Sarf London medic

In previous posts, I’ve explained why going to see the doctor can be dangerous, and why we should treat mental illness with compassion without embarrassment. This piece is much more personal.

The Cambridge medical course was and is six years long, three in Cambridge 1969-1972, three on the wards 1972-1975. In my day the hospital at Cambridge couldn’t cope with 250 medics each year, so it was the custom for almost all of us towards the end of second year to apply for a clinical place in another medical school for years 3-6. Most of us went to one of the London schools, and I ended up at King’s College Hospital on Denmark Hill (Camberwell), not too far from the Peckham of Del-boy. Peckham has now been well gentrified, but it most certainly was not so then.

In late summer 1972, a couple of weeks before the course was due to start, I arrived in London on the overnight sleeper from Carlisle, and met up with David and Steve, two more Cambridge medics, in search of student bedsit(s). We stayed in north Clapham with another friend who had already begun work in the Bank of England. I remember most vividly the invertebrates slowly sliming across the “bathroom” wall. Salubrious, huh? 

King’s was in south London but my two mates were attending more central medical schools: David in Whitechapel, east London, and Steve in Hammersmith/Fulham, so wherever we ended up, we would have to travel. We allotted ourselves search areas: mine was Paddington and north Kensington (think Grenfell but long before).

After a few days up and down the smelly and stained staircarpets of shifty letting agents, we settled on renting a basement flat on the South Circular road between Clapham Common and Balham (gateway to the south). It had its good points. It was a short walk to Clapham South tube, the living room and bedroom were spacious, and the gaff had its own side entrance. Less good were the fact that the bathroom and bog were just an incompletely partitioned area of the kitchen, culinary and other smells blending appetisingly, and the second bedroom was actually a cupboard under the stairs up to the ground floor. 

We were not in the least put off by any of this, not even by the flock wall paper that I see in my mind’s eye in the living room with its scenic eye-level view from the bay window of discarded cans and dog turds on the pavement. We invited a nonmedic friend of Steve’s to share the rent. He was a Nigel Planer (The Young Ones) type – lanky, lugubrious, long black hair – and was supposed to be at some college or other but as far as I could see spent most of his time on a mattress in the tiny, smelly, windowless under-stair cupboard with his girlfriend, doubtless engaged in mind-improving activities with mind-altering substances.

This meant that David, Steve and I shared the bedroom. Three blokes. We got to know each other pretty well. Single beds before you ask.

I had a daily commute across town of 3.5 miles each way. No car in those days. I knew nothing about London buses, but as a rail nerd I had a working knowledge of tube and rail networks, so my journey was 100 yards walk to the tube, two stops on the Northern Line to Clapham North, across the road to Clapham railway station, two stops to Denmark Hill station, 200 yards walk to King’s. I did it on foot sometimes along Acre Lane through Brixton – pleasant enough if I wasn’t pressed for time.

My first student attachment was at Dulwich Hospital, a couple of miles from King’s, up and over Dog Kennel Hill, one of the steepest in south London. A year later, after Susan and I were married, I cycled a fair bit, and up and over the hill got me quite fit.

Three things I remember quite clearly from my time at Dulwich.

The first is that there’s nothing new under the sun. Peter Friedlander, a most delightful and gentle consultant physician in his late 60s, told us that his first line treatment for any stomach upset was liquorice. “Oh sure”, thought we, “what would an old codger who was at medical school in the 1930s know of modern all-singing-all-dancing medicine?” Well, boys and girls, he was absolutely right in this as in so much else. Liquorice root is indeed the active ingredient of several therapies. Just because it comes from a plant and not a laboratory doesn’t mean it’s no use—the opposite in fact. Also from plants come aspirin, morphine and digitalis, and from mould, penicillin. Dr Grundy in Cambridge drilled into us that these drugs are four of the five essentials you need to have if stranded on a desert island. The fifth is insulin. (By morphine people actually mean heroin – diamorphine – but they have a fit if you call it that.)

Dr Friedlander also taught us that for patients on a lot of drugs, it’s often wise to stop the lot and see what happens. You see, the trouble is that drugs interact with each other, and when several are taken together they have unpredictable effects that make things worse. That message—keep it simple—still informs just about everything I do.

The other Dulwich realisation was that sometimes—often in fact—the best thing to do is let someone die. Too often I saw patients suffer unnecessarily just for the sake of being kept alive for an extra week or two or month or two, often in great distress. Why? Well sometimes it makes the doctors feel they’re doing something (doctors like you to think they’re omnipotent), but also sometimes—and I saw this in ordained ministry too—because family members use someone else’s pain as a weapon to score points off each other.

It was while I was living in Clapham South that Susan and I rekindled our school friendship. By then she was a primary school teacher in Droylsden, east Manchester, and one weekend in late 1972 she came to visit the grubby basement. An evening walk to Clapham Common found us in the Windmill tavern. I, then a junior clinical medical student, asked her to marry me. The wedding would have to wait four years, said I, until I was earning. 

So, dear reader, we were married within months in August 1973.  But all that’s another story. Until then, I leave you with this vignette from my bachelor social life at that time.

The year is 1973, the time Friday evening. The story concerns four young men attending King’s College Hospital Medical School who were taking an evening stroll. As they proceeded from Camberwell in a north-westerly direction towards The Oval, a thirst descended upon them somewhere in salubrious north Brixton.

“Behold, seest thou yonder hostelry?”
“Yea, verily. Let us hie thither and slake our thirst.”
“Aye, aye. Come, let us make haste.”

It was the Skinners’ Arms on Camberwell New Road. The four knights did enter.

“If it be thy pleasure, fair wench, we parchèd wanderers each desire a tankard of thy most toothsome nectar.”
“Most certainly, wandering knaves,” quoth she.

Some time and several flagons later, behold the lights did dim. Music rang forth and lo, a lady materialized on the podium. The knaves salivated in eager expectation. The performing lady gradually divested herself of her habiliments until she stood before the assembled company in a two-piece bikini that didst cover only the barest of essentials. She had a midline scar below the umbilicus.

“Ah, comrades, spiest-ye the scar?” saith I (for yes, I was one of the four). “Perhaps the lady hath undergone an hysterectomy.”

It was not that the utterance itself was foolish, but rather the volume at which it rang forth, for the intended whisper cameth more as proclamation. If thou understandest that, thou dost apprehend the nub of the issue.

“Thou art mistaken, fair friend,” quoth the lady, “for ‘tis an appendix scar.”

And having uttered those very words the bikini-clad performer hied herself to the bench at which the knaves sat, and reclined on the knee of the writer, and polished his spectacles with one of her removèd undergarments.

Now, the knaves were, admittedly, very junior medical students, but they possess’d enough anatomical knowledge to know that appendicectomy requirest not a midline incision but rather a right-sided incision. Nevertheless, they sensed that circumstances were not propitious for elucidation. They felt that discretion was in their interests, and without further quaffing or quoting they legged it back to their lodgings. The young men were lucky, methinks, not to have been set upon by the lady’s supporters. 

The moral of the story? To draw conclusions from observations is good, but proclamation of same should be judicious if one wants to avoid getting one’s head kicked in.

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