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Memories of playing House in my junior doctor days

A dressing-down from his literary hero sparks a nostalgia trip for Phil

A dressing-down from his literary hero sparks a nostalgia trip for Phil

I think Colin Douglas, doctor and author of The Houseman's Tale, has been writing about me. He was reviewing a book of essays by Dr John Launer in the BMJ, and he had this to say: ‘The pieces first appeared as columns in the Quarterly Journal of Medicine.

Not in the BMJ or The Lancet, and definitely not in any of the cheery throwaways whose columnists are the medical equivalents of Private Eye's immortal Phil Space and Polly Filler.

So the usual stuff of the lesser sort of column – the week's odd case [1]; the easy dig at management [2]; the facile reflection along the lines of "aren't our patients sometimes dim" [3] – simply will not do.'

It's always an honour to know you've made an impression on one of your literary heroes, even if it has left me a little bereft of material this week.

I've had to bin the story of a bloke with a fish up his bum (1); postpone my diatribe against PCT Equal Opportunities Enforcement Officers banning the use of the word ‘plump-titted' from medical records (2); and re-examine as possibly too condescending my anecdote about the patient who attended for advice regarding what sounded like a sebaceous cyst on the scrotum of her husband – a gentleman who, it transpired on further questioning, had been cremated five years previously (3).

Instead I decided to revisit The Houseman's Tale – and an illuminating few hours it turned out to be. I first read it in the weeks between qualifying as a doctor and starting work as a houseman, and it scared the hell out of me.

Could hospital medicine possibly be like this? I lay awake at night, dreading the thought that similar terrible events might soon be happening in my own life.

I was particularly entertained by Dr Douglas' story of the comedy phimosis in the proselytising religious nutter (1); the relentless stupidity of the nurses (2); and the recidivist patient wandering round the wards bearing the gift of a pot of his own shit (3) – but these were supplementary joys.

I had forgotten, or at least not noticed at the time, the relentlessly anti-GP tone of the story. Every GP in the book is portrayed as stupid, dangerous, mercenary, irresponsible and unprofessional.

And like every other arrogant, swaggering, newly qualified junior hospital doctor, I accepted this view as gospel, right up until the day I started my training in general practice and encountered the reality of primary care in the NHS.

But that's normal. We've all been there.

The most striking aspect of re-reading The Houseman's Tale is what a remarkable time capsule it has turned out to be.

Leaving the cynicism and self-absorption of its characters to one side, it paints an arresting portrait of the intense closed world of hospital medicine in the 1970s.

The junior doctors live and love in the hospital, their entire lives and relationships revolve around each other and their colleagues on the wards, and only rarely do any of them poke their heads outside the physical and emotional maelstrom of the hospital grounds.

I lived that life, for a few wild and memorable years, and my most intense and disturbing memories and experiences date from that period. We were baptised in fire, and forged in adversity.

It's all gone now. Hospital doctors are limited to a laughably short working week by European legislation, and free hospital accommodation has just been taken from them as a result. These days, no SHO (or F1 or whatever it is now) will ever experience the unforgettable sensation of having been continuously awake for 60-odd hours.

I would not, and could not, live that life now. But I'm very glad I served my time in the House of God. Something has been lost. The only place it survives is in our memories and in the pages of The Houseman's Tale.

Dr Phil Peverley is a GP in Sunderland

Pev

I lived that life for a few wild and memorable years. We were baptised in fire and forged in adversity.

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