The Best of Health

Tales out of Medical School

John A. T. Duncan

• Publisher: Austin Macauley Publishers
• Year: 2021
• ISBN:
  9781398413283
• Topic: Medicine
• Subtopic: Medicine Biographies

60 years ago, being a medical student entailed some hair-raising encounters in the course of training like giving a general anaesthetic without help or instruction, simply because you were the only help available; or assisting in emergency surgery when there was nobody else available.Distinguished doctors thronged the corridors of Edinburgh Royal Infirmary. Long after the war there was still a vivid memory of Burma and Libya.Find out why an elderly theatre orderly hinted darkly at "a doctor who got to Dunkirk four days ahead of the field hospital team".Get a new slant on the Penicillin story and read why the old NHS system in Edinburgh avoided "bed blockers".Here is an account of the almost explosive expansion of hospital medicine into ICUs – cardiac arrest teams, coronary care units, positive pressure ventilation, renal dialysis, etc. It was a time of medical progress and high morale.

Part One

Suez: A National Disaster and
a Personal Crisis

Suez is the point at which this highly personal account starts. My brother, Gregor, and I were industrial potters in our mid-twenties and working as managers in the same factory in Stoke-on-Trent as our father. Some years back, we had served a three-year apprenticeship and now considered ourselves to be fully experienced pottery factory managers. We were eager to strike out for ourselves in an independent family pottery. The Suez crisis changed everything. It was a tsunami that swept through British life, tearing at the wobbly foundations of industry and the armed services alike.

People today, faced with Brexit and its swamp of awful alternatives, can have some idea of what was involved in the Suez crisis in 1956. It was a great wave of successive disasters for British industry, for British society, for Anglo-American unity and for international stability. Suez opened a chasm between the young who had starry ideas about a better world, and the deferential, unthinking older generations who stuck to ‘my country, right or wrong’. The debacle ended any belief in the mission of the British to be an exemplary, high-minded and civilised nation, leading the world with assured moral authority.

By its brutally arrogant behaviour in Egypt, the Conservative government set the example for the Soviet Union, a month later, bloodily to suppress the Hungarian bid for independence. Young people in Britain might weep in angry impotence at the scenes of slaughter on the streets of Budapest, but there was nothing that we or our country could do about it.

The invasion of Suez very quickly brought practical punitive consequences for the whole of British industry. OPEC, the mainly Arab association of oil-producing and exporting countries, banned all supplies of oil to Britain. Petrol was suddenly rationed; that was only the start. As at least half of Britain’s electricity was produced by oil-fired generators, the Conservative government immediately tried to restrict its industrial use by imposing a ‘three-day week’. Power outages became frequent.

Intermittent working proved ruinous in the case of some modern pottery factories, which were heavily committed to continuous electrical furnaces. The older bottle oven factories, such as the one I managed with my brother, were heavily dependent on coal; it too was rationed. As the collieries struggled to keep the electricity generators working, so we struggled to complete our customers’ orders before they were cancelled in exasperation. Delivery times for exports just fell off the end of the calendar. Old and modern alike, the pottery factories lost great slices of their export market, in many cases permanently.

Father went off to Australia to look for orders from old clients and new ones. Before leaving, he brought out the whisky bottle to ease a painful conference with his sons. Father was heavily reliant on the old dictum: ‘In vino veritas’, but decisions floated on alcohol are not at all reliable. On this occasion, his decision was to announce that he was abandoning his long-held ambition to put his accumulated capital into a new pottery factory to be run by his sons. Instead of gambling everything on a fresh venture, he was going to retire at the ripe old age of sixty years and live on his savings.

To end the interview, Father opened the sitting room window and threw the empty whisky bottle into the garden, thus symbolising something or other; bottling out of a bargain with his sons, perhaps. My brother and I drew the same conclusion: we were on our own and need expect no further parental help. We were grown men, and it seemed to us both that it was high time that we leave the nest.

In the bitter winter of 1956/1957, it became obvious that ours was an industry in decline and that many of us must look elsewhere for a new career. Gregor began to make enquiries about emigrating to Australia, or possibly re-enlisting in the Army. I cast my net nearer home, though I, too, began to look at the map of Australia.

Enquiries about apprenticeship schemes with various large companies like Rolls-Royce, The National Coal Board, British Motor Corporation and Unilever produced negative replies. They were interested in graduates but not in untalented dropouts like me. In the shocked and shivering industries after Suez, their dismissive attitude was to be expected. Sadly, many of these companies were about to be put to the sword in a world of commerce that was crueller than anything that had gone before.

To see this required no special intelligence, no foreknowledge of things to come, no magical star. It quickly became apparent to all that because of Suez, the country had dropped over a precipice and was irreparably damaged. Like it or not, a big personal change was forcing itself upon me and many others. It would take both skill and luck to steer this runaway horse of change to a safe stable, and I was no jockey.

‘The Vicarage’

I had an old school friend, Tim Showan, an artist of promise, who had just married Betty, a dark-haired beauty from the same Bath School of Art at Chippenham. To be near to their teaching jobs in a market town not far away, they had moved into a couple of rooms in a large old country house, ‘The Vicarage’, the owner of which had, as they say, ‘fallen upon hard times’. I became a frequent visitor.

Stoke-on-Trent was (and probably is still) a place that youngsters abandon at the first opportunity, and I was left behind with very few male friends. An apparently carefree young man with a sports car and a good job, but few friends would probably get so bored that he would marry a local girl; there wasn’t much else to do.

With Tim and Betty in their ancient mausoleum of a flat, it was therapeutic to relax in front of a large basket fire in their living room and to build a new world of cigarette smoke. This fire gave both heat and light, two things not always simultaneously present in political discussions on the radio. There were frequent power cuts, so we sat in the flickering illumination of the fire, listening on a battery radio to wise words about the enduring crisis and to stupid justifications of the past. Betty had a rough pregnancy, so the fire often had to be carried on a broad shovel up to their old-fashioned bedroom, also fitted with a large basket fire.

Tim and I would pull up two armchairs beside the glowing fire, while Betty reclined gracefully on her four-poster bed. Thus, the scene was set for profound and searching thoughts about the meaning of things, the price of coal and what the devil John Duncan was going to do with his life.

I was a very unsure young man and struggled with a feeling of inferiority, possibly because everything so far had been made smooth for me. It is easy to succeed in the industry if your father is a senior director of the business. Vanity had not blinded me to the fact that I had been promoted over men, only a few years older, who had recently been on active service in the armed forces. Furthermore, I had been excused from national service on the flimsy grounds of ‘hay fever’ and, fresh out of school, had easily passed all the industrial examinations required for the management of a pottery factory.

They, on the other hand, had wasted years in the armed forces and had then to struggle for yet more years doing night classes to get their technical qualifications. We had nothing in common. These rather older men hated my guts and rightly so. While they had spent the years of their youth in the armed services, their reward was to be pushed aside by twerps like me. This was why it was important to succeed in something difficult and to stand upon my own achievements.

Applications to Medical Schools

As so often happens, the answer came quite casually and from an unexpected direction. The current girlfriend of the winter months was the daughter of a GP. One Saturday night while I waited for her to apply the finishing touches to her war paint, I sat for a while with the worthy doctor, who was reading the British Medical Journal. His daughter had obviously briefed him about my casting around for another career, so he didn’t now view me as marriage material.

Jokingly, he pointed to the article he had just read in the BMJ: “The Dean of Medicine in Edinburgh is suggesting here that his medical school should recruit more students from non-scientific backgrounds. Why don’t you apply?”

So I did.

Just about the middle of November, I wrote applications to fifteen medical schools in England and Scotland, explaining my position as a mature student with a technical but not scientific background. Eight replied, calling me to interview, but from Edinburgh, there came only silence.

I attended wintery interviews in London, Sheffield, Manchester and Liverpool, excusing myself from the factory with a story of repeated injuries from weekend club rugby. My brother, Gregor, took over the management of the factory on these various days through January, February and March. Nobody seemed bothered by this.

Gregor enjoyed being in full charge and made a few significant alterations. We agreed that our long-term future lay wrapped in woolly uncertainty but definitely not in the Potteries. Gregor looked at Australia, while I looked at British medical schools.

A Series of Winter Interviews at Various Medical Schools

New Year’s Day wasn’t much celebrated in post-war England; in fact, the Stoke-on-Trent City Police New Year ball of 1955/1956 ended at 11:30 pm because the town hall keeper insisted on locking the building before midnight. London, too, for all its fooling around in Trafalgar Square at midnight, treated 1 January as just another working day. For this reason and its own inclination, Middlesex Hospital called me for an interview at 2:00 pm that day.

Indian food was unknown to the Potteries in 1956/1957, but there in Gower Street, just yards away from the Middlesex, was an obliging Punjabi restaurant. I had absolutely no idea what the menu meant (I thought that chapatis were probably Indian chips). This place was handy, and I felt hungry.

With my breath laden with curry and my stomach rumbling rather rudely, I was ushered into the Dean’s presence. In a rather narrow, gloomy office on the ground floor of this imposing neo-Georgian building was a small man in a city suit. His hair was black and shiny, and his horn-rimmed glasses were circles of disdain. He sat writing at a roll-top desk in an office just wide enough to fit a standard casement window for ventilation purposes. As the light from this window was inadequate for reading, the Dean had a table lamp perched on top of his desk.

“Duncan?” he asked, before returning to his writing.

A long pause lengthened into a minute, a minute and a half, and two minutes of silence.

“This is bloody ridiculous,” I thought as the stomach rumbles forced out a silent fart. It was becoming imperative to make this interview short.

This Dean was playing games with me. It had happened before. Important men like to impress and use silence to crumble the self-confidence of the interviewee. The best defence is to conduct the interview yourself. It should always be easier to answer your own questions, especially if you have had four hours on a slow train to prepare yourself for the obvious, such as:

‘Why do you wish to change course at your age?’

‘Why do you wish to study medicine?’

‘Why Middlesex Hospital?’

And it goes on.

I ran through the lot in five minutes and felt that I might be cutting things a bit fine; the fire in my belly had nothing to do with my ardour for Middlesex Hospital. I stopped speaking.

The Dean said without looking up, “We’ll let you know.”

He went on writing in his dark, cramped office. My thoughts had already turned elsewhere. The head porter directed me to a door many yards down a gloomy corridor. In the cold winter dark of the men’s toilet, the embarrassing curry left me. I didn’t expect to hear from that disagreeable Dean again (though, strangely, he accepted me).

The train home was waiting for me at Euston. I tipped my hat over my eyes because, in those days, serious men wore a trilby, and I was a serious man. Weary exhaustion wrapped me in sleep. Wherever I studied medicine, it would not be in London.

The Sheffield interview was in March, by which time petrol rationing had become a worn joke, so without qualm, I drove over the wintry Derbyshire and Yorkshire hills. In my very comfortable, heavy, shiny Triumph sports car, I slipped and slithered over the city’s tramlines and fumbled through the centre to find the medical school. In a pleasant interview, it may have done me some good to mention that I thought highly of the Sheffield Medical School because its professor of biochemistry had just been awarded a Nobel Prize. They offered me a place.

An interview in Liverpool the following week was also very pleasant, though somehow it became a discussion of Russian literature and the relative merits of Tolstoy versus Dostoevsky. The university area was difficult to approach from the South. My main memory is of the Mersey Tunnel, and how driving down its steep slope induced in me feelings of vertigo, reminding me of Alice’s falling and falling and falling into Wonderland. They, too, offered me a place.

Manchester was not a success. The day was wintery and road conditions bad, so I took the train, arriving forty minutes later than scheduled time. There was no time for lunch, even if I could have found a likely place, so I arrived at the Dean’s office with five minutes to spare and a hollow stomach rumbling but this time in a plaintive way, rather than a menacing fashion. The interview went badly; it was entirely my fault.

The letter calling me to interview had fixed the time for 2:00 pm, but I was kept waiting until 2:45 pm on a wooden bench in a long, draughty corridor lined with bilious green encaustic tiles. The place had all the appeal of a Victorian public lavatory and smelled similarly of cheap disinfectant. The interviewers, two anonymous grey men, were similarly unappealing. One, a long, thin presence, stayed silent throughout my fifteen minutes; the other shorter and plumper, adopted the languid pose of one who really doesn’t enjoy this sort of thing.

I shot a line about being impressed with the scientific advances made in medicine and made the mistake of mentioning Sheffield and the Nobel Prize. That was a daft thing to do when I had absolutely no idea what Krebs Cycle was, nor how many wheels it had.

“You know,” said the languid one. “We have better things to do than pander to discontented young men. Have you never thought that in your work as a potter, you might one day make the perfect piece?”

What a fatuous thing to say! How terribly Edwardian! Straight out of Oscar Wilde. How quaint!

What did he know about working in a dirty old factory; doing the same repetitive task all day and tracing a lifetime through fifty wasted years? He enraged me. I groped for an absolutely devastating reply but only succeeded in: “I’m afraid the industrial ethos is rather more demanding than to allow a lifetime. My factory must produce five thousand perfect pots per day or two million per year. Even the great Wedgwood, when he produced his copy of the Portland Vase, made twenty to take account of faults, and wastage and gifts to valued clients.”

I had blown it at Manchester, and I knew it was my own fault that they did not offer me a place. There followed a long chilly April; while my brother and I continued to run the factory, we tried to smarten up the running of the place and even started to make our own oval saggars, by which means we reckoned to save one hundred pounds per week.

Gregor found a saggar maker and a saggar maker’s bottom knocker and had a den made for them right by the bottle ovens. You probably don’t know what I’m writing about but don’t worry, I thought that a dab of local colour would brighten the narrative. At last, Edinburgh Medical School is about to appear like a swallow in the summer.

Acceptance

One Saturday morning, the post came clattering through the large letterbox of No. 2 Milehouse Lane at 7 o’clock. A stiff white envelope bore the news that Edinburgh University, without even clapping eyes on me, was offering me a place in its medical school and rather imperiously demanded a reply within five days. With eager excitement, a letter of acceptance was written, followed by a brisk walk down to the GPO in Newcastle-u-Lyme, just to be sure that it caught the midday post to Edinburgh. My fate was decided in the manner of a Victorian novel, where a letter from abroad provides the solution to a difficult problem.

Edinburgh in 1957

Edinburgh is unique among the cities of the world in the honour that it bestows upon the medical profession. A statue to immortalise (or at least to remind us for a while of), a doctor stands at either end of its main thoroughfare, Princes Street. At the East ...