We are still in the medical training years, but things of course changed radically for me when I met Roger Tudway, my first husband. I met him in my penultimate year at medical school. I remember talking to this loud, smiling, crazy-looking student in the dinner queue and learning he was in the year behind mine. He had trained first in Cambridge, where at that time some students did their pre-clinical training before coming to London for the clinical years, so though he had only just come to London, he was in the group just a year behind me.

He had a strikingly mobile, handsome face. To my surprise, he seemed to pop up all the time after that. Roger later told me that he had lost no time in checking out my timetable and pursuing me relentlessly. He made me laugh, we could have long serious conversations, he was intelligent, we shared tastes in music and books and just hanging out together. Within days he sent me a Christmas card with verses from the Lord of the Rings—a clincher to a fan of Tolkien like me. In a few weeks we were deeply in love and completely committed to each other.

We married in October 1961, in London, thanks to the support—particularly the continuing financial support—of my parents. The medical school took a dim view of such an activity and when, as commonly happened, one or other of us had to spend a few weeks ‘living in’ or working in another hospital, no provision was ever made for a couple: indeed it was actively disapproved of. Remember, by this time I was 24 years old!

Our wedding day was happy and full of hope, though much had to happen before any real stability was possible in our lives. In addition to the lengthy time for all medical students, mine was extended to some seven years by the ‘catch-up’ year of First MB and then an extra year at the end by my failing my finals. After that came the obligatory ‘Houseman’ year, as a Preregistration Doctor, before being fully registered and able to start specialist training. In those days there were no set schemes, whereby you had a certainty of remaining in one place, so even if you could afford a mortgage, it was pointless until you became a Consultant, or at least a Senior Registrar with some security of tenure for three years.

So, we took a small flat in west London, though we both continued socialising in the Community Centre for a while until Megan Etholan and Bysshe got married and left. The next major change came when I—at last—successfully passed all my final exams and obtained a post, for a year, as a Prereg. House Officer in Hereford, with six months’ surgery first at the County Hospital, then six months’ general medicine at the General Hospital. Roger stayed in London, or at his parents’ house in Bristol, with occasional weekend visits.

This ordeal was known as ‘house jobs’. At that time, barely regulated or managed properly. You think I’m joking with the word ‘ordeal’? Three of my young colleagues died during (or just after) this year of incredibly tough work—from a heart attack, suicide, and car accident when sleep deprived. I knew of several more who had severe mental health problems after, always hushed up of course.

The atrocious pressures and risks taken with our health and abilities in that time drove me, a few years later, into medical politics and Chairmanship of the Junior Hospital Doctor’s Association to fight for the rights of these doctors. But that, as they say, is Another Story for Another Time, though recently several young doctors have written highly informative and witty accounts of their hospital times.

We junior doctors bonded well on the whole and helped each other out wherever possible. Another kindness, until the workload defeated it, was the good attitude of one of the Ward Sisters. She was in charge of the Uro-genital ward at the General Hospital and had seen countless first-year house officers come in green with ignorance and go out with, hopefully, the rudiments of surgical practice. She had no time for bumptious know-it-alls, but if you spoke to her with respect and asked her advice she taught you everything you needed. She did it very tactfully too, particularly in public. “Dr X likes you to do such-and-such for his patients,” she would say, as if it was a personal quirk you couldn’t be expected to know and not some vital piece of basic practice!

So—those were the touching and good things. However, I can do no better for the bad side of this than describe the situation in my last month of that first six-month period, at the end of my surgical placement.

Basically, in those days your contract was to work all week, with one official 24 hours off, but the understanding was that the on-call rota would mean two or three other doctors sharing the out of hours work. In practice, if they became ill or left, you could find yourself as the sole front line doctor for several wards and emergency-covering the rest. Older Consultants seemed to have no idea, either, of how much more complex the investigations and treatments were than in their day and expected you to carry on regardless. I was extremely conscientious, particularly over calculations—always my potential weak point.

There may well have been other near misses that I never found out about, but to illustrate the constant ‘Disaster Waiting to Happen’ of this way of ‘managing’ a medical service (if you can call it that), here is the true account from the last of my six months in that job. One day, the Consultant Surgeon suddenly discovered, in a side room, that a postoperative patient nominally in my care was so dehydrated that his blood was like tar. The nurses, who collected the daily ‘fluid in and out’ data, apparently never read it, the Ward Sister who would usually be a backstop for inadequate medical care was on holiday. There happened to be no Registrar cover either. The patient, rehydrated, fortunately made a full recovery so there was no official enquiry.

The Consultant questioned me and found that for the previous three weeks, the two other Surgical House Officers, who had only just started, were absent—they were a married couple and I think the father of one of them had died. I was doing the routine work of three junior doctors: single-handedly looking after two acute surgical wards, four orthopaedic wards, and the ENT ward, day and night. All I could do on my own was dash from crisis to crisis all the time, wherever I was called, to deal with collapsed patients, diagnose acute surgical crises, catheterise patients and put up drips. Whenever I explained and asked for help, I was regarded with indifferent disapproval and simply told to carry on.

Oh! And during this time I was also on-call for Accidents and Emergencies: the Casualty department as it was called then. The General Hospital in Hereford took all the surgery and most of the Accident and Emergency work for the whole area.

My opposite number was Harry, a kind, solid young man who went on eventually to become an army doctor. He was the only other doctor sleeping in the residency and covering all the general medical wards, also on his own. We shared the on-call for the Casualty department alternate shifts, day and night. There were some senior house officers second on-call. On paper, we were meant to have that one night off a week. In practice, there was only a thin partition between Harry’s room and my own. Every time one of us was telephoned, both were woken up.

Called to Casualty, one might find anything, from nose bleeds or choked-on fishbones to heart attacks and other life-threatening conditions. Because the General Hospital took in all the trauma cases for Herefordshire, we also had to deal with broken limbs and life-threatening injuries, usually victims of farm disasters or major traffic accidents. Of course, we called on the senior doctors, even the registrars and consultants, as soon as we had dealt with the life-threatening bit.

Normally all of this work was shared between at least five junior house officers, but by the time of these dreadful final weeks, there were only the two of us even for the first line Casualty Department. Six months earlier, I wouldn’t even have had a clue how to cope. Now, Harry and I helped each other as much as we could and stopped complaining after being told off every time.

The extraordinary thing was that until we nearly lost that poor patient, no-one seemed to have noticed or taken responsibility for the situation. If I failed to respond quickly enough to a Casualty call, a more senior doctor would be there before me, very angry but oblivious to my explanation of dealing with a crisis elsewhere in the hospital. I was constantly the recipient of snarling fury from nurses waiting in Casualty, nurses waiting on wards, and Consultants angry because they had no junior to assist them in theatre anymore. In vain, I had tried to point out the problem. No-one listened.

I could hardly sleep for adrenaline, even if I wasn’t called up. I had virtually stopped eating because the constant interruptions gave me indigestion. Over the six months, I had lost nearly three stone in weight. Talk about skeleton staff! I was living in a twilight state; a disaster waiting to happen.

The day they found that poor Mr X was almost dehydrated out of existence, his Consultant looked thoughtful and went off without a word. If I didn’t get any sort of apology, I didn’t get a reprimand either. The next day, a couple of locums turned up, one of whom dropped a tray full of instruments on the floor during an operation and gave three consecutive patients an infection. Soon after that, I finished my first six months and went on holiday with Roger for a fortnight, before my next house job. We went to a little B&B in the country, where I ate and slept most of the time.