Growing Into Medicine (8 page)

The journey down to Carcassonne was wonderful. We freewheeled round hairpin bends, the wind in our faces as the verges sped by. Once we reached the attractive town, with its castle on the top of a hill, we again boarded the train. On the way home we bought two small cakes at a French station to take back for Biz. I
discovered years later, when I tried to make them, that they were a kind of Vacherin, a mixture of meringue, hazelnuts, sweet chestnut puree and cream. This was 1947 and no one in England had tasted anything of the sort for years. The family could not believe that such luxuries were available in France, so soon after the country had been devastated and when we were still suffering severe food rationing. We all watched as my sister started to eat. Overcome by the need to be appreciative, she rushed away to finish them in private.

We had been encouraged by both our parents to make the trip. They had a passion for France and had taken various cars across the channel before the war. We had heard many tales and been shown the faded photo albums recording their meanderings, their adventures in tiny rural hotels and crossing high passes where the radiators of my father’s old-fashioned cars boiled. A small statuette of Phineas, a reproduction of the wooden mascot of their Alma Mater, University College Hospital, was mounted on the radiator cap of each car in turn. When the radiator was about to boil, the cap would work loose and the mascot turned to face them.

In retrospect I think it was generous of them to use their small allowance of foreign currency to send us abroad, rather than to seize the first opportunity to escape once more on a life-giving journey. For me, travelling around rural France with no definite plans, arriving at some unknown destination, up a farm track, in a mountain village or by a river, became my vision of the ideal holiday.

In my first year at Bristol the syllabus was less demanding than the one I had already worked through at school, giving me plenty of time to adjust to a different world. My first friend was a miner’s daughter from Abertillery who was experienced in the art of makeup and dealing with boys. She took me to buy lipstick and stood by while I smeared it round my mouth. We went together to dances at the Victoria rooms, now the department of music but then the student union. We girls did not dance with each other but sat around the walls until the boys had boosted their courage with enough beer to ask us to dance. Recently I met a man who had been in my year.
He told me that with a friend he devised a system whereby they could capture the prettiest girls. They would stand by the door watching as we came in, simpering and preening. Having made their choice they would rush to the bar, down a pint or two for courage and then descend on their chosen prey.

The best dance was the Paul Jones where the girls circled one way, the boys in an outside ring going in the opposite direction. When the music stopped you were expected to dance with the person opposite. If he was nice, one hoped he would ask for the next dance. If he was odious I would shoot away, often taking refuge in the ladies’ room to titivate my hair yet again. I still felt intimidated by the array of powder and paint used by my neighbours with such skill.

For my first two years I lived in Clifton Hill House, one of the halls of residence. The house is at the top of a steep hill. By the time we had walked up and down twice during the day we were ravenous. Bread was rationed until 25 July 1948 so my memory of eating a small brown loaf at one sitting, from the crust at one end to the very last crumb of crust at the other, must come from that year.

Men were not allowed in the women’s halls, certainly not during the evenings. Couples outside the front door, often three or four, would stand clinched for ages while those of us embarrassingly single would sprint past into the safety of the house, hoping not to meet a mouse or a rat. In retrospect the rodent that I encountered on the stairs has grown in size and ferocity. Its eyes glinted at me for what seemed to be several minutes but could have been all of ten seconds before it retreated. The only other rat I saw was trapped in one of the early washing-up machines. The shrieks of a maid drew me to the kitchens where I found it circling, frantic to get out. I calmed the frightened woman and turned on the machine, drowning it as quickly as possible. The memory of the kittens drowned at home helped my determination to do what I thought was the kindest thing.

Several young men showed some interest in me but I had no idea how to behave. My friend offered much good advice. Although I was flattered and excited by the hand holding and surreptitious
kisses I soon tired of them all. I continued to yearn after Richard until he let drop the remark that he would never marry a professional woman. When he and his second wife asked me to lunch recently I found a man who was still totally charming, but who firmly denied that he had ever said such a thing.

During the Easter vacation I hitch-hiked to Scotland and back with another girl. Many people had journeyed ‘on their thumbs’ during the war, especially service men and women going to and from home leave. It was considered bad form to drive past without stopping. We had little difficulty getting lifts, for the habit of picking up those without other means of transport was still ingrained in those lucky enough to have petrol.

I revelled in the mix of people we met. On one occasion we climbed down from the back of a lorry, windswept and covered in dust. We just had time to buy two buns and start to eat them when a luxurious car, it might have been a Bentley, swept past. It came to a stop with a squeal of brakes and backed towards us. The two businessmen inside had growing families of their own and were amused by the cheek of our trip. The studs of our boots left indents in the deep pile of the fitted carpet.

They drove us 148 miles, with a comfortable stop for a three-course meal. I was embarrassed by their generosity, which was altruistic with no sexual innuendo. I believed that the only way we could repay all such kindness was to encourage the drivers to talk, if they wanted to, and listen to their life stories. Showing interest was no hardship. The different lives I had glimpsed when visiting patients with my father had left me thirsty for contact with different sorts of people.

At last our route diverged from that of the Bentley and we clambered out. As soon as it had disappeared round a bend in the road we took out the remains of our buns, searching our pockets for the shredded morsels. We were both eighteen but must have been growing still for despite the large meal we were hungry again.

After the restrictions of boarding school the freedom at university was heady. Despite the possibility of a widening social life I hated to
have any commitments at the weekends and used any excuse to keep both days empty. I would walk alone to the centre of Bristol, where the buses started for the surrounding countryside. I took no notice of the destination written on the front but leapt onto the first one with its engine running. I always bought a ticket to the end of the line. When I got off I wandered wherever my feet took me with no interest in maps or making a plan. I wanted to be open to ‘adventures’. Any chance encounter with a horse, a postman or an old woman in a cottage helped to ease the constricting ache that had built up during the years of confinement. It was not too difficult to find a bus or train, or even to hitch-hike back to the city. These excursions were tame flickers of a candle compared to the flashing neon signs of today’s adolescent global travellers.

One day I got off at Brislington and followed a footpath to the river Avon where I found a rusty bell. I struck it with a piece of iron hanging by the side. In due course a man in a rowing boat arrived to ferry me across, demanding a few pence in payment.

Ever since my excursions on the river with my parents and grandparents I have loved rivers. Perhaps this was because those family holidays had been particularly happy times for my mother, and I was always sensitive to her moods. Now I had found my own river and a unique way of getting across. I was already composing a story to tell her, hoping to impress her as much by my escapades as those of my sister.

On the other side of the water a pub stood with its door open. I had never been in a pub by myself before but mustered my courage and went in to order a sandwich. It was not full of rowdy men, as I had feared. The bread was stale but I was so hungry that seemed unimportant. Afterwards I walked along the bank. Suddenly I saw something swimming in the water. Its flat head and sinuous, silvery body below the water convinced me it was an otter, though I had never seen one. All thought of my mother vanished, as I became absorbed in stalking it along the side of the river across two fields. I watched it moving from one side to the other, feeling that ineffable lift of the spirit that occasionally fills my being. The emotion is
private, perhaps nearest to the essence of me, quite separate from any need to please my parents or anyone else.

Such moments are rare and cannot be produced by an effort of will. They only arrive in response to some natural beauty and only when I am alone. After my husband died they deserted me for several years. I feared the loss would last forever. Then one day I was driving along the A46 from Bath to the M4. At the top of Swainswick hill the view across a wide valley drew my eyes. There had been a heavy hoarfrost. Every twig and blade of grass was shimmering in the new-risen sun. Marion Milner, whose writing inspires me, talks about near vision and distant vision and the discipline of using both. At the top of that hill the two perspectives combined with magical effect.

These fleeting moments are the nearest my plebeian soul gets to rapture or religious experience – my analyst called them ‘love’. I will not banish the word despite its amoebic ability to change shape, the lightness of a puff of wind and the density of a black hole. The ground beneath it shifts and the sky tilts but, when it pushes into these pages I will not be deterred from exploring its nuances.

6

Preparing for Medicine – and Marriage

Outside the dissecting room I braced myself, determined not to be shocked or faint or disgrace myself in front of the others. We were a disparate group, the girls straight from school, while more than half the men had served in the armed forces. Several faces were new, having been exempted from the first year, as I should have been if I had got adequate grades in my final school exam. I was in awe of the older men who had seen life and death, imagining they would have no qualms about dead bodies.

The doors opened and we walked in. Four of us were assigned to each table where a body was stretched out, the skin cold, not rock hard but resistant to the touch, firmer than dough. The features were shrivelled into anonymity. We sat on stools, two at the right arm, two the left. One person at each table read from the anatomy book while the others plied their scalpels. Two or three demonstrators moved between the stations encouraging the direction and depth of our cuts, explaining how to tease the yellow fat away from the exsanguinated arteries and the more difficult thread-like nerves.

My own nerves were under tight control. At no time, then or during the next eighteen months, did I admit to feelings of disgust. Only on waking from nightmares in which I was eating human flesh did I glimpse my private horror.

Several years after I qualified, I joined a seminar for General Practitioners run by Dr Michael Balint. He was an Austrian psychoanalyst with a revolutionary interest in what went on between doctors and patients. The psychodynamic idea, that the feelings of a
therapist or doctor might have been provoked by the client or patient, allowed us to accept that feelings were worthy of study. Those meetings helped me to realise that the day I walked into the dissecting room saw the first of many defensive layers, like the outer protective skins of an onion, clamp round my vulnerable heart. I realise this metaphor is not very accurate, for most of the layers of an onion are soft and provide nutrition for the inner sprouting potential. At the time I felt constricted and needed to be able to remove those dry, brown layers in order to be able to use my inner nourishment to develop.

Doctors need defences in order to survive the job, especially when they are confronted by the suffering they see in hospitals. I discussed this many years later with GP trainers who were introducing students to patients in their first year. They suggested that in order to practise a caring and humane approach, students needed to observe compassion early in training. The experience would then remain as a core of sensitivity which could be revisited later when they were emotionally mature enough to share a larger part of the suffering of others.

Dissecting the whole body took eighteen months and we spent many hours each week on the task. I remember few of the details, neither the four facts needed about each muscle – origin, insertion, nerve supply and action – nor the course of any of the nerves that I repeated in mantra form. But a general understanding of how our bodies are made is built into my understanding of the world. A medical friend pointed out that this knowledge separates us from many other people. We know what lies under the skin of each finger, the position of our internal organs and how the vertebrae work to perform their multiple functions, keeping us upright, allowing us to bend and protecting the spinal cord: whereas, in the main, non-medics do not.

I notice I have not included the brain in the list. We dissected the head and neck last. When the time came, a laboratory assistant sawed off the top of the skull for us. After careful inspection of the contents we severed the nerves that passed through holes in the base
and lifted the organ out. Slicing it into sections was a delicate job. It might have been done for us. I remember watching the special long knife sink into the convolutions as if passing through soft butter. This particular image is still disturbing, perhaps because I believe that if our cadaver had possessed a soul it had resided in that flesh.

Although we learned something about the different areas of the brain, such as those for speech and vision, the study of its gross anatomy offered no key to the magical way it functions. Recent advances in imaging the living brain have revealed wonders to rival any discoveries in particle physics, quantum mechanics or the depths of space. Even those people with no anatomical training will now have more understanding of the brain than we did in the 1950s.