Doctor in the House (14 page)

‘For God’s sake!’ Benskin exclaimed angrily. ‘Isn’t there anything we can do about it? Look at the time! If I’m not there in twenty minutes I’ve had it. Surely one of you fellows has got a stiff shirt to lend me?’

‘What! Your size?’ Bottle asked.

‘Why the devil didn’t I think of buying a dickey!’

I had an idea.

‘Let us apply the first principles of surgery,’ I said.

‘What the hell are you getting at now?’

‘Supposing you have tension on a surgical incision. What do you do? Why, make a counter-incision, of course, in a site where it doesn’t matter. Take your jacket off, Tony.’

A quick rip with the scissors up the length of the shirt-back from the tail to the collar and Benskin was once again the perfect English gentleman. He left the flat in high spirits, convinced that he would make enough in the evening to keep him in drinks for a fortnight. Unhappily, he was no better at serving hot soup than driving a car and was dismissed by the furious maître d’hôtel between the fish and the entrée.

‘BID,’ I said. ‘Brought in dead. What an epitaph!’

I was standing in the cold, bright post-mortem room on the top floor of the hospital. It was a large room with a glass roof, tiles round the walls, three heavy porcelain tables, and one side made up of a bank of numbered metal drawers like the front of a large filing cabinet. The unfortunate patients were brought by the cheery-looking fellow on his trolley to a special lift, taken to the roof, and packed away neatly in the refrigerated drawers. Each corpse bore a label giving the name, religion, and diagnosis, but the man on the table in front of me had only the three letters on his tab. He had been picked up in the street by the police a few hours before and brought futilely to the accident room.

I pulled the heavy rubber gloves tight and began my incision with the big post-mortem knife. I never liked doing post-mortems. They made me feel sick. However, under the medical school regulations I was required to perform three of them, so I had to get on with it.

Every morning at twelve the physicians and surgeons came up to the room to see their unsuccessful cases demonstrated by the heartless pathologist. Often they had been right in life, and had the satisfaction of feeling with their fingers the lesion they had built up in their imagination from examination of the body surface, deduction, and studying the black and grey shadows on X-ray films. Occasionally they were humbled.

‘So there
was
a tumour of the cerebellum after all!’ I once heard Dr Malcolm Maxworth exclaim, going red in the face. ‘Damn it, damn it, damn it!’

Maxworth was not angry on the dead patient’s behalf: it was simply that in the daily contest between his mind and the tricks of the body the body had for once won a game.

Our afternoons were spent wandering round the dusty pathology museum inspecting the grotesque specimens in the big glass jars of spirit. They had everything in the St Swithin’s museum, from two-headed babies to tattoo marks. Each specimen was neatly labelled and numbered, and a clinical history of the case was set out on a card attached to the bottle. ‘How much better than a tombstone!’ Grimsdyke said as he read the last dramatic illness of John O’Hara in 1927 and held the remains of his ruptured aneurism in his hand. ‘I suppose everyone wants to be remembered somehow. What could be better than giving a bit of yourself to the pathologists? Nobody knows or cares where this fellow’s grave is, but his memory is kept fresh in here almost daily. A whopping aneurism! I bet it caused a panic in the ward when it burst.’

Twice a week during the three-month pathology course we had classes in forensic medicine. This was a subject that fascinated me, because I was a conscientious reader of detective stories and took delight in the realization that I too now knew how to distinguish human blood from animal’s, compare bullet wounds, and differentiate murder from suicide. The lecturer was a portly, genial man whose picture appeared fairly regularly in the Sunday papers inspecting the scene of all the more attractive crimes. We learnt from him the favourite ways of committing suicide, abortion, homicide, and rape: the lecture on the last subject, which was illustrated with lantern slides, was the only one I can remember when I couldn’t find a seat.

After the pathology course we began a round of the special departments, spending a few weeks in each. I was sent to learn a little about eyes and then to the throat surgeons, where I learned how to look into ears, up noses, and down throats. The ENT clinic was busy from early morning until long after the others had finished at night, for the London atmosphere silted up patients’ sinuses and roughened their lungs. ‘That stuff’s really irrespirable,’ said the surgeon, flinging his arm in the direction of the window. ‘Thank God I live in the country.’ He was a big, brusque, overworked man who had nevertheless extracted a fortune from the respiratory damage caused by London air. He was supposed to be the fastest remover of tonsils and adenoids in the country, which he did every Thursday afternoon in out-patients’, passing the anaesthetized children through his hands with the efficiency of a Chicago pig-killer.

After the throat department I was glad to sink into the restful atmosphere of the skin clinic. This was run by two very old and very gentlemanly specialists who conversed with each other, the students, the nurses, and the patients in whispers. They were both formally dressed in expensive suits, and each arrived at the hospital with a Rolls and a chauffeur. I had not expected such opulence and satisfied tranquillity from dermatologists, but on reflection it struck me that diseases of the skin were the most agreeable of all to specialize in. They are quiet, undramatic affairs which never get you up in the middle of the night nor interrupt your meals. The patients never die, but on the other hand they never seem to get better. A private patient, once diagnosed, is therefore a regular source of income to his doctor for the rest of his long life.

I still lived in the flat in Bayswater with Benskin and Bottle. Archie Broom and Mike Kelly had qualified and left, and we had been joined by Sprogget and Evans.

One evening after supper Bottle leant back in his chair and said, ‘What shall we do tonight? Could you take a flick, anyone?’

‘There’s nothing on much,’ said Tony in a bored voice. ‘We might pop out for a pint a bit later.’

‘I’ve got a novel to finish,’ Evans said. ‘It’s got to go back to the library by the sixteenth. What’s the date today, John?’

Bottle picked up the calendar from the mantelpiece. ‘The fourteenth,’ he said. He frowned. ‘I say, do you chaps realize it is exactly five weeks today to our finals?’

‘What!’ Benskin jumped up in his chair. ‘It can’t be. They’re not till the end of October.’

‘Well, this is the middle of September.’

‘Good God!’ said Sprogget nervously. ‘We shall have to start doing some work.’

Bottle put the calendar back.

‘I’m afraid you’re right. I’ve hardly looked at a book since we came out of the anatomy rooms. We’ve had a bloody good holiday, and now we’ve got to pay for it.’

Benskin, who believed in making his unpleasant decisions swiftly, immediately picked up a copy of Price’s
Practice of Medicine
from the bookshelf and wiped the dust off the cover with his sleeve.

‘At least that settles our evening for us,’ he said. ‘From now on it’s a case of burning the old midnight oil. Good Heavens! Is there all this on tuberculosis?’

Our evenings afterwards were swiftly blown away in a gale of industry. We collected up our dusty books from the floor, the chairs, and the back of the cupboards, and left them in heaps, open, on the table. As soon as we returned from our work in the hospital we started reading. We ate bread and cheese when we felt like it and took caffeine and benzedrine tablets to keep awake. We worked past midnight, sometimes until four in the morning, cramming three years’ study into thirty-five nights.

Each of us developed a favourite attitude for concentration. I found I could learn best sitting on a hard chair with my elbows on the table; Benskin was apparently able to absorb knowledge comfortably only if he removed his collar, tie, shoes, belt, and socks and stuck his large pink feet on the mantelpiece. Bottle preferred to take his text-book and sit alone in the lavatory, and Sprogget would pace nervously up and down the narrow hallway repeating under his breath the signs and symptoms of innumerable diseases and giggling grotesquely when he couldn’t remember them. Only Evans passed the pre-examination stage in tranquillity. His mind was so efficient he found it necessary to do no more than loll in an armchair and read gently through his text-books as though they were the Sunday papers.

For an hour or so we would work without speaking, filling the room with tobacco smoke. But it was a thin, taut silence, like the skin of an inflated balloon. Benskin was usually the first to break it.

‘What the hell’s the dose of digitalis?’ he asked angrily one night.

‘Six grains eight-hourly for three doses, followed by three grains three times a day for two days, and half that dose four times daily for two days,’ I replied brightly.

‘I’m sure that’s not right,’ he said. ‘It’s somewhere round two grains a day.’

‘Of course it’s right!’ I barked at him. ‘I’ve only just learnt it.’

‘Richard’s right,’ said Evans quietly from his chair.

‘All right, all right! Don’t fly off about it. I haven’t got as far as digitalis yet, anyway.’

Sprogget’s head appeared at the door.

‘Is a presystolic murmur at the apex diagnostic of mitral stenosis?’ he asked anxiously.

‘Yes,’ Evans said.

‘Oh damn! I didn’t think it was.’ He looked as if he was going to burst into tears. ‘I’m bound to fail, I know I am!’ he exclaimed.

‘You’ll be all right,’ Benskin told him gruffly. ‘It’s nervous types like me who’ll come down. Do you get cyanosis in pneumonia?’

We took one night a week off: on Saturday we all went out and got drunk. The rest of the time we were irritable with each other, uncommunicative, and jumpy. Benskin’s usual sunny good humour seemed to have left him forever. He scowled at his companions, complained about everything in the flat, and developed the symptoms of a gastric ulcer.

The grim period of study and Benskin’s bad temper were relieved by only one incident before the examination. One Sunday night the famous helmet disappeared from the King George. No one knew who had taken it and no one had seen it go: it had simply vanished from its hook some time during the evening. The theft made Benskin furious, particularly as he had reasons to suspect the students from Bart’s, whom St Swithin’s had beaten soundly earlier on in the year in the inter-hospitals’ rugby cup. The next night he took himself off to Smithfield and climbed over the venerable walls of that ancient institution. He didn’t find the helmet, but he put his foot through a window and was asked to leave by a porter. His foray came to the ears of the Dean of St Swithin’s, who called him to his office, abused him soundly for ten minutes, and fined him three guineas. The Dean could not appreciate at all Benskin’s plea that the loss of the helmet justified such strong action. Whether this had any connection with an event that occurred shortly afterwards and established itself forever in the hospital tradition with the title of the Dean’s Tea Party was never known. Benskin was suspected, and there was a rumour that he had been spotted coming out of a small printer’s in the City: but there was never any proof.

A few days after his interview with Benskin the Dean entered his office to find his personal secretary rummaging through his desk.

‘Hello!’ he said. ‘Lost something?’

‘Not exactly, sir,’ she said, giving him a worried look. ‘I was just wondering why I hadn’t seen the invitations?’

‘Invitations? What invitations?’

‘To your At Home tomorrow,’ she replied simply. ‘The ’phone’s been ringing all morning. The Deans of all the other hospitals in London have been through to say that the notice is a little short but they will be glad to come for cocktails in the library. There have been some people from the Medical Research Council, too, and a professor from Birmingham.’ She looked at a pencilled list in her hand. ‘About thirty have accepted so far, and there looks like a good many more have arrived by the second post.’

The Dean hurled his hat on the floor.

‘It’s an outrage!’ he shouted in fury. ‘It’s a disgrace! It’s a…! By God, these bloody students! By God, I’ll punish them for this! You just wait and see!’ He poked a quivering finger at her so forcefully she leapt back with a little squeal.

‘You mean – it’s a hoax?’ she asked timidly.

‘Of course it’s a hoax! It’s these damn hooligans we’ve been giving the best years of our lives trying to educate! Send me the School Secretary! And the Professor of Medicine! Get me the Head Porter! Ring up all those people and tell them the thing’s a damnable practical joke!’

‘What, all of them?’

‘Of course, woman! You don’t think I’m going to be made a fool of by my own students, do you? Get on to them at once!’

At that moment the ’phone rang again. She picked it up.

‘Hello…’ she said. ‘Yes, he’s here now. Certainly. One moment please.’

She turned to the Dean. ‘The Lord Mayor’s Secretary,’ she exclaimed. ‘He says the Lord Mayor would be delighted.’

The Dean fell into his armchair like a knocked-out boxer.

‘Very well,’ he groaned. ‘Very well, I know when I’m beaten. Get me those catering people, whats-is-names, instead.’

The party was a great success. Although the Dean entered the library black with anger he found himself in the middle of so many of his distinguished contemporaries that he mellowed rapidly. Didn’t the leading heart specialist in the country grip him by the arm and tell him how much he appreciated his latest paper? Didn’t the Lord Mayor himself hint of a donation towards the new library, and, more important, ask for an appointment in Harley Street? Besides, he had quickly seen to it that the expenses would be borne by the Governors. He said a genial good-bye to his last guests as they climbed into their cars in the courtyard. Suddenly he saw Benskin, with his hands in his pockets, grinning at him from the shadow of Lord Larrymore’s statue. The Dean’s face twisted malignantly.

‘Do you know anything about this, damn you?’ he demanded.

‘Me, sir?’ Benskin asked innocently. ‘Not at all, sir. I think it may have been someone from Bart’s.’