Richard Gordon: DOCTOR IN THE HOUSE

_Give an account of the sign, symptoms, and treatment of heart failure_ was the first. 'Hell of a lot in that!' I thought. I read the second and cursed. _Discuss the changes in the treatment of pneumonia since 1930._ I felt the examiners had played a dirty trick by asking the same disease two papers in succession. The next simply demanded _How would you investigate an outbreak of typhoid fever?_ and the last was a request for an essay on worms which I felt I could bluff my way through.

Three hours were allowed for the paper. About halfway, through the anonymous examinees began to differentiate themselves. Some of them strode up for an extra answer book, with an awkward expression of self-consciousness and superiority in their faces. Others rose to their feet, handed in their papers, and left. Whether these people were so brilliant they were able to complete the examination in an hour and a half or whether this was the time required for them to set down unhurriedly their entire knowledge of medicine was never apparent from the nonchalant air with which they left the room. The invigilator tapped his bell half an hour before time; the last question was rushed through, then the porters began tearing papers away from gentlemen dissatisfied with the period allowed for them to express themselves and hoping by an incomplete sentence to give the examiners the impression of frustrated brilliance.

I walked down the stairs feeling as if I had just finished an eight-round fight. I reached desperately for my packet of cigarettes. The other candidates jostled round, chattering like children just out of school. In the square outside the first person I recognized was Grimsdyke.

'How did you get on?' I asked.

'So-so,' he replied. 'However, I am not worried. They never read the papers, anyway. I'm perfectly certain of that. Haven't you heard how they mark the tripos at Cambridge, my dear old boy? The night before the results come out the old don totters back from hall and chucks the lot down his staircase. The ones that stick on the top flight are given firsts, most of them end up on the landing and get seconds, thirds go to the lower flight, and any reaching the ground floor are failed. This system has been working admirably for years without arousing any comment. I heard all about it from a senior wrangler.'

Benskin's broad figure appeared among the crowd in the doorway. He was grinning widely and waved cheerily at us.

'You look pretty pleased with yourself,' I said.

'I am, old boy. To-day I tried out Benskin's infallible system for passing exams, and it worked beautifully. What number are you?'

'Three hundred and six.'

'I'm a hundred and ten. All I had to do was walk into the room labelled "Two to Three Hundred," wander round a bit while people got settled, and tell the invigilator chap they hadn't given me a place. He apologized at first, then he looked at my card and turfed me out pretty sharply to find the right room. I was pretty humble, of course, and murmured a lot of stuff about my nerves-however, in my wandering round the desks I'd taken damn good care to read all the questions. Now, if you look up the regulations you'll see candidates are admitted up to twenty minutes after the start of the examination, so I had plenty of time to dodge down to the lavatory and look it all up before presenting myself, breathless and distraught, at the correct room. Pretty smart, eh?'

'I hope they can't read your writing,' I said bitterly.

The oral examination was held a week after the papers. I got a white card, like an invitation to a cocktail party, requesting my presence at the examination building by eleven-thirty. I got up late, shaved with a new blade, and carefully brushed my suit. Should I wear a hospital tie? It was a tricky point. Examiners were well known for harbouring an allergy towards certain hospitals, and although my neckwear might convince them I was not from St. Mary's, for instance, or Guy's, my interrogators were quite as likely to be opposed to men from St. Swithin's.

I put on a quiet nondescript tie and a white stiff collar. The dressing-up was important, for the candidate was expected to look like a doctor even if he gave no indication of ever becoming one; one fellow who had once unhappily appeared in his usual outfit of sports coat and flannels was turned over to a porter by the outraged examiner with instructions to 'Show this gentleman to the nearest golf-course.'

It is the physical contact with the examiners that makes oral examinations so unpopular with the students. The written answers have a certain remoteness about them, and mistakes and omissions, like those of life, can be made without the threat of immediate punishment. But the viva is judgment day. A false answer, an inadequate account of oneself, and the god's brow threatens like an imminent thunderstorm. If the candidate loses his nerve in front of this terrible displeasure he is finished: confusion breeds confusion and he will come to the end of his interrogation struggling like a cow in a bog. This sort of mental attitude had already led to the disgrace of Harris, who had been reduced to a state just short of speechlessness by a terrible succession of _faux pas._ The examiner finally decided to try the poor fellow with something simple and handed him a breast-bone that had been partly worn away with the life-long pressure of an enlarged artery underneath. 'Now, my boy,' said the examiner. 'What do you think caused that hollow?' All he wanted for a reply was the single word 'Pressure,' but Harris looked at the specimen in blank silence. With a sigh, the kindly examiner removed his pince-nez and indicated the two indentations they left on each side of his nose. 'Well,' he continued helpfully, 'what do you think caused that?' Something clicked in Harris's panicky brain. The depressed nasal bridge…a picture flashed up that he had seen so often in the opening pages of his surgery book. 'Congenital syphilis, sir,' he replied without hesitation.

I was shown to a tiny waiting-room furnished with hard chairs, a wooden table, and windows that wouldn't open, like the condemned cell. There were six candidates from other hospitals waiting to go in with me, all of them in their best clothes. They illustrated the types fairly commonly seen in viva waiting-rooms. There was the Nonchalant, lolling back on the rear legs of his chair with his feet on the table, showing the bright yellow socks under his blue trouser-legs. He was reading the sporting page of the Express with undeceptive thoroughness. Next to him, a man of the Frankly Worried class sat on the edge of his chair tearing little bits off his invitation card and jumping irritatingly every time the door opened. There was the Crammer, fondling the pages of his battered text-book in a desperate farewell embrace, and his opposite, the Old Stager, who treated the whole thing with the familiarity of a photographer at a wedding. He had obviously failed the examination so often he looked upon the viva simply as another engagement to be fitted into his day. He stood looking out of the window and yawning, only cheering up when he saw the porter, with whom he was now on the same warm terms as an undergraduate and his college servant.

'How are you getting on this time, sir?' the porter asked him cheerily.

'Not so dusty, William, not so dusty at all. The second question in the paper was the same one they asked four years ago. What are they like in there?'

'Pretty mild, this morning, sir. I'm just taking them their coffee.'

'Excellent! Put plenty of sugar in it. A low bloodsugar is conducive to bad temper.'

'I will, sir. Best of luck.'

'Thank you, William.'

The other occupant of the room was a woman. A trim little piece, I noticed, probably from the Royal Free. She sat pertly on her chair with her hands folded on her lap. Women students-the attractive ones, not those who are feminine only through inescapable anatomical arrangements-are under a disadvantage in oral examinations. The male examiners are so afraid of being prejudiced favourably by their sex they usually adopt towards them an undeserved sternness. But this girl had given care to her preparations for the examination. Her suit was neat but not smart; her hair tidy but not striking; she wore enough make-up to look attractive, and she was obviously practising, with some effort, a look of admiring submission to the male sex. I felt sure she would get through.