All of the books and booklets offered were written by Dr.Dick either as sole author or as contributor and/or editor.
DOC LEAVES by Dr.Dick Richards:
Two new books have just been completed,.. they are, respectively, Doc-Leaves, Part One and Doc-Leaves, Part Two. Together they comprise the latest versions of Dr.Dick's own confidential memoirs,.. full of personal occasions, poems, jokes, related facts and data. Many pages of these volumes contain long-awaited revelations on subjects from his medical and security work as well as episodes related from the more vivid of his extensive list of published material. Surprising, provocative and informative. Few will read these books without being influenced,.. for the better or for the worse.
Both books will be listed here and will be purchaseable from this website as soon as final corrections have been completed. Propective readers can contact Dr.Dick any time from now on to show interest or to make advanced orders.
Opening pages of Part One:
A Kiss for Christmas
Two days before Christmas.
It was snowing. Huge flakes were falling thickly, slowly, dropping silently onto the shoulders and heads of the London crowds intent on their late shopping.
Oxford Street was a tangled mass of people. The trees were pointed with stars of light. The reds and greens of the Yuletide windows glowed warm in welcome. The air was cold. Folk were hurrying, watching excited children, struggling with packages and baskets full of brightly wrapped secrets. As darkness had fallen the excitement had increased. Time was getting short. Time to hurry, to think about crowded trains or buses. Time to ponder emptying pockets and wallets. A thousand anxious worries and diversions,.. traffic, shopping lists, arrangements... hurry, hurry, hurry. Time was precious. Time was short.
Then the snow had begun to fall and in moments the whole atmosphere changed. The calm flakes soothed the shortening tempers. Umbrellas put up in haste were taken down again so that flakes could fall on coats and hair and on deliberately upturned faces. Eyes strained up to spot the white frozen feathers emerge from the darkness, enter the swathes of festive light and swirl down to meet the people. The magic that had been missing from the commercial congregation of the London thoroughfare suddenly returned. The pace slowed, children's eyes widened, people smiled, stranger at stranger. Some of the girls shook flakes out of their locks. Others walked on with new, white haloes around their bright faces.
That was how he thought she looked as she came into the food store. He couldn’t believe it. He just stood there with his small bag of purchases and gazed at her, spellbound. The same open, cheerful face. The chestnut hair, damp and curled, and outlined by the lights twinkling on the fresh, white cherry-blossom flakes that had just fallen on it. A thick green scarf was wound around her neck. She loosened it in the warmer air. She wore one glove and carried the other, as she always had. He saw her twitch her nose as ever when she came into a room,.. testing? He saw the familiar turn of her shoulders, the shrug, the glance around. Nothing had changed. He held back behind a stand of fruit not to be seen while he watched, the voyeur in him already vicariously relishing the lines of her outstanding shape.
He loved her. He loved her still. Even after all this time; he loved her absolutely desperately. He knew it in a moment. He loved her more than ever. Though he'd not seen her for twelve years. She was more lovely even than he remembered. How could he not love her?
Cautiously he followed her as she picked up the items on her grocery list, mostly small luxuries. Again those familiar gestures,.. the tiny frown when she couldn't find something or the label didn't please her. Two or three times she looked up and around her. He thought it was almost as if she sensed someone or something was watching and influencing her. Then he saw her thrust her list into one pocket and look up and down to see if she might have forgotten something. She was heading for the check-out counter. In a moment she would be gone. His heart jumped. If he was going to speak it would have to be soon.
He followed her to the desk and stood next in line behind her. Her hair, still covered with tiny, shining, melted droplets, was scarcely two feet from his face. He could feel her warmth, catch the scent of her hair.
She was transferring her checked purchases into a small string bag. A can slipped from her fingers, rolled, and was at the edge of the counter before she grabbed at it. A strong hand closed over hers startling her. The can was saved. But there was more. The broad masculine hand had shot out and grasped the can at the same time as her own hand. It trapped both. There was still more. For a moment she looked down at the hand,.. bronzed, sturdy, short fair hair across its back, the knuckles curled, tense and confident. Something reached in and touched her inside. All in an instant she felt the male to female contact, a flowing power, a sensation of command and obedience, of needing to comply.
Still the hand didn't let go. It made as if to lift the can and her hand too. She looked up at the tall figure beside he. Eyes met. Her hand tightened under his grip. A sharp intake of breath,.. the doubt, the disbelief. Then the certainty.
'You,..?' she managed to say, her wide eyes turned up towards him.
He nodded. 'Me.'
She was flustered, had no idea what to say. His presence, the surprise, the old thoughts, the shattered dreams, the dim memories, all came rushing into the front of her mind. She thought she was going to cry, out loud like a child.
Then he was helping her. His old masterful ways again. She recognised them all. Efficiently everything was placed in her bag. Her change was collected, acknowledged politely, put positively in her hand,.. the hand she opened so instinctively,.. so symbolically. Then he had her by the elbow, steering her, using his height and presence to ensure a way through the crowd. She let him take control, insist, lead, as she always had let him. The gap of years and events meant nothing. It all seemed so natural.
They were outside again. The snow was whirling,.. heavier,.. the pavements and the roads between the busy car tracks were white. Fairyland was taking over there in the thronging street, the grey and beige of stone and tarmac glistening, lights glinting on the frozen flakes from a thousand new directions. Her hair was covered with the fresh arrivals, her eyes shining, her entire face glowing and alive. He couldn't take his own eyes from her for a moment. He held her by the shoulders, simply looking at her. And she just stood, spellbound, looking up at him, eyes wide with wonder and happiness at seeing him. The old magic was still working. She felt herself shaking inside, her knees literally weak and wobbling, as the years peeled away.
'Where are you going?' he asked, still holding and looking, peering into her very heart.
She answered without thinking. 'My car is on the corner. I found a place,.. er,.. lucky.' She stammered, pointing.
'Let's have a drink and a chat,' he said and steered her into a side street. The noise level dropped. No cars swished by. Darker yet whiter, the fresh snow almost untouched. There was a pub, 'The Cockatoo.' It was closed. Across the street was 'The Hand and Glove.' Closed too. It was four in the afternoon.
'I know,' he said, still the boss-man. 'You go to the car. Give me a few ticks and I'll join you. Do you have time?'
She nodded. There was no way she could have disagreed anyway. He was just sweeping her along. No resistance. She was helpless.
'Wait for me!' he said. 'Don't go. Don't run!' He turned and disappeared. She watched his easy lope up the street and back towards the store.
No sooner was she in the car, her wet coat thrown into the back seat than he was there, the big, open grin peering in through the window. He eased in beside her, plonked two paper cups on the dashboard top and began opening the champagne bottle.
'The occasion calls for it,' he said. '"Seven million people in London and who do I get to meet? Cheers!'
They talked, excitedly at first, then slower. 'Are you often in London?'
'First time in two years,' he answered. 'I never seem to get out of California these days except to conferences.'
'I saw you on TV last year. You looked good.'
'Must have been my better profile.'
'You looked tired though. Success must be expensive.'
'I probably was tired.' He looked steadily at her. 'Tell me, how's your dear old Dad?'
'He's great. Getting younger.'
'And how are you?'
He shook his head, '0h no. Not you. Just the world around you.'
Then his hands were holding her head, tenderly, safely, as if it were a child's. The weakness was back in her knees. His eyes were so huge. Caring eyes. She felt empty, hollow, betrayed by her own chemistry.
'You're married,' he said. 'I heard.'
She nodded. 'Two kids. One ten, one seven. Monsters.'
'Who's your husband?'
'You wouldn't know him. He's a company accountant. Up here for a meeting. I'm picking him up in an hour for the drive home.'
'Love him a lot?'
The wide eyes again. A tear,.. or a melted snowdrop?
'He's a wonderful husband. Adores me,.. and the monsters. Wonderfully kind to us all.'
'That wasn't what I asked.'
'I wish I could love him the way he loves me.'
'That wasn't the question either.' Silence. She shook her head, briefly, just the once. Her eyes dropped.
'He looks after us all marvellously. We're everything to him.' She felt herself apologising. She felt disloyal. It was not like her to feel that way. There was no cause.
She inhaled deeply.
'What about you? Married?'
'Was. She died four years ago.'
'I didn't know. I'm sorry.'
'No need to be. It was a mercy. Thank God we had no kids.'
'Nothing. No-one special,'
She was talking, her face illuminated by the sweeping lights of passing cars. Tyres shushed past. Screen wipers cleared only small patches. No-one noticed the two old lovers in the dark, parked car. He was not listening. He just watched her face, the curving of her lips, the lambent movement of her eyes,.. always those great, deep, lovely eyes.
Suddenly her head was between his hands again. It was as if he held her heart. She still tried to talk on. But he clasped her harder, tighter, stilling her face. She tried to avert his gaze, dropping hers, but could not. She looked up at him again. He filled the car, his large, lean, tweeded body dwarfing her fragile smallness. She saw his strength. He saw the sadness in her eyes. The space between them narrowed. Her aroma was in his nose, she could scent his man-smell. The firm, compelling hold on her head calmed her like a fretful pony. Only her heart raced, fluttering inside her ribs like a scared canary. Even less space between them now. Sharing air, sharing breath. His lips hovered, then touched, feather light, dry on her own, then pulled back.
She saw his tongue moisten his lips. That familiar move again. She knew. It was coming. It would happen. She moistened her own lips, letting them rest damply together as he neared her again.
He kissed her gently, tenderly, chastely,.. almost a brother's kiss. A brother's kiss except that it lasted and lasted and went on lasting. No more a brother. No longer a friend. He was an old lover, her only real lover,.. ever.
She had longed for him so often, so long ago,.. so tearfully, so tragically. The vicious words, the misunderstanding, the cruel phrases, his shocked face with her nail marks, his hurt,.. her own horror. Then the slammed door,.. and the footsteps fading, going down the stairs and out into a silence that would last for years and years.
But now he was here in this small, steel cocoon. His calm lips against her. The years dropped away,.. he was with her, he was here, he was now. Everything else was outside, away from them, dark,.. another elsewhere, a different dimension.
She yielded slowly but without doubt. Her head went back,.. and back, still held, poised for his visiting mouth. His nose touched hers, the edge of one flaring nostril against her own. There was most of a day's growth of stubble on his top lip and on his chin. The thousands of tiny, stiff bristles needle-pointed her smooth skin, sharp, and sharpening her,.. stimulating. Four lips,.. two his lips, two her lips, pressing, leaning, testing.
For a moment she pulled back. Her mind was a tangle of old fears and new doubts. She shouldn't, should she? She never did,.. never had,.. not really. Except in her mind, that was. But then, what else was there? Mind was all,.. and in her mind it had happened. She had let it happen,.. made it happen,.. every single day of the long parted years.
Her eyes were full of different tears, joy and sorrow, longing and fulfilment, all mixed. She focused on his dear, dear face. Wide forehead and its greying curls, long straight nose, so big and ugly,.. lovely ugly. The tight, curved lips. Cheeks high, almost eastern, and the pointed chin where he used to have that tickly beard,.. that gave her such raptures when it came against her, her face, her breasts, her tummy,.. her soft thighs and their secret meeting place.
She closed her eyes and parted her lips. She did not see him come closer again but she felt the movement,.. the last pause before their lips were together again,.. open this time. She put her tongue out against his top lip and ran it side to side along its lower edge. Her very tongue-tip touched his teeth,.. sharp edges,.. a taste of champagne and his salt.
And with his lips, his tongue and his mind alone,.. and with her willing consent,.. he took her right there in the tiny, locked chrysalis.
His tongue met hers and she drew on him, pulling him into her mouth,.. drawing him into her centre, tasting him more richly, more fully, a dozen flavours. Her mouth was open, slack, searched by his intrusion. In her throat there was his air and she inhaled it, snatching it into her lungs as if to keep and hold it. She felt the fluids of his mouth flow into hers and hers responding. It was years since she had been so kissed... or since she had so kissed. She felt the old, dreamy weakness,.. the old wanting,.. the female emptiness longing to be filled.
And from his old knowledge of her ways he felt her succumb to her longing. Her mouth could not be more open,.. his for the taking. So he took. He explored it and savaged it, hungry for her,.. eating her open and pliant body. Devouring. From the corner of his eye he saw her hands come up, reaching for his shoulders, then around his neck, her fingers in his hair. How he remembered those hands. The things she did with them when she was excited, sexually inspired and frantic. The way she would grip one hand around him when he had just entered her, holding him tight yet keeping them apart for a tantalising moment,.. until she removed her hand and drew him deep within her in one smooth, engulfing movement. How he remembered.
He saw her chest swell and push towards him,.. her knees and thighs parting. She was his, open and welcoming, yielding,.. all woman,.. his woman,.. giving herself willingly and completely,.. his for the taking. It was all in the kiss,.. everything.
The kiss went on, neither of them wanting to break the contact,.. on and on,.. moment after lingering moment,.. until there was nothing left and they had to part to breath to gasp, to stand back from the wonder of this profane but beautiful, mouth upon mouth exchange of spirit and love.
Both their bodies had stirred low down beneath their heavy, winter-chill clothing. Animal magic had its way. Neither of them curbed anything. It would have been unfair, dishonest,.. a sacrilege. Yet as they parted she knew he had realised how much she was roused.
'I shouldn't have done that,' she said, her fingers touching to his face.
'You didn't. I did. Blame me, ' he answered.
'It's wrong. It's disloyal,' she faltered, distressed. 'I wouldn't be surprised if it's illegal.' She looked at him. 'Is it illegal?'
'Only if you enjoy it,' he smiled.
They nodded then both spoke together,.. 'It's illegal,' they agreed, and burst into the relief of the happy laughter of their old, old joke,
They talked and talked. The years have been kind,.. success,.. the money I make is not always worth the price I pay,.. your home,.. my son,.. his wife's dreadful death,.. her husband's company,.. old friends, some gone, some left behind.
The champagne level dropped in the bottle. The things they had to say began to run out. So did time.
'I'm flying out tonight,' he said suddenly.
She shook her head, a small almost painful gesture. Again the eyes,.. and a silence. Again his hands holding her head.
'I love you, ' he said. 'And I'm sorry.'
She nodded. 'I know. I love you too. Never stopped.' She looked away.
'God, how small it sounds. It's everything and it sounds like nothing,'
The snow had coated the windows, blotting out light and sound. They were isolated, surrounded by millions of people yet all alone together. There was no other world just for their few moments.
He poured the last drops into their cups.
'Don't tell me where to find you,' he said. 'I'd have to. I wouldn't be able to help it.' She understood. 'And you know where to find me,' he added. 'I couldn't hide if I wanted to.'
'Too famous.' He smiled and let the smile drop swiftly from his face.
'My Love,' he said softly, 'My dear, dear Love,.. remember only this. I've always been yours. I was, I am now, and right until the end. And if ever,.. if ever you have need of me...'
She was in his arms, sobbing helplessly, childlike, shaking. She had nowhere to turn for comfort. He held her for long, timeless minutes. He was back with her in their old home.
'We must leave,' he said.
He picked up the nearly empty cups and passed hers to her.
'It’s bottoms-up time. What shall we drink to?'
They raised their cups. 'To now,' she said.
'To now,' he said. 'And to maybe,..'
He brushed his lips to the tip of her nose. That old familiar feeling again.
Without another word he got out of the car, squeezing her hand on the wheel as a parting gesture. He stood quite still on the pavement, numbed by more than the chill, yet not moving.
The car started. The indicators blinked sleepily. She pulled out into the traffic stream, turned the corner and was gone. He didn't even wave. He just stood there, shivering. Then he pulled up his collar.
And all at once he realised that the snow had turned to rain.
Please note: We understand that in order to get permission to publish stories concerning the Sovereign and her properties one must first apply to the Lord Chamberlain,.. or at least to his office. Permission was therefore sought. [*]
The British have, over the centuries, done a typically British thing. Solely in order to save money, instead of giving their retiring or dutiful staff gifts of goods, land or money they skimp via a system known all over the world as the British Honours Scam. After years of dedicated service therefore my father retired on the standard modest pension but was also given a few meaningless letters to put after his name. To the best of my recollection he never used the letters but, at the time,.. and really because my mother would not dream of missing the chance, he did attend an investiture Buckingham Palace where a medal proclaiming the ‘honour’ was duly pinned to his lapel. The cost of a new outfit for my mother plus the hiring of morning suits for himself and we two sons plus all the paraphernalia of travel, limousine for transport and so on must have added up to a sum he could manage but which undoubtedly dented the annual available funds.
Anyway, despite my feelings on the entire penny-pinching charade we turned up along with hundreds of others on the big day. One of the ‘royals’ also turned up, did the sword dubbing of a new knight or two and then steadily worked down towards the gongs for District Collectors of dustbins and so on. Somewhere in amongst them Dad had his little moment.
About the only thing that impressed me about the whole thing was a magnificent variegated ivy that grew in an enormous sort of jardinière and trailing over the sides from its eight foot high perch. It was the best I’d ever seen,.. a beautifully marked specimen, well cared for and thriving in the well illuminated investiture room. Being a keen gardener I examined it with some care. It really was very impressive.
When the do was over we all trooped out of the palace into the familiar open area just inside the gates at the head of The Mall. There we paused for photographs and some excited chat. Then we joined up with the rest of the family and Dad took us all out for a splendid slap-up fish lunch at Wheeler’s.
It was as we sat in the restaurant that my mother drew attention to the ivy in the fine tall jardinière.
‘Did any of you notice it? she asked. ‘That wonderful ivy plant?’
Of course we had all noticed it and we had all been impressed.
‘I’d love one like it,’ Mother said. ‘I wonder if we could find out what variety it was,.. or what’s its name or something.’
I then delivered a line which has gone down in the family history. I reached towards the inside pocket of my morning suit and said ‘Perhaps you’d like a cutting of it for your very own?’
Mother looked at me aghast.
‘Oh you didn’t,’ she said, clearly shocked and shaking her head in disbelief. ‘You didn’t do such a thing.’
Of course she knew I had. I always snitch bits of plants that take my fancy. I drew the two three-inch long snippets from my pocket,.. at which point some other diners saw what was happening. They had changed so we had not realised that an hour before they too had been in the crowd with us. We agreed that if the ivy cuttings struck I promised I’d send them one.
They both did strike and I kept my promise.
Since then there has always been one or more ivy plants growing in one or other of the family homes,.. the place where we then lived,.. in my other home in Cyprus,.. in my home in Malibu when I was working in California,.. and, to this day on the sundeck of my Sixteenth Century home in Kent.
It thrives,.. and it still looks magnificent.
Her Majesty while in her early eighties was visiting a famous rest home for old ladies in the Home Counties. She was shown around and all the staff were introduced to her before she began meeting some of the residents face to face and having a little word with them.
She paused at the easy chair of one rather vacant looking old lady who had not seemed to be taking much notice of the fuss.
Her Majesty leaned down over her and said, softly, ‘Hello,.. do you know who I am?’
The old dab peered back at her hard for a few moments then said ‘No, I don’t,.. but just ask Matron,.. she knows us all.
The late President Reagan paid a state visit to London and as part of the festivities he and Her Majesty took part in a lavish display of pomp and circumstance in the form of a horse draw procession including along The Mall and with both of them in the splendid open 1902 State Landau and accompanied by troops of mounted guards in full regalia.
As they progressed, at one point one of the horses drawing the royal landau emitted a great, damp noisy belter of a fart. Her majesty smiled and said ‘Now, you see, Mr.President, there are some things that even the Queen of England can’t control.’
‘The President smiled back and replied ‘Think nothing of it Ma’am. In fact, if you hadn’t said anything I’d have thought it was the horse.’
PS: We got no reply and no permission was actually granted.
The First Baby
On the corner of the side street opposite Cardiff Royal Infirmary [C.R.I.] was the Welsh National School of Medicine obstetrics unit. It was known to all as ‘Glossop’ because it was comprised of the five or six large and rambling Victorian houses that were collectively known as Glossop Terrace. These had been combined into one higgledy-piggledy warren. There were several small ‘wards’ of about four beds each and an uncertain number of smaller ones. There were also visiting rooms, kitchen, dining room, staff quarters all poked in here and there in what seemed to outsiders to be a purely random fashion. It gave much the same impression to insiders, too. In the dingiest downstairs back regions of the entire shambles were two rooms, - small cupboards really, - marked Students One and Students Two. Each had two beds narrow and hard, - students working there were not expected to get much sleep, - a hand-basin and the all-important telephone.
At some stage or other, usually somewhere in their fifth year, each student was allocated a space in one of these ill-equipped cells. Resident there for as long as it took each student had to carry out about fifty deliveries. These were all conducted under the eagle eyes of experienced SRMs [State Registered Midwives]. When I was in residence there were also two doctors, - a senior house surgeon and a registrar in charge. The consultants only put in an appearance under conditions of extreme urgency or when conducting their teaching rounds.
In those days, - the early 1950s, by far the majority of babies were born at home or ‘on the district’ as it was called. The family doctor made the arrangements and a local midwife carried out the actual confinement. If there were grounds for any concern the better class mothers were delivered in a small maternity hospital, usually private. The working class families could afford no such luxuries and, if there was deemed cause that rendered them unsuitable for home delivery, they mostly got delivered in Glossop. Of course many homes in that category were most unsuitable for home obstetrics. The war was only recently over, housing was at a huge premium and incomes had dropped as the nation’s armaments industries geared down and laid off workers. To find a dozen people living in one small, terraced ‘2-up and 2-down’ a hundred years old was an everyday experience.
To gain extra experience keen students, - of which I was one, - also got to do additional deliveries on the district. I saw and conducted some remarkable things in those days. I wish I had a pound for every baby I delivered into yesterday’s copy of the Daily Worker, the Mirror or The Sporting Life. Conditions were often deplorable in the poorer areas. Many houses still had missing windows from bomb damage or sheets of cheap tarpaulin tacked down over holes in the roof. There would be kids everywhere, men and lads coming or going to and from work, - not always sober. A dog and a cat squabbling in the kitchen. The bath was used to keep the coal in. It was a luxury to find a saucepan clean enough to boil water in. Any number of times I would be delivering a lady who was lying on one side of the bed while her husband, still dirty from his shift in the foundry snored his head off on the other side.
Some mothers did their wonderful best even under these conditions. One might indicate a neglected looking lower drawer in which, wrapped in brown paper, would be a couple of new towels, cut down sheets, soap, flannel and baby powder and a soft, fleecy little nightie to grace the new arrival. I so admired these caring ladies, - as poor as church mice and with so few civilised facilities, perhaps several other children and oafs for husbands and teenage sons, that they could, nevertheless, prepare even these modest facilities for their new babies. What a struggle it must have been to achieve even that little personal triumph over their daunting conditions. Some of them were amongst the most loving and devoted folk I ever met. Others, worn down by the endless attrition had utterly given up. In my way I admired and loved them all. They made huge humanitarian impressions on me that have lasted a lifetime. I still thank them for the things they showed and taught me. I know that it’s all part of the great natural inclination of all mothers but I met so many Mums who brought something else, - something warm and loving and caring into lives that were otherwise dirty, foul and brutish. Blessings on them everyone, - and my thanks for the lessons learned that even into the darkest holes light and love can be brought to bear.
But I digress,..
I really want to write about my first baby. I lost count somewhere after the first few hundred how many babies I’ve delivered. But, as they say a woman always remembers her first lover, so I still remember my first baby.
Delivery, - or childbirth which is a far nicer name for it, is a simple enough process or so you’d think. Lambs and cows and rabbits and giraffes accomplish it all the time with little or no help at all. When you read stories in the tabloids of how little Johnny, aged four, delivered his own baby sister it’s really just because he just sat there while Old Mother Nature did what she does best. In fact there is an old and absolutely true piece of medical advice that ‘Most of the time the best place for an obstetrician’s hands is in his pockets.’
As students we learned our first lessons in conducting a delivery by using a mechanical model. This was intended to resemble a female pelvis and to emulate the various procedures that affect the eventual arrival of the newcomer into the world. Rubber sheeting replaced the muscles of the mother’s pelvis and a hardly lifelike doll and placenta would be so placed in it that the way the whole business happened could be simulated, watched and understood. It also had the facility that the doll could be positioned incorrectly, - as sometimes happens during a real delivery, - so the budding obstetrician could be taught what to do if things went wrong. At best the entire contraption and the idea behind it could be described as a dead loss.
One comical anecdote persists and is worth the repetition. It appears that on this particular occasion a student, facing a wrongly positioned doll-foetus did his best to show how he would handle the situation. Such a bungle did he make of everything that, when he’d finished and stood there sweating and red-faced with embarrassment, the examiner picked up the pair of obstetric forceps he had just so dreadfully misused.’ Now, he said, passing the heavy forceps to the student, ’Now,.. hit the father with these and you’ve killed the whole bloody family.’
Babies are usually born head first. This is the way the process has been evolved and, being such, it is the best system possible in the circumstances. No surprise there, - evolution has got everything I can think of right. It had a long time to try out other options and discard them. The whole idea of childbirth remains, however, a matter of compromise. The baby while still in the mother’s abdomen grows in a safe, warm and well-fed environment. Didn’t we know that that just couldn’t go on? The way out of the pelvis is pretty narrow,.. though there are some who contend that narrower yet would be OK for some purposes. It is usually males who express this opinion.
As the baby grows its head approaches the size when passing out through the birth canal means it will be subjected to a lot of pressures. This has its risks. Nature seeks to solve this source of possible problems in a number of ways. A point is reached when the mother’s available food supply becomes less and less adequate for the growth requirements. Oxygen availability is a another such problem. The mother can breathe for two but, like the food she passes on, the available oxygen has to pass through the placenta [afterbirth] and into the baby’s circulation. Increasing demand means curtailed supply. Perhaps ‘aware’ of these supply limitations the baby becomes more active. Many experienced mothers can tell the doctor better than he can find out for himself that she is going to produce and when.
All these influences, - and I have drastically over-simplified, - eventually combine to initiate the birthing mechanisms. Hormonal/chemical responses are now also triggered and, as physician one soon learned how to spot the signs that both mother and babe are ready to quit the status quo. Sooner or later the first muscle contractions that signal the start of what is aptly called ‘labour’ are felt.
Throughout the months of its sojourn in mother’s abdomen the growing baby lives in a sort of plastic bag, the amniotic sac, of fluid. Of course it’s not made of plastic but the resemblance is a fair one. This fluid bath greatly reduces the effect of bumps and blows sustained by the mother. It’s yet another ingenious protective mechanism.
The walls of the womb [uterus] are almost all comprised of involuntary muscle. When it contracts the mother also feels the need to tense her own voluntary muscles,.. the diaphragm and the abdomen wall. Put bluntly this intense contraction feels similar to the impulse felt during a forced defaecation, - but much more powerful. During the first few contractions which are often some twenty to thirty minutes apart the baby’s head is pushed down into the pelvis so that it rests on the muscle layer surrounding the opening [os] in the cervix of the uterus and the muscles of the pelvic floor. All are working together to push the little head downwards towards the only available natural exit route.
Slowly, slowly, under pressure, the os opens, dilating further and further under the waves of pressure from above. From the mother’s point of view her contractions become more frequent, more sustained, more exhausting and more painful. The focus of pressure at the opening is a bulging protrusion of the amniotic ‘plastic’ bag’ Extruding more with every contraction it can be easily felt by the obstetrician’s examining finger as it pushes through the opening and, in doing so, further forces the opening of the os to widen. At some stage or other, - and one seldom knows quite when, the sac ruptures under the strain, - the ‘waters have broken’ is the old-fashioned name still used today.
The baby’s head itself is now the presenting object. It can be felt as it squeezes its way through the gap and down into the vagina. There is one more major object for it still to encounter, - the vaginal sphincter. This is one of several circular muscles that surround the body orifices, - mouth, eyes, rectum and so on.
What is happening, in effect, is that Mother Nature is seeking to squeeze a little soft ‘tennis ball, - the baby’s head, of diameter about 3.5 inches, through a bony pelvic outlet of barely larger dimension. The timing is so perfect that the tiny ‘bones’ of the baby’s skull are still little more than plates of soft cartilage. They are flexible enough to be safely compressed and overlapped to respond to the changing pressures. The presenting part of the skull, - normally the back part [occiput] is nearly hemispherical in shape and is the best available compromise between the space needed for the brain and the constriction through which it must pass to gain freedom.
Towards the end of labour the rim of the os can no longer be felt by an examining finger. It has dilated from a diameter of two or three millimetres in the virgin state to over three inches and has drawn up to be somewhere out of sight around the baby’s head. The tiny head itself has passed through its opening and is now pressing down onto the vaginal sphincter and stretching it. This is, not surprisingly, the most highly sensitive part of the birth canal. As the baby’s head pushes its way out the muscle becomes pulled back over it. This is the most painful phase for the commonly tired and overwrought mother.
Throughout the latter few minutes the midwife has been exhorting the mother to push, - to bear down at the same time as the birth pain contractions arrive. Now that command ceases and the order becomes to stop pushing and just gasp in and out when the pains come. Understandably all the mother wants to do is get rid of this painful creature. But if she pushes too much this gives the muscle and skin of the area [the perineum] too little time to stretch. There is the risk of a tearing of the tissues instead. And here comes a very important option.
In a well conducted delivery, some minutes earlier a large hypodermic syringe with a wide bore needle will have been filled with local anaesthetic. If it is judged that the perineum looks as if it’s going to tear then, with the next contraction the syringe is swiftly used to infiltrate the endangered area. With the very next contraction one blade of a three-inch, blunt-nose surgical scissors is inserted flat between the stretched skin and the baby’s head that is causing the stretching. Turned, then, through ninety degrees, one well timed and positioned closing of the scissors at the peak of the next contraction is all that is needed. The skin severs neatly instead of tearing, freed of its constrictions the head comes out easily and the pains immediately cease. The relief on the mother’s face is one of the great rewards of being an obstetrician.
It may come as a surprise to learn that the local anaesthetic was not given to numb the stretched and painful peritoneum. Nor was it to prevent the pain of the scissors cut. The extreme pain of that moment is such that the mother never even feels the incision. It is lost in all the rest of the pain. So why give it? We shall soon see. [There is an old saying in obstetrics that if the wife had the first baby and the husband had the second,.. there would never be a third. I expect readers are already starting to understand why that is.]
At this point the baby’s head is now out in the fresh air. As often as not the rest of the wet, slippery little newcomer comes slurping out into the waiting hands. Occasionally this does not happen at once and the mother needs to give another one or two gentle pushes. Either way it’s time to wipe the baby’s eyes and make sure its nose and mouth are unobstructed. For in the next few seconds a huge and essential change takes place. The placenta becomes detached from the wall of the uterus and, together with the umbilical cord comes tumbling out without much more ado.
Until this moment the baby has been breathing by absorbing oxygen through the placenta. That source of supply has now ceased abruptly and totally,.. and forever. Baby must now start the process that will continue non-stop for the rest of its life. It must start to breathe the outside air. This is so obvious that it sounds simple. Yet it is vital.
As a rule baby coughs and snorts as it automatically clears the remaining amniotic fluid from its tubes. If it doesn’t do so a little help swiftly does the trick. Baby is picked up by the ankles, - by no means easy with all that blood and mucous everywhere, - and given a couple of sharp slaps on its bum. This extreme cause for indignation usually does the trick and the baby has a good cry. The new breathing pattern is established.
Now follows the reason why that local anaesthetic might prove useful. Whether the perineum tore under the strain or was deliberately cut to make extra room [episiotomy] it is now necessary to repair the area. This will involve inserting anything from one to six or eight sutures into the already bruised, battered and stretched tissues. No time need be wasted while an aesthetic is injected and given time to work. The stitching can be started at once and it won’t take many minutes before the mother can be washed and cleaned up, changed and made comfortable after all her efforts.
Careful work is essential at this stage as it is an operation upon the successful results of which the parents’ future sexual relationship may well depend or at least, be influenced. I preferred to use old fashioned catgut suture thread as the stitches are either absorbed later or simply fall out without the need to be taken out perhaps with some discomfort. Most people hate having stitches removed even more than having them put in. The overall aim is to render the perineum as near new as it was before and without any trapped nerve endings that might render it oversensitive to manipulation.
Needless to say the matter of the association with the sex life lends itself to some tension-reducing ribaldry. Hence the question ‘How soon after childbirth can sexual relations be resumed?’ The traditional answer is that that depends on whether the patient is in the ward or in a private room. A more relevant though less generally understood point might be that it depends on whether repair was necessary. My old chief’s advice was sage, - the result of decades of experience. ‘When about to repair the perineum first consider how many sutures you will insert,.. then add just one more.’ This last one he named ‘the anti-divorce suture.’ Well,.. I said he was experienced.
But I digress,..
So back to the story of my very first baby. As stories go it is nothing special but I tell it as it means so much to me and is of an event that was, and remains, a peak experience in my life.
Sharp at seven o’clock on a bitterly cold winter morning and before my routine work at the hospital began I reported to the secretary of Glossop. She gave me a printed sheet of rules and also a key to my sleeping cupboard. I was cautioned, - wagging finger and all, that it was forbidden to use the room telephone for personal outgoing calls.
I checked the allocations list. I had been listed for three imminent deliveries due that day. One had already been admitted, - her husband had dropped her in on his way to work. I went to the ward to meet her and introduce myself. ‘Mum’ had loads more previous experience than I had. She already had five children. The only reason for her having a hospital confinement was because our Head of Faculty was Professor Gilbert Strachan and he insisted on purely statistical grounds that after the fifth baby subsequent deliveries should be conducted in hospital. It was a good rule as, statistically, from then on complications became swiftly more frequent.
Mum was a charming lady. Her eldest son, I learned, was sixteen and I was a young looking twenty-one year old. She knew exactly how to deal with that age group. I examined her and filled in her admission papers. There was no reason to expect anything but an easy, - medically speaking that is, delivery. As she put it ‘The production line in there,’ she pointed to her bump,’ Seems to be in good running order.’
I popped in to see her twice during the day and found her chatting with staff and with other patients. It was still in those days when a patient, - be it out of error or a mere effort to please, called me ‘Doctor.’ She did, in front of everyone, and she was immediately on my list favourites. Nothing else happened all day but at about ten that evening when I unlocked my sleeping cupboard to prepare for bed I again visited her and the other two allocated cases who had come in during the day.
‘I think things might be about getting started,’ she said. ‘Hope we don’t have to wake you in the night.’ There was no sign on examination that she was right. But I learned that very night that the best thing for a doctor to do is often just to shut up and listen. The Professor always advised,.. ‘Gentlemen, listen to the patient, - she’s telling you the diagnosis.’ As usual both he, - and my patient, were absolutely right. I admit to considerable excitement as I went to bed.
Sure enough the phone rang at about two-thirty. I dressed as fast as I could and was in the delivery room in no time. ‘Sorry, Doctor,.. I told her to wait, - but you know how they are,’ said Mum. ‘Impatient to enter the Vale of Tears.’ The attending midwife passed me what I gradually came to realise is the backbone of the British Way of Birth, - a cup of hot, sweet tea. I can’t bear the stuff, - to me it tastes like a lot of dead leaves in hot water,- but I was too timid to refuse it.
‘She’s fully, and one-in-three with OK presentation,’ said the midwife. ‘Fully meant the os was fully dilated. ‘One-in-three- meant the contractions were coming at about three minutes intervals. ‘OK presentation’ meant that it was the back of the baby’s head that was in the correct position. It all meant that everything was going according to plan, - things were well advanced and delivery was on the point of happening. The nurse had not called me too early. I did a quick routine examination to confirm the data and I was satisfied that everything was going according to the book. To give her a little of the confidence I was by no means feeling I gave Mum’s hand a little squeeze. I think she misunderstood as she said ‘Don’t worry, Doctor, - it’ll be OK.’
I had learned early on about the value of an actual physical contact with a patient to calm fears and allay worries. To this day I don’t take a pulse by holding the wrist between finger and thumb as if it were something vaguely distasteful. I take the patient’s hand in mine as if in a handshake. Then I curl the fingers of the other hand around the wrist and feel for the pulse with the fingertips. I often do this even when I have no real need to take the pulse anyway. Sometimes I swear I can feel the effect it has. This time though it was the patient who was reassuring me.
Plunging my hands into a bowl of warm Dettol I uncovered Mum’s downstairs department. The perineum was well stretched and I could see the baby’s had pressing against it. I wondered if I’d need to cut. The midwife guessed what I was thinking. ‘It’ll hold,‘ she said. ‘It’s been through this enough times before.’ Much relieved I stopped eyeing the brutal looking scissors.
Now, at this stage of the delivery mostly all the attendant needs to do is put the heel of the hand over the occiput and hold it to make sure it doesn’t tilt any way but towards the stretched orifice. This is in order that the back of the head is still the presenting part. It is usually necessary to maintain the head in its correct position during the last half dozen or so contractions. That way the head completes the stretching process and, at last, emerges without doing any damage. ‘Stop pushing, Mum,’ I said, - as taught. ‘Just breath in and out quickly a few times until the pain is gone.’ That should buy a few more seconds for the stretching.
Not a bit of it. Before the words were scarce out of my mouth nature took a hand. This mum’s birth canal was as loose as a duffel coat sleeve. Also the mum was more than ready for the whole process to be over. The baby too was clearly in indecent haste to get born. I had no real say in anything to do with it. Aghast I just stood there as everything happened on its own. Out came baby’s head followed by what looked like a three yard long coil of umbilical cord,.. though really only about ten inches when I measured it,.. and a bug, soft squishy placenta and all in one hasty headlong rush. I had absolutely no say in things. There was Mum looking relieved, baby whining like a Dervish, blood and fluids everywhere. Only the midwife had a grimace. She picked up the mewling infant and went to wipe its eyes. ‘Say thank-you to the nice kind doctor,’ she said to the infant. ‘Thanks for whooshing you into the world at such a rate of knots I think you’ve forgotten your suitcase.’
She handed the babe to me to check its orifices and its vital signs. Everything was just fine. The assistant nurse, - it was her first baby too, I learned, - took the little morsel from me and wrapped a big towel around it. She then gave the bundle to Mum who immediately put the tiny mouth to her breast. ‘Ooh,.. that’s working,’ she said. ‘I can feel the contractions.’
It is a fact that by yet another remarkable natural phenomenon with which childbirth is surrounded, most babies, with their first few instinctive sucks, trigger reflex contractions in the wall of the now empty uterus that they had lived in for the past months. These are nowhere near as painful as those of a few minutes earlier. But they do help the uterine muscles to squeeze down into a smaller size thereby compressing the damaged blood vessels and reducing the loss of body fluids and blood from the raw area where the placenta had been attached. Ingenious!
‘Oh, Doctor,’ said Mum, still high on the euphoria of the moment, ‘You were wonderful. I’ll bet your mum will be proud of you when you tell her about us. Won’t she nurse?’ The midwife gave me the seen-it-all-before look that really said, though silently, ‘Mmm, not too bad for a beginner.’
I wiped my hands and reached for the report sheet to complete it. My watch said two-fifty four. I entered the data. Less than half an hour for the experience of a lifetime. Then disaster struck. I looked around at the other faces nonplussed. ‘Er,.. er,.. did anyone notice if it was a boy or a girl?’ I asked. Smiles all around, mostly at my obvious discomposure.
‘Oh, it’s a girl,’ said Mum. I just knew it was going to be a girl this time. Five boys in a row,.. and now they’ve got a sister. I’m going to get a star in my book today alright.’
I was so relieved. That got me off the hook. And everyone seemed to be pleased with whatever little it was that I had done.
‘We’re naming her Barbara, after my mother,’ said Mum. ‘Or Baxter if it was a boy. The boys and her Dad have been calling her Babs already. They were all so sure too.’ Pause. ‘Oh, I’m so thrilled.’ She tickled the wee mite under its chin. ‘So thrilled.’
I was too. I went back to my cupboard knowing exactly how it felt to walk on air. The buzz was simply enormous. But when I got into bed I just cried myself to sleep. It had all been so indescribably magical.
After my morning teaching rounds in the hospital I nipped back across to Glossop to see my new baby. She was still wrinkled and folded from her ordeal of the previous night but clean and pink and altogether wonderful. I adored her. ‘Would you like to hold her, Doctor?’ said Mum. Would I? I cradled her in my arms and said ‘Hello Little Babs,.. welcome to the world. What do you think of it all so far?’ I swear she opened her eyes and winked at me. And through all the hundreds of marvellous babies I’ve had since I’ve never forgotten the fabulous delight of that first lovely little lady. I hope Babs has had the life and the sort of thrills she gave me.
I remember you so well, Little Babs, - and although you were in my life for only two days you have been in my memory every day since.
Boy or Girl?
Now I’ll let you into a little secret. If there are any future obstetricians reading it could even be useful.
Some years later in my career I had a locum job in a small hospital for a few months while filling in a gap before the start date of another job. It was a private unit specialising in Caesarian deliveries. Generally speaking this is quite a simple surgical procedure and I did one about three times each week.
As long as the particular case is without complications,.. as is usual, - the routine is of the following rough pattern. After induction of anaesthesia an incision is made in the abdominal wall. This is normally made fairly low down as the scar is then more easily kept out of site and also because the aim is to gain access to the uterus without actually opening the abdominal cavity. This may sound daft but is, in fact, the way it’s done.
Once the surgeon has access to the uterus the first thing to do is to open the amniotic sac and deliver the baby’s head. For the next few moments the head is the only part of the baby visible to onlookers. At this point the surgeon needs to ‘sweep the membranes.’ In effect this means that using hand or fingers as appropriate the membranous wall of the sac is stripped away from the inner uterine wall. Normally that task is accomplished during the uterine muscle contractions of labour but, as labour is not happening, the task must be accomplished by the surgeon.
At this point I always used to relieve the inevitable tension in theatre by asking for opinions as to whether the baby was male or female. Needless to say this is always a major factor with any birth,.. somewhat diminished nowadays as so many already know the baby’s sex.
There would be some discussion between anaesthetist, nursing staff, the surgical assistant and, sometimes, a student or two. Bets would be placed. Then someone would ask,.. ‘OK, Sir,.. tell us. What do you think it will be?’
Behind my mask I would try to give my most enigmatic smile and make my pronouncement.
I was always right.
There would be smiles and laughs and always the question,.. ‘You always guess right, Sir. How do you do it.’ I used to claim it was just my personal magic and wisdom. I didn’t divulge the secret until I was in my last day or two.
How did I know? It was easy. When I inserted my hand to sweep the membranes I would just feel whether or not there was a small male appendage to be felt in the relevant zone.
It was as simple as that. But as a prestige earner it was a gem.
DOC LEAVES Part Two:
Part Two - Opening Pages
Honi Soit qui Mal y Pense
[Evil to Him Who Evil Thinks]
Do you believe in evil?
I don't mean evil in the sense of someone doing something nasty. I mean, actual vivid, living evil,.. something that can take form, exert power and create malign influence over other things. The kind of evil you read of in old grimoires and religious texts. The kind of evil that is seen as truly the work of the devil and his foul entities.
I'm not sure that I do but there was one episode back in the mid-sixties when the passage of events came close to convincing me. I'm not a religious man but I report this story as near as I can remember, exactly how it happened.
One of my more engaging patients at that time was a semi-retired parish priest. Officially he was the Reverend Huw Medway. To me he was Huw and, although he was some twenty years older than me, we spent many a happy hour down on the marshes for a spot of rough shooting on the cold winter weekend afternoons. When it was near to dusk is the time the wood pigeons come swooping home from pillaging the farmers' best acres of cabbages and skim down into the trees to roost. That is the time to bag a few brace for the pot. There is no need for silence. You just stand very still under the branches and chat while you wait for them. It is a good time to talk, and Huw and I did just that. We talked about people, the villagers who were my patients and who had been his flock. He'd a fine education and a wild Celtic sense of humour. We enjoyed our time together. Even our gun dogs were good friends.
I mentioned that he was semi-retired for, since he had given up the day to day cares of the parish, he had become, quite officially, having been selected by the Bishop, one of the two exorcists accredited within the diocese.
Now it may seem strange to modern day thought that there should be such an official priest as an exorcist. Even more so that there might exist any reason for such a person to be needed at all. But that was the case. Huw was the senior of two official exorcists. He very seldom discussed this, to me, curious aspect of his life.
That's what made it all the more intriguing when he brought up the subject of the Chandler family. These were a group of people, patients of mine, all living in the same rambling country cottage, and amongst whom it was hard to work out exactly who was what and to whom. There were the two Chandler men, father and son, who were hard working chaps both driving heavy trucks of market-garden produce to the various city markets. They were rarely at home, at least when I called, and I never recall either of them ever being ill enough to take a day off. Then there were the womenfolk. A grandmother and her elderly sister, three or four women of middle age, three teenagers or thereabouts, and about six children who never seemed any more certain than I was who were their parents. It was the grandmother who was giving Huw cause for concern.
He'd first been called to the cottage some six months earlier after a call from the local curate. The curate, it appeared, had told Huw that the old lady was convinced she was being 'got at' by some wicked spirit or other. The parish curate had visited three times and found nothing amiss but, so insistent had been one of the younger women that her mother was genuinely troubled, that he thought it best to ask advice.
Following this, Huw explained, he also visited the family three times. On the first two occasions he had learned and experienced nothing, though he observed that, in retrospect, he had felt a sort of unease,.. 'More an unpleasantness in the surroundings,' he said, though he found that strange in what otherwise seemed a very contented if disorganised household.
It was on his third visit that he became more troubled. That time, just three days earlier, he had been phoned during the evening, by the woman who said she was the daughter, to say that her mother was having one of her episodes of being got at. Huw told me that when he got there, while he was still walking up the path and had not even entered the house, he had an oppressive feeling of cold and clammy despondency,.. as if he was having a fit of depression was how he described it. He said he had had the feeling as if someone had brushed against him while hurrying past him down the path towards the gate.
When he got inside the grandmother was sitting wheezing and gasping and looking very shaken. She expressed her gratitude that Huw had been kind enough to come, but, now that 'the beast' had gone there was nothing more to do.
Huw talked to the other women at some length. They told how her mother got these funny feelings about twice a week but that this particular evening she had been shouting and fighting and complained that she could not breathe. Huw's very sensible idea was that the woman might have been having panic attacks about something and that these were bringing on sort of asthmatic spasms.
I agreed that that sounded all very likely. The upshot of our chat was that we agreed that should it ever happened again that the Chandler family called, Huw and I would go together to the house so that I could help make a diagnosis.
We did not have to wait long. That very evening at about nine o'clock Huw phoned. 'It's the Chandlers,' he said. 'They sound to be in quite a pickle.'
I told him I'd pick him up in a few minutes,.. he lived only three hundred yards away. I did so and off we drove.
When we got there and went inside the entire female contingent of the family was there. I had to admit they looked pretty shaken. But at that moment I could detect nothing at all to be wrong.
The story was that an hour earlier they had all been sitting watching television when they saw 'a kind of shadowy shape' moving about the room. At times it actually seemed to touch or brush past them as it moved, they said. Apparently, after they had phoned Huw the apparition, or whatever it was, had disappeared and not been seen since.
The story left me entirely unimpressed. I had had, like all doctors, plenty of urgent calls to patients, who, upon my arrival, were able to report that they felt miraculously better. I could not see or feel anything the least bit odd apart from feeling the room was rather overheated. I certainly had no feeling of anything being wrong or unusual, let alone evil. However, I could see that Huw took it all seriously and was obviously concerned by what he was hearing.
He suggested to the women that they should all sit down and follow him in a prayer for protection. I did not join in but just sat quiet, watching them and listening to Huw. In retrospect I think my thoughts were that the whole thing was probably a mild hysterical phenomenon.
I quickly changed my mind.
All of a sudden old Grandma Chandler let out a gasp, then a cry. She was sitting rigidly upright in her armchair shaking from head to toe and making gurgling sounds. Then she began to flail and beat at the air just in front of her face and shouting. 'Help me. Take it away. Get it off me.' I started out of my chair and moved towards her. 'Get it off,' she shouted again, 'It's strangling me. Get it off me.'
She was struggling in her seat as if to try and get out of the chair and squirm down onto the ground. Her face was suffused and looked red as she tussled with whatever she could see and feel but which was invisible to everyone else. Next moment she was on the floor, eyes open and rolling, and still she tried to keep her hands in front of her as if to protect her throat.
Huw was astonishing. Without the least sign of panic he knelt down beside the woman and placed both his hands on her head. His erstwhile gentle prayers of mere moments before had died on his lips. This time his words were deep and resounding,.. full of a palpable authority. Later, at home, I tried to scribble them down as closely as I could remember. I still have the notes I wrote.
'Your name matters nothing, you evil creature,' he boomed. 'And you mean nothing. But I call the power against you that is greater than yours. In the name of Almighty God and the Holy Jesus Christ I command you to be bound,.. bound and shackled and to go back to the place appointed for you. I tell you,.. leave this woman. Leave this place and never again return. Do you hear me? I command you,.. be gone,.. now!'
The old woman shuddered again, several times, but she at once looked calmer. Then her face grimaced into a horrid snarl. In a deep and distinctly masculine voice she growled at us all, at me in particular, I felt. 'It's not finished,' was all she said. Nothing more. Her breathing returned to normal, as did her colour. Five minutes later two of the other women were brewing tea,.. though in my case I felt something a little stronger would have been welcome.
Huw wandered around the cottage repeating his quiet prayers and splashing all over the place from a plastic bottle of font water he had brought with him. When he too sat down for his tea he asked Mrs.Chandler if she could tell him how she had felt during the episode. 'I can't really remember,' she said. 'It was almost like dreaming. But I could see this horrible thing, - it was like one of those little mechanical tin dolls they have in fair-grounds. It was trying to choke me with its hands around my throat. I was frightened to death.'
Huw and I drove home talking about the event. We each had our own thoughts, but we agreed on one thing. This had been no ordinary bout of hysteria.
I dropped Huw off and, as I pulled into my own driveway I was surprised to see the light was still on in our bedroom. My wife usually turns in early if I have to go out on a call. Instead, when I went up, she was in bed with a book lying closed on the duvet beside her.
'Thank Heavens you're back,' she said. 'I've been really terrified.'
'Why? Of what? What happened?'
'Oh,' she said. 'I think I must have been dreaming. I went straight off to sleep when I came up. But then, in my dream, I dreamed that there was someone trying to get at me and the kids because you had been unfriendly.'
'I dreamed that I went down stairs and it was there at the bottom of the steps waiting for me. It was a dreadful feeling. It tried to get at me but I grasped it by the throat and tried to bang it against the wall. It was all sticky and damp,.. like metal that's been out in the rain.'
'Then I really woke up. And I couldn’t help feeling it was more than just a dream. It felt so real.'
'So what did you do?'
'Nothing, really. I just went into the kids rooms and checked they were sleeping. They were fine. But, don't laugh. I sat down by each bed in turn, gave them a kiss,.. and said their 'Gentle Jesus' prayers to them very quietly. Then I came back to bed.'
I asked her to describe whatever was the 'thing' she had dreamed about seeing at the bottom of the stairs. I'll never forget her reply.
Her very words were that 'it looked like a sort of ugly metal 'doll' thing.'
That story is as true as I sit here writing it. So, now I'll repeat the question. Do you believe in evil? You, as you sit there and read this? Do you feel a certain remote chill? A doubt, perhaps? A vague shadowing at the back of the mind that makes you just a little uneasy and uncertain?
Me? Even all these later I'm still not sure.
[THINKS: If you don’t pay your exorcist, do you get repossessed?]
This purported brush with the supernatural has, in fact, one special feature that helps reinforce my own belief that there is no such thing as ‘supernatural.’ Let me explain.
The second law of thermodynamics states, inter alia, that entropy [disorder] must increase. Numerous people who have experienced alleged supernatural events generally tend to mention the concurrent incidence of lower temperature in the zone around the manifestation. This would fit precisely within the requirements of the second law. Any ghost or apparition perceived by a living person must, in order to manifest itself and ‘appear,’ have drawn energy for that purpose presumably from the only available source,.. the nearby surroundings. [One reasonably assumes that ghosts don’t eat or digest food and derive energy from that source as would living folk]. This would mean that the energy for manifestation could be drawn only as heat and from the environment,.. hence the sensation of suddenly cooler surroundings.
And that is a perfectly normal and natural occurrence in full accord with natural, universal, physical laws.
Black on the Catwalk Published 2018
Funereal black on the Hollywood red carpets. Men who touch female knees condemned in the media without a hearing. Ethnic minorities that mustn’t be offended however much they merit criticism. Apologies from anyone, male or female, who was ever outspoken.
I just don’t believe it. How has it come to this?
The Equality Act 2010 rather vaguely defines sexual harassment and makes no attempt precisely to define some of the other words it uses,.. intimidating, degrading, humiliating. So how, exactly, do you abuse power? And where are the dividing lines between what is OK and what is illegal? No wonder that accusations are common while trials and convictions remain very few. And there are natural rules applying as well as legal restrictions.
In countless nature programmes males, everywhere, seek to attract females,.. an inclination also said to influence some female behaviour. It’s natural. Birds of paradise grow fabulous feathers,.. kangaroos indulge in displays of courage,.. men sport beards,.. and all these and thousands more costly physical attributes and behaviour patterns are designed under the influence of evolutionary pressures to attract the potential female partner. All this in exactly the same way as nylon stockings, and pretty underwear are expected to prove attractive to likely male contenders for partnership.
There is nothing wrong with any of this. And if, in some way, one or other of these features is offensive to you then it’s probably time you had a serious rethink.
Let’s get down to basic facts. Boys will always try to get lucky with girls. Their methods may be as simple as when, in the days of glossy hair slicked back with Brylcream or of kipper ties or blue suede shoes, they portrayed themselves as being at the burning edge of fashion. Others displayed bullying tactics against their associates in order to look the toughest in town. Some studied so that their brains and abilities would appeal to the more discerning of females. One way or another men will never stop trying to make it with girls.
When I was a medical student one of the things taught was that, where appropriate, one should make a physical contact with a patient,.. even if only by shaking hands or when taking a pulse. This made the relationship physical and more intense. [It’s a minor example of what biologists call primate-grooming]. The same thing, we found, worked with girls. Touch her hair as you pass her chair,.. hold her hand for a moment longer than necessary,.. take her arm crossing the street. These moves became embodied in much of what was regarded as gentlemanly behaviour.
The ladies too had similar wiles,.. the fluttered eyelids, the pursed lips and varied body language of early or tentative courtship.
Today it seems much of that has changed. But be sure it has only changed on a superficial societal level. Fundamentally nothing has changed the least bit.
Now, understanding these biological features does not in any way excuse the behaviour of rapists or wealthy or powerful men who use whatever prowess they possess to enhance their reproductive urges. But to a large extent it does explain them. Rich men have an easier time attracting women,.. as do healthy men and handsome men, and in just the same way as the head lion of the pride attracts his partners.
When we see someone as physically unappealing as Mr.Weinstein propositioning would-be young actresses it looks repulsive. But it’s just a different aspect of the same principle. Some of the women who co-operated with him really did make progress in their careers. Even if they regarded it as an unpleasant task at the time a fair proportion of these, we can assume, were quite happy with the bargain struck. Furthermore, some of those doing most of the complaining now seem to be the ones who didn’t enjoy quite such success. Whether that was due to a failure to co-operate or to an absence of talent remaining unsure.
The point is that men will always chance their luck. They are deceivers and sexual predators by design. Their biological impulses are wired that way. Approving or disapproving will make no more difference than legislating that dog shall love cat. The pressure stems from Old Mother Nature or the Almighty,.. whichever you prefer to blame.
Illegal acts like exploiting young boys or violence towards women should not and cannot ever be tolerated. Rape is a crime. But for a man or a woman to try to seduce someone, even persistently or clumsily, is not. And neither does a man making approaches to a lady comprise a chauvinist assault. We need caution in accepting the legally dubious hearsay about non-consensual contacts,.. and, likewise, the current Hollywood black-gear fluff and the indignant squeals and tantrums of the rather unrealistic femino-liberal sector.
Why do so many doctors drink?
It’s a question I have often been asked. I’m not sure there is an overall answer. I am sure there are lots of reasons,.. hard work, excessive responsibility, thirst.
I can only offer my own explanation. I was seldom a serious drinker, but, looking back and for the most part, the reason I drank was to try to make other people sound interesting.
One of my most memorable patients and friends was a lady named Sally Roles. She was of independent means the details of which I never knew. She was a tallish, smart, well-dressed lady of sparkling wit, wide experience and devastating charm. She was rather retiring by nature and was usually to be found gardening or walking her energetic Dalmatian dog, Prinz, across the fields and polders around her delightful cottage in the village of Finglesham.
Sally’s father had been in the Diplomatic Corps and was posted to Paris in the years immediately after the end of the Kaiser’s war. She joined the family there when she left school in England in around 1919.
She was always quite blunt about her life after that. Her mother was tubercular and spent most of her time just wasting away in bed, - there being no cure for TB in those days nor, indeed, any worthwhile treatment. If you got it you either made a spontaneous recovery or you died, and a miserable death at that. Sally’s father was a very busy man. The post-war years were filled with feverish activities over various punitive efforts like the lunatic reparations scandal, - Lloyd George, Clemenceau, Orlando [of Italy] and President Woodrow Wilson all intent upon outdoing each other at short-sightedly being beastly to the Germans. Sally was young, unsupervised, - and feverish. As she put it. ‘My ovaries must have been bouncing around like tennis balls.’
In about 1921 Sally married an up and coming young diplomat who had been introduced by her mother. It was Sally’s feeling that there had been something ‘informal’ between her mother and the young man though she admitted she was never sure. The marriage lasted less than a year. By the time it was over Sally’s mother had died and her father was pleased to be posted as soon as he was promoted to ambassadorial rank. In fact he never became an ambassador as he died in an insurrection in India two years later while attempting, literally, to read The Riot Act to some unruly natives.
At that point Sally was suddenly alone in the world but with a considerable income and a fiery zest for life. For her the Paris of the 1920s was the perfect place. Her second marriage, like the first, was rather brief. ‘Seven months I think it was,’ she told me. She had given up on her new groom partly because, like so many new grooms, he slept clean and partly because she was willingly befriended and bedded by a famous society photographer on more or less the same day, - a gent who’s name would be familiar to most readers even now. Several of the nude portraits he took of her still exist in books relating to that period. I, the present writer, am pleased to have one of the originals in my personal files.
Sally became well-known in artistic circles. She was attractive, shapely, wealthy, vivacious and promiscuous. ‘I had the very attributes that work,’ she said. ‘It was a hectic life but I was never able to take it seriously. It was too much fun.’
Before the 1920s ended she was married twice more. Once was to a man who threatened to fight a duel over her with a competitor. No such event took place, she told me, as the man who was sure to be the loser in fact shot himself. ‘I’m always trying now to remember which one of them was which, she told me with a grin. But just fancy men wanting to fight a duel over you. Quite goes to a girl’s head.’
Two of that first group of her husbands, dying some years later, remembered her in their wills with substantial bequests. ‘For all kinds of services rendered,’ she claimed.
I don’t believe Sally lied, - she wasn’t bragging about it at all, just stating facts as she recalled them about ‘My Paris period,’ but she claimed to have modelled for several artists including some quite famous ones. ‘There was Dali, rather later on before I came home for the first time. The gang used to call him Sally Two because he was a bit sweet on me. Then there was Pabbo, - you’d call him Pablo but he was Pabbo in those days, - Picasso that was. I also worked quite a bit for Ed Steichen. He was an artist too but he made his name and his money as a fashion photographer.’
Sally went back to Paris a few years later. ‘Things had changed a lot,’ she said. She married again in 1938 and with war drums once more sounding in the distance she and her husband left Paris and moved to Vienna. ‘He was a big business man and he thought we’d be alright there. But he was Jewish and we were lucky to get away six months later. He wanted to move to America – but I didn’t . We broke up just after the war started.
Two or three other marriages, or ‘Near misses’ as she termed them happened during the war years. ‘Then I lost Derek, my last husband, in Normandy,’ she recalled.
Apparently she moved about a good bit after that. Then, in the early 60s, she decided she’d had enough of the gay life and the bright lights. She bought a delightful if rather dilapidated cottage in a village just a few miles from Sandwich. She telephoned my office soon after that and asked if I accepted private patients. I didn‘t like private work but I accepted her just the same,.. she had a persuasive magic, and we became good friends over the several years she lived there.
Much of the rebuilding and refurbishing work on her cottage she did herself. Carpentry, a spot of stone masonry and brick-laying, electric wiring, even plumbing were just up her street. When it rained she worked in the cottage, when it was fine she worked in the garden. In less than two years she transformed the place into the most perfect English garden you ever saw. She didn’t own a car but spent her time either walking of rambling across the fields. Once a week a taxi took her to Deal for her to shop for her provisions. The taxi driver was, like most men, rather taken with her. So was the painter, the butcher, the postman and so on. As a said, she had a certain magic.
In all the time she was my patient, - about ten years, her records showed that she had received two bottles of cough mixture and, about once every two years a prescription for twenty five sleeping capsules. She said she needed them only rarely,.. ‘When my past sins catch up with me and keep me awake.’ I also remember recommending some Deep Heat, - a warming embrocation to rub into her shoulders when she’d been cutting brush or felling small trees with her power saw. She just loved to work. She also liked to entertain and many a weekend there would be one kind or another of smart car parked in her drive and which I would see as I passed by her place on my rounds. She never told me who these mystery guests were and the only one I ever met was one of her childhood friends, Julie, who lived about ten miles away in Ramsgate.
One day I well remember she asked me to visit her. When I got there it was to find that she had no medical problem but was concerned about security. She thought she had heard people in the garden at night,.. more than once. It was a very lonely spot. Knowing that I was a keen hunter and had several guns she wondered if I could get her one that wasn’t dangerous but which, fired into the air, would make the appropriate noises. In those days you could have bought a Browning 9mm automatic for a tenner so it was easy.
All around our area there were huge greenhouses growing mostly cucumbers and tomatoes. Stray birds easily got in through the ventilators and could do loads of damage. Every so often someone would therefore walk through and shoot the birds. In a greenhouse that can be a risky business, - how to shoot and yet not break the panes. The answer was a small pistol that fired tiny cartridges filled with shot that was just heavy enough to kill, or at least scare, the sparrows. The spent shot just rattles off the windows. I got Sally one of these and a box of rounds, - then I showed her how to load, cock and fire into the air. It was perfect for what she needed. Several times I enquired and she said it was marvellous insurance, - in fact, since she’d had the gun there had been no more unexplained sounds.
There is a sad and miserable ending to Sally’s story here. She requested a visit and when I got there she announced that she had found a lump. I had previously shown her, as I had most of my female patients, how to do a routine breast examination in the hope of making early and possibly life-saving diagnosis of any tumours forming.
I examined her and found a nodule so small that it might easily have been missed. It’s easier when the patient already knows where the lump is. I had no doubt that this was a simple fibro-adenoma, - a small lump of unimportant gristly stuff. It was inert and was no cause for alarm. Still, the diagnosis of a simple country doctor that everything was alright was clearly not to be relied upon. I therefore referred her to a colleague, - a general surgeon in Canterbury. She asked if I could be present during her ‘op’ so it was arranged that I would ‘scrub-up’ and assist my friend. The operation was simple and routine. The lump, - less than a centimetre across, came out easily and had no sinister attachments. It was sent to the pathologist to be fixed, microtomed, stained and examined under a high power microscope. It was, as expected, a totally benign chunk of nothing important.
There is always an element of relief, however sure the doctor might be, to see the completely reassuring report that everything is ‘all clear.’ I took the report to show Sally. Four times in the next six months she asked me to call again ‘Just to check everything is still alright.’ I did so,.. and it was. No re-growths were expected and none appeared.
On about the third visit I thought I noticed that she was somehow a little less amicably inclined to chat than was normal for her in our long and friendly relationship. Then there was a gap of several months when she didn’t call at all. I was vaguely anxious and decided that next time I was in the village with a minute to spare, - and as long as there were no cars there, I’d just pop in on the off-chance. By pure luck before I made the call she rang my secretary and asked if I could visit next day, a Saturday. She had some other arrangements to fit in, she said, and needed to time things fairly closely, - so could I call between nine and nine-thirty,.. about an hour before she expected Julie to arrive. I confirmed that that would be OK.
At a little after nine next day I got to her cottage and was somewhat surprised to see Julie’s car parked outside in the drive. It turned out that she had arrived an hour before the time planned,.. unexpected by Sally. As I got out of my car Julie came hurrying out, obviously flustered. ‘Come quick., Dick,’ she said. ‘Quick. It’s Sally. She’s in the bedroom.’ I hurried inside and up the stairs.
Sally was in her bed, calm and peaceful,.. but the briefest glance told me she was dead. I went through the usual routine of checking her vital signs,.. pulse – none, respirations, - none, temperature, - cool to the touch. I looked into her eyes with my ophthalmoscope. There were the tell-tale gaps in the blood supply network of her retinae. I took her temperature which, considering the air temperature in the room, told me she had been dead about six hours.
I went downstairs to phone the police. It was virtually certain that it was suicide but it was certainly a coroner’s case and the police were therefore the first step. ‘Did you see there was a letter for you?’ Julie asked. I opened it in front of her. At the time of writing this I still have it.
This is Sally’s letter less only a few personal words which I have erased.
I know from our long friendship that I can depend on you and I’m sorry our last contact is to give you yet another job. I arranged for you to come early so that you would be the first to find me and to make sure I don’t look too dreadful. Julie will come soon and will be a great help I know.
First, the package you loaned me [the pistol] is with others in my bureau. Please remove it and dispose of it as you see fit. No-one will notice that it’s gone.
You will have realised, I expect, that quite early on I saw through your well-meaning deception. I think you underestimated the tough inner me. I have been well able to stand up to the cancer business and now that it has spread I am not afraid of the circumstances. I am taking the quick way out not at all out of fear but in order to save everyone I know a lot of protracted trouble and inconvenience.
Dick, thank you for everything and, most of all, for being my trusted friend. Goodbye, and I wish you well.
PS: I expect you’ll get involved in the usual legal questions about my wicked deed. As you’ll eventually learn I’ve tried to make it up to you.’
I retrieved the firearm and put it in my anorak pocket. A few minutes later the police arrived. I knew the two officers quite well. ‘Morning, Doc,’ said one. ‘Hearse or ambulance?’ ‘Hearse I replied, ‘No hurry.’ That kind of familiar flippancy was common in those easy-going days when everyone knew each other The officer went out to his car radio, - they didn’t have hand-held mobiles in those days either. From then on everything was pure routine. Check the body in front of witnesses, identification if possible. Regular procedure. I was able to sign a death certificate as she was well known to me but, of course, it could only be signed after the inquest.
The coroner and I were old acquaintances and, for the most part, everything was routine. The verdict was predictable,.. ‘Suicide while the balance of the mind was disturbed.’ That was always the verdict in those days. If a person took his or her own life,.. a crime against the law and against God, it was held that it could only be while the balance of the mind was disturbed. Normal, sane people didn’t do such things. To me, and in this instance, that was simply not true. Sally’s arrangements had been carefully planned and executed. Every detail had been considered. Her farewell letters had been written and had been posted the day before. She had tied up every loose end meticulously. I could not agree that she deserved the stigma that her mind was disturbed. To me, she was in full possession of her faculties. She had simply decided to end her life.
As a result I declined to be a co-signatory to the accepting of the verdict. I went on record as raising objection to the disturbed balance bit. At the time it caused something of a stir but, during the following year or so there were numerous other serious objections to the routine and anachronistic phraseology. The phrase was later phased out.
Sally was dead. I missed her. Gradually other things about her were discovered. We had never known of her many secret good deeds. Of down and out locals helped financially. Of local charities supported. About the three old people she visited regularly with home made cookies and for a little encouraging chat.
The saddest thing of all to me was that all the way through Sally had been wrong. I had not been keeping things from her. She was all clear. The coroner’s post mortem, not conducted by me, - confirmed the total absence of any malignancy anywhere.
It also showed gastro-intestinal contents including about ninety sleeping capsules, - almost all of those that I had ever prescribed for her over ten years,.. carefully hoarded.
In her will Sally left me a thousand pounds, - no small sum in the Sixties. But it’s not that for which I remember her most. It was for her wild sense of humour, her endless reminiscent stories of a glorious if chequered past. And it was for one special remark that so very few people I knew could ever have delivered.
I had once commented, with a wink, about the strange cars I occasionally saw. ‘Aha,.. old spouses mostly,’ she said. ‘They pop in from time to time.’ I must have looked a bit quizzical for she then said, ‘Oh yes. I’ve always remained on the best of terms with all my husbands.’
In many ways, - but not in others, - Sally always reminded me of another unusual and memorable lady patient. I shall call her Miss Coates for reasons that will become understandable. Miss Coates was a living remnant of the days of the Great British Raj when India was still the jewel in the crown. Her father commanded a brigade of Bengal Lancers and the pictures of him on horseback leading the 1903 Royal Durbar show him as a ramrod straight horseman in full regalia, all stiff upper lip, bristling moustache and pork chop whiskers.
Being daughter of this renowned field commander made Miss Coates very much the darling of the regiment and she had many a tale to tell of escapades at the Governor’s Ball or in the Viceroy’s Summer Palace. The endearing thing about her tales was that she always spoke precisely and without hyperbole. There was never a strong word and even criticisms were expressed politely as if over afternoon tea, - cucumber sandwiches cut very thin and with the crusts trimmed off, - cream scones and Earl Grey tea drunk with the right little finger delicately raised and hooked.
As she was careful to point out every event related appears to have been conducted with complete decorum and according to the pecking order of rank accorded one’s status. ‘There was never any actual hanky-panky,’ she often assured me. ‘Whatever was done was done after an exchange of calling cards on silver trays,.. and mostly with white cambric gloves on.’
‘The things they do these days are quite disgusting,’ she once said. Then, almost in the same breath, ‘The subalterns blues were so tight they were forbidden to carry even a pocket handkerchief so not to spoil the line. But oh, Doctor, the effort was rather flattering. Most revealing. And when they were mounted,.. ooh those marvellous horses could have some pretty disturbing effects.’
Miss Coates had been married to a young captain,.. ‘He was so dashing. He won the Delhi Tent-Pegging Cup in 1899’. The story of her marriage was short but tragic. She and Herbert were married in the cathedral and with much pomp and circumstance, then, after a lavish ball they travelled by carriage and with full military escort,.. ‘All the officers of his regiment, - no other ranks,’ on an all night journey to an official Assault at Arms in Gurugaham some twenty miles away. Herbert was captaining the lancers polo team. ‘What a wedding night,’ she said. ‘We hardly saw each other.’
By eleven o’clock next morning the horses had been unloaded, fed and watered. The officers and their ladies stood around drinking lemonade until it was time for the first chukka. The game plan involved Herbert walking at a slow pace to be ready to receive a swift pass. He had taken but a few paces when his horse bucked, - probably stung by an insect, they thought. Totally unprepared for such a sudden move Herbert was instantly unhorsed. He fell almost in front of the now calm animal, landed on head and shoulder and never moved again. His neck was broken. Herbert died where he fell. And from that moment Miss Coates resumed her maiden name. To use her own phrase, ‘I went just a wee bit off the rails after that.’
When I knew her Miss Coates lived in a tiny self-contained bed-sit on permanent loan from the wealthy owners of a big house in Sandwich’s Mill Wall Place, Group Captain Guy and Mrs.Jane du Boulay. Some members of her family had been long term staff of her benefactors and, knowing her of old, when she was reduced to penury they took her in and cared for her. Ranking families used to do that sort of thing for their unlucky servants in those days, - it was a kind of noblesse oblige. In fact Jane, the lady of the house, used to visit Miss Coates virtually every day. She often sent meals around. And the domestics who cleaned the big house also ‘did for’ Miss Coates. In fact many a time I saw Jane roll up her sleeves and do the difficult or messy jobs herself. She too, was an astonishing woman, loved and highly thought of by many,.. very much including myself.
It was from her little pied-a-terre that Miss Coates entertained all comers with her often wicked tales of the sub-continent. I heard tales of ‘bedroom swapping’ and of the way the virile new officers were ‘initiated.’ The fiercely applied rules of decorum, it appears, were strictly observed, - but, she explained, ‘That was mostly downstairs. Upstairs could be very different.’
One day she asked me, ‘Doctor, did you ever see that one of the Aldwych Farces,.. what was it called,.. something like ‘The Cuckoo’s Nest?’ I explained that at the time of those famous West End plays I was about five years away from getting born yet ‘Well, that’s a pity, - it was really very like that. In the middle of the night there were always bedroom doors opening and closing somewhere or other. One way and another we didn’t always get much sleep.’
Looking back I have the feeling that Miss Coates rather enjoyed the kudos she accrued from her Rabelaisian tales, some of which were really pretty vivid especially coming from this sweet and demure seeming old lady.
Some little while after she died I was chatting to the Group Captain and I mentioned my doubts. We exchanged recollections of some of the stories and the names we’d heard from her. I commented that one female however rampant and randy could hardly have done so many such things.
‘Oh,.. I don’t know,’ he replied. ‘It’s hard to confirm them all of course but I’ve often heard that she was quite famous and much sought after for a decade or more. She was seen with all the top people, - officers, colonial bigwigs and even the occasional Viceroy or two. In fact she was famously known as ‘The Romp of Simla’ and ran the most salacious soirées ever seen in the sub-continent. She’s referred to by one name or another in no end of books of fiction as well as historical memoirs. Be sure that the Romp of Simla once carried very high acting rank indeed.’
What a girl.
Ker-ist-offer Robin Published Sep., 2016
When I was a little boy I loved Christopher Robin [CR]. I remember one story where he was a little lad getting bullied and he consoled himself with the lofty thought that ‘When I grow up one day they’ll need my help,.. and when that day comes I’ll forgive them and help them.’
What a bloody wimp. Sounds like a Social Worker. And it was A.A.Milne’s own son,.. Christopher Robin Milne around whom all these stories about Pooh, Piglet and Eeyore were fashioned. There were several books,.. The House at Pooh Corner, When We Were Very Young, Now We Are Six,.. and so on all of them relating his ideas, ramblings, rhymes, drawings and chicken-livered behaviour patterns.
Why remarkable? Because CR was, in fact, a wretched, spoiled, poncey little twit who talked to himself and wore a sun hat and leggings. He was pretty girly and had absolutely no street cred whatsoever. He didn’t climb trees, there is no record that he ever farted and he never used naughty words. He wouldn’t have said ‘shit’ if he had a mouthful. He was actually about seven years old and he’d not yet even been introduced to Guinness. He never had anything to do with girls.
His idea of a cool dose of Saturday Night Fever was to go for a nice walk with Nanny. They’d talk about good wholesome things like porridge for breakfast and changing the guard at Buckingham Palace. When they’d finished all that walking they’d sit under a tree in the orchard and drink cool lemonade. Or, if it was winter that would all happen in the nursery and the drink would be hot milk or cocoa.
He didn’t have a computer or an iPhone. He didn’t tweet or have a Facebook page. Word was what dictionaries were full of. Windows were for gazing through into the middle distance. Texting was many blissful years into his future. If you mentioned xxnx he probably thought they were Roman numerals.
When he went for walks he always kept his feet dry and he absolutely never got dirty. Furthermore he always got home on time. When he wasn’t walking he rode his tricycle, - the one that had a little basket on the front handlebars in case he wanted to bring home some bluebells for Mummy. His trike had a dainty wee bell he could ring with his little finger if he needed to keep somebody out of the way of his breakneck speeding. He always had a clean handkerchief. He wore sweet little shorts that showed his little sissy knees,.. and he didn’t even care. He’d once had iodine on his leg that jolly well stung.
He always said his prayers before bed and he’d even kneeled down to say them. His main prayers were always for others,.. especially that God would send lots of warm clothes to all those ladies who didn’t have any,.. like he had seen in the books Grandpa kept in the bottom drawer of his desk. He also went to Sunday School and he knew ‘Gentle Jesus’ and similar maudlin tripe off by heart.
He thought that crumpet was those soggy bun things you could toast in front of the nursery gas fire on cold afternoons when Jack Frost had been about. And he could play Snakes and Ladders,.. and Snap. Sometimes he talked to animals or,.. and I kid you not, to flowers and trees,.. a bit like that Prince of England that they wishfully call Prince of Wales does.
Next door he had a little friend named Mary. He’d roughly figured out that she was a bit different from him,.. probably something to with her pink socks,.. and things. It remained something of a puzzle though that she didn’t have any of those girly sort of wobbly bits on her chest, - like Nanny had.
Saturday night was always bath night followed by Ovaltine while Mummy and Daddy listened to ‘In Town Tonight’ on the wireless. He slept with his teddy-bear,.. named Pooh,.. so called because he was a bear and he smelled accordingly. Bears tend to be like that.
Fundamentally speaking CR was a dead loss. He was more like a girl really and totally uncool. Today he’d never get as far as the corner shop before someone would throw sand in his face, half-heartedly mug him and nick his Saturday sixpence and his mobile phone.
Of course this nauseating nostalgia does not work today. Now we are all able to stand a little headlong irreverence and rude words, insults and dirty jokes.
Well,.. aren’t we?
I suppose that for most medical students, much like for any other young people, the first sight of a dead body comes as a bit of a jolt. In every way I can think of there is such a great chasm of difference between a living and a dead human. Even the old, tired, gently departing person might, right to the end, exhibit some features of life. Be the eyes closed and the respirations brief and shallow the feeling that life is still present is unmistakable.
The change that takes place in the moments after death are equally so. Death itself is an extremely brief, - even momentary event. The moment before it happens the person is alive. The moment after the person is dead. The transition, and I have witnessed it many times in very different circumstances, takes place in an instant. From my experience of it I would suggest that whatever might have preceded it, it is not the death that is feared so much as the fact of afterwards being dead, - and forever.
My grandmother, who died ridiculously young, I had seen the very day they put the lid on her coffin. It was a brief and emotionally overflowing moment. She was, apart from my own mother, the only woman I really knew and at that time I loved her more than any other woman alive.
After that the next corpse I saw was the first day when, as an extremely junior pathology student in my second year in medical school, I first walked into the mortuary-cum-post mortem room in the Cardiff Royal Infirmary. It was a shock to the senses in a number of ways. About ten mobile slabs or gurneys were spaced around the room. These were on lockable wheels so that they could be wheeled up to the observation glass screens that partly separated the room from the students benches. At any time most of the gurneys had a body on top of them, some already being autopsied while the others waited in turn, - and very patiently.
It is a recognised and very sound principle of medicine that a great deal of one’s eventual knowledge derives from the time spent in the post mortem room. Consequently, at any time there were sure to be a number of students engrossed in the proceedings and examining the organs that were brought to the screens to be demonstrated.
Post mortem [PM], - Latin for ‘after death’ was the more common name for the procedure in the old days. Autopsy has largely replaced that as it avoids any mention of the word ‘death.’ There is no other difference. By far the majority of PMs are just matters of routine. Some may be needed for insurance purposes or where, as in cases of coal miners suffering from silicosis, there is a question of state compensation to be assessed, quantified and paid to the family. The coroner may require a PM if he or the police doctor have even the least grounds. This may happen when someone dies in somewhat unusual circumstances, - or if the deceased had not been seen by a doctor for a long period before death occurred. Many PMs are done as part of continuing research into various medical concerns. Other than by coroner’s order a PM can only be conducted with the consent of relatives. No body parts, - with the exception of very small laboratory samples for further examination, may be retained without similar permission. Apart from such samples all organs and parts of organs must be returned to the body when the procedure has been completed.
If there are suspicious circumstances, - anything from unexpected death to cases of public notoriety, the PM is often conducted by a widely experienced pathologist. He will pay attention to factors not of the run-of-the-mill kind. He and his forensic assistants will vacuum the hair for clues from dust, chemicals and the content of the hairs themselves both of recent growth or those that grew months earlier. Ears and other body orifices will be meticulously examined. There will be a search in the webbing between toes, behind the back teeth and in the walls of the rectum just inside the orifice. These are all sites chosen for the injection of poisons. Intestinal contents, lung linings and sexual organs will all be under scrutiny and tissue samples will be taken from several areas for subsequent histological [microscopic] examination. Pre-existing or recent pathology, the presence of injuries, the skin discolouration will all be searched for and recorded in minute detail. It is a skilled business in the hands of a qualified expert.
That said, most PMs are not like that at all. They are just simple routine examinations needed for some reason, - legal, statistical or, sometimes, mere curiosity. Commonly the pathologist will dictate his findings as he goes along as his hands are usually not in a suitable condition for note-taking.
‘The body is that of a well-preserved, average weight, white male. Post mortem lividity [a discolouration of the skin caused by gravitational effects on the blood after death], is present in the dependant [lower] parts. There is no external sign of injury or abnormality.’ That might well be the start of a routine report. The body is turned this way and that to check, confirm and report the way in which it was received for autopsy. From this point on the procedure is not for the squeamish.
The first incision is just skin deep and runs in a near straight line from immediately below the larynx [Adam’s Apple] down to the pubic symphysis, - the ridge of bone that marks the lower border of the abdomen. Unless there is good reason the spot below the larynx is the start point as, if it extends above that point, it becomes harder to conceal the incision later on when the undertaker prepares the body for viewing by the family. The long cut also deviates a little around the umbilicus [navel] as that way it is easier to open the abdominal cavity. A two-inch snip in the mid-line and immediately below the breastbone [sternum] now opens the cavity itself. The pathologist will usually insert two fingers of his left hand into the hole, part them, then run his blade downwards between the fingers. This protects his fingers which slide down behind the knife while the fingers also push the abdominal contents out of the cutting path to prevent lacerating the bulging and often gas-filled intestines and thus preventing premature release of the rather offensive odours that will come later.
The slack margins of the abdominal incision are now, in turn, folded back away from the midline thus deflecting the body wall skin and muscles outwards and pulling them away from the margin of the rib cage. The knife is then used to separate both skin and muscle of the chest wall from the bony parts of the rib cage itself. The process is exactly the same as when you see a butcher slice the same tissues away when he is exposing the area to make spare ribs. This is done on both sides.
It is usually the job of the assistant, if there is one, now to open the chest, - thorax. Using a simple carpentry saw [tenon saw], - though nowadays a low speed electric circular saw can be found in the better places, - a saw cut is made down through the ribs from and including the collar bone [clavicle] to the bottom, - then repeated on the opposite side. The breastbone and attached rib stumps can now be lifted off exposing the heart and lungs inside. It often comes as a surprise to inexperienced spectators that there seems to be remarkably little blood about. Dead bodies don’t bleed much, - they just ooze a bit.
Next, the internal organs must be removed. A knife with a fairly long blade is slipped up alongside the larynx then passed around, fore and aft, to sever the muscles around the throat. The tongue can now be grasped and drawn down into the open chest wound, - rather in the fashion of the so-called Mafia Necktie. With little or no strokes of the knife the entire mass of tongue., trachea, heart and lungs now pulls easily away from the posterior wall of the thorax. By cutting through the diaphragm sheet of muscle the liver, spleen, stomach and intestines can be drawn out and put aside for further examination thus leaving the chest and abdominal cavities more or less empty.
If deemed necessary the skull must now be opened for examination of the brain and major blood vessels that supply it. A single incision is made up and over the top [vertex] of the head from just behind one ear and then back down to just behind the other. The reason for this route is, again, largely cosmetic as the re-stitched wound is not too difficult for the undertaker to conceal. The assistant next grasps the forward flap of scalp and tugs it forward until it lies, rather grotesquely over the forehead and eyes. The action is similar to the familiar N.American Indian method of scalping except that the scalp is merely displaced rather than completely removed as a trophy. The rear part of the scalp also comes away quite easily and is pulled back to form a second flap over the back [occiput] of the head. The bone dome of the cranium is now widely exposed.
Before the arrival of the electrical circular saw the next step required the use of a ‘coronet.’ [It is still quite widely used is less well-equipped facilities]. It consists of a foldable circlet of metal which fits loosely around the skull from about the level of the forehead bones to the bulging of the back of the cranium. Adjustable thumbscrews anchor it into position. Using this rigid frame as a guide a saw is now used to saw all the way around the skull. The skullcap lifts off quite easily and the pathologist will now examine the exposed brain before separating its nerves and the spinal cord and completely removing the organ for closer examination.
Each pathologist will have his own routine but most will complete work on the near empty body carcass next as this gives the assistant chance to get on with re-stitching and making good the scalp incision.
The main arteries passing along the posterior abdominal wall will be checked for evidence of damage by ‘hardening’ [atheroma] and maybe for specimens to be collected. Likewise he will take out the kidneys and carve them into thin slices. The urinary bladder too remains in its natural position and will be opened and observed. There will also be need to check the internal and external sexual organs in some instances with close and detailed attention.
The assistant can now get on with his job. He will pack the empty skull with something, crumpled newspaper or old cotton waste, to stop the skull cap wobbling as he stitches the scalp folds back over it for appearance sake. Meanwhile, the pathologist will carefully slice the brain and the heart looking for the blood clot blockages or hardened arteries or, in the brain, for signs of haemorrhage from a stroke, - these being very common causes of death.
Other internal organs, liver, spleen, intestines and pancreas will all be closely checked and perhaps further specimens reserved for the laboratory. Then it’s time to pack the shredded but unwanted organ remains back into the cadaver so that the long incision can be re-stitched using cord, a heavy curved cutting needle and a simple over-and-over stitch. After that a thorough hose and sponge down will restore the body’s external appearance ready for handing over to the undertaker’s disposal team.
Post mortem examinations are seldom an exciting branch of medicine. Some doctors, indeed, never become accustomed to the task partly because it can be a pretty smelly business but also, very often, because of the psychological stresses it can produce. Personally I never found the task particularly unpleasant and I’ve done many hundreds in my lifetime. Mind you, I had a very good start as a senior pathologist in my hospital group, Dr.David Stern and his ribald assistant technician, Phil Wheeler, taught me the tricks of the trade long before we got around to that stage in medical school. I owe them both great debts for techniques taught and wisdom passed on so freely and so effectively,.. and for the numerous small fees thus collected for my services..
The worst case I ever had was once when, in a small village in Wales, a local man had disappeared for several days. He was found late one Saturday evening after spending almost a week on an exposed hillside decomposing in the hot summer sunshine. The local police decided that they need swift answers to some questions as to whether there might be grounds for suspicion of foul play. I was the only available doctor without a good excuse to decline the job, - that weekend I was the only duty doctor on call at the local hospital. Rotten luck. And believe me it was a rotten job carried out on a more or less rotten corpse. The smell was dreadful and despite vigorous swimming and showering it lingered for days. I do not propose to relate the details. Suffice it to say that I found no suspicious circumstances and the coroner agreed it was ‘death from natural causes.’
At least I got my name in the paper,.. and a very welcome fee.
THE LOVE [and Sex] BOOK : A collection of deliberately, highly erotic short stories. Strong adult fiction,.. but all based on stories and people encountered in the Sexual Medicine sessions of Dr.Dick’s own consulting rooms or those of colleagues. A mine of information on strange habits, deviations and perversions. Exciting,.. and extremely informative, too. [These stories are also available in cassette or CD form]. Be warned though,.. these pages may not be suitable for all tastes. Recommended only for the broad-minded and unshockable reader.
PSYCHIC SEXUAL COMMAND by Dr.Bryan d'Gwent MD: This book is NOT a gimmick! Written by a British physician it tells of secret techniques of influencing others remotely, without their consent or even knowledge. Personal, business and sexual influences can be exerted on others to make them behave in thoroughly co-operative ways often against their will. Actual instructions and scripts are included of deliberate psychic attack which can seriously curtail or harm victims by a morally foul but, in most countries, perfectly legal method! If you train to become adept at these procedures things will never be the same again.
THE MALE CHAUVINIST’S COOK BOOK by Dirty Doctor Dick [MD,.. yes, honestly] and Surly Shirly Pardoner: Being 500 recipes, tips, ideas and general clues for getting her into bed,.. and feeding her too. Very funny and having such good recipes and helpful hints, it really was written by Dr.Dick [who is also a cordon-bleu chef in his own right] and a lady already famous in the world of haute cuisine. The basic premise is that 'the road to the bedroom door lies through the kitchen.' The whole idea is to offer flagrantly chauvinist advice to male and female alike. Recipes to tempt her, trick her, induce her,.. and, with luck, seduce her. Packed full of good ideas [for all sorts of things] and a riot of humorous entertainment,.. it tells you how to cook things, too.
THE PENIS by Dr.Dick Richards MD: This is the Thirteenth [and latest] Edition of this, perhaps the most definitive book on the male human sexual organ ever. Earlier editions have sold over three-quarters of a million copies! Now completely revised and re-written by the original author. It embodies not only the original entertaining data and wit but includes full details of the most up-to-date methods of penis training, enlargement and skilled erection techniques. Also wide coverage of sex aids, energising rings, unusual sexual techniques, problems of the penis,.. and, yes, The Female Penis, too.
I CAN MAKE YOU HAPPY,.. in just THREE DAYS by Dr.Richard Silurian MD: A practical handbook of home and self-hypnosis. The book they tried to ban,.. for twenty years. Tells how it can be easily learned and used on self or others. How to control obesity, treat insomnia, stop smoking, combat stress, build immense ego and confidence, and so on. Also how to overcome sexual handicaps like premature ejaculation, impotence and female frigidity. Actual scripts that can be used by anyone. Also public performance of hypnosis, complete with tricks and features that are simple to perform. Also shows how to overcome resistance to hypnosis,.. how to hypnotise someone who is not willing to co-operate.
THE HUMAN APHRODISIACS by Dr.Steven Roles MD; Oh yes,.. they DO exist. Many genuine aphrodisiacs are available right now and are easier to find and safer to use than most people imagine. It is all part of a well-kept secret, - accurate data has been purposely withheld from the public. This book contains medical data, and witty and entertaining anecdotes,.. PLUS the exact details on how and where anyone can obtain real aphrodisiacs and use them cheaply, safely and PERFECTLY LEGALLY. Everyone can now increase and replenish the sexual repertoire.
AGE and SEX by Dr.Richard Silurian MD. The population is getting older,.. but today it is a population already accustomed to plenty of sex and which is, consequently, unwilling to lose its enjoyment. There are plenty of safe ways to slow down anti-sexual problems of ageing. The author, a Consultant Physician in Sexual Medicine for thirty years, shows how. Also details some strange and uncommon techniques of sex that can expand the sexual repertoire and prolong activity on and on and on. A MUST for the over-50s; a revelation to the young too.
MALE IMPOTENCE and the TWENTY MINUTE MIRACLE by Dr.Richard Silurian MD: For a long time there has been need for a fully detailed book on this subject,.. the most common serious affliction of men in Western society today. The expert author explains not only how impotence happens but shows how it can often be actually prevented. He also details the methods of treating the condition medically and surgically, and, most important of all, he explains fully the method, known in U.S.A. as 'The Twenty Minute Miracle Method for Men,'... the ONLY known way that guarantees vaginal entry for impotence sufferers in only twenty minutes.
DOCTOR'S BOOK of SEXUAL HEALTH TIPS by Drs.Dilys and Ridgard Wales MDs: Widely regarded as the ultimate and definitive book on sex for all readers, including professionals in the health industries. In alphabetical order this book covers an enormous spectrum of questions, answers, programmes, and remarkable data on every important subject to do with sex. Everything that matters is covered, - from frigidity, problems of the menopause, how to control weight, how to relax and meditate, how to achieve orgasm and extra sensitivity of the genitals, male and female,.. all for the purposes of maintaining and improving the sex life.
ADVANCED SEX and EVERYTHING YOU WANT TO KNOW ABOUT IT Edited by Dr. M. F. Holmes MD: In the trade this book is familiarly known as 'The Monster,' because that's how extensive and how crammed it is with useful material. Concentrating thoughout on aspects of 'Advanced Sex,',.. everything about the more exotic and uncommon sexual techniques now widely in use in certain of the more experienced sectors of society.
IRRITABLE BOWEL SYNDROME and its Home Management by Dr.Hugh Cross MD: The very last word in explaining, avoiding and treating this distressing condition that now affects the lives of over five million people in the UK alone. Orthodox and alternative methods are thoroughly detailed and then assembled as parts of an integrated yet simple, home-management programme. Held by many doctors and patients to be the best book of its type. Don't give up on the problem, for until you have read this book you have not tried everything!
HYPNOSIS TAPES At our associated medical clinics our physicians make cassettes with many different purposes. Regular, general purpose tapes are available to address a number of subjects. One favourite is a simple music tape but with virtually undetectable, sub-liminal messages counter-recorded into the music to help overcome obesity and over-eating. Its effects are truly remarkable and many have experienced the way in which those extra kilos just quietly disappear seemingly without any dietary effort. Or, tapes can be made individually to combat particular personal problems like under-confidence, smoking, sexual frustration, low female libido, impotence, vaginismus and premature ejaculation. (Clients are encouraged to write to the physician involved with details of their problem and needs). These latter are personalised cassettes; not cheap mass-produced tapes but the result of years of skilled experience in the use of therapeutic hypnotherapy.
THE LOVE BOOK TAPES: Our unequalled series of Erotic Short Stories. This is a collection, on audio-cassettes, of highly erotic short stories,.. but with a difference. There is no outright pornography,... only erotography, - a style intended to provoke, entice and stimulate the reader but stopping short of the kind of language so often used in erotic literature. Virtually no strong language is used, the emphasis being on subtle and sensual arousal instead,... a rare commodity. Each tale is based on a common story heard in the Consulting Room, a common female sex fantasy or a typical sexual incident in a woman's life. One concerns loss of virginity, another- sex with a stranger, another- sex with an older man, another- enforced sex, another- unusual sex with a long-term partner,.. and so on. The stories will certainly prove erotic for men. For women they are fascinating, stimulating, even arousing,.. and, furthermore, they are highly instructive. They make remarkable bed-time listening,.. and that in itself, can have astonishing and rewarding results. A wonderful gift from a man to his partner,... or vice versa. The stories are recorded by a well known voice from the entertainment world,.. see if you recognise him.
[Two cassettes. Sold together or separately].
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