Heart Beat It was time to resume the medical pathway, having taken an intermission to undertake a B.Sc.(Med) degree - a year I thoroughly enjoyed. This brought a new class and new friends. It also brought my first real introduction to hospital life, writes Maurice Neligan.
In my wisdom, or lack of same, although living on the south side of Dublin, I became a student at the Mater Misericordiae, Hospital on Eccles Street. This involved a lengthy commute from home and also time-consuming journeys between the Mater and Earlsfort Terrace and other medical locations.
It was a decision I never regretted. My first student clinics there were attended in 1957 and I retired from the Mater as a consultant in 2002.
What follows, should not be taken absolutely literally. Any impression given of chaos and disorganisation is erroneous, in fact it was a highly structured and regimented existence or so it was meant to be.
Medical students, on the other hand, are an unruly and wilful lot and the introduction to the regime of the hospital proved interesting.
Our first exposure lay in attending clinics, both on medical and surgical patients. These were approximately one hour long and were held in the mornings including Saturdays. The afternoons were spent back in Earlsfort Terrace grappling with a range of new subjects, some interesting, some less than fascinating. Sadly, they were all deemed necessary on our path to graduation.
It was a broad curriculum and inclusive of nearly all medical disciplines. It was no mean feat to keep it up to date given the almost daily advances in medical science but by and large that has been managed well to date. It is an area which requires continual watching and recent plans to change entry to medical school to so-called graduate entry seem inappropriate as of now for many reasons, Bright students do medicine and this is as it should be.
To dumb down the profession will serve nobody well, least of all the patients. However, the issue of dropout from medicine post- graduation and, even more alarmingly, from nursing must be addressed and certainly more attention must be given to the vocational element as opposed to the purely academic. This is a subject to return to, as it is extremely important.
In the hospital hierarchy, the medical student is the lowest form of life. One counted for nothing in the beginning other than being a nuisance and later when you became a resident student you were a source of initially incompetent but free labour. You were expected to know your place, keep out of the way and jump when ordered. Becoming quickly hospital-wise, we adapted as lesser organisms do, to ensure our survival.
Initially, we presented in pristine white coats of which we were expected to have several and in possession of our very first stethoscopes, some of which were about as effective as an udder on a bull. We also had some high-tech gear like a pin, to test the sensation of pain, and a small piece of grubby cotton wool to test the sensation of touch. Moving up market, we had a tuning fork to test vibration sense and a percussion hammer to test reflexes. These latter instruments came in various shapes and sizes, many apparently having been inspired by the Gestapo. A vital component of our kit was also a pocket torch, a functioning battery was entirely another matter.
God only knows what the unfortunate patients thought of the visitations visited upon them by the tyro doctors. I am forever grateful for their tolerance and forbearing that allowed us to learn.
The clinics initially were given by the bedside in the ward, with the students pressing around the bed, while the clinician exhibited the physical signs of illness or taught us how to properly take a medical history.
A major fear was being required by the consultant to demonstrate these skills before your classmates and indeed the patient. A hard lesson learned that way was not easily forgotten. I well remember a zealous overseas student who travelled under the bed to stand nearer the consultant, and demonstrate his enthusiasm and skill. We canny Irish closed ranks around the bed and he spent an uncomfortable hour underneath.
So we had got to the bedside, we had seen our first patients, we were being instructed by lofty beings. What happens next? The worm's eye view of the medical student will continue.
Dr Maurice Neligan recently retired as a leading cardiac surgeon