Celebrating 140 years of caring for sick children
In November 1872, Temple St, Children’s University Hospital started life as a charitable infirmary at 9 Upper Temple Street where it opened with just 21 beds. Despite such modest beginnings, the impact that the hospital has had on improving the health and wellbeing of Irish children has been immense.
Below Hospital Historian, Dr Barry Kennerk PhD charts a history of the hospital .[/vc_column_text]
The Buckingham Street infirmary soon proved to be a success. One of its first patients was a child with spinal disease known simply to all as ‘Willie’, and in May 1873 the following account of his care was reported in the hospital’s newly-published Tiny Bulletin: In keeping with the religious ethos of the hospital, (although all were accepted, regardless of denomination), a large statue of the Sacred Heart stood in the main ward and sacred pictures hung on the walls. The beds had white coverlets, each trimmed with a strip of red. One of the volunteers later recalled that:
They [the patients] were often so weak that they could not stand on their feet because their parents were so poor that they could not give them food…a poor mother might take them up on her knee and cry over them for a little while, but she had soon to put them down again and shut them up alone, and go away to her work. They were there when a friend went in, sitting on the earthen floor perhaps or among the cinders by a small spark of fire, or lying on some straw in a corner, all grimy, with their hair matted and rough, and red feverish spots burning on their wasted little cheeks. Sometimes they were coughing and crying for their mothers, sometimes quite quiet and patient, not expecting anything good to happen to them.
Unsurprisingly, the number of children attending the Buckingham Street infirmary increased dramatically, so fast in fact that by 1876, its founders decided to transfer governance to the Irish Sisters of Charity. By then, the sisters had an established track record in providing medical care, particularly in Dublin where they helped to treat the 1832 outbreak of Asiatic cholera.
The lease on the Buckingham Street premises expired in 1879. As a result, a new location for the hospital needed to be found.
The site chosen was No. 15 Upper Temple Street, the former mansion of the Earl of Bellomont. Its purchase was made possible by a bequest from a lady named Mrs Simpson. Even today, it retains some of its original features – an enfilade of doors between the back parlour and ground floor boardroom for instance and the remains of the lead flashing that once supported the stable awnings.
The house was one among many abandoned buildings in the area and a number of alterations were needed before it could be made suitable for patients. Amid what the sisters described as ‘sawdust and confusion’, the old stables were converted into a dispensary and the coach house became a laundry. Inside the main building, the reception rooms were turned into two large wards and baths were installed.
The back steps led to a large and overgrown garden – once part of the Barley Fields where the 1798 insurgents convened. Chickens were brought in so that fresh eggs could be provided and part of the space was turned over to the growing of vegetables. One section became a play area for convalescent children on sunny days and inside, the basement was re-opened as a kitchen with space for a larder, stores servants’ rooms and patient wardrobes. Coal was delivered into great bunkers under the street as it had been during the days of the Earl of Bellomont. The porters carried it up to the wards as part of their daily rounds.
By 17 June 1879, the hospital was ready to open its doors to the public. It boasted 21 beds and was staffed by the same doctors who had attended Buckingham Street. Many continued to hold posts at other hospitals but they were unable to claim a professional salary for their work. As a result, nearby North Frederick Street, with its string of private practices, became the ‘Harley Street’ of Dublin. Among them were two clinicians who could rightly claim credit for putting the hospital on a sound clinical footing.
These were Thomas More Madden, a field surgeon of the Franco-Prussian War who had modified the long and short midwifery forceps and Dr John F. McVeagh – an innovator whose interest lay in the treatment of asthma and diabetes mellitus.
In late 1884, the Irish Times announced that a new chapel was going to be built at the rear of No. 14 which had been added to the children’s hospital a year previously. The chosen medium was red brick – the standard building material of the times.
The tender was awarded to the renowned late Victorian church architect, William Henry Byrne who was a specialist in Roman Renaissance and Gothic revival styles. He is perhaps best known for his design of Loughrea Cathedral (1897-1901).
The foundation stone for the new Temple Street chapel was laid on 12 October 1884 by Canon William Walsh – an eminent name in Irish life. He had been involved in pastoral and public affairs and achieved academic distinction by becoming Maynooth Professor of Theology at the tender age of 26. He served consecutively as vice president of the college in 1878 and as president in 1880.
On the morning of the ceremony, Walsh, whose motto was ‘Fide et Labore’ (Faith and Work) was presented with a silver trowel and mallet and in the presence of a number of friends and benefactors of the hospital, he pushed the stone into place.
When the chapel was complete, it featured cut stone dressings and, in keeping with the architect’s chosen style, seven windows in the Gothic fashion. The panelled ceiling was punctuated by fleurs de lys motifs and a richly-moulded chancel arch divided the sanctuary from the nave. Two statues in ornate marble reredos flanked its approach on either side. In its early years, the chapel floor was of French-polished mahogany with the motto of the Sisters of Charity, Caritas Christi Urget Nos appearing on a painted banner overhead.
In 1900, an altar was installed. Funded by the St. Aloysius Altar society, it was originally of the high type with a richly ornamented tabernacle flanked by marble candleholders above the flat surface or mensa. Later, these features were removed and a carpet laid to make the space more inviting for staff, children and their families. The altar depicts a scene adapted from Mark 10:15-16: ‘suffer the little children to come to me, and forbid them not: for of such is the kingdom of God’.
Just a few years after Temple Street Hospital opened, its work came under the scrutiny of the Dublin Hospitals or ‘Spenser’ Commission which was established in 1885 to investigate hospital accommodation.
A related matter was the alleged abuse of the poor law red ticket. Widespread use of the ticket (which was similar to the medical card) was beginning to impact upon the quality of medical care available for those who could afford to pay. By then, Dublin had fourteen dispensary officers with another set attached to the city’s hospitals. They carried a huge burden in caring for the poor and attendance at the Temple Street dispensary had almost doubled.
On 24 November 1885, the Commission interviewed a number of the doctors attached to the hospital. One of the first to be called was Dr Thomas More Madden, who told the panel that although there were 80 beds at Temple Street, funds would only allow 36 of them to be kept open. When it was suggested that space might be set aside for children at the Mater or in another adult hospital, he was emphatic. Sick children deserved to be treated in a special environment of their own. Surgeon J. McCullough agreed. He informed the commission that there were plans to build a separate infectious wing at the rear of the hospital.
On the recommendation of the Commission, the Children’s Hospital was allowed to continue its life-saving work. John Dillon, an Irish Parliamentary Party M.P. and erstwhile medical student summed the matter up when he said, ‘It has always occurred to me that the Sisters of Charity in undertaking the starting of the hospital [Temple Street]…have done one of the greatest, most beneficent, and humane acts which ever entered the mind of man or woman’.
At mid-day on Easter Monday 1916, some nurses from Temple Street Hospital rushed into the front hall. They had been out for a walk. Their breathless cries that the ‘Sinn Feiners have taken over the General Post Office’ soon caused a flurry of excitement throughout the building.
Dr John Shanley (then a medical student) later recalled that he heard the first shots of the rising as he walked home from Mass at the Pro-Cathedral on Marlborough Street.
That evening, the hospital received its first casualty – a little boy who had been shot in the arm by a stray bullet. Over the following week, a total of eleven gunshot cases were admitted.
Today, such a situation would call for instigation of the hospital’s major disaster plan but in 1916, the staff had to cope with the situation as best they could. Fortunately, many of the surgeons who worked at Temple Street had experience working in tented hospitals on the battlefield. A number of Belgian refugee children had also been sent to the hospital shortly after the beginning of the Great War. Combined, these two factors equipped the hospital to handle the surgical and psychological consequences of the Rising to some extent.
Throughout Easter Week, the Jesuit priests of nearby Belvedere College were a constant source of comfort for patients and their families. On Tuesday, St. Philomena’s private ward was pressed into use for adult casualties. That same evening, a young man was admitted with a gunshot wound to the leg. It was too dangerous for the hospital consultants to cross the city to operate so instead; this task fell to the resident surgical officer. By and large, most of the casualties came from the North inner city which was closest to the fighting – North King Street, Gloucester (Sean McDermott) Street, North Cumberland Street, Waterford Street and Parnell Street.
The hospital staff scarcely had time to draw breath before they were accepting the first casualties from the War of Independence. At 5am on 14 November 1920, shots were heard outside the hospital, waking many of the young patients and frightening the nuns who tried to calm them. The following morning, several bullet marks were found on the front door and other parts of the building. The matter was raised in the House of Commons.
Three months later, the hospital was placed under martial law for an entire morning while British soldiers combed the building in search of fugitives on the run. It was suspected that they were hiding in the boiler room at the end of the garden and the maintenance man was placed under arrest for a few hours. The army met their match in the stern figure of Mother Superioress Polycarp Cummins however and the wanted men could not be found.
On 21 May 1921, a Crossley Tender containing some RIC personnel was attacked between King Street and Capel Street. Afterwards, the Irish Times reported that ‘a child aged 1 ½ years, of 5 Bolton parade, who was in his mother’s arms, received a wound from a bomb splinter’. Both were taken to Jervis street Hospital, but the child was later removed to Temple Street.
That October, a meeting was held in the adjacent St. George’s Hall (then owned by the Y.M.C.A.) to debate the motion that the amalgamation of small nationalities with large states was detrimental to the interests of a small country like Ireland. Somewhat prophetically, independence came to pass but the period that followed gave rise to a bitter Civil War. In mid December 1922, the houses of three members of the new Oireachtas were raided and set on fire by armed men. Three of the children of pro-treaty Captain Sean McGarry were trapped in a room and their mother was very badly burned when she tried to save them. The children were later admitted to Temple Street for treatment.
One doctor who witnessed many of these events first hand was Patrick MacCarvill (1893-1955). He is remembered by a small stone font erected to his memory on the chapel landing.
MacCarvill’s allegiance lay with the anti-treatyites after the Civil War and when some doctors proved reluctant to treat Eamonn DeValera’s children on political grounds, his services were called upon. He nursed the Fianna Fail leader’s three-year-old son Terry at the family home. Afterwards, another son, Brian, became seriously asthmatic. DeValera was reluctant to take him to Temple Street but MacCarvill was unyielding. ‘’I’ll leave the politics to you, Chief’, he winked, ‘but leave the medicine to me!’
The Children’s Hospital had not been open for very long before the sisters found it necessary to expand. In the main hospital, the huge upstairs reception rooms were dissected to make separate wards and in 1894, an archway was built over the lane that divides the main hospital block from No. 13. In 1899, an extension was built in line with the main building at the Hardwicke Street end.
By 1901, the nuns had relocated from the old coach house toNo. 14 Temple Street. At that time, there were sixteen sisters, led by their Superioress, Christina Hodgens. According to the National Census, the average age of each was 35. Thus, the hospital had a young, vibrant community that was able to meet the challenge of running a growing service.
In 1904, a new operating theatre was opened by the Lord Lieutenant, Earl Dudley. Until then, it had been standard practice to operate on the ward, daylight permitting. In 1907, further progress was made when Dr Henry Mason – a physician and radiologist from Mercer’s Hospital – was appointed as medical officer in charge of a new x-ray department.
The following year, Lady Martin, daughter of the famous Victorian physician, Sir Dominic Corrigan, bequeathed her lands and a large house in Cappagh to the Sisters of Charity. On 8 September 1908, twelve children from Temple Street were transferred there for convalescence. For the most part, they suffered from tubercular bone disease and treatment was carried out along the lines of heliotherapy (sunshine) and splintage. Cappagh remained in use for that purpose until 1920 when it became an orthopaedic hospital. The staff of Temple Street helped to raise funds for the project.
In 1914, a new outpatient department was completed, modelled on one of the foremost paediatric centres in Vienna. It housed the hospital pharmacy, pathological laboratory and theatre. The date of construction, along with the Sisters of Charity motto: Caritas Christi Urget Nos (the love of Christ compels us), is still clearly visible over the doorway.
The next great wave of redevelopment did not take place until the 1930s. Inside, the central hospital staircase was removed and a new ceiling installed in what is now the front hall. St. Patrick’s ward for infants was built and placed under the care of Miss Mia Rotter from Professor Moll’s renowned Vienna clinic. A new wing, comprising two storeys was built at the back of No. 13. The top storey was named St. Patrick’s Ward and was used for dietetic cases. It had space for 16 cots. At its southern end was a veranda, enclosed by a large Vita glass window to allow children access to fresh air and sunshine when the weather was bad. The ground floor housed a physiotherapy department with a rowing machine, exercise bike and medicinal bath.
For the first time, the hospital could begin to tackle the problem of cross-infection. Wards on all floors were divided into sections on either side of a central corridor. These were shielded by heavy plate glass and one room was renovated to house a new sterilising plant.
The decade also witnessed the purchase of new radiological equipment. Besides the addition of a mobile x-ray unit, a permanent machine was installed. Powered by a massive basement generator, it featured an oil-cooled tube and 4-valve rectification set. At a stroke, radiological exposure times were reduced to hundredths of a second.
By the end of the decade, the hospital had succeeded in making the transition from a charitable infirmary to that of a modern institution. Funding from various sources such as the hospital Sweepstakes enabled the construction of other badly needed facilities including a milk kitchen, a new operating theatre, a plaster theatre and St. Michael’s Ward.
Heating and hot water services continued to lag behind such advances and it was not until the 1950s that the coal-fired boilers were replaced. Electrician, Jackie Brogan who started his apprenticeship in 1947 recalled that:
The supervisors of our work were the Reverend Mother or Sister Ministress at the time. You then submitted an invoice for works carried out to Lily Butler [hospital secretary] for payment. This invoice was put amongst all the others on her very large desk, and on occasions you would be told, ‘I can’t pay this, I have no money’. You would accept this statement knowing, however, that when monies became available the account would be settled…in 1954, it was decided to install an oil-fired boiler to serve the main building, operating theatres and laundry. Then over the following years, all other coal-fired boilers were dispensed with and all systems linked to the main boiler.
Meanwhile, development of hospital services continued apace. In 1959, Sister Marie de Montfort started a speech therapy clinic which was initially held in the outpatient department. Six years later, St. Francis’ Clinic was opened. It was soon home to a number of complementary services such as psychiatry, psychology and audiology.
During the 1960s, the hospital purchased a whole block of houses comprising Nos. 1-8 Temple Street. Later, these were demolished and a new convent was built to house the community of nuns who were still resident in the main house. When the hospital acquired St. Anthony’s (A&E) Lane from Dublin Corporation in 1977, a new thoroughfare was opened through the site of the old No. 8. Today, this leads building onto Nerney’s Court past the IMPACT building. A subway was built between the convent and main hospital so that the nuns did not have to go onto the street as they moved between their work and meals.
1966 was another ground-breaking year for Temple Street. For the first time, a screening service for phenylketonuria (PKU) was established under the direction of Consultant Pathologist, Dr Seamus Cahalane. Of him, Professor Philip Mayne writes that:
Although Dr Cahalane had trained primarily as a histopathologist, he was particularly interested in developing micro-analytical methods for investigating small samples from children. It was this interest that brought him in contact with Dr Robert (Bob) Guthrie in 1961. Bob Guthrie had developed a simply microbiological method for measuring phenylalanine levels from a few drops of blood in his laboratory at the Children’s Hospital at Buffalo, New York.
A system of blood tests was quickly established to ensure early detection of this genetic disease in the newborn with necessary materials for specimen-taking made available to all maternity hospitals and registered doctors in the health authority area. Today, the ubiquitous ‘Guthrie Card’ is still in use throughout Ireland for all newborns and these are sent to Temple Street for analysis. Another scheme which started life as a pilot project at the hospital was the detection and treatment of genito-urinary defects in children.
During the same decade, the first proposals for a new hospital were made but nothing further was achieved until the 1970s when a board of management, chaired by the Hon Mr Justice T.A. Finlay was formed. In 1984, the Department of Health accepted an ambitious new plan for the construction of a new paediatric hospital on the site of the old one but it was later abandoned due to health service cutbacks. In 1988, the hospital’s position was reassessed and the Mater site chosen as a suitable location.
In the meantime, Temple Street continued to meet the needs of sick children. The 1990s witnessed a dramatic flurry of redevelopment on a par with that of the 1930s. Some highlights included the annexation and restoration of St. George’s Hall for student lectures, replacement of the old cage lift that ran through the main hospital and the conversion of St. Brigid’s into a dedicated metabolic ward. The old convent on the top floor became a neurology unit and a second storey was added to the outpatient department.
Towards the rear of the hospital, the old pre-fab buildings were demolished to make way for St. Ultan’s Metabolic Unit and the old assembly hall – once the venue for many fantastic Christmas pantomimes made way for a new A&E department and day ward. For many, the disappearance of the hospital garden, although regretted, was a small price to pay for a well-cared for child.
Fortunately, the sisters were able to get help from other sources. The Association of Charities, based in Molesworth Street, ran a cooperative scheme that encouraged benevolent organisations to work together. These included the ‘Police-Aided Children’s Clothing Society’, ‘Church of Ireland Clergy Widows and Orphan’s Society’ and ‘Sisters of Charity School’ in Gardiner Street which gave breakfast to the area’s poor children every morning.
Directories and newspapers were another important outlet for Temple Street Hospital because it could advertise for donations in them. In addition, The Irish Times and its ‘League of Kindness’ paid for a cot, as did the nearby Loreto convent. Nevertheless, despite such efforts, the hospital could not have existed in its early years without the support of such Irish notaries as Charles Bianconi, the famous stagecoach maker and author and playwright Oscar Wilde.
It soon became apparent that despite their help, a more formal fundraising arrangement was required. In response, the Moy Mell Children’s Guild was inaugurated during the 1890s. It took its name from a Gaelic name for heaven, meaning ‘Field of Honey’ – a place where everyone grows young and never ages. In launching the guild, its first president, Countess Cadogan, issued the following appeal:
Dear Young Friends,
In the Children’s Hospital there are a large number of poor little patients, who are sick and suffering, and I want you to help them. It is always very sad to see a little child suffer pain and sickness, even when a loving mother, a kind nurse and a skilful doctor are doing everything possible to lessen the suffering. But it is far, far sadder to know, that there are many children ill and helpless, some of whom have careless or even cruel parents, and others, too, whose mothers, with all their affection, are too poor to provide their little ones with the relief and comfort they want so badly.
The response was enthusiastic and soon, collection boxes began to appear in homes and businesses all over Ireland. The rules of admission stated that each guild member had to pay a yearly entrance fee of 6 pence. Girls gave two items of clothing and boys sent two toys or a money order in December. Children under seven could also take part by collecting pennies for the children’s guild cot.
Every year, Dubliners eagerly awaited the arrival of a fundraising bazaar which was held in the grounds of the Rotunda Hospital. The gardens were lit with electric lighting, flags and bunting and people thronged to visit the various tents, marquees and merry-go-rounds. Against a background of brass band music, they took a turn at the swing boats and shooting galleries or had their fortune read by a clairvoyant. One novel feature during the 1890s was the cinematograph – an early precursor of the film reel.
In 1893, the fete featured a performance by the Grand Continental Circus. When some of the artistes realised that the sickest of the children could not attend, they visited the wards in person.
The most distinguished members of the Moy Mell Guild included Princess Beatrice’s two children, both of whom visited the hospital during Queen Victoria’s trip to Dublin in April 1900. Later that year, they sent a large consignment of toys from Windsor.
For the most part however, it was the ordinary boys and girls of Ireland who made the guild a success. Moy Mell helped to keep the hospital open until the 1930s when the Irish Sweepstakes began and still serves as a sweet reminder of how Ireland’s young people can move mountains to help each other.
If the saying that there is a story behind every photograph is true, there is surely no better example than that of the boy king of Spain.
For many years, his portrait stood in the front hall of Temple Street Hospital. It depicted a young eleven-year-old Alphonso XIII, dressed in military uniform; his high, broad forehead and arched eyebrows reminiscent of paintings of his Bourbon forebears. It continued to hang long after any memory of how it came to be donated had been forgotten.
The story began in early 1897 when the sisters at Temple Street wrote to Maria Christina, Queen Regent of Spain, asking whether she would permit her son to become a patron of the Moy Mell children’s guild. In the aftermath of the hospital’s annual fund-raising bazaar, theFreeman’s Journal of 6 May 1897 reported that:
A conspicuous feature at one stall was the portrait of HM the King of Spain, specially sent over to Moy Mell by HM the Queen Mother, as a token of sympathy for the poor children of Temple Street Hospital. The Hospital Stall, with its shaded yellow draperies, was under the presidency of the Hon Mrs Nugent, Mrs Browne and Mrs Armytage Moore, whose helpers were distinguished by their light blue sashes.
Alphonso had been the king of Spain from birth but he could not assume control of the country until he turned sixteen. Until then, his mother ruled in his stead. Considering his poor health, it is not hard to understand why she was so responsive to the needs of Temple Street and its children.
The king had always been a slight boy who suffered from several bouts of childhood illness. In 1890, aged just four, he spent some months in bed with what the newspapers described as an ‘affliction of the heart’. It was rumoured that he might have hydrocephalus and crowds gathered at the palace gates every day for the latest news. For the duration of his illness, his mother stayed within earshot (a corkscrew staircase joining their two bedrooms) and a speaking tube was installed near his cot so that his nurse could summon the doctor in a hurry. Every morning, Queen Christine would ask ‘Good morning. And how is your little Majesty?’ If Alphonso were particularly unwell, he would reply, ‘Mother, do not go away from me!’ Against the odds, he made a slow but steady recovery, fortified on a Spartan diet of wine and beef tea.
Afterwards, in order to strengthen his delicate frame, a regimen of outdoor pursuits was prescribed. In 1897, he spent a summer at San Sebastian where he took the sea air, learned to ride at the palace stables and was invited to inspect a children’s regiment of 700 mock soldiers. When cycling became the latest craze to sweep the Continent, he eagerly took it up.
Alphonso’s patronage of Temple Street Hospital was gratefully appreciated and the sisters lost no time in drafting a letter to Madrid. They enclosed a picture donated by the sick children. In November 1897, the Mother Superioress received the following reply:
My Dear Madam,
I had the honour to present to Her Majesty the Queen Regent of Spain the picture offered by you to His Majesty the King. Her Majesty was very grateful for your attention, and the picture will be placed in the ‘Children’s Refuge’ of Maria Christina.
Your obedient servant,
Que besa su mano (who kisses your hand), Luis Moreno
In 1902, the young king put his childhood behind him for good when he acceded to the Spanish throne. The week of his majority was marked by great national festivities which included receptions, balls and bullfights. From the outset, France’s Le Figaro described him as ‘the happiest and best-loved of all the rulers of the earth’. A few years later, he went on to marry Princess Ina, who had visited Temple Street in 1900. Thus, the girl who had once seen his portrait hanging in the front hall herself became Queen Victoria Eugenie ofSpain.
Unfortunately however, the remainder of Alphonso’s reign was somewhat tempestuous. Under his rule, Spain lost its remaining colonies in the Americans and Philippines and when the second republic was declared in 1932, he was forced to flee the country. He spent a period of exile in Italy and Paris before making an attempt to return to Spain in 1936. Near the French border, General Mola had him arrested and expelled and he eventually abdicated. He died in Rome in 1941. Today, Alphonso’s childhood portrait serves as a reminder of a once great patron of Temple Street Hospital– a friend to its children whose afflictions he, of all people, could understand.
On 16 April 1982, Lady Sheila Butlin visited Temple Street Hospital with her daughter Jacquie to unveil a bust of her late husband, William (Billy) Butlin. In life, the affable old gentleman went by the motto ‘sell yourself big’.
‘Sir Billy’ (as he chose to be known after receiving his knighthood in 1964) had dreamt of opening Britain’s first holiday camp in 1921. With just £5 in his pocket, he set about making that dream a reality. He was the very epitome of the self-man man – just three years of formal schooling and a wealth of life experience.
Mr Eamonn Andrews, OBD, at the laying of the foundation stone by Sir Billy Butlin, MBE (second left) for a new x-ray unit. Also in the photograph are Mother Ann Eucharia, Mother Rectress, Temple Street Children’s Hospital; Mrs Andrews and Lorcan Burke, chief barker, Variety Club of Ireland. (Tuesday 25 Aug. 1970)
During the First World War, he inveigled his way into service as the youngest bugler in the Canadian army (aged 15) and was posted overseas to France. After being demobbed, he was employed briefly as an office boy before working his way to Liverpool on a cattle boat. He opened his first holiday camp in 1934 in a potato field at Skegness. It cost him £100,000 but by 1946, his personal bank balance was just over £1 million.
Butlin’s work with the Variety Club of Ireland brought him into contact with The Children’s Hospital, Temple Street– just one of the numerous charitable organisations which he assisted. On 25 August 1970, he laid the foundation stone of the new x-ray unit and presented a cheque to the hospital for £3,000. The next project with which the club was involved was the construction of a new laboratory. A new amino-acid analyser took pride of place. The Irish Times of 27th August 1971 described the use to which this modern marvel would be put. It would be instrumental, it claimed in ‘the early detection of hereditary metabolic disease’. Later that decade, the new laboratory and theatre were completed.
By December 1973, the Variety Club had presented £30,000 to Temple Street. Amongst other uses, the money had gone towards the provision of scholarships for doctors, a mobile laboratory and baby care units. Ex staff member Kay Maguire recalls that when a meal was hosted for Sir Billy in Temple Street, one of the dietician’s legs went through the floorboards. Miss Lily Butler’s response to the canteen staff was quick-thinking. ‘Don’t panic girls’, she whispered, ‘just keep serving and smiling’.
As the hospital began to expand during the 1880s, it soon became apparent that additional help was required.
The mother superioress placed an advertisement for nurses. Each candidate was to be under 25 years of age (unless she paid one guinea per week) with an entrance fee of £10. Her acceptance was subject to an interview and she needed to provide written testimonials of good character. Once she commenced as a ‘probationer’, she had to provide two uniform dresses, six aprons and two caps but if she passed her first three-months, an indoor uniform was supplied.
During their first year at Temple Street, students attended lectures. These were delivered by members of the hospital staff as well by as the lady superintendent. Since infectious cases were not admitted to Temple Street, probationers were sent on a special course at the Cork-Street Fever Hospital. Exams were held at intervals and when not on active duty, they were expected to undertake needlework or household work. They could not receive money from patients or friends under any circumstances and were liable to instant dismissal for any act of ‘moral delinquency’.
Breakfast was served at 6.35am after which the household servants took their own meal. Two hours later, a more leisurely second meal was served for the lady superintendent, staff nurse and resident doctor.
By 1893, the sisters were so happy with the quality of their nursing candidates that they decided to buy and fit out No. 13 Temple Street as a home for them. That made it easier for country girls who until that point, had to find accommodation in lodging houses. Each room was to be kept ‘in the same manner as if it were in a private residence’.
In his AGM address of the same year, the Registrar General, Dr Grimshaw praised the hospital’s nurse training programme. He admitted that he had often ‘found nurses in his time to attend to sick adults well’, but added that ‘it was very hard to find nurses who were able to manage sick children properly’.
The following year, the Dublin Metropolitan Technical School for Nurses was established. Each candidate paid a one guinea fee and received a diploma when they passed the examination.
By 1898, some of the hospital nurses were being sent into private practice in an effort to boost hospital revenue. They attended the bedside of sick children in wealthier homes – a service which the mother superioress was keen to advertise as one that was available at ‘moderate cost’.
When St. Mary’s Convalescent Home opened at Cappagh in 1908, young ladies were invited to apply to the Superioress at Temple Street for training there as nursery nurses. Instruction was practical and covered subjects such as daily care and feeding of children, cookery, laundry, needlework (including cutting out and making clothes), religious teaching for young patients and nursery hygiene. The duration of the course was nine months and the inclusive fee for board, residence and tuition was £20.
A statistical analysis of the hospital nursing registers from 1917 to 1939 is very revealing in what it tells us about the student nurses who came to Temple Street. Of the 299 candidates, some two thirds came from outside the city and of those, almost half had a farm upbringing. The addresses and paternal professions of the remaining third from Dublin puts them in an almost exclusively upper middle class category – the largest number of admissions coming from the townships of Clontarf, Drumcondra and Rathmines.
The lady superintendent charted the career of each student in scrupulous detail. At first glance, the high expectation held by the parents of rural girls is clearly evident as is the strictness of the sisters in matters of appearance and hygiene. An unhealthy interest in ‘outside pleasures’ was frowned upon. Occasionally, a student, having passed out of service might join a religious order or, if she decided to marry, might fail to return after her summer holidays.
Besides the constructive comments, there are also occasional less favourable ones such as: ‘An intelligent capable girl who ought to make a good nurse but was evidently spoilt in upbringing and sulked like a bold child when corrected for faults’. For the most part however, the general impression is one of affection towards the young ladies upon whom so much responsibility rested.
In 1919, the State Registration Act was passed. This meant that student nurses were now required to train according to a syllabus laid down by the General Nursing Council (later An Bord Altranais). This included the preliminary state and final sick children’s state examinations. Cookery now took second place to classes in anatomy, physiology, hygiene and bacteriology with special courses in medical and surgical nursing.
By the 1940s, the career pathway was becoming increasingly well defined. Every year, about 30 probationers enrolled at Temple Street for preliminary training with approximately 20 passing their final exams. Living circumstances were often difficult however, particularly during the winter months when the only form of heating came from a single hearth. Nurse Thomasina Mackey, then twenty years old, recalls:
This of course was not glowing invitingly as you came off duty tired and cold – the damp turf was there and you spent your two hours’ leisure time in an often vain endeavour to light it, or else you retired, defeated, to your bed – not with a hot water bottle – you were not allowed to boil a kettle in the nurses’ home in those days.
Each student had to be indoors by 9.30pm each night. Smoking in the rooms was forbidden. Occasionally, some sought to break the monotony by attending a dance but although leave was occasionally given, abuse of the privilege was frowned upon, especially when latecomers were caught sneaking through the ground floor windows. Of one particularly high-spirited probationer, the lady superintendent wrote:
Flighty and uninterested in work. Main reason for nursing appeared to me, to be in City and have a good time. Stayed out late without permission, left hospital door open at 12am while she went on a quest for chip potato [es]. These she had for supper in the ward kitchenette.
Rigid discipline was also enforced during the morning. If a nurse arrived late to breakfast four times a month – even one minute after the 6.30am bell – her day’s leave for that month was forfeited. On the other hand, there were many things to look forward to such as Christmas festivities with outings or religious retreats to the countryside during the summertime.
In 1954, a new nurses’ home called St. Joan’s was built on the site of three old houses between the main block and St. George’s Church. For the first time, student nurses had access to built-in wardrobes and hot and cold running water. Further work was done during the early 1970s with the construction of No. 3-5.
As the century wound to a close, a tunic and trousers replaced the dress and cap of the past. By then, the role of the nurse had evolved considerably. Men were now able to choose nursing as a career. Medical advances had improved survival rates for neonates and children and a new treatment was now available for a range of metabolic disorders. The era of the specialist nurse was born.
The crumbling tenements on nearby Hardwicke and Gardiner Streets housed families of ten or more in one room and ailments such as arthritis and hip disease were common. On arrival, each child’s clothing was removed and a new set was issued. Regardless of sex, hair was cropped short to limit the spread of lice.
During the late nineteenth-century, it was standard practice to keep inpatients in bed for an average of a month – far longer than would be considered usual today. One of the reasons for this was that the children might suffer a relapse if returned too soon to the conditions from which they came.
In 1884, some 650 children attended the hospital dispensary with scrofula, described by contemporary textbooks as tuberculosis of the lymphatic glands and (occasionally) the surface of bones and joints. It was essentially a disease of early life. In 1882, Koch discovered that TB was an infectious disease, but it took some time for this to become widely accepted and it was not acknowledged as a significant factor in the city’s high death rate until 1900.
Many of the doctors who practised at Temple Street had learnt their trade during an earlier era in which ‘Heroic Medicine’ predominated. It included practices such as intestinal purging (with calomel), bloodletting (venesection), vomiting (tartar emetic), profuse sweating (diaphoretics) and blistering.
Although such methods had begun to fall out of favour by the 1870s, a number of unscientific beliefs continued to prevail. One generally held theory for instance was that hospital infection was transported by a noxious gas or miasma. For that reason, the standard practice at Temple Street was to soak bedclothes and doors with chloride of lime and Condy’s fluid. It was believed that fires burning in the wards would draw up the ‘miasma’ through the chimney and children were encouraged to sit in chairs in front of them.
Sepsis was the ‘pestilence that walketh in darkness’ in the dingy, overcrowded wards of large hospitals. Four illnesses flared up with such frequency that they came to be known collectively as ‘hospital disease’ – erysipelas, septicaemia, pyaemia and acute gangrene. As a result, very little abdominal surgery was performed and there was no knowledge about the teratogenic effects of viruses. The rate of congenital deformities of the nervous system was higher in Dublin than elsewhere in the country with 380 cases of hydrocephalus seen at Temple Street in 1884 alone. Most of these cases were managed palliatively since the techniques necessary to drain and re-circulate cerebral spinal fluid had not yet been devised.
On 20 August 1887, the British Medical Journal summarised the findings of a paper given by Dr More Madden in which he attributed the root cause of the ‘increasing prevalence of cerebral disease’ (including meningitis, cephalitis, headaches, sleeplessness and neuroses of all kinds) to ‘the daily increasing educational pressure now brought to bear on children from a very early age’. Madden received support from Dr Charles Cameron who added that children of the poorer classes were unable to apply themselves at school due to malnutrition.
On certain days, the smell of manure from the piggery in Nerney’s Court came through the hospital windows and there was a farrier’s forge alongside the garden wall (now St. Francis Clinic). On a weekly basis, the horses from two local bakeries – Johnston Mooney & O’Brien and Kennedy’s – were taken up the lane to be shod.
Despite these difficult circumstances, the removal of children from the wards of general adult hospitals was a positive step. Disregarding infectious patients (who were cared for at the Cork Street Fever Hospital), it is a remarkable fact that in a city where one-third of the total deaths were attributable to children under five, the death rate in Temple Street prior to 1900 remained under four per cent.
A large number of accident cases were treated at the hospital. Just like the incidence of disease, these were also often attributable to terrible housing conditions. Contemporary newspapers are littered with reports of children tumbling down broken stairwells or through defective railings.
Anatomical knowledge had reached quite an advanced stage when Temple Street opened its doors and was of some assistance in treating such trauma cases. Other techniques such as clinical thermometry, chemical tests and auscultation were still quite new however. As a measure of this, one of the hospital physicians, Dr J.C. O’Carroll, recalled that when bitten by a rabid dog as a child, he was one of the first to be vaccinated by the famous Louis Pasteur in Paris.
As early as 1877, H. MacNaughton in his Clinical Teaching in Hospitals recommended that students attending the sick should carry a stethoscope, clinical thermometer, pocket measure, scissors, forceps, probe, small scalpel, lancet, silk and silver wire, and litmus paper. Students were also advised to carry a pocket urinary test apparatus. The testing of urine for signs of illness was now becoming part of standard practice. At the same time, ‘youthful license and…ungentlemanly frivolity’ was to be avoided.
In the era prior to the First World War, many of the doctors who worked at Temple Street were obliged to improvise. They devised their own surgical instruments, worked out novel solutions to problems and even provided their own rubber gloves. Dr Michael Staunton, one of the first paediatric surgeons, recalled that:
Not only were there no antibiotics or blood transfusions, but parenteral fluids [saline with glucose, electrolytes etc] were usually given subcutaneously or intraperitoneally, both of which must have been very painful to the patient; the anaesthesia of that time would now be considered quite primitive; usually it was the ‘rag and bottle’ method.
In its favour, the Children’s Hospital was well equipped with medical staff. By comparison, the County and City of Cork Hospital for Women and Children had just one consultant surgeon and five medical officers, despite its comparable number of inpatients. Temple Street Hospital retained physicians as well as dental, resident and assistant surgeons and children were referred from all over the country due to its favourable patient-doctor ratio.
In part, this was assured by the large influx of students from the city’s medical schools. There were three of these – the Royal College of Surgeons, Trinity College and the Catholic University School in Cecilia Street. The Children’s Hospital maintained an especially close relationship with the latter, with Dr More Madden sitting on the governing board of Cecilia Street after it was brought under the supervision of the Education Endowment Commission in 1891.
Since 1886, students were obliged to pass examinations in midwifery and surgery as well as medicine, and towards the end of the century the period of time spent as an undergraduate gradually increased. Although hospital positions went unpaid, it was often considered essential to obtain a post in one, particularly if one’s career and reputation was to be established.
As was the case at the nearby Mater Hospital, students attended Temple Street during the morning to visit the outpatient department. There were no sub-specialities in the early days and they helped the consultants to treat everything from broken bones to sore throats. The afternoon left them free to attend lectures and dissections.
The absence of paediatrics as a topic in the medical examination meant that only a small number of students walked rounds with a permanent member of the medical staff. This came as a source of regret to Dr John McVeagh who in November 1889 ‘urged upon students the importance of devoting a part of their time to the study of the peculiarities of disease as observed in children’.
Unlike today, the wards prior to 1900 were more like large nurseries. During one memorable visit to the hospital in 1892, Mary Banim, daughter of the novelist Michael Banim, wrote that the children were kept ‘in rows of snug cribs ranged around the walls, a number of little girls are keeping holiday, some in bed, some up and dressed…there was a real nun…holding a small baby on the prancing rocking-horse, laughing the while as if her own turn were coming next’.
Banim took particular delight in speaking to the patients, one particular favourite being a shy five-year-old named Lily whom she described as ‘an old sufferer’. As a treatment for her spinal deformity, Lily was obliged to lie strapped day and night in bed with heavy weights attached to her legs. An adjacent sliding table was covered with ‘whole families of dolls and their peculiar belongings and a box full of scraps of coloured stuffs, out of which “the dolls’ dressmaker” selects the materials for costumes’.
In another corner, a nun cared for a three-year-old child ‘whose death from bronchitis was expected all through the night, but who the Sister says they now trust will pull through’.
The sixty patients were usually put to sleep at six o’clock each evening, but some, by virtue of their adult responsibilities could hardly be described as such. ‘Miss Kate’ (aged 10) was obliged to support her mother and three younger sisters after her father’s death. Another girl named Mary (aged 12) explained that she received her injuries while preparing supper for her father who was out at work. “My legs and hips were nearly scalded off”, she explained, “and sure, wasn’t it well I’d just laid the child down out of my arms!”
There were several Irish-speaking patients at the time of Banim’s visit, most of whom spoke no English. One boy, whose father had been drowned in a storm the previous winter, had been taken there from his Aran island home by his grandmother. She came to Dublin ‘dressed in her island costume of red petticoat, dark gown, white or plaid shawl, and on her feet “pampoaties” [sic] or cow-hide sandals’. Afterwards, she wrote to the nuns, eliciting a promise that if her grandson could not be cured, he would return to ‘sleep in the old church-yard where the sea rolls up almost to the very graves’.
Every day, healthy children were encouraged to visit Temple Street and the wards were thrown open to them from 2 until 3 o’clock and again from 4.30 – 5.30pm, apart from Sundays when only parents were allowed to stay on. One particular bed was paid for solely through donations given by the pupils of nearby Loretto Convent, North Great George’s Street. Other children were encouraged to donate their pennies or toys. Girls were particularly sought after for their sewing skills and on request, the superioress was prepared to post clothing patterns to them. ‘They will think’ Banim wrote, ‘of the lessons of love and mercy preached by that first gentle Disciple of Charity, St. John, and take for their motto his one great sermon – “Little children, love one another.”
Table: Attendances at Buckingham Street and Temple Street for the years 1874-1902
Figures for 1890 remain the same until 1894
|* The addition of an apothecary and surgeon is listed.± The new hospital atTemple Street is mentioned in the Directory for the first time.This substantial rise in patients is explained by the equipping of No. 14, purchased in 1883.¥A clinical assistant joined the hospital during this year.Source: The Medical Directory, London, Provinces, Wales, Scotland, Ireland.|
As part of the preparations, the hospital’s sixty or so inpatients were dressed in red flannel night jackets and each cot was decked out in white counterpanes and warm blankets. From early morning, they eagerly awaited the arrival of a throng of visitors – usually led by the wife of the Lord Lieutenant and her vice-regal entourage and followed by the lord mayor, the police commissioners and other dignitaries.
‘Every ward was tastefully wreathed’, the Freeman’s Journalof 29 December 1891 reported, ‘with holly and ivy and the walls were hung with bright pictures and coloured mottoes’.
Two of the cots at Temple Street were sponsored by charitable donations. One source was the nearby Loreto convent. The second was the ‘League of Kindness’ – an organisation established by the Irish Times and whose members were children. Since all personal garments were removed on admission, boys and girls were encouraged to donate toys and money or to make items of clothing for their unfortunate bed-bound peers. In order to rally further support for the hospital, the Times often sent special correspondents to report on how the patients were faring.
One such account, written by Lucy Leonard prior to the fete in December 1893 is charming in its detail: ‘A very small child was in a comfortable chair by a blazing fire’ she wrote, ‘but had a cough and was so sleepy and cross that she would not even look at us’.
Leonard was led through the hospital by the mother superioress who remarked that although the children on the ground floor looked like boys, their appearance was somewhat misleading due to their cropped hair. ‘These are all girls’, she explained. Upstairs, one little boy who called for Miss Leonard’s attention was later heard to remark: ‘Did ye hear what she said…that if I’m a good boy I’ll get somefin’ nice at Christmas’.
Fête day was very busy for Temple Street. Every year, upwards of 500 visitors thronged around the little cots and various entertainments were laid on for the patients. On 29th December 1893, the Freeman’s Journal reported that:
In the Convalescent Ward, a magic lantern entertainment was given by Mr. Lawrence of O’Connell Street. All the scenes were of a humorous character, and it was a treat to hear the screams of delight with which they were received by the children.
Many of the visitors handed out sixpence pieces but the younger children who were liable to eat them had to be watched carefully. Once the various dignitaries had visited all the wards, it was traditional for the Lady Lieutenant (at first the Countess of Zetland and in later years the Lady Cadogan) to distribute toys from the large Christmas tree. Some of these gifts were donated by wealthy patronesses such as the Marchioness of Derry who included a card for each patient or by the German Empress Augusta of Saxe Weimar Eisenach who was responsible for providing most of the toys in 1890 – rather poignantly it seems, as she died on 7th January of that year.
Blissfully unaware of how great or small their visitors were, the children tucked into a meal of sweetmeats and fruit. Santa joined the festivities but wore a green rather than a red costume and after the toys had been handed round, a concert was usually held around a piano in the largest of the halls. By 1897, there were so many visitors every year that the hospital board decided not to issue any more invitations for the safety of the patients and to restrict the fête to a select group.
Despite the fun and frivolity, there was a serious side to all of this merrymaking however. The sisters, who started life in Temple Street by sleeping in the tack and harness rooms above the old stables, were doubly ‘saddled’ with a large debt.
Some among the Irish medical profession felt that the children would be better served by being catered for in special wards in the country’s adult hospitals but there was a large amount of public support for the work and despite the odds, the fledging institution was able to remain open. In 1895, it received further assistance when the Countess Cadogan chose the Christmas fête as an ideal time to announce the commencement of a fund-raising bazaar to be held in the Rotunda gardens every year.
Today, just like the leaves on the gift tree, the gospel message conveyed by the Sisters of Charity on behalf of the Temple Street Hospital fête all those years ago remains evergreen: ‘Whatsoever you did unto one of these’, a Times article of December 1888 ran, ‘my little ones you did unto me’.
More often than not, the domestic scene was heart-rending – the waxen face of a deceased parent surrounded by candles or a malnourished child lying on dirty straw. During the 1880s, Dublin was hit by an economic depression. As the number of children deserted by one or more parents increased, the wards began to fill with malnourished patients. Most could not be sent back into the community without some kind of support.
In December 1896, the Jesuit Irish Monthly – always a strong supporter of the hospital – printed a short drama written by Rosa Mulholland (Lady Gilbert). It began with two angels visiting a poor home near Temple Street (‘no bread upon the shelf. The ice-winds blow, and down the smokeless chimney whirls the snow’). Inside, sat a poor mother with a sick baby but help was at hand:
Hist! There are Sisters passing. Brother, come
And lure sweet Charity to this sad home.
See how they modest walk, each fair face hid,
Enveiled each eye beneath its snowdrop lid.
The second scene opened with the poor mother at the children’s hospital:
Here I sit by my babe’s cot;
Sweet he sleeps, his pain forgot.
Lightsome touched him with his hand
After just a little while
Baby Jim began to smile!
The following year, the Association of St Anthony of Paduaset up a fund to help local children and their families. Presided over by Mother Superioress de la Salle Hodgens, it drew a much needed source of income from the St. Anthony’s Annals – a popular hospital-produced magazine. Poverty was deep-rooted in Dublin however. In June 1923, one student nurse who had been educated in Edinburgh was surprised about the ‘dirty condition of children on admission’. A decade later, many families still depended on the hospital for support. The official report for 1933 describes the nature of this ‘Silent Service’:
Only he who observes those groups assembling at the Out-Patients’ Department each evening to receive bread, tea and sugar, meat, clothing, and those little tickets which mean the open sesame to milk and coal can realise that the dispensary is not finished when the doctors leave…then there is the whispered plea to the Sister in the ward of the black-shawled mother who is taking her cured child back to the same squalid surroundings and unthinkable hardship which but a few weeks ago had sent it in an ambulance to the hospital door.
In the decades that followed, the sisters continued to make home visits. They were particularly interested in the health of recently discharged patients and in the case of tuberculosis sufferers; an assessment was made to determine whether or not others living in the house had caught the disease. Coughing mothers or fathers were persuaded to attend hospital and in extreme situations, a relapsed child was ferried out to Cappagh or Linden Convalescent Home for further treatment.
What is most remarkable about all of this is that for the most part, the work was done in the absence of a formal aid-giving system. Later, a sister almoner’s officer was set up in the outpatient department and by the advent of the Second World War, the hospital was distributing an average of 40 food tickets per day – a figure that remained constant into the 1950s. The sisters visited approximately 300 homes a year, providing clothing and other essentials and sent some of the children on holiday to a home built for that purpose in Baldoyle.
It was not until the 1960s that the first professionally appointed social worker was appointed. In the meantime, Temple Street continued to reach out to the local community. The support and gratitude shown towards the hospital in return was often overwhelming.
Nowhere is this more evident than in the story of the ‘buried treasure’. Some years ago, hospital porter Michael Fielding was asked to clear out the old coal cellars. The first
artefacts he came across were some old wine bottles which he put to one side. Digging on, he was surprised to find a number of coins – some of them quite old. The reason for them being there soon became obvious. Many years earlier, the sisters had placed a donation box in the railings overhead. When the hospital was no longer reliant on voluntary funding, the box was removed but the cellar chute was forgotten. It is a testament to the loyalty shown by Dubliners that even without the box; they continued to drop in loose change as they passed by.
Throughout its long history, Temple Street Hospital has been about ordinary men and women doing extraordinary things on behalf of the children of Ireland. It is both an honour and a privilege to write about them and their achievements. Ar dheis Dé go raibh a n-anama.