In the bad old days

I embarked on medical training in 1961 as a mature student with two years of general dental practice and three years of hospital oral surgery and maxillofacial trauma behind me. My second six month preregistration post was as a surgical house officer at a busy London hospital. My responsibilities spread over four firms, each headed by a teaching hospital consultant, and included 60 beds on-take alternate weeks with an additional 60 to cover plus casualty at night time. The experience of “hands on” general surgery, urology, and gynaecology was fantastic, but so was the fatigue.

One evening I was called to casualty to find an obese, partially collapsed lady bleeding copiously from the vagina who had missed a couple of periods. Her pulse was weak, her blood pressure barely recordable, and her major veins impalpable. As I started to catheterise the patient to provide fluid, I sent …