Now I felt fully equipped, and ready to go on the wards! Before that, however, came the six-week Clinical Introductory Course.
The senior lecturer in medicine was a big man, who - in his day - had played rugby for The London; his startlingly red hair was thinning on top; his skin was starkly white, covered in freckles, and there was a gingery fuzz on the back of his hands. He spoke eagerly, but with a marked stammer: he was known by the students as “Fl - Fl - Flaxman”.
Our conversation dribbled to a halt, as he surveyed us with a warm, friendly smile. His speech impediment remained in abeyance - to our mild disappointment - as he commenced his lecture-demonstration. First he discussed the merits of the different models of stethoscopes, patella hammers and ophthalmoscopes - confirming me in my judicious choice of instruments; next, the whole year crowded round, while he demonstrated - on a student - the examination of the cardiovascular system: feeling for the pulse, checking the neck veins, measuring the blood-pressure, and examining the heart.
“We must look for pulsations over the praecordium, f-feel for the apex beat and for any thrills (rolling of the eyeballs from the male students), percuss for the heart s-s-size - to detect a pericardial effusion - and fur-finally listen with the bell of the stethoscope over the cardiac apex, pulmonary area, aortic area, and into the neck; posit-positioning the patient ap-ap-appropriately for each heart valve.”
Reassured that we had not been misled about his speech, we broke up into groups of ten to practise. To the regret of all the men, the ladies were exempted from being “patients”; no doubt their time would come when we progressed to the examination of the nervous system …
Monday, 21st May: Sebastian and I stood outside the closed doors of Oakley Ward, a female medical ward, whispering together nervously; we were equipped with duplicated sheets on Taking a History and Performing a Clinical Examination (handouts at the end of Dr Flaxman’s lecture-demonstration); however, as soon as we entered the ward, all details of Taking a History, which I had so carefully learnt the night before, vanished.
Bright sunlight poured through the windows, and I had to squint to accommodate. Beds stood in neat rows on either side of the ward - most of them occupied; the ladies’ ages ranged from sixteen to sixty, yet all had their hair neatly groomed, faces carefully made up, night-dresses decorous, and bed-jackets (in pale pastels) festive with frills and bows; to me they all looked surprisingly well!
As primed, we made our way to the central desk, where sat the ward sister, impressively surveying her domain; she was a shrew-like middle-aged woman, with a poker back, grey hair peeping out from under a tall white frilly cap; she wore a long dark blue dress, a starched white apron, and starched white collar and cuffs; around her waist was a thick blue belt with an ornate silver buckle, and pinned to her left breast was a gold watch. While we made our way down the length of the ward, she scrutinized us with evident disapproval.
“Well?”
“Please Sister, may we talk to …”(a pause as I glanced at my notes) “ … Mavis Watson, Bed Ten?”
“As long as you just talk to her … Mind, don’t go upsetting her … And don’t speak to the nurses … Draw the curtains so you don’t disturb the other patients, and remember to pull them back when you have finished.”
She resumed her administration, to show we were dismissed.
Mavis Watson was a pretty girl of sixteen, in a revealing sleeveless pink nightie; she had short curly auburn hair and rosy cheeks (A malar flush, I remembered from my notes). She gave us a bright smile; then sat waiting patiently, while we introduced ourselves - hesitantly - and then dried up completely! After a long pause:
“Er, what are you complaining of, Miss Watson?”
“I’ve got mitral stenosis.”
“Oh!”
My heart constricted with pity for this young creature, whose life would be so tragically shortened; I sat there, her case notes on my lap, marvelling at her composure and serenity, and totally at a loss for words.
Sebastian came to the rescue:
“Can you tell us your symptoms, Miss Watson?”
“Well … I’ve been a bit short of breath these last six months playing netball … and I’ve developed a bit of a cough, especially at night, if I slip down from my pillows.”
I took notes while she spoke; Sebastian asked the questions, referring less and less frequently to his crib-sheet as he grew in confidence.
“Do you get short of breath at night, Miss Watson?”
“Yes.”
“Do you cough up any sputum?”
“Yes - frothy and pink.”
“Do your ankles swell, Miss Watson?”
“Only at the end of the day.”
After half an hour, we finished The History of the Present Condition; we exchanged roles: now I asked the questions, while Sebastian filled in the student’s section of the case notes, as we progressed through Past History, Family History, and Social History.
“Please don’t keep calling me ‘Miss Watson’ - makes me feel really old.”
We learnt that she had had Rheumatic Fever as a child, but no other illnesses or operations. There was no family history of heart disease, “But my aunt has TB …”
She blushed when asked her marital status:
“Single, of course.”
(I didn’t ask about children.)
“What work do you do?”
“I’m still at school, silly … (She stopped, dismayed at the rudeness of her unintended comment, but I only smiled.) … but I’m going to train as a secretary, soon as I finish.”
Again, I experienced a pang of pity and a feeling of sadness; yet she had regained her former cheerful manner.
“How many cigarettes do you smoke a day?”
“I don’t smoke at all - ugh, filthy habit!”
“Do you drink alcohol?”
“Occasionally I have a small shandy of a Saturday night; you won’t tell my mum, will you?”
We explored, at length, her recreational pursuits and interests - she liked music, dancing, ice skating … We were interrupted by the staff nurse, young, pretty, lacking the sister’s stern demeanour:
“I think you’ve had quite long enough. It’s time for Mavis to have her lunch.”
“Will I see you both again?” the patient asked eagerly.
“We’ll come back to do our physical examination …”
As we left the ward, I glanced at my watch: we had taken an hour and a half over the history!
Sunday 27th May: Although I was a few minutes early, Jill was waiting for me when I emerged from the ticket barrier at St James’s Park Underground Station; she was dressed casually in brown: slacks and roll-neck jumper; she smiled shyly as she caught my eye, and we walked out of the station together, into the brilliant late-spring sunshine.
We passed the passport office in Petty France, strolled down another back street, and crossed the broad but empty Birdcage Walk (Strange street names, I thought). I inhaled the scent of new-mown grass, as we entered St James’s Park; apart from the teeming bird-life, we appeared to have the place to ourselves. In the distance, on our right, were the massive buildings of the Foreign Office and the Old Admiralty; and, between these, the wide flat expanse of Horse Guards Parade, where toy soldiers in antique uniforms - mounted on miniature horses - were being scrutinized by crowds of tiny tourists.
A Union Jack fluttered bravely in the light breeze, as the wispy clouds scudded across the heavens.
“That’s Downing Street, just before Horse Guards …”
The high sun warmed the back of our necks; we walked hand in hand across the park, comparing the introductory courses at St Thomas’ and The London, and the special merits of the medical instruments we had just acquired.
She listened good-naturedly, whilst I told her at great length about my girl with mitral stenosis; it transpired that Jill, herself, had seen three patients already:
“There was a deeply jaundiced man with carcinoma of the pancreas; a young
woman with a large pleural effusion; and a very blue toddler with a congenital heart condition ... It’s called Fallot’s tetralogy - but we only observed him from the end of his cot!”
The narrow lake stretched the whole length of the park. We stopped at the Oriental bridge, to gaze about us: in the shallow water stood flocks of flamingos - tall skeletal birds in hues of delicate pink; on the mirrored surface floated plump white pelicans, their pouch-like beaks capable of accommodating a set of encyclopedias; they never seemed to fly, and I wondered whether their wings had been clipped; birds overflowed onto Duck Island - a promontory at one end of the lake - and even onto the footpaths.
Jill broke into my thoughts:
“Did you know, Edwin, that in the seventeenth century a pair of pelicans was presented to Charles II by Tsar Peter the Great of Russia? And their descendants have been here in St James’s Park ever since!”
As we strolled along a path beside the lake, past beds of flowering shrubs, I had the absurd yet uncomfortable sensation of someone watching me, of eyes boring into the back of my neck. We sat down on an empty bench by a weeping willow, and brought out our sandwiches. It was now after mid-day, and the park was beginning to fill with people from the surrounding offices on their lunch breaks: they, too, sat on benches, or lay on blankets on the grass; they came in pairs or in small groups; but mostly they were solitary, their only company the birds, with whom they shared their meal; one or two read newspapers; others closed their eyes against the sun; they wore dark suits and dresses, but the men had removed their jackets, and loosened their ties, as a concession to informality and the baking heat. On a bench, almost facing us, sat a man with a flaming red beard, incongruous in a long cashmere overcoat. Could this be my man? After five or ten minutes, he waved to someone behind us, got up, picked up his briefcase and rolled umbrella, and left. Still I felt uncomfortable, still I felt eyes boring into my back. I couldn’t rid myself of the sensation. Slowly, I allowed my eyes to sweep around the park. I regarded everyone closely though surreptitiously; nobody returned my gaze, nobody within my field of vision would qualify as my secret watcher. I’m just being paranoid, I decided.
As I relaxed, the tranquil scene around us lost its focus, dissolved; we looked into each other’s eyes - and discussed music! Why did Schubert leave his Eighth Symphony unfinished, only to complete a Ninth Symphony, later? Why did the Romantic composers - Beethoven, Schubert, Bruckner, Dvorak - stop after nine symphonies? Had anyone composed a greater number? (I had a sudden strong feeling of déjà vu: we had had this identical conversation years ago, when we first met.)
We drowsed in the warm afternoon sunshine; Jill nestled against me, her head slipping down on to my shoulder. In the background came the drone of distant traffic on the Mall, hidden behind a row of plane trees in full leaf.
Time passed …
“My parents would like to meet you,” Jill’s voice woke me from a pleasant reverie. “It’s my fault really: I keep talking about you! Could you come down one weekend? We live in Putney … I know it’s a drag, but when my mother wants something, she will usually persevere until she gets it.”
I took out my pocket diary, and, after some further discussion, we tentatively pencilled in a date for a month’s time …
The park was again in the possession of the birds: the humans were back in their offices; the sun had moved westwards, and, though still warm, was no longer at its height. It was four o’clock, and Jill had promised her parents that she would drop in for tea - when she hoped to finalise our meeting. Slowly and reluctantly, she came upright …
We lingered as we crossed the park; then skirted Buckingham Palace, on our way to Victoria Station.
“I’ll catch the District Line train to East Putney.”
With a brief kiss and a sharp stab of regret, I left her at the Underground entrance.
An empty day stretched suddenly ahead: how ever would I get through it? Perhaps, after supper, I could go on a pub-crawl with some of my friends from the hostel …
You have humiliated me, Edwin Scott. You have persisted in your womanising, even after that vile physiotherapist departed the scene. Don’t think I don’t know - for I know everything! You have flaunted your new wench shamelessly in front of the whole world, oh dear me yes. You are poisoning our once wonderful friendship.
Well, my patience has finally snapped, and my affection has turned to hatred. From now on, I will work to bring you down. And mark my words, I will succeed, oh yes. I shall sit in my web, just like a giant spider, and weave my plans. And when I’m ready, I shall act, I shall pounce!
So enjoy yourselves while you can, my friends, for soon enough you will all be rotting in Hell!
Chapter Seventeen - July, 1957
Monday, 2nd July: We waited inside the main entrance to the hospital - the registrar, the house physician, and the whole junior medical student firm; all my friends were here, but I noticed with a touch of irritation that Michael Ffrench and Anne Baker-West had been appended to our group.
A tall distinguished gentleman appeared through the outside doors promptly at ten o’clock; there was just a touch of grey at his temples, and he wore an immaculate white coat over his charcoal pin-stripe trousers and waistcoat. My heart beat a little faster: could this be the legendary Sir Henry Wilmshurst, Physician to the Queen, and Senior Physician to the London Hospital?
“Good morning. I’m Tony Crisp, Sir Henry’s senior registrar. Afraid He couldn’t make it this morning … Sends His apologies.”
He paused. After a brief survey, he smiled his approval.
“Good! You’re all suitably dressed: ties, suits, dresses, clean white coats, gentlemen’s hair neat and not too long. Have you all got stethoscopes, patella hammers, neurological pins? Then let’s get started.”
The hall-porter had kept the lift waiting for us, and now we crowded into it.
We emerged on the second floor, and filed into Uffingham Ward behind the senior registrar. I blinked in the bright sunlight of the ward: beds were all neatly made, curtains drawn aside; the patients, men of all ages, freshly washed and neat in their pyjamas, appeared to be sitting to attention. Sister met us at the door, polite and deferential:
“Good morning, Dr Crisp.”
The house physician took up position behind her, with the notes trolley, and we moved on; we stopped at the first bed, above which was displayed the prominent notice: “SIR HENRY WILMSHURST”; a round middle-aged man gazed cheerfully at us from the bed.
“Tell us about Mr Potts,” Dr Crisp addressed the houseman …
Altogether, we saw four patients this morning: on each occasion, the houseman gave a confident and concise history; the middle grade registrar put in an occasional comment, but otherwise remained in the background; the senior registrar demonstrated the examination of the patient; next, one or two of us tried our hands at listening to the chest - Michael Ffrench and his superior stethoscope especially prominent - or palpating the abdomen; finally we would leave the bedside to discuss the case (out of earshot of the patient). Time rushed by like an express train. I was exhilarated.
“I’ll leave you with our house physician, Mr Percival, who will give you your time-table for the Firm, and allocate you your patients. Good morning.” It was twelve-thirty, and Dr Crisp ambled away, accompanied by the younger registrar.
Michael Ffrench and Anne Baker-West kept aloof from the rest of us, though Anne always treated everyone with scrupulous courtesy; as the junior medical firm progressed, she even managed an occasional wintry smile. Ffrench was handsome, tall and fair, but had a permanent sneer of disapproval on his face; he remained uniformly obnoxious - especially towards me; he still despised me for my background and my South London accent, and he ratcheted up his Etonian drawl by a couple of notches, whenever he deigned to address me; his father was a Lieutenant-General in the Army, and this he never tired of pointing out; he had a high opinion of himself, though his intellect was distinctly average; his veneer of superiority was marred not
only by his stammer - which got worse whenever he became excited - but also by a general accident-proneness.
Michael Ffrench was especially proud of his expensive Specialist Model stethoscope, and extolled its virtues constantly to the rest of the Firm: “Let me show you how to really listen fuf-for an aortic diastolic m-m-murmur, Scott …”
The contraption was draped prominently around his neck, on permanent display. By the end of the first week, we were all heartily sick of Ffrench and his super-duper stethoscope!
Saturday, 7th July: We had come to a Saturday night students’ hop. It was still broad daylight, when I strode confidently through the wide courtyard of University College, a far cry from the apprehension of my first visit - for the badminton match - more than a year before; we followed the casually-dressed couples streaming into the building, and found ourselves in a large hall, already hot and crowded (though it was still quite early). There was a buzz of voices, and people moved back and forth to the bar - in the pause between dances - like bees at a hive.
I ushered Jill to a couple of vacant chairs in a corner. At the bar, I bought two pints of rather watery beer, which we sipped while taking stock of our surroundings. The subdued lighting was upstaged by daylight from the uncurtained windows, depriving the hall of its sought-after aura of mystery and romance. I had been to only one of these functions before (with Vicky): they were much larger and felt more impersonal than those at The London; tonight, apart from Jill, I knew not a soul.
In the Footsteps of The Whitechapel Slasher (Edwin Scott Crime Trilogy Book 1) Page 13