Tuesday, September 22, 2015
Making of a Child Psychiatrist (23): Med School (1)
The lecture theatre in the Medical School at King’s College London in the Strand (Founded 1828) feels ancient. It may partly be the darkish brown rows of seating, or cleaning materials used, or the polish on the floor, but there is a residual person smell that reeks of learning. It rises for two levels, with sloped seating rising into the Gods. I had followed the written instructions, and arrived in good time, choosing to sit about 8 rows back. I never did like sitting right in the front and, to be honest, was too lazy to climb right up the back just to gain obscurity and have a secret overview of the crowd. There was nobody out front controlling the crowd or guiding, nothing of interest to look at on the pristine green black boards, and so there was a rising hubbub as 9am arrived and passed, and people began to introduce themselves. There was some fidgeting and I guess others were, like me, wondering whether we had misread the notice. We had such a lot to learn about power and crowd control.
At thirteen minutes past nine, a diminutive man (I was later to learn his height was 5ft 4ins) walked into the theatre wearing a white laboratory coat over his suit. He was slightly portly, very unprepossessing and totally bald. He had a new piece of chalk, and in large letters slowly wrote ‘14%’ with a slight scratching audible in the silence. He turned to face us, and ran his eye over every face from left to right and then row-by-row from the bottom to the top. You could have heard a pin drop as 140 young souls packed into the theatre watched this man slowly walk up the left hand stairs, within inches of me, to about two rows below where people were sitting. He paused dramatically.
Then, enunciating clearly, in a broad Scottish accent, he spoke: “Fourteen per cent!” (pause) “Fourteen per cent fail Second MB…” (slight pause for impact) “… and this is where they sit!” There was silence as Professor of Anatomy Tosh Nicol strode down the steps to the front. We listened in wrapt awe over the next 40 minutes as he went on to describe the medical course over the next 18 months, the expectations overall and in his own subject. I can still capture the cadence of his voice when telling the story. In addition, I can still get the feeling of awe, if not fear of this small man who writ large. Unknown to me in my youth and naiveté, Professor Nicol in many ways reiterated the words of Robert Bentley Todd who, exactly 110 years before, had stood in the same spot and welcomed those new to studying Medicine at King’s (his lecture (1st October 1852) was published as ‘On the Resources of King’s College London’ – available free on Google Library). I suspect Todd’s address (judging from the transcript) had a certain gravitas, and would have lacked the aggressive directness of Nicol. I now have a certain fondness for Todd, given he focussed on neurological disease, writing several books about it. Five years later, I was to gain the Prize in Medicine for King’s, a bronze medal in the name of Robert Bentley Todd. I have always been curious about him, and his effigy cast on the face of my medal. But all that was a long way into the future.
As I remember it there were presentations from other academics introducing their topics and the structure of their courses. Strangely, I don’t have much memory for any of them. On reflection, this makes me think that Professor Nicol’s address was, for me, in the manner of a screen memory – an apparently aggressive man with enormously high expectations – someone we might never please, someone to be seriously avoided.
I suspect we were directed to a canteen for lunch, and spent some time making introductions and discussing the morning. Somewhat later on that first day, in groups of 12, we were taken up to the top floor by ‘demonstrators’. We entered a strange and open room with an awful smell I came to know as formalin (which did not disguise several other scents of unknown, but guessed at, origin). Shockingly, there were a dozen metal dissection tables in ranks 2X6, and on each of these was a preserved human body laying face down. I would guess this to be some device to lessen their humanity until we were used to the place and the processes. We were informed that these bodies had been freely given to the school for the express purpose of training future doctors; an odd privilege which has been mostly lost in today’s medical schools. We were assigned 10-12 to a body, with 5-6 to a side. We were given rosters listing the times we were expected to attend, and lists of the surgical instruments that would be required to do the job. A number of texts were recommended for purchase, to explain in some detail how we were to go about the exercise. Having been introduced, we were shepherded out.
In the corridor, while we were milling about coming to terms with our recent gruesome experience, a number of confident young people stood smiling with understanding next to small plain and unmarked cheap wooden boxes about a metre by 30cms by 30cms with a handle on the top. The young people were medical students who had successfully completed their eighteen months of pre-clinical training in the previous year, and wanted to sell their skeletons to the newbies for something between ten and fifteen pounds each. Having had the contents of a box demonstrated, and having been assured there was not one bone missing, I bought one; cash and no receipt.
Having collected some timetables and a guide to the med school, the day was complete and I walked with several new friends down The Strand to Charing Cross station, each of us hugging a cumbersome but surprisingly lightweight box. We arrived before the rush hour, used our newly purchased season tickets and sat reflectively on the underground, hugging our odd possessions until we got to Clapham South. From there, we walked the short distance along Southside to Halliday Hall, my home through to the spring of 1964.
In 1962 King's provided quality student accommodation for about £50 per term at Halliday Hall, on Southside at Clapham Common. This suited me eminently in my transition into the real world, as long as my parents were able to continue to supplement my KCCC quarterly grant. I was on the 4th floor, and had one of sixteen single rooms sharing two bathrooms. Luckily, there was a lift. It was full board with breakfast, dinner at night, and a cash bar with some snooker tables, and a television lounge. Rooms were cleaned and tidied each day. There were neatly kept lawns and tennis courts for the energetic.
In the first few days of living there I had been somewhat nervous of mixing with what turned out to be a lively (and naughty) mix of male Divinity, Engineering and Medical Students. I would eat quietly and quickly, watch a little television, and then retreat to my room where I had my record player. Day by day I made new friends who, of course, were in the similar situation of finding themselves living away from home in the big city for the first time.
After that first day of actually being at College, the group of med students began to grow close, and friendships were forged which certainly lasted strongly until the day we all qualified and went our separate ways. On that first day I wanted to retreat and examine my skeleton, looking at the markings and indentations on the whitened bones with curiosity. I had left the skull of this long dead person till last. Eventually I picked it out of the box and turned him round and upside down. He and I were to become old friends, so I thought the least I could do was to give him a name. In memory of my old school friend and mentor, I called him Fred. I hope whoever he was has forgiven me.
On about the third or fourth day, one of the med students asked me if I played Bridge; they were short of a fourth hand. And life began to take a pattern.