Growing Into Medicine (9 page)

When my daughter studied anatomy in the late seventies she did no personal dissection. Although detailed anatomical knowledge is obviously essential for someone who is going to be a surgeon, with medicine now so specialised many doctors never touch a scalpel after they qualify. Belatedly, it has been recognised that other subjects are more important at the undergraduate level.

I cannot leave the dissecting room without recalling one of our demonstrators whose right hand was a useless claw. Her ambition had been to work as a surgeon in some far country. She had developed an infection in one of the deep compartments of the hand, each separated from the other by a strong band of fascia. An essential part of the treatment of any infection in such a confined space is the release of pus. Her doctor inserted his lance into the wrong pocket. The resulting scar tissue was so strong and dense that it contracted the muscles and destroyed the nerves. All students who passed through the department in her time were word perfect when tested on the fascial divisions of the hand.

Physiology was the other subject in our second and third years. Much of the work was practical and consisted of testing our own body fluids. We stalked down corridors carrying pots of urine and took blood from each other’s veins. I cannot forget the sickly smell of new-drawn blood when it was not smothered by disinfectant as it is in hospitals. I wonder if this tang is present in war zones or
whether the stench of mud, excrement and explosives overpowers the spilled blood.

The worst part of the experimental work was swallowing a Ryle’s tube to withdraw some of the contents of the stomach for analysis. At first we pushed them down each other but if that failed the staff were fierce, taking no notice of our gagging but continuing to shove, intoning ‘swallow, swallow’. One girl vomited repeatedly and was eventually excused. But I was glad to have survived what was a frequent procedure for patients.

The pre-clinical departments of the hospital were scattered in various buildings, allowing plenty of opportunity for coffee, chat and a cake (if one could afford it) between sessions in the labs and lecture theatres. I continued to go to dances at the Victoria rooms, to sing in the choir and take an active part in university ‘rag’ weeks. One year I exhausted myself shaking a tin as I jumped on and off buses dressed in pyjamas and dressing gown. In support of our efforts, the bus company charged us no fees.

Once the second MB exam was behind us we progressed to ‘walking the wards’ of various hospitals. A group of students was assigned to a ‘firm’, usually consisting of two consultants and their junior staff. We moved through attachments in medicine and surgery at the Bristol Royal Infirmary (BRI), interspersed with other subjects. ENT was covered at the general hospital, where the air was heavy with the stench of brewing from the local industry. We were introduced to the paediatric enthusiasms and piercing questions of Professor Neal in the children’s hospital, at the top of St Michael’s Hill opposite the site where the new maternity hospital would be built. For our obstetrics we had to sleep in at Southmead in order to fulfil our quota of twenty deliveries. At the same time we were studying pathology at Canynge Hall under the watchful eye of Professor Hewer, his exotic bow ties jumping on his Adam’s apple as he explained what we were seeing down the microscope – or not seeing.

When each student was assigned a new patient he or she had to take a history, perform a physical examination and then present the
findings to the whole firm at the bedside. Some consultants were more sensitive to the listening patient than others. I was shy, finding it difficult to relax with the patient alone and even more uncomfortable talking about his signs and symptoms to the others.

I had particular difficulty hearing the heart murmurs that were the signs of diseased valves, a serious complication of rheumatic fever. That illness could follow an attack of scarlet fever, common at the time and a more serious disease before the introduction of penicillin, although some consider the streptococcus has also become less virulent. Our professor of medicine, Bruce Perry, had a particular interest in the cardiac complications. My good friend Christine Willis suffered from a bad attack at the end of our first year. She had to rest for many months and her medical training was delayed by a year.

The student common rooms at the BRI were segregated by sex. The men played bridge and if I had been given the opportunity to join them I would have played all day. My passion for cards was born playing rummy with my grandmother. She loved to gamble and her grandfather clock, inherited by my brother, was won in a card game aboard ship on one of her winter cruises. I never played for money but my daughter tells me that when her turn came to be initiated into rummy her great grandmother took her pennies with no compunction.

In my fourth year I moved out of Clifton Hill House to share a flat with my cousin Jenny. She had come to Bristol to study social work and we continued the friendship that had been so important to us before it was interrupted by the war. Clifton suspension bridge, one of my favourite places, was within walking distance. If I needed to escape, usually from my own feelings of embarrassment or inadequacy, I would storm up the path to a corner where I could gaze at the single span supported by thick cables. The water, or more often the extensive mud banks, glistened below in the light of sun or moon. On the surface of a sloping rock a bright track gleamed, with a patch of rough grass at the bottom to act as a safety stop for the
generations who had used it as a slide. Leigh valley woods covered the opposite side, and the buildings of Bristol lay beyond the bridge to the left, the cranes rising like exclamation marks in several areas. The sky above could provide spectacular sunsets.

Although the war had been over for several years a great deal of rebuilding was still taking place in the city. With the wind in the right direction one could hear the thump of pile drivers. I would imagine the houses with their varied occupants: children coming home with school satchels, housewives at the doors in their pinnies, men hurrying home for tea.

Jenny and I continued to share our inner worlds in the way we had done when we had galloped our horses round the garden at Green Gables and stabled them in the garage. One evening we took a cloud-formed journey into a land of beaches and seas, rocks and mountains that led to our imagined future. Her dream was of a house in the country, children, horses and chickens, with croquet on the lawn. That dream materialised in much of its detail. My own was less clear-cut, the edges obscured by the need to fit a professional life into the jigsaw.

Perhaps my daydream was also vague because reality, in the form of my future husband, was now edging into my life. I first met Ralph at one of those dances held in the house of some friends, although I had a single previous image of him. He had attended a small school that my mother had organised at Green Gables before Arthur went to boarding school. She employed a trained teacher and asked a few children of local friends to join him in classes. I was only three at the time. Daisy told me that when they marched round the garden doing squats and stretches I would follow, remaining down to play with stones after they had risen and moved on. I can see Ralph, perhaps standing taller from my perspective on the ground, at the top of a grassy slope, a pale, freckled boy, withdrawn but in some way a presence, at least in my mind.

When I told my mother whom I had met at the dance she said, ‘Whatever you do, don’t marry a diabetic.’ It was not perversity that made me do just that. Ralph intrigued me. He had gone into the
Rajputana Rifles, via the Somerset Light Infantry, straight from school. At the age of seventeen he sailed for India as a private. Unwilling to scrabble for a better place he slept on the dining room table. He was a quiet man who wrote poetry and had an ironic sense of humour.

He had hoped to cure his fear of heights by learning to parachute. It did not work and throughout our marriage I had to change light bulbs and fix curtain rails as he was never comfortable standing on a chair.

In 1946 he had developed diabetes, undiagnosed until he returned from India to his home in Bath weighing five stone. By the time we met at the dance he was studying philosophy and psychology at Oxford, leading a fairly isolated life, organising the local judo and boxing clubs, and listening to jazz, but doing little else while he recovered from his experiences. He did not discuss these with me, as if in some way he needed to keep me innocent, or perhaps to keep his innocence in me. After he died I discovered he had confided stories of his war to one of my friends. She told me of the time he threatened to kill an English doctor who refused to go into a cage to treat the confined prisoners. Ralph’s gun did not waver – so the doctor went in.

All his life he was on the side of the underdog, one of the qualities that attracted me to him. In a railway carriage once, three men were lamenting the number of foreigners, especially coloured people, who had immigrated into the country. He said nothing until he was asked for his opinion. Then he raised his head. ‘It is hard for me,’ he said, ‘I am a quarter Japanese.’ Then he retired back to his newspaper. His landed family had been in Somerset since the beginning of the sixteenth century and may have arrived with the Vikings. But his typical, thin-lipped Skrine face could, with some imagination, have concealed a smattering of oriental blood.

After I passed my pathology exam, at the end of the fourth year, I planned a short holiday on the Isle of Sark. At that time Jenny could not come with me and as no other friend was free I decided to go alone. I joked that people would think I was going in order to decide
whom to marry or to recover from a broken heart. As the day drew near the humour wore thin. One evening when it was pouring with rain I burst into the flat.

‘This is the most important moment of my life,’ I said as I stood with my hands pushed against the closed door, water streaming down my face.

Jenny smiled at my self-dramatisation. ‘Really? How do you know?’

‘Ralph has just asked if he can come with me to Sark.’

‘Is that such a big deal?’

‘I’ll have to ask my mother.’ I went home the next day and put the question to her. The reply was typical.

‘An excellent idea, see if you can stand each other, but I won’t tell anyone outside the family.’

Such a trip alone with a man was still not considered respectable unless one was engaged.

With no cars on Sark, the smallest of the Channel Islands, we were taken to the hotel by horse and cart. When we arrived, the clerk asked if we were together. I answered defiantly that of course we were not. But no one was deceived when we spent the next days together exploring the coastal paths and beaches, almost deserted at that time of year. Inland the gorse was in full bloom, covering the hills in a sea of yellow. When we missed a path Ralph began to slip down the grassy slope towards the edge of the cliff. As if in slow motion he disappeared from sight. I peered down as an arm, followed by his head and torso, rolled into sight on the beach below. He lay still and I thought he might be dead. After a moment he stood up, shook his head and tested all his limbs. His judo training had saved him. Frozen to the cliff with fright I waited to be rescued by a passing man.

My mother had implied that we would return with the matter of our future settled one way or another. The evening of Ralph’s fall, the last one before we returned, I forced the issue. I don’t know whether I acted because I wanted the matter settled before we returned, or whether his fall had made me realise that I wanted him
as a permanent part of my life. When he asked me what I was thinking (something couples did in those days, do they still?) I replied that I was wondering if he was going to ask me to marry him. He said yes. He could not have answered otherwise. At moments of self-doubt I have wished I had waited for him to ask me spontaneously. However, he said later that he could never have asked a girl to marry him if he had not known her as a child. ‘Known’ is an exaggerated description of his brief contact with me as a three-year-old. I like to think that by the time we returned to the mainland from Sark, ready to tell the world that we were engaged, he had convinced himself that he had done the asking.

I now had two more years to qualification. Jenny left Bristol with a social work degree and I moved into a series of lodgings. Ralph came down from Oxford with a third class degree. He was not surprised as he had done no work. Those three years had been spent adjusting to civilian life. The freedom of university life must have been a strain for he had lived in male societies since the age of seven and felt comfortable in a hierarchy with a well-defined role.

We had a difficult year while he looked for a job, applying to various hospitals for work as a psychologist. My parents disapproved of him living at home doing no work. In their eyes he should have laboured on the roads or in a factory if he could get nothing else. My future in-laws would have been shocked if he had done anything so menial. Eventually he applied for a job in the prison service. At the interview he was turned down yet again for the post of psychologist. Then one of the assistant commissioners said, ‘Have you ever considered joining on the governing side and subverting them from within?’ The suggestion appealed to him. He was appointed as an assistant governor and assigned to an open borstal, one of the special institutions for young offenders, in Yorkshire.

Now that he had a job we could proceed with the wedding and managed to negotiate all the conflicting emotional difficulties caused by my mother. I wanted us to get married and live together immediately but I still had one more year of undergraduate training.
In the Bristol medical school brochure I found a paragraph that stated a student could study for a year at some other university. I got in touch with Leeds, whose admission panel turned me down without taking the trouble to see me. But Sheffield offered me an interview. When I explained the situation they said their policy was to foster ‘oddballs’.

We started our married life in one half of the upright side of an H-shaped prefabricated building, built by the RAF during the war and then taken over as a borstal. It was a remarkably comfortable building with a furnace in the middle that heated four bathrooms in the cross of the H and provided central heating to all four quarters. Washing, hung over the bath at night, was bone dry by morning, very fortuitous as any garment exposed to the air outside was covered in smuts within a few minutes.