Agnes Arnold-Forster explores the portrayal of hospital care in Margaret Drabble's feminist novel.
Margaret Drabble’s 1965 novel, The Millstone, tells the story of Rosamund Stacey, a young female academic who was brought up by middle-class, well-intentioned socialists. When her story begins - the novel is written in the first person - she is working on a PhD on Elizabethan sonnet sequences, living alone in her absent parents’ London apartment.
Set in the 1960s, against the backdrop of the emerging women’s liberation movement, Rosamund has some freedoms (as much a product of her class and race as of her newly-politicised gender) but not others. She meets a man, has sex, and becomes pregnant. She experiments with self-induced, back-alley, and authorised abortions, but ultimately decides to carry the baby to term, give birth, and become a parent. The book manages to be, therefore, ‘both radical and a paean to motherhood’. It’s a fascinating novel with much to say about womanhood, motherhood, and life in 1960s London. As many of its scenes take place in doctors’ consulting rooms and on hospital wards it is also a novel which sheds light on the social and emotional world of mid-century medicine.
Rosamund recounts a blissful birth and a restful recovery on the maternity ward. She takes her baby, Octavia, home and settles back into the life of a mother and a working academic. When Octavia is just a few months old, she catches a cold: ‘At first it did not seem to worry [Rosamund], but then she started to wake coughing in the night, and when she breathed she wheezed terribly like an old sheep’ (p. 112). Rosamund prevaricates over whether to call the doctor but is eventually persuaded by her daughter’s high temperature (p. 113).
The doctor refers her back to the hospital, where she ‘waited, in a queue, with other small children and sordid array of teddy bears and other rubbish, for an hour and a half’ (p. 116). She speaks with the surgeon and then trails off to the X-ray department, ‘a good mile away it seemed through dark corridors’ and then back again to see the surgeon (p. 116). He recommends an operation and murmurs ‘on about the pulmonary artery’ (p. 117). The reader is never given Octavia’s diagnosis, partly because Rosamund is too struck with panic by the words ‘pulmonary artery’ to concentrate on what the surgeon says (p. 117). However, it is likely that Octavia undergoes surgery to correct a congenital heart defect.
As the surgeon goes on to say, operations of this type on babies so young were progressing quickly but still in their very early stages, ‘As little as five years ago, in an infant of this age, I should have said that the chance of survival was about five to one. Now we would put it at four to one, I think’ (pp.117-118). Operations to correct congenital heart defects symbolised technological advance in mid-century surgery and were frequently reported in the popular press. These articles told stories of heroism and success against the odds, and framed surgeons as life-saving risk-takers. An article published in Woman’s Own in 1954 described the case of Pamela, an American child who underwent open heart surgery while being kept alive by cardiopulmonary bypass: ‘In her desperate bid for the right to live, baby Pamela needed the help of a miracle. And it came - in time - when doctors discovered this wonderful new method of heart surgery’ (p. 18). Articles like this one that romanticised the role of surgery were a regular feature of Woman’s Own, a British magazine with a circulation of millions. The Millstone was, therefore, part of a broader cultural landscape in which healthcare and its potential played an increasingly prominent role.
However, surgery occupies an ambivalent position in Drabble’s narrative. The surgeon who offers to operate on Octavia is presented as detached and disinterested - an emotional state that damages his relationship with Rosamund and only heightens her suffering. She says that while he was describing the operation, ‘I could see that he was not really attempting to explain’ (p. 117). She goes on to reflect, ‘It has never ceased to amaze me that they showed, at this stage, so little professional sympathy; I see now, and suspected then, that his only emotion was professional curiosity. She was an odd case, my baby, a freak’ (p. 17). The Millstone reflected and reinforced the pervasive stereotype of the masculine, stoic, and emotionally illiterate surgeon.
It is not just surgeons who the novel portrays as distant and disinterested in Rosamund’s affective tribulations. Throughout the novel, the hospital is described as an emotional dead-zone disrupted by only maternal distress. The nurses, too, work to maintain this affective landscape and keep the institution emotionally ‘sterile’. After Octavia’s operation, Rosamund returns to the hospital hoping to see her baby. However, she finds herself ‘met by a certain unhelpful stalling’ and while the Sister assures her that all is well and that the operation has been a success, Rosamund is told, ‘with calm certainty’, that she’d be unable to visit her baby for roughly a fortnight (p. 124). This restriction was not unusual and in the 1960s visiting hours were limited even for infants and young children.
The nurses have clinical reasons for keeping the mother from seeing her baby, but also provide an emotional rationale (and the two blur into one). In response to Rosamund’s questioning, the Sister ‘embarked upon a long explanation about upsetting children, upsetting mothers, upsetting other children, upsetting other mothers’ (p. 124). She used ‘smooth even tones’ to try to calm Rosamund into submission and maintain the emotional landscape of the hospital in accordance with her vision of affective healthiness (p. 124).
Rosamund is undeterred, however, insisting that she won’t leave, ‘I don’t want to be compelled to wander round upsetting the whole of your hospital until I find my baby’ (p. 128). Eventually, they relent and Rosamund is allowed to see her daughter, but only after she screams and screams. The taciturn surgeon comes to her rescue, recognising her as the daughter of one of his friends. Rosamund’s position as part of the educated middle class allows her to circumvent the hospital’s rules and side-step the Sister’s desire to keep the place calm, quiet, and free from maternal distress. The Millstone, therefore, not only causes us to reflect on love, female identity, and motherhood but also gives us an insight into the social and affective conditions of the postwar British hospital. It represents and reifies stereotypes of surgical dispassion and demonstrates the elision between emotional and physical wellbeing that was fundamental to healthcare practitioners’ efforts to maintain order and restraint on the hospital wards.
 Margaret Drabble, The Millstone, (Penguin, 2016)
 William Peters, ‘A New Heart for Pamela’, Woman’s Own, (December 16th 1954)