“Haven’t you any idea at all what you want to do next?” I had asked him a few days previously in the surgeons’ room, as he took off his sterile gown after the day’s operating list.
“Not in the slightest,” he had replied cheerfully. “I shall again throw myself on the medical labour market. The happiest times in my life have always been when I was out of work.”
I was concerned, because I felt that Grimsdyke’s unusual talents needed careful organization. But I had overlooked his most enviable quality, which generally saw him out of his scrapes and difficulties – a knack of meeting chaps in pubs. A few days after our conversation in the surgeons’ room he had run into a doctor called Paddy O’Dooley in Mooney’s Irish House off Piccadilly Circus, who discovered that Grimsdyke was a graduate of the Society of Apothecaries of Cork and immediately offered him a locum in his practice in County Wexford. This my friend accepted, and he was leaving from Paddington the morning after our farewell drink in the King George. His only worry was discovering the exact whereabouts of his new post, the letter of appointment being scrawled on the back of a packet of Player’s cigarettes which his new employer had pressed into his hand before disappearing into the seductive glare of Piccadilly.
“I’m a bit vague about the whole set-up,” Grimsdyke, confessed, ordering another beer and a tonic water. The gloom of our evening was deepened through Dr Pennyworth’s forbidding me to taste alcohol for three months. “I gather it’s really Paddy’s old man’s practice, which is at the moment being run by a Polish chum of doubtful morals and doubtful qualifications. Still, it’ll be a change of scenery. There’s a lot of money round there, so I hear – estates and so on. And no NHS.”
“You’re sure you don’t want to go on with anaesthetics? You might have a big future there, Grim. You didn’t kill anybody and you kept the operating team amused when things were going badly. Those are the only attributes a successful anaesthetist needs.”
“Ah, a professional stuffist! I really wouldn’t have minded specializing in it, I must confess. I rather like messing about with the knobs, and it brings out the artist in me. A good anaesthetist’s like a French chef, you know – take some pure oxygen, flavour with a touch of ether, add a soupçon of pentothal, mix with pethidine, and serve garnished with gas. But you realize the trouble with anaesthesia as a life work?”
“Surgeons?”
He nodded. “Charming and erudite chaps most of them, but as soon as they get into their operating theatres their characters change. It’s just like other people getting into their cars. And their stories! Even such an amiable bird as old Cambridge insists on telling his five funny ones to each new batch of students. When you’re one of the permanent fixtures in the theatre, the laughter comes less blithely to the lips after the eighth or ninth repetition. Has he told you the one about him and old Sir Lancelot Spratt chasing a duke in his pyjamas down Devonshire Place?”
I nodded.
“Well, imagine hearing it regularly once a month for the rest of your life. Not that it’s much of a tale to start with. No, I’m afraid anaesthesia is going to lose me.”
“But haven’t you thought of trying some other specialty before burying yourself in Ireland? ENT, for instance? Obstetrics? Or psychiatry, now? That ought to be in your line.”
“I’ve thought of it all right. But contrary to popular belief, psychiatry doesn’t consist of listening to beautiful blondes lying on couches telling you all about their sex life. Before you get to that you have to sweat it out for years with ordinary common-or-garden lunatics. I don’t think I’d last long working in a mental institution – they say the medical staff soon get dottier than the patients. No, old lad. Not uncle Grimsdyke’s cup of tea. In fact, the whole ruddy National Health Service isn’t. Some chaps may like being able to look up the book and see exactly how much cash they’ll be getting at the age of sixty, but not me. I’ve got the pioneering spirit. The only trouble is, these days there’s nowhere left to pioneer to.’’
“Well… County Wexford might be the start of a distinguished and prosperous career, then?” I suggested hopefully.
“As well it might, Richard. I feel I’ve got sympathetic vibrations with the Irish.”
“Steer clear of the poteen.”
“And you steer clear of the girls.”
The following morning I packed my books and belongings at St Swithin’s, and saying good-bye to my friends went into lodgings in that indistinct part of London known as “South Ken”. I had chosen for economy a seedy Victorian house which seemed to have every Underground train on the Inner Circle passing immediately under its foundations. As each of the rooms had a ring attached to its gas fire they were called “flatlets”, and were occupied by young women who dashed in at six and dashed out again at six-thirty, students from the hotter parts of the Commonwealth, and several fat fair-haired women who puffed up and down stairs with cigarettes between their lips, carrying cats. Like many similar houses I had occupied as a student in London, it was a place where people seemed to arrive from nowhere, talk to no one, and leave suddenly. Rent was always payable in advance, and the green-baize letter-board next to the bamboo hat-stand in the hall was heavy with official-looking envelopes to former tenants who had gone to the happy lands of no address.
Without the distraction of gainful work, I now settled down to study for the next Primary Fellowship Examination. As the National Health Service pays its junior hospital doctors about the same as its junior hospital porters, my savings were so small that I had to live frugally. I fed mostly on fried eggs and kippers, cooked on the gas-ring in defiance of the grease-spattered notice demanding “No Frying”. I spent my time reading Gray’s Anatomy and Samson Wright’s Physiology and staring out of the window at the forbidding outlines of the Natural Science Museum opposite, until after a few days it became clear that either the Museum would have to move or I should. Perhaps I was still looking at the world through jaundiced eyes, but I soon became unable to concentrate, to feel enthusiastic about the exam, or to see any future in the medical profession at all. Even if I passed my Primary I should have to find a house surgeon’s job before taking the Fellowship Final, and the only ones advertised in the British Medical Journal seemed to be in large industrial towns which, however useful their population for aspiring young surgeons, didn’t strike me as places to spend the summer. After a spell as house surgeon I might be promoted to a surgical registrar, but the step between that and full consultant was as uncertain as the naval one between commander and captain. I remembered so many registrars fretting into middle age looking hopefully for signs of arteriosclerosis in their seniors that I even began to wonder if I should have taken up medicine at all. But it was far too late for such reflections. An unemployed doctor, unlike an unemployed barrister, is fitted for nothing else whatever. I supposed that a knack of analysing confusing noises at a distance in people’s chests would make me a reasonable garage mechanic, and an ability to feel hidden lumps coupled with a smattering of practical psychology might be of use in the Customs, but otherwise I was a national economic loss. Then as the Natural Science Museum showed no signs of shifting, I decided to take my books across London each day for a change of scenery by exercising my rights as a member and working in the British Medical Association building.
BMA House in Bloomsbury is a large, red-brick place standing about midway between the Royal Free Hospital and the National Union of Railwaymen, originally designed as a temple for the Theosophists. Its doorway, barely large enough to take a consultant’s Rolls, leads into a pleasant courtyard in which the medical intellectuals responsible for the British Medical Journal and the medical politicians responsible for keeping up the doctor’s pay can be seen conversing thoughtfully in the sunlight. There is a club room as satisfyingly gloomy as any in St, James’s, which is decorated with animal heads sent by sporting African doctors and provides desks and writing-paper. As it seems to be used only by provincial practitioners waiting for trains at nearby St Pancras, or surgeons
sleeping off official luncheons, I found it an excellent spot for concentration.
I was sitting at my writing-desk one morning about a week later trying to master the perplexing arrangement of tendons and nerves round the ankle, when a voice behind me said, “Timothy doth vex all very nervous housemaids.”
I spun round in my chair.
“Dr Farquarson!”
Dr Farquarson was Grimsdyke’s uncle, with whom I had spent the most pleasant, and probably the most instructive, fortnight of my medical life as assistant in his general practice in the country. He was a tall, lean Scot who wore a stiff wing collar which he considered as much a professional mark as a clergyman’s, and for London a dark suit replaced the tweed one that he used impartially for shooting and surgeries. On the whole, he resembled one of Low’s old caricatures of Ramsay MacDonald.
“A very useful mnemonic I always found that for the ankle,” Dr Farquarson said. He had the knack of starting conversations with acquaintances as though he had left them only a moment before, “Not so good as the one giving you the advanced signs of Casanova’s infection, of course –
There was a young man of Bombay
Who thought lues just went away
Now he’s got rabies
And bandy-legged babies
And thinks he’s the Queen of the May.
Did you know it?”
I laughed, and admitted I did.
“And how’s that idiotic nephew of mine?”
“Very well, I gather. You know he’s gone to Ireland? He sent me a postcard the other day.” This had shown the main street of a village which seemed to consist of alternate public houses and betting shops. On the back Grimsdyke had scribbled, “Note Irish town planning. Natives friendly, though much addicted to funerals.”
“Ireland, eh? It’s about time he decided to settle down and place whatever brains he has got at the service of some unfortunate community. And this anatomical effort,” he added, indicating my open books, “would be in aid of the Primary Fellowship examination, I take it?”
“Yes, I’m afraid so.”
“Of course, since my day they’ve gone and anglicized the whole anatomical nomenclature,” he went on. “Which is a pity because it gives the medical profession at least the appearance of being educated like gentlemen if they can mouth a few Latin words occasionally. I remember the time I found myself asked to say grace at some luncheon or other. I bowed my head and intoned:
‘Levator labii superioris alaeque nasi, Amen.’ A small muscle in the front of the face, you will recall. No one was any the wiser.” Producing a large gold watch from his waistcoat he added, “Talking of lunch, could you tear yourself away from your studies to listen to me rambling over a meal?” Dr Farquarson enjoyed giving the impression of extreme age, though he could not have been much older than my father. “I might even be able to give you some tips on how to bamboozle the examiners.”
“Why, I’d be delighted. If we go now we’ll still find a table in the members’ dining-room.”
“Members’ dining-room, rubbish! We’ll go to a place I know in Holborn. The last thing I want to do is eat looking at a lot of doctors.”
Dr Farquarson led me to a restaurant in a cellar at the end of a dark alley, in which steaks were cooked on an open fire and customers from the City sat in high-backed chairs like choir-stalls with their bowler hats clustered like bunches of huge black grapes above them.
“So you’re still going in for surgery?” he asked in the middle of his mutton chops.
I nodded.
“These days it’s no good just doing surgery, y’know. The hairs of specialization are split finer than that. In America, so they tell me, they have a man for the right kidney and another man for the left kidney. I always believe a specialist is a fellow who charges more and more for knowing less and less, and if I had my own time over again I’d become an omphologist.”
I looked puzzled.
“From the Greek omphos. A specialist in the umbilicus.” Dr Farquarson rarely smiled, but his sandy eyebrows quivered violently whenever he was struck by something amusing. “There can’t be many people smitten by diseases of that particular organ, but on the other hand there can’t be many people who’ve made it their lifelong study. Folk would flock from all over the world. That fellow James Bridie once wrote something about it.” He took another sip from his tankard, “Which brings me to my point. Would you consider going into general practice?”
“You mean as a temporary measure?”
“I mean as a permanent measure.” As I said nothing, he went on, “I’ve just changed my pitch. I’ve done a swap with a fellow called McBurney I knew up at the University – he’s had bad luck, poor fellow, going down with the tubercule. So I’m in Hampden Cross now.”
“You mean north of London?”
“That’s right. Do you know it? It’s in the so-called green belt, which consists largely of a forest of traffic-signs and petrol pumps. But there’s pleasant enough country nearby, and there’s an old Abbey and a cricket ground to satisfy a man’s spiritual needs. They’re building one of these new town affairs on top of it, so I’ll soon be wanting an assistant – with a view, as they say in the advertisements.”
I hesitated.
“I apologize for asking,” he said quickly. “You’ll be through your Primary this shot, and you’ll have your Fellowship in your pocket by Christmas. You’ll be in Harley Street soon enough. Then you can be sure of getting some cases from an old has-been like me.”
He spent the rest of the meal talking about Test Matches.
I took the Primary Fellowship a fortnight later. In the days before the National Health Service the examination was conducted for a handful of candidates in the quietly academic atmosphere of a dissertation in a mediaeval university. But as young doctors now enter for it in the same spirit as they back horses in the Grand National, the contest has to be run on sharper lines. The written papers had for once left me reasonably hopeful, and a few days later I was back again in that bleak little upstairs room which is decorated with the particular blend of green and yellow paint so heavily favoured in Britain for mental hospitals, station waiting-rooms, and the surroundings of police courts. Waiting for my oral, I suddenly felt sick of all examinations. I calculated that since childhood I must have sat a dozen of them, including my School Certificate and driving test. As a medical student I had taken them in company with my friends, which gave the ordeal something of the sporting air of a chancy rugger fixture; but now I not only had to face the examiners alone, but I was aware that my next year’s salary depended on it.
These depressing thoughts seemed to be occurring to the other occupant of the waiting-room, a sad-looking young man with mauve socks who sat staring out of the window in silence until he said suddenly, “If you get old Professor Surridge, you’ll know if you’ve failed.”
“Will I?” I asked in surprise. “How?”
“He always asks people he’s decided to plough what the dose of morphine is.”
“A tough examiner, is he?”
“On the contrary, he’s very jolly. He’s too kind-hearted to keep chaps in suspense until the results come out. My registrar got through last time – sixth attempt – and was so amazed to find himself outside without being asked the fatal question he put his head back and said ‘It’s an eighth to a third of a grain, sir.’”
We sat without speaking for a while, pondering what the kindly Professor and his less considerate colleagues were at that moment asking the candidates across the green-baize tables.
“You from Bart’s?” asked my companion.
“Swithin’s.”
“I’m Guy’s. First shot?”
“Second.”
“I had a go at the Membership last time.” He was referring to the corresponding examination for prospective physicians. “Damn near passed, too. I thought my long case had a collapsed lung, and I even decided to perform the coin test for good measure.”
“The coin test? That�
��s a bit old-fashioned, isn’t it?”
“Oh, yes, it went out with leeches and gold-headed canes. But some of the examiners are pretty old-fashioned, too. Anyway, in this case it proved a most valuable investigation. I had just produced two half-crowns from my pocket to bang together on the chest – as directed in the textbooks – when the patient stuck out his hand and pocketed them, whispering, ‘Thanks, Guy, it’s a gastric ulcer, actual.’”
I managed to overcome my surroundings with a laugh. “Didn’t that see you through?”
“No, worse luck. The next case – the short one – was a heart. Damn it, I diagnosed it perfectly! The patient was sitting up in bed, and I had plenty of time to listen all over his chest. ‘Patent ductus, sir,’ I told the examiner, ‘Quite correct,’ he said. ‘Anything else?’ And I said, ‘No.’”
This seemed unreasonably unfair. “But why on earth didn’t they pass you?”
“I hadn’t noticed that some blighter had cut both his bloody legs off as well.” A bell tinkled, and we made for the examination-room door. “I hear they’ve got a bottle with an orange-pip impacted in a parotid duct,” he whispered helpfully as we went in.
I was directed to Professor Surridge, who turned out to be a little pink fat bald man, giving the impression of just having been lifted from a pan of boiling water.
“Well, Doctor,” he said genially, passing me a large bottle. “What’s that?”
“It could be an orange-pip impacted in a parotid duct, sir.”
“Indeed it could,” he agreed. “But it is a cherry-stone impacted in an appendix. Both rare conditions, eh?” He handed me an odd-looking syringe. “What would you use that for?”
“Syringing ears, sir?” I suggested.
“Better than the last candidate, at least, Doctor. He wanted to inject piles with it. Actually, it’s from Clover’s chloroform apparatus. Historical interest, of course. Now let us discuss the anatomy of the appendix and its various aberrant positions.”
Doctor in Love Page 4