Spike Island: The Memory of a Military Hospital

BMJ 2002; 325 doi: (Published 06 July 2002) Cite this as: BMJ 2002;325:49
  1. Alex Paton, retired consultant physician
  1. Oxfordshire

    Embedded Image

    Philip Hoare

    Fourth Estate, £8.99, pp 423

    ISBN 1 84115 294 3


    Rating: Embedded Image

    On 19 May 1856 Queen Victoria sailed across the Solent from Osborne House on the Isle of Wight to lay the foundation stone of the Royal Victoria Hospital at Netley. The site was on a spit of land—between the Itchen and Hamble rivers overlooking Southampton Water—known as Spike Island, a name which Philip Hoare, who grew up nearby, says is shrouded in mystery, although a glance at the map suggests that the area looks like a spike. The dimensions of the new hospital were awesome: said to be the largest in the world, it occupied 200 acres of landscaped grounds, and its frontage was a quarter of a mile long, with 138 wards on three floors to accommodate 1000 patients. It was “as though a Venetian palace had been erected on the scale of Versailles,” said an admirer, and the only way the whole could be photographed was from a balloon.

    The first thing that confronted anyone entering the imposing central tower block was a large museum of natural history and anatomical specimens; beyond were the more prosaic offices, a chapel, and the nurses' quarters. On either side, immensely long corridors provided access to the two ward blocks, one medical, one surgical, made up of small, gloomy wards with little natural light and poor ventilation. Netley was the first military hospital to employ female nurses, who were trained at St Thomas's Hospital; a medical school was also established, and early teachers included Almroth Wright and William Leishman.

    The hospital was overwhelmed by the casualties of the 1914-18 war, so that hutted hospitals had to be built in the grounds to provide another 1000 beds. Ambulance trains arrived almost daily at Netley station, and during the battle of the Somme 30 000 wounded and sick were delivered by 151 trains. Hidden away behind the main hospital was the Military Lunatic Asylum (D block) which, led by Arthur Hurst and J H M Symns, played an important part in treating casualties with mental illness and shell shock.

    Netley was again under pressure in the second world war; in 1944 it was handed over to the Americans, and from D Day on received some 68 000 casualties, including 10 000 Germans. But its days were numbered and by the 1950s only D block continued to function. Demolition began in 1966, but a last minute plea to save the chapel and central tower was successful and a new museum was installed. The asylum closed in 1978 and the landscaped gardens became a country park.

    Hoare admits that he was “haunted” by Netley, and anyone expecting an objective history will be disappointed. His tale is a speculative, self indulgent, and overblown mix of his own unremarkable life story; a Gothic fantasy fed by a belief in psychic phenomena, and a biased approach to military medicine, and especially psychiatry, which he regards as a brutalising form of restraint and manipulation. The sad story of a grandiose vision deserves better.

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