I grew up with a knowledge of mental illness: of people locked in large institutions and of those who cared for them. My mother worked as a nursing assistant in one of those institutions, two nights a week. She brought home stories about patients who should not have been there in the first place, or had suffered short bouts of mental ill health thirty or forty years before and were never released.
I remember going to a summer fete at the hospital; seeing the extensive, well-kept grounds. I remember, as an adult, giving my mother a lift to work and walking the corridors with her to the ward; long, glass-sided corridors that seemed to run for miles. I remember walking past the laundries with their huge boilers. I don't remember seeing a single patient.
In July 2008, I heard a news story on the Today programme on Radio 4 by the reporter Angus Stickler. It was about women typhoid carriers who were locked away in a mental asylum – Long Grove Hospital in Epsom, the town where I grew up. Long Grove was familiar to me as a place where aunts and friends of our family worked, and as a neighbouring hospital to the one that employed my mother. My ears tuned in; the radio no longer a background buzz to my breakfast.
These women, who had contracted typhoid fever and continued to carry it in their faeces after recovery, were locked away in the sanatorium ward in Long Grove. None of them was mentally ill when they entered the hospital, but they needed to be kept away from a population that was afraid of infection. What place more isolated than a mental asylum in the country?
Before the advent of appropriate antibiotics there was no cure for typhoid carriers and the women were effectively condemned to a life sentence in the hospital. Some were treated and cured, and were released from isolation, but were sent to other wards in the hospital. Some of them were, by then, badly mentally deteriorated; some remained lucid. None of them went back to their homes or former lives; none of them received visitors, or had families that inquired about them. In those days, the stigma of having a relative locked away in a mental institution was so great that people just disappeared and were never heard of, or mentioned, again.
Some women remained resistant to the antibiotics and lived and died in isolation. One woman lived in a single room for the last six years of her life, and remained 'compos mentis' to the end, with her only company the nurses, the newspaper and a small television.
I looked on the BBC website and read more about these forgotten women. There was a list of their names and a request for information from anyone who might recognise a family member who had disappeared. That list made me weep. A former ward manager, Jeanie Kennet, spoke of the women with affection, spoke of them as her 'family'. The women had received loving care from some of the nursing staff, despite their instructions to merely feed and water them; to warehouse them.
Forty-three women were admitted to the ward between 1907 and 1957: some died and were marked as 'deductions' in the hospital records; others remained in the hospital until its closure in 1992. Rosina Bryans, one of the typhoid carriers, spent 60 years in the hospital and was transferred to another asylum when Long Grove closed.
On a trip to Ireland the year before hearing this programme, I met my father's cousin, Nellie. She told me of her sister, Norah. Norah had left Mitchelstown, Co. Cork, to go to London and train as a nurse. This was in the 1940s, a time when English hospitals were advertising for Irish girls to come and train as nurses and work as domestics. Nellie told me that Norah came home to Mitchelstown on holiday and got into rows with their father. She was out late, dancing, and she wanted to smoke at home, which he would not allow. There was a big argument. Norah went back to London, and was never heard of again.
Norah haunted me: what if she were still alive; what would her life had been like; did she regret her break from her family; was it the making of her; what if she were killed shortly after returning to London, run over by a bus? How easy it must have been, in those days, to disappear without a trace.
Then the story came to me: what if Norah were one of those women locked away in the typhoid ward in Long Grove Hospital? Norah became Noreen, and the story began.
I decided to start writing in the first person, as Noreen, early in the morning, shortly after waking. I was writing in a semi-conscious state, slightly muddled, emulating Noreen's state of mind. I wrote episodes from her current life and from her past, disjointed scenes and memories. Some of these were based on my mother's stories of hospital life, some on other family stories of emigrating from Ireland in the 1940s and 50s. Some details were drawn from the true-life accounts in Across the Water, Irish Women's Lives in Britain (Mary Lennon, Marie McAdam, Joanne O'Brien). Bits were added to the story as I saw them, and as they occurred to me. While picking blackberries, I was reminded of doing this as a child, and that my father would never eat them, like Noreen's father in the story. The shabby dress that Noreen's mother wears is identical to one I saw worn by an older woman who was tidying her garden, complete with slip hanging below the dress. The taffeta dress that Noreen wears to dance is one I saw on an antique stall in Harrogate. There was yellow enamel jewellery to go with that dress; it didn’t end up in the story, but I knew Noreen was wearing it.
Then came the task of joining these episodes in a way that could be understood, without losing the manner in which Noreen's thoughts jump between past and present, her hopes of cure and release and despair. There was a great deal of reordering, and reading the story again recently, I'm not sure I got it right.
An even greater task was revealing the fact that Noreen is a typhoid carrier. My first attempt was clumsy, ending the narrative with a simulation of the radio interview that Angus Stickler (the reporter on the Today programme) conducted with Jeanie Kennet, ward manager. I showed a draft to the tutors on an Arvon writers' retreat, Julia Bell and Martina Evans. Both liked the story, but strongly disliked the ending. More subtle reveals were suggested and the idea was planted that Noreen was a woman of appetites, and that somehow her appetite should be linked to her downfall.
I went home and did some more research on typhoid: how it is contracted; symptoms of the fever stage (hence the reference to pea soup in Noreen's narrative); when the antibiotics became available that cured carriers, and why some people were resistant to them.
I also thought more about Noreen's appetites. She loves women, but is denied fulfilling that appetite, partly because of her own inhibitions as an Irish Catholic of that era, and because there is no indication that Shrub reciprocates her love. There is also Noreen's love of food. The story begins with a list of meals, the way that Noreen marks the passing of the hours and the days in Long Grove. She loses her appetite after Shrub marries, then regains it at the restaurant meal with Sid, allowing him to touch her knee beneath the table:
“but it was the food that got me going, not him. It was all I could do to stop lifting the plate and licking it clean. After Shrub married, I got so thin that my curves all but straightened, but my appetite returned that night. And a hand on my knee beneath the table, which did nothing for me, but I let him.”
That night is her downfall. Literally, she contracts typhoid from someone working in the restaurant kitchen.
“That was the night that did for me: someone in the kitchen of that restaurant. Someone that was a typhoid carrier like I am now, not washing their hands, passing it on to all that ate there.”
Metaphorically, the typhoid is a punishment: not for being a lesbian, but because she is denying her true nature by allowing Sid to make love to her, when it is Annette Shrub that she loves.
“He drew me onto the bed beside him, slipped the dress from my shoulders and kissed my neck. His face was red; he was breathless. I shouldn’t have led him on, so.”
Poor Sid – I feel for him, and some readers have asked what happens to him. That is not my story.
Lastly, the title. Some readers have disputed the use of Katharine Hepburn as an unattractive woman as compared to the other Hepburn, Audrey. Noreen's views are mine, as are her favourite films. I have seen The Nun's Story (Audrey Hepburn) more times than I can remember. Noreen's reaction is indeed my own:
“The times I saw that film, and each time the tightness in my chest, a hankie at the ready when she goes into that room at the end of the film, to leave the convent, and she gets her old clothes back, the ones she came in with, and there’s no one there to say goodbye, as if it’s a disgrace, wanting to go back into the world.”
As for Katharine Hepburn, I suppose she is attractive, but ugly at the same time. She looks too skinny for her frame in her films. Personally, I have always wanted the gamine frame and look of Audrey Hepburn, but like Noreen:
“I could never be like Audrey Hepburn; my hips are too wide.”
'Life Sentence' http://news.bbc.co.uk/today/hi/today/newsid_7523000/7523680.stm
Across the Water, Irish Women’s Lives In Britain, M. Lennon, M. McAdam, J, O'Brien (Virago 1988)