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Sunday, November 15, 2015

Making of a Child Psychiatrist (31): Back to the Grind (1)

We all have sad feelings returning home after a holiday, especially if it was a fabulous opportunity to get to know relatives who are not much more than names on a family tree. But both Jan and I were excited about our second year at University, and Jan was very keen to be back in touch with her parents and her sisters. We had done our best to keep her from feeling lost, but when you have always had such close emotional ties, to be away from them can be agony. If it were possible, I loved her more for putting up with me re-emerging as a Martin, and for the input from an often overwhelming tribe of us. She had put up with living in very strange places, erratic hours, working in alien environments, and being abused; the stress had taken its toll with migraines – her cardinal sign of needing to slow down.
We arrived back in England, and picked up at the airport and driven back to Kent, telling stories about our adventures and filling in gaps between the sparse letters sent home to Westgate. However, there was barely time to get over jetlag before we were back into the maelstrom of living in London, and lectures and practicals, social gatherings. During the time we were away, Reg had purchased a small flat at Kidbrook near Blackheath in South London, and Wendy had already moved in. Cute, first floor, square box in a three storey modern building, close to the Kidbrook station, and with heating. Jan got settled. It was somewhat longer to travel into Bedford College by train, but much closer to Halliday Hall.
King’s was a flurry of pressure to revise all the work from the 1962-3 academic year, and build towards the exams in early March 1964. I remember that pharmacology became the bane of my existence, probably understandably given my rather poor underlying knowledge of chemistry. I did my best. In fact I worked hard to get my head around the various drugs used for systems and illnesses, but it was not really to fall into place until we began to have contact with real live patients and their medical problems. Almost every week we were expected to try a small dose of a medicine and report on the results in our own body systems. A great way to experience the drugs and any minor side effects, but I have to confess I balked at taking each of the aperients, of which there were several types expected to be taken week by week to compare results, and compile a report. These days, of course, you would touch the button on your iPhone, and ‘Google’ the drugs, using eloquent descriptions from others. I did manage some, but I also laboriously constructed some of my written work from written texts from various books. This cavalier approach to such a core subject came back to bite me when I did my finals exams, but that was in the future.
‘The writtens’ took place over three packed days. Six exams of three hours each sitting uncomfortably at ancient etched desks in a large chilly hall at King’s on the strand. A one-hour lunch break to wind down, discuss some of the questions in a desultory way with friends, and then back into it. I remember the musty atmosphere, the occasional cough or moan, the shuffling of bottoms, the intense exam technique of writing brief notes on each question and then expanding the notes somewhat more fulsomely, but under time pressure. I do not remember any of the questions.
Within days we were into ‘The practicals’, of which the only one I sort of remember is the anatomy exam. We were seated outside one of the large demonstration rooms. Once your name was called you passed through a large wooden door. The examiners sat at a large desk covered with bits of bone and pictures, and various specimens floating forever in formalin in a variety of glass containers. My steps echoed on the wooden floor as I walked across the room and sat facing the tribunal. The central figure, of course, was Professor Nichol. The exam began. “Mr. Martin, (ah, the strains of that Scottish accent etched into memory) will you peruse this organ, tell me what you think it is, and point out to me the arterial and venous blood supply”. Haltingly, I did so to a non-committal grunt. Several more jars followed, and nervously I stumbled through. “Tell me what you think this bone may be, what function does it serve, and show me some of the insertions of relevant muscles.” “On this diagram, point out where you think the aqueous humour resides.” On and on we went, and I gradually gained in confidence, and became less hesitant, until: “At what level of the spine does the oesophagus begin?” I was flummoxed. I searched through what I knew, and tried valiantly to visualise the oesophagus in place in relation to the spine. I stumbled out “At about C2, sir…” (praying). “Would you like to think again, laddie?” “Somewhat lower, sir?” The response was one of those pauses that tell you that you have no hope, and have failed miserably. I felt winded. “Yes, laddie, somewhat lower…”
“Come over here to the model” (a live male stripped to the waist, removing what appeared to be a dressing gown. “Now, I want you to ask the model to perform a movement that will demonstrate Latissimus Dorsi.” Well, I did know that this muscle was the broad one either side of the back. I thought quickly, and asked the model to pull against my hands in front of him. Phew, the muscle stood out quite well. I felt pleased. “Now show me another way of demonstrating the Latissimus Dorsi.” I asked the model to pull down on my outstretched hand above his head. He did so, and the muscle stood out. “Can you tell me a much simpler method?” I thought hard, my momentary confidence fading. “The model could push upward, sir.” “Well he could, but he won’t.” And the Professor of Anatomy turned to the model and commanded: “Cough!” The model did so, and the muscles on either side of his back stood out very well, of course. “You may leave.” I knew I had failed, and head down I turned to retrace my dragging steps to the door. Nearly there, I heard this triumphant Scottish voice: “You won’t forget about C6 will you laddie?” Not only had I failed, I was being mocked.
The next couple of weeks went by in one of those miseries that follow failure, however big or small. My medical career was over before it had really go going. How would I face Jan? How would I face my friends? Whatever could I do? Well, like all of us in the small group of med students at Halliday Hall, I waited in limbo. Well, mainly in the bar, and then sleeping well into the morning. During the afternoons, I read or went for runs around Clapham Common. Jan and I visited the Tate Gallery on The Embankment, and the National Gallery in Trafalgar Square. But she had pressures in her own Degree studies, as she moved towards her end of her second year exams in June. She (not for the first or last times in our lives) told me I had to be patient.
It seemed such a crossroad. If I had failed, I was not quite sure what would happen, what I would do (you must remember, I still had not come to terms with the system; I did not understand I would be given a second chance of doing battle with the Scottish professor). If I had passed, I would have to make rapid arrangements to leave Halliday Hall, and find other accommodation nearer the hospital.

More tomorrow…

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