Memories of the workhouse.

  • John Launer
  • Published 2015 in Postgraduate medical journal


I trained as a doctor at the Middlesex Hospital, close to the centre of London. When it was built in the eighteenth century, the Middlesex was on the very edge of the city, in open fields, but London swallowed it up and then extended a huge distance beyond. The hospital found itself close to the capital’s main shopping streets and private medical consulting rooms. It became a leading national centre for patient care and for training. Then history had some more tricks to play. In the 1980s, all the medical schools in London were reorganised, and it was merged with the hospital at University College London (UCL) – originally founded because the Middlesex had refused to allow UCL students onto its wards. It was then demolished to make way for a massive commercial development of shops and expensive apartments. Only the listed chapel – a fantastical gothic creation from the 1920s, with a marble interior and mosaics – has been left intact. Some of my memories of training at the Middlesex are good, but others are not. Among the most uncomfortable ones are from the out-patient clinics. These took place not in the main hospital but in a drab brick building a hundred metres further north, in Cleveland Street. Patients sat massed together, all waiting in one large hall. The doctors sat at desks at the front of the hall, and saw each patient in full sight of everyone, and within earshot of the front rows. There was a distinctly ‘poor law’ feel about the place, as if patients should be grateful to be seen at all, even if their suffering was a public spectacle. Some of the doctors – although not all – had attitudes that reflected this. Once, in a side room off the main hall, I witnessed the most horrible consultation I can remember. In front of at least a dozen medical students, a famous surgeon broke the news to a middle aged man that his cancer would require removal of half his face. With an ineptness that makes me wince to this day, he stuttered out a ghastly mixture of hints, euphemisms and evasions that forced the man to confront him, in order to elicit the full horror of his disease. If I could have chosen one word to describe both the place and its proceedings, I probably would have used the word Dickensian. Strangely enough, the word would have been entirely apt.

DOI: 10.1136/postgradmedj-2015-133436

Cite this paper

@article{Launer2015MemoriesOT, title={Memories of the workhouse.}, author={John Launer}, journal={Postgraduate medical journal}, year={2015}, volume={91 1075}, pages={299-300} }