The Women who ran Britain’s Trailblazing Military Hospital
London, Allen & Unwin (Atlantic Books), 2020
Hardcover 384pp RRP $34.99
Reviewer: Joy Cullen, November 2020
Endell Street is a thought-provoking book about the First World War on many levels. In February 2015, Sir Arthur Keogh, Director-General Royal Army Medical Corps (RAMC), invited two women doctors, Flora Murray and Louisa Garrett Anderson, to run a 1000-bed military hospital in London, funded by RAMC. This remarkable request occurred at a time when female doctors were barred from serving in the British Army, and experienced difficulties obtaining medical qualifications and employment. Endell Street hospital, dubbed the Suffragettes Hospital, was to become acclaimed as one of the most efficient First World War military hospitals. The two directors, Dr Murray as Chief Administrator and Dr Anderson as Chief Surgeon, were awarded CBEs in 1917 for their services.
Louisa Garrett Anderson was the daughter of Elizabeth Garret Anderson, the first woman to qualify in Britain as a doctor, founder of the New Hospital for Women in Marylebone, and a teaching staff member, later Dean, of the London School of Medicine for Women (LSMW). Flora Murray, the daughter of a naval commander and Scottish Laird, and Louisa both studied at the LSMW. Louisa subsequently travelled to Paris, Baltimore and Chicago to gain wider clinical experience in surgery, Flora studied anaesthetics. Both women experienced the career obstacles facing women doctors and became friends through their common interest in medicine and suffragette activism. They established a small hospital for children in Harrow Road, West London.
The unique request from Keogh followed the women’s determination to serve despite numerous barriers. Murray and Anderson, with the support of the French Red Cross, had opened a hospital in Claridge’s Hotel in Paris in October 1915, to care for medical evacuees. As the war escalated and evacuations centred on Boulogne, they opened a second hospital at Wimereux, near Boulogne, that soon obtained the status of an auxiliary military hospital, with food, coal and petrol rations supplied by the army. Senior RAMC officers visited the two French hospitals and sent glowing reports to the War Office.
Moore suggests that Keogh’s offer was motivated as much by necessity as liberation – 46 doctors had already lost their lives in the first months of the war. Murray and Anderson did not hesitate, and on 12 May the first patients arrived at the hospital in the refurbished derelict workhouse at Endell Street, Covent Garden. The two directors were joined by fourteen doctors, all graduates of the LSMW, 29 qualified nurses and 80 orderlies, predominantly from middle and upper class backgrounds, and including many Volunteer Aid Detachments; with a few male RAMC orderlies were allocated for heavy duties. They were joined by staff from the two French hospitals that closed as evacuation procedures to England improved. Five Australian women doctors similarly barred from entry to the Australian Army Medical Corps, and numerous other volunteers from the colonies and the United States, travelled to support the hospital. As the war progressed three auxiliary hospitals were established in large houses in London to provide convalescent care.
Endell Street aimed to provide a bright and comfortable environment, including use of bright quilts in the wards, flowers, a library, practical activities ranging from billiards to needlework, and regular entertainment, taking advantage of the staff’s theatre, musical and social contacts. Heavy demands were placed on staff who worked long hours, carried out heavy physical work, and frequently wakened at night to the courtyard bell announcing the arrival of ambulance convoys and an early start to work. Moore makes effective use of letters, diaries, memoirs, newspaper cuttings, and other extant records, as well as Murray’s 1920 book about woman army surgeons, to depict life at the hospital for soldiers and staff. Significant phases of the war permeate these formal and informal sources, with graphic descriptions of the grievously mutilated, gassed, and ill patients, and the impressive stamina and commitment of hospital staff. From the chaos at Boulogne to the influenza pandemic, the war unfolds through the eyes of the women and patients. One Australian soldier’s light-hearted description of staff as the “What Ho Corps” illustrates the women’s ability to maintain the positive ‘Endell Street spirit’, despite the endless challenges they faced.
The clinical and medical challenges that arrived with each ambulance led not only to long working hours but to the need for the women doctors to upskill for the surgical and medical roles from which they had previously been excluded. Endell Street was in the forefront of medical research as staff participated in trials, including use of X-rays, anaesthetics, electrotherapy, and antiseptic procedures. When Louisa Anderson published the results of the hospital’s use of the BIPP method to treat septic wounds in The Lancet, she became one of the first women doctors to publish a scientific research paper. The Endell Street doctors were to publish seven research papers during the hospital’s life.
As the war progressed Keogh appealed for female doctors to join the RAMC, there was increased acceptance of women doctors in hospitals throughout Britain, and medical schools began to accept women as students. Murray and Anderson continued to canvass for better conditions for female medical staff who paid more tax than their male counterparts, and had no rank, or clothing, transport and accommodation benefits. They also fought to improve the inadequate pay and allowances received by all the women at the hospital, including clerks and cooks.
Following the Armistice on 11 November 1918, the hospital remained frantically busy as ambulance convoys continued to arrive, and there were mixed feelings at the news that Endell Street had been asked to remain open for another year. The second lethal wave of influenza had peaked at the height of the Armistice celebrations and this was to be a difficult period for the hospital. Extra beds had to be supplied to cope with the influx of cases and nurses recruited to replace those who contracted the disease. With no antiviral medicines the death rate was high. Many soldiers, unhappy to be hospitalised after the end of the war, were difficult patients, RAMC orderlies replaced the demobilized orderlies and the Endell Street spirit began to disintegrate. By November 2019 the hospital had closed to patients.
The General Election of 14 December 1918 was the first time that women could vote, a gain that was attributed to the magnificent contribution of women to the war effort. The impressive medical advances by women were not sustained. Most of what they had gained during the war disappeared as men returned to their former status and positions. Drs Murray and Anderson returned to their Children’s Hospital.
This book provides a unique medical perspective on the history of wartime sacrifice and is a useful source book for the specific contribution of suffragettes who reframed their suffrage campaign as a message of service. The book is meticulously researched, well-documented with endnotes and references, and includes interesting photographs of key personnel.
The RUSI – Vic Library thanks the publisher for making this work available for review.