There were certain advantages to being a senior
house officer rather than a registrar in psychiatry. I was not deemed to be
experienced enough to be on call, so essentially the job was 9am to 5pm, even
if I had to do the occasional weekend. As you would now have guessed, the work
was intense and somewhat wearing. Not only was I learning how to manage a wide
range of fairly serious disorders but there was also an expectation of doing a
fair amount of introspection. I have never shied away from that, and understood
from early on the importance of it in relationships with people who were
struggling. The phrase ‘Primum non Nocere’ (first do no harm) took on a very
special meaning.
I was also on a very steep learning curve at
home. As I have noted before, we had moved into our first true home in about April
1968, with Jonathan born in the February. By the time I took up the psychiatry
job in October, he was getting on for nine months, and able to sit and begin to
take in the world. He provided endless fascination and nappies. Jan seemed to
have taken on the tasks of parenting so naturally, but I was a learner and
paediatric training in medicine does not provide you with much in the way of
skills to be a parent. We had both had siblings about 7 years younger. Jan had
always been fascinated by her little sister and her development, and took an
active part in helping whenever she could. In contrast, as a boy, I had very little
interest in my baby sister; she was just a noisy nuisance taking up all my
mother’s attention, and doing that embarrassing breast-feeding thing. I was
happy to be roaming around with my friends outside the house.
So, I know I was not a very competent parent
to begin with; rather, I was a rank beginner on a steep learning curve. Jonathan
was not easy to settle down at night, so we often had to stay awake till late,
or get up repeatedly. Even so he was a joy and, like every set of new parents,
we were fascinated with each tiny developmental advance, overjoyed by each
smile. I guess I was also taking a professional view of his development. Was he
on track? Was he normal (whatever that means)? Who would want a doctor and
proto-psychiatrist for a parent?
There was also a lot to be done in our new
home home. While the outside of the house had been renovated and appeared
modern by comparison with the rest of the street, we wanted to decorate the
inside to our taste. Like all new homeowners, we wanted to make it ours. So we
painted walls and ceilings, organised carpets, and built simple bits of
furniture.
Jonathan was getting too old to go into work
with Jan, so we had a compromise to make, and were both unhappy about it. Jan
found a day care situation with a woman she quite liked, where Jonathan was
duly parked each day at the block of flats to allow Jan to go into work. She
was very torn, but got into a rhythm of dropping him off each morning with his
pram for morning naps, then walking the remainder of the 2 miles on to King’s
for her half time job. She was relieved when she returned each lunchtime to
find him still in one piece.
There were also, of course, times of great
anxiety. One evening when Jonathan was about fourteen months old, he developed
a fever and was literally ‘burning up’ with a temperature in excess of 100
degrees Fahrenheit. We tried cooling him down, gave him some infant aspirin,
but it went on and on. My paediatric skills were not helpful when I was so
personally involved. Late that night we decided we had no choice but to take
him down to King’s Casualty. We got clerked in, and watched in horror as our
little bloke was stripped down to nothing, and sat disconsolate on a cold metal
trolley inside our screened cubicle, while nurses wiped him down with cold wet
flannels. Jan was desperate because we would have done nothing like that at
home and it seemed so brutal. I was outraged because I feared he might develop
pneumonia, if that was not already the problem. We were turned from
professionals into scared parents, and felt that sense of helplessness that
everyone must feel when you become a number, just another case. He was seen by
a paediatric registrar and had an Xray of his chest. All good apparently!
Eventually his temperature did come down, he was given a dose of penicillin,
discharged, and we dressed him and took him home – not all that impressed, and vowing
to never repeat the experience.
The house was very close to Peckham Rye
Common, so when weather allowed we would go down to the park and enjoy being a
family. We have photos of sunny days, and all of us smiling, as well as one
glorious one of Jonathan in a pushchair with his curly hair, pudgy baby face
covered in ice cream. We were just an ordinary family out having fun; just as
it should be.
My year in psychiatry was coming to an end.
It did not matter how well I had done, how many apparent successes we could
count, how much I had enjoyed the experience, or how much I was liked; there
was no immediate prospect of a registrar position at King’s. I looked
elsewhere, but just could not find a job in the medical journals; all very
depressing. For the last six months I had become increasingly anxious about
what to do next. I discussed my career with consultants and registrars but no
leads began to appear, and our little family needed financial security. I know
I became increasingly morose, and not much fun to live with.
And fate stepped in. Jan’s father had from
time to time played golf with a couple of general practitioners in Kent, and
had discussed our situation. Apparently an elderly GP Dr. Alan Bowie, who had completed
35 years of medical service in Birchington (the town of our old drama group,
and early courting days), was about to retire. His junior partner, Dr. John
Hayden, was now looking for another doctor. Jan and I spent days discussing the
option. It meant moving on from psychiatry, and moving house again; but what
could be nicer than a beachside and rural practice, only 2 miles from the town
where we had both grown up? What could be nicer than moving close to family?
What could be nicer than almost trebling my current salary?
I met up with John Hayden for a discussion
one weekend, and we got on well. The job sounded manageable. In addition to
John, there was one other long-term doctor (Dr. Denis Merritt). The practice overall
had just over 10,000 patients, but with some new council estates being built,
the numbers were growing. My flock would be about 3,000 people in Birchington
and perhaps some in Westgate, as well as the surrounding farming communities of
Thanet including St. Nicholas at Wade, Sarre and Pluck’s Gutter in one
direction, Acol and Minster in another. I would be expected to look after a Dr.
Barnardo’s home with about 100 children, and be on call for the whole practice
one week in every three. I had no concept of what that might entail, but John
assured me it was not overly taxing, and I would not take long to grasp the
whole thing.
John suggested I would be well advised to complete
6 months of Obstetrics training before beginning, given the number of births
each year in the practice and surrounding villages (about 200 a year). Given my
joy in my student midwifery training, that sounded good. John had heard there
might well be a senior house officer job coming up at Margate Hospital (where I
had worked very briefly as a nurse assistant 10 years before); he said he would
find out more. I put together a brief curriculum vitae, and wrote to the
Director of Obstetrics at Margate Hospital, discussing the plan to move into
General Practice, and noting I would like to work towards a Diploma in
Obstetrics. The response was rapid and positive, so I guess there had been few
other applicants (if any) for this small hospital outpost on the tip of Kent.
There was a bonus. A ground floor hospital flat in a small block almost next to
maternity would become free shortly after I began work. Would we be interested in
moving into that? How fortunate could we be?
