ninety years of service - University Hospital Southampton NHS ...

This appointment although it was good to be back in the medical field, involved me once more in an entirely new methodof working: I was as it were out on a limb, the premises being much too limited to house a team. If the children I wasasked to see lived in the Borough, it was possible to refer them on for full investigation and, if necessary, prolongedtreatment at the Health Centre, but for children from the County a flexible and modified type of treatment was oftennecessary. There was also considerable difficulty in the use of beds; if one wanted to admit a patient whenever beds werein short supply my patients understandably, had to make way for emergencies however disruptive it might be to them.This ceased to be a problem when in 1952, Dr Christopher Haffner was appointed to Portsmouth to plan and operate aspecial unit with in-patient and out- patient facilities for disturbed children and their parents. These points apart, much thatwas interesting and experimental was tried out at the hospital, largely initiated as a result of the co-operative attitude ofthe paediatricians. A joint round took place regularly at Bursledon when I accompanied Dr Williamson, and also a monthlypsychosomatic clinic was held by both of us and, largely owing to the fact that the two out—patient consulting rooms hadan intercommunicating door, a child could be given an (almost) immediate psychiatric interview at the paediatrician’srequest, or be seen by both consultants togethe, thus saving a second journey for long-distance travellers.Possibly most interesting of all the combined activities was the presentation of cases from time to time at the monthlyclinical meetings when G.P.s, young doctors and nurses attending could be given some further insight into psychologicalproblems and their treatabilityTeenagers were not seen at the Children’s Hospital beyond the age of 16, and there were fewer referrals in this agegroup but they were often considerably disturbed. When in-patient treatment seemed advisable they were admitted toLeigh House in Chandlers Ford. This was a special unit for adolescents which the Regional Board had set up when thebuilding became available (it was previously used for treating women with TB.). Dr W. Allchin and Dr Rosenberg wereappointed in 1961 to run the unit which was conveniently near to Southampton and Winchester.It became noticeable as the years passed that more girls than boys were referred to the Children’s Hospital, mainlysuffering from psychosomatic disorders such as feeding problems, asthma and anxiety states whereas more boys, manypresenting with behaviour disorders, were referred to the L.A. Child Guidance Centre, a number coming from the JuvenileCourt, thereby indicating a need for both types of facility since behaviour problems would be largely inappropriate seen ina hospital settingVisitingThe whole question of children being visited by their families and of infants and toddlers being accompanied into hospitalby their mothers was coming under public discussion at the time of my appointment. The late Sir James Spence hadreported in 1946 on his Babies Hospital where he had had twenty years experience of admitting mothers as well, and Drand Mrs Pickerill in New Zealand reported very favourably on their plastic surgery unit where they had admitted mothersto counter cross infection. They had found this beneficial in a number of ways. These reports coupled with the research ofDr John Bowlby on separation anxiety and the late James Robertson into the emotional after effects of hospitaladmission, which were in their initial stages, seemed to make a lot of sense. I raised both the issue of visiting and ofmother’s being admitted fairly soon after being appointed, appreciating that there would be great difficulty in achieving thelatter owing to the very limited space in the hospital, but the former was discussed at a number of medical committeemeetings. Dr Ormiston, who was the first paediatrician to be appointed to the staff in 1947, had come fresh from theU.S.A. and was seriously worried about the degree of infection and the high mortality rate in the wards and wasunderstandably apprehensive about any infection being introduced from the outside world. It was finally decided by MrRichardson, the Children’s Surgeon, who was Chairman of the committee, that a vote should be taken, which resulted inan equal number of votes for and against, leaving him to cast his vote – in favour. At first the visiting was somewhatrestricted but as the worst fears failed to be realised the rules became increasingly relaxed. Some doctors found thevirtual pandemonium after the subdued atmosphere in the wards difficult to take but not the children! I must say thatthough these discussions involved strongly held opinions, the final outcome was accepted without the least acrimony.Several years later in 1959, two rooms were set aside so that some mothers, eventually, were able to come into thehospital with their children.It might be of interest in this context to make a brief reference to a W.H.O.study group. Dr Begg the medical director of theEuropean Office asked me, in 1951, to organise a small conference or study group on the care of children in hospitalwhich was to include the respective roles of paediatricians and child psychiatrists, the coordination of their work and theinter-relation of somatic and psychological processes in sick children. The meeting took place in Stockholm where it washosted by Prof Wallgren of the Children’s Clinic at the Karolinska Hospital, with Sir Alan Moncrieff chairing the clinicalproceedings. The Paediatricians and Child Psychiatrists who presented these had had experience in close cooperationtogether and included Dr R. Bonham-Carter and Dr Soddy from UCH. London, Prof Milton Senn and Dr Solnit from theU.S.A. and two pairs of Swedish doctors,and the delegates were largely drawn from Scandinavian Countries. It was alively and useful meeting and in 1955 a report entitled “The Child in Hospital” was published by WHO, and was widelydistributed.As a final thought I look back with pleasure at the memory of the murals in the anaesthetic room at the Children’s Hospitalwhich were painted by Miss M. Wilson, a Winchester artist. These made a rather bare and forbidding room into anattractive one and the children enjoyed counting the colourful balloons as they gradually lost consciousness,