OCTOBER 1954
HOW CAN I GET A PLACE IN A LONDON UNIVERSITY MEDICAL SCHOOL?
A significant problem during my last few months at Queen’s College was that there were no Careers Masters there who could offer advice as to, having obtained a Scholarship from Devon Education,how I could apply to a Medical School in London to be considered[or not] for a medical student place .
This was late in 1954 and anyone wanting to apply usually went to Bristol, if successful, ‘cos it was nearest my home.I wanted London or bust!
In 2020 this would have been easy..look it all up on Google and get the application forms e-mailed,send them back,completed, and wait for a yea or nay.When you are a raw,unconnected 17 year old from a country farm,however ,there are seemingly a myriad of obstacles in the road.
After much research and a long, long wait, I found a competent typist and, with references and a short CV in hand,licked the sticky stamps, kissed the envelope,said a selfish prayer,and posted my effort to the Registrar of the Board of the famous Charing Cross Hospital,Chandos Place(behind Trafalgar Square and St Martin’s in The Fields,London).
Charing Cross received 1500 applicants a year and accepted 45,of which 20%(9) were women.It was named after one of the twelve Crosses built by Edward Ist in 1291 to commemorate his wife’s (Queen Eleanor) coffin journey in which,on her death,she was carried from Lincoln to Westminster Abbey, and at each overnight stop a Cross was built.The Charing Cross memorial was pillaged and burnt by the Puritans in 1647 though a number of others remain in place in the 2020’s.
A short list of applicants was chosen for interviews with the Board.
Some weeks later I was invited to be scrutinised by a squad of
seriously important, famous Board members.
Chair was Prof William Hamilton,a huge Country Antrim man with a prominent jutting jaw (he of the many Anatomy and Embryology books and Dean of the Medical School) assisted by Dame Josephine Barnes(as she eventually became after a star studded career as London’s very top operating Gynaecologist).
She gained Fellowships galore,Awards by the score,hundreds of publications, five Caesarian Sections herself to deliver her children and a visit to Buckingham Palace to collect her well deserved gong.
Dr “Bomber” Brown ,Prof Tony Glenister, Medical and Surgical Specialists from the Hospital made up the rest of the Board.
The previous candidate exited, unexcited, having been grilled about Chemistry and other academic stuff. I took two big breaths,wiped some shine onto my shoes from my trouser leg,checked my cutaway collar,waistcoat and grey and white silk Thai tie and answered to the Porter’s call of “Alan Mark Tucker”.
Well,they couldn’t have been more charming ;questions about holidays i’d taken,newspapers I read (and why),nothing about whether my parents were medical,no nasty Physics,Chemistry or Maths.Easy p easy.
Then they got stuck in!!
In the 1950’s, it seems that the Medical School had lost a number of fine Rugby Union players,depleted as a result of the Hospital Board’s willingness to only let them pass their final qualifying exams, after about the fourth or fifth time,thus retaining their sporting services to regularly play in the all important, all encompassing Annual United London Hospitals Rugby Cup.
For the uninitiated in Rugger matters, Guy’s Hospital ,in the 1950’s, sported a number of South African Springbok International Rugby players in what was a Club with a virtually unblemished record over every British Isles Rugby Club for 3 years.A win in”The Cup” held great esteem in the ranking of Hospital events of greatest importance annually. The Times and Telegraph newspapers took much delight in devoting large columns of all the intricacies of the matches and the social happenings there.
Whatever has that got to do with me,a boy from the country, struggling through an interview with my elders and betters?Simple!!Charing Cross were having huge difficulties,re-enforcing their depleted Rugger team,especially with nine new women coming into the student fold each year,so that anyone applying,with an oval ball background, probably had a red flag placed discreetly in an appropriate spot to indicate “another player to help fill the depleting swamp and I think we should nab him before he disappears to Guy’s,St Thomas’s,Westminster or St Bartholomew’s.
Yes, I did play in seven Hospital Cup matches eventually, and we won two games, not Hospital Cups.
I smiled briefly as I left the Board room,aware of the kindness extended toward me, yet I feared a final exit to my long held aspiration was about to descend and crush me.Prof WH towered over me at the door,offered his plate sized hand,looked me in the eye and said”Welcome to Charing Cross, lad, I’m sure you’ll fit in here fine.”
He was a man of stature and talent,a fierce but fair Anatomy examiner and a Rugby supporter, whose booming voice on the touchlines, put the fear of God into the hearts and heads of both opposing teams at the same time.He was also a most delightful, approachable mentor to his students and was always there for anyone who needed his advice and presence.
I recall an Anatomy Examination day when my mate Richard ,whilst undergoing an important exam with Prof,was chastised for failing to remember the ossification centres in the human femur, a difficult question but one which usually resulted in a pass or fail answer.Prof gently struck Richard across the top of his skull with the knob of the femur bone and boomed “What’s that lad?”
Richard retorted ”That’s my head sir!”
Prof replied ”Yes, so it is lad, and the femur’s got one too and it’s got an ossification centre in the middle of it .Don’t ever forget it!”
Richard a soccer goalkeeper who became an Orthopaedic and Sports’ Surgeon, meekly responded ”I won’t Sir,as soon as I’ve got rid of my headache”.
CHARING CROSS HOSPITAL MEDICAL SCHOOL
On the first day of starting Medical school things are pretty chaotic and very
different.You know nobody,dozens of admin people are chasing you, with tons of complex documents, and you’re not quite sure where you are ‘cos you’ve never been to this place before. You’ve travelled, from your lodgings which you’ve never stayed at before last night, on buses and Tube trains from stations that you’d not heard of, let alone travelled to and from until a hour or so ago.
London is busy,noisy,full of barrow- boys, a bit smelly, because the Clean air Act hadn’t yet cleaned the air up, but people are friendly, trusting ,not too pushy and it’s 1955.
You just hope that it’ll stop raining for a little while so that you can collect your thoughts,roll up your Dad’s old brolly,find someone who knows a bit about the drill and take it from there.
Of course,every student feels exactly like you do unless they live in London,know the place, like the back of their hand, and Mummy or Daddy have just dropped you off from their shiny Rolls,Daimler,Jag,Mini or clapped out Wreck outside of the Main door.They will then have hugged them,filled them with warm fuzzes and said that important goodbye line .. “Do give Prof Willy a big hello from the family darrrliinnggk…byebyeeeee!!”
There wasn’t a clapped out old Wreck to be seen,so it was probably wise that my Dad didn’t offer to drive me up from Devon in our noisy old Morris MUD 982 after milking the cows and cleaning out the sheds at 4 am.
I slid silently into a not too obvious, quiet looking, vantage position and realised that a few weeks ago, at Queen’s, I had been well known and popular with the populous. There were former pupils’ Sports and Achievement plaques from floor to ceiling in the Main Hall, a number of which already had my name recently embedded in the brass.But, that was then, and now is now.
Here I was , an unknown, well brylcreemed,smartish, name- badged young male among many persons of both genders who also had,almost certainly been awarded multiple brass plaques with their names scratched in by their London engravers and plonked in prominent places visible to all and sundry.
Gradually we were individually introduced to everyone then collectively advised on all manner of things, finally being invited to a very informal evening of free food and drinks at the Lemon Tree Pub,40 metres away at 5 pm that very evening.
The Lemon Tree has been a famous watering hole for Charing Cross students, doctors and their partners for over a Century. Countless actors and actresses were regular attenders because it was in the heart of Theatre land.It was not exactly an initiation evening but rather an invitation to dip your feet into what most people do some of the time!
“Shandies all round please,barman Bennie!”
Bennie owned The Lemon Tree.He was a brilliant saxophonist,had a great four piece band,which provided all of our ”dance floor snog music” at the weekend and regularly played with Humphrey Littleton at his infamous 100 Oxford Street gigs.
It was at The Lemon tree,after a Rugby match,about a year later, that a guy came up to us and said he was looking for a team with which he could play an occasional game of Rugger because he missed playing nowadays.
He said that his boss was always Overseas, and,if it was any help he had a pretty roomy vehicle with which he could take 3 or 4 team mates on a Saturday to the game and bring them back to the Medical school after the match.
Well, you could have got killed in the rush because most of our Rugger matches were 30 or 40 miles away outside of the City.
Barman Bennie confirmed that our new chum, Bernie, was a good bloke and very genuine,so the following Saturday,true to his word,he arrived as planned,and, true to his word,he picked the four of us up and plonked us in his “pretty roomy vehicle.”
OMG !! Look at that Number Plate………..VLO 1 !!!!
Yes,Bernie was a real find…he was Vivienne Leigh and Sir Laurence Olivier’s
private chauffeur who looked after their Roll Royce whilst they were travelling Internationally.He would then taxi them around London Town, or wherever they were performing in England when they returned.
He did play some games in the lower grades,wasn’t the best or worst player ever to grace a Rugby ground, but was a great short term
Chauffeur to us and a good mate. Bon Vivant Bernie.
SOME BODY HAD TO BE IN THE DISSECTION ROOM.
Charing Cross was well known for the high standards of the teaching of Anatomy.Prof WH was the Dean and his reputation for being a fierce,fussy, but fair examiner was a planet- wide fact.
All Medical schools taught Anatomy and used Gray’s Anatomy and Dissection Manuals with complex illustrations and instructions to guide the wary candidate through the gory details.
Every care and respect was paid to the donated bodies so that any suggestion of improper or inappropriate behaviour in the hallowed dissection room was treated very seriously and could even get you kicked out of the course altogether.
WHAT’S ANATOMY ALL ABOUT ANYWAY? DOES IT HELP YOU AS A DOCTOR?
In 1955 there were no Ultrasound, MRI, PET or CT Scan Facilities available to assist diagnosing. A reliance on an excellent knowledge of where, and what everything was in, or on the human body,together with a top quality systematic clinical examination, was the essential ‘sine qua non’ to equip yourself with when you examined patients.
Anatomical detail is a bit less important in a Medical school’s curriculum in the 2020’s,unless you want to be a surgeon. This is because every human orifice can be entered with fine precision using flexible wiggly instruments with biopsy cutting facilities and video attachments.
What organs can’t be entered can be focused on by up to date Radiology dept equipment with little, if any, physical or financial discomfort to the patient. All of the films are either live or in black or white or glorious technicolor.
Six student Colleagues acted as a dissection team, and, guided by an Anatomical Lecturer, were taught, on site, and examined weekly as a group after each completed dissection.
Over a period of two years your team shared and dissected nine areas of each of the major six body components…..The Arm, Chest, Abdomen, Pelvis, Leg, and the Head and Neck.
The cadaver bones were not damaged during dissection . Specially articulated skeletons,either real or plastic ones, were provided for lecturers and students to study from. Our skeleton was respectfully and fondly known as Napoleon because he had spent much of his life in France and was “Full of Bony Parts!”
There are a number of very important Legal Acts which govern all aspects of the management of Human tissue in all of its forms and these must be very strictly adhered to by all partaking Organisations.
There was one small snag associated with the weekly group exam.Questions were asked in rotation around the table, and,traditionally, if one person failed to correctly answer any of the questions, asked of them, everyone was failed. You had to come back next week to repeat it all over again.
This was quite clever,and without any resort to a Union appeal, so everyone made sure that everyone else had put in the hard learning yards.A sort of ”All for one,and one for all,Musketeer dilemma.”
The other major subjects covered during the first two years were Physiology,Biochemistry,Histopathology,Pharmacology and Therapeutics.
It is a surprise to many that there were rarely any contacts with patients on the Wards clinically, until Third Year. During the last 40 years most Medical Schools have tended to introduce “Community Medicine” topics and “Behavioural Science” teaching early in the very first term.
This emphasises the importance of the needs of real people and families as they live and work in real places in real worlds.After all, looking after people is why we chose to serve as doctors in our Communities in the first place.
HOW MUCH STUDY DID YOU NEED TO DO IN THE EVENINGS ?
I found that I needed to study for at least 3 hours on 5 evenings a week after I arrived back at my lodgings, just to keep up with the Anatomy & Physiology workload.After a while,of course,you get into your routine and are rarely interrupted except for the odd short phone call.
Remember that Apple, Facebook, Instagram, Smart phones and Smartwatches, Fit Bits, Apps, Sky News, My Health Record, Netflix and Microwaves didn’t appear until some 50 years later.
I would never have dreamt that the hate behaviour of Metastatic Wokeness and Cancel Culture would run riot in the 2020 Social Media. Neither could I have imagined that a virus, called COVID-19, would rampage,across the whole world, infecting 70 million or more people, and devastating the social, physical, economic and mental health fabric of tens of millions of those who survived and those were never actually infected themselves.
I still had my Bakelite BBC radio in London. A great Rescue Remedy that I would turn on, and leave on, until I tucked myself into bed, turned it off and fell into arms of the Goddess Morpheus.
Bob Dylan, in 1964, had a lot of foresight, as well as hindsight, when he sang his archetypal folk song lines …”The Times they Are A-Changing” …. and …..”When will they ever learn,when will they ever learn.”
TIME TO VISIT CLINICAL WARDS AND TALK TO REAL PEOPLE
Today was the first time that had I talked to a real patient who had a real illness,and was in a Major teaching hospital ward bed.
Of course my relatives and friends in Devon,even when I was a humble Pre-
Clinical quasi-Anatomist,thought that I was a full fledged doctor and pestered me with their own “worried- well” symptoms. Occasionally they would ask “udderly” irrelevant questions about the milker’s node viral warts, that were transferred from the cow’s teat onto their fingers when milking their cows. Mad cow disease, cat scratch fever and tetanus were also favourites.
WHAT’S IT LIKE ON YOUR FIRST VISIT TO A WARD?
You had to look clean and smart, have well shone shoes, wear a short white coat, carry a patella hammer, have a bright torch visible in your breast pocket and be capable of flourishing your posh new cardiac stethoscope,. That would clearly delineate you as a medical student and not a ward clerk.
Only real doctors wore long white coats with the word”Doctor”, and “Hospital Ward” prominently displayed.Consultants could easily be insulted by being asked to give their name to Security. It was theoretically possible for a relative or stranger to start a ward round with a new Sister or Locum Nurse before the penny dropped.This actually happened to 40 year old Medical student colleague, Rendle. Rendle was a man of great empathy and many talents and had worked in a number of interesting jobs in a number of interesting countries. He was visiting the Medical ward ,as a student,sans white coat, for his very first time. Rendle was spotted by the Sister in Charge who mistook him for the brand new Consultant Physician
who was to arrive in the Ward that day to undertake his first ward round.
Sister,usually a grumpy old woman, charmingly invited Rendle to start the ward round .She provided him with a copy of each of the patient’s notes which she took from a mobile trolley as she wheeled it from bed to bed.At the end of their shortish ward round Rendle,repaying her charm,proffered his gratitude and left the ward .The twain were not to meet until the next
weekly ward round when Rendle arrived wearing his short white student’s coat, shiny shoes ,patella hammer in hand, torch in breast pocket and flourishing his brand new cardiac stethoscope. The Consultant provided a splendid teaching ward round for Rendle and the other five younger students of his clinical team but Sister was horrified and was never allowed to forgot it.
The Anatomy dissection teams from Pre- Clinical School again worked together as a Clinical Group when we started seeing patients on the wards.
Our team was Colin,Tony, Ken, Sally, Martin and me and we all got on famously well in every aspect.Tony and Ken were Soccer players who were both London Amateur Division League players.They were the best players in the United London Hospitals Team.Sally was a Sporty, sometime hockey player,already married to a super husband.Martin was a 10 Handicap golfer and Colin was, to say the least, our brightest and best.Colin eventually won the Governor’s Gold medal in the Hospital Finals’ exams, was chosen for every job he ever applied for in the future, became a top Consultant at a very early age, accumulated accolades as if they were going out of fashion,and was knighted (Sir) in his early 60’s. In his last Wikipedia mention, 2020, he was an extremely powerful and important person,professionally, in many European Countries and a top WHO International Adviser in Malignancy matters.
A famous Sculptor provided The London Hospital Museum with a bronze head and neck job on Colin, which will rest there forever, deep in thought , remembered, admired and, as always ….. polished.
I was the last of our Clinical team, and , apart from being awarded the only Hospital Year prize [for Pharmacology and Therapeutics] that escaped Colin’s clutches, I just managed to come second to him in The Hospital Surgery Prize…he won the $150 prize and I was given a Certificate of Merit (and no money ) .Every group needs a Colin to stabilise,develop and consolidate it’s reputation, going forward, in the Medical School and Colin was our gift from the Gods….”Good On ya Col!”
My family continued to be ever supportive and were very proud
that I was the only Tucker family member,so far to have made it to a University, ever,let alone one who could eventually qualify as a doctor.
My Grandma,when I was a child, had hung a biblical text on a nail above my bed head. For many years it remained,gathering dust, alone and wanting to be noticed.
For her sake I learnt the Biblical words,which became a go-to reassurance in times of need, help and necessity..Luke 9:11…”Ask, and it will be given to you, Seek and you shall find,Knock and the door will be opened unto you..for to every one that asks it will be given and he that seeks will find and to every one that knocks the door will be opened.” Nowadays it might be construed as either a load of religious nonsense or a simple direction to follow. In hard and difficult times I took it as the latter, it worked and seems to have always worked.
My parents, realising that travelling 2 hours a day to and from the Hospital, was getting a bit too much for me,added to my Scholarship stipend so that I could share a 2 Br unit, 200 metres from Charing Cross Emergency Centre, arrive on time for lectures, ward rounds,clinical duties, and meetings. It would allow me to get involved in a whole lot of other things that are part of a Med student’s life contribution outside of the purely academic stuff.
This was to be a huge step in the right direction to widen my networking activities and loyalties to the Hospital. I now had a two year lead up to Qualifying as a Doctor and fulfilling so many childhood aspirations.
I would live in York Buildings,Watergate Walk for three years, sometimes alone, or with my mates Gxxxy, Dxxn or Jxxn, depending on what duty rosters had been allocated and where.
YOU’D HAVE BEEN PRETTY HOPELESS DOING DAILY CHORES ALAN?
I had had, up to now, no idea at all how to cook anything (except eggs on burnt toast), clean a Unit ,vacuum clean the carpets, wash the outside windows,unblock a toilet, change a car tyre after a puncture, scour dirty saucepans, clean white shirts so that they were still white, iron my trousers, and myriad other simple tasks that were routine daily jobs.
Why is this so?? Well,someone had always done it for me of course. I simply chucked stuff or left it all over the house and when I came back it had miraculously disappeared and reappeared where the clean stuff was always kept. SIMPLE!
There are special people who take on these filthy jobs for you ..they’re called Mums.They are always there to beaver away for you, they’ve only got their own thousand or so things to attend to, and my Dad’s stuff, and the house,the animals,the car ,the shopping ,cooking, cleaning,family clothes to iron ,toilets to unblock…get it?
They are still there and you have left home with your bag of tricks, everywhere you tread gets dirty and you’ve got to fathom it out for yourself. OMG! Now you’ve got Gxxy,Dxxn and Jxxn to mess the place up for you too.
All great mates but boy could they wreck and filthy up a joint.John was seriously lacking in any housekeeping skills. Every saucepan ,plate, cup and saucer, knife, fork, spoon, bowl, frying pan, cheese grater, would be used and unwashed of all residual food.Then, when there were no utensils left and the dustbin stench had become unbearable, he would dump them all in a water-less bath. There they would stay, putrefying.
Baked beans were the very worst for clinging to the pans.The appearance of fungal fibres and fermentation would nudge one of us into getting rid of the lot in one massive, greasy smelly effort.
Jxxn’s habits were so recalcitrant that we would hire,at his expense, a semi pro- Cleaner to do his dirty work when it was his turn to clean up the Unit.
YOU SHOULD SIT DOWN, AND PLAN A LIST OF THINGS THAT YOU WANT TO DO IN LONDON DURING THE NEXT TWO YEARS, ALAN.
Yes, I should, and yes I did! I sat down one evening and compiled a whole list of the wannabee,wanna-do things to enjoy, in Central London
in addition to studying, during the next two years whilst living in York Buildings.
Plays and comedies in the West End Theatres,The Old Vic(Shakespeare), Gilbert and Sullivan with D’oyly Carte , see the original cast of Rex Harrison and Julie Andrews in My Fair Lady,Aida and Wagner’s Tannhauser Opera
and Ballet at Covent Garden, and the Penultimate night of the Proms at The Albert Hall.
The Hospital staff were offered loads of free tickets to many of these events and the Matron was the ”keeper and dispenser of free tickets.”
Beyond the Fringe,The Goons,(with Harry Secombe,Peter Sellers and Spike Milligan), Kenneth Williams,Peter Cooke and Dudley Moore and dozens of other stars of screen and stage, were in the West End performing regularly.
This was also a time that I played a lot of Rugby and Cricket for the Hospital.
There was a West Country Rugby tour ,to Barnstaple,Newton Abbott and Torquay with The United London Hospitals and an Easter Welsh tour to Cardiff, Swansea, Bridgend and Pontyclun. I played Cricket for Charing Cross including Three annual tours to North and South Devon.
On summer Sundays I was invited to play for The Secretary of the Hospital Board’s Cricket team…the latter played on beautiful old country cricket grounds outside of London and had Annual Cricket dinners at the MCC Lords.We flew to Ireland to play three Irish teams at Trinity College Dublin, one of whom,The Irish Civil Service, had seven left handed batsmen ..enough said!
I think that the Secretary of the Board had more than considerable influence on the Matron’s gifting of special tickets to us artisans. I myself regularly in grateful receipt of such rewards
It would be remiss of me,when writing about my cricketing stories,not to give important space to our family friend Dr Daniel O’Connell a Charing Cross Oncologist.
At Trinity College Dublin,Dan caught polio and was left with a lifelong weakness in his right arm and leg.He had been an excellent all round sportsman but adjusted his life and medical career,had a wonderful ,happy family and became our Sunday cricket team’s umpire.
A self- effacing Consultant with a wicked Irish sense of humour and a brogue to match, Dr Dan invited Anita and I to spend Easter 1962 at his newly renovated family beach house at Derrynane, County Kerry, knowing that we would be travelling around Ireland in a car at that time.
Little did I know, until we arrived, that Dan was the great, great grandson(in direct line) of Daniel O’Connell,”The Great Liberator” of Ireland.
From his beach house,at low tide ,the ruins of the Ancient Abbey, and an Island graveyard, are accessible by foot at low tide.Traditionally, coffins have been carried , for burial, and carried shoulder high across this historical spit of land to the local graveyard .
The Monastic site WAS founded by St. Finian in the 6th Century. Politician Daniel O’Connell’s wife Mary was buried there. He died, however, when on his way to Genoa , Italy in 1847 and he had willed that his heart be given to Rome and the Church and that his body had to be interred in Glasnevin Cemetry, near Dublin.
O’Connell’s ancestral home was Derrynane House and here he planned his political career.
Oncologist Dr Dan and his wife,Una, passed in their late 80,s. She was a radiologist and both were passionate supporters of free health care for everyone.
In the last few years of his career Dr Dan helped set up The Mount Miriam Cancer Hospital in Penang , run by the Sisters of the Franciscan Missionaries of the Divine Motherhood.
Our firstborn was named Dan as a measure of our love and great respect that we have always held for Dr Dan, Dr Una and their family. Sadly we last saw them in the late 1960’s.Their son and heir ,Daniel, is a Doctor,who lives with his family in Scotland.
A SWING AND A SLICE AT GOLF BUT NO SWINGING OR SLICING AT THE RITZ TEA.
I play golf badly,all slice and a regular lost ball person, but Colin and Martin,my Clinical Colleagues,were steady, true, patient and dedicated.
Despite my shocking game they supported my efforts to improve and we regularly teed off at the the famous Roehampton Club near Hammersmith. ”Ah!” you say, “That was an expensive waste of stipend,I bet!”
Well it wasn’t actually, because we were artisan members at The Club as a result of the gifting of a large sum of money to the Hospital.One of our famous surgeons performed life saving surgery on an important official of the Roehampton Club. We each paid three pounds for an 18 hole round instead of approx three thousand pounds a year for the average, unusually wealthy, invited Corporate member.
Good manners and smart golfing gear were essential, of course…..” go, go the Artisans!”
It is a good feeling to be a beneficiary of a philanthropist’s kindness and, in later years, I recalled the need to act, in some small ways, for others, who were less fortunate than myself, in this role.
One of my bucket list of wishes was to have Sunday tea at the Ritz Hotel in London with an, as yet, undecided chosen friend.It was probably a need to enjoy something that only really posh people do, like people who had returned from India or Africa after serving “their country”and needed to re-establish their English Colonialism.
Well,of course, I haven’t so far achieved that one …..no champagne, cucumber sandwiches and loads of creamy fat and sugar laden cakes.
No posh reminiscences about how bad the servants were in the Colonies.
The simple reason was that it was a far too expensive caloric gorge and none of my girl friends were willing to treat me.The 2020 Google price for this 90 minute Pig Fest at the Ritz is about 11O pounds sterling plus an extra 600 pounds if you want to be collected at Heath-row Airport by a Chauffeur driven Rolls Royce,one way.
The writers of the 1930’s Swingers’ song ”Putting on the Ritz” (Irving Berlin and Zdenek Borovec) would be disappointed that I have failed my bucket list wish to go there.Perhaps I will just accept that i’m “Putting OFF the Ritz.”
Disappointing news recently reached me that The Landsborough Hotel now tops the vulgarity finance stakes in the race to be screwed by a High tea provider in London. A whopping 120 pounds for champers, a cuppa, bits and pieces and washing your sticky fingers in a Royal Albert finger bowl.The Savoy Hotel ,too, is now highly in contention for the pocket-picking profiteer of the year.
NO SAVELOYS AT THIS SAVOY BALL AND DINNER.
The more achievable bucket list came as an opportunity out of the blue.
Rendle,my terribly smooth older, more worldly colleague, invited me to become Assistant Annual Hospital Ball Secretary in 1960 because he was The Ball Secretary, and this particular year it was being held at The Savoy Hotel (in The Strand ..just around the corner from my unit).
The Assistant Secretary became the Annual Ball Secretary the following year and that was going to be held at the Hurlingham Club.I fell for the opportunity,hook ,line and blxxdy sinker, didn’t I?
Around 800 guests bought tickets for the Savoy Ball and five bands, singers and comedians entertained the guests throughout the night during, and, after a superbly produced , all seated, meal.Virtually all of the Charing Cross Specialist Staff came with families and their guests and, in true Cross tradition, extended their genuine pride and support for a memory box fun-filled event.Speeches were short , sharp and to the point and Rendle and I received appropriate mentions and extra brownie points for a job well done.
The following year, as official Ball Secretary, I organised it to be held at The Hurlingham Club, a huge flood lit venue with acres of tailored gardens in Putney. It was a balmy summer’s night and a huge success. Thanks to Anita’s (Midwife,RN and Wife to be) gymnastic accountancy and generally perfect organisational skills,many hundreds of guests danced under the stars and a comfortable wave of inebriation was experienced all round.
THE CHARING CROSS HOSPITALS’ ANNUAL THEATRE REVUES
Not reviews of the operating theatres, of course, which were always clean and anaesthetically quiet whilst work was in operation.
No! Westminster or Russell Square University Collegiate theatres, where we performed our Annual Hospital Revues.
The atmosphere there was usually rowdy or raucous, some rare acts squeaky clean, others student bawdy, and political correctness was not permitted.
Anyone, in the audience could become the victim of known, or unknown truths, about themselves (rather than the usual rumours), all in good faith and without prejudice.
Nothing vexatious, plenty of juicy stuff and poignancy, with simple cutting and dicing of any Consultant,Registrar,House Doctor, or student whose story had been leaked to the Revue team.
You would be amazed what grubby information can be extracted from a medical student who is poor and thirsty for a couple of pints of beer. 2020 year bikie- type physical threats to persons or their relatives, I promise, were totally banned ..beer was exclusively the best currency lure.
I look back, in 2020, to 1958, and ask myself… “Whoever dragged you down, Alan, from climbing towards ethereal heights, to feeding off Theatrical fun from the very bottom of the pig sty?
Perhaps it was my grandma Louise’s foresight.
She was the one who insisted that I learn the organ and piano and play all those Methodist hymns for her as a little boy.
Gradually, throughout school and University, peers and colleagues would ask me to play something on their piano or in the Lemon Tree Pub after the Rugger matches when everyone has their sing-song.
By the time you’ve learnt The Sting, a little Mozart, Schubert’s Impromptu in A Flat, some Christmas Carols, God save the Queen, all the Welsh Hymns that Welsh sportsmen sing, with great gusto, and other odd ethnic songs to satisfy, a drunken Scot or Irishman, I never needed to buy another shandy for myself again!
Now, where’s the rub? The rub lies when you get dragged into volunteering to write songs and sing them at The Hospital Revues, as part of a duo or trio, with equally uncouth mates.
Then, you’ve got to gather a team of non-theatricals, and persuade them that what we are all doing will actually bring us grateful thanks.
The thanks would flow from an exceedingly important group of the medical professionals ,who responded as such, if you insulted and publicly shamed them sufficiently from the stage.They would also need to be in the presence of their family, in the Theatre, and with lesser mortals, such as other raucous students.
Finally, the raisons d’etre, were to generate prolonged hand -clapping, cheering, jeering,persistent bawdy laughter and shouts of ”ENCORE , ENCORE!”
The odds of you getting absolute cooperation and regularly rounding up your feral friends to rehearsals, were at levels which high enough to put the bookies out of the betting business. Then, do it again, to packed audiences on three consecutive nights.
And yet, you just do it, they love it, the audience revels in it, nobody gets,badly injured or divorced, and the chances of you getting a decent job as soon as you qualify soars heavenward.
It shatters the implication that “Pride goes before a fall” and, rewrites it as, ”Pride, in success, is followed by a substantial elevation in your confidence going forward.”
Possibly our best double entendre moments were in our Noel Coward version of the song ”Let’s do it, let’s fall in love” by Cole Porter.
17 verses of the original words were transmogrified using replicated words, and transformed into a version of up to date truths, on everyone.
Just, for the eternal record, no person of high or low degree or of any gender, ever complained about any sketch, word, line, verse or song that we performed on the stage ……me thinks that most attendees were constantly reminded that that was exactly what they were doing , saying and singing when they were students 10,20,30,40 or even 50 years before.
The Grand Pooba star of my last two participating Revues was ,without doubt, Michael Moreno , a family name in West End Theatre history because his father, Harry, was a Royal Variety Performance Star, in 1945,and starred in a number plays and films throughout his career.
Mike had trained as an actor in his teens and took Hospital revues to a new level of skill, hilarity and absurdity. He was great company, a man with multiple talents, whose dedication to his family and profession led him to qualify as a surgeon in London and Australia(his father was born in Balmain ).
With a ten pound ”POM” ticket, Mike took his wife Jenny, and kids, age 1,2,3,and 4 to Bundaberg in Queensland. He set up a private surgical practice there, was the local Hospital surgeon, collected many Awards, including the O.A.M., and served his Communities’ needs with unswerving, tirelessness and aplomb. Mike passed in 2019 at age 79.
Of necessity, I include a short vignette to illustrate his quick wittiness and humour. It occurred when, as a student, he was asked, in my presence, by our most Senior surgeon, to peer into the rectum, via an examining proctoscope , of a patient who was undergoing bowel surgery.
“What did you see, young man, when you looked through the proctoscope?”quizzed the man wielding the scalpel.
“I saw a thread worm Sir!” Michael retorted,
“And was it a male or a female thread worm, young man?”the Senior surgeon boomed, not able to contain his laughter.
Michael replied immediately without a pause or grimace,
“It was a female Sir.”
Somewhat aghast, but out of curiosity, our boss blurted out,
“How, in God’s name, did you know that, Moreno ? “
“She winked at me Sir!” exploded Michael.
The theatre staff erupted and, rumour has it, that the patient
smiled coyly, though still deeply intubated and anaesthetised.
Michael 1 Surgeon 0.
Vale, dear Michael.
FINALS EXAMS ARE COMING UP IN 1961
The Doctor in The House series of films had started to enliven cinema-goers across the UK.It was megastar studded stuff, with Dirk Bogart, James Robertson Justice, Muriel Pavlov, Donald Houston, Donald Sindon, Kenneth Moore and Kay Kendall.
As a cinema going Medical Student it made you realise that, the schematics of this film was, more or less, what’s been happening in your life for the last five years, albeit in a much lower gear and at far less expense.
Not the same glamorous experiences or life full of technicolor, not with quite the same joie de vivre and no impressive red cars. Definitely no River Thames boating days,with boater wearing, punting and Regattas.
I suppose there were some Rugby crowds, post match congratulations, rather than adulation, and plenty of hospital corridor recognition.
The original blurb,clips and pre-release info did contain the following…..”Simon Sparrow,a medical school freshman,involves imbibing,wooing and jeering along with his three upper class friends.He has to balance his various amusements but without flunking his Final exams!”
Have you just read anything vaguely familiar in the previous paragraphs? Perish the thought, Grandma Louise, if you are fact- checking this article from a Cloud station.
Early 1961 was a time when reality bites your bum and whispers, ”Only five months left,young fellow and then, if you get through the exams, you’ll have to get used to working for the next 45 years.” Actually, it was not so much a whisper as a clarion call.
This was,indeed, the great moment of truth because it was what you had always dreamed of , dreamed about,and it was no longer an illusion, or a possible delusion.This was your highway of endless opportunity and
this moment was for Mum, Dad, Ian, Grandma Louise and Granddad, so let’s hop into the Sports Car of the Mind and accelerate!
WHO WAS ANITA,WHERE DID I FIND HER, AND WHAT HAPPENED?
I met Anita, a soft spoken, gorgeous blonde,Mancunian Nurse/Midwife, when I was starting my Obst /Gynae compulsory eight week term at Kingsbury Maternity Hospital.
It was an unusual meeting because I arrived a few days early and she had been visiting nurses there and had stayed on for a few extra days.
It was even more unusual because my long term golfing mate,bridge partner, table-tennis opponent and Med Student team colleague had died accidentally, when,three days earlier, he fell from a cliff in Southern England whilst on a short camping holiday.
We were roistered to study our Obstetrics together at Kingsbury Hospital.
I had great difficulty in obtaining any information, either initially or subsequently, with regard Martin’s death, partly because, in those non- social media days, the landline phone was the only communication link available, but mainly because a Coroner’s Inquiry prevented the release of any info at all for many, many months.The eventual verdict, is ethically a privileged matter and has always troubled me.
Anita was a great friend and a wonderful loving, lovable and much loved support to me during these trying times.My family adored her.
After six months we were married in the village of Landkey, North Devon at our Local Methodist Chapel with the Rev Rod Foster, my school religious Master, officiating. My very best Queen’s College mate Bob Cull was our best man , as I had been for him when he married Sonia. Anita and I spent a wonderful honeymoon in Majorca in the sun,the sea the sands and the surf.
Marrying, as a Medical student was not unusual, and, in fact, made it easier to meld our many study hours a day with all of the other benefits that being together and growing together brings whilst halving the occasional disappointment.
WE’VE ALL QUALIFIED, SO WHO GETS WHAT JOB?
Charing Cross Hospital, in the early 1960’s, in addition to the main Hospital, had a number of other peripheral Hospitals under its’ administration and many of the junior posts were offered to doctors through invitation by Senior Consultants for whom you would be working and were rubber stamped by the Board.
All of the jobs were in demand, whether main or peripheral hospital appointments, but, basically most people were thoughtfully accommodated through the wisdom of the system and its’ advisers.
I was very pleased to accept a job as House surgeon with a team of Surgeons for my first six months, then as a House physician with two paediatricians for six months,followed by six months as a Senior house officer obstetrics and gynaecology.
Those jobs were very suitable, to pursue a career as a Country GP, because they facilitated your obtaining Post Graduate diplomas in Child Health and Obstetrics/Gynaecology and made you a more desirable working Trainee in the College of General Practice in the UK.
You didn’t have to choose a final career path at this stage though, and, looking back, I was never quite sure what tracks would emerge. They did unfold, were many, varied and yet, oh, so stimulating.
I will let that story develop in later chapters.
When you started work at your initial House Officer posts there were many ” vast differences” between contracts in the 1960’s and present day conditions of service in the 2020’s.
There were no such things as ”hours of work”/time off /availability/Union support etc and, you very soon realised, that you were the valued product of a system that had been in place for a very long time and which outlasts you however long you stay with it.
HOUSE SURGEON DR ALAN TUCKER 1962
You’re not really a surgeon, just a poorly paid dog’s body with a title that
keeps the patients reassured that you are more like a surgeon but without the slashing and chopping responsibilities.
Real surgeons, in the 1960’s, used to leave the skin stitching to be done by their House Surgeon if you said that your Grandma had conducted quality sewing lessons with you and could demonstrate them on some pig’s skin to your Registrar!
Everything, thank God, is different now in 2020, because patients audit their surgeon’s initial results by the neatness and smallness of their scars and their friends scars.
Actual outcome satisfaction only comes when the pains have gone for good and you can eat, drink and be happy again, ‘cos Google has ticked all the check-up boxes with regard to your surgeon’s performance.
My team of surgeons were all top of the tree material and there were very few organs that they couldn’t do a top job on either singly or collectively.
From the single inguinal hernia and the double inguinal hernia, appendices, gallbladders, haemorrhoids, diverticulae poking out all over the place,thyroids to snatch, lymph nodes and breast lumps to biopsy, damaged heart valves needing repair and those really nasty lung cancers that those really nasty cigarettes had caused over the years.
Sir Richard Doll [1912-2005] was the first doctor to prove that tobacco smoking caused lung cancer and increased the risk of heart disease.
There had been arguments for years, before, that car emission pollutants,tarmacadam and a myriad of other things might be the cause of lung cancer but cigarette manufacturers always won the contrary viewpoint battles, in the daily papers, magazines and the Courts.
In 1954 Sir Richard Doll published a stunningly well researched article, in the British Medical Journal, having studied the illnesses of 40,000 doctors for over 20 years. His conclusions were irrefutable.
On that day Sir Richard stopped smoking cigarettes, as did hundreds of other doctors.
It was a sad reality that, as students and nurses , we nearly all smoked, blissfully unaware of the multiplicity of diseases that active and passive smoking caused, and still causes, though to a greater extent in countries and communities that do not have efficient and effective preventive health strategies.
Australia has reduced the male smoking rate, from 58% and female rate, from 28%, in 1980, to 16% and 12% in 2020.The target reduction is 10% in 2025.
It is estimated that 40% of Aboriginal people, there, are still smoking in 2020. Strong measures to address this and other inequality issues have been introduced, following a recent review.
WHAT AM I GOING TO FIND IN MY BRAND NEW JOB?
For a newly manufactured young doctor,in charge of a surgical ward, to
return from a half day off on a Sunday, go back to his ward and prepare a list of patients for tomorrow’s operating list, I would discover that at least six of them were there to have their lung airways bronchoscoped for lung cancer biopsies, and a further two would have their chests opened up by Mr A. Makey for single lobe or total lung removal.This was a common routine was usually the start to each roller coaster week .
After everyone had had their ops, all would need to be fully briefed, with or without a relative, and the bad news empathically given with regard to the, often, bad prognosis anticipated.
Some would have already stopped smoking, some would stop smoking and others would continue to smoke, come what may.There were no Social workers to ease you through Death’s door.
Oncology and Radiotherapy were fairly ”new kids on the block”and of ill- defined value, chemotherapy was a blunderbuss shot in the dark and immunotherapy a word yet to be invented.
My Surgical bosses were simply wonderful caring people and the victims of their own smoking addiction were treated with the most appropriate up to date therapies available.
Acceptance is an indefinably human characteristic when reality presents itself. So mote it be.
WHAT ARE SURGEONS LIKE AS BOSSES?
I was always in awe of them as they patiently, quietly, and with great kindness and encouragement, set about their task of transforming me from my very low status in the pecking order of things, to a loyal , obedient sponge that wanted to soak up everything there was to know about my job without hesitation or equivocation.
“Time out from work”,however, was indeed frugal. Wednesday night from 6 pm and every second weekend from Saturday 1 pm to Sunday 6 pm. That’s how it was.
I was recently reminded that my FIRST monthly pay cheque, after tax, was equivalent to $A60..00 . It got gobbled up by paying three parking ticket fines which were incurred for leaving my car outside of the Emergency Dept on three separate occasions…Anita and I made uncharitable utterances towards the Parking meter men and shared a few wet tears together.
BUT LET’S TALK OF MORE POSITIVE AND BETTER THINGS.
My most senior Surgeon was listening to a 66 year old country lady recall her gallbladder attack history,having caught the train from outside of London.
She came to our busy afternoon Outpatient Clinic.
She was a bit flustered and was having trouble, remembering , exactly where and when she was, when she first got the colic.My Chief was very patient and then she said.. ” I remember now, doctor,it was the same day, last December 4th,that my 12 year old granddaughter, Annie, fell down and broke her right arm.”
My Chief carefully compiled her notes with pen and an A 4 sheet(no computers), examined the lady and reassuringly said that, Dr Tucker will make all the arrangements for you to come in and we’ll take out the gallbladder and stones and fix it up for you.
Nothing unusual about that, but when she came back for her check- up in Out Patients 8 weeks after her surgery, my Chief quietly asked her how she was and she replied.. “I’m very well doctor,thank you, the best I’ve been in years”.He scribbled her response back into her hospital file and looked at her face through his silver spectacles and said…..”And how’s your granddaughter Annie’s right arm,the one she broke last December 4th?”
The dear lady almost fell from her chair.Here was one of the top surgeons in London remembering such a tiny detail about Annie’s arm. He must have seen hundreds and hundreds of patients in the Clinic since she came here months ago.
I treasure recalling this touching moment of humility and humanity when chatting to my medical students.
As doctors, our patients’ medical records, and the notes that we write in them, however simple or complex , are exceedingly important and need to be carefully preserved because our memories cannot store, forever, things that might be needed at a later date.
If you ever have the misfortune to be asked to attend a Court of Law with your patient’s medical records, because of a legal dispute or a complaint, either on behalf of the prosecution, or defence, there is a well known maxim which says, ”Good notes, Good defence, bad notes bad defence, no notes no defence”.
It can never be emphasised too much to all colleagues and students the wisdom of this overriding necessity and it could just save your butt one day.
My surgeon chief was a life long trout and salmon fly fisherman, who learnt his fly- tying and casting art in the Isle of Skye, Scotland, where his famous Clan owned a swag of land, the Dun-vegan castle and were direct descendants of a 13th Century Norse King, Olaf the Black. He also owned a stunningly, picturesque little Tudor cottage near the Frencham trout fishing
lakes south of London .
We had had a very busy few weeks at work on the wards and in the operating theatre and the trout fishing season was going to end soon.My chief had found out that I also loved trout fishing though I wasn’t a dab hand like him.In a moment of grand generosity he arranged to go to the Tudor cottage,meet Anita and I there[we had a little car] let me use his special rods ,reel and flies, stay overnight and go back to London having fished all day with him at this desirable location.
After a scrumptious fried breakfast we set out,on a freezing day,encouraged
and assured that there were lots of hungry trout,all over 2 lbs in weight,just waiting to rise to his specially tied flies.Gentleman, as he always was, he gave me the opportunity of catching the first fish,he would catch the second one and would hand the rod to me to catch the third one..there was a bag limit of three.
Everything went like clockwork for a while,I caught my fish,he caught his and handed me the rod for the final cast.
His rod was very special, his father had passed it onto him.It was a genuine James Hardy of London, vintage cane in three pieces,and the ferrules were locked into each other by a very skilful craftsman’s technique so that they
couldn’t possibly pull out of their position if you had to tussle with a really bit trout or salmon.Fibre glass rods were not welcome at many of the top clubs..sort of infra dig, disrespectful to the members and the Club or whatever.
A very fine trout broke the surface, about thirty yards away from the bank,
in deeper,darker water.Adrenaline flushed,then flooded through my cardiovascular system and I peeled off and launched a sufficient amount of line directly towards the moving monster,hoping that, with two flies on board,the fish would have a choice and take quickly and I would strike and succeed.
Well, that’s the theory, isn’t it? What really happened was the most seriously embarrassing moment in my 59 year career as a doctor.The fail safe ferrule lock had failed and the end two pieces of the cane rod had flown apart, the end piece stripping the flies from the trace as it disappeared with great speed into the murky freezing lake water.I dropped the rest of the rod and reel onto the muddy bank and rushed toward the water whilst Anita froze and my host,unaware of the exact nature of the current panic that I clearly exhibited, quietly said,”Is everything alright, Alan,did you land that big Brownie?”
Of course nothing was alright!
I rushed toward, where I thought the 2 ft rod end piece should have landed, took off my coat, shirt and trousers and wandered, in my underpants, through the freezing water hoping and praying that I’d find the lost piece of antique cane.Occasionally I took a deep breath, ducked my head into the depths, searching,ducking,praying and panicking and being watched by a couple of other members of the Club who were unaware that I
was unaware of the strict rule that you MUST fish from the bank and NEVER enter the water.
It will not surprise you that the thought parachuted through my brain that medically I was no longer viable, dead as a dodo,and “the days that were they never would be more”
My host,ever the gentleman,brushed the events over relatively lightly and, with great empathy,reassured me with …”Don’t worry ,old chap,I’ve got another rod back home in Hampstead !” I replied, ”I’m really sorry Sir,i’ll ask Anita to take the rod into James Hardy’s in The Mall next week and ask them to replace the end piece.”
So that was the plan,we enacted it and Anita went into the famous shop wearing her full Nurse/Midwife uniform, exhibiting absolute professionalism, but indicating that the net result of my stupidity could have unknown consequences.
.She was served courteously and informed that her request could be met but it would take several weeks to do it and they would be in touch.No mention was made of the cost because if you buy goods in a posh place like Hardy’s you are assumed to be fully loaded up in the Bank.
Eventually the repairs were effected,they had been done with great skill,
and returned to my Chief.He was so full of genuine joy for Anita and I,
rather than for himself, and recalled the story to his family and friends in such a way that it was a problem with the rod rather than something that I
was in any way responsible for.Alexander Cameron Mcleod retired the following year, returned to his beloved Skye and spent his last years fishing,boating, walking,writing, reminiscing and ,of course being remembered by so many for being part of, and contributing ,in the very best sense of the word,to the lives of thousands of grateful ordinary ,as well as extraordinary, human beings.
How much did the James Hardy repairs to the fishing rod cost?Well it doesn’t sound much at 28 pounds sterling in 1962,but when you update that amount to the year 2020 monetary values, it would be,at a rate which doubles every 15 years, approx 450 pounds sterling or $A800..00…wasn’t that an expensive 2lb trout ?
DR TUCKER, HOUSE PHYSICIAN,PAEDIATRIC UNIT, CHARING CROSS.
The first rule to learn about sick babies and little children is that their physical, mental, social and other problems and presentations are different to their Mums, Dads, Grannies and Granddads. If you believe otherwise perhaps you should reconsider your future, perhaps as a Vet. As Shakespeare put it so succinctly in his play ”As you like it” the first two of the seven ages of man are.. ”At first the infant, mewling and puking in the nurse’s arms ,then the whining school-boy, with his satchel and shining morning face, creeping like a snail unwillingly to school.” Having had five wonderful children and [so far]thirteen fabulous grandchildren, I can attest to his musings and my family probably place me as approaching the seventh age…”Second childishness and mere oblivion, sans teeth, sans eyes, sans taste ,sans everything.
So there’s another new learning road ahead for me and what better teachers to walk me through than Dr DB and Professor HJ, two wise but contrasting individuals. Dr DB was retiring shortly, was another keen fly fisherman and would weekend whenever possible on the banks of the river Test pitting his skills against the rainbow trout and locally famous grayling. He was adored and respected by everyone, had had a celebrated career having passed through ranks only attained by the very best of career paediatricians in London and was blessed with an ability to make even the crabbiest of unhappy kids morph into angels within seconds.
Prof HJ had a seemingly inexhaustible capacity for work and an unquestionable appetite for knowledge whether general or medical. He had a unique and inextinguishable love of teaching and could refine complex problems and explanations to very simple ,understandable ones. The word “doctor” means educator or teacher and Prof HJ had a mission in life to change the way paediatrics was taught. He placed the child as the central pivot of need in the family and cleverly taught everyone involved in the management of that child through it’s ongoing years with the best information available towards achieving success. He listened attentively to every word spoken at clinics by all participants where a child’s management was being discussed, and, when there was agreement on the plans ,going forward, would implement them. In this way he exploded previous management techniques whereby the doctor took charge of everything from the start, told everyone what to do and expected every one to agree. In 2020 we would accept this as normal common practice but it certainly caused controversy in 1960 as many naysayers felt this was a bit too nanny state, especially when social workers and psychologists attended at Outpatients Dept. or on ward rounds.
Prof HJ,s new approach caught the eyes of the newspapers, popular women’s magazines, and television and radio shows. He suddenly and deservedly became a most desirable Professor of paediatrics to interview nationally and internationally and rarely declined invitations. America had, Dr Spock a famous paediatric gentleman of similar ilk and inexhaustible vitality. He also was a very controversial character especially when he backed draft- dodgers at anti-military marches. According to HJ’s Royal College of Physicians[eventual] obituary ”Hugh Jolly was probably better known to the general public than any other living doctor.”
Prof Hugh Jolly did have an unfortunate habit of arriving in the paediatric ward to undertake unscheduled ward rounds. Normally a ward round is planned well in advance [usually regularly on particular days and times] and Sister- in- charge would have all the sets of notes, x rays and records, for each patient, neatly set out in order of each that were to be seen, examined or whatever. There is an orderly pecking order for each Professor, doctor, nurse social worker or other person attending a ward round and the pecking order is strictly adhered to. Well that is unless Prof HJ dashes in, takes his bicycle clips off, rolls down his socks and announces that there will be a ward round in 10 minutes. For the Sister in Charge this is a seriously upsetting, irritating, arrogant though ethical, act that would make her hotter than usual under the collar. It was as rare as hens’ teeth for someone in 1960 to use the b…..word on a ward and I only ever heard
the stronger expletive beginning with f… slip out between the lips of one of Sister’s Staff nurse colleagues, once, but today was the day. I doubt whether HJ heard it but a snigger from an adjacent student seemed to indicate that he most certainly did! HJ was always good company even when baited deliberately by his medical friends; he was good humoured and tolerant and a man of great principles, always acting in the best interest of his patient.
We looked after a premature baby Unit and a main paediatric ward of about fifteen children. After hours, I covered the duties of the resident obstetric junior doctor on alternate nights and weekends .All in all a very reasonable work load in a good location with well trained ,helpful, willing staff support.
THE STORY OF CONJOINED TWINS CAROLINE AND MYRTLE OCT 1962
Carolyn and Myrtle Hurd, on their first day of their lives were the toast of London. They were born at a peripheral hospital to the main Charing Cross Hospital and, because they were Joined [or Siamese] twins, an incredible rarity, they were immediately transferred by ambulance, in an incubator, to our Paediatric Unit for assessment and management. The paparazzi splashed the event across all of the London evening newspapers and stalked and hounded anyone involved for multi-angled stories, either formally or informally. In a situation, like this, clearly there were strict processes to follow, and they were.
The following eight days and nights evoked most of the emotional feelings, their highs and their lows, that it is possible to have to go through, as a young doctor during this period, and I list them at the end of this section.
These dear little babies were born face to face, and joined together from the lower part of their chests down as far as their tummy buttons. They could smile at each other, cry together or separately, touch each others fingers and generally looked snuggled up with each other.
Remember that this was 1962,there were some x ray techniques that were available and some ECG tracings but, unlike in 2020,there were no CT,MRI,PET, U/S SCANS and no flexible instruments, with lights and videos attached or isotopically labelled fluids with which assessment teams could work on and formalise an algorithmic plan to maximise a satisfactory outcome, for both of their lives, should surgery be agreed upon and performed. Even the most highly skilled clinicians, with top embryological, surgical and anatomical knowledge would be unable to provide an exact account of which organs were shared and whether surgery was the answer and at what stage.
Senior cardiothoracic surgeon Mr AM, after widespread consultation, gathered together a team of extremely famous London surgeons, who would risk analyse all aspects of a timed operation and proceed when Carolyn and Myrtle were well and thriving .The babies were monitored 24/7 by our ”Special” ward team and for six days we held our hopes high.
Suddenly all plans had to be revised because one of the twins began to develop early symptoms and signs of heart failure for no easily explicable reason. Immediately, the Paediatric medical team started appropriate treatment and the twins were continually monitored and up to date reports given to the surgical team. During the next 24 hours the heart failure worsened and it became obvious that she was in imminent danger of dying.
As is always the case in these circumstances, all stakeholders ,including family, met to discuss all aspects and options in the best interest of the babies, and, of course, there are many complex ethical areas which are included in the considerations.
A decision was made to commence surgery asap to try to separate the twins
in the hope that the heart failure twin ,after surgical separation, might be more responsive to her treatment and the other twin would receive what treatments were appropriate in her best interests post-operatively.
The operation theatre was, not surprisingly, busy and everyone was allocated to positions which would enable them to carry out their responsibilities. My job was to assist with the iv infusion lines and act as a general gopher to others who were less familiar with the general layout of the theatre. A large surrounding viewing balcony was filled with specified pre- screened persons who were suitably dressed in correct sterilised
attire.
The details of the operation are not covered here. However, the separation of the lower chest and abdominal connections were completed, even though there were more serious complexities to be repaired than was previously thought from the pre- operative available assessments.
At the time that the Cardio-thoracic surgical team were preparing to make an incision into the twins shared chest to effect separation the Anaesthetist in charge noted a very serious, sudden decline in the condition of the twin who was being treated for her heart failure. Suddenly she died on the operating table and the surgeons began immediate separation in an attempt to at least save the remaining baby. On opening the shared chest the heart was found to be shared too and, instead of two hearts each of four chambers, there was a single eight chambered heart which was fused and impossible to separate. Within a very short time after the death of twin 1.
the second twin passed away without any possibility of remaining alive
given the brutal revelations.
The result of the outcome affected many, many people in many, many ways
whether family, nurses, junior doctors, famous medical, surgical, paediatricians and anaesthetic staff, even the hospital theatre porters. The newspapers, whilst understanding the complexity of the whole situation, greedily exploited their once in a lifetime scoop and ran with multi-angled stories which they sucked dry until other up to the minute
news took precedence. The Coroner’s Inquest found nothing untoward in any aspect of care and dealt with the issues involved with dignity and legal professionalism.
My reflections are my emotional feelings, experienced during these eight days, and I ask the reader to match them in their own minds with the timings of everything that occurred in the reality of each phase of the care
and treatment that I was involved with in the short lives of Caroline and Myrtle.
ADJECTIVES DESCRIBING MY PERSONAL EXPERIENCED EMOTIONS
Calm, caring, expectations, anticipation, kindness, anxious, tense, queasy,
sympathy,apprehension,optimism,hope,fascination,fear,stoical,sad,sorrow,disappointed,helpless,denial,flummoxed,disturbed,acceptance
resigned, lonely, miserable.
After a further three months of thoroughly enjoying working in the Paediatric ward and Premature baby unit with Prof HJ and Dr Doyen Bell
I was ready to move out to Kingsbury Maternity Hospital when two special
happenings occurred.
I was contacted by the Secretary of the Hospital Board
to say that Channel 9 TV had been broadcasting a program each week on the subject of…”I want to be an …Architect, Accountant, Chemist etc ,etc,” and they were preparing a program, to be released in a couple of months, called ..”I want to be a Doctor”; they would be filming it at Charing Cross Hospital, using the operating theatres and the Paediatric and Premature baby Units.
The TV program had very good ratings and was an excellent opportunity to
educationally promote all of the wonderful things of which I had already been a beneficiary. I dutifully agreed to take part as the finished product.
A series of situations were chosen .. firstly a young doctor showing medical students a series of x rays, secondly, the doctor examining a premature baby inside an incubator, and, thirdly performing an appendix operation in the operation theatre. The latter, was ,of course a complete mock up but the result ,thankfully was convincing and not a complete c..k up. Anita and I were at Kingsbury Maternity Hospital when the program went to air
and it was well received with favourably competitive ratings.
My final task prior to completing my Paediatric House Physician term was to drive to the River Test in Hampshire during my last weekend at work, with Anita, and spend the day fishing with Dr Doyen Bell on his favourite stretch of trout and grayling water. He was a true gentleman, in the very best sense of the term ..he died a few years later fishing that very same stretch of his favourite water, quietly, suddenly, quickly and without any sense of fuss
or ceremony. Vale Dr DB.
OBSTETRICS AND MATERNITY AT KINGSBURY MATERNITY HOSPITAL
In early 1964 the top of the pops music radio shows in the UK were dominated by Cliff Richard and The Shadows singing “Here comes summer,” ”Let’s all go on a summer holiday ” and ”Living Doll”. Occasionally Kenny Ball and his Jazz men would take over with Midnight in Moscow.Now that might not be of great interest to you, but it was certainly of interest to Anita and her best nursing friend Tricia, both of whom were hitch hikers on their way to their Nursing Prize giving ceremony in Manchester, UK. Kenny and his van crew took them all the way to Liverpool, after an initial refusal to be picked up, where Anita and Tricia caught a connection to Manchester.
This was not the beginning and end of the usual” pick-up job” because ,from time to time, when Kenny and his Jazz men were performing in Lancashire Anita and Tricia would manage to get to the gigs.
Anita’s last meeting with her long lost friend was at the Wrest Point Hotel Casino in Hobart, Tasmania, in the late 1990’s,where they talked about old times and mutual friendships prior to his performance, at which he played, especially for Anita,” The Jungle song”. Kenny Ball’s band was eventually taken over by Kenny Ball’ Junior’ and his Jazz men and thrived in the UK.
Kingsbury Maternity was 20km from Charing Cross, built in substantial grounds and rather cosier to live in than the ”horse-boxes ” that Charing Cross provided as the resident doctors’ accommodation. It was roomy, had an adequate TV room and, best of all, very edible food for breakfast and dinner.
Getting used to a new mob of midwives was challenging since students and doctors were the enemy and territorial-ism the rule of law. Midwives ,of course, know far more about where babies come from and how they slide from darkness into our brave new world, assisted by their soft hands, or are pulled out with steel forceps around their head if the doctor
happens to be around and the little babe has failed to meet its’ intended timely arrival for whatever reason. Perish the thought that there may be a need for a fully trained obstetrician to be the final common denominator in the retrieval stakes; anyway they are all brilliant, let’s face it, even if somewhat ‘confined’ occasionally .How do all those other non- human animals out there in the dark of night manage? They seem to manage on their own most of the time and without BUPA or Medicare. I remember home on the farm that sheep usually had their lambs when it was really cold and Dad and Mum often had to go and fetch the newly born lambs and put them in the warming oven part of our Aga cooker till they defrosted. I often thought it saved the lives of a lot of lambs for somebody else’s future Sunday roast .
We did have a great Scottish local vet, with non- human obstetric experience and, just occasionally, we’d have to call him out because a cow was in labour and not ”progressing’. Well, to scrub up pre operatively, he just seemed to wash his hands and arms up to his shoulder socket, slip on a huge rubberised condom looking thing[on his arm]and go full length inside the cow’s vagina, grab a calf leg and both he and the cow would moan and groan until out came the leg then the pelvis ,tummy, chest, head, more legs and all the other attachments. He would then congratulate himself, bow to the audience, grab the strong antiseptic bottle, wash his sterile rubber arm protector then his arms up to the shoulder socket ,and, when he had cleaned up with cold hosed water from the well, ask for a large whisky and give you the bill….now that’s real obstetrics.
It’s unlikely that budding obstetricians amongst us would envy his techniques or flourish in today’s medical market. I think that on those nights my career aspirations turned sharply away from the nether and pelvic regions
to more proximal body parts where rheumatologists and dermatologists
frequently roam. I almost became an ovo- vegetarian because of these non-human obstetrical happenings but gave it away when I found I missed my defrosted and roasted leg of lamb.
After six months of witnessing the joys of proud pregnant Mums, and their eventual contribution to the world’s population explosion, I proudly satisfied The Royal College of Obstetricians and Gynaecologists Examiners,
tucked my Diploma firmly under my armpit, pointed the car away from smoggy London Town, and, with Anita in tow, headed for Dartmouth Town and the sand, sea
and surf of my home county Glorious Devon…..where the cider apples grow!
A WARNING though for budding Midwives and Obstetricians before temporarily closing the stable door on the subject.
You must have heard about the Hippocratic Oath,which contains the words that many doctors are required to recite when they are pledging themselves,after qualifying,to all the legal, ethical and other things that we must do as members of our proud profession.Interestingly,it is not a compulsory oath to take for all doctors. I recently found, in Hippocrates 5th book ,his 42nd Aphorism which I am pleased to say that I have never trusted,as a clinical ‘sine qua non,’ when faced with deciding whether or not my patient was pregnant.In a 1718 translation of the great man’s words his Aphorism states..”If you desire to know whether a woman hath conceived or no,give her,going to rest ,a draught of Metheglin and if afterwards she feels pains in her belly caused by wind she hath conceived.If none she hath not.” Methinks Hippocrates was gambling a little with his professional reputation here.Thank goodness for those accurate urine droplet tests that the anxious can readily pick up from the Chemist.
During my six months as a House surgeon at Charing Cross Hospital I was truly blessed by having another senior surgeon, Mr Arthur Makey, a tall dark and handsome middle-aged cardiopulmonary specialist who operated mainly on patients with lung cancer or other major pulmonary surgical problems and those who had developed valvular heart disease as a result of rheumatic fever some years previously and who were now cardiovascularly compromised.In the early 1960’s there were no CT, MRI, PET, FAST or other special scanners to investigate pre- operatively and confidently delineate where and what damage a patient had sustained.Even electrocardiography was in it’s relative infancy compared with the widespread and accurate role it plays in 2020. A thorough medical history, meticulous clinical examinations,some relevant x rays,tons of experience and intuition were the sine qua non guidelines for preoperative explorers seeking to maximise their knowledge prior to their initial incision.I assisted Mr Makey many, times and he simply exuded an air of calmness,confidence,a phenomenal breadth and depth of knowledge together with great surgical skills in managing any operative situation.He was a man with an enviable bedside manner.During my next position as House physician in paediatrics, my ward admitted an incredibly rare paediatric surgical problem which I was very fully occupied with looking after for a week prior to major surgery intervention by a team led by Mr Makey. [see next section of text].
ARE YOU A SPECIALIST DOCTOR OR ARE YOU JUST A GP ?
These words ring loud like church bells next to your ears if you are a GP.
I can confidently state that there isn’t a GP living or passed on, who hasn’t been greeted by this epithet at some stage in their careers by a well meaning person in Woolloomoolloo, Wagga Wagga, Wembley, Winchester, Woomera or Westmorland.
Dr R.M.S. [Mac] McConaghey, was, I thought “just a GP” in Dartmouth Devon, when he took me on as his Medical Practice Junior doctor in 1964 for one year .He and his partner Dr Giles Keane were founder Members of the Royal College of General Practitioners in 1952, and was also Founder Honorary Editor of the British Journal of General Practice.
In 1951 a published article of Mac’s,in the Journal stated.. “Everything that is worthwhile is worth the struggle and hard work necessary for its’ attainment.”
That’s a challenge isn’t it? I have, from time to time, ruminated on those words and have taken up the challenge when it seemed worthwhile.
Mac was an incredibly gifted person, modest, a scholar, a brilliant medical historian, a committee man, a planner and a quiet achiever doctor with great foresight into what it needs to be to become a leader of present and future generations of GP’s. His initial strategies were to teach the craft to junior doctors and then set the pathway for the future of General Practice, at first in the UK, and then further afield.He was awarded the OBE for his lifelong dedication and contribution to General Practice.
Dartmouth Medical Practice, in 1964,was an NHS practice, which provided GP and a wide range of allied health services to the Dartmouth Town Community as well as to a ring of Country Villages within about an 8 mile radius .We provided emergency and some obstetric services at the Dartmouth Hospital but major problems were ambulanced to Torquay .
I have known many,many very gifted general practitioners during my career, none greater than Monash University Prof John Murtagh. John has been a man of enormous talents and gifts, whose modesty and wisdom has guided and generously taught thousands of doctors the art, science and craft of General Practice.John and Mac are legends who have had an enormous influence on doctors and allied health professionals becoming the best that they can be. They have set the highest standards bar for us, and those who come after us ,to attain.
“Well done ye good and faithful servants.”
Dartmouth is a 5000 population tourist haven, on the River Dart, with tens of thousands visiting it for their annual holidays.There’s fishing, yachting and every conceivable water loving event virtually in the centre of the town.
The Royal Naval College juts out high above the town, like a beacon, and contributes, significantly, to Dartmouth’s unique lifestyle. The arousing music from their Brass Band is an historical reminder of the importance Dartmouth played in British Naval history. Captain James Cook and The Endeavour frequently used the harbour as a base for a number of his international journeys.
Daniel, our son, was born 4/6/1964 in the Maternity ward of the Torbay Hospital, Torquay. He spent many hours of his early months in a Nanny’s pram watching [or not] me play Rugby, Cricket or Tennis for Dartmouth.
Our social life was extensive and blended with a busy professional life. On the occasion of the 150th Anniversary of the Royal Britannia Naval College I was invited to play Rugby for a Representative team chosen to oppose the College.We won 66 points to 3 points. I did not score, Our points were rightly shared between our nine invited International players and five County representatives.
I do however recall that I was regularly required to minister to the injury assessments and treatment needs of our Internationals throughout both 40 minute halves, though these unpaid duties were duly rewarded with the better than average wines that were supplied during the evening celebrations. I remember all of our players and their performances really well, but, apart from being ”just the local GP” it is unlikely that any of them will have remembered my dashing runs on the right wing.
CHRISTOPHER ROBIN LIVED IN DARTMOUTH…WE KNEW HIM WELL.
Dartmouth was the home of A.A.Milne, Ex-World War I, Battle of the Somme soldier,author and inventor of the delightful Winnie the Pooh collection of books and Winnie’s forest animal friends Tigger, Rabbit, Roo,Eeyore et al.
His son, Christopher Robin, set up a bookshop in the Shopping Centre area of Dartmouth, in 1951 ,which he ran with his wife Lesley until 1983 when he retired.
Thousands of visitors came annually to see the real Christopher Robin, buy the books and woolly replicas of Winnie and her friends. and go home with Christopher Robin’s autograph.He was a kindly, quiet and shy man.
We met him at the shop occasionally but had no medical dealings with him or his family.
Lesley, his wife was a more forthright, busy, business woman who exercised a deserved protectiveness over Christopher Robin in the face of his adulators,who could be pushy and quite overwhelming . CR sometimes travelled through days of loathing the limelight
The Dartmouth folks understood and empathised with him but could do little to fend off the fans.
In 2017 a British ,classic biographical drama film,’ ‘Goodbye Christopher Robin”, was screened and covered the lives of the Milne family. It had very mixed reviews and all Winnie the Pooh lovers should read all about the circumstances surrounding the making of the film, the choice of actors and actresses and the angles covered in the plot.
Reviews of the film were legion. Some reviews engaged in speculative analyses by a bunch of psychiatrists about which character suffered from which, if any, mental disturbance. Google can assist you in the relevance ,or otherwise of most of their comments ….then have an entertaining night at the films and make up your own mind.
I SLEPT IN THE SAME BED AS AGATHA CHRISTIE BUT SHE’D LEFT EARLIER.
Agatha Christie bought a large Georgian home (Green way House),in 1938,
on the banks of the River Dart opposite Dittisham , a 10 minute boat ride from the centre of Dartmouth.
She wrote 66 detective novels and her sales numbers are now over 4 billion copies. Hercule Poirot and Miss Marple were her most famous characters.The house is now owned by the National Trust , UK and is a mecca for tourists in Devon.
In 1937 Agatha went to Egypt, and, in the Old Cataract Hotel , on the banks of the Nile River at Aswan she lived for over a year whilst writing a best seller book called “Death on the Nile”.
The Old Cataract Hotel , built in 1899 by Thomas Cook, has been carefully preserved and beautifully updated whilst leaving a number of suites furnished as per their original furnished design.The Agatha Christie Suite has the original Four poster bed and The Hotel is now called The Sofitel Legend Old Cataract Hotel.
Anita and I stayed in the Agatha Christie Suite in January 1993 for a few nights,having travelled from Jeddah in Saudi Arabia where I was working as Deputy Chief of Primary Care and Emergency at The King Fahd Military Hospital.
Agatha had, in fact, left her Suite, and Four Poster . ….56 years earlier.
Vale Agatha Christie 1890-1976.
GREAT SADNESS DURING MY LAST WEEKS IN DARTMOUTH.
Lots of happy things happened at Dartmouth Hospital,before I arrived,when I worked there, after I left, and no doubt they still continue to happen and,God willing,with continue to, for ever.
This day started as an ordinary day but ended tragically. Our friend and colleague, Matron, a universally popular middle -aged woman, had recently bought a brand new four seated car.She was backing it out from her Hospital parking spot when her foot seemed to get stuck on the accelerator.The car was propelled backwards across the road, across the pavement, and into the River Dart where there was some ten feet depth of water.
The car suddenly filled with water before rescuers were able to reach it. Every one knew how to deal with a car that is filling up with rushing water but, unfortunately Matron weighed 17 stones, and could not be extricated in time for her to be resuscitated.
I was at the Hospital entrance, near to all necessary resuscitation equipment, and fully trained to manage such a situation.
Three of us were unable to achieve a satisfactory airway, any signs of breathing or any signs of circulation during fifty minutes of attempted resuscitation.Matron had died from accidental drowning .
The town was shocked. She was farewelled by hundreds of locals and visitors.
A few weeks later,when my one year contract had finished, we left Dartmouth to spend two years in Cheddar,Somerset.
Dr Mac continued, as always, as an outstanding mentor and not “Just a GP.”
Another young doctor would come along and the ongoing cycle would be repeated. I don’t believe in “What if” and ”If only” thinking processes, because it smacks of a loser mentality and there are no satisfactory answers to the questions.However, Dartmouth was one of those places where you could be excused for thinking ‘”What if Dr Mac had got a career vacancy in his practice?” Well, he didn’t, because he only trained one doctor for one year.What a total, value packed year, it was for us all.
Thanks Mac!
I have always subsequently thought and taught that the world is full of oysters. When you find one which hasn’t got a big enough pearl inside it, you must put it back and let it grow for someone else to find it, and be happy with it, and then you musT go and look for a larger one!
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