A Rakes Progress

In my previous piece I described some of the experiences of being a student at Barts in 1970 taking 1st MB and my encounters with Professor Rotblat. The editor must be short of copy as she has invited a further instalment of witterings and bygone curiosities. At the end of the 1st MB year I returned to Clarke’s fish and chips emporium on Southend seafront for the summer, basking in my achievement and being promoted from kitchen porter to frying chips… a white coat at last!

Before return for the dreaded two year 2nd MB course I had to purchase half a skeleton in a stout cardboard box…a slight female… and a huge number of books, some of which I actually read. I still have the formalin stained Cunninghams anatomy volumes. This was a tough course in anatomy, biochemistry, physi­ology and pharmacology with a huge amount of factual learning, most of which I have of course never utilized as a doctor. As I said last time, you have us to thank for getting consid­erable cuts agreed in this in 1976!

As an aside, I have little idea what life is like as a pre-clinical medical student now… if you even have such divisions.

I think the anatomy course alone could rea­sonably have taken two years. In my day (and I did promise I would not deploy that tiresome phrase of the elderly, old git but I just cannot help myself ) it involved I think six students to a body, a full dissection of a cadaver over two years in a large, tiled swimming pool lab stink­ing of formalin, presided over by a curious el­derly technician straight out of central casting for Frankenstein movies who would wander round with a large spray bottle of formalin and periodically lift a cover and squirt the corpses.

We were exhorted to respect the bodies with dark stories of students rusticated for play­ing conkers with human testicles and told no tissue could ever be removed from the lab. I recall on my 45 minute tube journey from Queens Park, where I had my first experience of flat sharing, looking down and seeing a small piece of human fat on my shoe.

I cannot remember anybody fainting at the begin­ning but I still recall the sensation of immersing both my arms in a mixture of liquid fat and formal­dehyde when we first had to turn over the body. (Here’s a tip you young ‘ens. Never do this with a hangover.)

We had regular viva exams which had to be passed and repeated if failed with a variety of anatomy demonstrators, some surgeons to be, some sur­geons who hadn’t quite been, all capable of ruin­ing your day with a fail. Dr. Clarke, the Reader, a wee scotsman, charming but deadly, responding in his rich, Edinburgh brogue to his victim’s answers for the name of random bits of tissue pointed at: “Yes… yes… yes. That’s right…. No… no…. Lad­die, ye’re going doon!”

The professor was O J Lewis, a kiwi as dry as only a New Zealander can be… as dry as a great big dry thing in the middle of the Kalahari on an es­pecially hot day… and deeply sinister. He once turned round in a lecture and covered half his face to demonstrate some cranial nerve whazzit and I nearly fainted in fear!

We were the first generation of medical students who did not have to have Latin O level and a few generations before us, the anatomy lectures had actually been given in Latin. (Me, I never ‘ad the Latin for the judging… which for younger readers is a reference to the great Peter Cook. Look him up.)

I loved his lectures… OJ’s not Cook’s. Most didn’t. He was another genius, outlining with no notes hugely complex embryology and neuroanatom­ical development in a vast series of unfolding 3D drawings made across three blackboards in mul­ti-coloured chalks. (For younger readers a black­board was a surface covered in special paint upon which those lecturing could make marks in chalk which could be easily removed with a duster.)

I am an artist and enjoyed the challenge of keep­ing up with this absolute tour de force but for those with poor drawing skills it must have been a nightmare. And woe betide the young lady or gentleman who failed to complete their draw­ing in coloured pens before the duster of doom wiped out the chalk. You could never catch up if you fell by the wayside.

As with Professor Rotblat’s, I kept these lecture notes for years too. (I suspect now students would just video these on a telephone.) Any­ways, I had a sneaking regard for him and he passed me in my 2nd MB viva in which I… made him smile! Well, a kind of crooked, sardonic gri­mace over a sarcastic comment! (Here’s another tip. You can get a long way in medicine with charm.)

The biochemistry was a huge course and, whilst I am a climate change skeptic, carbon certainly had a lot to answer for in our studies in 1971. All those formulae, rings, and cycles! Professor Crook was charming but I was dismayed to find Dr. Armstrong’s enzyme kinetics was challeng­ing with maths which I had hoped had disap­peared forever in my studies with Professor Rot­blat. I can recall little of the physiology course but pharmacology introduced huge numbers of drugs and side effects as a kind of fourth wave of facts.

So on we grafted and grafted for 2 years. Then came the exams. It is a curious thing but I have, and I have had this discussion with two old comrades recently, absolutely no recall at all for the written exams, where we took them, how they were and little recall for viva experiences. I cannot say whether this is beer holes in the hippocampus or some effect of cortisol flooding but I certainly remember getting the results.

We were lined up alphabetically in a long line at the back door of the chemistry lab in Char­terhouse square. In you went individually to be given the news. The Wine Committee, of which I was a member, a body of students who ran the bar and entertainments, had set up a bar on the lawn with champagne cock­tails for celebrations and commiserations. Those unlucky enough to have had incon­siderate ancestors who had not looked into research on the effects of surname ordering, could see our chums emerging from the front door, most elated, some slinking and stooped with the realization of a ruined summer and a last chance with the retake.

It took a very long time to get through all of us, seemingly several days, but joy unbound­ed! I passed and collapsed into the welcom­ing arms of several of the world’s most lethal drinks. I will outline the social life and cultural changes in the seven years I spent at Barts in a further installment, Madame Editor allowing. This was a time of major changes. And then there is the clinical education of the time for the final three years which largely seemed to consist of bullying and public humiliation!

Here’s a taster. The very first patient I had to examine the next year, resplendent in a white coat that didn’t smell of chip fat, (me, not the patient), seemed quite well, but I just couldn’t find a pulse and I had read the early parts of Hutchinson’s how to do everything. What sort of trainee doctor cannot take a pulse? Anywhere! The patient didn’t let on and I was finally rescued from my sweating anxiety by the SHO. How he laughed! That’s right. One of Professor Lowther’s Takayasu’s disease exotica. Only at Barts. I have never seen another.