Doctor On The Job

by Richard Gordon

  ‘He isn’t in the canteen having a quick coffee?’ asked Tony Havens. Sir Lancelot Spratt’s house-surgeon was burly, dark-haired, clean shaven and wearing at that moment an unaccustomed frown of intense concern.

  ‘He’s not having anything. I’ve even been through the loos.’ His companion was Hugo Raffles, fair, slim and pink-cheeked, one of the junior anaesthetists resident in the hospital.

  ‘I’ve phoned his digs. The landlady says he hasn’t been in all night. Stroppy she was, too. Got him eggs and bacon for a specially fortifying breakfast. He hasn’t kipped down across in the residents’ quarters, I suppose?’

  ‘I’ve looked there, too. In and under every bed. We’d have surely heard by now if he’d decided to doss in the nurses’ home.’

  ‘I suppose he hasn’t taken an overdose of barbiturate, to avoid facing the examiners?’

  ‘That’s most unlikely. He can never even remember what the normal dose is.’

  ‘I’m fed up with nursing this case of chronic infantilism. Remember how we just got him here last time? When he thought the examination was the following day.’

  ‘Which he explained to Sir Lancelot –’

  ‘Who congratulated him on anticipating to learn the entire subject of surgery overnight. You should never give Sir Lancelot half a chance for a nasty crack. It’s fatal.’

  ‘Remember when he failed his anatomy?’ Hugo reminisced.

  ‘After being shown a pelvis, and asked to identify Alcock’s canal –’

  ‘And pointing to the vagina.’

  ‘There he is!’ Tony exclaimed.

  Pip came hurrying through the front door, open frilly shirt flapping.

  ‘What a bit of luck, running into you,’ he remarked. ‘Lend me a few quid.’

  ‘If that’s your only worry –’ Tony began crossly.

  ‘I’ve got a taxi waiting to be paid outside. I spent all I’d got on tombola tickets.’

  ‘Compulsive gambler, eh?’ murmured Hugo.

  ‘Do you realize, you git, that you have precisely six minutes before appearing for your surgery clinical?’

  ‘I rather thought the time was getting on. My watch has been somewhat disrhythmic recently. But there’s no need to panic. I made it in the end, didn’t I?’ he ended smugly.

  ‘But you can’t walk into an exam looking like that,’ Tony told him sharply.

  Pip stared down at his dishevelled clothes. ‘I suppose I can’t. But you can lend me your white coat.’

  ‘You also need a tie.’

  ‘And a shave,’ said Hugo. ‘You know how dangerous it is, giving Sir Lancelot half a chance of referring to Sweeney Todd.’

  Pip rubbed his chin again. ‘Perhaps I do. Well, I know I can rely on friends like you to sort me out.’

  ‘Come on, let’s at least get near the field of battle,’ Tony exhorted, grabbing Pip by the sleeve of his velvet jacket.

  The examination was being held in Virtue Ward, Sir Lancelot Spratt’s men’s surgical on the tenth floor. Surgery itself had been transformed since the heyday of Sir Frederick Treves and Sir Bertram Bunn. The surgery finals had hardly changed at all. Cases from the wards and from out-patients, whose diseases did not proclaim themselves too subtly, were invited to pit their ills against the wits of the students. The patients’ fee was small, but many volunteered readily to return to the hospital for the chance of so painlessly helping to advance surgical science. Besides, the uninhibited discussion of each other’s ailments during the breaks for tea and biscuits had the flattering effect of membership to an exclusive club.

  The three took the lift to the tenth floor. Hugo remembered a large cupboard outside the ward, used as a store for patients’ clothes and belongings. They dodged inside. Tony and Hugo had two minutes to prepare Pip, physically and mentally.

  ‘Remember, Sir Lancelot has mellowed recently. Everyone says so. There’s no need to be scared of him any more.’ Tony Havens was hastily knotting round the neck of Pip’s frilly shirt a pink and silver St Swithin’s Cricket Club tie, with a motif of crossed bats and scalpels. ‘He won’t eat you.’

  ‘Not in one bite anyway,’ said Hugo Raffles, busy on Pip’s chin with an electric razor.

  ‘Yes, but do you know any of the patients?’ Pip asked impatiently.

  ‘Only two. Sir Lancelot’s been switching them around this time. He knows there’re too many of the old chronics who come up for exam after exam, which we all get wise to. Look out for the patient with a large lump on the back of his neck. It’s a lipoma.’

  ‘A simple lipoma should be easy enough to diagnose.’ Pip nodded with gratification.

  ‘Watch it. Don’t forget to whip back the bedclothes. He’s got no legs,’ Tony informed him.

  ‘I hope this shave is quite comfortable?’ inquired Hugo. ‘The razor’s a bit ropey. It’s the one they use for the ward preops.’

  ‘Miss the absence of legs,’ Tony continued severely, ‘and Sir Lancelot’s got you spit-roasted for not obeying the basic rule of examining the whole patient. There’s one old boy you must particularly look out for. I heard he was there from last week’s candidates. He’s one of Sir Lancelot’s old patients, a gloomy-looking skinny fellow with smooth grey hair and a camel-coloured dressing-gown. He’s generally reading the Daily Mirror. You’d think there was nothing wrong with him, except for slight varicose veins in the left leg, which don’t require treatment –’

  ‘He’s one of those trick examination cases?’ Pip interrupted brightly. ‘With nothing whatever the matter, but the students make up the most fantastic diagnoses –’

  ‘Not on your life. He’s got a glass eye. Miss it and you’re sunk.’

  ‘Sir Lancelot has a spectacular way of failing students with that one,’ Hugo added, shaving Pip’s upper lip. He takes a pencil and simply taps the glass eye smartly with the butt of it.’

  ‘Grey-haired old boy? Camel-coloured dressing-gown? Daily Mirror? I’ll remember that one.’

  ‘The rest will be the usual surgical slag of bumps and bones,’ Tony told him. ‘I haven’t been able to lay hands on any more dead certs, though I heard the rumour of a Chinaman with jaundice just to fox everybody.’

  ‘I’m quite sure I can pass by my own unaided efforts,’ Pip declared proudly. ‘I feel superbly confident this morning.’

  ‘Where did you get to all last night, anyway?’ Hugo asked.

  ‘I was at a home for destitutes.’

  ‘Is there any room? Your breath reeks of stale booze.’

  ‘It’s champagne,’ Pip told Hugo, sounding offended.

  ‘I’d still advise you to answer all the questions out of the side of your mouth.’

  The ting of a bell came from outside.

  ‘You look good enough to kiss,’ added Hugo admiringly, switching off the razor.

  Pip slipped Mike’s white coat over his velvet jacket. To their calls of ‘Good luck!’ he shot through the swing doors of the ward. Standing immediately inside was Sir Lancelot.

  ‘Cold?’ the surgeon greeted him.

  ‘No, sir. If I’m shivering, it must be from fright.’

  ‘Then turn down the collar of your white coat. Good God, boy,’ he exclaimed, as Pip obliged. ‘I thought that sort of shirt went out with Beau Brummell.’

  ‘It has come back, sir.’

  ‘This is an examination, not a dress show, I suppose,’ Sir Lancelot admitted wearily. ‘I have become so resigned to the sartorial vagaries of our students, I should not be unduly disturbed if they appeared for their finals in an ermine jock-strap and a straw hat. Of either sex.’

  Pip’s confidence rose. His two friends had been right. Sir Lancelot was mellowing. Pip had been studying energetically if disorganizedly the past six months. He felt that, barring some outrageous howler, he had a good chance of leaving the ward virtually a qualified doctor.

  ‘I didn’t know you played cricket?’ added Sir Lancelot with a frown.

  ‘I thought this tie went rather prettily with the shirt, sir.’r />
  ‘H’m. Well, you can open the bowling, Mr Chipps, by taking a look at that grey-haired gentleman just over there. The one in the camel-coloured dressing-gown who’s reading the Daily Mirror.’

  What luck! thought Pip. He was already on the path to qualification. He decided to make the most of his foreknowledge. ‘I think I can make at least one diagnosis in that case from here, sir.’

  ‘Indeed?’ said Sir Lancelot with interest.

  Nonchalantly strolling up to his patient, Pip took a skin-pencil from the top pocket of Tony’s white coat, and grasping the patient firmly by the top of the head thrust the end without a word firmly into his right eye.

  ‘Yahhhhhhhhhhhhhhh!’ said the patient. ‘You bloody maniac! Do you want to blind me?’

  ‘Get out of the ward this instant, you juvenile Oedipus,’ roared Sir Lancelot.

  ‘Oh, bother,’ murmured Pip. ‘Wrong eye.’

  ‘My dear Alfred, I do apologize,’ continued Sir Lancelot hastily to the patient. ‘I’m afraid there’s always the risk of some student becoming completely unbalanced through the stress of the examination –’

  ‘Unbalanced?’ demanded the man in the camel dressing-gown, hopping about and clutching his eye. ‘He’s not unbalanced. He’s a sadist. He’d commit grievous bodily harm easier than kiss my –’

  ‘Ah, Sister, an ophthalmic dressing, quickly,’ Sir Lancelot ordered, as she hurried to investigate the disturbance. ‘Please let me see the injured organ,’ he added with pressing solicitude, peering into the man’s face. ‘No permanent damage, I hope, as far as I can tell.’

  ‘I really am most dreadfully sorry,’ apologized Pip.

  ‘Get out,’ repeated Sir Lancelot furiously.

  ‘Does that mean I’ve failed?’ he inquired.

  ‘What on earth’s going on?’ asked the dean, fussing into the ward wearing his white coat. ‘Is one of the patients having a fit?’

  ‘This menace to society came into the examination room and promptly started attacking people with a sharp instrument,’ Sir Lancelot explained.

  The dean gave his thin smile. ‘Sounds like a typical surgeon.’

  ‘This is no time for joking,’ Sir Lancelot reminded him fiercely. ‘The fool might well have injured the patient’s one good eye for life. Worse still, he could have laid the hospital open to astronomical damages.’

  This took the smile from the dean’s lips. ‘Exactly. It’s bad enough already, patients queueing up to sue us if they so much as get a splinter under their nail from the ward draughts’ board. We have to carry more insurance than a jumbo jet. Particularly as the judges are utterly reckless throwing about our money. They take a mischievous delight in getting the better of we doctors. Lose your sense of smell and you can go off on a world cruise, lose an arm and you can retire in comfort for life. We’re a source of huge and unexpected wealth for the British public, like the football pools – It’s you, Chipps. As I might have expected,’ he recalled.

  ‘The idiot luckily missed the cornea,’ said Sir Lancelot, peering again. ‘But it’ll have to be bandaged up for the best part of a fortnight, I’m afraid, leaving you completely in the dark, Dimchurch. It’s particularly unfortunate, as you so kindly volunteered your services out of admiration for our noble profession.’

  ‘It is a blessing for humanity as a whole,’ the dean comforted the patient. ‘I can assure you that this young man, purely as a medical student, was a greater danger to the public than a berserk abattoir attendant. Had he gone into the world as a qualified doctor, he would have made the Black Death look like a flu epidemic. You should join the roll of great medical martyrs –’

  ‘I don’t want to be a bleeding martyr. I was planning to play golf this evening.’

  ‘Do you want to see me in your office, sir?’ Pip asked the dean mildly.

  ‘No.’

  ‘You mean the…the incident is closed?’ Pip suggested hopefully.

  ‘Firmly closed. But not, I fancy, in the way you imply. I do not wish to see you in this hospital after the next five minutes. Nor in its vicinity. Mr Chipps, I know your father well. I admire him as a general practitioner of the best old-fashioned sort. I did my utmost here to allow you to follow in his path. I turned a blind eye to so many of your antics at St Swithin’s, that I must on countless occasions have shared the affliction of our friend here in the camel-coloured dressing-gown, who would from his manner of jumping about and swearing still appear to be in considerable physical and mental suffering. This is too much, even for such a reasonable person as myself. You are expelled. You can appeal to the medical school council, but I would advise against it. I believe there is a paragraph in our original Charter from Queen Elizabeth the First, empowering the flogging of students at the front gate, if not their hanging from it.’

  Pip stood staring at the floor, slowly shaking his head. ‘I didn’t come to St Swithin’s just because my father wanted me to follow in his footsteps, you know. There’s something much more important. I am simply filled with an honest desire to help sick people.’

  ‘In which case, I suggest you apply for the job of a hospital porter,’ snapped the dean. ‘Please do not omit to return to my secretary the keys of your locker, or the appropriate sum of money in lieu.’

  ‘So this is the end?’ asked Pip, still unbelievingly.

  ‘It is. Goodbye, Mr Chipps.’

  Pip left the ward, sadly unbuttoning his white coat. Tony Havens and Hugo Raffles were waiting at the end of the corridor.

  ‘How did you get on?’ they both asked eagerly.

  ‘Pipped,’ said Pip.

  5

  ‘Matron. Sisters. Nurses. I am greatly honoured that you should ask me to officiate at this joyous occasion of presenting the student nurses’ prizes.’

  The dean leant slightly forward, his spread-out finger-tips touching the table, wearing an expression of infinite benevolence.

  ‘I only wish it was an occasion which had occurred at a more joyous time for our country. Change and decay in all around I see, to make an appropriate quotation from Holy Writ. Well, from Hymns Ancient and Modern, at least,’ he corrected himself. ‘There is nowhere respect for Government, for Law, or for any authority whatever, sometimes even my own. Every day our peace is disturbed and our traffic jammed by a “demo” – horrible word, horrible habit. Generally by the idiotic public objecting to something which does them a lot of good, like fluoridization and vivisection. If people want to air their grievances, why can’t they write letters to The Times like me?’

  He took a sip of water. ‘Violence is rife. So is vandalism, eroticism and absenteeism. Clap people in jail, and their accomplices demand “justice” – by which they mean instant release – for the “Wapping Six”, or some other popular combination of geography and numerals which, to my mind, indicates exactly where a tally of villains met its deserts.’

  The dean gazed for some moments at the ceiling. ‘Where was I? Oh, yes. I want to tell you of a paperback book I found the other day in the hospital corridors. I mean library. It is called “1984”. Quite horrifying. Though I suspect a good deal cosier than the real thing we’re going to face. I see our magnificent City of London –’ He waved an arm in its direction. ‘A distressed area, with workers coming with their battered bowlers from the ghost towns of Sevenoaks and Guildford, the offices of our great financial institutions recycled for the manufacture by hand of plastic Beefeaters and Union Jack knickers, to sell to Japanese tourists on Tower Hill. The Bank of England preserved as a national monument like Stonehenge, the Stock Exchange turned into the National Casino its doctrinaire enemies keep calling it –’

  ‘Lionel! You can’t say all that,’ objected his wife Josephine, who was laying the table round him that same Tuesday lunchtime, in the dining-room of their small house near St Swithin’s.

  ‘It’s a little joke, dear.’

  ‘You didn’t say it in a very jokey voice. Your whole speech is far too gloomy for the nurses’ prizegiving. You’ll have to rewrit
e it before tomorrow night.’

  ‘I can’t help it if the whole world is on the Cresta Run to ruin,’ the dean complained testily, banging the dining-table.

  ‘You’ll break a glass, dear. You should take the chance of cheering everyone up with an encouraging word, instead of passing round that the brakes have failed.’

  ‘Odi profanum vulgus,’ muttered the dean even more gloomily.

  ‘What’s that mean?’

  ‘It’s a polite Latin way of saying I loathe the common herd. Unfortunately, these days we have to go mooing along with the rest. Packaged tours, packaged foods, packaged views on television – ah, hello, my dear. As you were coming home for lunch today, I decided to join you,’ he greeted his daughter Faith. ‘I’ve rather eaten my way through the menu in the Bertie Bunn.’

  ‘Did you have a lovely dance?’ asked her mother, who was younger than the dean, dark-haired, soft-eyed and soft-bosomed. The dean had wooed Josephine while he was a St Swithin’s registrar, in the traditional medical way. She had been a nurse on night duty, and his romantic murmurings in the shaded light, his proposal of marriage itself, were jarred only by the recumbent patients periodically breaking wind.

  ‘The dance was fantastic.’ Faith kissed her mother. ‘I took hundreds of pounds for the tombola. Men seemed to be pressing money on me all evening.’

  The dean frowned. ‘After a life of service to humanity, I am beginning to wonder if we show misplaced generosity towards society’s misfits. All these destitutes and meths drinkers and so on would be better treated by being given a good, solid day’s work digging up Oxford Street.’

  ‘Anyone there you knew?’ her mother asked.

  ‘Not a soul.’

  ‘I would offer you both a glass of sherry,’ the dean explained. ‘But I am examining again this afternoon, so must keep a clear head. Not that some of the candidates wouldn’t drive to drink the entire Salvation Army, with the band playing. Do you know what happened this morning?’ he continued fervently. ‘Sir Lancelot and I not only had to fail – that would have been a vastly inadequate penalty – but kick out of the hospital a harebrained public menace called Chipps – What’s the matter?’ he demanded, as Faith gave a cry.