HEART BEAT: Reading recently about poets who were also physicians, I came across reference to Oliver Goldsmith. He certainly studied medicine, and may indeed have practised. Whether or not he actually qualified as a doctor remains uncertain.
It is not of course for his medical skills that he is remembered. What struck me forcibly were the lines from the Deserted Village:
"Ill fares the land, to hastening ills a prey,
Where wealth accumulates and men decay."
Prescient indeed Noll, did you see us as we are today?
In the real world, we appear to be facing industrial action in the medical sphere on a number of fronts. The possibility of such action has been well flagged for a long time and yet no meaningful steps to avoid such a catastrophe have been taken.
Is this a case of once more unto the brink, as is usual? Maybe common sense will prevail, even at this late stage. As for me, while awaiting the outcome with interest, I shall return to the past.
It seems to me that there were more certainties and fixed points when I was an intern than there are now. Career paths were more inflexible, and accountability and discipline were more tightly enforced.
Whether this was a good or a bad thing depends on your viewpoint. I shall endeavour to describe the life of a hospital intern in those days, how we managed to grow both as people and doctors, in our self-contained little world.
Having survived my first and needless to say unpaid day, I began my six months as a surgical intern. Firstly, we were instructed in the routine. What we were expected to do and how we were to be organised. What rotas were to be established, and how we were to be fed, housed and, most importantly, to be paid (a whole £30 a month). We were taught how to liaise with pathology, radiology, anaesthesiology, etc. and even how to deal with the mortuary and, God forbid, the coroner himself.
In such a deluge of information, you often remembered only pieces, and not the most important pieces at that. The rest you learned slowly and often the hard way.
Each intern was attached to a consultant team or department. You were the most junior doctor. Working for the professor of surgery, I had the benefit of having the tutor in surgery and a registrar on the team.
My job was simple, know all the patients, admit them, and write up their medical histories.
Order basic relevant blood tests and X-rays; fill out consent forms for operations, and under direction write out the theatre lists. Order blood for theatre and apprise the anaesthetist of the content of the theatre list.
Frequently at that stage I had to point out that there was no point in shooting the messenger, later I gave as good as I got.
I had to be present at ward rounds, to relate to the great everything of relevance and to take orders for further tests and procedures. I had to assist in theatre when required, and participate in the post-operative care. More about that will be described later.
I was the first port of call for the relatives, and always meant to be there for the frightened and upset patient. I hardly had time to polish my halo.
As a group we were told that the best interns were those who coped with the minimum of complaint either from themselves or, more significantly, from others.
Above all, the problems, where possible, were to be kept away from the great ones. We had an average of 30 patients to look after, so time to rest, read, eat or sleep was severely curtailed.
Worse again, we were rostered in an A/B system where you covered for the intern in another firm and he/she covered for you. This in essence meant every second night and every second weekend. It also meant a straight fortnight on duty when you're alternate went on holiday. That's the way it was and that was the only way we knew.
Some 58-hour weeks, study leave and overtime were concepts as yet undreamt. There was and is a fierce loyalty among us. Everybody did their best to see that their cover was protected as much as possible, and that routine work was completed as far as possible before hand over.
Casualty duty came up every 10 days and was added to your other duties. Throughout the State, doctors of whatever medical school or hospital will recognise similar experiences.
Did we, eat, drink, socialise? Of course we did, once we had worked out how this could be done. This took a little time, principally in realising that not all of our patients were teetering on the brink of eternity, and that a vast majority would survive our best efforts.
We needed to lighten up a little and, like interns throughout time, we eventually managed just fine. To this day most doctors share more than will ever divide them, a point to be borne in mind by our often ill-informed mandarins.
• Dr Maurice Neligan is a cardiac surgeon.