I qualified as a doctor in June 1975. As I’ve explained before, since autumn 1972 I’d attended King’s College Hospital in south London but nevertheless remained a student of Cambridge, albeit one who was “using” King’s for the clinical course – a Cambridge cuckoo in a London University nest. At that time Cambridge didn’t have enough resources to look after all its own students (similarly for Oxford, but that’s a dump so we don’t mention that car factory on the upper Thames).
It was, therefore, to the city on the edge of the fens that I repaired for all exams – written, face-to-face, and exams with patients. In those days that meant taking the 36 minutes past the hour from London Liverpool Street calling at Harlow, Bishop’s Stortford, Audley End and Cambridge, then on to Ely and King’s Lynn.
I have two vivid exam memories from summer 1975.
The first is the Obstetrics and Gynaecology clinical exam.
“Monkhouse to the patient in bed 23”. I was instructed to take a history from her. So I did. After about 10 minutes, the examiner hove into view to give me the third degree in front of said lady. The examiner – coincidence or what? – was one of the King’s consultants, Michael Brudenell, a descendant of the Charge of the Light Brigade Brudenells. If he recognized me, he didn’t let on.
Surprisingly, his first words to me were “why would Mrs X know more about her pregnancy than most people here?” A strange question, you might think. In those days I was a very quick thinker and I said without hesitation “because she is a librarian”. Think about that – he wanted to know if I’d been thorough enough to discover her occupation. I most certainly had – such attention to detail was drummed into us from the beginning.
Then: “what advice would you give Mrs X about feeding her baby?” Without hesitation I said “breast, for breast is best.” “Come, come” said Mr Brudenell, “explain yourself”. “Because” says I “cow’s milk is for cows, and human’s milk is for humans”. Then I thought “you fool, Monkhouse, this is not the time for being a dick”.
Mr Brudenell looked at me for about three seconds – which is a very long time when your underpants are at risk of being soiled. “Haw, haw haw! Very good, Monkhouse. Off you go.”
And that was that.
He didn’t want to know if I’d read the latest research (I hadn’t), or knew the likely cause of a very rare disease found only in Papua New Guinea (I didn’t). All he wanted to know was that I was safe, thorough and coped under pressure. He evidently thought so. Perhaps he liked my impertinence.
By the way, I am right. Cow’s milk is more poisonous to humans than is generally acknowledged. Think snot, allergies, bellyache, bloating, belching, colonic dysfunction, farting, lactose intolerance, and more. As a child of the 1950s in a Cumberland village I had milk from an uncle’s cows poured down my throat. I speak from sad experience and numerous unnecessary hospitalizations. It was another hospital consultant at King’s – can’t remember the name – who said that cow’s milk should come in bottles labelled “poison”.
The other 1975 exam memory is being grilled by three eminent surgeons, all professors or Knights of the Realm. It went something like this.
Examiner: Good morning. Take a seat. Name?
Me: Monkhouse (no such thing as Christian names then).
Examiner: And which medical school?
Me: King’s, London.
Examiner: Haw, haw, haw, a royal flush, eh? Haw, haw!
After I’d picked myself up from rolling around on the floor in fawning laughter, I was shown a radiograph (x-ray) of a wrist. There was a fracture of the bone at the base of the thumb where it meets the wrist. I recognized it.
Me: Ah, a Bennett’s fracture.
Examiner: Good, Monkhouse, very good. Pause. Tell me, who was Bennett?
Me, confidently, looking smug: a nineteenth century Dublin surgeon.
Examiner, surprised: Oh. Long pause. Quizzical look. Was he really?
Me: I’ve no idea. I was just guessing. There were so many eminent nineteenth century Dublin surgeons, so I thought the chances were good.
Examiner: Haw, haw. Very good.
Then followed a brief discussion of fractures that can result from falling on the outstretched hand, before I was dismissed.
The irony is that Bennett was indeed a 19th century Dublin surgeon – in fact (how spooky is this?) he was one of my kind-of predecessors at the Royal College of Surgeons in Ireland. There must be a God after all. The commonest wrist fracture, by the way, is named after Abraham Colles, another of my Dublin predecessors – perhaps the most famous of all. See what I mean.
It was very entertaining. Comedy really.
I was there. L.O.L. (as David Cameron would have texted).
In these exams I often felt that my presence was incidental to the examiners’ attempts to impress and outwit each other.
Quite so – that was how the Bennett’s fracture viva played out. I was much more uncomfortable in the Medicine viva with Roy Calne and others, but the Medicine short cases were an absolute breeze.