Richard Gordon: DOCTOR AT LARGE

I was not left much time to brood on him, for either the drivers and pedestrians of London were becoming more careless or I was becoming less efficient: the patients in the casualty-room never thinned until supper-time, and I often had to go without my lunch as well.

'I say, old chap,' be began late one evening, as the benches were at last clearing. 'How about buzzing up to the ward and having a quiz round some cases? There's an absolutely top-hole pyelonephrosis and a retroperitoneal abscess side by side-bet you half a dollar you can't spot which is which.'

'No thanks,' I said. 'As a matter of fact, I'm fed up at looking at suffering humanity for a bit. I'm going out for a pint.'

'Forgive me for saying so, old man, but it's hardly the way to get through the Fellowship, is it?'

'I don't care a monkey's damn for the bloody Fellowship at the moment. My feet hurt, I've got a headache, I want my supper, and I'm thirsty.'

'Yes, cas. is a bit of a bind. I'll be glad to get out of it next month and start proper surgery in the wards.'

I looked him in the eye. 'I will remind you that the post of senior house surgeon will go to only one of us.'

He smirked 'Of course, old man. I was sort of forgetting for a minute. Best man win, and all that, eh?'

'Exactly, Bingham.'

Another fortnight went by, and I began to hope that the Hopcroft affair might be forgotten by a busy man carrying the responsibilities of a surgical Chair. Then one afternoon the Professor appeared in casualty. He stood before my desk, looking at me with the same stare of scientific interest and holding in his hand a patient's treatment card.

'Did you write this?' he asked.

I looked at it. It was directed to the Surgical Registrar, a genial young specialist with whom I had played rugger and drunk beer, and who disliked Bingham almost as much as he did the Fellowship examiners. The card asked for his opinion on a suspected orthopaedic case, but in the stress of casualty I had scribbled only three words

_Please X-ray. Fracture?_

Now I remembered with alarm that the Registrar had the afternoon off to visit the Royal Society of Medicine, and the Professor was taking over his work.

'Yes, sir,' I admitted.

'Have,' he snapped. 'Isn't.'

He turned on his heel and disappeared.

Bingham said eagerly a few days later, 'The Prof. was talking about you this morning, old man.'

'Oh, yes?'

'I'd nipped into the theatre to have a dekko at him doing an adrenalectomy, and he asked if I knew what school you went to. I told him I couldn't say off-hand. Then he made a most surprising remark, old chap-he thought it was probably one of those progressive ones, where the kids learn all about self-expression and bash the teachers over the head with rulers but are never taught to read or write. I suppose you didn't really go to a place like that, did you?'

'As a matter of fact I did. We never learnt to read, write, do arithmetic, play cricket, or swap marbles, but at least we were brought up not to go around kissing the backsides of people we wanted to get jobs from.'

Bingham stiffened. 'I might say that's an extremely offensive remark, old chap.'

'I might say that I meant it to be. Old chap.'

My ambition to be a surgeon now burned low. But it was not extinguished until the week before my casualty job was to end.

Bingham and I lived on the top floor of the Resident Medical Staff Quarters at St Swithin's, a tall, gloomy building containing a couple of dozen bleak bed-sitters and a dining-room enlivened by a battered piano and a picture of Sir William Osler gazing at us chidingly down his sad moustaches. On the table was a collecting-box in which anyone talking shop at supper had to drop half a crown; this was labelled FUND FOR THE BLIND, and underneath in smaller letters _And What a Blind!_ Every six months, when half the house surgeons left, this box was broached. As the Professor's retiring house surgeon had also passed his Fellowship, found a new job, and become engaged on the same day, he asked me to take his night duty for him. I was delighted, because it showed I was capable of accepting higher surgical responsibilities. Also, it made Bingham furious.

There was usually a trickle of emergency cases entering St Swithin's during the night, but that evening I was disappointed to find that the admission-room inside the gate was quiet. About midnight I went to sleep, leaving Hamilton Bailey's _Emergency Surgery_ beside my bed and my trousers hopefully receptive on the chair. I dreamed that I was in casualty, operating with a soup spoon on Bingham's double hernias without an anaesthetic, and I woke with a start to the porter's knock.

'What is it?' In a second I was scrambling out of bed, switching on the light, and jumping into my shoes. 'What's the time?'

''Arf past three.. Case of intermittent abdominal pain. Getting worse over last three days. Mostly subumbilical.'

'Really? Does the patient look very ill?'

'Nah. Came in a taxi.'

I immediately felt sorry: it looked as though I would not have the chance of assisting at an emergency operation. The porter stood picking his teeth while I pulled a sweater over my pyjamas. 'Gall-stone colic I reckon it is,' he said.

I made my way downstairs, through the cold, empty, black halls of the out-patients' department. It was a bitter night outside, with sleet falling heavily and freezing immediately on the pavement. There was no one in sight except a porter sweeping in the distance in the thin light of a lonely bulb. I suddenly felt that I was the only doctor in the world.

I found the patient sitting under a blanket on an examination couch. He was a thin, neat-looking man in a blue suit and a white collar, with a small moustache, carefully-brushed hair, and horn-rimmed spectacles. He looked worried, but unfortunately not like an immediate candidate for the operating table.

'Well now, what's the matter?' I began, as briskly as possible.

'I'm extremely sorry to have troubled you, Doctor. Extremely sorry indeed.' He spoke quietly, with a faint Cockney accent. 'I have took you away from your no doubt well-earned repose. I apologize, Doctor, and ask your forgiveness for that which I have done.'

'That's quite all right. It's what I'm here for.'

'I said to myself as I came in, "The doctor is now, no doubt, reclining in the arms of Morpheus. He is sleeping the sleep of-"'

'What's the matter with you, please?' I interrupted.

He suddenly clutched his abdomen with both hands and groaned.

'Abdominal pain?' I said, flicking the pages of my surgical text-book through my mind. 'Colicky, no doubt? Any relation to food?'

He relaxed, looked round, and whispered, 'Are we alone, Doctor?'

'Alone? I assure you, professional confidences will not be divulged.'

'You're the Professor's house surgeon, ain't you, Doctor?' I nodded. 'Well, Doctor, it's like this here. The Professor operated on me six months ago-partial gastrectomy, up in Faith Ward. All was well, Doctor, until three days ago. Then I began to have pains.' He groaned as another spasm caught him. 'Something shocking, Doctor. Tonight, after a bite of supper, I coughed and found something hard in my throat.' He glanced over his shoulder again and whispered, 'It was a nut, Doctor.'

'You mean you'd been eating nuts?'

'No, no, Doctor. I mean a metal nut. Then five minutes later I produced a screw. And after that two more nuts and a bit of spring. I've been bringing up bits of old iron all night, Doctor. So I thought I'd better come along here.'

'But dash it, man! That's almost impossible. Are you sure?'

'Look, Doctor,' he said proudly. From his pocket he pulled a screwed-up piece of the _Evening News,_ which held several bright nuts and bolts and a small coiled spring. We looked at them solemnly. Our eyes lifted and met. I licked my lips.