Many Lakeland families can boast of grandparents and great-grandparents who lived active and healthy lives well on into their eighties and even nineties. Yet they had no comprehensive health care; calling the doctor was an expensive measure only resorted to in extreme illness, and it was well after the First World War before the trained and trusty district nurse wobbled into view on her bike.
This month, The Way We Were examines health from cradle to grave, and just what sort of health care was available to country people, who were, in so many ways, far more fortunate than town dwellers.
Country folk ninety years ago had a better diet of fresh food than people living in towns; even the very poor hardly ever went hungry, and country water supplies were usually cleaner than polluted town supplies. Added to this, families in Westmorland enjoyed cleaner air and wide open spaces in which to live, so serious epidemics of disease were less likely to occur.Their jobs, which were chiefly out of doors, were also healthier than the noisy, airless mills and factories where town people were forced to work twelve hours each day.
But when a country person did fall sick, or a woman in labour needed her baby delivering, the "nurse" would be called first before anyone contemplated calling the doctor. Each country village always had a woman well versed in simple remedies, who would nurse the sick, care for the dying, lay out the dead and deliver the babies. Nearly always untrained, these country women were usually paid for their services in butter, eggs, or meat and for many of the poor, these ladies were the only help available until the arrival of proper trained nurses:
"She sat up with people, she nursed people, she laid them out, she brought children into the world and if she was there the doctor never bothered to come... and they always used to say if it was her going out in her blue coat it was either to bring'em in or taken 'em out of the world!...for a very long time she was the only midwife and she never lost a child, she never lost a mother and she never had a set of twins."
Sometimes the doctor would be asked to make up some medicine, which the "nurse" would administer:
"...she never used anything else, only the medicine the doctor brought. The doctor used to come round and he'd have three bottles. If it was a cough it was a brown bottle, if it was stomach it was a white bottle and if you had pains it was a pink bottle.
"...She didn't want anything, didn't charge anything, you just did it because it was friendship. If it was a farmer he might give her a dozen eggs..."
Before the last War, it was as rare for anyone to die in hospital as it was to be born in one. Birth and death took place at home, and it was unthinkable for the dying to be transferred to hospital. But caring for the dying at home put great strain on the family and often involved the "nurse":
"You used to sit up with people in those days, they never went to hospital. You sat up all night and sometimes all day."
When a death took place, the "nurse" traditionally laid out the body, and even after the first trained district nurses arrived, it was unheard for the professional nurses to perform the task. It was always left to the village "nurse", and her equipment was simple.For a laying out it was clean cloths, boiling water,lots of strong mints to suck to counteract any unpleasantness and a large white handkerchief. Everybody then came to view the body, even the children.The clocks had to be stopped at the time of death, the windows shut, the blinds drawn and the clocks were only re-started when the body had been removed from the house; and the house was never left empty at the time of burial. A friend remained behind until the funeral party returned for cold ham and beef, pickles and bread and butter.
A confinement usually began with the nervous husband requesting her to "come and do the necessary"; but her bag was already prepared:
"I can remember her always making a linen thread ready, with her scissors and everything in a bag so that when she was called all was ready. She sterilised, she boiled everything, there was always boiling water ready where she was at and her kit for delivery was scissors, cotton wool, and four-stranded linen thread."
Some families belonged to a club and would pay about two shillings a month to cover any visits from the doctor that might be necessary. Others went without proper help:
"The nurse was called first because you often didn't pay her. It was an expensive business, being ill and I suppose some people would refrain from calling the doctor when they should have had him."
Nor was the untrained village "nurse" as clean sometimes as she might have been:
"If women in childbirth didn't go to a doctor or a nurse, they could die. They weren't all very spick and span, the village midwives, the thing was to get the district nurse in, they put things right."
In the 1920s and 1930s, the district nurses arrived and gradually took over from the village amateurs, and it wasn't long before their expertise and dedication soon took them to the very heart of village life. So trustworthy and dependable were they that families scrimped and saved to afford the better service that the proper nurse offered:
"The district nurses were awfully nice, they absolutely made village life, such a help...they had a tough time, building up the service, I remember my husband ( who was a doctor) fighting for getting the nurse a car when cars were first used and peoples' attitudes were, 'Oh, she does alright on a bicycle'. All the way up Langdale on a bicycle! Out all hours on a bicycle, doing a job like a nurse's, they were so casual about it, they needed stirring up."
The transition from amateur care from the village's 'wise woman' to the professional nurse sometimes caused illwill and jealousy, but not if handled sensitively:
"My mother brought all the children into Little Langdale. She was never licensed. The doctor wanted her to take a license but she'd never do that...so I was going to start to do the same thing, and then in April there was a nurse came, she was a very sweet nurse, they had her at Langdale for a long time. And she didn't hurt my mother, she said she was sure she couldn't manage the first time, she wanted Mother to help, and that suited Mother down to the ground because she was beginning to feel just a little bit - well...she'd always brought everybody into the world, and everybody out...I think that would have been the 1930s, I don't know actually when the nurse came, but up to then my mother did everything."