Saturday, 5 April 2014

Dr Elizabeth Garrett-Anderson advises on 'cruel' cruises

Sometimes in researching my book on women's history of seawork the oddest connections emerge. I’d never have expected that Britain’s first woman doctor was interested in the sea.

But here Elizabeth Garrett Anderson is in January 13 1900 writing to the British Medical Journal to strongly warn against the myth that taking a sea cruise was restorative for patients with consumption(TB.


Several doctors at the time all said effectively, ‘use extreme caution before prescribing such a trip’ for patients with what they then called pulmonary phthisis. The reasons were summed up by Doctor Garrett Anderson.

On ships, she said, life was ‘almost exactly what would be carefully avoided in a good sanatorium.’

• It’s constantly violently draughty. ‘People have, perforce, to spend their days as if they were on a railway platform open at both ends and moving swiftly through the air.’

• If you have to take refuge in your cabin or even in a public saloon the air ‘is bad even in the day time …[and] intolerably bad at night time and when the ports have to be shut.’

• Often you endured all this lonely distress far from home and loved ones for six weeks, only to arrive in the Antipodes and ‘die alone in lodgings … [or] boarding houses.’



The BMJ pages had several items of public correspondence on this subject at that time. Doctors also pointed out that:

• people who had no money, would be sharing a very cramped cabin for four (meaning they accessed only shared and limited air.

• A busy ship at that time had only one doctor for 300 or so patients, and no nurse. Good health therefore partly depended on how many other people needed his help – and whether he was any good. And at that time ships' doctors tended to be novices on a kind of gap year; (the job was ill-paid, like working in McDonalds, so many doctors would only do it as a brief holiday, not with real commitment.

• If prostrated and debilitated by seasickness for a week or two, as so many steam passengers were, they would be in no fit state to hoist themselves up several companionways and go on deck to get fresh air.

So all in all, EGA concurred that ‘an ocean voyage is excellent for tired people if they are good sailors and have nothing organically wrong with them. To order it for anyone really ill is in the last degree cruel.’

EGA’s letter had the most impact of any of these ‘don’t do it’ letters on me. It’s not that I would say that about a heroine, wouldn’t I. Long before noticing the signature on the letter I was feeling impressed by how remarkably direct and cogent this writer was. Only then did I notice it was Dr Garrett-Anderson.

It turns out that she held that opinion after herself sailing to Australia in 1885. She found Sydney ‘full of stories of the suffering caused by sending consumptive patients across the sea.’