Preview: You Can See The Doctor Now                                                                                     

                                                                                                                                                                                  

Chapter 1:  How It All Began


I don’t know anyone who decided to become a doctor.  I certainly didn’t.  It just seemed to be one of those assumed things in those days, like girls wear pink and play with dolls and boys wear blue and fire guns.

I suspect, when medical research has advanced far enough, the answer will be found to be laid down in the DNA - the “when you grow up, you will become a doctor” gene, laid down in the hereditary framework. If so, however, I must say that, in my case, I do not know where that DNA came from because nobody in the family had been a doctor before - or since, for the matter.  But it does happen a lot in other families - the DNA gets passed down and descendants of doctors become doctors.  Perhaps I was a mutant.  Anyway, meanwhile, until the research has been done, I blame my mother.  And my teddy bear.  Well, not really, but without those two I wouldn’t be writing this book because I wouldn’t have become a doctor and this book is about being a doctor.

The real danger as a child is to pretend to be a doctor, a much worse risk if some indulgent relative gives you a Christmas present of a doctor’s kit, including a pretend stethoscope.  You do not know what it is for or what it can tell you but you have seen doctors visiting you at home when you lay prostrate in bed with mumps or measles and it becomes easy to copy by wrapping it around your neck, putting the bits in your ears and pretending to diagnose every condition you have heard of at that young age by applying the bell of the implement against a relative’s chest.  All you are doing is playing but, for ever-hopeful parents, it demonstrates without doubt that you are destined for a career in medicine, especially if no-one in the family has been a doctor before.  It may be the same the world over although possibly in India you could get away by wanting to be a world-class cricketer; in Wales, a first-class singer, especially in a valley choir, or a love of rugby might divert the parents’ attention away from the stethoscope.

But, in England, playing doctors is a no-way-back activity.  Your career is set. Everyone wants to see that stethoscope around your neck for the rest of your life.  I don’t think Dad cared very much what I did as long as it was moral but Mum, especially, was keen and my toy bear did not help.

At first sight, Teddy seemed healthy enough but he was not a well bear.  Like an indulgent father, I attended to his every complaint with thorough attention to detail and a desire to do whatever was in my power to help.  Thus, Teddy was at the heart of my first forays into surgery.  Instruments in those days were limited to a blunt penknife but, despite the technical limitations and the lack of anaesthetic, I managed to carry out a number of what I would regard as successful operations in pursuit of the stuffed bear’s complaints.  As I discovered to be a surgical maxim later in life, the operation went well but the patient failed to recover.  Despite an assiduous search through his internal straw, I could never find any pathology to account for his symptoms.  In order to oblige, I would regularly remove some of the straw to show him postoperatively that treatment had been carried out but he would only come back with more complaints requiring more surgery.  After a while, Teddy was embroidered from head to hind paw with incisions, carefully sutured using my mother’s darning needle and wool.  It was only later that I heard of Munchausen’s syndrome, which is a condition where people feign illness in order to attract attention.  I realised then that that diagnosis summed up my teddy bear.  

My aunt was complicit with my mother in the choose-a-career-for-the-child conspiracy.  She had once been a psychiatric nurse but I suspect this was so she could get access to a psychiatric ward before she became a full-time patient, as she later did. My aunt lived with my grandmother not far away from us and we would visit every Sunday.  From my father’s perspective, I am sure this was for the sake of my grandmother because, in respect of my aunt, he couldn’t stand her.  However, whatever the reasons, the weekly visit left me exposed to the combined influences of my mother and aunt and, since I usually took him with me, my psychologically disadvantaged teddy bear as well.  

And so the scene was set.  Each phase of growing up was geared around a future career in medicine.  Not that being a child wasn’t fun – at least more than being an adult, as I later learned - it was just that there was an implicit understanding within all this fun and jolliment that the happiness and fulfilment were self evidently being experienced by a future doctor.  

We worry about what a child will become tomorrow, yet we forget that he is someone today.  Stacia Tauscher

The education establishment was also clearly complicit in this plot.  After all, it is a lot easier to steer a child along the route necessary to achieve his or her expressed goal than to identify the goal as well as doing the steering.  To be fair, the issue of career choice never really came up until there was a need to choose A-level subjects.  Until then, the expectation was simply to “do your best”, whatever was put in front of you.

Knowing that I was going to be a doctor, I realised how important it was to “get on”.  Fortunately, the 50s and 60s were highly meritocratic.  Success was rewarded handsomely and failure was either scorned or ignored.  At primary school, recognition took the form of being to made to stand on one’s chair if successful at gaining ten out of ten in a test, not by way of some form of deviant punishment but so that the rest of the class could gaze in awe at this paragon of intellectual virtue.  Obviously future doctors would do well or, at least, somehow, somewhere, that was what I learned so, whenever I stood on that chair, my future career was reinforced.

At my grammar school, parents received “fortnightly lists” which detailed their darling offspring’s position in class at each subject.  The average position across all subjects was reflected in the seating position in class, the better performers being nearer the teacher.  It always struck me that it would have been better the other way round because presumably the worst performers were in need of the most attention but nobody else seemed to have thought of it.  I do not know if future doctors were selected to sit near the teacher - probably not but, when I did gain a position in the front row, Mum convinced me it was true.   I don’t recall my toy bear’s having an opinion.  By the way, fortnightly lists were issued once a month. 

My mother loved the system, provided it conformed to her possibly biased assessment of her son’s abilities.  She had only two reactions to my academic performance: delight at my high positions in class and disdain for my assessors if my position was low.

Have you ever been in therapy? No? You should try it. It's like a really easy game show where the correct answer to every question is: 'Because of my mother.’  Robin Greenspan

At grammar school, we were blessed with a teacher who held responsibility for careers guidance and a dedicated careers room.  Unfortunately, the careers teacher never seemed available, at least to discuss careers, and the careers room bore a startling resemblance to one of those stands in a hotel foyer, containing a mismatch of unrelated leaflets tempting the passerby to sample some new adventure, visit a garden or have a fun-for-all-the-family day, often at great expense.  The careers teacher and careers room also functioned independently of each other, at least in so far as he was never in it.  Thus, it became very difficult to get an opinion on how to choose between Ancient Greek and Accounting, should one need to.  Needless to say, non-mainstream and non-academic careers didn’t get a look in.  If you were one of the forward-looking pupils (or their parents) who had formulated their career prior to entering secondary school, so much the better, especially if it was Law, Medicine or Divinity.  Rest assured no-one would dream of disrupting such a good plan.  So nobody ever thought of distracting me away from a dedicated career in medicine.

Most of the time we did what was necessary to get the requisite A-levels.  We even went into school at weekends to do extra dissection before the biology examination although the effort involved usually had to be compensated by a trip to the Town Hall Tavern in Tib Street.  The pub was known simply to its friends as the Town Hall.  My father never did understand the connection between a school trip for biology revision and a delayed return caused by a visit to a civic building on the way home.  

It’s alright, Ma, I can make it.  Bob Dylan “It’s alright, Ma (I’m only bleeding)”

    C    © Harvey Sagar 2013