A Missionary Doctor's Autobiography
In 1949 I enrolled in the University of Cape Town Medical School. The first year, was spent at the University main campus and was really a "Pre-Med" year, with Physics, Chemistry, Zoology and Botany (listed in order of preference!) Physics was exciting, Chemistry interesting, Zoology tedious and Botany was torture! In medieval ages, doctors used to pick their own medicinal plants and make up their own potions, but what was the use of studying Botany in the middle of the 20th century? As might have been predicted, at the end of the year, I did well in Physics and failed Botany! Fortunately I was allowed to proceed without having to repeat the exam. It was the only subject that I failed during my medical training.
During the first quarter of the first year, all new male students had to wear yellow ties and females, yellow ribbons. This was part of the initiation process, which I believe is fairly common world-wide. Those living in the university residences had to undergo some bizarre and rather unpleasant rituals. I was more fortunate, living off-campus. I stayed with my Uncle Bob and Aunt Jeanette, whom I have mentioned previously and travelled to and from "'Varsity" by bus, hitch-hiking and later by bicycle.
Zoology practicals caused travel problems - this was when I was still in the bus or hitch-hike stage of travel. After an afternoon of dissecting a dogfish, one's hands, clothes and books would be saturated with a distinctly fishy smell. One couldn't expect any kind motorist to give such a smelly student a lift - it would probably put him off fish for life! Travelling by bus was just as bad - there would be noses wrinkling, heads turning and then fellow travellers moving away to a far corner of the bus. That was when I decided to travel by bicycle - at least, that way, there was plenty of fresh air.
Chemistry lectures provided an interesting glimpse of human nature. An enterprising student of previous years had taken down the lectures in shorthand and produced a complete set of notes. These were duplicated and sold. This relieved one of the need to scribble furiously as the lecturer spoke, and maybe helped to preserve some semblance of legible hand-writing in the aspiring doctors. There was one problem - the notes were copied verbatim, including the jokes. The lecturer became very annoyed when students started laughing before the jokes were even told!
It was during the first year that I persuaded a friend, who was a third-year student to show me around the anatomy department at Medical school. I wanted to see what I was in for the following year. The sight of partly dissected bodies, laid out on their marble slabs did not upset me, but there was a characteristic smell, a mixture of formalin and methylated spirit, which seemed to permeate the department. What rather upset me was the sight of a whole vat-full of bodies and one being hoisted out by his feet! I did not have nightmares; in fact, I think it was a good experience, as I had a better idea of what was in store the next year.
Second year involved mainly anatomy and physiology. At last we were getting into subjects that could be definitely related to "becoming a doctor". Physiology practicals included a number of experiments in which electrodes were attached to the ischiatic nerve of a frog's leg and tracings of the contractions were made on a smoked drum. I wonder if modern medical students still do these experiments, or do they just watch a video recording? At least that would be better for the poor frogs!
Anatomy proved to be more interesting than we had expected, although the first few weeks were a real trial - learning a new language. One no longer said "front to back"; it was "ventral to dorsal". "Medial", "lateral", "superior" and "inferior" all seemed so artificial, but one soon learned that precise terms were necessary in order to describe medical entities. For instance, an injury to "the stomach" could colloquially mean anything from a bruise to the lower abdomen to a stab wound of the anatomical stomach.
The dissection room was rather daunting at first, especially the smell, but we soon became accustomed to it. Toward the end of the year, there were a few students who would eat their lunch in the dissection room, while their partners carried on with the dissection! I must admit that I always preferred to wash my hands well and get into the fresh air before eating.
The following year was remembered mainly for the Pathology lectures and practicals. Pathology means the study of disease processes and it was interesting how students would suddenly "develop" the disease they were studying about. One night, soon after we had gone into all the manifestations of tuberculosis, I had a fever and profuse sweating. Convinced I had TB, I went to the student's clinic but was told it was an ear infection, for which I was given Sulphonamide tablets.
The practical part of pathology was mainly attendance at post mortem examinations. Most students had a rather queer feeling the first time they watched a fresh body (as opposed to one that had been "pickled") lying on the slab and being cut open for examination. At our first attendance at a P M, one of the tallest men in the class fainted and fell through a plate glass window, requiring stitches to his scalp. (Yet, he continued with his studies and graduated with the rest of us).
The other main subject that year was Pharmacology - the study of medicines and their effects. The practicals consisted of making up a prescription, not by taking a pre-packed box of pills from the shelf, but by taking the individual ingredients, weighing them and grinding them together with a pestle in a mortar, then measuring each individual dose into a little paper square, folding it correctly and labelling it. We also learned how to mix ointments and make emulsions, such as orange flavoured emulsion of castor oil!
The following year was devoted mainly to the diagnosis and treatment of "medical" diseases. I was very proud of my new stethoscope, although at first I didn't know what I was hearing!
Gradually we learned to distinguish the various heart sounds - normal and abnormal, as well as the various sounds in the air passages. The terms "gallop", "machinery murmur" and "amphoric breathing" were rather grand; in time we learned to distinguish them.
Mastering the art of examining a patient was a formidable task. My first patient was a female with acromegaly, diabetes, hypertension and cardiac failure, who was also obese! I was rather shy and having to hold up a pendulous breast in order to listen to the heart was an ordeal. It took several days to examine the various systems - circulatory, respiratory, digestive, musculo-skeletal, etc. and record the findings. Why could I not have had a straight-forward case of pneumonia or heart failure? But that is the way one learns!
Fifth year was concerned mainly with "Surgery" and its various branches such as ENT and Orthopaedics. Obstetrics and Gynaecology, as well as Psychiatry, made it a busy year. I found the visits to the Psychiatric Hospital, on Friday afternoons, very depressing.
Other "minor" subjects like Ethics, Psychology, Dermatology, Paediatrics and Ophthalmology were incorporated in the last three years - I cannot now recall exactly where.
The final year was a grand revision and putting into practice of what we had learned - in preparation for the final exams.
In recalling my medical training, I have gone ahead of my story, and will now return to events that happened at the end of the fourth year.