(facsimiles of hand-written memoires part 1, part 2, part 3)
Transcription:
Part 3
The next problem was to find a job – this was 1948 and a few months before the NHS came into being.
I used to look at the advertisement columns in the BMJ and came across Resident Surgical Officer, Bolingbroke Hospital Wandsworth Common SW11.
I applied and appeared before the medical committee at Mr Edward Muir's consulting room in Harley Street. Having had my say I was asked to wait whilst the other candidates were interviewed. In due course I was asked back, Mr Muir said "Well Bain, we would like to have you but you don't seem to have had much experience of operative surgery and the consultant surgeons (all teaching hospitals) are too busy to deal with emergencies at the Bolingbroke so you would be expected to do them all". By this time I hankered after the job and seeing my chances slip away I boldly said "Perhaps you can tell me what I should do as, before obtaining the fellowship no one lets you perform operations and when you have got it, no one will have you because you have not done enough operating". "All right", said Mr Muir "I will hold your hand for the first week and then you are on your own".
The medical committee only made the recommendation and then one had to appear before the lay committee for ratification.
The Bolingbroke was a splendid little hospital of about 90 beds with a most impressive consultant staff and superb nursing – the sisters were quite outstanding. If it hadn't been for the theatre sister I might indeed have had to summon Mr Muir - as it turned out he was soon allowing me to do all manner of major surgery, at first under his supervision and then on my own. I became so absorbed with surgery that in my year at the Bolingbroke I took one weekend off.
The General surgeons were Norman Lake (Charing Cross), Edward Muir (King's) and Howard Handley (Middlesex). In addition I looked after Charles Reed (gynaecologist). Reed was a large overweight specimen of 50 or so and a most beautiful operator who never spent more than 20 minutes on the most complicated operation. I later learnt that his hypertension limited him. He used a Reverdin needle that had to be threaded by the assistant at each stitch. If I was a split second late it evoked the comment "Bain is dreaming of some girl he met in Rio". Charles Reed used to arrive at 9 a.m. precisely on Wednesday mornings – stepping out of his chauffeur driven Bentley to be met on the steps by the RSO. I would then conduct him round the wards by the shortest possible route (or there would be hell to pay) and then to the outpatient clinic – after which there was a pause for coffee and then to the operating theatre. The list had of course been arranged and reported to him the night before. He left the hospital at midday without appearing to hurry. On one occasion he said, "Bain, we are going to have lunch at the Savoy now". I asked if it was his birthday or something, "No, but it is the first time I have earned £1000 Guineas before 9 a.m." (this was in 1948 and just after the NHS had begun). Charles Reed tried to persuade me to take up his speciality and sought the help of Douglas MacLeod at Mary's in his efforts. To no avail.
Edward Muir was a less flamboyant character but an operator of great artistry mainly abdominal. He subsequently became surgeon to HM the Queen and president of the Royal College of Surgeons (he died in this last office at the age of 64 from a cerebral haemorrhage) and his delightful Dutch wife who on the telephone referred to him as Edvard was distraught. He performed a very successful colectomy for carcinoma on Queen Elizabeth (she is now 90). He had a Rolls Royce and went to East Grinstead on Friday p.m. and Monday a.m. – sometimes I deputised for him at the sessions. Early on he took me there in his Rolls to show me the ropes. As we came to a hill through a bit of wood land he slowed down and whispered "this is where the badgers live". It appeared that these animals fascinated him and indeed he looked rather like one with his dark hair and white plume at the side.
Norman C. Lake was a doctor of medicine, a master of surgery and a Dr of science (MD MS DSc). He arrived after lunch on Thursday is in his Rolls-Royce from Charing cross. His outpatient clinic was long and rather tedious as he insisted on getting to the bottom of everything. After a cup of tea we went to the operating theatre where most of his list was carried out under spinal anaesthetic (administered by himself). He rarely finished before 10 or 11 o'clock at night and then drove home to Berkhamstead. Despite his triple qualification he was taken aback when his Rolls-Royce, only three years old, seized up. He did not have it serviced and never added any oil or even bothered to check the level.
Another Bolingbroke surgeon was Richard Handley of the Middlesex hospital. He was the son of the famous Sampson Handley and really preferred pathology to surgery however he followed in his father's footsteps and made his main interest radical mastectomies. he had an ancient Aston Martin that frequently needed a push start. On one occasion he was slumped in an armchair after lunch in the mess when I came in rather hot and red in the face after a game squash. He enquired what I had been doing and then quoted Oscar Wilde "Sometimes the urge to take violent exercise comes over me but I just lie down until it passes off". Although perhaps only 40 also he had an appalling posture and was rather weedy.
A very happy year ended at Bolingbroke and I went on to St Paul's Hospital Endell Street WC2. This was part of the Institute of Urology (St Peter's, St Paul's, and St Phillip's) and I thought that perhaps a foray into urology would be an advantage. The post was graded senior registrar and there were two of us (resident alternate nights). My bedroom was at street level and rather noisy – revellers until about midnight, Odham's press despatching early editions to mainline stations in fast reving vans and Covent Garden market began to open when the newspapers quieten down.
There was a practical joker in the vicinity who placed a perforated balloon containing a few ounces of water beneath the bed sheets. It only leaked when laid upon.
We did not have any other resident medical staff and this had to carry out HS duties as well. A chap called Yates was my fellow incumbent. He was a dab hand at the recently introduced transurethral prostatectomy and was engaged by the younger consultants as an instructor (David Ennis Williams and Howard Hanley. Semple and JD Fergusson were content to carry on in the established way).
The hospital was of about 30 beds and converted from two or three townhouses. The operating theatre was a sort of box room in the attic but a replacement in a more strategic position was under way.
Cystoscopies were frequently carried out in the outpatient clinic (after all they were the equivalent of stethoscopes to the physician) the cystoscopes were stored in large glass jars ostensibly filled with antiseptic fluid. In a mischievous mood I sent some of this murky solution for bacteriological assay. The result was interesting in that it was found to grow most of the virulent organisms then available.
I left St Paul's mainly because they wouldn't or couldn't do anything about the food! On reflection rather a poor excuse – but one had one's principles.
My next appointment was as senior registrar to the Canadian Red Cross Memorial Hospital at Taplow. This had been built for our Canadian allies during the war on the Astor Polo Grounds at Clivedon. Apart from the impressive colonnade entrance block it was a hearted encampment but much more modern and open than anything I was accustomed to. It was also cited in it inaccessible but please in countryside. A car was essential and there were many good eating places in Cookham.
At the interview I was told to prevent the resident medical staff placing chamberpots atop the flagpole.
During my two years at Taplow (1950-52) I shared my flat with a succession of lady house physicians including Liz Wort and Peggy Sheldon.
My surgical Chiefs were: –
Sir Ralph Marnham Who came in his Lagonda on Wednesday mornings and was based at St George's Hospital, Hyde Park Corner. He was a formidable diagnostician and a first class opinion. His operative technique was painful to watch and he was always in a desperate hurry. For some unaccountable reason the post operative course of his cases was extremely smooth.
Richard Vaughan Payne was the archetype surgeon elegant at work and play. He was probably technically the best surgeon I ever came across. He had a charming wife and family; shot and fished and enjoyed his Claret. Unfortunately he developed a sarcoma of his right lower radius which killed him eventually though he had to endure a fore quarter amputation and multiple spinal metastases aged 44 years.
James Brown was another excellent surgeon with a classical training and a good brain. Unfortunately he had a problem with alcohol and died from an overdose of "antabuse" while taking "the cure" at the early age of 52.
The days passed pleasantly and the big house at Cliveden was an added bonus. Nancy Astor was the mistress and the master (seldom seen) was in a wheelchair and I think died in 1952. Nancy was a spiritualist and didn't believe much in doctors. However it came about that one of her houseguests got a foreign body in his eye which no amount of the available remedies seemed able to shift. Rather reluctantly I was summoned and did the needful. This rather simple act paid rich dividends and I was frequently summoned to parties, lunches and dinners.
Nancy Astor was a rabid teetotaller and only supplied soft drinks for her guests who made good the deficiency at the Feathers opposite the main gate. I certainly got the sharp edge of her tongue when I pointed this out. We sometimes sat down to lunch with visitors passing through the dining room (roped off of course). Nancy Astor had two awkward habits – impatience so that she fell upon food as it reached her plate, and using her fingers to dislodge a bolus that had got stuck amongst her teeth.
At Royal Ascot Nancy Astor complained to Lord Roxbrugh that he never left the Royal box and might as well be the resident dentist. The noble Lord replied that if ever he was called upon to extract the King's teeth he would require Nancy Astor to provide the gas.
It was at Easter 1952 that my brother Keith fell some 400 to 500 ft from a cliff at Hartland point North Devon. I was with him at the time and saw the look of grim determination on his face as he hurtled passed me to his death on the rocks below.
One day in the summer a letter arrived to tell me that the post I held at the Canadian was to be downgraded from senior to middle surgical registrar and that I would be eligible to reapply. Whilst I was considering what to do another letter arrived from R.M. Handfield Jones at St Mary's inviting me to return to Mary's as senior surgical registrar to himself and Arthur Porritt. I accepted this most fortuitous suggestion with alacrity.
Of course I was sorry to leave Taplow but it was obviously going to be easier to get a consultant appointment from a teaching hospital and, with Arthur Porrit's support, I thought I might achieve my ambition to become a consultant South of St Albans! Ralph Marnham had already promised to foster an application for the Isle of Wight – I rejected this as too insular.
Back at St Mary's and non-resident. I lived in Ealing with my parents and door-to-door was 15 to 20 minutes. I had inherited my brother Keith's yellow MGTC called Chomopari and this, plus the courting of a dancer in Paris (Julia) gave me, I suspect, a rather raffish air.
In 1940 when I did my resident jobs at St Mary's there was one surgical registrar to look after the whole of the surgical site, Gerald Orens who subsequently became a professor in the Caribbean, Barbados I think. Now there were three of us and the NHS was four years old. One for the unit, one for Dickson Wright and one for HJ and Porritt. At one stage the last had an HS by the name of Lord Suridale and the firm was known as Sir Arthur Porritt, Dr Jones, Mr Bain and Lord Suridale very unkind.
At the time Professor Robb was leading the way in vascular surgery and was snapped up by the Americans. My particular job was a rotational one with the Peter Bent Bigham Hospital in Boston - 2 years at St Mary's and one year in Boston. By the time I went back to St Mary's I was ready to adopt consultant status.
When the Boston exchange was nearly due a consultant job came up with three sessions at Upton Hospital Slough and two at the Canadian Taplow. Prompted by Porritt I applied and was shortlisted and so was Raymond Ramsey. The selection committee deliberated between us and one of them, James Brown from Taplow days argued for me saying "is it more meritorious to have been a Japanese POW or to have served on the Russian convoys? The POW camp won and Raymond was appointed.
A little later when I had decided not to go researching in the States another appointment was advertised three sessions at King Edward VII Windsor and two at St Luke's Maidenhead. this time Porritt saw to it that the competition was eliminated and Julia and I (for I was now married 22/2/1954) came to Windsor.
This was a relief as I had to resign from St Mary's and lived on locums at Teddington kindly provided by my friend Lance Bromley (thoracic surgeon at St Mary's).
POSTSCRIPT:
DWB remained as Consultant Surgeon at King Edward VII, Maidenhead and Heatherwood from 1954 to his retirement in 1980. After a break of a month or so he returned to do some locums but discovered he was "out of practise" and thus unable to comfortably perform any more operations.
He hated the monstrous, impersonal Wexham Park Hospital in Slough that was swallowing up all the smaller hospitals in the area. It was perhaps inevitable that it was there, whilst awaiting tests, he was left alone after having a heart attack for too long to revive him successfully.
DWB's remains are interred at:
51° 27.324' N 0° 35.676' W