Doctor at Large (3 page)

‘Hello, old chap.’ He grinned. ‘Sorry you didn’t get the senior HS job and all that.’

‘Yes, I’m sorry, too.’

‘You had hard cheese rather, old chap, didn’t you? About that loony, I mean. You ought to have had him X-rayed before calling the Prof. Or asked “patient’s occupation’’ as your first question. I’d have done.’

‘I suppose I ought.’

‘Now you’re going to look for a job in the provinces, aren’t you? There’s some jolly good hospitals outside London, so they tell me. Not up to St Swithin’s standards, of course, but you might do pretty well in time. Do you want me to say goodbye to the Prof. for you? I don’t suppose you’ll want to see him again, will you – after that.’

‘It happens I’ve just been to him. For my testimonial.’

‘Any time I can be of help to you, old chap, just let me know.’

‘Thanks.’

We reached the ground floor, and I got out.

‘I’m going to the basement,’ Bingham explained. ‘Going to have a dekko at some slides in the lab. Now I’m senior HS I thought I’d better run over my path. and bact.’ I slammed the gates. ‘Don’t expect I’ll see you before you go, old chap. Got to give a talk to the new cas. HS – they don’t seem to know a thing, you know, these chaps who’ve just qualified. Toodle pip!’

He pressed the button. The lift moved six inches and stopped. Bingham pressed all the other buttons in turn. Nothing happened. He rattled the gate. It wouldn’t open.

‘I say, old chap,’ he called after me anxiously. ‘I’m stuck in the lift.’

‘So I see, Bingham.’

‘Absolutely bally well stuck.’ He gave a nervous laugh and rattled the lattice again. Several nurses, porters, and patients had gathered round to watch. Passengers were often stuck in the St Swithin’s lift, which provided a regular diversion to the otherwise monotonous aspect of the corridors.

‘I say, old chap.’ His voice wavered. ‘Get me out, will you?’

‘But I don’t think I know how.’ Some of the nurses began to titter. ‘Do you mean I ought to send for the fire brigade, or something?’

‘No, dash it, old man. This is beyond a joke.’ He rattled the gate loudly, terrified that his dignity was slipping away from him. ‘Be a sport, old chap,’ he implored. ‘Get some help. You can’t leave a pal like this, can you?’

‘Oh, all right,’ I said testily. I supposed even Bingham had human rights. ‘Wait a minute.’

‘Thanks, old chap. I knew you’d do the decent.’

As I strolled away as slowly as possible to fetch a porter, I noticed a loaded food trolley moving down the corridor with the patients’ lunch. An idea struck me. When I returned to the lift I was pleased to see the crowd had doubled and Bingham was rattling the bars again.

‘Ah, there you are, old chap!’ he said with relief. ‘You’ve been pretty nippy, I must – here! What’s the idea?’

I slowly peeled half a bunch of bananas and poked them one after another through the bars. This simple pantomime delighted the audience, which had now been joined by a party of convalescents from the children’s wards and blocked the corridor. Bingham himself became mildly maniacal.

‘I won’t forget this!’ he spat at me. ‘I won’t bally well forget it! You wait and see!’

I left him still in the lift and walked straight out of the hospital, for the first time in my qualified career feeling reasonably contented.

On the bus I opened the Professor’s testimonial. It was short:

TO WHOM IT MAY CONCERN

Dr Gordon has been my Casualty House Surgeon for the past three months, in which time he has performed his duties entirely to his satisfaction.

I began to open the
British Medical Journal
as the Chinese open their newspapers, from the back: the last twenty pages are filled with advertisements for jobs, and I suddenly found myself less concerned over the progress of medical science as a whole than the next source of my own bread and butter.

There were plenty of hospitals advertising for house surgeons in the provinces, so I bought a book of stamps and wrote a dozen elegantly phrased applications. As I would receive free third-class tickets to attend the interviews I felt that at least I would see something of the country at the National Health Service’s expense.

I soon found that I was not a success at interviews. First of all, the waiting-rooms upset me. Before an oral examination, a group of students enjoy the deep, sad comradeship of a bunch of prisoners awaiting the firing squad, but when a job is being decided the atmosphere in the anteroom is more like a lifeboat with the food and water running low. Although none of the candidates could have wanted work more urgently than myself, I always reached the empty chair at the foot of the committee table with subconscious feelings of guilt. This made me always say the wrong things, find difficulty in knowing what to do with my hands, fiddle with my tie, break pencils in two, and tear the sheet of pink blotting paper into little bits.

I went through several interviews, though now they are as indistinguishable, in my mind as different visits to the dentist’s. They were all held in hospital boardrooms, containing a fireplace crammed with coal, three portraits of men in frock coats suffering from obesity and hypertension, the hospital reports since 1840 bound in red leather, a bust of Hippocrates in the corner, and black panels of donations recording in gold leaf how ennobled local manufacturers cast their bread upon waters with reliable tides. In the middle of the room was a mahogany table that looked strong enough to support a tank, round which sat a dozen of the most intimidating people I had seen in my life.

It was important to decide on entering the room which of the committee were doctors and which were lay governors, in order to tune the pitch of each reply correctly – there was no point in giving a clinical examination answer to a wholesale draper in his best suit. At one of my earlier interviews I was asked solemnly by a man in a clerical collar, ‘What would you do, Doctor, if you were operating alone at midnight and suddenly produced an unstoppable haemorrhage?’

Feeling sure of myself, I replied, ‘Pray to God for guidance, sir.’

A small man on my right stirred. ‘Don’t you think, young fellow,’ he said quietly, ‘you might ring up a consultant surgeon before calling on the advice of an unqualified practitioner?’

I didn’t get the job.

Some of the committees wanted to know if I played cricket, others if I played the piano; some if I were married, or if I were moral; one chairman asked my politics, another the names of my clubs. Whatever answers I gave never seemed to be the right ones: there was always a sharp silence, a slight ‘Oh!’ from somewhere, and the chairman was thanking me very much and saying they would let me know in due course: My saddest discovery of all was that an education at St Swithin’s did not automatically waft you to the head of the profession on the sweeping bows of your colleagues. We had been brought up to assume the same relationship to the graduates of other hospitals as Sherlock Holmes to Watson, and it was a shock to find someone who had never heard of the place.

‘What’s your hospital, lad?’ demanded one florid, fat surgeon, who held the degree of a northern medical school never mentioned in our wards.

‘St Swithin’s, sir.’

‘Ee, lad, you’ll live it down,’ he said, and everyone roared with laughter.

This was too much, even at an interview. ‘I might say, sir,’ I declared indignantly, ‘that I am extremely proud of the fact. At least, they say you can always tell a St Swithin’s man.’

‘Aye, lad, and you can’t tell him anything.’

I didn’t get that job either.

After a disheartening month of cold train journeys I began to feel worried. I no longer faced the problem of finding a befitting start to my surgical career, but of keeping myself alive and fed. I had four pounds ten in the bank, one suit, a bag of golf clubs, a roll of minor surgical instruments, and a small plaster bust of Lord Lister. I lived in a furnished room in Muswell Hill, the weather was wet and icy, all my shoes needed repairing, I always seemed hungry, and my depressing circumstances made me want to drink twice as much as usual. My microscope had been sacrificed long ago, and my skeleton lay in a pawnbroker’s near St Swithin’s, whose cellars must have resembled the catacombs after a plague year.

The only objects of value left were my textbooks. I looked at them, packing my landlady’s cheap bookcase with their plump smooth backs and rich gold lettering, like a hungry tramp eyeing a flock of geese. For a week I resisted temptation. Then I decided that there were two or three volumes on subjects like public health and biochemistry that a rising surgeon could do without. Later I unashamedly took the lot, one after the other, to the second-hand medical bookshop in Gower Street, saying at every meal a grace to its provider. Whitby and Britton’s
Disorders of the Blood
gave only bacon and eggs and coffee in a teashop; but Price’s
Textbook of the Practice of Medicine
was much more nutritious, and ran to tomato soup, steak and chips, a pint of beer, and apple tart. I saved up Gray’s
Anatomy
for my birthday, and when I at last carried
The Encyclopaedia of Surgical Practice
downstairs I booked a table at Scott’s.

Soon I had nothing left but a few
Student’s Aid
handbooks,
What to do in Cases of Poisoning,
and
A Table of Food Values,
which together would hardly have risen to tea and sandwiches. I therefore set out to my next interview, at a large hospital in Northumberland, determined to win the job. I stood in the waiting-room staring out of the window, trying to forget the other candidates; I marched into the committee room, clasped my hands under the table, and answered all the questions like an efficient policeman in court. This time I had the whole length of the table to myself with the committee in a line opposite, which somehow increased my confidence. I felt I was doing well, particularly when the tall surgeon in the corner who had been asking most of the questions nodded after investigating my career at St Swithin’s, and said, ‘That seems all very satisfactory. And you really mean to go in for surgery, do you?’

‘Most certainly, sir,’ I answered promptly. ‘However much personal hardship it means at first, that’s always been my ambition.’

‘Excellent. That’s the spirit I like to see in my house surgeons. Don’t you agree, gentlemen?’

A heartening volley of grunts came across the table.

‘Very well,’ the surgeon said. ‘Now Dr Bryce-Derry, our Chairman, will ask you a few routine questions.’

The Chairman, who sat immediately opposite me, was a pleasant-looking, youngish man in a tweed suit, a check shirt, and a homespun tie.

‘Now, Dr Gordon,’ he started with a smile. ‘You’re certain you really want to work in our hospital?’

‘Yes, sir.’

His smile vanished. His lips tightened.

‘You have been qualified a little over three months, I believe?’

‘Yes, sir.’

He paused. He glared at me.

‘You are a member of the Medical Defence Union, I take it?’ he went on slowly.

‘Oh, definitely, sir.’

I felt bewildered. There was suddenly an odd atmosphere in the room. All the committee members were either looking at the ceiling or staring hard on to their squares of blotting paper. Nobody spoke.

‘And of the BMA?’ the Chairman continued, now scowling.

‘Y – yes, sir.’

This sudden malevolence was impossible to explain. I felt awkward and nervous, and wanted fresh air. I pulled out my handkerchief to wipe my forehead, and pushed back my chair. Then I saw opposite me under the table the edge of a tweed skirt, thick fishnet stockings, and a pair of sensible brogues.

‘I – I’m terribly sorry, my dear sir – I mean madam – I – I – Oh, God!’ I jumped up and ran for the door.

I didn’t get that job, either.

In the train to London I pulled the latest medical journal from my overcoat pocket and sadly turned again to the advertisements, which were conveniently arranged alphabetically under specialities from Anaesthetics to Venereology. It seemed time to try my luck at a different branch of medicine. Bacteriology meant regular hours and no talkative patients, but there was always the risk of catching something like smallpox or plague. Tuberculosis offered work in pleasant country surroundings with plenty of fresh butter and eggs, but the drowsy routine of a sanatorium often drugs the doctors as well as the patients. Orthopaedics needed the instincts of a carpenter, and pathology the instincts of Burke and Hare. Radiology sent you to work in unhealthy, dark, dripping grottoes underground, and paediatrics meant children being sick over your trousers.

I looked gloomily through the window at the English industrial landscape thirstily soaking up an afternoon’s rain, and tried to review my years at St Swithin’s to find another subject for which I had shown some aptitude. But my education was represented in my memory only by a series of smells – there was the acrid smell of the first-year chemistry class, the soft smell of Canada balsam used for mounting zoology slides, the mixed stink of phenol and formaldehyde in the anatomy room, the rich aromatic breath of the biochemistry laboratory, the smell of floor polish in the wards and ether in the operating theatre, and the smell in the post-mortem room like a badly kept butcher’s shop. I sighed, and reluctantly turned back the pages: there was nothing left but general practice.

Under
Practices
(
Executive Councils
) was printed
For vacancies
(
except those in Scotland) apply on Form E.C.16A, obtainable from the Executive Council…
The first breath of bureaucracy! It had such a depressing effect that I turned to the less formal advertisements tucked among prospectuses for private lunatic asylums and offers of used cars and second-hand RAMC uniforms in the back. One on the cover itself struck me:

EMINENTLY SUITABLE FOR RECENTLY

QUALIFIED PRACTITIONER

1. Medical Officer in luxury liner on world cruise. America, South Seas, West Indies, Australia, Japan, India. Leaving almost immediately. All found and salary £2,000 per annum (in US dollars).

2. Personal Medical Officer required by South African millionaire travelling widely Africa, America, Asia. Salary by arrangement, but money no object for suitable man. Apply at once.

3. General Practice. Suitable partner required for quiet practice in Wye Valley. Free sixteenth-century house, fully modernized, free fuel and food, free car and chauffeur, three months’ holiday a year.

Many Other Similar Posts

Apply to: Wilson, Willowick, and Wellbeloved, Medical Agency

The address was not far from St Swithin’s.

The next morning was foggy, my rent fell due, and I was developing a cold, but even from Muswell Hill the agency shone brightly with hope. I made for it directly after breakfast. I had never seen the office, but I found it at the top of a bare, sagging staircase between a hospital for chronic diseases and a pub.

On the door was a notice saying WALK IN. Inside was a small room lined with varnished planks, containing two plain wooden benches facing each other and fixed to the wall, like seats in a French railway compartment. Opposite was a door with a cracked, frosted-glass panel saying PRINCIPAL; there was a window curtained with London grime, and on the floor the small, upturned face of a circular electric fire gave a wan greeting. Sitting on one bench was a pale, thoughtful man about my age reading
The Journal of Neurology, Neurosurgery, and Psychiatry,
and on the other an old, untidy, dirty-looking fellow with an insanitary moustache and a crumpled trilby was staring at the floor and muttering.

I sat next to the young man. None of us spoke. I waited until both of them had entered and left the inner room, then I went in myself.

The office was smaller than the waiting-room, and contained a high, narrow desk at which a benevolent-looking old man with gold-rimmed glasses and side-whiskers was sitting on a stool. He was wearing a wing collar, a cravat, and an old frock coat. A light in a pale green shade hung from the ceiling to the level of his nose.

‘Mr Wilson, Mr Willowick, or Mr Wellbeloved?’ I asked cheerfully. The sensation of applying for a job as a customer rather than a supplicant was unreasonably stimulating.

‘Alas, Doctor, I am neither.’ He smiled good-heartedly. He put down his pen and clasped his arthritic fingers. ‘And what can I do for you?’

‘I came about your advertisement. I’d like the millionaire one if it’s still going, but if not I’ll take the cruise liner instead. I can pack up and go any time. I’m perfectly free.’

‘Alas, again, Doctor,’ he said, still smiling kindly, ‘but those vacancies are already filled.’

‘But the advert only came out yesterday!’

‘The rush was very great… However, I have many equally attractive posts to offer. You wish to go abroad, Doctor?’

‘I wouldn’t mind. As long as it’s sunny.’

‘Then I have just the very place. The Acropolos Oil Company – a Greek concern, but most respectable – require a doctor in Iraq. Most interesting. The first tour of duty is five years. I have the contract here–’

‘I don’t think I want so much sunshine as that.’

‘Are you a man of faith, Doctor? You look it, to my eyes. A medical missionary is needed in Siam. The remuneration is admittedly not high, but–’ He sighed. ‘One gains one’s reward in Heaven.’

‘I should prefer to gain my reward here.’ I was beginning to feel disappointed. ‘I suppose you haven’t any ordinary practices? I’m working for my FRCS, you know, and taking up surgery and all that. I thought I’d better get in a bit of GP experience first.’