A little bit of theatre

HEARTBEAT: Recent controversies involving the Minister for Health and almost every branch of the medical profession prompts …

HEARTBEAT: Recent controversies involving the Minister for Health and almost every branch of the medical profession prompts a revisit of the old story about the proud mother watching her son in the passing-out parade for a group of army recruits. "Look father, they're all out of step but our Johnny."

Matters political and medico-political, are not, thankfully, the whole world, and I can take refuge in memory and reminiscence, which although sometimes selective, cannot be altered.

The moving finger writes; and having writ
Moves on; nor all your Piety nor Wit
Shall lure it back to cancel half a line
Nor all your Tears wash out a Word of it.

Fitzgerald's Rubayiat of Omar Khayyam simply expresses the fact that the past cannot be altered, although it may be re-interpreted.

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But to return to the incontrovertible and unimportant happenings of my student days. The last installation culminated with my success in curing the patient with the tapeworm, which occurred during my resident year as a medical student. Lots of other memories of that first hospital year come back to me. It was very demanding, particularly in university term time when we not only had our hospital duties in the mornings, but also lectures in the afternoon.

To add to your woes, you might then be rostered for casualty or hospital cover that night. It was not, of course, that our presence in the hospital or casualty department was necessary, or possibly even desirable, but it was one of the best ways to learn about patients and hospital life. In this year also, we received our initiation into the new world of operating theatres. I did not realise the operating theatre was the place I was to spend most of my working life.

Some of my fellow students did not like this environment; some were indifferent and some were; like myself, fascinated. At first, in theatre you were in everybody's way.

The awkwardness started with changing from everyday clothes and white coat into theatre scrubs. As the student changing room was small, this was akin to six people changing simultaneously in a telephone box.

Footwear consisted of plastic overshoes, or you inherited ancient clogs or rubber boots. Some of this ancient footwear dated back to Viking times and a fatal dose of athlete's foot was an ever-present possibility. A face mask and a cap or hood - more likely the latter, since these were our long-haired years - completed the outfit. These were cotton and re-usable. There were few disposable items in those days.

Finally, fully changed and feeling very self-conscious, you ventured forth into this busy, brightly-lit world, where everybody else seemed to know what they were doing. As for consultant surgeons, they were really gods and could not be expected to notice insect life.

Finally, someone would notice the huddled group of students. "Which of you is working for Mr X?" You would suddenly realise that you were in the firing line and grimly acknowledge your presence. "You will be needed to scrub up and assist." A brief prayer - "O Jesus, let me not make a complete balls of this," - and on rubbery legs you took the next step, to be initiated into the mysteries of washing hands and forearms in a sterile fashion and then donning your surgical gown and rubber gloves.

This sounds relatively easy, but believe me, it wasn't, or otherwise I was seriously deficient. The basic premise was to keep the unwashed non-sterile bits away from the washed, gowned and gloved you. As a gentle exercise, try putting on your gloves without touching the outside. We must have de-sterilised enough gloves, gowns and drapes to affect the hospital budget for years to come. Our instructors, usually nurses, tended to get exasperated and impatient as we, at what then seemed the nadir of our careers, struggled to put gloves on five-thumbed hands.

If you were unlucky, the operation would be over before you joined the fray and you became even more an object of ridicule and contempt. Otherwise, finally cleaned and dressed, like the turkey, you were propelled towards the action. "Touch nothing other than the green drapes," you were commanded. "Oh God, you clown, come back here and scrub again."

In time, we became more comfortable and less maladroit and even, dare I say it, useful. The interest grew with the involvement. It was then that I knew I wanted to be a surgeon.

Dr Maurice Neligan is a cardiac surgeon.