Suicide, Syphilis and Septal defects

Comment & opinion

Sue Smith RGN, RHV, MSc

What on earth do those three have in common? Sitting over your coffee you may want more light-hearted subject matter. But all three made huge impressions on me during my 'first year night duty' at (the old) Westminster Hospital, London, back in the sunny hot summer of 1959.

When I walked into the ward for my first night on duty, I tried not to look surprised to see a policeman sitting by a patient's bed. He was in full uniform, his helmet parked on the patient's locker. This was in a 12-bedded men's ward. The patient appeared to be asleep. As one of only 3 nurses on duty that first night, I sincerely hoped the patient was not a murderer.

So sad then, when I learned that the man had, indeed, tried to kill himself. A pretty good effort: he'd taken an overdose of aspirin, made an attempt at cutting his wrists, and then put his head in the gas oven.  The gas was on but unlit. In 1959 ovens were fuelled by poisonous coal gas. His friend had returned home unexpectedly--and found him, in time to save his life. But what was his 'life' like I wondered, that he should have tried so hard to take it?

The policeman was there to arrest him as soon as he came round. A conviction could result in a prison sentence. Sounds barbaric, doesn't it? Yet it was only just over 50 years ago. Suicide was a criminal offence until 1961. Thank goodness for more understanding.

This unit was an odd combination: part medical; part plastic surgery, plus a children's ward. Every week we had patients coming for facial surgery to reconstruct bridges to their noses. The gap between the two front teeth was not treated. For you young things reading this (!) noses without bridges, and gaps between front teeth were the tell-tale signs of congenital syphilis. Since vastly improved treatment and the introduction of antenatal testing for syphilis, congenital syphilis became a thing of the past, and syphilis rates declined. However--I read very recently that the figures have been increasing again since 1997. Syphilis has quite a history: many people think that Henry VIII suffered from it, and it is reputed that Hitler, Mussolini, Beethoven and van Gogh all had it.

So, what of (ventricular)-septal defects? In 1959, a Westminster thoracic surgeon, Charles Drew, developed the technique of profound hypothermia for open-heart surgery. This was the absolute forefront of surgery, and I was on the ward the night a little girl came back from many, many hours in theatre for repair of a complex heart defect. We could not believe it--no use of a 'heart-lung' machine. Mr Drew had developed this technique, of cooling the body down to 8-10C. The cooling down and warming up processes took hours, but it enabled time for the repair of complex congenital heart defects. The excitement was palpable, we knew we were witnessing an incredible breakthrough--at our teaching hospital.

All of the above actually happened in the space of the six weeks of my first night duty. Looking back now, I am in awe of the progress made at, and since that time in drug therapies, technology--and attitudes.

Progress happens--even while we are just getting on with our lives. Enjoy--but let's always remember that good nursing care is the key to healing.

Some famous people who had syphilis include: Christopher Columbus, , Adolph Hitler, Mussolini, Napoleon Bonaparte, Ludwig Von Beethoven, Al Capone and van Gogh.