So! We’ve finished with school and covered my starting at university, with my inadequate science background safely behind me. Middlesex Hospital Medical School—an ambition achieved! As they say, ‘Be careful what you wish for!’ However, I enjoyed the first three years very much. As before mentioned, I had to do a full year of what was known as ‘First MB’—now abolished, as I and about 20 other students had not done science at A-Level so we all had to do a crash course year on Chemistry, Physics, Biology and Physiology. Then there was another two years of preclinical study, before the last three years ‘on the wards’ doing the clinical course in many different firms and specialties.

I very much enjoyed my student life out of the hospital and even—much of the time—on the course. However, all the time I looked forward to this clinical three years as being the ‘real medicine’, as in a way, it was. On the course itself in those years, there was much that I—a rather lively but oversensitive, very naive young woman in the 60s—found extremely challenging

When life occasionally became intolerable—such as when the patronising scorn of some of the tutors became too much to be borne—I would creep off and find my new cronies, who were the cleaners for the medical school, just like it had been in my holiday job. Dear ladies, I spent many happy hours when I should have been studying, tucked in your tiny broom cupboard, out of the supervisor’s line of sight. I might choke in the constant cigarette smoke, but I knew you accepted me—and my gifts of chocolate—for who I was, even though I had no clear idea myself of who that might be.

Later still, when I started working ‘on the wards’, I found it daunting and a great disappointment. I had enjoyed my pre-clinical in lots of ways, but always waiting for the true, the real, the WORK with patients.

The sick people were fine. What I hated was the attitude of the staff: to me, to the patients, to each other. The nurses (all female in those days) hated the female medical students because they saw us as competition for their designs on the doctors. The male medical students were testosterone-filled rugby playing bulldozers, in competition with each other and everyone else in the world. The senior doctors were unsympathetic, they didn’t see why they should be nice to anyone; they’d had it tough, so should we. The House Officers (first level junior doctors) were just exhausted all the time.

The patients knew their place, which was at the bottom of the pile. Most seemed creepily dependent and demoralised. Stroppy patients had a bad time.

Of course, all this was only very partial truth. Many of the young male medical students were as scared and subdued as I was. Not everyone hated me, nor did I hate everyone. Nevertheless, the London teaching hospitals at that time had a bad attitude. I had been brought up in an old fashioned way, to respect everyone of any age or class. I was used to speaking politely and being spoken to politely. Those brought up nowadays, in the rough and tumble of comprehensive schooling, must be much more able to deal with sneering, sarcasm, scornful sexist remarks and a general belittling of one’s abilities and intelligence. Even so—was there really any excuse for the way we were taught? I was bewildered to be scoffed at for ignorance from day one on the Clinical Ward rounds, before having had a chance to learn anything.

I dealt with it badly, withdrawing inwardly and spending as little time as possible in the company of those who treated me like this. So, I didn’t shine, particularly in certain ‘Firms’ and did well in only a few. I felt more comfortable with old-fashioned courteous consultants, who simply ignored you politely if you didn’t conform to the norm. Since the norm was male, rugby-playing, ambitiously desperate to come top, I didn’t really stand a chance to conform to it anyway.

So, it was hardly surprising that I tended to spend a lot of time doing things other than those I was supposed to. I hated the morning rounds. We were expected to be standing in a group by the door of the ward for when the Consultant in his white coat swept in, no matter how late he was (they were virtually all male). I was bolshie enough to believe my time was as valuable as his and just about tactful enough not to say that, but to ask the Ward Sister if I couldn’t go and get on with talking to the patients. They would never let us. It was the last remnants of the old way and it was slower to go at the Middlesex than at most of the other hospitals. The Middlesex, I found when I delved into its history, had been the last teaching hospital to admit female students. It did so, grudgingly, only when compelled by law and still took the absolute minimum required. It also had the ‘proud’ distinction of having refused to receive Florence Nightingale, the heroine of nursing in the Crimea!

I did love talking to the patients on the wards and in the outpatient clinics, but alas, this was not so much for their fascinating cardiac complications and abdominal diseases but for their conversation and their life stories at a time when they were raw and open and vulnerable. I already knew I wanted to practice psychiatry—though my ideas on it were vague and mostly wrong. If I could have realised that what I was doing was both a humane approach and a valuable base for my career, I would have been happy. I only knew I was constantly crossing invisible boundaries in my sitting with patients, always neglecting what I was supposed to be learning, losing confidence in myself more and more.

It took me a long time to fully recognise that I did not need to avoid the skills and knowledge of being a doctor in order to treat people as individuals and I needed all that knowledge and skill as well as a respect for my patients. More importantly, that outside the rarefied and artificial confines of the London teaching hospitals there were plenty of doctors and nurses too busy to play competitive games and too caring to ignore so completely the humanity of their patients as in the big London teaching hospitals, even if the pressure meant that patients often did get poorer care than they should have.