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SPIRIT OF DELIGHT: Part 2. A tale of two cities

By Alan Craxford

This is the second half of the first of a series of articles based on my University years and beyond. The beginning can be found at Spirit of Delight: Part 1. Queen's College, Dundee

The Prologue

Mr Morris: Physics Master, Alderman Newton's Boys School, Leicester

Mr Morris (1)

My Hayman: Biology Master

Mr Hayman (2)

"Surgeon?", Mr Morris' steely grey eyes glinted from behind his half-moon spectacles, "If the lad doesn't pull his socks up he won't make second lieutenant in the St Johns Ambulance!". The Physics master was dissecting my results in the parent teacher’s A-level post mortem meeting at school sometime during the autumn of 1963. Not that I had failed the examinations exactly, but my performance the previous summer had been well less than sparkling.

At grammar school I had shown an aptitude for the natural sciences, encouraged by biology master Harry Hayman, and had dropped the options of Geography and Latin in the second form. After O-level (expedited in the fast stream over four years), maths was the next casualty and, with no other career guidance or previous family exposure (save watching “Doctor Findlay’s Casebook” and “Emergency Ward Ten” on television) it was assumed I would “do” Medicine. I had the luxury of an additional year in the sixth form to repeat Chemistry and Physics.

Once seen never forgotten

The River Tay and rail bridge, Dundee from Airlie Place 2007

The silvery Tay and rail bridge from the bottom of Airlie Place

I had two serious conditional offers of university places; one at Liverpool, the other, St Andrews. During the Easter holiday of 1964 I ventured north to Scotland for the very first time to attend an open weekend in Dundee and to sit the St Andrews University bursary examination. I recall very little of the interview or of the paper and at the end of it I didn’t gain any money. However, my conditional place was backed by a definite one in the first year pre-medical course if my re-sit results were still substandard.

The memory of the trip was seared into my brain. The journey, my first undertaken solo, was an adventure in itself and I was stationed for the duration in one of the University Halls of Residence. The weather was freezing, the room was small, draughty and bitterly cold and the only source of heating came from a single bar coin-in-the-slot electric fire. It had a single tall and narrow window which was covered by a roller blind. The view from that window was spectacular over the River Tay and the majestic sweep of the Tay Railway Bridge. The quality of the light as it played on the water was hypnotic. I was sold – and I made my choice.

The summer came and went and with it I achieved the necessary grade improvements. It was only as August gave way to September that the enormity of the life changing circumstances ahead started to dawn on me. Home to college (Leicester to Dundee) was a journey of 350 miles, a marathon of eight hours or more on the old LMR (London Midland Region) railway. It took the somewhat circuitous but picturesque route through Sheffield, Carlisle and Edinburgh. It was a once-a-term expedition, there would be no respite or room for homesickness in between. My meagre belongings were gathered together and stowed in a large antique cabin trunk which was dispatched northwards by British Railways to await my arrival.

Still, I do have recollections of industrial cityscapes of the north between Nottingham and Leeds which gave way to the desolate and empty countryside of Cumbria and the Borders. I remember once seeing a magnificent stag standing silhouetted against a blizzard on top of the hill above Dent Station. The line between Carlisle and Edinburgh was called the “Waverley Route” and meandered around the hills and across the valleys through glorious scenery. It was closed as part of the Beeching cuts of the 1960s when a young liberal MP, David Steel, was at the forefront of the campaign to keep it open. Strange to think that the Scottish Parliament has voted to reopen part of it again.

The other side of life

The branches of the trigeminal nerve: illustration from Gray's Anatomy

Branches of the trigeminal nerve (4)

In truth, I have only hazy memories of the teaching in Dundee. The first five terms were taken up with the study of Anatomy, Physiology and Biochemistry with formal lectures in the lower levels of the Old Medical School Building in the mornings and practical sessions in the afternoons. Anatomical studies were carried out in the dissection rooms on the top floor. For this we were organised into groups of six or eight to a table and we spent one term in the minute examination of each area or system. Each preserved body lasted the whole year and while the second years were dissecting the arm or the leg, the third year students were dissecting the head and neck. I do recall the hours spent pouring over Gray's Anatomy learning mnemonics (aides-memoire) parrot fashion to help remember everything from the attachment of the muscles of the thigh to the order of the bones of the wrist. Did you know that there are at least seventeen recorded variations for the cranial nerves (3)? I also recall experiments in the old biochemistry "hut" somewhere behind Small's Wynd. One involved the subjects, me included, taking a strange white powder (hippuronic acid), carting our collected urine to the lab and generating the smell of bitter almonds over the assembled class. These five terms of endeavour culminated in the second MB examination.

Perhaps now is the time to introduce the first paradox of my story. One of my main reasons for choosing Dundee was the significant distance away and to make a break from the confines of family, home life and Leicester. The University year was divided into three terms, each of which lasted for a period of ten weeks. The medical course, although it lasted for five years (after the first MB year), matched this and so we found ourselves with the same pattern of University holidays including the three month break for the Summer.

Logo of Leicester Royal Infirmary

Leicester Royal Infirmary logo

Prior to leaving school I had a Saturday and holiday job with the Co-op department store in the High Street, Leicester working in the hardware and decorating section. I continued this during the vacations of my first year to supplement my grant and the shop's management were always keen to offer me overtime during the annual stocktaking. By the Easter break in my second year (after taking the 2nd MB examinations) I felt it would be beneficial for me to get some exposure to hospital life. The natural place to apply was my local hospital and for a period of three weeks I worked as a porter at the Leicester Royal Infirmary (the LRI).

Main Entrance, Leicester Royal Infirmary mid 1960s

Leicester Royal Infirmary mid 1960s (5)

Back in 1966, medical services in Leicester were part of the Sheffield Regional Health Authority, and although harbouring aspirations for the future the LRI was not a teaching hospital. In competition with its neighbour in Nottingham some 26 miles away, the University would have to wait another seven years to acquire its own Medical School. There were postgraduate rotations in all the major specialties from the Medical School in Sheffield and St Thomas' Hospital in London both at registrar and senior registrar level . However, the appearance of an undergraduate was a rarity. As soon as it was known that I was a medical student I was assigned to the "Wintergardens rota". This included providing a transfer service from the wards to the mortuary.

Dr EM Ward

Dr E.M. Ward

Almost immediately I was introduced to the Senior Pathologist, Dr Ernest Milford Ward. Outside of my portering shift hours I was invited to visit the laboratories, attend post mortems and was shown the other hospitals in the group. Dr Ward was of the "old school" and practised all the pathology disciplines. He was also a Home Office Pathologist and a member of the Regional Hospital Board. He delighted in regaling me with stories of his own training in the 1930s and his subsequent clinical experiences. He had to pay an honorarium of fifty guineas to gain his first post at Groby Road Hospital, Leicester. In those days a six month residency meant just that - he entered the hospital at the beginning of July and did not leave again for a full six months - with only an occasional Sunday afternoon off duty as a concession from his consultant. I was also introduced to other members of the consultant staff who would have a significant role in my future progression. I left the portering job with a promise of a student clerkship for the following Summer.

Clinical Academia

In Dundee we moved on into the pre-clinical subjects. In my third year (the fourth year of the course), we were exposed to pathology, pharmacology (I'm told that quite a number of the class failed that examination at the first attempt) and microbiology.

Dundee Royal Infirmary about 1970

Dundee Royal Infirmary (6)

Blinshall Street

The walk to the DRI today


The old Maryfield Hospital, Dundee

Maryfield Hospital (7)

The last two years were devoted to the clinical specialities. We had been promised that our training would take place in new hospital surroundings and indeed work started on the Ninewells Teaching Hospital in 1965. However this did not open its doors until 1974 - five years too late for us. So, teaching rounds and out patient activities remained at the old institutions of the Dundee Royal Infirmary (the DRI) and Maryfield Hospital. The day started with a lecture or two in the Old Medical School building on campus and this was followed by a brisk walk past the old jute mills which lined the back streets on the other side of Hawkhill to the foothills of Dundee Law in time to reach the wards of the DRI. Observing protocols, maintaining decorum and not exhibiting total ignorance at the patient bedside under the glare of the consultant and watchful eye of a stern Sister (and occasionally Matron!) was as much part of the experience which demonstrated just how lowly the position of the student was in the teaching hospital heirarchy. Perhaps not quite so severe (I don't recall any "What's the bleeding time?"; "Ten past ten, sir" moments), but there were distinct shades of "Doctor In The House" (8) from the previous decade.

The Royal Dundee Liff Mental Hospital

The Royal Dundee Liff Hospital. (7)

Some subjects required periods of residence to acquire a degree of practical experience. In fifth year, Harry Brooks, Nigel Birkin and I spent two weeks at the Royal Dundee Liff Hospital to study psychiatry. Situated on the western edge of the city, it was an austere Victorian building which had extensive gardens, locked wards and a small medical residence which boasted its own chef. I recall one demonstration case of a manic-depressive patient who had only just been considered safe enough to be interviewed "by the students" so long as we remained under supervision. Psychiatry was one of the subjects examined at the end of that year. My long case consisted of an unfortunate patient with Huntington's disease who spent the whole interview perseverating (the uncontrollable repetition of a particular response, such as a word, phrase, or gesture (9)) in a broad Dundonian accent through ill-fitting dentures.

Obstetrics was another specialty which required a period of "living in". We were expected to attend twenty deliveries which we had to write up in a case book which was then signed off as part of our course. Six of us at a time spent two weeks at Maryfield Hospital where we occupied a sitting room waiting for the call to the nearby labour ward. Unfortunately we were in competition for the same experience with the student midwives so none of us recorded our full complement and the idle hours were passed becoming proficient at bridge and canasta.

Although our class was not large by present day standards (100 in total) practical teaching space was still at a premium and other hospitals in the area were also pressed into service. Sessions were held at Stracathro Hospital in Brechin and at Perth Royal Infirmary. Orthopaedic visits were made to the Bridge of Earn Hospital in the small town just south of Perth.

Many of these institutions are no more. The DRI closed in 1998. The main building has been redeveloped and much of the out buildings have been demolished; the site having been converted into apartments and residences. Maryfield Hospital closed its doors in 1972, its activities transferring to Ninewells.

Continued in column 2...


Alternative experiences

Dr CW Lawson

Dr C.W. Lawson (10)

Back in Leicester that next Summer I arranged a ten week clinical attachment with Dr Charles Lawson's Unit. He was consultant in Cardiology and General Medicine at both the LRI and Groby Road Hospital. My timetable was divided between the out patient department and his twice weekly ward rounds. In between I shadowed the registrar and senior registrar, learning simple practical skills.

Dr Lawson was a superb clinician and a very proficient teacher, but disguised the learning process with a great subtlety and humour. He would start an out patient clinic by demonstrating two or three cases which he had selected and then I was sent off to interview a patient and make a case presentation to him. He himself had a tendency to gout, so all his patients had a serum uric acid assay. He had a curiosity for the works of Linus Pauling, so everyone was examined for corkscrew hairs. An admission diagnosis would be rendered as a) gout, b) subclinical scurvy and c) acute myocardial infarction. He would challenge his juniors to carry out a white cell ascorbic acid level on any case that they did not believe but he was never proved wrong. At the end of that first attachment, I was reasonably confident that I could read an electrocardiogram, assess a chest Xray and differentiate the common heart sounds and murmurs through a stethoscope.

Dr BDL Johnson

Dr Brian D.L. Johnson (11)

And that set the pattern for vacations for the next couple of years. I was introduced to Drs Espir (Consultant Neurologist) and Hearnshaw (Diabetes and Endocrinology) who set aside teaching sessions whilst their registrars got on with the main business of the clinic. I visited the Neurosurgical Unit at Derbyshire Royal Infirmary. The next Summer I moved across to the surgical side of the hospital. Again the consultant team was only too happy to invite me into their theatre sessions and ward rounds. I spent a week with Dr Brian Johnson, Consultant Anaesthetist (another brilliant and funny raconteur) gaining a basic grounding in induction techniques, including the use of an ether drip mask, the workings of an intensive care ward and even a smattering of medical hypnotism.

Into final year I spent one vacation at the maternity unit at Leicester General Hospital. I completed my case book over the course of the first weekend. After that the senior registrar took me under her wing guiding me through a variety of procedures in the labour ward, theatre and ante- and post-natal clinics.


Graduation and beyond

Awaiting graduation in Caird Hall 1969

Peter Dangerfield and Alan Craxford await graduation (12)

Before we knew it, the Summer term of 1969 was upon us and with it came revision and the final examinations. The subjects this time around were Medicine, Surgery, Obstetrics and Gynaecology and each required a three hour written paper followed by an oral and a practical session. Once again I have no recollection of the ordeal or the question papers except that the Surgery vivas were a very gentlemanly affair conducted in the parochial surroundings of Arbroath Infirmary.

My parents and sister came to Dundee for the graduation ceremony. In seried ranks, arranged alphabetically by surname, I sat with my compatriots, bedecked in a black gown wearing a magenta hood with a fur lining, in the body of the Caird Hall. I took my turn to walk onto the stage and be tapped on the head with a ceremonial cushion by the Chancellor to signify my qualification. Contrary to general understanding, we were not obliged to take the Hippocratic Oath although the Dean did give us an impromptu 'pep talk' which included something on the expectations of the profession for our future conduct.


Caird Hall 1969
Caird Hall
The author on the steps of the Caird Hall

L to R: After the ceremony 1969; The Caird Hall; The author's return 2007

After that, I was back in the bosom of the family. We left the hall, packed our suitcases and trunk and headed off the same day for a family holiday. That evening we were travelling westward towards Perth. Two weeks later my first house jobs beckoned. I was not to see Dundee again for 38 years.

Degree certificate

Degree certificate


Postscript

It is only recently that I took the trouble to discover where the quotation attached to my Yearbook entry came from. Having read the poem in its entirity, I'm not entirely sure that this was the sentiment the dedicator had intended!

Rarely, rarely comest thou
(Extract)
by Percy Bysshe Shelley (1792-1822)
Rarely, rarely comest thou,
Spirit of Delight!
Wherefore hast thou left me now
Many a day and night?
Many a weary night and day
'Tis since thou art fled away.

How shall ever one like me
Win thee back again?
With the joyous and the free
Thou wilt scoff at pain.
Spirit false! thou hast forgot
All but those who need thee not.


Added: April 9th 2009
Last updated: August 12th 2012


Comments and recollections

If you could find a space for my recollection, I distinctly remember our very first Pathology lecture from Prof Duguid when he announced the subject was THE PIMPLE and proceeded to show us slides of some bluey purplish blobs. Having expected murdered bodies it was a grave (sic!) and boring disappointment. We did also go to Arbroath for some teaching.

Which brings me to my own query. There seem to be only the basement and two stories on the Google Earth street view of number 2, Airlie Place. Yet my recollection is that the end on the left included the library - a very fine room with some old atlases - and that above there were some garrets reached by a very narrow winding staircase, ie more stories than there are shown now- indeed as there still appear to be on the right hand side. Can anyone clarify?

Chris Morris, Walsall, England - April 17th 2009

I found your second article very interesting. I have to say that I was about to challenge you on something mentioned about your graduation - ie the article with which you were capped. What is currently used is a tartan 'bunnet' and I had thought that this had been around at least since the University separated from St Andrews in 1967. However, before committing myself, I thought I'd better check with University Archives.

Honorary Degree ceremony at the Inauguration of Dundee University

Dundee University, Inauguration 1967 (13)

Queen Elizabeth the Queen Mother with Professor Drever

The Queen Mother with Professor Drever (14)


My colleagues there have confirmed that the current tartan bonnet was gifted to the University by the Bonnetmaker Craft of Dundee, but that did not happen until 1971! They did a little research to try to ascertain exactly what type of article was used previously. It is thought that the St. Andrew's Cap (supposedly made from John Knox's breeches) had been used, certainly prior to 1967. However there is a photograph from the University inauguration in 1967 (which included an honorary graduation) which show the Queen Mother capping an honorary graduate with a small object. Another photograph from around the same period shows Principal Drever with the Queen Mother. In Drever's hand is his mortar board and what looks like an earlier version of the current bonnet (although it also looks quite cushion like).

Barbara Boyle, Dundee, Scotland. May 11th 2009


References

1. "Mr Morris"; Alderman Newton's Boys School Leicester (1965): Photograph courtesy of Peter Carr
2. "Mr Hayman"; Alderman Newton's Boys School Leicester (1962): Photograph courtesy of Nigel Baker
3. Cranial nerve mnemonics: wikipedia
4 "Distribution of the maxillary and mandibular nerves and the submandibular ganglion" in Anatomy of the Human Body 1918 (Henry Gray 1825-1861): Gray's Anatomy: Great Books Online at Bartleby.com
5. Main entrance photograph from "The Leicester Royal Infirmary 1771-1971" by Ernest R. Frizelle and Janet D Martin: The Leicester No.1. Hospital Management Committee (1971)
6. "Dundee Royal Infirmary in the 1970s": Courtesy of Archive Services, University of Dundee at Scran
7. "History of Medicine in Dundee University": John S.G. Blair: Dundee (2007)
8. "Doctor In The House": 1954 film from the book by Richard Gordon: The Internet Movie Database
9. Perseveration: a definition on wikipedia
10. C.W.Lawson. Obituary Notices in British Medical Journal July 20 3(5924): 178–180 (1974)
11. B.D.L. Johnson. Obituary Notices in British Medical Journal June 18 308(6944): 1632-1633 (1994)
12. Detail from Dundee University graduation ceremony: Caird Hall, The Courier June 1969: Photograph courtesy Lewis Reay and © D.C.Thomson & Co.Ltd
13. Queen Elizabeth, the Queen Mother at the Inauguration Ceremony for the University of Dundee, 1967: Courtesy of Archive Services, University of Dundee
14. Queen Elizabeth, the Queen Mother with Professor Drever: Courtesy of Archive Services, University of Dundee


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