Growing Into Medicine (11 page)

We lived close to the wards with a housekeeper who would make us scrambled eggs and other delicacies at any time of the day. On the wards too we were fed, especially at night, with toast or more, when the staff judged we needed it. Because we carried the label Doctor,
everyone in the hospital afforded us automatic deference. Like the muscles of childhood that pull bones into characteristic shapes, their expectations helped to change me from a frightened girl to a passable doctor.

At home I also had to adapt, to the strange man I had married. He had no experience of living with a professional woman and although he never made a single overt demand on me, like all men of his generation he expected the house to be cleaned and food to appear as it had always done in his childhood home. Even if he had been prepared to share the household duties in the way most men do in the twenty-first century I would not have welcomed it. I too believed that it was the duty of the woman to manage the home and indeed enjoyed doing so when I was not overtired. I could not have managed without the indefatigable Mrs Nutt. She would arrive from the village on her bicycle to ‘siden up’. That activity consisted of efficient tidying and cleaning but no help with washing or cooking.

When I qualified, my parents had given me a second-hand car of my own so Ralph and I now had our own individual means of escape from the isolation of Pollington. I would buy food on my way home, cook a meal and try to leave something in the fridge for the nights I would be away. Ralph would have been quite happy to live on packet soup and toast but I always felt I was not fulfilling my job as a proper wife. He was fussy about food, the legacy of a sadistic nanny in early childhood. His instinct was to ignore the process of eating but when he developed diabetes he had to take notice, even weighing his food until he could judge the portion by eye. He disliked social meals, using supposed dietary prohibitions as an escape from eating many foods he hated. Most people did not know that diabetics could perfectly well eat liver, stewed fruit, and crab, all anathema to him. I remember cooking a lot of rabbit (myxomatosis did not spread widely in England until 1955). Steaks, fishcakes and rissoles were also acceptable, together with fried eggs and bacon – not the best diet for a diabetic already at higher risk of arterial disease. At that time the long-term risks of a poor diet were less well
known. But with my need to provide something he could enjoy, I fear I would probably have ignored the recommendations.

Before my second job started I developed tonsillitis, a recurring problem since childhood. At one time I had begged my mother to let me have my tonsils removed. She was against any intervention unless absolutely necessary and the attacks gradually became less frequent. The one at the beginning of 1954 led to the only occasion when I deliberately played truant from work. I stayed at home for a week with a high temperature but then added another week of unnecessary ‘convalescence’. Jenny came to stay.

Her visit was a heart-warming interlude at that time in my life. I never admitted that I was finding it hard. Indeed I took some pride in coping with what my mother thought was an impossible existence. Then and later, she was so sympathetic about my life, spent moving from what she considered one desolate prison to another, that she made a point of trying to help me make a garden at each place. Outside our hut in Pollington she planted a hedge of Berberis Stenophylla. The plants never grew in the wind and grime, but never managed to die, remaining as stunted little bushes. At times she might have wondered if they were symbolic of my life, so different from the one she had imagined for me.

After Jenny arrived the weather turned very cold and the ground froze. We went skating on a nearby lake. Having lived in Canada she circled with great proficiency while I tottered about on my mother’s skates. The boots were too small but with the cold air on my cheeks I began to recover from the emotional traumas of the previous six months.

The friendship that Jenny and I enjoyed was so deep and solid that it could survive long periods of separation. But during that first visit after I was married, something had changed. Alone together in the open air we were fine. Once Ralph came in we became more stilted. The special closeness of our childhood was only recaptured after both our husbands had died.

Back at the hospital my second job was in the surgical wards. As well as interviewing new patients I had to assist in the operating
theatre. I showed little talent with a scalpel and soon changed to helping the anaesthetist who had no junior staff of his own. I was also responsible for many intravenous drips. After I had inserted the needle into a vein in the crook of the elbow the arm was bandaged onto a board to keep it straight. The needles we used were metal and pierced the vein with the greatest ease. Phone calls in the middle of the night were usually to re-site a drip that was running into the tissues. I would put my white coat over my dressing gown, enter the ward bleary-eyed, and be back in bed within ten minutes. Unless there was no suitable vein left to use. Then I had to ‘cut-down’ at the ankle to expose the vein with an incision, a longer and more complicated procedure. The plastic cannula that allows so much more movement had not arrived before my time in hospital came to an end. I have never inserted one.

Sometimes I was summoned from my bed to retrieve the cat. Luck had given me a room with a window opening onto a large balcony, which made it possible for me to adopt her when she arrived in the hospital as a stray. She had found her way onto the ward and snuggled under a blanket until discovered by one of the nurses who threatened to throw her out. The elderly patient had been comforted by her presence and hated to think of her turned out into the night. When I offered to take her to my own room and care for her she was somewhat consoled. Every time the cat found her way back to creep into another bed, the staff sent for me. She gave birth to one family of kittens in a box by my bed, but once they were weaned she left. She was a wanderer by nature.

When summer arrived, Ralph and I spent our holiday in our canoe. Our wedding presents to each other had been the front and back halves of a double-seated kayak. The wooden struts were covered by canvas and collapsed into two bags. We had set off on our honeymoon in the Austin Seven with them strapped to the roof rack, choosing to go to the Vosges mountains, not a very suitable location for easy paddling though we did camp for two nights on an island in the Moselle river.

The norm in the 1950s was one annual two-week holiday, with
shorter breaks in lieu of Christmas and Easter. We managed to visit our parents for one or two weekends a year. The drive, only about 175 miles, took at least six hours for there were no motorways. We returned laden with bottles of soup and Christmas puddings from Ralph’s mother and good advice and plants from my own.

Our next canoe trip was down the river Cherwell. The water was very low and after two days carrying our craft over reeds and across fields of new-cut hay we abandoned the effort and changed onto the Oxford canal. We became adept at portaging round locks but by that time we realised we were not comfortable in the same craft. Ralph sat at the front and I could not adapt to his quicker stroke. We invested in two singles for our excursion the following year when we embarked on a stretch of the Wye. Now we had the problem of getting in and out. In one canoe we could steady it for each other but my clumsiness made it difficult for me to step in without such help. In addition, the Wye flowed fast and we were not ready to face rapids. We were supposed to be good on rivers and were a bit embarrassed when we gave in and transferred to the more leisurely Stratford Avon.

But the rest of that trip passed in great contentment. Motorised craft were forbidden; indeed they would not have been able to travel far, as there were no locks by the weirs. We drifted in isolated silence. On the last day the air became heavy with an impending thunderstorm. As we slipped silently past a bed of reeds we saw a bittern standing, unaware of our passing. Later I hardly noticed the rain thudding on our tent and the moisture seeping in as I relived that shared moment of wonder.

I worked as the casualty officer for the first few months of my second year. That job included some minor surgery. I circumcised babies – the reek of Friars Balsam soaking the strip of lint that we tied round the mutilated organ is with me still. I also had to change supra-pubic tubes, permanent bladder drains through the abdominal wall in old men whose prostatic enlargement could not be relieved. I hated the task. The smell was overpowering and the procedure
painful. One man started to whimper as he came through the door, and his shriek, as I yanked the tube out, echoed down the corridors and in my mind down the years.

Another common problem was breast abscesses. These occurred in women who were breast-feeding and are not seen so often now. Perhaps we did not recognise them in time or give adequate doses of antibiotics. It was important to break down all the fibrous compartments with a gloved finger and I used to feel brutal as I poked deep into the tissue.

During that time we had the chance to see the work of general practitioners from a particular angle. My parents’ old adage that doctors were either ‘poo-pooers’ or ‘wind-upers’ was borne out. One man brought his patients in almost every day. His lack of confidence was in striking contrast to our ill-founded certainties. We laughed at him and had little understanding or sympathy for a man who had lost his nerve. Others referred serious cases with dismissive notes: ‘Please see and treat’. One conscientious doctor often joined us in the common room for coffee and chat. He was lonely, but also still genuinely interested in medicine and wanted to be close to the centre of things. I often found his suggestions helpful.

My appointment as a junior medical officer in geriatrics came as a relief, although it was not without its horrors. Long wards filled with all kinds of physical and mental suffering stretched into the distance. The smell of disinfectant was overpowering but at least the place was clean. One woman had half her face eaten away by a malignancy. Some of the patients called endlessly for help, others dragged themselves to the bathrooms from which, on the male wards, men would emerge with their trousers round their ankles.

The idea that old people needed a special medical approach was only just developing. The hospital in the neighbouring town of Castleford had been the old workhouse, and was now classified as ‘part-three’ accommodation. The patients had been confined to bed for years without investigation, diagnosis or rehabilitation. I was lucky to have an enthusiastic consultant who was determined to sort out the medical problems of the inhabitants in order to diagnose and
treat the treatable. He was one of the first specialist geriatricians who realised that rehabilitation was crucial in the fight against what were called the ‘Giants of Geriatrics’: Immobility, Instability, Incontinence, and Intellectual Impairment. He fought hard against entrenched positions, building a multidisciplinary team to tackle the problems.

I also worked on a ward in Wakefield, another twelve miles beyond Pontefract. By that time I had exchanged my small car for a Ford consul convertible. For me a car is a means of getting from one place to another, not an object of interest or emotion. But I loved that first vehicle that I had bought with my own money. It was pale green with a fawn hood that folded right back. I drove under the sky with the wind in my hair and the wireless blasting, so that the sights sounds and smells of hospital were blown into the ether.

I was now getting back to Pollington every evening having driven up to fifty miles during the day. It never occurred to me that our marriage was not secure although we were clearly not a close couple at the time. Our love life was pleasant although not totally satisfying until several years later when Ralph bought himself a book on sexual technique. At no time, even years later when I became more comfortable with the subject, could I have shown him, far less told him, what my body liked. My personal shyness never abated, but I hope that perhaps it helped me to empathise with some patients.

By the end of that second year in hospital, my wish to be a nurse forgotten in my passion to be a better doctor, I had been shut up for most of the days and many nights with a variety of unattached, attractive and helpful men. We worked in the highly charged atmosphere of life and death. At Christmas and for some birthdays we gave small parties in the common room where drink flowed. On two occasions I found myself tempted into a cuddle and some kissing, but it never went very far. The idea that it was wrong to seduce a married woman was still strong and the men helped me to remain faithful to Ralph in a way that might be more difficult today.

I believed I had kept these lapses well hidden. When we heard that we were to be moved to Portsmouth I was not surprised for I
knew that governor grade staff were moved fairly often. It was only many years later that Ralph told me he had requested a transfer because he thought our marriage would not survive if we continued to live such disparate lives.

8

General Practice

Our quarters in Portsmouth consisted of a two-bedroom ground floor flat, outside the walls of the prison. The sitting room was long and narrow with the fire on the short wall. In an effort to get warm I sat so close that my legs developed brown marks, which took a year to fade. The kitchen looked out onto the wall of the house next door with room between for nothing but dustbins. The tiny front garden faced a busy main road. My mother planted two cherry trees; despite the pollution they flourished and were a good size when I drove past ten years later. By the start of the twenty-first century the area had been flattened and redeveloped.

I was lucky to find a post as a trainee general practitioner. The scheme had only recently been devised and was not yet compulsory. It consisted of just one year’s training. Such scanty preparation must be hard for today’s trainees to imagine. Now they have to work a mandatory two years in hospital, followed by three years’ training for what is recognised as the speciality of general practice.