will see what I can do in the next few days,’ Alice told the couple, after noting down their daughter’s address.
‘Don’t go after six though, duck,’ Hetty said warningly. ‘That’s when our son-in-law gets home.’
The almoner nodded. ‘I cannot promise anything, but I will try.’
Ted and Hetty watched Alice as she headed off for her meeting with Dr Harland, their rheumy eyes watery with gratitude.
The almoner is a general practitioner in social healing. It is the almoner whose job it is to deal with the personal difficulties and troubles of the patient … the constructive side of the social work done by the almoner seems to know no limits.
(The Scotsman, 1937)
From its earliest days as an apothecary, doctors from the Royal Free went out into the community to treat patients who were too ill to leave their homes, or rose in the early hours to meet them at the hospital. ‘As there were no telephones,’ explained Dr Grace de Courcy, a medical student in 1894, ‘if an emergency arose at night and the resident required assistance he would go into the street and take a hansom cab or a growler to the house of the surgeon or physician in charge of the ward to bring him back.’
Dedicated to their patients and uncomfortable with the idea of their private lives being examined, medical staff at the Royal Free had initially been reluctant to share any information with the almoners. For some, the whole idea of conducting financial assessments on the sick was repugnant. Sir E. H. Currie complained to a reporter for the London Daily News in 1904 that vetting patients using ‘special detectives’ was ‘a scandal’. Currie ‘strongly condemned’ the use of inquisitorial methods to ‘denounce’ well-off patients. ‘What possible good can one woman investigator do?’ he argued. ‘It is ridiculous.’
Mr Rogers, a secretary from the London Hospital, defended the appointment of an almoner who was to ‘watch in the receiving rooms for cases of imposition’. The secretary stated that local doctors running private practices had accused the hospital of ‘robbing their profession’ by treating patients who ‘they had personally seen … driving to hospital in their own carriages’.
Like his predecessors, Dr Peter Harland was another of those people who subscribed to the view that any sort of surveillance of the private lives of others was a disagreeable pastime. He was waiting at the top of the stairs leading to the almoners’ basement office when Alice arrived. ‘I’m so sorry, doctor. Have you been waiting long?’
‘A minute or so.’ There was no reproof in his voice, but his features were strained.
Alice led the way down the dimly lit stairs, stopping before a sturdy-looking oak door inset at eye-level with a small barred window. Dr Harland waited silently as she opened the door to the office, where arrow-slit windows high up across one wall overlooked the sodden grey pavement of Gray’s Inn Road. The window sills provided neat cubby holes for reference books and medical journals, the heavy tomes blocking much of the natural light.
Before the fires were lit by the caretaker each morning, the almoners’ office lay silent, the stillness broken only by the rumble of underground trains beneath them. Now, the room was bustling with activity. Frank was seated at the nearest desk, taking ledgers one by one from a small pile and checking them against a list of the hospital’s assets. Alexander was kneeling on the floor beside a solid leather trunk and setting a trap for the mice that emerged at night to nibble the edges of his financial reports. He fumbled with the steel mechanism with a harried air, his handsome features twisted and pink with annoyance. In the far corner, Winnie sat behind her typewriter, her habitual anguished frown in place.
At the opposite end of the office, the Lady Almoner, Bess Campbell, was busy preparing lists for a post-New Year party; a get-together for those acquaintances who had missed out on the New Year’s celebration that had taken place in her considerable residence in Kensington. Miss Campbell, a woman with a flair for combining dynamic guests with those of a quieter nature so that everyone felt at ease, had a calendar packed with social events, dances and dinner parties.
She was a slim woman in her late forties, with greying shoulder-length hair and sharp but pleasant features. An accomplished and formidable character, she had a love of fine clothes and an air of authority, but she was also possessed of a natural humility, an essential quality in someone working so closely with the poor.
Like the majority of her colleagues, she had been selected from a class superior to those she served, the appointing committee believing that only someone gifted with eloquence could suitably advocate for the working class, who were generally less able to express themselves.
Each member of staff glanced up as Alice entered. At the appearance of Dr Harland, Alexander got to his feet and brushed down his trouser legs. Puffing absently on his pipe, Frank merely jutted out his chin. Miss Campbell beamed. ‘Peter, my dear, how are you?’
‘Too busy to be here. And you?’ The doctor’s expression settled as far into solicitousness as it ever went, though his face, all blunt lines and irregular angles, retained its slightly grumpy expression. About six inches taller than Alice, at just under five feet eleven, he was a tall man, sturdy and strong. In his mid-thirties, his square face was framed by a crop of thick curly black hair, his jaw displaying the hint of a beard.
‘Well, it’s most generous of you to spare some time for us, isn’t it, Alice? And I’m splendid, thank you.’ Miss Campbell ran the office with a regimen as strict as the fiercest sisters on the wards above her, but there were times when her staff caught a glimpse of the compassion she usually reserved for patients. When Alice had returned to the office after discovering the bodies of Molly and her infant son, Miss Campbell had been the first to her feet, steering Alice with tenderness towards her chair. Within minutes she had pressed a hot, disturbingly sweet cup of tea into one hand and a vinaigrette of smelling salts into the other. Alice was to take her final exam in social work the next day, but after what had happened, she told her boss that she was tempted to withdraw. ‘I’m not suited to this sort of work,’ she told Miss Campbell mournfully, after everyone else had gone home.
Miss Campbell had reached across the desk and taken Alice’s hand in her own. ‘If you’re not suited to it, my dear, I don’t think any of us are.’
‘If only I’d acted sooner,’ Alice had burst out, pulling her hands away to cover her cheeks. She shook her head. ‘I knew something wasn’t right. I should never have left Molly alone for so long.’
Miss Campbell scoffed gently. ‘Would not the world be a finer place if only we were all possessed with blessed foresight?’ She paused. Alice dropped her hands and looked at her. The Lady Almoner levelled her gaze. ‘Alice, you need to accept that we all have limitations, and that includes you. You’re not responsible for every vulnerable waif and stray in London, you know. But you have more empathy and intuition than almost anyone else I know. So you’ll go tomorrow and take your exam and then you’ll return here to carry on with your work.’
Alice’s eyes pooled with tears. ‘But I’ll fail, just like I failed Molly.’
‘Then you shall take it again,’ Miss Campbell had said with a note of finality and a short sharp squeeze of Alice’s hand.
At her desk, Alice removed her hat and gloves and tucked them into a drawer. ‘Would you like a cup of tea before we get started, doctor?’
Dr
