I felt I was living the true liberal life and developing my intellect, which were excuses for not settling down to the more concrete problems set by my text-books. The thought of the anatomy exam nevertheless hung over me uncomfortably, like the prospect of the eventual bill to a guest enjoying himself at a good hotel. One evening we discovered with a shock that the contest was only a month away, which gave Benskin and myself no alternative than cramming. We opened our text-books and drew a deep breath of knowledge, which we hoped we could hold until the examination was over. It was the worst time we could have chosen to start work. Mike Kelly had decided to learn the clarinet. Archie's landlord was trying to raise the rent, and Vera had disappeared again. On this occasion she never returned, and by the time the exam was held I was as miserable as her lover.
5
When I heard I had passed the anatomy examination I felt like a man who had received an unexpected legacy. I had cut down my work preparing for the test by refusing to study at all topics that had been asked in the past few papers, in the belief that examiners, like lightning, never strike twice in the same place. I scraped into the pass list in company with Tony Benskin, John Bottle, Sprogget, Evans, and Harris. Grimsdyke also succeeded, and confessed himself amazed how near he must have come on previous occasions to the disaster of getting through.
I was elated: now I was released from the dull tyranny of the study of the dead in the dissecting room to the investigation of the dying in the hospital wards. I could start to perform like a real doctor; I could buy myself a stethoscope.
I strolled into a surgical instrument-maker's in Devonshire Street to select one, like a boy buying his first pipe. With the grave and critical air of a consultant cardiologist, I chose an impressive instrument with thick rubber tubes, a chest-piece as big as a jam-pot cover, and a few gadgets I could twiddle while delivering my professional opinions.
The choice was an important one, because in hospital a stethoscope is as undisputable a sign of seniority as long trousers in a prep. school. It was not thought good taste to exhibit the instrument too blatantly, but a discreet length of tubing poking out of the coat, like a well-set pocket handkerchief, explained to your colleagues you had quitted the anatomy rooms for ever. With a bit of luck you might even be taken by the public for a real doctor. To the layman the stethoscope is the doctor's magic wand; if he sees a man with one round his neck he assumes he is a physician as readily as he takes a fellow in a clerical collar for a parson. These are a pair of conditioned reflexes that have from time to time been used for extracting small sums of money from well-meaning citizens by sufficiently respectable-looking confidence tricksters.
The next morning I walked proudly through the gates of St. Swithin's itself instead of going into the narrow door of the medical school. My first call was the student's lobby, to find which consultant I was appointed to.
Teaching of the clinical subjects-medicine, surgery, gynaecology, and midwifery-is carried on by a watered- down continuation of the old apprenticeship system. The year is divided into three-monthly terms, each of which the student spends attached to a different consultant. The doctor is the Chief, who usually takes on six or seven pupils known collectively as his firm, and dignified in the physician's wards with the title of medical clerks.
Each of the clerks is given four or five beds to look after. He is obliged to examine the patients admitted to them, write their notes, and scrape up an account of the case on the consultant's weekly list. Teaching is done at the bedside either by the Chief himself, his junior consultant, the registrar, or the houseman, and the students are expected to educate themselves in the intervals by nosing round the ward for instructive signs and symptoms and doing the unending medical odd jobs.
I began clinical work on a medical firm under the instruction of Dr. Malcolm Maxworth, M.D., F.R.C.P. Dr. Maxworth was one of the hospital's oldest physicians and had charge of male and female wards-Patience and Virtue. As he appeared only once a week the new students had to start by attending a small class given by the houseman on examination of the patient. We had at the time no more idea of the correct method for this than water-divining, and a Boy Scout with a first-aid certificate would have been more use in the wards than any of us.
The wards of St. Swithin's, which were contained in two large red-brick blocks, were dull, hostile galleries made up of a succession of irritating corners in which the nurses dusters flapped for ever in defiance. They were repeatedly being redecorated in an attempt to give them an air of modernity and cheerfulness, but the original design of the corridor-like rooms made fresh paint as ineffective as make-up on a crone. There was always a plan on foot to pull them down and rebuild, but the execution of this seemed to meet with baffling postponements. Meanwhile the staff took pride that they trod the same boards in the exercise of their art as their professional forebears, and the nurses spent a great deal of time they should have given to the patients sweeping the floors.
I walked across the court and up the dark stone stairs to Virtue ward. Tony Benskin, Grimsdyke, and Evans were already standing outside the heavy glass doors, dangling their stethoscopes and trying not to appear a little in awe of their surroundings, like Oxford freshmen or new prisoners at Dartmoor. We greeted each other in low, church tones.
The houseman came jumping down the stairs three at a time. We stiffened ourselves, like sentries coming to attention. He shot straight past and through the ward door, without appearing to notice us. A moment later his head popped out again.
'Are you relatives waiting to see someone?' he asked. He caught sight of our proud stethoscopes. 'Oh, you're the new clerks, I suppose. Damn it! I'm far too busy to show you anything.'
He scratched his curly head. He was a pleasant-looking fellow, about three years older than ourselves.
'Look,' he went on cheerfully. 'Get a sheet of instructions from Sister Virtue and see how you get on examining a few patients. I've got a lumbar puncture and a couple of aspirations to do, but I'll give you a hand when I can.'
He disappeared again. The small glow of self-importance over our promotion was dimmed. Glancing nervously at one another we went through the doors into the ward.
The houseman had already disappeared behind some screens round a bed at the far end. One or two nurses were busy attending to the patients. The four of us stood by the door for ten minutes. No one took the slightest notice.
From a small door on one side of the ward the Sister appeared. She immediately bore down on our quartet.
'Get out!' she hissed savagely.
I had never seen a sister close to before. This unexpected proximity had the effect of being in a rowing-boat under the bows of the _Queen' Mary._
Sister Virtue was a fine body of a woman. She was about six feet tall, her figure was as burly as a policeman's, and she advanced on her adversaries with two belligerent breasts. Even her broad bottom as she passed looked as formidable as the stern of a battleship. Her dress was speckless blue and her apron as crisp as a piece of paper. She had a face like the side of a quarry and wore a fine grey moustache.
My immediate impulse was to turn and run screaming down the stairs. Indeed, all of us jumped back anxiously, as if afraid she might bite. But we stood our ground.
'We're the new clerks,' I mumbled in a dry voice.
She looked at us as if we were four unpleasant objects some patient had just brought up.
'I won't have any nonsense here,' she said abruptly. 'None at all.'
We nodded our heads briskly, indicating that nonsense of any sort was not contemplated.
'You're not to come in the ward after twelve o'clock, in the afternoons, or after six in the evening. Understand?'
Her eyes cauterized each of us in turn.
'And you're not to interfere with the nurses.'
Grimsdyke raised an eyebrow.
'Don't be cheeky!' she snapped.
She turned quickly to her desk and came back with some foolscap sheets of typewritten notes.
'Take these,' she commanded.
