Doctor On The Boil

by Richard Gordon

  The dean shook his head. ‘To be given a free introductory lesson at a dancing school.’

  ‘That hardly seems a cause for jubilation, I must say.’

  ‘How was the Far East?’ the dean went on hastily.

  ‘Bloody.’

  ‘Oh. Did you see the Taj Mahal by moonlight?’

  ‘I did not see the Taj Mahal at all.’ They both sat down. Crossing one knickerbockered leg over the other, Sir Lancelot observed, ‘You’ve still got that ghastly sentimental picture by Fildes on the wall, I see. You know it was described by our late professional colleague and playwright James Bridie as depicting “a middle-aged man scratching his beard and wondering what the devil is the matter with a sick child he is expected to cure”?’

  ‘I happen to like it.’

  ‘I must say, Dean, I expected a rather more substantial welcoming committee. After all, I have been away from the hospital for some time.’

  ‘Several members of the consultant staff have gone unexpectedly on holiday.’

  ‘But they knew perfectly well I was coming.’ The dean said nothing. ‘That, I presume, is why they went unexpectedly on holiday? Well, I can only hope it keeps fine for them. Professor Bingham’s here?’

  The dean smiled. ‘I don’t think our new professor of surgery ever takes a holiday. Young and keen, you know. Bags of drive and energy. An excellent choice for the job.’

  I bet that keenness is spilling a few basinsful of unnecessary blood, Sir Lancelot thought. But he said nothing. He was a fair man, who never made a professionally slighting remark behind others’ backs. To their faces, of course, he allowed himself to be as colourfully offensive as possible.

  ‘I gather from the newspapers you and young Bingham are in cahoots over this transplant business?’

  ‘I am the physician, and he is the surgeon heading the team, certainly,’ said the dean guardedly. ‘A very good team, too. We have had some excellent results.’

  ‘Yes, your last picture in the papers looked as though you’d just won the Cup Final.’

  The dean looked offended. ‘It is the surgery of the future.’

  ‘In my old-fashioned view, we would be better employed trying to perfect the surgery of the past. My dear Dean! These surgical fashions – I’ve seen them come and go, like women’s hats and skirts. Once we used to fill the patients up with liquid paraffin until they leaked. We tried to remove every organ compatible with the continuance of life, for every complaint from constipation to mother-fixation. After that, we invented the floating kidney, and lashed down everything inside the abdomen like deck-cargo in a storm. Do you remember the septic focus, Dean? I never saw one, quite honestly, but I seemed to have removed several hundred of the nasty little things. That was at the end of the war, when we thought they caused every bodily condition possible except pregnancy. Then we all forgot about them – I fancy because of the horrifying distraction of Nye Bevan with his National Health Service–’

  ‘Where are you staying in London?’ asked the dean. Sir Lancelot’s reminiscences, though authoritative and captivating, quickly grew impregnable to interruption.

  ‘I booked a room at the Crécy. I’ll drive round later.’ Sir Lancelot pulled a large red-and-white spotted handkerchief from his pocket and coughed into it.

  ‘I only wish I could offer you hospitality. Josephine and I would be absolutely delighted if you could stay with us. Absolutely delighted! But we’re quite full, right to the eaves. There’s not only Miss MacNish, but now we’ve an au pair girl from Sweden, and the only spare bedroom the two children use for studying.’

  Sir Lancelot grunted. ‘How are your kids, anyway?’

  The dean’s expression, so far in the conversation resembling a man in the dentist’s waiting for the drill to hit the nerve, relaxed into a proud smile. ‘Muriel won the gold medal in anatomy, and George has got through his second MB – admittedly after one or two tries he is never at his best in examinations, being a somewhat nervous lad. So both have started work in our wards.’

  The dean’s fingers, feeling idly in his pocket, discovered a ball of crumpled paper. Mystified, he drew it out and spread it across the blotter. He read the message, hastily screwed it up and pocketed it again. ‘To what must we be grateful for this – er, brief visit?’ he asked Sir Lancelot, who was staring at him with raised eyebrows.

  The surgeon helped himself to a pinch of snuff. ‘I am here for two reasons. Firstly, I have a cough.’

  ‘Oh? I’m sorry.’

  ‘It’s not frequent. Worse in the mornings. No haemoptysis, or anything sinister like that. It came on towards the end of my eastern tour. That’s what prevented me from seeing the Taj Mahal – it seemed best not to risk the expedition, and anyway you can always look at the place on picture-postcards. I don’t think I’ve anything serious. But of course, one must have any persistent cough investigated.’

  ‘Most certainly.’

  ‘So I’ve come to you. You’re a member of the physicians’ union. I’m a surgeon, and therefore know nothing whatever about the chest, except as a convenient shelf for your instruments while you’re operating.’

  ‘My dear Lancelot, of course I’ll do what I can.’ The dean was flooded with the sympathy of all medical men towards others undergoing the indignity of being ill themselves. ‘Come up to my ward after lunch. I’ll examine you and fix up X-rays and so forth, if necessary. There’s a side-room empty at the moment, getting ready for the class examinations on Monday week.’ He rubbed his hands. ‘I’m really going to stretch the little blighters this time. There’s been far too much slacking in the medical school lately, nothing but girls, poker, and electric guitars.’

  ‘That’s very good of you,’ said Sir Lancelot amicably. ‘My second reason is another complaint, one from which the whole world suffers. Boredom.’

  The dean gave a sigh, drumming his fingers lightly on the desk. ‘It is the blessing of our arduous profession, the unending flow of interesting work.’

  ‘Exactly,’ Sir Lancelot agreed firmly. ‘As you know, I retired prematurely. At the height of my powers. But I felt I’d done my bit for both humanity and the tax-collector. I wanted to enjoy my country house in Wales. Perhaps it was selfish of me.’

  ‘All of us here thought it an estimable idea,’ the dean assured him warmly.

  ‘Then of course my poor wife died. Now I’m lonely. One can fish only during the season. One cannot continually orbit the earth as a tourist. As an Englishman, I would not presume to interest myself in local politics, and anyway they are totally impossible to comprehend. I need an object in life.’

  The dean nodded. ‘They say philately can be most interesting. Or the collecting of butterflies and moths. Possibly bird-watching? Or pot-holing?’

  ‘My dear Dean.’ Sir Lancelot rose, with his hands behind his back, starting slowly to pace the room. ‘You are of course familiar with the charter of our distinguished hospital?’

  ‘Granted by Her Majesty Queen Elizabeth the First,’ the dean recited fondly. ‘I have often studied the original parchment. Quite awesome how its terms still govern much of our life here.’

  ‘Quite awesome.’ Sir Lancelot paused to cough. ‘Then you will remember that the hospital’s physicians and surgeons, though retired from active work, are fully entitled to return, to take over the care of such patients in the wards as they feel inclined to, with no questions asked. Clearly, our founders felt it desirable for the long experience of a retired surgeon never to be wasted–’

  ‘Lancelot!’ cried the dean.

  ‘Of course, in those days people were always retiring to serve the Queen or explore the American colonies–’

  ‘That right has never been exercised in the entire history of St Swithin’s,’ exclaimed the dean, turning pink.

  Sir Lancelot fixed him with his eye. ‘Well, it is now, old cock.’

  ‘But…but…this is outrageous. Absolutely outrageous. What do you imagine in this day and age the patients would say? Supposing you walked
into Professor Bingham’s ward and simply told one of them that you were going to remove his gallbladder–’

  ‘As my fees used to be the highest in London, they’d be getting better value for their National Health Insurance stamps.’

  The dean slapped his desk-top. ‘I shall have the charter amended.’

  ‘That’ll need an Act of Parliament. Ask the Prime Minister if you like, though there may possibly be more important things on his mind.’

  ‘Really, Lancelot, this is most unreasonable of you,’ the dean continued angrily. ‘It’ll raise all manner of problems with the Ministry. And just at the time I particularly want to keep my nose clean because–’

  He stopped. ‘Yes?’ demanded Sir Lancelot.

  ‘I happen to have mislaid my handkerchief. No, no, it’ll never do.’

  ‘We’ll see about that. Meanwhile, I think I’ll have a prowl round the old place. See you in the ward after lunch. And do provide a decent-sized jar for a specimen, there’s a good chap. From some of the receptacles you physicians produce, you seem to imagine a camel could widdle through the eye of a needle.’

  3

  ‘Good grief,’ muttered Sir Lancelot Spratt. ‘Ruddy sacrilege.’

  He felt a lump in his throat. A tear formed in the corner of his eye, ran down his rugged cheek and soaked into his beard. He dabbed it away with the red-and-white handkerchief and adjusted his features manfully.

  ‘One mustn’t mourn for bricks and mortar,’ he told himself severely. ‘But it’s sad to lose the shrine of your memories.’

  The cause of his distress was the surgical block of St Swithin’s. It was never a handsome building. It had been erected about the time Lord Lister was introducing a lot of new-fangled nonsense called aseptic surgery, when architects believed institutions catering for the sick poor should have a forbiddingly ecclesiastical appearance, to put the patients in a pliable mood of terrified gratitude. It had resembled the cross between a Thames-side warehouse and Dr Arnold’s thunderous chapel at Rugby School, but like so much of London’s richness in Victorian curiosities it was no more. The wards Sir Lancelot once strode in surgical majesty had almost unbelievably vanished. So had the operating theatre in which he had won – and sometimes lost – so many bloody battles. Even the poky ill-lit lecture room, where he had hammered the finer points of surgery into the skulls of countless students, had been unsentimentally crushed to a heap of rubble. Now there was nothing left. Only a hole in the ground, with a bulldozer nosing up piles of mud and half a dozen men in white helmets drinking tea.

  Sir Lancelot was about to revert from the harrowing sight when his eye caught something in the morning sunshine amid the brick fragments at his feet. He picked up a rusted scalpel – the old-fashioned sort with a fixed blade, the surgical equivalent of the cut-throat razor. He stroked his beard thoughtfully. ‘I fancy that’s the one I threw at my theatre sister during a nephrotomy in 1939,’ he decided. ‘Often wondered what became of it.’

  He slipped the relic into the top pocket of his tweed jacket, and turning his back on the past made briskly for the new St Swithin’s surgical block, which had risen on the site of the old kitchens and mortuary beyond the demolitions.

  ‘Looks like a ruddy supermarket,’ he grunted at the plate-glass-and-concrete tower. ‘Strange, how in another hundred years that, too, will be thought a first-class eyesore. Though perhaps a medical supermarket’s what’s wanted,’ he reflected. ‘Push your little basket round the doctors, and complain like hell if the latest line of treatment isn’t in stock. How different in my early days, when you didn’t have to tell people what was wrong with them, you just told them what was good for them. And sent ’em away with a flea in their ear if they dared to ask any questions.’ He sniffed as he entered the automatically sliding main doors. ‘No smell. Nothing at all. I liked the old stink of antiseptic and stewing cabbage. It gave the place an atmosphere.’

  He took the shiny staff lift to the top floor, where the professor of surgery had his wards. His intention was to see the sister in charge of the male patients, who on his own ward had for twenty years somehow tolerated his idiosyncrasies without even one attack of hysterics. He felt that she and Harry the porter, who had placed his bets and provided highly unreliable turf information over the same period, were the only people on the St Swithin’s staff who interested him.

  He walked along the short, plastic-tiled corridor frowning. The strangeness of modern wards was a shock to him, split into small rooms, hardly large enough to contain the surgical courtiers he liked following him. They were filled with the latest electronic equipment, which he cheerfully recognized he had no more hope of understanding than the latest pop singers’ lyrics.

  ‘Why, it’s Sir Lancelot!’

  Sister Virtue came fluttering joyfully towards him in her new-style uniform. It occurred to him that for the first time in his life he had seen the middle of her calves.

  ‘My dear Sister.’ He eyed her keenly. ‘You’re wearing make-up. On duty.’

  ‘Oh! Yes. It’s allowed now. The new matron, you know. In moderation, of course.’

  He stroked his beard. Amazing, he thought. She didn’t look such a bad old hag after all. ‘A lot of things seem to be changing.’

  She clasped her hands. ‘Everything. The dean, the professor, the whole medical council, want us right up-to-date. All our equipment seems plastic and disposable – the syringes, the bedpans, the masks and gowns. I sometimes long for those lovely old chipped enamel washing bowls and the solid porcelain bottles.’

  Sir Lancelot was inspecting the label on her uniform. ‘In all these years you never told me that your name was Esmeralda.’

  ‘Didn’t I?’ She blushed and looked at the floor.

  ‘Pity. I rather like it.’

  ‘Oh, Sir Lancelot!’

  He smiled. He had always been aware of two weaknesses in his character – a tendency to go into an abdomen too easily, and a fondness for the ladies. Fortunately, he often told himself, he managed to keep both failings reasonably in check.

  ‘Here, I say. It’s Sir Lancelot. Sorry I wasn’t at the door to greet you. Unbelievably busy these days, you know.’

  The gallant conversation was interrupted by Professor Bingham himself, in a white coat and carrying a long ribbon of punched computer tape. Sir Lancelot did not gaze on his colleague affably. He had admittedly expressed the belief that Jimmy Bingham would end up as a professor of surgery when the young man was one of his own students. But he had hoped that the chair might be in Sydney, Vancouver or some other academic centre well away from St Swithin’s.

  ‘Morning, Bingham. A few innovations in the hospital, I see.’

  ‘Even such a venerable institution as St Swithin’s must recognize the progress of the twentieth century.’ The professor pushed his glasses up the bridge of his nose, a habit which had irritated Sir Lancelot since he first interviewed the man for entry to the medical school. ‘The adaptation has become a little easier with the retirement recently of so many older members of the consultant staff.’

  ‘H’m,’ said Sir Lancelot. The same attitude of mind, doubtless, he mused, enjoyed by Macbeth when he’d cleared away Duncan and Banquo. Well, if there’s any haunting to be done, I’ve had a lifetime’s experience in making flesh creep. He said nothing about the charter. It would be more amusing simply to snatch a patient or two and let Bingham work it out afterwards. ‘What’s that contraption in the corner?’ he asked. ‘Electrified bingo?’

  Bingham’s face took on a knowledgeable expression which Sir Lancelot found barely tolerable. ‘That contraption, as you call it, is connected to the central computer. The days are passing when we had to examine patients with our bare hands, assemble the facts in our heads, and hit on a diagnosis. Quite out of date, like quill pens and inkpots. Now we do the requisite chemical investigations, feed them into the computer on punched tape, and within seconds receive the diagnosis. No possibility of error, to which all human beings are liable – even you, Sir La
ncelot, eh?’ Bingham smirked. ‘In a few more years, of course, it’ll be commonplace.’

  ‘No need for dreary old flesh-and-blood doctors, you mean, except to sign sick notes and hold the vomit bowl? And what are you intending to do with that dirty great hole where the surgical block was, may I ask?’

  Bingham’s glasses seemed to flash with pride. ‘That will be a new sterile unit entirely devoted to transplant surgery.’

  ‘Good grief,’ muttered Sir Lancelot.

  ‘I take it you don’t approve?’ Bingham asked in a pained voice.

  ‘I most certainly do not. The whole world’s gone crazy about transplants. All sensationalism is deplorable, and in surgery it is unforgivable. Besides, it is all too experimental for my peace of mind.’

  ‘You cannot turn back the advance of science,’ said Bingham, shaking his head sagely.

  ‘You take my advice and switch the money to something useful, like finding a cure for the common cold. Where’s the cash coming from anyway? God knows, there’s little enough of it about these days. The country can’t even afford a regiment of Argylls and a decent motorway to Wales.’

  ‘The dean handles all that. I cannot allow myself to be distracted by mere problems of finance. But we don’t have to go begging to Whitehall. The Blaydon Trust is supplying our funds, on, I understand, a generous scale.’

  ‘The Blaydon Trust?’ Something seemed to amuse Sir Lancelot. ‘Well, well.’

  ‘I gather Lord Blaydon is no longer alive, but the millions which he made from Ploughboy’s Beer – which, being teetotaller even as a student, I regret that I have never tasted–’

  ‘It’s weasel’s water,’ observed Sir Lancelot. ‘I suppose his widow controls the till? I once knew the lady socially.’

  ‘We deal only with her lawyers. She appears to be a rather mysterious person. But she certainly seems to entertain an attachment to St Swithin’s, for which we must be truly grateful.’

  Sir Lancelot’s eye fell on the patient in the nearest bed. ‘What’s the matter with that feller?’