Life as a student before the NHS
George Watts (M 1944)
Despite the romanticised descriptions of authors, it is difficult to see why anyone wished to become a doctor. It was certainly not for money! One soon saw that it would be an arduous life with little free time for amusement or leisure. The medical course would be twice as long as any other and several times as arduous yet we still joined! By the end of the pre-clinical course we would work far harder than graduates in other disciplines, yet have no degree to show for it! Like the students of today, our problems began with money. The cheapest way to pay for the course was to pay ahead – nearly £400. This was almost twice an ordinary artisan’s annual wage and that was the beginning. One had to allow for one’s bodily needs – Lodgings cost at least £1 weekly without food (for £1=5s. one got one meal a day added). Then there were other expenses. A skeleton cost £10, a microscope, £20 and of course there was the price of textbooks. We also had to pay ten guineas(£10=10s) to be taught vaccination.
Life began with the pre-clinical years and the 2nd M.B. –the first hurdle which seemed to bear no relevancy to one’s future life. Life in the dissecting room only taught anatomy if one had read the subject before the pertinent dissection. The tutors seemed to live in a vacuum un-related to medicine! Few of them were as informed as we ourselves soon became. For those of us who had already chosen surgery as our future, this was not important as we aimed to take the Primary F.R.C.S. exam as students! We could not wait to escape the department! Here in Birmingham there was one bright spot – a German refugee named Bauer (his wife was Jewish) who taught both anatomy and embryology superbly – the latter being an invaluable asset still too little recognised. On the other side, the physiologists taught as well as they could the limited knowledge of the day. We were later to discover how inaccurate that was!
The bright spell was on Saturday mornings when we had clinical demonstrations in the hospitals. Everyone attended these. For most it was a shock to see at first hand the real horrors which awaited us. It was the era before antibiotics or inoculations! But after the drudgery of the pre-clinical years we were full of enthusiasm. We could not see enough! We were attached to firms in three month units. There were two on surgical in-patient firms and one in Casualty. On the medical side we spent nine months on a single firm. In the surgical firms the Chief did a formal round once a week and we presented our histories etc. for his approval. The rest of the teaching was in theatre where we were fourth assistants at operations. We learned asepsis well for there was no recourse if a wound was contaminated (a lesson which has nowadays been too often forgotten) and saw pathology in real life.
On the medical side teaching was more formal and the ‘Honoraries’ (they were not paid to teach us) usually did a round most days. Diagnosis was the prominent feature as there were very few truly effective therapies available. Casualty was the highlight of the early clinical part of our course. We saw every type of illness and injury and did much of the treatment ourselves. We learned to suture wounds, drain abscesses, reduce fractures and apply plasters. Under the eye of residents and experienced sisters we were allowed great experience. W even gave anaesthetics – although anaesthesia was more a case of nitrous oxide suffocation than anaesthesia – patients were strapped to the table! The next phase was the ‘Specials’ when a student spent time with different specialist firms. There were also visits to specialist hospitals. Every town had Infectious Disease hospitals where patients died in droves from un-treatable infections such as diphtheria and there were the Sanatoria for the tuberculous who also regularly died. Treatments were rarely logical and often did more harm than good. We students had to bow to the ‘Wise’!
The most exciting was ‘Midder on District’ We had been taught delivery using cloth dummies which we learned to pass through a hole in a pottery basin. At the maternity hospital we saw it for real. After one or two deliveries we went ‘on District’ with the local midwives. We saw the squalor of the lives of most of the population in reality with our own eyes.If the midwife was late, we did the delivery alone. We had little equipment and the delivery took place on used newspapers as the cleanest surface available. To our great embarrassment these people called us ‘Doctor’ and showed us an un-believable degree of gratitude. On return to the hospital one had to submerge in a bath as long as possible in the hope that the ‘bugs’ would all float off.
Life as a student was hard and that as a resident even harder, but when after the finals one was everywhere called ‘Doctor’ it all seemed worthwhile. I have never regretted my choice of career.