Wednesday 28 December 2022

The Sane Psychiatrist. (or, it ain't easy being a shrink!)



   It's not easy being a shrink.  Nobody ever let's you forget it.  Everyone is just a little apprehensive, that you look right through the skin and fat and bones that shelter the few pounds of jelly in your skull that determines everything you think and do.  They think you know just how vulnerable it is - and you do!!  I have a thousand stories of the strange results of its gyrations.



The Manipulator
 



     I hadn’t seen my cousin Peggy McGoldrick  since she she came over  from Dublin to visit us in Canada in 2012, the year after her divorce.   She was staying with a friend in Toronto, convalescing from the effects of a two-year marriage which had gone sour after a few months, and that took longer to recover from than the marriage had lasted.   Maggie and I live on a small farm two and a half-hours drive from Toronto.   When her father, my Uncle Jimmy, phoned us to suggest  that  since she was in Canada we might like to have her visit us, ("you know, it would help her to get over things"), we were more than willing to do so.   My Uncle Jimmy was a special person, despite his idiosyncrasies, and was especially kind to Maggie and me, eons ago, when we were first going out together.   He was a great fly fisherman and had often tried to interest me in that art when I was a kid.   The problem was that if we didn’t catch something in the first thirty minutes I rapidly lost interest.       Anyway, Maggie phoned Peggy, and in her warm and welcoming way she soon convinced her to spend a week or two with us.    
     She had been a spoilt kid as I remembered her, but she turned out to be good company and we had a nice couple of weeks together, despite her underlying post divorce blues.   She had a great sense of humour and if ever I gently nudged the conversation in the direction of her marriage, she found a good-humoured way to firmly steer the conversation in another direction.  She wasn't having any snooping from me!  However, when we were saying our good-byes, her parting words to me were “since you’re such an expert on marriage, maybe someday we’ll see if you can evaluate what went wrong with mine.”

I had in arrived in Dublin a couple of days earlier for the funeral of an old friend and to fulfill my commitment as the executor of her will.  For various reasons Maggie couldn't come at this time so I was on my own.  I phoned Jimmy soon after my arrival in Dublin and he had invited me over to dinner.

“Mary’s away too’, he said when he heard Maggie wasn’t with me.  “Come over and I’ll show you what a good piece of fish should taste like.  I’m a pretty good cook you know and I caught the fish myself.”

 I arrived on Sunday evening and was surprised when Peggy, his daughter opened the door delightedly. 

“It’s good to see you, ”, She said.   “It’s been a long time”.

“Yes,” I said, “I've tried phoning you several times when I knew I was coming but never actually managed to connect.



It was a fine dinner and Uncle Jimmy made much of the facts that he’d caught the trout and shot the partridges, and talked as though he’d cooked the whole dinner, even though I knew it was Peggy who’d done most of the work.   We talked a lot about the good old days, and the more we sipped our 'Bushmills Black' the better they seemed.

“And what’s new with you, Peggy,” I said.

“Quite a bit,” she said happily, “ I’m getting married – again” and then, more seriously,

“You remember, when I visited you in Canada a couple of years ago and you said to me that that we could discuss what happened in my marriage, and I brushed it aside mainly, I suppose, because I just wasn’t ready yet- too painful.   Well, I think I’m ready for that now.   I know that things are going to be right with Hugh, but I still think I should learn as much from my failure as possible.    Does your offer still hold?”

“It certainly does, “ I said, “after all, if we don’t learn from our mistakes we are doomed to repeat them, and this is a good time to do this, if it won’t embarrass your Dad.”

     I glanced over at Uncle Jimmy.

    “It won’t embarrass him,” she answered for him, “will it, daddy?  It’ll just bore him to death.  He and Mom lived through all that too, and I don’t think I could ever have gotten through that time without their support.”

            “Go ahead,” Uncle Jimmy lit up his pipe contentedly, “maybe we’ll all learn something”. 

            I said, “I know there’s a great danger in trying to simplify complex situations, but usually people used to manage to handle the myriad of minor irritations associated with day to day living within their marriage.  These days people are much more inclined to walk away at the first major confrontation rather than try to work them out.   A great deal depends on how good the marriage was in the first place and in the flexibility of the couple.  Why do you think your marriage failed?

            She considered the question for a few moments.  “Kenny, - that was my former husband’s name, was a real control freak.   You’d probably call it an obsessive-compulsive personality or something like that.   I should have seen the writing on the wall, because it was evident long before we got married.       Kenny, he insisted on being called Kenny, not Ken or Kenneth, started when we were planning the wedding.   He had to have his own way in every little thing."
   " A sure recipe for failure, if ever there was one.  One that has to be sorted out before the marriage because it's not likely to be resolved afterwards.
 Some of the issues were really trivial, and yet if he didn’t get his own way they could blow up into a major fight.   We hadn’t been married very long before he started making demands.   He wanted me to become active in the Church, which he had never even been interested in, or belonged to before we were married.  He became very involved himself and expected me to do the same.   Initially, I thought he was having an epiphany, but after a while I began to realize that he saw it more as a step to success, than anything else.   Kenny was an accountant doing okay, but certainly not setting the world on fire, and I think he thought being perceived as a family man might help him.   I had my own career which I certainly thought no less important than his.  But other than my bringing home my pay packet to share in the house expenses he didn't seem interested."
   "And how was your sex life?' I asked.
   Her father busied himself filling his pipe and trying to move out of ear shot. 
    "Not that great, but it did exist." she responded, and added, "I did let him  know that on a couple of occasions and I guess that didn't help very much."
    No, it wouldn't" I couldn’t help observing..
    “I guess I was being mean.  Our sex life sure wasn’t anything to write home about.   But what really bothered me was that he never seemed to want to be alone with me.   Almost every week-end and holiday was spent with his mother, or middle-aged bachelor friends and some of the time I could come if I liked, or not, and some of the time I was just not invited.   And if we weren’t going out, he thought we, or rather I, should be entertaining them.  After a while that started to wear pretty thin.   It wasn't long before I was making all sorts of changes to my plans to facilitate Kenny.   I found I was resenting it increasingly because it seemed to me that he wasn't making the same sort of concessions.   For instance I changed my work schedule at his request so that we could spend more evenings together and found that his concept of spending evenings together was visiting his friends or entertaining them and his family.   We rarely had an evening together to go to a movie or to just to sit and watch television.   He wanted me to work and share all the expenses of living, including paying him rent, I might add, but was very resentful when my work interfered with his social expectations."

            "You can be sort of anti-social at times, Peggy," her father said quietly.

            "I don't think I'd call it anti-social, Daddy," she said, " I just don't like being with people all the time, and Kenny never seemed to get enough.   But I thought if someone really loved you, it was without reservation."

            I shook my head sadly, "that's the way it is in romance novels, unfortunately in real life it rarely works that way, and if things get bad enough between a couple they both find that there are very real reservations and limits to their love."  

            "I realize that now," Maureen continued, "so we were fighting more and more frequently, and he said horrible things to me and - "

            Her father interrupted, "you have a pretty sharp tongue yourself ".

            "Oh Daddy, who's side are you on?" she asked angrily, "you'd think it was all my fault!"

            "I'm sure it was both your faults," he said.

            They both looked at me as though seeking some judgement.   I thought I'd just listen.

            "So what happened next," I asked solicitously.

            "What happened next was the inevitable spiraling of our conflicts until eventually even the silliest little difference ends up with us screaming at each other.   He was so controlling that eventually everything ended up as a conflict and he was just impossible to live with.  He said such horrible thing to me."

            "Whoa," I said, "you knew this man for some time before you married him, are you telling me that you didn't see this side of him at all before you married him?"

            "Well, I suppose I did, but I thought we would be able to work it all out after we got married," she said sheepishly.

            "I don't want to sound cynical," I said, "but marriage tends to magnify these problems, not diminish them.   Put two people in close proximity on a daily basis and sooner or later they will have to confront these differences and if they don’t respect each other’s boundaries living together soon becomes untenable.”

            “Anyway,” Peggy said, “to cut a long story short, it ended up with him running back to live with his Mama when he found he couldn’t just get me out of his house.   It was his house, and he was going to get me out of it, and I wasted the next two years of my life depressed and miserable trying to get over it.   I’m sure not going to make any of those mistakes again.   This time I’m really sure things are going to work.”

            “That’s encouraging to hear, Peggy,” I said. “What have you learned that inspires such confidence?”

            “First of all, I have learned that the person you marry is going to be the same person after the marriage as before it.   In fact, any problems that exist before the marriage must be resolved then, because after the marriage living in close proximity magnifies those irritants.   When Kenny and I got married, I made a whole series of promises for change, which ranged from quitting smoking to becoming more of a social creature that just was not me.   I found myself making promises that I just couldn’t keep, but he was such a nag, that I’d have said anything to shut him up.   With Hugh, I had the maturity and self-confidence to say ‘what you see is what you get’.   Sure, I want us to please each other, but not under the circumstance ‘do what I say and change to suit me or get out’.   No promises of that nature from me, and I don’t expect them from him!”

            “That’s certainly an important lesson,” I said, “maybe the most important one.   If you want to make over your partner even before the wedding, it doesn’t bode well for the future. 

From what you’ve said to me, I think you can realize what harm words can do.   Nothing could be further from the truth than that old saying children used to quote when they were the victims of hurtful words. ‘Sticks and stones can break my bones but names can never hurt me’.   In fact sometimes words can hurt much more than sticks and stones.   And the problem is once said they can’t be unsaid.   Words said in anger can reverberate long after the anger has dissipated and the issues that gave rise to them are forgotten.”

Peggy looked at me thoughtfully, “yes, I think you may be right,” she said.   “Another important thing is the change in relationship that normally takes place between a married person and his or her family and friends.   I think those relationships are very important, but a successful marriage depends on the persons involved placing themselves above all else – without in any way depreciating the other relationships in their lives.   I’m sure there is a lot more about marriage that I’ve learnt that I can’t just put my finger on right now.   I know this is your area of specialization, maybe you’ve discerned some other messages in my story that I’ve missed?”

It's often the small things, Peggy, give me an example of some small thing that provoked a third world war between you and Kenny?”

“Well there was the bloody ridiculous picture thing just before we broke up.   I thought a few of our pictures needed to be moved and started early on Sunday morning, full of enthusiasm to do the moving.   I must have woken the bastard gently hammering a nail in the wall, and he came downstairs in his pyjamas ranting and raving when he saw what I was doing, and asked me what the fuck I meant by moving pictures in his house  without discussing it with him first.   I was so furious that it took me days to get over it.”

“Do you think your anger was out of proportion to the circumstances?” I asked her.

“What do you mean out of fucking proportion,” she responded angrily, “you didn’t have to listen to the bastard going on for hours.”

“You said twenty minutes,” I said.

She looked at me angrily and said nothing.

Peggy, when people  over-react to something, sometimes they are transferring an unresolved conflict from their early life onto the present situation without realizing it.   Does this remind you of any feelings from your early life?”

“What do you mean?” she asked.

“Well, as you are having these feelings, does that remind you of similar feelings when you were growing up?”

“Oh, you mean when me and Mom got into it?  Well yes, she always did seem to have it in for me!”

Uncle Jimmy looked uncomfortable. “Oh God, the two of you used to be at it terrible, I was even glad to have to go to some of those evening meetings on occasion. And then there were those evening meeting of the Irish Fly-fishing Association.   It seems to me that you and your mother were two peas in a pod.   You could both be equally unreasonable at times with me burying my head in the sand as I ambled down to my fly-tying equipment in the garage to get a couple of hours of peace and quiet.”

            “So you and your Mom are sort of similar personalities, eh Peggy?” I asked. “We tend to pick someone like one or other of our parents to be attracted to.   So which of your parents was Kenny most like?”

            Uncle Jimmy picked up his well chewed browning Meerschaum pipe and looked as though he were about to leave the room.

            “Sit down Jimmy,” I barked.   He may have been a favourite uncle but there was no way he was escaping right now.

            “Oh he always tried to get away like that when the situation was getting uncomfortable, I hope Hugh isn’t too like that.”

            “Let’s get back to the point, Peggy,” I said, “which of your parents is Kenny a bit like?”

            “You mean, that I’m like my mother?” Peggy’s voice elevated an octave, “and that Kenny was a bit like me?” her voice had risen another half octave.

            “You have to understand, that what I am really explaining is that you tended to transfer the unresolved control conflicts with your mother onto the similar personality of Kenny, resulting in minor angers becoming major rages.”

            “I never thought of it that way before, but if you are right, there’s probably nothing that you can do about that, is there?”

            “Peggy, when you spot transference of unresolved feelings, from an early life intimate relationship, you have to put the feelings of anger and sadness, back where they come from.   This can sometimes be done by writing about it briefly, in a journal, recognizing the original feelings of anger and sadness that you have never dealt with and putting them on paper.”      
   
       “So how does that help me with the picture hanging, or should I call it the ‘picture lynching’ episode, Dr. Freud?” she said sarcastically.

            “Most couples are pretty competitive with each other these days, rather like the competition between siblings.   Couples are best off when they clearly define zones of responsibility.   Each partner must have clearly defined responsibilities for the various tasks that have to be accomplished on a day to day basis.   Traditionally the woman always looked after the house, the man the outside and the cars for example.   Yet, if the man was going to change the appearance of the garden, he should consult with his wife before he makes any final decision, just as much as if you were going to change the pictures, you should have consulted with your partner first.”

            “But why would he flip out over moving a couple of simple pictures?”

            “Maybe his father wouldn’t let him put posters up on his bedroom wall as a kid, and he’s pretty touchy about this.” I said, then added, “how were things done in your house when you were a kid?”    

            "I never cared about that sort of stuff."

     “ Well, if you had checked with Kenny, it may never have bothered him.   It may just have been a lack of communication, or it may have been a truly touchy situation.”

         "I think my husband and my mother were both control freaks," she said.
         
         "And there was no way you were going to be controlled by anyone?"
           
           "That's right."
   
             By now, I was thoroughly fed up with all this nonsense.  I needed to wind it up so that it wouldn't ruin my holiday.  I wasn't even getting paid for talking or listening - unusual for me.
So this was the best way to wind it up quickly.  
              
         Said I,  “Look, I didn’t do everything right, and tended to take the line of least resistance a lot of the time, that’s my problem that I have to deal with – but there’s no way I can blame my parents for that, and equally there is no way you can blame yours.   If you’re frustrated with them for not being more assertive and more to your liking that’s your right, but don’t blame them for your problems.  And, believe me, you have no idea what they are going to be, yet.  They might just make ours seem mild. Remember, the secret of a successful life is not necessarily to be dealt a great hand, but to play the hand you were dealt the best possible  way.

Wednesday 30 March 2022

Monet & Me!

Claude Monet & Me. 
 post-impressionism /pəʊstɪmˈprɛʃ(ə)nɪz(ə)m/ ♫ noun [mass noun] the work or style of a varied group of late 19th-century and early 20th-century artists including Van Gogh, Gauguin, and Cézanne. They reacted against the naturalism of the impressionists to explore colour, line, and form, and the emotional response of the artist, a concern which led to the development of expressionism.     Long long ago I went through a period when I fancied myself as an up and coming artist. It only lasted as long as my first few attempts, when even I could recognize a lack of any exceptional talent.  However, one of my pictures was sufficiently passable for my wife to suggest that we have it smartly framed and hung in our home. I was doubtful but she had such confidence in me that I went along with the idea. There was a fine picture framer in our neighborhood and we had some pictures framed from time to time and we were always happy with their recommendations and their work. Cut a long story short,       Betty, the owner, looked at my picture and asked , "Did you say it was his first painting ?" 
   "Yes," said Irene, "Good, isn't it? That's why I'd like to get a really nice frame for it." 
   "It's quite good for a first attempt. I wouldn't recommend spending a lot of money framing it. You could buy a very nice frame for it in one of the 'Big Box Bric a brac stores for a few dollars, that would look quite nice hanging in the basement or in a den. Custom framing is really quite expensive and I don't think you need to spend a lot of money on this." Irene told me the story and ended up saying,    "Well, I still like it. It's better than a lot of the junk you see in many of the artsy stores."  
   Being the thrifty souls we are, we ended up following Betty's advice and I found a frame in a local hobby shop that fitted my picture perfectly. Instead of throwing my work of art out, Irene hung it in the den part of our basement and there it hung for many years.       Five Years later. my office or den in our basement. was a separate room squeezed between tyke playroom and the utility area of the basement.. the kids used to frequently play in the playroom and on this particular day, as I dashed down to the office to sign off various urgent papers,I see my daughter and her little friend, both about nine years old, standing looking at two paintings side by side on the wall. One was a nice little inexpensive print of a picture by the great impressionist artist Monet and beside it was my pathetic work that even Betty the Art Framer, could not bring herself to charge invest my money in! The two girls were pensively evaluating the works of art. Unobserved, I watched them. "Oh, I like that one best," said the little girl. "Yes, I like that one best too," said the other little girl, who happened to be my daughter, dismissing the Monet. I was thrilled!             Years later. It was that stage of life when we were gathering the desiderata of a lifetime and deciding what could be dumped and what sentimental garbage the kids (middle -aged now) might be interested in keeping. As we groped our way through the boxes of toys, kids books and pictures, we tended to reassign items from the 'dump' group back into the 'keep group'. "Hey! Look what I've found here," I yelled, pulling a painting out of a cardboard box. ' It's the painting that Betty the picture framer wouldn't waste MY money framing!. I think it's pretty good now - or perhaps it's that my vision isn't what it used to be. Still, I do recall Rena and her little friend preferring my picture to Monet's." [Monet, Claude /ˈmɒneɪ/ ♫ (1840–1926), French painter. A founder member of the impressionists, his fascination with the play of light on objects led him to produce series of paintings of single subjects painted at different times of the day and under different weather conditions, such as the Water-lilies sequence (1899–1906; 1916 onwards).] Now it so happened that my daughter and her husband had just bought a new condo and high on their list of imperatives was filling those lovely walls with appropriate artistic endeavours. "When she and Bill come to visit next we'll see if she still thinks I'm better than Monet." They came to visit a few weeks later. "We have some nice pictures that I think you and Bill will really like for your walls," Irene said. "They are stored in boxes in the basement. I'll call you when dinner is ready. " "Okay," said Rena, beginning her descent into the basement. Bill followed her down an we heard no more for a while. Shortly after, we heard quite a lot of noise coming from the basement as Bill and Rena made their way back up to the living room. 'Well, did you find anything that you'd like to hang on your walls?" Irene asked. 
    "Yes we did, several things," Rena said excitedly, "but this is what we both like best like of all". They both held out the favoured picture. Here it is:   A genuine Smith!  (I note that modesty prompted me to leave it unsigned.)


And still it hangs.  For their next birthday I'm going to have it professionally framed!
 Someday I may paint another picture!!

Saturday 12 March 2022

The Dental Fairy V The Great Barber -Surgeon -Dentist.

 





The Great Barber-Surgeon-Dentist!


“His pole, with pewter basins hung,

Black, rotten teeth in order strung,

Rang’d cups that in the window stood,

Lin’d with red rags, to look like blood,

Did well his threefold trade explain,

Who shav’d, drew teeth, and breath’d a vein.”


-The Goat without a Beard, by John Gay.

    

                                       &&&&&&&&&&&&&&&&&&&


   From the Middle Ages to the late eighteenth century when folks had a bad toothache and many other surgical conditions, they went down to the barbershop. The Surgeon Barber's were the practical surgeons of the Middle Ages and looked after many surgical conditions as well as the grooming of their patients.

   Dental extractions were one of the commoner procedures of the barber surgeons or of a family member good with pliers, but in those pre-anesthetic days people often pulled out their own teeth using everything from a string tied around the tooth and the other end around the door handle. A good slug of gin, then slam the door and voila - the tooth is out.

   The point of all of the above is that before I cut to the chase, I wanted you to know that in 1902 a dental extraction was 25c. Now let's carry on with the story!

   My wife developed a toothache and a loose tooth recently. She went to her dentist. The dentist confirmed the loose tooth and decided it should be extracted. The dentist referred her to a specialist which mildly surprised me, since in my day, dental extraction was the bread and butter dental procedure. (see the published tariff above in 1902 the procedure cost twenty-five cents).

   The appointment date rolled around pretty quickly and I drove my wife to the dental appointment. Initially, I thought the appointment was to have the tooth pulled. Perish that thought! The appointment was to have the tooth that was to be extracted assessed, the 'surgery' to be planned for a later date. We went into the waiting room, where my wife was given a five page medical history form to complete that I filled in for her. (The print was too small for her failing vision so I guess if I wasn't there they would have had to find someone to do it for her.) Apart from the basic medical history required, the document appeared to be put together mainly to indemnify the dentist in case anything went wrong.

   The waiting area was comfortable enough and dominated by a large OLED television screen with one of the best pictures I have seen - at least that's what I think it was. A colorful collage of ocean creatures displayed their magnificently spectacular, spectral antics in a manner that suggested that even for fish and other sea creatures the virtual life superseded reality. A real tank could not host the drama as magnificently. It was obvious that this was going to be one expensive piece of dental surgery. I was enjoying the show when the assistant came to take my wife into the dentist. Since this was the tail-end of Covid (one visitor in the office at a time!) I waited outside, which I was more than happy to do as I had become engrossed in Oceanography.

   "Everything okay?" I asked.

   She nodded, "Oh yes, I'm going to have it out on Thursday. I hope you don't have an appointment for that time ?" she asked anxiously.

  (Now that we are both octogenarians we have so many maintenance appointments from head to foot that we have to be careful that they don't conflict.)

  "Did it hurt when he wiggled the tooth to see how loose it is?" I asked.

  "No" she shook her head as we both struggled to get our seat belts done up.

  "Well," I said impatiently, "What did he say when he looked in your mouth and probed it?"

   "He didn't look in my mouth at all," she said, struggling to get the seat belt off."

   My wife doesn't hear as well as she used to. I increased my normally loud vocal volume up a notch. "I asked what he said when he looked in your mouth," I shouted. She has the best teeth I've ever seen in a person of our age, and in sixty years this old General Practitioner spent a lot of time looking in mouths.

   "Oh, he didn't look in my mouth at all," she said.

   "He didn't ask you to open your mouth at all?" I asked

   "No! He just put my head in a big thing and took some sort of x ray. I think it was some sort of MRI thing "

   Now I know I am old, very old. So old in fact that way back in the days of CB radio, (remember that?) my moniker was "The Dinosaur"!

   THE SURGERY.

      A week later we arrived at the dentist's office at 1.25pm, for our 1.45 appointment. I was relieved that the same oceanography program was still on.

   In no time at all my wife appeared back in the waiting room, biting on a large bloody gauze square with a prescription for an antibiotic, an analgesic, a box of gauze squares as well as a prescription for a mouthwash that dentists prefer.

   The price had gone up considerably since the 1902 rates published at the top of this blog, but then so has everything else!

We've come a long way since the tooth fairy used to visit me!!


Wednesday 23 February 2022

Vaccintion Politization.

Vaccination Politization. 

When I was born in 1935, no-one asked my mother if she'd like me vaccinated against small-pox, they told her I had be vaccinated. Neither her permission nor my father's was required. Although she had no special medical knowledge, she, like many others, did have enough perception to realize what a killer smallpox had been and was happy to have her newborn protected against it. That general realization was sufficiently widespread and the vaccination sufficiently accepted as being effective, that the lethal disease has been wiped off the face of the earth. People showed off their small ugly vaccination scar on their upper arm with pride! When I was growing up, the countryside in Ireland was peppered with TB Sanatoria. Now there are none. Not many years later tuberculosis was preventable by vaccine or treatable and when my daughter was born no one asked her mother or me if we would like her immunized against that scourge. The same applied to numerous other serious diseases that had crippled or killed people, particularly children. Diseases like polio (infantile paralysis), diphtheria and a myriad of other diseases. Much of the population was aware of the patients who lived out their lives in an 'iron lung' to breath for them or spent their life wheel chair confined and so were relieved when their children had their vaccine even though the approval was post facto. Widespread dissemination of infectious disease has largely been avoided in recent years thanks to immunization. Unfortunately, the public as expert as they believe themselves to be are largely unaware of why they have enjoyed protection from so many potentially lethal infectious diseases. Unfortunately, many of the experts are lacking in historical perspective and fail to appreciate how much of the success of modern medicine is due to the contribution of Edward Jenner and 'The Dirty Dairymaids of Devon'.

In 1796, Jenner carried out his now famous experiment on eight-year-old James Phipps. Jenner inserted pus taken from a cowpox pustule and inserted it into an incision on the boy's arm. (He'd be sued and crossed off the medical register for that today!) He was testing his theory, drawn from the folklore of the countryside, that milkmaids who suffered the mild disease of cowpox never contracted smallpox, one of the greatest killers of the period, particularly among children. Jenner subsequently proved that having been inoculated with cowpox Phipps was immune to smallpox. He submitted a paper to the Royal Society in 1797 describing his experiment, but was told that his ideas were too revolutionary and that he needed more proof. Jenner experimented on several other children, including his own 11-month-old son. In 1798, the results were finally published and Jenner coined the word vaccine from the Latin 'vacca' for cow.
Jenner was widely ridiculed. Critics, especially the clergy, claimed it was repulsive and ungodly to inoculate someone with material from a diseased animal. A satirical cartoon of 1802 showed people who had been vaccinated sprouting cow's heads. But the obvious advantages of vaccination and the protection it provided won out, and vaccination soon became widespread. Jenner became famous and now spent much of his time researching and advising on developments in his vaccine. Jenner carried out research in a number of other areas of medicine and was also keen on fossil collecting and horticulture. He died on 26 January 1823. His discoveries and their offshoots developed by others have probably saved more lives than any other medical management.
So, the anti vaccine luddites can rant and roar as much as they like: study the facts carefully and apply simple logic and the answers will usually become obvious. Meanwhile, each and every one of us should be grateful for the vaccines that have saved so many lives - and let there be no doubt about it, they did save many lives.


If you have any vaccination views - share them.

Tuesday 15 February 2022

The Surgeon Poet.

 



The Surgeon Poet.


   I got a little ahead of myself, launching into quotations from the book before relating the difficulty in getting hold of a copy of it. At first I set out to buy a copy, after all, Amazon has everything.

   They had one copy available and t was over a thousand dollars (Yes, a were dollars!) I didn't want to own a copy of the book, I just wanted to read through it to see if I was missing anything by postponing the search for fifty-five years! Being a 'Life Member' of the Canadian Medical Association and of the College of Family Physicians of Canada, I knew I would have no difficulty in accessing the text on line. I was quite prepared to pay the going rate for online access. I checked them out, I even phoned the librarian of the CFPC without success. Fortunately, I mentioned my frustration to a family member who is faculty at Canada's senior University and he offered to try to access it for me.

   Lo and behold, the entire canon became available to me in a short time, for which I was extraordinarily grateful because as I continued my on - line search any sort of copy was unacceptably expensive. Interestingly, the copy to which I had access was last accessed several years ago, after several years in limbo.

   During the first world war Cope served in the Royal Army Medical Corps as a Major and was no 'behind the desk' officer. He saw active service in the Middle East from 1916-1919. In the WW2 he was a senior officer of the Emergency Medical Service. Two clinical volumes of the 'Official History of the War if 1939-1945 were edited by him.


  Despite his brilliance, Sir Zachary did not hesitate to use his own errors or omissions as teaching opportunities. Not an easy thing to do. The following few stanzas tell a personal story that many a physician would prefer not to publicize:

     I still remember with regret,

     Indeed I never could forget

     What drove this lesson home to me

     And now to you a guide shall be.

     All day long I had been busy

     And then with fatigue nigh dizzy

     They called me to an urgent case

     To which I went with laggard pace.

     The patients pain had been severe

     But when I saw her it was clear

     They were much less and since she seemed

     To be improving fast I deemed

     Perhaps she could be left a while;

     My conscience I did reconcile

     By thinking that the patient's state

     Might still improve if we did wait

     And in the morn at any rate

     We could if needful operate.

     But yet I knew that she was ill

     And spite of all felt doubtfull still.

     So I went home and had my rest

     With hopes all would be for the best.

     But on the morn she was much worse

     And my delay I then did curse

     For at the urgent operation

     I found a gastric perforation.

     And so the end of my sad tale is

     She came to 'exitus lethalis'. (Latin for dead.)

Two morals of this story should be starred -

When very tired be doubly on your guard,

All slackness in the surgeon should be barred.

Then, when not sure and full of hesitation

Don't wait too long before an exploration.

   The lesson in this story needs no explanation but it takes a courageous surgeon to use himself as the bad example!

Much of his advice is as relevant today as it was when he gave it. For instance,

"Examine from the head and toes,

Before you dare to diagnose.

More harm is done because you do not look

Than from not knowing what is in the book."


Friday 11 February 2022

The Acute Surgical Abdomen in Rhyme.

 A Memo to Me. (Written circa 1955)


  I'm at the stage of life when it is necessary to start eliminating the trivia of a lifetime. Among the cards commemorating birthdays, anniversaries and certificates of all shapes and sizes and the endless albums of photographs, I came across some lecture notes from my earliest clinical years. I was always a prolific note taker so I thought I would review some of my student surgical notes to see if they were as good as I thought (things aren't always!). The notebook that I chanced upon was on abdominal surgery. As I reached the end of the topic I noted that I had scratched in a personal note to myself which read 'The Acute Abdomen in rhyme, be sure to read it. Prof says it is brilliant and hilarious!'

  It was forgotten of course, until the message jumped out at me after fifty-five years. I obviously had to take prompt action. I started my search pursuing the usual channels. Secure in my knowledge that 'Mr. Google' knows everything, I typed in the name of the book and found it had been written in the forties by Sir Zachary Cope. Sir Zachary was already internationally famous for his knowledge and text book on acute abdominal surgery. It was the recognized definitive benchmark on this topic in the world. It was published continuously by Sir Z from 1947 to about 1987 and thereafter continues to be updated by a surgeon who had served as his House surgeon.

  Not long after the acclaim of his book (and many other publications) Sir Zachary, who despite his protestations to the contrary was something of a poet and a humorist, began work on the book published in 1947, that was to be called "The Diagnosis of the Acute Abdomen in Rhyme". He wrote under the pen name of 'Zeta'. It is this work and its genius in maintaining scientific accuracy with his poetic humour that is fascinating.

   Part of his preface goes like this:

"Well, wait and see, at least this I can state

A rhymster needs to think and concentrate,

And chose his words more carefully than those

Who oft repeat themselves in common prose.

Of course I do not claim to be a poet

And at the outset I would have you know it;

So look not for the fanciful sublime

Nor coloured metaphors in my plain rhyme;

My aim, which well may be I shall not reach

Is to amuse you while I try to teach.

So in the future when in doubt who knows?

Some couplet may help you to diagnose."

   

   He goes on into the general principles and with extraordinary prescience in 1947 anticipates the replacement of clinical skills with technology.

   This is how he puts it:

   "The diagnostic problem of to - day

   Has greatly changed - the change has come to stay;

   We all have to confess, though with a sigh

   On laboratory tests we much rely

   And use too little hand and ear and eye.

   We culture this, we plant out that with care,

   And on the plates with hope we daily stare;

     

    He finishes this paragraph,

      "..........but now there is the danger

    That student to the patient may be stranger,

    And though he deal with culture-tube with ease

     Forget the signs and symptoms of disease."

      

I couldn't have said it better myself!


   More about Sir Zachary soon.