Wednesday, December 19, 2007

Dr Patrick Plunkett Mulhall

Dr. Mulhall

“I went to Craig-y-nos first in 1952 to assist the medical superintendent at the time, Dr Ivor Williams, and I was there until 1985. The last fifteen years or more I was on my own there, but I just visited once a week … to visit the patients and I did rounds and also held a chest clinic downstairs in the outpatients.

Nurse Glenys Davies

Glenys Davies was one of my nursing assistants at the time. The ppatients were getting on very well then at that time because in 1952 they were starting to get new drugs. They were there then for about three or four years before they were transferred to Talgarth sanatorium (in 1959), and they ended up there for a couple of years more I think.

I was based at Brecon. I ended up there as consultant chest physician. The latter part of the time, probably the last ten years, the chest patients completed their treatment and it was turned over to geriatric patients. I looked after those as well.

Could you describe the treatment regime?

It was a very strict regime. The regime was strictly bed-rest, as much rest as possible and good food and fresh air. A lot of the children spent most of their time on the balconies. Before my time there were more severe conditions prevailing when they used to be left there in the rain, snow, everything. Of course, they were covered up but they had to endure that as well. A lot of the children also were in plaster casts for tuberculosis of bone joints and spines. Other children had tuberculous glands of the neck. They were treated by ultra-violet rays and they had a course of treatment.

Most of my work was with the adults and they spent most of their time in bed but they were gradually given graduated exercises to get them rehabilitated and continued to walk outside the grounds. That’s how they recovered, most of them.

When I went there first, probably for the first ten years, there was a monthly surgical session where a surgeon came from Cardiff – Mr Dillwyn Thomas (Dr Mulhall – I found a Malcolm Eward Dillwyn Thomas in the Medical Directory, Thoracic Surgeon, Sully Hospital) – to do minor operations on the patients that needed surgical intervention such as cutting fibrous tissues (adhesions) in the pneumothorax (collapsed lung) cases. These patients were treated by pneumothorax – by insertion of air into the pleural spaces – and because of the disease, quite a number of the lung surfaces were adherent to each other and to the pleura on the chest wall, so they had to be separated to give a complete relaxation of the lung. It was collapsed down to its smallest size. The patients were reviewed by the surgeon for possible surgery in Cardiff, in the thoracic unit, to be transferred down there. For example, people with cavities. So, it was quite a lot of activity at that time.

Were there more people in Craig-y-nos with TB of the lungs or TB of the bones?
Oh, TB of the lungs. There were only a small number who had tuberculous bones. Those were children mostly.

Have you any idea what the mortality rate was? Because there are no hospital records, it’s very difficult to ascertain.
I don’t recall any deaths in my time. I think perhaps they were selective. The patients were selective in that the worst cases were transferred down to surgical units and didn’t come back. Perhaps some died after they went home, but I don’t recall any sad cases of people dying there (in Craig-y-nos).

And of course there was streptomycin?
Yes, streptomycin and PAS (para-aminosalicylic acid). That made a big difference indeed. It changed the outlook completely for people who had diagnosed positive TB.

One of the things that the children always mention with some horror is gastric lavages.

Yes, that was necessary to try and obtain some tuberculous bacilli in the gastric juices being swallowed. It was very difficult otherwise to get a specimen from the sputum. Some didn’t have much sputum or they swallowed a lot of it. It was important to know whether the child was positive or negative so far as tuberculous bacilli was concerned. That also dictated what treatment they should need. It was not a very nice procedure at all for children and in those days, perhaps … I wasn’t involved in that … in these days they’d be a bit more refined now. The techniques of doing that are with simple tubes now.

Is there any other medical information that would help give a wider perspective of the hospital?
Well, the new drugs, streptomycin and PAS came in. Eventually, they found that people were becoming resistant to them. Then a new drug came in called Isoniazid and that was useful to help solve the problem of preventing patients developing resistance to the drugs and become tuberculous resistant.

Did you notice resistance quite early on, particularly with streptomycin?
If it was uncontrolled, it became apparent about six weeks after treatment, and if patients – particularly outpatients – took their drugs intermittently or not continuously, that could give rise to resistance very easily. It’s the problem they have in the third world.

Absolutely. Some of the nurses (Glenys Davies was one) developed sensitivity to streptomycin. Was that a problem with staff giving the injections?

Not a big problem. There were only a few that had problems with it.

Dr Hubbard with some of the small children from the Glass Conservatory
Is there anything else that I haven’t asked you that you think is important?

I don’t think so. Of course, Dr Hubbard was there. I’ve seen photographs in the exhibition of Dr Hubbard
Dr Hubbard was a very strict doctor amongst the patients there (laughs).

Some of the children have good memories and some don’t. I don’t know what you would say about her.
Well, she didn’t seem to have much feeling in one way, and then at other times she was very kind. She was a person who lived on her own in a flat up at the top of the building and I used to have my lunch with her in the dining-room adjoining to it once a week. She would never talk about her experiences. She came from Vienna (she qualified MD in 1923 in Vienna), and when the Austrian Anschluss came into effect she got out before that. She had a lame leg (she seems to have had polio). She used to limp around, she was a bit overweight and a formidable figure to these children, I’m sure.

I think they were frightened of her.
Oh, I’m sure they were.

And she had an Austrian accent as well.
One of the gardeners was also there at the time of Adelina Patti.

Is that someone by the name of Hibbert?
I think it might be. He used to live in a house opposite the hospital.

One of his relatives is in contact with us. I think it’s his grandson (Glenys Davies is also related to the Hibberts). I also interviewed a 99-year-old lady who was Sister Betty Lewis. Do you remember her?

The name is familiar. Can you remember who was the first medical superintendent?

It was Dr Frank Wells. He was there until 1930 when Dr Lizzie Robertson Clark became superintendent. She was followed by Dr David William Fenwick Jones who was, in turn, followed by Dr Ivor Williams. Dr Jordan (Norman Theodore Kingsley) was a chest physician in Brecon but not at the Adelina Patti Hospital, unless he went there in a consultative capacity. He was a physician to the Welsh National Memorial Association.

Dr Jordan was a chest physician in Brecon as well, which was the post I inherited eventually.

Sister Margaret Phillips
The first sister was a lady called Sister Margaret Phillips. We’ve got photographs of her in the exhibition, sent by her son, Phil Lewis. (Sister Betty Lewis is actually the niece of Sister Margaret Phillips).

Sister Roberts.

There was a Sister Roberts. She took the place of Sister Outram when she retired.
She went to Talgarth sanatorium and became matron there.
She died eventually.( She died at aged 50 – her niece contacted us and gave us that information. Dr. Reeves )

A lot of the girls have talked about you. I think a lot of the teenagers fell in love with you (nurses too, according to Sylvia Moore [née Peckham]). They said that you were very kind.

Dr Patrick Mulhall in conversation with Dr Carole Reeves, Outreach Historian , the Wellcome Trust Centre for the History of Medicine, University College London.

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