Post 15 Life as a resident at Manchester Royal Infirmary in the 1960s

Thursday 5th July 2018 marks the 70th Anniversary of the NHS so this week, instead of relating a story, I offer you a bit of history; a factual account of my life as a resident doctor 52 years ago.   The year was 1966, the year in which England won the World Cup.   Could this be some sort of omen?

Having qualified as a doctor, I was appointed as a ‘houseman’ at Manchester Royal Infirmary.   For 12 months 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 - but in those 12 months, I learned more about medicine, and indeed about myself, than I had in the five years I’d spent at Medical School.

Between 60 and 70 patients were cared for by two housemen, who worked on a clinical unit, 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, I was on duty continuously  from 9 am on Friday morning until 6 pm on Monday evening, as well as 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 during the night and by Monday, 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, in addition to our other duties, we became the casualty officers through the night.  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 doctors’ 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, by common consent, 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, 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 surprising for this was the decade that came to be known as the ‘swinging sixties’ though we were working too hard to notice!   Within a week we had arranged that we all dine together.   The food was waitress served, it 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 were coffee stained and worn.   This was where we relaxed when ‘off duty’ and where we passed the time when waiting for calls when ‘on duty’.   At one end there 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 to be many years before hospitals adopted alcohol policies. At the other end of the lounge was a veranda. It overlooked the junction of Oxford Road and Denmark Road where ‘ladies of the night’ often congregated.  Bets were sometimes taken to estimate how long they would be absent when ‘off-station’ providing innocent amusement for weary housemen.

We were in the same boat, all suffered the excessive hours of duty, shared the same anxieties and exhaustion and all felt abused by the regime under which we worked.   But it was here that camaraderie developed as we survived by a combination of bloody mindedness, dark humour and dogged determination, much as young squaddies survive 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 candle lit lantern held atop of a shepherd’s crooks. 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 revue of songs and sketches; an ideal chance to have some fun at the expense of matron and the hospital consultants.

We were paid £750 a year for our labours, 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’d 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.

I have written four novels based on my life as a junior hospital doctor in the 1960s and 70s.  For further details see the Home Page.


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