What does the Doctor think this month?

August 2015 Looking backwards through one of a doctor's most useful instruments – the retrospectoscope

When you get to my age, it is sometimes more comfortable to look backwards than to look forward. I have been sorting out my old files and I came across my letter of appointment, dated 2.10.68., as House Physician in General Medicine at Redhill General Hospital in Surrey. This was to be my second “House Job”, of which, more later. The University of London Medical faculty was vested in the medical colleges attached to the hospitals in London and I qualified at The London Hospital Medical College in Whitechapel in January, 1968 when I was just over 22 years of age. My first house job was in Orthopaedics at The London Hospital and I really enjoyed myself. The consultants were rarely seen on the wards (being in Harley Street, The London Clinic, etc) and the registrars ran the show with my help. In those days, microscopic orthopaedic surgery was unheard of and there was great use of mallets and chisels – glorified carpentry with lack of carpentry skills! Many of the patients were young men, perfectly fit except for their shoulder repair, and the nurses had to be most careful to avoid the testosterone laden advances from the young men in the beds – or, perhaps not, as the mood took them. Back to the Redhill job and an excerpt from my letter of appointment - “The salary applicable to the job is £1,100 per annum and a £208.18.8d annual rental charge for married accommodation will be deducted from your salary.” The annual rent was made up as follows: Basic rent £72.13.6, General rates £29.5.0., Water rates £4.1.0., Garage £7.16.0., Use of furniture £39.2.2., Central heating £29.19.7., Gas and electricity £26.1.5.(Any young readers who do not understand pre-decimal money should talk to their grandparents!). I have often wondered how they arrived at these precise sums of money for each item of rent. We arrived with all our belongings in a hired Commer van at about 4pm on 31st December 1968, to start work the next day. While unloading the van into our upstairs accommodation, the medical registrar turned up to inform me that there was to be a ward round at 6pm for me to familiarise myself with the patients before I started the job. This was not optional and it rather messed up the return of the van to London. This summons rather set the tone for the job as my salary of £21 per week, less tax, involved me working all day every day, seven days a week, being on call for my own patients every night and, in addition, on call for all new medical admissions every third night. We were not allowed any holidays but they did give me one Friday afternoon off every month. As this was “the norm” it never occurred to me that it was a bit strenuous. We all had to do it, the consultant came in every Saturday and Sunday for a ward round and was available to me 24 hours every day, so the whole work ethic was different from today's. I even had an office and bedroom on the ward where I spent many nights when we were busy. The consultant would telephone me at 6.30am every morning to see how all the patients were doing. As I had always been on the ward most of the night, this was not unreasonable. Smoking was prevalent in those days, and most of the emergency admissions involved either a heart attack or a gastric bleed, usually caused by taking “Alka Seltzer”, which was full of aspirin. We did not have stomach protecting medicines like Omeprazole in those days, so we saw a lot of Haematemeses (vomiting bright red blood), vomiting of “coffee grounds” (blood altered by the stomach acid) or melaena stool (blood which had passed through the intestinal tract and came out like tar – very difficult to clean up) and we also saw many perforated ulcers. My abiding memory is of glass syringes which fell apart during use and nausea caused by overwhelming tiredness but I did learn a phenomenal amount of medicine. Enough use of the retrospectoscope – let's have some jokes. One of my readers likes the narratives and the other one only reads the jokes, so here we go:

A young girl asked her mother is she could take their dog for a walk. .“It's difficult because she is on heat” replied the Mum. “What's on heat mean?” “Go and ask your Dad” “Daddy, can I take the dog for a walk?” He thought for a minute, soaked a rag in patrol and rubbed it all over the female dog's backside before saying “Go around the block once and don't let her off the lead” The girl returned after half an hour, swinging the lead in her had – no dog. Father became angry but she reassured him “Oh, she ran out of petrol half way around but it's OK Daddy – a big dog is pushing her home”. A man was sitting reading his papers when his wife hit him round the head with a frying pan. 'What was that for?' the man asked. The wife replied , 'That was for the piece of paper with the name Jenny on it that I found in your pants pocket'. The man then said 'When I was at the races last week , Jenny was the name of the horse I bet on.' The wife apologized and went on with the housework. Three days later the man is watching TV when his wife bashes him on the head with an even bigger frying pan, knocking him unconscious. Upon re-gaining consciousness the man asked why she had hit again. Wife replied. 'Your horse phoned' Best wishes to you all Ian Nisbet