoe began to assist Gillies with his plastic surgery cases, he discovered a new interest and aptitude for this type of surgery. He began work in Gillies’ practice and in time became his junior partner, alongside another New Zealander, Rainsford Mowlem. It was during this time that McIndoe learned many of the skills and techniques of reconstructive surgery which were to form the basis for his work during the Second World War.

In 1938, McIndoe took over from Gillies as Representative Consultant in Plastic Surgery to the RAF and at the outbreak of war in September 1939 he was posted to Queen Victoria Hospital to head up the new Maxillo-facial* unit under the government’s Emergency Medical Scheme.

McIndoe in theatre, 1940s

It is impossible to do justice here to all of what McIndoe achieved during his time at East Grinstead. In response to an unprecedented influx of burns casualties from members of the RAF and Allied aircrew, he initiated a painstaking new regime of treatment based on the regular use of saline baths and dedicated nursing care which became influential through all the medical military services. Applying and refining the surgical techniques he had acquired from Gillies, McIndoe worked tirelessly to repair and rebuild faces rendered unrecognisable by devastating burns. With the quantity of reconstructive work now needed far exceeding the number of trained plastic surgeons, McIndoe’s expertise brought countless younger surgeons to QVH to learn from him.

Perhaps most significantly of all, he took a holistic approach to healing and rehabilitation which involved taking responsibility for his patients’ emotional and psychological well-being as well as their physical recovery. He saw his role as enabling them to fully re-integrate into a ‘normal’ life and challenged head-on the societal barriers and prejudices which confronted those suffering facial disfigurement.

The front page of the East Grinstead Courier in the week reports McIndoe’s death and achievements including giving ‘new hope’ to the Guinea Pig Club, 1960

When the war was over McIndoe remained at Queen Victoria Hospital, but as the service casualties gradually began to be replaced with civilian patients he began to divide his time between East Grinstead and his private practice in Harley Street. Alongside his former partners Harold Gillies and Rainsford Mowlem, he was closely involved in the foundation of the first British Association of Plastic Surgeons (BAPS) who had their inaugural meeting in 1946.

In 1947 he was awarded a knighthood for his wartime work. In the years which followed he operated on patients ranging from victims of industrial accidents to film stars wanting a nose job, at the same time taking an active role in training a generation of new surgeons in the art of plastic surgery. He also never ceased in the battles he fought on behalf of his Guinea Pigs, doing all he could to ensure that they continued to be taken care of and given every opportunity to make a success of life beyond the confines of QVH.

Memorial to Sir Archibald McIndoe on East Grinstead High Street

Archibald McIndoe died suddenly in his sleep on 12th April 1960 aged just 59; his daughter believed that the intensity of his work had finally caught up with him and he was ‘literally worn out.’ A memorial service was held for him in the RAF church of St Clement Danes, where his ashes were also interred – a unique honour for a civilian.

His memory is still held in high esteem in East Grinstead, where a memorial statue of him was unveiled in the High Street in 2014.

*Maxillo-facial surgery deals with injuries and conditions of the face and jaw

Joanna McConville, Project Archivist

Queen Victoria Hospital Archive Project: the history of the hospital

 

 

 

The story of Queen Victoria Hospital (QVH) begins in 1863 with its founding as a cottage hospital on Green Hedges Avenue, East Grinstead, in the home of Dr John Henry Rogers. It was only the fifth cottage hospital to be established in England – from its earliest days the hospital was a pioneer.

The first Queen Victoria Cottage Hospital in Green Hedges Avenue, c 1860s

This original hospital had just seven beds and was run and funded almost entirely by Dr Rogers himself with help from a few local residents – possibly the reason for its closure a few years later in 1874. The hospital re-opened in 1888, moving first to Lansdowne House, and then in 1902 to an old coffee house in Queen’s Road, when it was named the Queen Victoria Cottage Hospital in honour of the recently deceased monarch. In 1931 a plot of land was donated by Sir Robert (later Lord) Kindersley and so began the building of the current hospital in Holtye Road, which was opened on 8th January 1936 with 36 beds and a team of trained staff.

Whilst there is very little in the QVH archive which dates from before the Second World War, the hospital’s annual report from 1939, the earliest annual report that we have, includes a list of subscribers which runs to several pages demonstrating the extent to which the hospital had the financial, as well as the moral, support of the local community.

New hospital on Holtye Road site, 1936

The looming threat of the Second World War radically changed the course of the hospital’s history, with the arrival of New Zealand-born plastic surgeon Archibald McIndoe. His appointment was announced with little fanfare in the 1939 annual report – there was little indication quite how great an impact McIndoe would have on the hospital. At the end of the 1930s, with war imminent, the British government had set up the centralised Emergency Medical Service which took responsibility for employing additional staff and arranging for treatment of the inevitable casualties in hospitals across the country. Mindful of the horrific nature of the disfiguring injuries suffered by soldiers in the First World War, there was recognition of the importance of plastic surgery. ‘The Great Four’ (Harold Gillies, Thomas P. Kilner, Archibald McIndoe and Rainsford Mowlem) – the only full-time, experienced plastic surgeons in the country at the time – were despatched to establish plastic units at various hospitals to treat servicemen from different branches of the armed forces.  McIndoe was appointed as civilian consultant to the Royal Air Force and sent to East Grinstead.

McIndoe, Gillies and Mowlem, three of the ‘Great Four’ outside QVH, 1940s

The impact of McIndoe on Queen Victoria Hospital cannot be understated. His dedicated and groundbreaking plastic surgery work and the inspirational stories of his patients, the ‘Guinea Pigs’, put Queen Victoria Hospital on the map, placing it at the forefront in the field of reconstructive surgery in this country – and renowned around the world.

With the rising reputation and profile of both McIndoe and the hospital came further physical expansion. 1943 saw the start of the construction of the Canadian Wing, paid for by the Canadian Government, to treat the many Canadian airmen who ended up at East Grinstead. This Canadian wing was at the forefront of treatment at the time with elaborate saline baths, one of McIndoe’s innovations to aid the healing of burns, and space for 50 patients. 1943 also saw the decision to drop the word ‘Cottage’ from the name of the hospital. With 230 beds, the ‘Cottage’ denomination hardly seemed appropriate!

Proposed new Surgical Centre at QVH, 1946

The hospital’s ongoing expansion saw the opening of a new surgical block in 1946 and new wards opening throughout the 1950s. In the post-war years Queen Victoria Hospital has continued to go from strength to strength, building not only on the areas of expertise developed by McIndoe and his team in burns treatment and in maxillo-facial surgery but also making a name for itself in fields such as orthodontics and corneo-plastics  thanks to other distinguished innovators such as Sir Benjamin Rycroft.

The strengths of the archive also lie in the Second World War and post-war period. Key among the records are over 650 files relating to the Guinea Pig Club which provide an important insight into the revolutionary work undertaken by McIndoe and his team. The story continues with nearly 14,500 patient case files which demonstrate how the practice of plastic surgery has changed and developed over the decades.

Two of the minute books from the QVH archive

The administrative records of the hospital, which include House Committee minutes from 1948, shed further light on the hospital’s story, recording its expansion and growing reputation. The annual report for 1941 even features a reference to the foundation of the Guinea Pig Club! Significantly McIndoe’s own papers form part of the archive, including plans for his revolutionary saline baths and notes and correspondence concerning the rehabilitation of some of his RAF patients. WSRO also holds copies of the Guinea Pig Club magazine for the 1940s-2002 (with gaps) which record the activities of club members during and after the war. Illustrated with cartoons and photographs they make interesting, and at times amusing, reading!

The hospital has come a long way from its humble beginnings more than 150 years ago, and many of these important changes are recorded in the archive. Despite the success and prestige, it remains firmly rooted in its local community of East Grinstead.

The hospital today

If you would like to know more about the Queen Victoria Hospital Archive project, Archibald McIndoe and the Guinea Pig Club, please come along to Joanna McConville’s illustrated talk to be given at the Record Office on 27th March at 7pm. Tickets are priced at £8.00 each and include light refreshments. Telephone 01243 753602 to book a ticket.

Tickets for the end of project event at Queen Victoria Hospital on 2oth April will shortly be available to purchase via Eventbrite, full details and a link will be published on this blog in the near future.

 

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