submitted by Archie Kalokerinos on 03.10.2005
From the book MEDICAL PIONEER OF THE 20TH CENTURY
The relaxation of entry requirements into the faculty of medicine resulted in a record number of enrolments. Three hundred students, more than twice the usual number, crowded into the lecture theatres of the Old Medical School and hoped to eventually be tagged with the title of ‘Doctor’. There were, however, some major hurdles to overcome. Six years of study would be highlighted with a series of examinations. At the end of the first year fifty percent would fail. Some more would be weeded out at the end of the second year. Most of the survivors, except for a few that would die from natural illness or commit suicide,. would reach the treasured goal. The examinations would dominate almost everything. Brilliant students had little to fear, but the average ones feared even the simple tests because there was so much to learn in such a short space of time, and it was impossible to cover every subject with confidence. In other words, Lady Luck would decide the fate of many. For me she proved to be more like a guardian angel.
I knew that physics would be my first stumbling block. With an enormous effort I read and re-read the textbook until I could recite most pages. This, unfortunately, proved to be my undoing. The theory exam paper included a question on the electric motor. I drew a diagram and labelled it clockwise. My mind, unfortunately, was thinking about a diagram labelled anticlockwise. The text that I wrote was for an anticlockwise diagram. The examiner, who was a senior lecturer, spotted this, decided that I had learned the subject parrotfashion (correct), had no understanding (correct), and despite the fact that the subject matter written by me was, apart from that fatal diagram, correct, awarded me no marks. I had broken a university record by becoming the first student to achieve the distinction of a zero mark!
The practical examination in physics was, nearly, another disaster. I was having great difficulty arranging the components of an experiment in the correct order. The supervisor, Dr Nichol, (a coauthor of the physics textbook), watched my efforts for a while until she could no longer stand my discomfort. Quite openly, she walked over to the bench, arranged the components correctly and said, ‘I think that you will find that that is better,’ and walked away. Yet another disaster was in the pipeline. The theory paper on chemistry included a compulsory question on physical chemistry. Somehow, the particular portion of that subject had escaped my attention. I was unable to answer it, and therefore faced the bitterness of failure.
When the examiners met to decide our fate the physics lecturer was quite adamant. As far as he was concerned I would never become a doctor and should be cast out of the university with little ceremony. But that was not to be. Sometime later one of the examiners, who lived in Rose Bay and followed my progress with interest, told me what happened. Despite my obvious failure in physical chemistry the chemistry professor was so impressed by my practical work that, as far as he was concerned, I was not only fit to complete my training as a doctor but would make a good doctor. All of the other examiners strongly supported me. The physics lecturer was forced to agree with the others and allow me to sit for what was called a ‘post’. This was a second examination in that subject -in other words, a second chance.
With that opportunity granted it would be necessary for me to study hard for a few months and I would need to know the specific aspects of physics on which I would be examined. So I come face
to face with my enemy. He listed for me the various topics that, according to him, I would need to study. This list did not include the physics of sound. I queried this and received a definite assurance that sound would not be included. A few months later when I sat in the Great Hall, and opened the exam paper, I was shocked to find a compulsory question on sound. I had been betrayed!
Someone, my guardian angel perhaps, came to my rescue. At the examiners meeting an argument ensued. Once again the physics lecturer wanted my blood. Once again the others wanted to allow me to continue as a medical student. The ‘goodies’ won. I was given a third chance to demonstrate my ability - an opportunity rarely offered. Fortunately, that opportunity resulted in success. Otherwise I would not be writing this book. It was, however, a very subdued Archie Kalokerinos who sat amongst the other students when our second year commenced.
However, all was not yet won. Biochemistry was a notorious executioner for any careless second year student and I knew that I would be a candidate for the noose. The textbook, even in those days, was an enormous tome filled with, what was to me, meaningless symbols. I looked at it knowing that I could never master this beast. Something had to be done. Some tactic had to be devised to save my soul and body from eternal damnation. I turned to my brother James.
During his second year as a student he had summarised the textbook. In beautiful handwriting and with remarkable ability he had summarised what he considered to be the essentials of biochemistry. However, even this was too much for me. Fortunately, James had proceeded further. He had summarised his summary. That is what I studied. I studied it until my eyes were sore and my brain was working along train lines. Because it lacked detail there was, of course, no true understanding involved but it had to do. When examination time came around I wrote what seemed to be a reasonable paper. Afterwards, outside the exam room, I compared notes with the bright lads and realised that my answers were very different. Thus, I considered the possibility of failure. At the very least my confidence was shaken.
The practical exam in biochemistry was a farce. There were three questions. Facing me first was a heap of whitish powder and the question, ‘Is this powdered milk?’ I was supposed to perform a series of tests and arrive at a conclusion. The tests were not easy to perform and took quite a long time. I decided to use a short cut and simply tasted it. It was obviously powdered milk so I did not bother to actually do the tests. Ijust wrote them down as ‘positive’. By the time I completed this task ten minutes had passed. One hundred and seventy remained. Next, I was looking at a stain on a rag. The question? ‘Was it blood?’ Now that was really a difficult test. I could never get it to work properly even without the stress of an examination. First, I applied the ‘smell test’. This did not reveal an odour that might have helped. So there was only one way for me to go. Mentally, up went the coin. Down it came. Heads! On such a gamble rested my entire future. According to my answer the stain was blood. Later I found that only some stains issued to students consisted of blood. The others were boot-polish stains. Mine happened to be blood.
The third section of the examination involved the estimation of the amount of sugar in a specimen of urine. I had plenty of time to relax and perform the test carefully. It so happened that I was spoton - a combination of luck, care and a little skill.
The examiner’s meeting, that year, was another circus. The lecturer in biochemistry was an astute man (whom I admired). He deduced that, although my theory paper was technically perfect, I demonstrated little understanding. He therefore wanted to fail me. The professor, however, argued that my work was ‘perfect’ - and that would be that! I was given a ‘high distinction’ - the only one ever achieved by a Kalokerinos. Bad news was to follow. I was appointed as a ‘demonstrator’ in biochemistry and delegated to assist in the teaching of students. Never will I forget the embarrassment that I later suffered when the students realised that, despite having a high distinction, I knew virtually nothing. Forty years later, at James’s funeral I related how he had so brilliantly summarised the biochemistry textbook and howl obtained the high distinction. Geoffrey Kellerman, professor of biochemistry, who knew James and myself, approached me and said, ‘I always wondered how you did it.’
Third year medicine was hard but straightforward work. Fourth year saw us begin studies in hospitals and with real patients. Although we had all dissected preserved bodies in the anatomy department, when we were faced with the freshly dead and the reality of autopsies the final traces of childhood innocence vanished. We had entered the real world of suffering and responsibility. This was clarified during the fifth year when specialties, obstetrics, gynaecology, skin, eyes, ear, nose and throat, children and psychiatry were studied. There were, of course, examinations in each subject. Some were more-orless straightforward. Others could be difficult. Lady luck, and that guardian angel that always seemed to be there when needed, calmed what could have been for me, troubled waters.
The pressure of so much to study in such a short period was beginning to take its toll. Some subjects were neglected to an extent and one happened to be eye diseases. There was an oral exam complete with patients who had a variety of diseases. I was surprised to be called in ahead of my turn. A kindly looking old doctor, who was to examine me, came straight up to me, shook me violently by the hand, invited me to sit down, called his secretary, instructed her to fetch me tea and sandwiches, and began to talk about everything but eye diseases. When the tea and sandwiches were finished he said, ‘I suppose we should proceed with the examination.’ I was escorted to a patient, given an instrument and asked, ‘What do you think of that?’ ‘That’ happened to be something that I could not recognise. It was just a dark mess. So I simply said nothing. The examiner slapped me gently on the back, said, ‘You will be O.K.’ Then shaking my hand again, added, ‘Your brother, Jim, was the best resident (“intern”) that I ever had.’
With this sort of influence I entered the final year and the universal horror of the final examinations. The theory papers seemed to be straightforward without being easy and I moved on to the oral examinations and the most important one of all - ‘the case’. This involved a patient in a hospital away from where I trained. In three hours I was supposed to take a history, perform a physical examination and recommend treatment.
Patients selected for these examinations were told not to divulge certain details that would give the student an unfair advantage. I found myself sitting behind a screen next to a ‘rough diamond’, from a slum area in Sydney. When we were left alone she reached over, patted me on the knee and said, ‘The boy who had me on Tuesday got me wrong and they tell me that he has failed. I would not like the same thing to happen to you. I have high blood pressure and they are going to do an operation’. Only a few seconds had passed and I had the diagnosis and the treatment!
Half way through the examination, while I was busy writing, the consultant physician, Thomas Greenaway, (later Sir Thomas Greenaway) noticed me as he did rounds with a dozen or so hangers-on. He stopped, looked over the screen and asked me where I came from. When I answered, ‘Sydney Hospital Sir’, he said, ‘Do they teach you all about essential hypertension and the indications for sympathectomy there?’ Then before I could say another word he walked away. Apparently he knew that the other student had failed and considered the diagnosis unfairly difficult. There are many gentlemen in medicine. Sir Thomas was recognised as one of the best.
The medical oral examination was another possible stumbling block. The well-dressed examiner sat behind a table that was littered with bottles containing various pathology specimens. He reached amongst them, found what he wanted and pushed it towards me. It was a ‘glioma’ - a particular type of brain cancer. This was something about which I knew ‘everything’. My neighbour in Rose Bay had one. I saw the operation and, when my neighbour died, attended the autopsy. I knew the fine details of the history and various special investigations. ‘What is it?’ I was asked. To answer that was easy. ‘Have you ever seen a patient with one?’ was the next question. I was able to confidently state ‘Yes.’ ‘Then tell me what you know,’ was the final request. My summary was concise but detailed when necessary. The examiner was most impressed. But my luck was about to run out - or so I thought. As a final test I was escorted to an X-Ray screen on which there was a chest X-Ray. The question was, ‘What is that?’ I looked at ‘that’ carefully. There appeared to be nothing abnormal about it but I hesitated because it could have been a deliberate trap for the unwary. I opened my mouth, said,
‘The lung fields...’ then hesitated because of nervousness. I meant to go on and say that the fields were normal. But I never got the chance. The examiner slapped his fist on the screen, exclaimed, ‘Good lad. I knew you would get it. You are the only one who has. It is the lung fields.’ Never have I seen an examiner so pleased. He looked down at the list of names in front of him, ticked against mine, looked up and said, ‘I believe that you have a very clever brother too.’
In this way I graduated as a doctor. In January 1951 my name was entered in the medical register. I was free to practice as a surgeon and a physician. One part of my life had ended. Ahead was the unknown. I’m glad that it was so because, in retrospect, I doubt that I would have welcomed the sufferings that I was to experience.
Dr Norman Rose, medical superintendent of Sydney Hospital, was a man who in his relatively short lifetime, for very many reasons, earned the respect and admiration of his colleagues and the Australian community. He was by necessity a man who demanded obedience. My brother, James, had worked under him for over one year without any problems but my own relationship with Dr Rose was a little clouded. Every student training at Sydney Hospital was sooner or later challenged to a game of billiards and itso happened that at that particular game Dr Rose was skilled. While he was in the process of defeating his luckless opponent he would loudly proclaim his own skill and poke fun at the clumsiness of his victim. I was determined not to take this without a fight. When I was asked if I would like to play billiards I replied, ‘Yes sir, provided that after the game we put on the boxing gloves.’ If Norman Rose was going to beat me at his game I was going to beat him at mine. Of course, this did not go down very well. In time I learned to be a little more diplomatic.
One day I assisted Dr Rose with an appendectomy. During the operation he asked me (it was more like a ‘demand’) to take the operation specimen to the pathology department, follow its progress and hand him the pathologist’s report. Later, when I went to collect the specimen, I was told that a nurse had flushed it down the sluice. Now, there was no way by which I could explain this to Dr Rose. Something had to be done to cover up this dreadful crime. Armed with some scissors I visited the autopsy room while one was in progress, waited until no one was watching, and went ‘snip’. The pathologist’s report was an education in itself. It stated that the appendix was an ‘interesting’ specimen because it demonstrated
unusual features of inflammation. When I handed the report to Dr Rose he said, ‘I hope that you have learned something.’ I certainly had!
After graduation, when the time came for the listing of hospital postings I was not allocated to Sydney Hospital. I am certain that this had nothing to do with Norman Rose, despite our rather sour relationship. Our year was record in size and all the teaching hospital appointments went to the best students. More than half of my fellow students had examination marks superior to mine. But I was fortunate because I was granted my first choice in other hospitals - the Lismore Base Hospital, six hundred miles north of Sydney, twenty miles inland from the coast. The area was well known to me, I had many friends and some relatives scattered around the district. The nearby beaches and rocky headlands were my favourite fishing spots. Life there would be very pleasant.
The oppressive humidity of a semitropical summer greeted my arrival In Lismore. The receptionist in the hospital entrance had been expecting me. She told me that Dr Rawle was in the casualty room examining a small boy. It seemed a good place and time to commence work, so I left my bags with the receptionists and walked the few paces to a small room that was to become a part of me. To this day I can recall how Dr Rawle looked up after being introduced and said, ‘This boy has polio.’ The little patient was fair, beautiful to look at, obviously in pain but cooperative and very brave for one so young. He was to suffer a great deal over the next few weeks and, as I was to discover to my horror, he was the first of many polio victims. The 1951 epidemic was one of the worst experienced in Australia, and Lismore was to become a base for diagnosis and treatment.
Poliomyelitis is a viral disease that can damage parts of the brain and spinal cord. In most cases the disease is so mild that the person infected is totally unaware of any problem. Some patients will have obvious paralysis of one or more muscles and the most severely affected develop paralysis of the respiratory muscles making unaided breathing impossible. A few patients will progress to paralysis of some of the essential centres in the brain and death will be inevitable. If survival is achieved, the amount of muscle movement that recovers is variable. Often there is a degree of permanent paralysis, varying in severity, of one or more muscle groups. Some individuals appear to have natural immunity that is inherited from their parents. It is thought that this is because the parents had come in contact with the disease, suffered an obvious, or not obvious, (‘subclinical’) infection, developed antibodies which protect against infection and passed the antibodies on to their offspring. There is no doubt that amongst the multitude of factors predisposing an individual to a clinical attack is excessive exertion during the incubation period. This was dramatically demonstrated by one of the patients who came under my care.
I was called one day to see a young soldier in the back of an army vehicle parked in the hospital driveway. An army doctor was bending over him and holding a bowl into which the soldier was vomiting. By that time I had seen so many polio patients doing just that that I could make the diagnosis without any further investigation. So I simply said, ‘This man has polio.’ The doctor thought that I was crazy. We helped the soldier walk into the ward. I had great difficulty performing a spinal tap (to collect spinal fluid for testing). The young man could not remain still, but I did manage to obtain some fluid that confirmed the diagnosis of polio. A few minutes later it was all over. As I signed the death certificate I attempted to piece together the details of this obviously unusual case.
The soldier had been exercising vigorously during the past few days and this had reduced the power of his immune system. The polio virus simply took over. That much was obvious. The specific factor involved in this, however, was elusive. Unknown to me, at the time, was the work of an American chest physician, Frederick Klenner. This pioneer had published details of his treatment of a variety of viral diseases, including poliomyelitis, with intravenous injections of Vitamin C. The medical establishment, unfortunately, reacted in an extremely hostile manner. Dr Klenner’s treatment was not accepted. The result was tragic. Untold suffering and many deaths could have been prevented. Almost certainly, the treatment would not have saved my soldier patient (because the disease had progressed beyond the point of no return) but it would have saved many others.
In those days if a patient developed respiratory paralysis we helped the breathing by placing him (or her) in an ‘iron lung’. This was a box-like structure with an opening at one end through which the head and part of the neck protruded. A diaphragm around the neck provided a seal that was necessary, because a pump produced relays of positive and negative pressure, that pressed the chest in, then allowed it to relax back, thus forcing air into and then out of the lungs. After a few weeks there was a row of these machines with polio victims struggling to stay alive. Caring for the patients was sometimes hectic and desperate. I was vomited upon and dirtied by faeces, urine, and sputum. Infection control during those times was, to say the least, crude. The hospital domestic staff seemed to be more concerned than I was, and for a period refused to clean my living quarters and wash my clothing. In retrospect I realise that I was running an enormous risk. Fortunately I did not suffer from a clinical bout of polio. A colleague of mine, Brad Norrington, was not so fortunate. He spent the rest of his life in a wheel chair but with incredible determination learned to live with his disability and become a valued specialist in the field of rehabilitation.
There were other infectious diseases even more alarming in onset than polio. Of these diphtheria topped the list. Some cases were mild but many went on to develop membranous casts that blocked the breathing passages and threatened life. I became, through necessity, expert in the art of quickly cutting through the windpipe below the voice box and letting air into the lungs below the point of obstruction. One little lass, however, developed a membranous cast that extended down to the smaller air passages in the lungs. I was able to insert a tube that permitted observation of the area but could not grasp the friable membrane with forceps or suck it out with the sucker available. Obviously, I needed a stronger, controllable sucker. But where could I get such a machine in the few minutes that were necessary? One of my mother’s brothers, Michael, had at one time, a dairy farm. He milked by hand but some of his neighbours used machines. It occurred to me that a milking machine would be ideal. One quick phone call was all it took. Within half an hour I had the machine installed and in use. I almost shouted aloud with relief when the membrane came away and the little girl’s colour changed from grey to an acceptable pink. For many days afterwards I found myself unable to resist the temptation to pick her up and feel the life in her that had been so close to ending.
Times have changed since then. There are now, of course, more refined methods of dealing with complications but the presentday bureaucracy would never permit the instant action that saved this girl’s life. There would be a host of forms to fill in; conferences, meetings, papers to write, officials to consult and six months would pass. By then the patient would be dead!
Tetanus was the other terrible infection that I was to confront. The first patient, a little Aboriginal boy, died. In this way I was to learn about the horrors of infectious diseases. Years later when I fought to have certain complications of vaccines against these infections recognised I was accused of not knowing how dreadful were the days before vaccines were introduced. My accusers stated that had I seen cases of polio, diphtheria and tetanus I would not be so keen to highlight rare complications following the administration of vaccines.
The luck that was with me during university exams did not desert me during my internship. One patient, a man in his twenties, was dying from a mysterious form of heart failure. He had been more or less ‘written off’. His legs were swollen; his lungs full of fluid and it seemed that his end was near. One evening I was reading a medical textbook. It had been a hard day. I was tired and began to doze. My eyes, half closed, read the same line over and over again
- ben-ben. Then instantly I was wide-awake. Beriberi -a vitamin B deficiency disease that could result in cardiac failure. The patient was an alcoholic. His diet was almost pure alcohol and certainly vitamin deficient. I threw the textbook onto the floor and rushed up to the ward. ‘Did we have some injectable vitamin B?’ The answer was, ‘Yes.’ I administered several ampoules intramuscularly - and waited. Next day the recovery was dramatic. And it is said that one must not go to sleep on the job. At least I had demonstrated that being half-asleep was sometimes better than being fully awake.
Treating accident victims was another test of efficiency and resolve. One evening I was called to an ambulance. In it was a collection of bits and pieces. Someone driving a car had collided with a train at a level crossing. With the dead were two who were living - an old man and a little boy. They both needed intravenous fluids and blood urgently. I could treat one. I knew that by the time another doctor arrived or I finished with the first the other patient would be dead. There was only one thing to do. I picked up the little boy and carried him inside. I gave him the two bottles of blood we had in stock. A few minutes later the old man was dead. He was the little boy’s grandfather.
Another accident was not so bad. A young man had been given a motorcycle for his eighteenth birthday. A few nights later he was coming home on the correct side of the road. A car coming towards him was on the wrong side of the road and driven by a man under the influence of alcohol. The two collided on a bend. The young man was killed. I examined the driver of the car and determined that he was under the influence. All this was documented. Some weeks later I was summoned to give evidence at the inquest inquiring into the motor cyclist’s death. I was the only doctor called. I was asked one question and one question only, ‘What time did the young man die?’ Nobody asked about the driver of the car. Nobody wanted to know if he was drunk or sober. I was not allowed to offer any further evidence. I was unable to understand why further evidence was not called for. Many, many years later, I was listening to the news on a radio. I heard that the car driver and his mother had been killed in an accident. At least, the names were the same. It is possible that they were different people.
One sad episode was, at the time, rather strange but proved to be of considerable importance to me many years later when I struggled to understand why so many infants and children died suddenly and without known reasons. I knew the father of the children involved because he worked in the hospital. He had several children including, if my memory is fight, a son aged about eight and a daughter aged about ten. These two had been mildly unwell and both died suddenly within a few hours of each other. I performed the autopsies. The only abnormalities noted were yellow patches in the livers -what I assumed to be areas of partial liver death. As far as I was aware the only cause for that was poisoning by a toxic agent. When I suggested that all hell broke loose. It was as good as accusing someone of murder. Fifteen years later I was to find the real reason for those deaths. It had nothing to do with an introduced poison. Bacteria in the gut had manufactured a toxin that could not be adequately detoxified by the liver and sudden death resulted.
Life for me in Lismore was not all work. In the town there was a big Greek community and they were nearly all Kytherians engaged in the business of providing food and drinks to the local population in a number of cafes, milkbars, fruit shops and fish shops. I could, with little difficulty, trace some family ties and this generated a problem. Their hospitality was touching in its extent and sincerity. Just being a Kytherian was sufficient to explain this, but added was the fact that doctors of Greek descent in Australia at the time were rare creatures. I was regarded as someone rather special and whenever my crowded timetable permitted I was entertained in homes and fed with nothing but the best Greek-style food. Unfortunately, I was unable to accept more than traces of this magnificent hospitality. Furthermore the hospital food was only just edible. On occasions I would find myself with just sufficient time to race down to the town centre and order a meal in one of the cafes. This, however, generated another problem. None of the café owners would accept payment and this was an
embarrassment. So I searched for an establishment where, to the best of my knowledge I was unknown and payment would be accepted. One busy lunch hour I walked into the Vogue Milk Bar, sat down and ordered a ham salad. The place was packed with diners. Sitting opposite me was a stranger who heard me make my order. He saw what was a very nice ham salad served. He then heard me order a ‘banana split’. The waitress gave this order to a gentleman working behind a counter. I noticed that there was some delay in filling it but when it was finally delivered I was astonished to see a gigantic plate loaded with all sorts of ice cream, fruits, nuts and flavourings. My fellow diner nearly choked with surprise. I saw his eyes scan the menu, ‘Banana Split.., one and threepence’. He called the waitress and placed his order, his face gleaming with anticipation. But he was soon disillusioned. When his banana split arrived it was microscopic in size. His expression changed considerably and I was glad that I had eaten what was in front of me and was able to arise and walk towards the payment desk. It was there that I learned the facts of life. Payment was refused. The owner introduced himself and his wife. Jack and Patra Baveas were Kytherians. To them it was a tradition and an honour to provide me with whatever they could. To accept payment would be to offer an insult.
Many of the old Kytherians are now dead but the tradition survives. About ten years ago I was passing through the town of Grafton with my wife and two very small children. We stopped in the main street to stretch our legs and look around. I was surprised to run into Irene Notaras, the daughter of my mother’s first cousin. She had just reopened the ‘Saraton’ (‘Notaras’ spelt backwards) picture theatre that had been built by her father and uncle but had
closed after the introduction of television. That night there was to be a gala premiere of ‘Crocodile Dundee’. My wife and I were invited to attend as guests. But what were we to do with the children? A passer-by solved that. His sister was the little girl whose life was saved by the milking machine and his wife would be only too happy to act as a baby sitter. While we yarned about old times a little lady joined our group. ‘Do you know who I am?’ she asked. I reached back into the past but failed to come up with an answer. She was Matina Coroneas. The same priest had christened us, in the same water, in Glen Innes. She had lived in Lismore during my time there. I recalled her beautiful children. Strangers used to stop her in the street and comment about how beautiful they were. Her husband now owned one of the hotels in Grafton. Would we honour her by being guests for dinner? And that is how we got a free meal, free baby sitters and free tickets to the cinema!
I cannot end this account of the time I spent in Lismore without mentioning the local doctors who taught and guided me through my period of initiation. ‘Old Man Opie’ was a foundation member of the Royal Australian College of Surgeons. He was a skilled practitioner with a sense of duty and caring that would satisfy the most ardent disciple of the Hippocratic oath. His son, Jim Opie, was a physician. His son-in-law was Dr Nugent Brand. Tom Boyd-Law was the ophthalmologist, Dr Robertson, the ear, nose and throat specialist, Don Sillar, Tom Hewett, Ken Lawrence, Sam Hatfield, Dr Meek, Dr Ryan and Dr Gribben were general practitioners and surgeons. They earned my admiration and respect. They helped to make me what lam and I look back with a sense of gratitude and appreciation. Two more individuals entered my life during those times. The first was Bob Turnbull, the radiographer for the Lismore Base hospital.
Bob had ‘been around’. He showed me the simple but important tricks of the trade. Whenever I needed him he was there. Some years ago his son, Bill, commenced practice as a radiologist in Inverell, near where I practiced for ten years. He followed in his father’s footsteps and to this day, whenever I have a problem involving aspects of radiology I seek his help. Ted Lamberton was the second. As the pharmacist in the hospital he was a senior with many years of practical experience. As much as possible he injected a sense of ‘fun’ into the practice of medicine. Beneath it all, however, was a world of common sense and clinical judgment that was of immense value as I struggled to understand the practicalities of pharmacology.
It was with this background that I changed from being a medical student to a doctor in the accepted sense of the word. Within eighteen months my initiation was complete and my footsteps turned to the next stage of my career. I needed further training in many fields that Lismore could not provide. There were very few posts in Australian hospitals and I could not compete with the brighter graduates of my year. The only alternative was to go to England where positions were freely available. Brother Jim had done this two years earlier. Obviously, I would have to follow him.
The cheapest and easiest way by which young Australian doctors could get to England during the early 1950’s involved becoming a ship’s surgeon. The term was not strictly accurate because, since the days of sailing ships, surgery at sea was rarely performed. ‘Ship’s doctor’ would have been a better description. One applied for a position through the various shipping lines and waited. I did just that but did not remain idle. I filled in my time by relieving Dr Bob Macarthur in Bombala, on the southern highlands of New South Wales. His father had been a family doctor in that town for many years and, as an elderly man, had studied for, and qualified, as a fellow of the Royal College of Surgeons of London -a feat requiring more than considerable ability. Bob went away for a few weeks and left me in Bombala with his mother, who would cook meals and see to my welfare. This rather active lady loved one thing more than anything on earth. Every midday she would down tools and listen to her favourite radio serial - Blue Hills. For the uninitiated this was a top-rating Australian rural drama, written by Gwen Meredith. It did not particularly interest me, but Mrs Macarthur insisted that I join her before lunch, and take it all in. I thought of refusing, but Mrs Macarthur had a huge dog that took upon himself the task of protector. If I did not sit down with Mrs Macarthur the dog saw to it that I did. My education was therefore enhanced with much radio rural gossip. The heroine at the time was the daughter of a wealthy Australian grazier. Her mother was extremely ambitious and was arranging to send her to England for the coronation of Queen Elizabeth in the hope that she would meet a titled gentleman and marry. I was not very impressed with this, but the details did sink in
and were to be recalled a year later with startling clarity.
In October 1952 I joined the crew of the Imperial Star in the port of Newcastle just north of Sydney. My father came to farewell me. I was not to know that we would never meet again. As I stood at the top of the gangway and saw him walk away with his brother-in-law, George Crethary, I wondered what my future would bring. It happened to be a beautiful day. The water of the harbour spread blue and inviting away to the river mouth. The ship looked magnificent. She was a cargo vessel, a floating refrigerator, part of the Blue Star Line owned by Lord Vesty. This was something that I had dreamed about since early childhood. It was going to be an adventure, an experience that most would envy. My father was about fifty-seven years old. He had, I thought, many years of life ahead. That this would not be was something that I could never have imagined.
Built as a cargo vessel the Imperial Star was also equipped to cater for about a dozen passengers. They came aboard the next day. Leading them were Mr and Mrs Sillar. Mr Sillar was the brother of Dr Sillar from Lismore. Then there was Gwen Harrison and her husband. I was soon to discover that she was ‘Gwen Meredith’ of ‘Blue Hills’ fame. Another passenger was Gwen Plumb - an actress friend of the Harrisons. She played a role in Blue Hills. Finally, there were a few others including one family with a young pre-teenage daughter. The crew was a mixture of Englishmen and LiverpoolIrishmen. Captain Gaudie headed them with the assistance of Mr. Ray, the chief engineer. I cannot recall the name of the chief steward, although his deeds were to demonstrate that he was the living epitome of Casanova. In every port one of his many ‘friends’ would come on board to be entertained in a manner fit for royalty.
For a few days we all enjoyed the tranquillity of Newcastle harbour while we waited for the loading of some cargo. My first duty was to check the ship’s medical stores. They appeared to be adequate so I was rather surprised when the chief steward presented for signing an order form for a colossal amount of injectable penicillin. ‘We will never use so much,’ I tried to explain. ‘If we treat every member of the crew in every port between here and London for gonorrhoea we will never use so much penicillin.’ ‘Just sign,’ I was told gently but in a manner that suggested that a refusal would not be welcome. So I signed! Next day there was another order to be signed. This time it was for about two thousand condoms. I was flabbergasted. I thought of the reaction of the staff in the office in Sydney when the order came to their attention. They would probably think that 1 was about to embark not just on a sea voyage, but on one big sexual orgy. For a few moments I thought that there should be some discussion about such an order but once again the expression on the chief steward’s face left no room for compromise. I signed. I never did discover what happened to the penicillin or the condoms. Certainly they were not on board when we eventually docked in London.
I was allocated a magnificent cabin overlooking the length of the forward holds. The one next door was occupied by Gwen Meredith. Each night I could hear her typewriter at work as she composed future episodes of Blue Hills. Naturally, I wondered how she developed her themes. She never spoke about them although together we enjoyed ship life and explored foreign ports when opportunity made this possible. One day while playing a deck game Gwen slipped and strained her hip. There was only one pair of crutches on board and as luck would have it they were far too large.
With the help of the ship’s carpenter I cut them down to size and Gwen was able to hobble about until recovery enabled her to walk normally.
Six months later, in England, I received a series of ‘please explain’ letters. When the episodes of Blue Hills went to air, the heroine, whose mother was so eager to see her married to a titled gentleman, was travelling on a ship to England for the coronation. She fell on the deck and broke her leg. The young and handsome ship’s doctor attended to her in not just an ordinary professional manner. There were some very tender love scenes and the not very happy mother expressed considerable displeasure as her hopes of a title in the family vanished overboard
My mentor during the voyage was the chief steward. He warned me not to lean over the rail at night while alone because, he said, many a person was deliberately flipped overboard and never seen again. I had reason to recall this one balmy night in the tropics. I had decided to take a stroll around the decks before retiring. Rounding a corner near a lifeboat I saw the ship’s baker struggling for his life as a young crewman tried to force him over the side. My intervention prevented this, but despite reporting the issue, to the best of my knowledge no further action was taken. The crewman was drunk and this was my first experience of violence initiated by alcohol - a subject that I was later to become very familiar with.
This was to be my only unpleasant experience during the voyage to England and Europe. Cruising through the tropics and around the coast of Africa to Tenerife was sheer luxury. Then, as we moved northwards the temperature dropped and we were gripped by the icy blasts of winter. It was during this period that the chief engineer suffered a mild but worrying coronary occlusion. I had grown to like this man. His obvious skill, quiet efficiency and fatherly manner had endeared him to everyone on board. When I gave him the usual physical examination I was to learn a great deal about him. Both buttocks were badly scarred. He was on a ship sunk by the Graf Spee during the war. Confined for many days to a lifeboat he gave his lifejacket to another person and therefore sat on a hard wooden seat instead of a soft cushion-like life jacket. The result was a deep ulceration of the buttocks. With enormous confidence he told me that he would survive his ‘trivial’ heart attack and live to see the white cliffs of Dover and his family waiting for him in England. He did, I’m glad to report, but I was asked by the captain to stay on the ship while it visited various European ports in case the engineer suffered another attack. Apparently there was some bookwork that could only be completed by the chief engineer and, as the whole world knows, bookwork in an English-run institution must receive top priority. That is how it came to be that I found myself one extremely cold day walking along the famous beaches of Dunkirk.
Very few traces remained of the war not long finished. When I could not stand the cold any longer I sought refuge in a beachside inn where I hoped to warm myself with a hot drink and good French food. The innkeeper, fortunately, could speak English. When he found out that I was an Australian he was all over me like a rash. You must not eat with ordinary common people. You must be my guest. My wife will cook something special just for you.’ I was very touched, even more so when the best bottle of wine was produced. I knew that alcohol and I did not go well together. But what could I do in the circumstances? After only a few glasses I was somewhere between heaven and an anaesthetic. Then through a haze I thought that my host said, ‘You must meet my daughter. You will like my daughter.’
I could not believe my good fortune. Men of my age will recall that it was during the early 1950’s that French movies began to circulate around the world. In many of these there was a beautiful blonde ‘maiden’ - usually an innkeeper’s daughter - who was prepared to enliven the hearts of men and shower upon them French hospitality at its best. So there was I, still very innocent, only just parted from my mother’s apron strings and about to sample pleasures beyond my wildest and best dreams. All that study, all those exams, all that responsibility. Every bit, I thought, was now worthwhile. Fuel was added to it all by the innkeeper’s wife who came in from time to time to report on the progress of the cooking and tell me about the virtues of her beautiful daughter. Everything was just like the wonderful, romantic French movies. Then more wine was pressed upon me. There were more glowing reminders about the beauty of the young daughter. My imagination ran wild. What could be better? I discovered the answer to this after a few more glasses of wine when the daughter was finally produced for my admiration and attention. She was, to say the least, plain and ugly! Instantly I was sober. I must have been shocked as well because I could feel a cold sweat running over me. Then I remembered that the ship had to sail on the high tide. The dial on my watch was for various reasons unreadable. I was unsure about the direction I should aim at as I fled. I do recall half-crawling, half-walking, up the gangway and the not very amused expression on Captain Gaudie’s crimson face. For the next few days I was terribly ‘seasick’.
The remainder of the voyage was relatively trouble free. We crossed the channel entered the Thames and berthed in the King George V dock. I was officially ‘signed off’ with a pay of two shillings, took a cab to the city, arranged accommodation and rang my brother, James, who was a senior casualty officer in the Hillingdon Hospital near London airport. It was bitterly cold. A dense ‘pea-souper’ fog engulfed everything. I did not see a ray of sunshine for a whole month. At nights I had ‘nightmares’ when I dreamed that I was on Bondi beach with the blue sky and warmth of the sun. Then I would awake to the dreariness of the fog and its peculiar smell. Homesickness overwhelmed me and I seriously thought of boarding the first boat back to Australia. A visit to James and a few hours in the company of some remarkably fine young doctors changed all that dramatically. I was amongst some of the finest doctors in Britain. The conversation, the keenness, the obvious dedication was like a blood transfusion. I had to become a part of it. Life without it would be intolerable. All thoughts of an early return to Australia vanished into the mist and dampness of the English fog.
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