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NHS 70 – Life as a junior doctor the last time football ‘came home’

Wednesday, 04 July, 2018
NHS 70 – Life as a junior doctor the last time football ‘came home’

Victorian plumbing, no emergency department, no intensive care wards, 100 hour weeks and discounted beer in the ‘doctors mess’ – Dr Peter Sykes recounts his experiences as a ‘houseman’ a decade and a half on from the NHS’s founding.

In July 1966, the hospital became, not merely my place of work, but my home.  It proved to be the most daunting, exhausting and at times frightening year of my medical career.  During those twelve months, I learned more about medicine as a preregistered ‘houseman’ and indeed about myself, than I did in the previous five years spent at Medical School.

Between 60 and 70 patients were nursed on each clinical unit. They were cared for by two housemen who worked under the supervision of the consultants.  We worked on the wards from 9 am until 6 pm each weekday but in addition, one or other of us was required to be ‘on call’ for our patients at all times.  This meant working on alternate nights and alternate weekends.  Once a fortnight, therefore, one of us was continuously on duty from 9 am on Friday morning until 6 pm on Monday evening, as well as working two nights during the week.

These were the days before the advent of intensive care units so very sick, seriously ill patients were nursed on the general wards.  Inevitably we were disturbed a couple of times in the night and by Monday evening, after 80 hours on duty, we were utterly exhausted, both physically and mentally.  We were terrified that we would make some catastrophic clinical error and afraid that if we did, the circumstances in which we were working would not be recognised.

Unfortunately, the housemen had another cross to bear.   In the 1960s, emergency medicine had yet to develop as a speciality.  The casualty department was run by clinical assistants, often local GPs, during office hours and by the house officers out of hours. This meant that once every three weeks I became the casualty officer through the night (in addition to my other duties). There were, of course, more senior staff available in their rooms who could attend if required, but on the first night I undertook this duty, having been a doctor for precisely eight days, I was the ‘first responder’ for a catchment population of half a million people.  It was a crazy system; it wasn’t safe for the doctors and it certainly wasn’t safe for the patients!

As housemen, we lived in the doctor’s residency, always referred to as the doctor’s ‘mess’. We had our own rooms, sparsely furnished.  It chanced that two of the housemen were married to each other (the term ‘houseman’ applied to all, regardless of their gender) and they were allocated adjacent rooms. Understandably they rearranged the furniture to have one room as a bedroom, the other as a sitting room. However, each day, when they returned to their rooms in the evening, they found that the Irish maids had returned one of the beds to its original place.  It seemed that they didn’t approve of cohabiting.  It took the production of a marriage certificate before their concerns could be allayed.

The bathrooms were communal and the plumbing Victorian.  Fortunately, my prostate was not a problem at that time so I never needed to visit during the night!  There was no shower, simply a large cast iron bath in the centre of the unheated bathroom. When you removed the plug from the bath, the water ran into an open gulley then across the tiled floor and out through a hole in the wall.

When our group of housemen arrived there were two dining rooms, one for the male doctors and a smaller one for the girls. This was strange in a decade which came to be known as the ‘swinging sixties’ (though we were working too hard to be ‘swingers’). Within a week we had arranged that we all dine together. The food, waitress served, was tasty and wholesome and kept hot for us when we were late for meals – as we frequently were. There was also a television room, (black and white, of course) and a snooker table.

The heart of the ‘mess’ was the lounge; a large room furnished with numerous old sofas and easy chairs, their arms pockmarked by cigarette burns, the cushions coffee stained and worn. It was where we relaxed when ‘off duty’ and where we passed the time when waiting for calls when ‘on duty’.  At one end was the bar where beer, supplied by the local brewery at a discount price, was available twenty-four/seven. There was a ‘serve yourself and sign the honesty book’ policy and incredibly at the end of each month, the amount of beer consumed always tallied with the total in the book! It was many years before hospitals adopted alcohol policies.

All the housemen were in the same boat, all suffering the excessive hours of duty, sharing the same anxieties and exhaustion and all felt abused by the regime under which we worked.  But it was here that a camaraderie developed as we survived by a combination of bloody-mindedness and dogged determination, much as young squaddies survive under the discipline and hardship administered by a belligerent sergeant major. And it was this togetherness that resulted in lifelong friendships.

Once a month we held a formal ‘mess dinner’, donned our best clothes and invited one of the consultants to give an after-dinner speech. If they gave us a lecture on secondary hyperparathyroidism or some such academic subject they weren’t invited back. Those who amused and entertained were always welcome.

Once a month we also held a mess party in the lounge.  Dim lights, loud music and a well-stocked bar were essential ingredients.  It was the only occasion on which the nurses were allowed into the doctor’s quarters.  At all other times, they were barricaded into their own residency.

Christmas was a special time in hospital in the 60s. A carol service was held in the hospital chapel, after which the nurses’ choir toured the hospital singing carols. Before they arrived on each ward, the lights were dimmed, then the nurses entered, side by side, each with a candlelit lantern held atop of a shepherd’s crook.  It brought a tear to many a patient forced to spend the festive season away from family and friends.

Christmas was also an opportunity for the resident doctors to present a review of songs and sketches; an ideal chance to have some fun at the expense of matron and the hospital consultants.

For our labours, we were paid £750 a year, from which £250 was deducted for our food and accommodation. It wasn’t a lot, our hourly rate made us the worst paid employees in the hospital but surprisingly at the end of the year, I felt quite rich. I had been so busy working with little chance to spend and most of it was happily sitting in my bank account.

All in all, the year was a kaleidoscope of different emotions; high highs and some very low lows but undoubtedly the most memorable year of my medical career. It was, however, not one that I would care to repeat.

Reproduced here with authors permission, all rights reserved. Follow Peter @medical_stories and find more lighthearted medical stories at: