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August 31, 2009

London Health Care, Medieval Style

St. Bartholomew's courtyard in the early 19th century by Thomas Hosmer Shepherd

by Clive Irving

Health care was a big concern in 12th century London. There wasn't any. That is, until a humble citizen called Rahere went to Rome on a pilgrimage. There he fell sick with malaria. Roman health care, it turned out, was so good that he recovered. And so it came to pass that to thank God for his recovery, Rahere returned to London and founded a hospital, in 1123, on a site on the edge of the city called Smithfield. The Roman hospital had been dedicated to the apostle St. Bartholomew, and that was the name Rahere gave to his London hospital.

Today it is a key player in Britain's National Health Service. A huge new wing dedicated to cancer treatment is just being completed. Smithfield itself is a storied location, still the home of London's central meat market (and, allegedly, the source of the phrase a bull in a china shop, when an animal fleeing its fate ran amok through nearby high-end stores). The core of the hospital remains four 18th century wings enclosing a piazza. And it was on the edge of the piazza that I found what is one of London's smallest (and least-known) museums devoted to the hospital's history, beginning with Rahere, whose tomb is in an adjacent church.

Within the few rooms of the museum you get a concentrated history of medicine through the ages--in fact, the hospital, having been there so long, becomes a palimpsest revealing, layer by layer, the progress (or lack of it) of the medical and nursing professions. For the first few centuries, treatment was a haphazard concoction of prayer and potions--herbal, chemical, spiritual. Later, St. Bart's pioneered techniques in surgery and drug treatment.

A crucial moment came in 1546, when Henry VIII, who was burning through money as fast he was wives, decided that socialized medicine (or at least the royal-funded variety) was insupportable and proposed to abandon St. Bart's. At the last minute the burghers of the City of London stepped in and Henry signed over the hospital to them. The legal document transferring control is in the museum and if you think modern litigation involves too much small print and too many prolix caveats, take a look at this one. Lawyers have been practicing obscurity a long time.

Two weeks after Henry handed over, he was dead.

There is another treasure attached to the museum. In the 18th century the hospital governors were looking for an artist to decorate a staircase and great hall, and were disposed to enlist a Venetian painter. Luckily, however, a local artist, born in Smithfield, offered to do it, free of charge. He was William Hogarth. This is the same Hogarth whose searing drawings of 18th century society, from the bottom (Gin Lane) to the top (The Marriage Contract), left an irreplaceable documentary record. Hogarth isn't generally appreciated as a painter, but the two works on Biblical themes he carried out for St Bart's--of The Good Samaritan and The Pool of Bethesda--are so different in scale to his drawings and so inimitable in their human detail (faces the equal of Caravaggio's) that they have immense impact. The paintings can be viewed by special arrangement every Friday afternoon; the museum is open Tuesday through Friday,10am to 4pm.

Further reading:
* Clive Irving, Condé Nast Traveler's senior consulting editor, on the hellhole of Heathrow's Terminal Five and the London Olympics
* Read The Daily Beast for aviation expertise from Clive
* Dispatches: On the road


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