Of course if they ran a tramline along the North Circular Road from the cattle market to the quays, value would go up like a shot - (Joyce in Ulysses)
YOU WERE ahead of your time Mr Bloom, but at least they're talking about it now.
As young doctors in the Mater in Old God's time we were not really familiar with your journey despite the fact that it originated in No 7 Eccles Street, the site now incorporated into the Mater Private Hospital. I am sure we would have been more interested in your "good puzzle would be cross Dublin without passing a pub". That indeed would have been a challenge to be relished and planned.
Summer was different in hospitals. The pace slackened and occasionally you deluded yourself into thinking that you enjoyed a reasonably normal life. The miasmas of winter, the accidents of the dark and icy days were distant memories and even those on duty occasionally had a full night's sleep.
We did not share the tribulations of the final-year students having passed successfully through the flames ourselves but we did take an interest in the final exams as much of the organisation of the clinical component fell upon our shoulders.
We were expected to oversee the histories and case notes of the patients selected for the exams and to explain to them that their participation was essential for the maintenance of standards for the doctors of the future. This was seldom a problem and most entered willingly into the system.
Some were very enthusiastic and immediately informed the exam candidate of their putative diagnosis and the tests they were undergoing. Trouble was their knowledge sometimes did not match their empathy and could be very misleading for the candidate. On the other hand, there were those who felt that it was the embryo doctor's task to diagnose their problem and were sparing almost to taciturnity in their replies. Needless to say, all the students prayed for a garrulous sympathetic patient who knew everything about their condition!
There were other murky methods to help the afflicted students. Tradition founded on common sense dictated that the students should not be examined in their own teaching hospital. Furthermore, the students to be examined might come from any of the three medical schools in the city; accordingly a further tradition of medical freemasonry evolved. Late in the evening before the clinical exam, a little group of students would assemble at the hospital in question where a conspiratorial registrar would read a list of what was likely to be encountered the following day.
To this day, I can recall the strained faces and the furious scribbling as they grasped this final straw. Entreaties to be calm and hold the head went unheeded as they headed back to meet their classmates and plug the remaining gaps in their knowledge.
It should have been foolproof. It wasn't. Tales of students trying to persuade a reluctant patient to acknowledge a condition which they did not have were legion, and this in particular failed to impress examiners who in their own time had passed through the system.
The addition of a few extra patients on exam day or a change of ward could cause consternation. In vain as invigilator you counselled them to calm down, take the history and do the physical exam as they had been trained and that everything would be alright. You explained that the examiners were far more inclined to pass you than fail you. You might have saved your breath. The truly paranoid believed implicitly that those bad bastards of consultant examiners had, as their mission in life, to do down the unfortunate students.
I remember one fine day, sunlight streaming through the tall windows of a Nightingale ward, a diligent and very capable student conducting an examination of the nervous system of a patient. The examiners arrived at the bedside, listened to the history, expressed their satisfaction and were about to move away when the professor asked the student to demonstrate the knee jerk reflex.
Simplicity itself you might think, but then things started to go wrong. The patellar hammer locked in shaking hands and aimed at the tendon just below the knee landed on the shin exacting a yelp from the patient and winces from the examiners. A second attempt landed in the region of the groin.
The student, sweat pouring down his face turned to the examiner; "It's very hot in here Sir, would it be alright for me to remove my jacket?" "By all means," replied the examiner, "You're behaving like a navvy, you may as well look like one."
The inconsolable student passed easily and the great men laughed through the examiners' lunch.
Maurice Neligan is a cardiac surgeon