Holiday jobs and career choices.

I think many people get into their career by chance - this was certainly the case for me.

I wanted to be a scientist as a boy, but became an obstetrician and gynaecologist! The stages from would-be scientist to O&G consultant mostly resulted from chance events opening unexpected doors.

My advice to young people setting out is to be confident about your abilities and potential and to follow your career plan. With no clear plan, stick with the things you like and develop your abilities to their maximum, while staying open-minded about the opportunities which will arise.

Holiday jobs offer experience of ordinary folk and ‘real life’ and may be particularly useful for children reared in highly protective middle-class families as most of us were. Most are boring, repetitive and badly paid, so a good incentive to strive for something better.

This is the nub  of my advice, for what it is worth. What follows is expansion, inadvertent repetition, self-indulgent biography etc. and can be ignored.

Interest in teaching is widespread through our clan, but as yet no single gene has been linked to an enthusiasm for teaching. My earliest memory of teaching is from when I was off school at about the age of 15. Brother Matthew, who was about ten, was also off and we were bored. I had recently mastered calculus after a lot of effort and was excited by the simplicity and beauty that came with understanding it. I decided to teach Matthew. He was a good choice as he was super-bright and he grasped the basics very quickly. I particularly became involved in teaching as a senior registrar in O&G and, 12 years retired, I am still involved.


My boyhood and adolescent dreams of being a scientist were grounded in being obsessed with physics and having notions of working in a laboratory making major discoveries and inventing things.

We would sometimes have holidays in Edinburgh with our cousins, the Lockharts. Uncle Andrew was a huge hero of mine. He taught science at the school for deaf children and had built lots of working models: lighthouses, electric motors etc., and his classroom was an Aladdin’s cave. In addition to all the models and scientific paraphernalia, he kept tropical fish and reptiles. He bred tiny aquatic crustaceans such as daphnia: water fleas that were a favourite fish food and  fascinating to watch because of their jerky swimming motion. Cousin Andrew continued his family’s involvement in education and was Director of Education for many years.

My father had an aquarium built for me by the local blacksmith and glazier – no easy matter in those days when they had little idea of what they were doing. An expedition to Byers road in Glasgow brought a heater, thermostat, air pump and a supply of fish. Days of effort and considerable expense, where nowadays it would be a drive to Pets-R-Us or an internet order and wait for everything to arrive the next day. I joined the Ayrshire Aquatic Club at nine or ten and travelled by bus with a couple my mother knew to the club’s monthly meetings in Kilmarnock some 20 miles away. All rather pretentious, but I enjoyed it. I remember an evening devoted to the cichlids of Lake Malawi. Arcane stuff, you might rightly think! Geological changes had led to Lake Malawi being cut off from other waters and its cichlids evolving uniquely. Little did I know that I would one day spend almost a year by its shores.

Uncle Andrew organised trips to the local science museum with working models of mines, steam engines, motors of various kinds; marvels enough to hold a young mind in thrall for days. He took us swimming at Portobello, an indoor swimming baths. There was no equivalent back home and it was a marvel. On one occasion he pointed out a local hero who had swum the English Channel. My memory says that his title was ‘Captain’ which added greatly to the glamour – in the decades after the 2nd. World War all captains were heroic figures. It also gave me the never-fulfilled ambition to do the same.

Mr Medine was our enthusiastic science master at secondary school and ran a science club – we stayed on for a couple of hours on one night each week. There was not a lot of science – we built balsa wood planes and basic radios and spent a lot of time brewing tea in glass beakers – but we had the sense of being immersed in science and on the verge of great things.

This inevitably lead to me reading maths and physics at university. Several hundred students joined the department each year and the exams at the end of the first term ruthlessly segregated them into a fast-track honours group and those destined for ‘ordinary’ degrees. In the third year there was the ‘milk round’ in which big companies tried to recruit from the ranks of these bright youngsters.

I was desolate to find none of the jobs attractive - back to the drawing board! I listed all the things that I wanted from a job – it had to be interesting, challenging, worthwhile etc. and had to pay enough to live comfortably – I had watched my parents struggle financially despite two teachers’ salaries. Eventually I concluded that it should be medicine.

There was no financial support for people taking second degrees, so I had to find enough money for the fees, books and living costs. My parents could not afford fees and I would not have expected them to, but I lived at home and had my basic living costs covered by them – they must have been very pleased when I eventually started to earn a living as a doctor!

There were plenty of opportunities to work in the holidays when we were young. Many boys went ‘tattie howking’ (picking potatoes) on local farms. Tattie howking was mainly done by bands of itinerant Irish workers, but local lads could join in and earn £1 a day. That was a huge sum – the average adult wage at the time was about £10 per week. You were allocated a ‘stint’, a stretch of about 20 yards. A tractor ploughed the length of the stint exposing the potatoes. You collected the potatoes in a basket and transferred them to a large barrel. The barrels were emptied into a trailer pulled by another tractor by the strongest of the young men, known as ‘timmers’. Lifting the potatoes was back-breaking and exhausting,  but at 12 or 13 you soon adapted and looked forward to your wages. We gave ½ to our mother and kept the other half, which bought the fishing gear and other prerequisites for 12 and 13-year-old lifestyles. The Irish workers were uneducated and from poor backgrounds. Most were decent, some were some were decidedly ‘rough and ready’. I remember the eye-opening experience of a pair going off to copulate in a ditch at the edge of the field where we were working, to a cacophony of ribaldry from their peers. There was no sex education in those days, but I doubt this was the best introduction for the local 12-year-olds.

When I was 14, brother Jim, who was a couple of years older, got a job in a brick factory. He was fit and powerfully built and soon settled in. The wages were more that 50% higher than on the farm. I went along, lied about my age and got a job, probably on the back of Jim being a good worker.

My memory is that the bricks comprised the detritus from the local coal mines, pulverised in a great crushing machine and mixed with sand and various chemicals with oil as a binding agent, then squeezed into moulds and fired in kilns. The unbaked bricks were stacked to an exact pattern in the kilns to allow them to be fired efficiently. The spaces between stuffed with straw and other combustibles which were set ablaze. The doors were sealed and the bricks were baked for a couple of days. By the time I got the job, Jim had migrated to working in the kilns: filthy work in impossibly hot conditions when the fired bricks were ‘broken out’, but better paid.

I was stuck in the basic job of tending the machines – this involved lifting the newly-formed bricks onto bogies – small wagons that carried a couple of hundred bricks and ran on rails to the kilns.

The bogies were pushed along the rails, which were mostly laid flat, but it was hard work. The biggest problem was when you came to the points where the rails diverged. These were crude and even with the greatest care, the bogies often left the rails. It was a Herculean task to restore them to the rails – usually achieved using lengths of old rail as levers – and under great pressure as brick production ground on inexorably. To add to the difficulty, there were usually metal plates covering the ground where the points were located, making it very slippery in wet weather.

Occasionally a disgruntled worker would bring things to a halt by tossing a fired brick into the part of the machinery where the brick mix was being processed, but this was a sacking offence.

You certainly learned some basic physics about how levers worked.

I lived full-time on a farm for one summer, which was a great experience. Up at dawn to milk the cows, then breakfast – porridge with the new milk followed by bread, butter and jam. And any kind of work from cutting and baling hay then stacking the bales in the hay barns to clearing fields of thistles with a scythe. I remember an afternoon spent rescuing a cow that had fallen into a ditch. We had plenty of scope for traction with a tractor and copious ropes and chains – the challenge was to apply it without damaging the animal.

A regular worker on the farm came from his usual job as a steelworker for two weeks each summer. He had a 500 cc. BSA motorbike, which I learned to ride. Fortunately the country roads were almost empty, so this was not too hazardous. I also learned how to service the bike and do basic repairs.

Other summer jobs included working on the railways – one day a clerk selling tickets, another mucking out wagons used to transport cattle.

In medical school I worked one summer as an ambulance driver. There was no training and you worked on your own – to move someone on a stretcher meant waiting for another ambulance to join you or getting a neighbour to help. This was my first experience of the single-handed stretcher bearer, of which more below in relation to the 21st. LADR. One ambulance had been built using a Rolls-Royce front end and was a favourite to drive. Synchromesh gears existed on cars, but not ambulances and you had to learn the art of “double-declutching”, something unknown these days except for vintage car enthusiasts.

I spent one summer building roads around Ayrshire and still bore passengers by telling them ‘I built this’ as we drive over. That was hard work as it was all manual, including digging out culverts and laying massive concrete drains, which I still remember vividly.

There was plenty of work in local bars, though it was poorly paid. As Charles has pointed out, it provided great opportunities to learn psychology and to realise that people were not what they seemed. One of the hotel bars I worked in was the Kilmeny on South Beach in Ardrossan. A regular was a man in his 40s who was to be seen every morning walking to South Beach railway station to take the train to Glasgow. He was always immaculate, in black blazer and grey flannels with his rolled umbrella under one arm, his coat over the other. I imagined that he worked in an office. On his return he stopped off in the Kilmeny for a few beers, sometimes more than a few. One winter night as I walked home from the Kilmeny across the grass esplanade, I found him lying slumped. He had had too many that night. I got him to his feet and walked him to his home in Glasgow street. It was up a ‘close’ and a winding stair and was a tiny hovel. I got him inside and made him a cup of tea. His sad tale poured out. He had married the girl of his dreams and they were blissfully happy, though poor. Five years or so before she had developed breast cancer. He wept as he told me that ‘they cut off her breasts’ and how he had nursed her as she declined and died. Treatment of breast cancer was rudimentary in those days and there were no support systems such as the MacMillan nurses we have today. His march each morning to the station, like a proud little penguin, belied the reality of his tragedy and devastation. I saw him often  in the bar after that, but the incident was never mentioned, though there was an understanding between us.

Christmas time saw an army of students employed as postmen and postwomen.

Most summers I worked in an aluminium refinery in Kinlochleven in the north of Scotland. It was very hot work but nothing like as heavy as the brickworks. I could work extra and double shifts and it was not difficult to generate my fees and enough for books. Sister Catherine used to take pity on me and give me the occasional handout, which was extremely generous as she was a young teacher on a pittance for a salary.

With a degree in maths and physics, I tutored at weekends in addition to bar work and earned enough to survive. My advice in these circumstances is to find a bright pupil who has been badly taught and they will come on leaps and bounds despite your deficiencies. My main student was Barrie, whose mother became a good friend with Valerie. Barrie went on to a successful career as an accountant.

Entering my final year in medical school I had a crisis – we had no holidays, so no scope to earn. I did not want to get in debt. More importantly, there was a beautiful young woman I desperately wanted to marry.

I joined the Royal Army Medical Corps. They would pay my fees and expenses and a salary of £1,000 a year in return for 5 years’ service. This meant Valerie and I could live very comfortably. We even ran a little green mini.

Six months later I traded it in for a sky blue Jaguar, like that of Inspector Morse. It was at a knockdown price as the doors on the near side had been bashed. I had been taught how to do basic bodywork repairs and re-spraying by Ian Halbert’s dad. My father's car had been bashed and Mr Halbert offered to repair it. He was the janitor at the local school, but had many talents and was a perfectionist. He taught me how to bash out the major defects and then fill in any residual defects with special filler, which had to be built up layer by layer to maximise strength. Most time was spent filing and then rubbing down the surface with special 'wet and dry' sandpaper before repsraying. All very enjoyable for a teenager.

Valerie and I spent the next six months as I had a job in Wick. It was an idyllic time, just us and Jonathan who was not yet a year old. We lived in a cottage in the hospital grounds and I had access to a garage with an inspection pit. I was on-call most of the time as the medical staff consisted of a consultant and me, but I had plenty of time to bash out the body work and respray the Jaguar and generally put it to rights. It was a fantastic car and tremendous fun on the roads of Caithness where you could drive 20 miles and not see another car.

There were about 50 of us in my RAMC intake. We had to do a basic training course, but they could only take 25 at a time. The first chance event was about to shape my career.

I was posted to the Louise Margaret Hospital in Aldershot – a major and well-run maternity hospital.

Army hospitals were responsible for almost 8% of all UK deliveries in those days, which seems amazing now, and the hospitals attracted non-civilians because of their high standards.

Two brothers, called Gavourin, were the senior doctors, both colonels but about to be brigadiers.

One had a son who was struggling with maths and I offered to teach him. He was bright, responded quickly and did well in his A-levels.

At the end of the basic RAMC course, we had an exam. Ian Plant, a good friend to this day, got the prize for obstetrics and gynaecology and became a consultant psychiatrist; I got the prize for psychiatry and became an O&G consultant!

I was posted to Tonfanau. I had no idea where it was and hoped for the Far East or Africa. But the map said Wales and the 22nd. Light Air Defence Regiment. I also looked after the army’s outward bound school which was located nearby. The Brigadier in charge of the OBS was our neighbour and decidedly odd with a penchant for nude sunbathing – which was a bit of an eye-opener for Valerie, with her Irish Catholic upbringing, particularly as his sunbathing occurred in all weathers. It was an idyllic time for Valerie and me. Jonathan was a delightful toddler and we made friends with many of the military families in the adjoining houses. Enough work to keep me interested and enough time off to enjoy family life. Our major excitement came on a hot summer day. Valerie had taken Jonathan into the garden. It was fenced off, so he should not have been able to escape. But one minute he was there, the next he had vanished. All the neighbours turned out to scour the surrounding area and the camp made the guard and all soldiers on site available. The hunt became ever more desperate until we had a think about where a 2-year-old might head on a hot summer afternoon. The strawberry patch! I had planted a large patch of strawberries and they had grown luxuriantly. There he was, under the netting, full of strawberries and fast asleep. What a relief to have our beloved boy back.

Correspondence with James, the adjutant of the 22nd. LADR became a major entertainment. He was a punctilious bureaucrat and his paperwork had to be complete and perfect. Early on he asked for my religious denomination. I declined to offer one and he suggested Church of England, the default faith for these circumstances. I refused this offer and his need for an answer generated an ever more urgent correspondence. Eventually I offered ‘pantheist’. He duly entered this in my records and was relieved and happy until I wrote a few weeks later asking what arrangements he was planning for me to have the temple which was essential to my religious observance. This brought religious matters to a definite end!

Daily life with the regiment generate frequent opportunities to bait poor James. When I checked the certificates of training held by my medical orderlies, only one had been trained as a stretcher-bearer. Imagine my glee as I anticipated the great fun ahead pondering the gravity-defying techniques he had mastered to allow him to function and suggesting that we bring them to the attention of the rest of the army.

I was called one night to the cells to deal with a soldier who had ‘gone mad’. He had been to town, had too much to drink and got into an argument with the soldier on guard duty at the camp entrance on his  return. This led to his arrest. He wrecked his cell and ranted at his custodians. He was handcuffed and put on bread and water with only indestructible utensils and no bedding. I was asked to see him the next day to declare him insane. I asked the guards for two cups of tea and removal of the handcuffs and then dismissed them. As I expected, I was dealing with an immature lad who had found himself in escalating trouble fuelled by more alcohol that he usually consumed. He was soon sobbing his sad tale. His girlfriend had gone off with someone else and he had no one to confide in. His aggression disappeared and was replaced with sobs and I suggested that he be discharged to his barracks to be with his mates while awaiting the inevitable disciplinary consequences. It gave me a great opportunity for mischief with questions to James about putting prisoners in irons. when ‘bread and water’ had been re-introduced as a punishment, when punishment was legitimate without legal process etc., etc. To add fuel to the fire I asked how it would be portrayed if it got to the press. I gave James a hard week or two. The colonel in charge of the regiment was a Northern Irish gentleman, Oxford educated and very liberal and urbane. He must have known what was going on but kept his distance and did not interfere. Perhaps he enjoyed James’ discomfiture.

It emerged that my RAMC predecessor had been alcoholic. He would vanish for days and no one ever knew when he would turn up for a clinic or in what condition. Brownie points for me for just appearing on time and sober. There was a dental officer, Captain Stark. I increasingly suspected that it was probably a short form of ‘Stark-Raving-Mad’ the more I got to know him. He came to see me soon after my arrival to tell me that he was keen to continue the joint work he had done with my predecessor in providing dental services under general anaesthesia. In medical school we had heard amazing stories of children having their tonsils removed on the kitchen table under general anaesthesia, but the dangers were becoming better known and it was something I was certainly not going to encourage. All the more so when I heard from Eric Gilbert, my senior medical orderly,  that the pair had nearly killed the old Brigadier effecting a tooth extraction. I thought the best way to block the madness was to encourage his dreams of building an empire until they were patently absurd. I arranged to meet with him to order the equipment I deemed necessary. Soon we had a list that would have graced a medium-sized hospital. His eyes grew wide in anticipation. I said that I would need to arrange specialist training for me as I had never given a general anaesthetic on my own. He demurred – he would put the patient to sleep and I could maintain the anaesthetic while he did the dental work – but I insisted. We sent off the list to my parent unit, a Field Hospital in Chester. We had probably ordered as much equipment as they had in preparation for going off to war! I had a perplexed call from the colonel in charge, clearly wondering if I was following in my predecessor’s alcoholic footsteps. I explained the situation and the reasons for the request and he agreed that it would be processed, but very slowly. And so ended dental work under general anaesthesia in Tonfanau! It did lead to the Colonel from the Field Hospital deciding that it was time to inspect our facilities. There was no decent local hotel, so Valerie invited him to stay with us. He was short and very fat. His Sam Browne belt circumnavigated his midriff like an equator. He was the embodiment of a gastronomic black hole. Everything that came within his orbit was consumed. We looked on in amazement as food enough for three or four was downed. He also drank all the alcohol that we owned. Valerie recalls that he brought her a box of Lindt chocolates, extolling their eminence and proceeding to eat almost all of them. But we got a good report.

The 22nd. LADR was the setting for my biggest career break and one I could never have anticipated. It was still equipped with the ancient guns it had used during the second World War and was awaiting conversion to modern anti-aircraft rocketry. It was made responsible for the arrangements for the investiture of Prince Charles as Prince of Wales, a kind of occupational therapy. This was a huge event and you will still see old footage of Charles as a gauche youth undergoing the ceremony at Caernarvon castle. For us the culmination was a regimental ball at Portmeirion, a magical place that is well worth a visit.

I received lots of correspondence about a visit by the GOCIC to inspect the regiment and their work. I had no clue about what ‘GOCIC’ stood for and was too arrogant to ask. I just knew he was coming by helicopter and that I had to turn out with my ambulance and team of orderlies in case of mishaps. Down came the helicopter on the great day and out came a number of khaki-clad persons, including a small figure with a limp, who has whisked away in a staff car.

I had arranged for the local GPs to provide medical cover and went off to the Officers’ Mess as lunch was to be served once the military bits had been done. The sergeant in the Officer’s Mess held me in terror. One of my duties was to do hygiene inspections and I had inspected the Officers’ Mess a month or so before. It had lived up to its name of being a mess.

I took great pleasure in narrating my findings: the solitary washbasin for the staff being filthy and not in use for its intended purpose as it contained someone’s pants and socks. The only toilet roll, half-used, had pride of place on the food preparation table. The horrors of the refrigerators, with inadequate separation of raw and cooked meat. There were layers of grease on the cookers – I wondered if a section through the grease might reveal how long it was since they had last been cleaned, like the rings on a tree revealing its age. The sergeant in charge should have been dismissed! It was clear that there had been no inspection for years, which was no surprise given my predecessor’s problems with alcohol. On my arrival in the Mess on the day of the GOCIC’s visit, I had a glass of champagne pressed into my hand by the Mess Sergeant. I rarely drank alcohol in those days but did not decline.

We moved to lunch when the officers assembled. It was a buffet and I found myself behind the GOCIC, as the little man with the limp turned out to be, and a thin, acerbic-looking Welsh Presbyterian minister, clad all in black. The three of us got some food and went off to a large settee. As so often happens, my stereotyping of the minister was entirely misjudged as he was a livewire with a great sense of humour. I told the GOCIC of my battle to understand the meaning of the GOCIC acronym and how light had dawned today as I watched the helicopter descend and the elderly chap with a limp alight. ‘Gouty old chap in a chopper’ had sprung to mind – I use ‘chap’ out of delicacy, though it was not the 4-letter word on the day.

This caused much merriment and the next couple of hours passed most convivially, with none of the other officers venturing to intrude. I went home to sleep off my glass of champagne.

Later that afternoon the CO of the 22LADR phoned to say that the GOCIC was very keen that I should come to dinner that evening with the minister – I was too junior to have been invited and the minister had not been considered. We had an amusing evening and I thought no more of it.

A week later I received a posting to become the Families’ Medical Officer at RMAS, the Royal Military Academy, Sandhurst. Sandhurst is one of the most prestigious establishments in the Army and had never had a junior officer on its medical staff – the posts had previously been filled by senior doctors who were close to retirement, so I guessed that this was the work of the GOCIC and perhaps a manifestation of his sense of humour.

It was a fantastic posting as the site also included the Army Staff College, to which the brightest young officers come for the training needing for senior command. It also attracts similar officers from lots of countries around the world. The social life was outstanding and Valerie took to it like the proverbial duck to water and made friends she is still in touch with today.

The only drawback was that the Senior Medical Officer, Colonel McNeil, hated me within days and did his best to get rid of me. There were two other doctors, Majors Sammy Bernstein and Ronnie Houston. Sammy was Jewish and from Dublin, wise, humane and with huge experience – a great character and senior colleague. Ronnie was also Irish, but younger and a great support; sadly he died of SADS (sudden adult death syndrome) a couple of years later.

As is often the case with new arrivals, I was put on call the first weekend. One of the first patients I was asked to see was a nurse, married to a Brigadier in charge of one of the Staff Colleges. She had developed a sore throat a couple of weeks before and now was so weak that she was mostly bedbound. She had also developed a rash on  her legs. If there are any doctors reading this, they will see clearly where we are heading. She had been under the care of Colonel McNeil, who had visited daily but not reached a diagnosis. I examined her and found that she had a low fever, a thumping heart murmur and a rash on her legs which was in the form of raised, round, red patches:  erythema nodosum, I decided. I had learned at medical school that erythema nodosum was particularly associated with TB, sarcoidosis and rheumatic fever. The last best fitted the bill.

This was not a difficult diagnosis to make and the colonel should have made it but the system almost determined that he would fail to do so. He had mainly worked in India in administrative roles and his appointment to Sandhurst was meant to be to a pre-retirement sinecure. Being sent back to clinical work having done none for more than 20 years was almost certain to expose his loss of clinical skills.

I discussed rheumatic fever with the woman and her husband. They asked if I was sure as the colonel had not come up with a diagnosis. I said that I  was and that I wanted her transferred to hospital that day. The colonel was away for the weekend or I would have discussed things with him (or, at least, I hope I would have had the wit to do so, though my youthful arrogance might well have precluded it). I phoned the on-call consultant and arranged her admission to the Cambridge Military Hospital in Aldershot – the hospital adjoining the Louise Margaret hospital where I had worked. She made a good recovery, though the complications of rheumatic fever can cause serious heart damage and may take years to develop.

Word flashed round that there was a bright young doctor in town who made diagnoses that the old man could not, which led the colonel to hate me and start to plan my removal.

My clinic nurse (amazingly, her name eludes me for the moment) was in her 40s, bright, kind and able and also married to one of the brigadiers in charge of a Staff College, so I soon heard all the gossip surrounding me and  Colonel McNeil.

A few months later he attempted to oust me. Valerie and I had gone to Scotland for a week on leave. On the evening of my return Sammy Bernstein called to say that one of the babies on our books had died as a cot death. Typically, the baby had seemed perfectly well when put down to sleep, but was dead in the morning and no explanation had been found at post-mortem. The baby had been very healthy and had not been seen at the health centre apart for routine immunisations and checks on development, which had been normal. I went to see the family who were devastated. We still don’t understand cot death. It, unexplained late-pregnancy stillbirth and SADS have unknown causation, but may be linked via defects in the heart’s electrical conduction system that coordinates its activity, leaving a predisposition to fatal abnormalities of heart rhythm. But I’ll resist the temptation to write more on the subject.

I was astounded to be summoned by Colonel McNeil next morning and informed that I would be removed from Sandhurst as the cot death was my fault. I told him that the cause of cot death was unknown, that I had never seen the child and that if he attempted to have me removed, I would make a formal complaint to the general in charge of Sandhurst and to the MOD. He backed off very quickly! I made the facts known to my nurse as a backup, knowing that this would ensure that the senior staff would become aware of his threat. I had met the General some time before and he impressed as a fair and decent man. His adjutant had phoned me one Friday morning to say the General was flying to South America the next day and had found that his yellow fever immunisation was out of date. He would be barred from entry to the countries he planned to visit without an update and I was the only doctor in the medical centre. We discussed times and he decided on the early afternoon. I warned him that this would be in the middle of my baby clinic. The general arrived twenty minutes early while I was with a mother and baby. I instructed my nurse to put him in the waiting room, which was filling up with young mums and babies. One of the mothers had an appointment ahead of him, so I saw her first. He was seen on time, had his jab and all the linked paperwork was completed. He departed with his retinue. A few weeks later he returned and my nurse informed me that he had regaled a dinner party with his immunisation experience. He had been plonked into the clinic with the young mums but had enjoyed the experience. The informality of the setting and him being very charming had led to the mums ignoring his rank and chatting freely. He had thought it correct that he had not been given priority. This was typical of the fairness and lack of pomposity that I had found in most of the very senior staff I dealt with. I think he appreciated that he was treated efficiently but no one was bowing and scraping. When I joined the army I had expected senior staff to be brain-dead, ‘chinless wonders’, but could not have been more wrong and came to hold them in high regard as intelligent, decent and professional.

General Practice is the most difficult of the specialties: an obstetrician needs to know most of what is known about obstetrics, but not a lot about other things such as dermatology or ear, nose & throat medicine, while a GP needs to know 70% of what every specialist knows about their subject.

GPs now have several years training after qualification in which they work in different specialist posts, but this did not exist in my day. After a few months at Sandhurst I realised that my knowledge of paediatrics and gynaecology were particularly inadequate and that I needed further training. My problem was that this meant getting hospital posts in these specialties and doctors, like me, who were on short-term commissions, were specifically barred from them – the army wanted its pound of flesh and consigned them to what were seen as the more mundane jobs in regimental duties.

Undeterred, I  set about applying. I put in an application and went to see Colonel Gavourin, whose son I had taught. He was now the senior doctor at the Louise Margaret hospital and was supportive but realistic about my prospects. Once again,  my next big break came by chance.

On arrival at Sandhurst I set up evening clinics for children who were showing signs of being off-colour. This was partly to relieve parental anxiety, but a lot to do with trying to reduce night time emergency call outs. It worked well, so I started clinics on Saturday mornings too.

One Saturday Colonel Bluett brought his son to see me. The child had pus pouring from his ear. The father wore a RAMC tie, so was a doctor, and it emerged that he worked at the Ministry of Defence. I gave him a severe dressing down as the child had been ill for more than a week and the pus had been present for days. “Is World War 3 imminent?”. “What is going on in the MOD that stops you spending half an hour to bring the child here?” Big rant: Blah, Blah, Blah. I phoned the ENT specialist at home and persuaded him to see the child that day.

On Monday my nurse said she had learned that I had met Colonel B. I asked how she knew and she told me that they had been at dinner. He told her he had had the biggest bollocking of his career on the Saturday!

I had pause for reflection when she asked if I knew who he was. I had no idea – some goon working in the MOD who could not take proper care of his child. Not so, I was told – Colonel B is very well-regarded and  runs AMD2(a). “And what is AMD2(a)?” I asked. The department that decides all medical postings. I had done it again!

Colonel B must have had my application for training in paediatrics and gynaecology in his pipeline and gone to the trouble of digging out my folder. A couple of weeks later I received a posting back to the Louise Margaret hospital to spend six months in paediatrics, then six months in O&G, despite this being specifically forbidden by army regulations.

The senior registrar in paediatrics was Gordon Kember. Super-bright, enthusiastic and a great teacher – I had landed lucky, yet again. He also lived a couple of doors away from us in the army ‘quarters’ in Ash Vale. He and Mags,  his wife, remain friends.

By this time Ian Plant’s first son had arrived. His wife was a geologist and decided that she did not want to raise a child, so Ian was left trying to manage on his own. Valerie gave a lot of support with baby-minding, washing and ironing etc.. After a few weeks she said she could not watch him struggle any longer and suggested that he and Mark, the baby, should move in with us. This meant that she had Jonathan, now about 4, plus the equivalent of twins, as Tim was only a few months old. This caused loads of speculation on the ‘patch’ over the gins and tonic as this beautiful young woman and what seemed to be her three children were sometimes at home with Ian, sometimes with me and sometimes with Ian and me.

One morning there was a knock at the door. A child of seven or eight stood there. She introduced herself to Valerie as Suzie Kember. “Do you have babies?” she asked. When informed that she had she asked if she could see them. Tim was huge and plump, Mark smaller and thin. “I like that one” she said, pointing at Tim. “Can I look after him?”. Thinking it would be a passing whim Valerie agreed. But it was no passing whim and she proved better than any au pair or nanny. Suzie came every morning, lunchtime and evening, getting Tim up, washed and dressed, playing with him and generally acting like a little mother. She reappeared at lunchtime to feed him and play with him and in the evening to carry on her care. Her maturity and competence belied her years.

When I finished the paediatrics job, I moved into the O&G post. The local policy was that the second-on call could live at home when the first-on-call was competent with the ventouse – an instrument like forceps for delivering babies. This was a great incentive to teaching. The juniors were called for every delivery and we rapidly became proficient, even expert. My megalomania determined that after 6 months I was convinced that if I could not deliver a baby with the ventouse, no one could deliver it safely other than by Caesarean section. We were also taught how to perform Caesarean section. It was a great job and I loved it.

And then another chance event massively influenced my career.

As I was coming to the end of the six months and assuming that I would return to general duties, we had a Caesarean section booked for 2 pm. The woman had placenta previa, in which the placenta lies low in the womb. Such a placenta can block the outlet of the pelvis, making vaginal delivery impossible. More importantly, the placenta can detach without warning causing horrible maternal bleeding and putting the mother and baby at huge risk.

Everything was organised for a 2 pm. start. Mike Houlton, the other junior trainee, and I were in the surgeons’ room adjoining theatre with the junior anaesthetist. Colonel Gavourin and the consultant anaesthetist were in the Officers’ Mess, about ten minutes away, having lunch and the patient was in the anaesthetic room, all set up with an i.v. drip etc. and with a couple of midwives looking after her. About quarter to 2 one of the midwives ran in to say she was bleeding. We thought she was joking, but she was not. Ian Donald, Professor of O&G in Glasgow when I was a student  and the “Father of Ultrasound in O&G”, wrote that bleeding from placenta previa could be like pouring petrol from a jerrycan. And so it was here. It was absolutely terrifying and the woman looked likely to die within minutes. We put out a panic call for the consultants and got the woman into theatre. The junior anaesthetist said he would not anaesthetise her and we must wait for the consultants. I knew he had enough experience and feared that delay would see the woman dead. He changed his mind under threat of physical violence! Mike Houlton and I went off to scrub. When we had gowned up and moved to the table I was surprised to find that Mike had moved to the assistant’s side. He was my senior by three months or so and had done more sections that I had. I was particularly surprise as he was normally very confident, but he refused to budge, so I got on with the operation as there was no time to argue. Once the baby and the placenta have delivered, the bleeding usually subsides and so it proved here, with the consultants arriving just as things were coming under control. The consultants got changed and came to supervise, but let us finish the operation without direct involvement. Mother and baby did well. A few days later I was surprised to be summoned to Colonel Gavourin’s office. The usual ‘what have I done now’ passed through my mind but he stunned me by telling me that he and consultants had decided that I should be promoted immediately to a second-on call position. This did not happen to people with less than six months’ experience and I was flattered. More importantly, it meant I would stay in O&G, which I loved, and came with a significant increase in salary. The only benefit I missed was being able to live at home as we lived too far away.

I loved the job and learned a lot. About a year later I was summoned by Colonel Gavourin and told that I was to have a new post for a year, that there were two possibilities and that I could choose.

The first was to Belfast. The ‘troubles’ in Northern Ireland had kicked off in a big way and internment had been introduced for suspected IRA activists. The alternative was to provide medical cover for an exercise in Malawi, so I chose that although I had only a vague idea that it was somewhere in Africa.

In 1967 there had been a short war in the Middle East between Israel and its neighbours. The Israelis bombed the Egyptian airfields, destroying much of its air force. With air superiority, it waged a highly successful war, capturing territory from Egypt, Jordan and Syria with names still mentioned because of continuing disputes over ownership: the West Bank, East Jerusalem and the Golan Heights, in particular. Military minds around the world were put to solving how the effects of air strikes on military airfields might be mitigated. One aspect was to have a capacity for rapid runway repair and the British army set up a specialist unit. It would take off to Dartmoor and  like places, create great holes and then fill them is as fast as they could. Rather mind-numbing! ‘Exercise Laborne’ to Malawi involved this unit. Malawi is a long country and the underdeveloped north is cut off from the south by the Nyika plateau, which is about 7,000 feet above sea level. The peak of Ben Nevis, the highest mountain in the UK, is a mere 4,400 feet, for comparison. Residents of the north could get to the south via Zambia, but at this time the Zambians had closed the border. A northern representative in the Malawian ‘parliament’ complained about the inability of his constituents to get to the south. Malawi was ruled by the autocratic and  ruthless Dr. Banda (once a GP in Edinburgh) and his solution was to order that a road be constructed over the Nyika plateau, ignoring the fact that Malawi, one of the poorest countries in the world, had only one bulldozer and no capability to build such a road. The Minister for Works went to the British Ambassador to ask for help. He asked the Army, who were delighted to offer the Rapid Runway Repair Unit, who for once would have something constructive to do. The unit tackled the exercise with gusto, not only completing the difficult task of building the road up and down the plateau’s escarpments, but going on to build an unplanned 30 miles into the northern territory – a great tribute to their enthusiasm and skill.

I went  out with the advance party to help set up the camp. This involved ensuring a safe water supply, sewage disposal etc: all new to me. We had a meeting with the troops, who numbered a couple of hundred when they arrived. I introduced myself and my team of orderlies. I told them how I had been picked out as among the brightest of my generation (I was being unusually modest)  etc., etc and they listened without throwing things. I then told them that their only problem was that I was a gynaecologist. I used this and the fact that we were hundreds of miles from the nearest hospital to stress how important it was for them to stay healthy and to avoid injuries. When work began on the road I placed my orderlies at strategic points to ensure that dangerous practices were stamped on. It paid off as we were there for nearly nine months without serious illness or incident. I was also concerned about syphilis and gonorrhoea which were rife. Fortunately there were no facilities for socialising on the plateau and the only concern was when they went off on ‘R&R’, but that was in a centre on the shores of Lake Malawi and could be controlled. We had no incidents of either disease. This was probably just as well as HIV was almost certainly common, though its extent was not yet know. But getting infected in those days was effectively a death sentence.

It was a fantastic experience, but tough leaving the family, particularly as Valerie was pregnant with Julian.

When I returned to the UK it was time to think about life after the army. I thought I was too old to have a chance of becoming a consultant in O&G and had a notion to be a GP with a special interest in O&G, either in the UK or Canada, which was a popular destination in those days. It made sense to complete my basic O&G training and take the specialist qualification by passing the MRCOG exam. I needed 1 year of additional gynaecological training and the only job that became available was at St. Mary’s hospital in Manchester. Hence our move to Manchester. I was extremely lucky to have John Wright as my senior registrar. He was extremely able and experienced and completely unflappable. He liked teaching, so I had lots of experience operating and was taught the best of techniques by him.

Conditions for junior doctors were abysmal – we worked 80+ hours per week for poor basic salaries and with no overtime pay. I got involved in BMA politics and was soon chairman of the local junior doctor committee. After 9 months or so, a registrar job was advertised. The system had been extremely unfair to hospitals outside the big cities. The teaching hospitals kept all the UK graduates and the peripheral hospitals had to make do with foreign graduates who had no experience of the UK way of working and mostly got little or no training. It was very unfair for the peripheral hospitals and the overseas graduates. There was a lot of pressure to change things and the registrar post was the first attempt to do this in the NW. The appointee would spend a year as registrar in Preston and then return to St. Mary’s. I got the job and caused consternation as I knew all the regulations,  in particular all the things one could claim when moving from post to post. We moved from a small house in Manchester, to a much larger one in Preston and to an even larger one in Didsbury on our return. Even with all our savings and the maximum mortgage we could muster, we did not have enough to buy the house in Didsbury. There was a little known regulation which made NHS employers provide a ten-year, interest-free bridging loan in these circumstances. The admin people had not heard of the regulation but did not argue when it was pointed out to them, so we moved to
Didsbury and here we remain.  It was reckoned that the moves had cost more in expenses than my salary and the financial viability of the scheme was called into question.

A year later I had another lucky break. A senior registrar post was advertised at St. Mary’s. Promotion to senior registrar was critical and meant that a consultant job was assured unless you did something disastrous. The post was with Harold Walker, an old consultant. Before the NHS came into being in 1947, there had been local hospitals. Their financing was limited and they were short of specialists. Fully-trained consultants existed but mostly worked in private practice. Many provided support to the local hospitals as a charitable activity. When the NHS started and consultants were paid large salaries for what should have been full-time jobs, many retained the attitude that their NHS work was charitable and not something they needed to get immersed in. Several other registrars applied all with more experience than I had. My interview was remarkably positive: ‘I see you have a degree in maths and physics – that must be invaluable as a doctor’. I couldn’t see how, but did not argue. ‘Your time at Sandhurst must have taught you a lot’ – his brother was a much-decorated major-general, so he might have thought this was true. It was clear that he had decided that I was a no-hoper or the one for the job. None of the other consultants on the interview panel was allowed to ask me a question. The other candidates came out sweating as he had chewed them up.  I duly got the job. Weeks later I found out that he had gone to the senior sisters in each department and asked for their preferred candidate and I had got all the votes. Richard, the other registrar from St. Mary’s was very competent but temperamental and had a difficult relationship with the nursing staff. The registrars from outside were unknown quantities, so I got the job almost by default. It was a fantastic opportunity as Harold was happy to leave me to run the whole show, including all the operating lists, giving me a real grounding in life as a consultant.

As a senior registrar you moved around hospitals and consultants about once a year to give a wide experience. A major boost to my reputation and prospects came from the people who preceded me on the training circuit as they all had problems, another beneficial chance occurrence. The person I followed was Bill Clow, often referred to as ‘slow Clow’. He was a very competent doctor and a thoroughly nice man. But he was very slow and deliberate in everything he did. His parents had been missionaries in China and their ethos had clearly been deeply ingrained in him. He was exceptionally kind and would always take time with patients. On a ward round before an operating list he might come across an old lady whose husband had died. That could mean Bill sitting with her for half an hour, holding her hand and just being kind. A fantastic way to behave, but driving the nursing staff mad in both the ward and the theatre. After working with Harold Walker, I moved to North Manchester General hospital to replace Bill as senior registrar to Howard Rowley, a solid, hard-working, down-to-earth consultant. My first day involved ward rounds in the morning and an operating list starting at 2pm. The ward rounds were straightforward and I got to theatre for 13.30. Being used to Bill, this caused astonishment. The anaesthetist was summoned. There were only two cases on the list, a hysterectomy and a laparoscopy. The first patient was slim and the operation without problems, so it took less than half an hour and the laparoscopy about ten minutes, so we had finished before 3. In those days the list stopped at the half-way point for tea, sandwiches and cake with the theatre sister holding court. The goodies had to be sent for and the word went round that there was a whizz kid in town. Nonsense, of course, but it shows the value of a slow predecessor.

Ahead of Bill was Kath, with a fragile personality. She would detect slights where none existed leading to animosities that could not be reversed. For me, just turning up on time and behaving normally was enough to make me a superhero: easy-peasy!

This could continue for pages yet. It started out as a short piece on careers and holiday jobs, but developed a life of its own as I remembered stuff I had not thought of for decades. Like Topsy, it just grew, but now I’ll stop.