For those drawn to the medical profession and its fiendish accoutrements, there is one quiet, deserted, and strangely peaceful spot in London, a curious eerie built over a red-brick church which can be found at 9, St Thomas Street, Southwark.
Outside in the street a small sign swings in the rain and the wet, announcing the Old Operating Theatre and Herb Garret. One steps into the door of what seems a perfectly ordinary church porch, and finds a very narrow and winding stair coiling off to the left which takes one up, in a vertiginous manner, to the sort of cock-loft perched above.
Opening the door, I stepped in to be met by the extremely surprised gaze of two gentlemen, one young and one middle-aged, who seemed not to have seen a soul for months. They were like castaways, high in this tower cut off from the street, and though they immediately sat up from their semi-recumbent positions and asked in a slightly sheepish manner for a quid, the air of being startled did not go away. The middle-aged man asked me how I knew about the place, with the air of one who has long been sending notes off in bottles and has given up any hope of them being answered. I said that I used to work in the district; I had walked by the place for years and never gone in, so now seemed a good time to make amends, especially as the alternative was to kill an hour instead at that abomination, The London Dungeon. My explanation seemed to disappoint him, and he sunk back in his seat.
The young one gave me some confused instructions about how to get around and a large card with a suitably bloodthirsty account of an operation in which the patient died. Then they despatched me up another set of vertiginous stairs to the wards and the operating theatre above.
The operating theatre is off to the left, up more stairs. One enters a perfectly empty room and gazes down through five very steep rows (standing room only, each railed off) to the operating room which lies at the bottom like a sunken bath. By now one has entirely lost all sense of the geography of the place, in which rooms and buildings interlock in the most bizarre manner. However, it is a rare privilege to go somewhere and not be hustled and harried by five thousand other gawpers like oneself, so one, with a curious sense of guilt, savours the moment.
Painted in the most lugubrious tans and creams, the room is lit overhead by an enormous skylight from which a harsh light beams down on the splintered and warped operating table, stained with the years and constructed of what looks like rusty iron and driftwood. Its closest resemblance is to a much-abused school desk, which after being kicked around for decades by generations of children, has finally come to rest in the darkest and dustiest corridor. Nothing could be more uncomfortable or more unhygienic.
Aseptic operating equipment, made of steel and glass, did not come in until the 1880s, and the instruments as well as the table were distinctly insanitary, with cracked wooden handles, crevices and cracks. Nothing was ever sterilised. The surgeons were more likely to wash their hands after an operation than before, and worked in filthy frock coats, stained with blood and pus, which in between operations hung on a row of hooks by the door.
Antiseptics were not used until Lister published his epoch-making discoveries in The Lancet in 1867. He realised that the infections caught by patients were due to minute airborne organisms and discovered these could be killed by carbolic acid. By drenching the entire site, the surgeons’ hands, the dressings and the instruments, the rate of post-operative infections and the mortality which they brought sunk almost to nothing.
So high had been the risks before antiseptic and the associated traumatic shock of being operated on without anaesthetic, that up to 30% of patients had died after surgery. This was despite the extremely limited nature of operations carried out, generally only amputations or the removal of easily accessible cancers – the abdominal cavity was only opened up in the direst necessity as patients almost invariably developed fatal peritonitis.
Until 1847 all operations were carried out without anaesthetic. The patient was usually blindfolded and given a leather strap to bite on; wine and spirits were administered to keep the sufferer going. Strong men held the patient down. There is a particularly nasty little painting on display in the garret, originally discovered concealed in a house in Norfolk, which shows a man yelling, screeching and blaspheming as the surgeon attempts to remove his leg and six enormous men try to hold him down.
The agony and the terror of the blindfolded patients do not bear thinking of. But for all their faults the surgeons were extremely skilled and quick, and could remove a limb within a matter of a minute.
There were two reasons for using a blindfold on the patient. The first was that the sight of the instruments and the general proceedings would only have added to the patient’s distress. The second was that, as a general rule, the operating theatre would have been crowded with spectators, very different from the silent and rainy afternoon that I was there. The five rows of the standings would have been full of students from The United Borough Hospitals of St Thomas’ and Guy’s. If an important surgeon was to operate or the case was one of special interest, then admission was by ticket only.
On the floor of the theatre a semi-circle of wooden chairs was sometimes placed, within inches of the operation. Assisting the surgeon would be his dressers and apprentices; they kept the place in order, mopped up the blood and replenished the box of sawdust that stood beneath the operating table to catch the gore and prevent it from seeping through to stain the church ceilings. One cannot help wondering whether the screams and yells of the patients sometimes rang out over the church services. But perhaps for the most part the patients were effectively gagged by the leather strap they were given to bite on.
For non-medical people it is hard to conceive, looking at this accumulation of horrors, that the surgeons really were humanitarian people and not sadistic and brutal torturers. The whole atmosphere is repellent and disgusting, and the motto painted up on the wall, Miseration non Mercede (‘From compassion, not for gain’), is a necessary reminder that they were working for human good not evil.
It was something of a relief to wander off to the garret, where there is a display of revolting but thankfully inanimate objects to round off the trip. The only beautiful articles are the enormous medicine and chemical jars, large blowsy glass containers in vibrant shades of emerald, amethyst, and ruby. Next to them we have diseased lungs in a pickling jar (looking for all the world like bits of manqué stilton), half a heart, a strangulated hernia, some kidney, and a minute discoloured slice of brain. One looks at that last and thinks – “Can that be what it’s all about? – all thought, all pain, all sensation, down to that bit of congealed rice pudding?”
So perhaps it is just as well that there is a church directly beneath – vain dreams of a spirit free from flesh, vain hopes of the immortality of the soul.
‘The Old Operating Theatre’, appearing under the pen name of Lacunae but clearly written by Jennie Gray, was published in The Goth, June 1991, and also in The Best of the Goth, 1993.
THE OLD OPERATING THEATRE, MUSEUM AND HERB GARRET, 9A ST THOMAS STREET, SEI thankfully is still going and has a website to bring it into modern times:
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