in england now

1
89 In England Now A Running Commentary by Peripatetic Correspondents A FEW years of happy leisure before decrepitude used to be a legitimate ambition. Now it is considered not only dangerous but immoral. " I cannot understand how any doctor can do other than go on being a doctor until he drops," said an older colleague, looking at me severely: and other puritanical friends have denounced me for not doing locums in (shall we say) Huddersfield and Merthyr Tydfil. Now, it seems, a Foundation is being urged to study how ageing doctors can be " used ".1 My paternal ancestors were Scots, almost as fierce and savage as their own wild cat. Though only a half-caste myself, I don’t recommend any Foundation to attempt interference with my pattern of living. Winter, tiny cottage in South Devon—you can get them very cheap then: spring and autumn, fixed caravan with superb prospect of the lively Bristol Channel: summer, off with the tent to one or other of my little country estates, Exmoor, Dartmoor, Yorkshire moors, Northumberland fells, and the Lunatic Fringe. " What do you do ? " they say. " Nothing in particular: but the days slide by with incredible ease." Devastating though it may be to some classes of workers to be thrown out at 65 or less, that we are no longer important shouldn’t mean a thing to us higher types. ’*’ "" ’*’ What is the Iron Curtain really like ? If you cross by car, as we did, from Western Germany into Czechoslovakia, it is a very real thing which would seem to be deliberately designed to frighten you. When you leave the German customs station you immediately enter a no-man’s-land of high, wild grass, with a typical border road-narrow and pot-holed-running straight across it. You can see the hills of Bohemia ahead of you. The first sign of the new country you are to enter is a huge notice which says " No Photographs " in several lan- guages ; this is repeated after about a hundred yards. Next there looms out of the grass a tall watch-tower in which stands a sentry with rifle at the ready. Then-and this is the actual Iron Curtain-there are two post-and-wire fences, each ten feet high, about four feet apart. The whole of the space between is filled with a tangled mass of barbed wire. The road goes through a small gap in the fence, which reveals a further identical fence. Shortly after this you see the Czech customs post, where your reception will be coldly courteous. This must be because of the Czech attitude to the Germans. When we left Czechoslovakia, we crossed into Austria and everyone was as friendly as could be. There were no for- malities. There was even humour. " I do not suppose", said the Czech frontier guard with a smile, " that you have any Czech money left ? " This was obviously his standard joke. The reason is that one is not allowed to take Czech money out of the country; so everyone spends it, to the last crown, before he leaves. Indeed, our last two hours in Bratislava provided one of the strangest experiences I have ever had. It was a wet Saturday afternoon and there were long queues outside the shops; but we queued like all the rest, determined to lose no chance of turning our money into goods. We bought presents for the whole family, Czech cigarettes by the hundred, and tins of Russian fruit and Chinese fish-anything and everything. There was no trouble at all about taking it back through the Iron Curtain. Indeed, there was no curtain: just a single-bar gate. ’*’ ’*’ ’*’ My chief is paranoid, not manic-depressive, but I find his remarks on the old days puzzling too. He says that his routine work as a resident used to take him 18 hours a day; that those who wish to make a name for themselves, like him, must keep thoroughly up to date with the medical literature; that the development of a broad personality needs time for cultural pursuits; and that a healthy body, which is important above all 1. Hart, P. D’A. Lancet, 1963, i, 1373. else, needs regular exercise and plenty of sleep. Just how many hours were there in an old day ? ...... * "" The new diamond needle for the record-player, costing eight dollars plus tax, was guaranteed for 500 hours’ play. It was to hansel a good new Scottish record. After the first three minutes the patriotic sounds fainted and began to wobble. We thought the dealer hadn’t fixed the needle in properly, so I took the player back. " Broken clean through," he said. " Did you drop it ? " I told him no, and how gingerly we always treat the player. He had trouble getting the root extracted, and went on about it. " So you didn’t drop it ? " All my life I’ve been dogged by my ability to make facts sound like fiction. " No," I said. " Maybe there was a flaw in the diamond ? ... Oh! I’ve just remembered what the record was playing when the needle broke. It was Scots Wha Hae. Was the needle made in England ? " He gave me a queer look and said: " No. Would you be Scotch by any chance ? " I said: " What do you think ? " I was glad the needle hadn’t been made in England, although it rather weakened the point of my observation. I suggested he might tell the manufacturer that it was Scots Wha Hae that had done for the needle. " It makes a good story," he said in a way that made me doubt if he would mention it. I thought of writing to the manufacturers myself, suggesting Scots Wha Hae for routine testing of their guaranteed needles. But what would they think ? ... " Probably dropped it." "" "" "" Son went through a trying time waiting for the 11 + results, despite all exhortations that he was still a valued member of the family group, pass or no. During the long wait he had occa- sional headaches which responded well to the latest presenta- tion of paracetamol. Since he observed the regulations for scheduled poisons, in letter and spirit, more closely than many a doctor, he was entrusted with a small plastic tray containing 6 tablets for self-administration at need. By accident, it was discovered a few days later that his stock was reduced to one tablet. " How many have you taken ? " " I have only needed one; but I had to treat two of the masters." ... "" ... Check your references; this wise counsel is all too often ignored by authors, but on occasion it is the reader who is at fault. Recently I was the second examiner of an M.D. thesis in which several references were to Command Papers which were variously cited as Cd., Cmd., Cmnd. Inadvertently my co-examiner had left his notes in the volume, and I observed that he had listed these official prefixes and commented " careless ". But who was careless ? The Director of Publica- tions of Her Majesty’s Stationery Office is a thrifty chap and the prefixes C., Cd., Cmd., and Cmnd. are not only abbrevia- tions for Command but an integral part of the numbers allocated to Command Papers, forming a chronological sequence which runs: C. 1836--69 Nos 1-4222 C. 1870--99 1--9550 Cd. 1900-18 1-9228 Cmd. 1919-56 " 1-9889 Cmnd. 1956- 1- ...... * "" Cats are multiplying round our hospital, and the Secretary has sent out a decree against them. In ringing, warlike tones, with the full weight of the Board behind them, we are called upon to put our responsibility to the patients first and not to jeopardise their health and comfort-in short, not to feed the poor pussies. No wonder opposition has been aroused. Motherly orderlies are contributing to a Freedom from Hunger campaign. Nurses are organising a flag day of black cats cut from X-ray envelopes. A seditious poster has appeared, " Spare the Cat and foil the Board ". The contractor employed to remove the animals is anxious about his continued income. So we continue to feed our feline friends. After all, we are in England now. "" ’*’ ’*’ Epitaph for a pathologist: The body was that of a well- nourished man.

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Page 1: In England Now

89

In England Now

A Running Commentary by Peripatetic CorrespondentsA FEW years of happy leisure before decrepitude used to be a

legitimate ambition. Now it is considered not only dangerousbut immoral.

" I cannot understand how any doctor can doother than go on being a doctor until he drops," said an oldercolleague, looking at me severely: and other puritanical friendshave denounced me for not doing locums in (shall we say)Huddersfield and Merthyr Tydfil. Now, it seems, a Foundationis being urged to study how ageing doctors can be " used ".1My paternal ancestors were Scots, almost as fierce and savageas their own wild cat. Though only a half-caste myself, I don’trecommend any Foundation to attempt interference with mypattern of living.Winter, tiny cottage in South Devon—you can get them very

cheap then: spring and autumn, fixed caravan with superbprospect of the lively Bristol Channel: summer, off with thetent to one or other of my little country estates, Exmoor,Dartmoor, Yorkshire moors, Northumberland fells, and theLunatic Fringe. " What do you do ? " they say. " Nothing inparticular: but the days slide by with incredible ease."Devastating though it may be to some classes of workers to

be thrown out at 65 or less, that we are no longer importantshouldn’t mean a thing to us higher types.

’*’ "" ’*’

What is the Iron Curtain really like ? If you cross by car,as we did, from Western Germany into Czechoslovakia, it is avery real thing which would seem to be deliberately designedto frighten you. When you leave the German customs stationyou immediately enter a no-man’s-land of high, wild grass,with a typical border road-narrow and pot-holed-runningstraight across it. You can see the hills of Bohemia ahead of

you. The first sign of the new country you are to enter is ahuge notice which says " No Photographs " in several lan-guages ; this is repeated after about a hundred yards. Nextthere looms out of the grass a tall watch-tower in whichstands a sentry with rifle at the ready. Then-and this isthe actual Iron Curtain-there are two post-and-wire fences,each ten feet high, about four feet apart. The whole of the

space between is filled with a tangled mass of barbed wire.The road goes through a small gap in the fence, which revealsa further identical fence. Shortly after this you see the Czechcustoms post, where your reception will be coldly courteous.This must be because of the Czech attitude to the Germans.

When we left Czechoslovakia, we crossed into Austria andeveryone was as friendly as could be. There were no for-malities. There was even humour. " I do not suppose",said the Czech frontier guard with a smile, " that you haveany Czech money left ? " This was obviously his standardjoke. The reason is that one is not allowed to take Czechmoney out of the country; so everyone spends it, to the lastcrown, before he leaves. Indeed, our last two hours inBratislava provided one of the strangest experiences I haveever had. It was a wet Saturday afternoon and there werelong queues outside the shops; but we queued like all the

rest, determined to lose no chance of turning our money intogoods. We bought presents for the whole family, Czechcigarettes by the hundred, and tins of Russian fruit and Chinesefish-anything and everything. There was no trouble at allabout taking it back through the Iron Curtain. Indeed, therewas no curtain: just a single-bar gate.

’*’ ’*’ ’*’

My chief is paranoid, not manic-depressive, but I find hisremarks on the old days puzzling too. He says that his routinework as a resident used to take him 18 hours a day; that thosewho wish to make a name for themselves, like him, must keepthoroughly up to date with the medical literature; that thedevelopment of a broad personality needs time for culturalpursuits; and that a healthy body, which is important above all

1. Hart, P. D’A. Lancet, 1963, i, 1373.

else, needs regular exercise and plenty of sleep. Just how manyhours were there in an old day ?

...... * ""

The new diamond needle for the record-player, costing eightdollars plus tax, was guaranteed for 500 hours’ play. It was tohansel a good new Scottish record. After the first three minutesthe patriotic sounds fainted and began to wobble. We thoughtthe dealer hadn’t fixed the needle in properly, so I took theplayer back. " Broken clean through," he said. " Did you dropit ? " I told him no, and how gingerly we always treat theplayer. He had trouble getting the root extracted, and went onabout it. " So you didn’t drop it ? " All my life I’ve been

dogged by my ability to make facts sound like fiction. " No,"I said. " Maybe there was a flaw in the diamond ? ... Oh!I’ve just remembered what the record was playing when theneedle broke. It was Scots Wha Hae. Was the needle made inEngland ? " He gave me a queer look and said: " No. Wouldyou be Scotch by any chance ? " I said: " What do you think ?

"

I was glad the needle hadn’t been made in England, although itrather weakened the point of my observation. I suggested hemight tell the manufacturer that it was Scots Wha Hae that haddone for the needle. " It makes a good story," he said in a waythat made me doubt if he would mention it. I thought of writingto the manufacturers myself, suggesting Scots Wha Hae forroutine testing of their guaranteed needles. But what would

they think ? ... " Probably dropped it.""" "" ""

Son went through a trying time waiting for the 11 + results,despite all exhortations that he was still a valued member ofthe family group, pass or no. During the long wait he had occa-sional headaches which responded well to the latest presenta-tion of paracetamol. Since he observed the regulations forscheduled poisons, in letter and spirit, more closely than manya doctor, he was entrusted with a small plastic tray containing6 tablets for self-administration at need. By accident, it wasdiscovered a few days later that his stock was reduced to onetablet. " How many have you taken ? " " I have only neededone; but I had to treat two of the masters."

... "" ...

Check your references; this wise counsel is all too oftenignored by authors, but on occasion it is the reader who is atfault. Recently I was the second examiner of an M.D. thesis inwhich several references were to Command Papers which werevariously cited as Cd., Cmd., Cmnd. Inadvertently myco-examiner had left his notes in the volume, and I observedthat he had listed these official prefixes and commented" careless ". But who was careless ? The Director of Publica-tions of Her Majesty’s Stationery Office is a thrifty chap andthe prefixes C., Cd., Cmd., and Cmnd. are not only abbrevia-tions for Command but an integral part of the numbersallocated to Command Papers, forming a chronologicalsequence which runs:

C. 1836--69 Nos 1-4222C. 1870--99 1--9550Cd. 1900-18 1-9228Cmd. 1919-56 " 1-9889Cmnd. 1956- 1-

...... * ""

Cats are multiplying round our hospital, and the Secretaryhas sent out a decree against them. In ringing, warlike tones,with the full weight of the Board behind them, we are calledupon to put our responsibility to the patients first and not tojeopardise their health and comfort-in short, not to feed thepoor pussies.No wonder opposition has been aroused. Motherly orderlies

are contributing to a Freedom from Hunger campaign. Nursesare organising a flag day of black cats cut from X-ray envelopes.A seditious poster has appeared,

" Spare the Cat and foil theBoard ". The contractor employed to remove the animals isanxious about his continued income.

So we continue to feed our feline friends. After all, we arein England now.

"" ’*’ ’*’

Epitaph for a pathologist: The body was that of a well-nourished man.