Heart Beat Maurice NeliganI watched with interest some of the RTÉ programmes following the four interns in St Vincent's Hospital, Dublin.
Times have changed though realistically not all that much. They have more in-depth support than my vintage had at a similar stage. The non consultant hospital doctors (NCHDs) are multiples of those available in our day. This is on the credit side; on the debit sheet, hands-on experience, of necessity, comes more slowly.
I don't think anybody viewing could have gained any impression other than that these young doctors work very hard indeed. I would also hope that it was clear that those teaching them, more senior NCHDs and consultants, took their responsibilities very seriously indeed.
For the young doctors, it was clear that this was their first step on the professional ladder, when the requisite skills were being acquired for the lifetime ahead. They realised only too well that more hard work and examinations lay ahead, whatever the path chosen.
May their enthusiasm never waver and I wish them as much fulfilment and happiness in their professional lives as I had in mine.
They had some advantages that I lacked. Bank managers must have been different in those days. I was frankly envious of the young doctor driving home in his BMW, courtesy, as he explained, of the bank.
In my case, a highly suspicious bank manager reluctantly allowed me the necessary funding to acquire a ZF 1860, a war-worn Morris Minor with a buckled back wheel. Furthermore, the funding depended upon my taking out an insurance policy with himself as the broker.
I didn't have any medals for Irish dancing either, or parents who burst into song whenever I came home. I doubt if any of my fellow interns did. Were we deprived? I did share one similarity with the young doctor blessed with these attributes. I didn't have a Cavan accent either. I couldn't resist that last little bit, but I can assure you that it was not meant unkindly.
Since I am wandering again, you may have noted the reference to the car number above. Many if not most of my age group can readily recall car and telephone numbers from the early days. It is a different matter now, when every second human activity appears to be circumscribed by PIN numbers, security codes etc. Such facility of recall is no longer a given and one fervently hopes that such does not presage worse to come.
WHERE WAS I? Ah yes, now I remember. I had resolved to ignore the medico-political fray temporarily to regain my equanimity, indeed my sanity. The young doctors programme brought my thoughts back to my own memories of a surgical life.
I had arrived back in the Mater hospital as a surgical registrar, one of two such in residence. In those days there was no such post as senior house officer, which is now interposed between intern and registrar.
Accordingly, it was very much a question of being thrown in at the deep end. I had seen a lot of surgery and assisted at many operations. I had read widely and was familiar with most common and emergency conditions.
Now there was a difference; the judgment calls were mine in the first place. Help and direction were available but at a remove. I was the man on the spot.
Horace wrote: Aequam memento rebus in arduis, servare mentem (when the going gets rough, hold the head). I think this would be a worthy motto for NCHDs - indeed for any medical person, especially a surgeon.
I was again resident in the hospital, although in view of my lofty status I now was in possession of a one-roomed flatlet known, from its position on the main staircase to the residence, as the "mezza". It also had its own telephone. We had a different dining room from the interns, a race apart indeed. It all seemed very important at the time.
My first duty night brought my first call. The phone rang and a disembodied voice announced that there was an "acute abdomen" in the A&E department. It identified itself as the intern on call, also on his maiden voyage. On his being pressed as to the nature of the problem, he ventured that the nurses thought it was a perforated duodenal ulcer.
He did not add his own opinion and I knew just how he felt. I made my way to the A&E department, through the sleepy night world of the hospital. A friendly staff nurse said: "We've got a perf here Maurice, we've had the X-rays taken and they confirm the diagnosis."
She continued: "We got the intern to notify theatre and ring the anaesthetist."
I thanked her and prayed that she might be right. She was, of course, and history and physical examination left little doubt, in so far as you can say that. I rang the consultant on duty and informed him.
"Right, get on with it," was his testy reply. I was about to tell him that this would be my first independent operation, but I figured that at 2am he wouldn't be too riveted by my life story.
Anaesthesia by a classmate of vast experience (she had been in the post for six months) and surgical assistance from an intern on his first night in the hospital; we were a formidable team.
Draped the patient, cut into the abdominal cavity and cleaned it, found the hole in the bowel and repaired it. Sewed the patient up and waited until the patient was awake.
I realised that I had not had time to be uncertain or scared. The patient was returned to bed (these were the halcyon days when there were beds). I also returned to bed. I was mildly surprised that my head fitted through the door.
Maurice Neligan is a cardiac surgeon