EXTRACTING TEETH IS still a significant part of the job of a dentist.
When I qualified as a dentist in 1982, I joined the practice in Rainham (Kent) run by Julian U. He was a generally competent dentist and very skilful when it came to extracting teeth. If, as it happened from time to time, I was having difficulty removing a tooth, he would come into my surgery to apply his skill and experience to the problem at hand. Whenever he did this, he would work on the offending tooth, but would stop when he knew I would be able to complete the operation.
Julian could have easily finished the job himself, but he left it to me to do this for a good reason. He knew that if I removed the tooth, the patient would believe that it was my skill that contributed to the successful conclusion of the operation and therefore would not lose confidence in me.
Later in the day, after the patient had left, Julian would explain to me why I had had difficulties and how to avoid repeating the problem. He was a great mentor as I began my career in dentistry.
The NHS used to pay a standard fee for an extraction. If an extraction proved to be particularly difficult, involving bone removal for example, the practitioner could write to the NHS explaining why the operation was not simple and enclosing a radiograph (xray image) of the tooth in question. In these cases, the NHS used to pay a larger fee than the standard one.
On one occasion when I had not taken a radiograph prior to an extraction because I had assumed it would be simple, the operation proved to be very difficult. After completing it, I applied for the supplementary fee but did not receive it because I had not submitted a preoperative radiograph. I was furious not only because I had not been adequately remunerated for my effort but also because my word had been doubted.
Some months later, a distressed couple brought their infant to my surgery. The child had chewed on a keyring and it had got stuck between two teeth. Carefully, I cut through the ring and thereby removed it from the kid’s teeth.
Still smarting from my failure to convince the NHS that my extraction of a few months earlier was truly difficult, I wrote up my keyring removal and applied for a fee for this unusual procedure. I explained that neither had I taken a radiograph (because it was unnecessary) nor was I able to send them any evidence, such as the remains of the keyring because the parents had wanted to keep them. I waited patiently for the NHS to reply, which they did. To my great surprise, they believed my story without me sending any evidence and paid me a decent fee. Nowadays, it would be unwise to perform any extraction without having taken a preoperative radiograph. This is not for the purposes of seeking enhanced remuneration but to protect the practitioner should the patient decide to make a complaint against the dentist. Sad to say, but by the time I retired, preventive dentistry acquired a new meaning. In addition to preventing dental disease in patients, it has also come to mean preventing the dentist from litigation and defending him or her when malpractice is alleged.
A DENTIST NEEDS manual dexterity and good powers of observation (amongst many other skills). My PhD supervisor, Robert Harkness, used to teach physiology to the first year (pre-clinical) dental students at University College London. He not only encouraged them to learn the rudiments of the subject but also how to improve their dexterity and skill in observation.
While the students were under Robert’s care, he tried to instil in them something of his spirit of scientific curiosity. Each student had to carry out an investigative project as part of the physiology course. This had to make use of the students’ powers of observation. He felt, quite correctly, that a good physician must be very observant. He had students, with their pencils, watches, and notepads at the ready, measuring, for example, the blink rates of people travelling on the Underground, or how many times a minute peoples’ jaws moved whilst chewing gum, or how often and for how long people scratched their heads. Projects like these, simple though they sound, honed the students’ ability to observe carefully. These projects also helped to instil something else in some of the students: many of them went on to have academic dental careers.
Robert had great manual dexterity and knew that development of this in his students was of great importance to those aspiring to practise dentistry. When he or his wife Margaret was interviewing prospective students, they always enquired whether a candidate played a musical instrument or enjoyed making models or sewing/knitting/embroidery. If they did, then there was a good chance that the candidate’s manual dexterity would be sufficient to perform dental procedures. Robert encouraged this in the practical physiology classes that he arranged for his pre-clinical students. Typical of this was his insistence on the use of the archaic smoked drum kymograph.
Most students doing experiments in physiology would record results from their experimental set-ups, be it a contracting muscle or a stretch of live nerve, on an electrically operated pen and ink tracing that produced a graph on a piece of paper tape. All that was necessary was to plug the measurement transducer out-put lead into the electronic moving chart recorder and wait for the results.
Robert insisted on his dental students using a kymograph with smoked paper, a mechanical predecessor of the modern electronic equipment. A sheet of white paper had to be attached around the outside of a metal cylinder (drum). This had to be rotated carefully above a smoky flame until the entire surface of the paper had been uniformly blackened by a thin layer of charcoal particles. Without disturbing this fragile black layer with a stray finger or thumb, the smoked drum had to be carefully attached to the vertical spindle that emerged from a cylindrical motor. The experimental tissue – often the students measured the contraction rates and strengths of lengths of rodent gut – was attached via a thin cord to a delicate lever which had a sharp point (stylus) at one end of it. This point was then placed against the smoked paper and then the motor was activated, causing the drum to rotate at a known speed. As the gut contracted, it moved the lever up and down which in turn caused the sharp point to displace carbon particles beneath the stylus point to leave a white tracing on the slowly moving blackened paper covering the metal cylinder. When the tracing had been made, it had to be removed from the drum without smudging it, and then immersed in some liquid, a smelly lacquer, that fixed the image to the paper. This procedure, I can assure you, is no less demanding on one’s manual skills than, say, preparing a tooth for an inlay or a bridge abutment or placing an implant.
Many generations of Robert’s dental students remember him fondly. Recently, someone with whom I studied dentistry at University College reminded me about his curious laboratory coats. He did not wear the long white coats that most scientists and many medics normally use. Instead, he wore a long coat coloured brown or ochre. Why he wore a lab coat that looked more like the work wear of an old fashioned grocer I have no idea – I never thought to ask him – but Robert did many things in his own inimitable style. Often his approach to things seemed eccentric at first sight, but usually after reflection you would realise that there was a lot of sense in what he did and how he did it.
WALKING ALONG A SHORT street in London’s Kensington recently, I observed things that I had never noticed before and was reminded of Tony ‘M’. When I was a student of dentistry at the University College Hospital Dental School, I first met Tony in the third year. In that year, we began to learn how to make crowns (‘caps’) for our patients. Instead of sending the work out to be done by technicians, we students had to learn the nitty gritty of fabricating crowns, mostly gold ones. We were assigned to one of three or four technician tutors. I was assigned to Tony’s group. Why visiting Peel Street in Kensington sparked me to think of Tony will be revealed later.
Peel Street in Notting Hill Gate lies in land that used to be known as ‘The Racks’. It was part of the extensive estate of Campden House, which was owned by the Phillimore family. In the early 19th century, the land was bought by John Punter and William Ward, who divided the land between them in 1823 after having agreed to lay out two roads: Peel Str and Campden Str. Peel Street lay in Punter’s share of the area. Although Punter retained several plots along Peel Street, the rest were sold to a variety of different people. Nearer the eastern end of the street several buildings were demolished between 1865 and 1875 during the construction of what is now the Circle Line. Though the tracks are underground, there are no buildings built above them. If you look through the gap on the north side of the road, you can see the rear of a brick building which fronts on Edge Street. Near the top of this place, some bricks have been made to project slightly and to spell the name ‘LESLIE’. The rear part of this L-shaped building is currently occupied by ‘The Spanish Education Office’. This building was flying Spanish and EU flags. I have no idea about the significance of ‘Leslie’.
One of the houses on the south side of Peel Street used to be a pub. It still bears the lettering ‘Peel Arms’. It was probably in existence by 1889, but today it is a private dwelling. The pub’s clientele were probably mostly workers who toiled in the gravel pits that abounded in the neighbourhood. The pub is not far from the six-storey Camden Houses, brick-built blocks of flats erected in 1877-8 for labourers, some of whom might well have drunk at the Peel Arms. The blocks contain 125 separate flats. The entrances to the blocks have art nouveau features. The building were designed by the architect Edwyn Evans Cronk (1846-1919) for the National Dwellings Society Ltd. Cronk was born in Sevenoaks (Kent) and died in Redcliffe Square in South Kensington.
At the western end of Peel Street, there is another pub, The Windsor Castle. Unlike the Peel Arms, this is a working establishment, now popular with the locals, most of whom are not poorly paid labourers. It was originally built in about 1826 and then remodelled in 1933. The pub contains much of its original late Georgian building fabric and is a Grade II listed place. Although I have passed it often, I have never entered it or its reputedly fine garden. At the Eastern end of Peel Street, there is a wine bar, The Kensington Wine Rooms. When we were getting married, back in 1993, the premises were occupied by a branch of the Café Rouge restaurant chain. We held a pre-wedding dinner there. The premises now housing the wine bar once housed a pub, The Macaulay Arms. It was listed as being in existence in the 1868 edition of “Allen’s West London Street Directory”. Thus, residents of Peel Street were only a few steps from three ‘drinking holes’.
“1 Upfold George, sweep/ 2 Arnold F., carpenter/ 3 Miles Frederick, painter/ 23 Mansell H., painter/ 26 Redman J., marine stores/ 28 Redman J., beer retailer/ 37 Taylor W., gardener/ 46 Lucas Wm. Grocer/ 53 Hobbs Mrs. general shop/ 55 Horskins Thos. Baker/ 63 Pollett —, bootmaker/ Harris W., greengrocer/ 67 Smart M., The George Brewery/ 69 Dunnett Mrs. dressmaker/ 77 Elson George, oilman/ 80 Evans H., gardener/ 82 Atwood Mrs, dressmaker/ 83 Salmon —, bootmaker”
Most of the inhabitants appear to have been tradesmen, merchants, and craftsmen, rather than labourers. This is probably because the list was compiled before the Campden Houses were built to house manual labourers and their families. Incidentally, there is still a greengrocer on Peel Street. Jack and Jessie’s excellent shop is opposite the Kensington Wine Rooms.
Peel Cottage stands almost at the corner of Peel Street and Campden Hill Road. It is next to number 118 Campden Hill Road (aka ‘West House’), a building on the corner of Peel street designed for the artist George Henry Boughton (1803-1905) in the late 1870s by Richard Norman Shaw (1831-1912). New Scotland Yard and Lowther Lodge (home of the Royal Geographical Society on Kensington Gore) were amongst the many other buildings designed by Shaw. Another artist, the landscape painter Matthew Ridley Corbet (1850-1902) lived at number 80 Peel Street, where once lived the gardener, H Evans.
The entrance to Peel Cottage, which is dwarfed by its neighbours, is partially covered with ivy. It was seeing the blue, circular commemorative plaque on the wall next to its entrance that reminded me of my former teacher Tony M. The plaque informs the passer-by that the artist Sir William Russell Flint (1880-1969) lived in Peel Cottage from 1925 until his death. This brings me back to Tony M, about whom you must have thought I had forgotten already.
As a dental student, I spent many hours with Tony M as I struggled to make decent gold crowns that would fit my patients’ teeth in the conservation clinics of the Dental School. Each encounter with Tony involved a trip to the canteen in the school’s basement. Tony was unable to function without a fresh cup of the school’s barely mediocre coffee. Over cups of coffee, Tony used to encourage us when the clinical teachers made our lives miserable, help with our technical work, and chat. During one of our sessions together, Tony, knowing that art interested me, suggested that I visit Cottrell’s showrooms in nearby Charlotte Street (numbers 15-17) to see the fine collection of paintings that hung on its walls. Cottrell’s were an important supplier of dental equipment and materials. Today, although it has retained its original Victorian frontage, it is the premises of the Charlotte Street Hotel.
Dutifully and because I was curious, I visited Cottrell’s showroom and looked at the framed watercolours hanging on the walls of the two ground floor showrooms. The paintings were all works of the inhabitant of Peel Cottage, William Russell Flint.
Flint was born in Edinburgh. He studied at Daniel Stewart’s College and then Edinburgh Institution. Between 1900 and 1902, he worked as a medical illustrator in London. Later, he produced illustrations for books and “The Illustrated London News”. He was elected President of the Royal Society of Painters in Watercolours (now the Royal Watercolour Society, of which my wife’s cousin, Varsha Bhatia, is a member), a position he held from 1936 until 1956. He was knighted in 1947. Flint produced many well-executed, delicately tinted water-colour paintings. He often visited Spain, where he made plenty of images that often included sensuous portrayals of women in various stages of undress. It was some of these titillating paintings that Tony had sent me to see on the walls of Cottrell’s showroom.
It was in the late 1970s or early 1980s (before 1982, when I qualified) that Tony M encouraged me to pay a visit to Cottrell’s in Charlotte Street to widen my knowledge of the world of art. Many years have passed since then, but a memory of that brief glimpse of Flint’s paintings lingers in the back of my mind. Visiting Peel Street and seeing Flint’s home brought that all back to the forefront of my memory.
MANY LONDONERS WILL HAVE walked past Mortimer Market without knowing it exists. Yet, I used to visit it every working day for about five years. It played an important role in my life and greatly affected my career. How it did, I will reveal later.
Mortimer Market lies a few feet east of Tottenham Court Road (‘TCR’) between Capper and University Streets. Immediately to its east, runs Huntley Street that is parallel to TCR. I used to enter Mortimer Market through a short, covered passageway leading off TCR. Vehicles can enter the Market via Capper Street.
Until 1886, Capper Street was known as ‘Pancras Street’. This street has existed for over 300 years. Its history is outlined in some detail on an interesting website (https://regencyredingote.wordpress.com/). Before it was laid out, the land on which it runs was part of Capper Farm, which was in existence by 1693. The farmer, Christopher Capper, whose widow died in 1739, kept cattle. Members of his family, his daughters, kept the farm going until at least 1768. After his death, the family moved to crop growing in preference to rearing cattle. In 1756, the Duke of Grafton constructed the Euston Road that ran along the northern boundary of the Capper’s farm. At first, the Capper sisters raised an objection to it, saying that the dust raised by traffic along the new road would spoil their crops. The Duke and the sisters eventually came to some agreement. By 1770, the Capper sisters gave up their farm. It was then bought by Hans Winthrop Mortimer (1734-1807), who merits an entry in Wikipedia and on the History of Parliament website (www.historyofparliamentonline.org/volume/1754-1790/member/mortimer-hans-winthrop-1734-1807 ).
Mortimer was a property speculator and a Member of Parliament between 1775 and 1790. In the 1774 General Election, he was defeated by Sir Thomas Rumbold (1736-1791), who served as British Governor of Madras between 1777 and 1780. Rumbold became well-known for being corrupt. His misdeeds included what was effectively the theft of a precious ring from the Nawab of Arcot (Muhammad Ali Khan Wallajah, who reigned 1749-1795). Rumbold’s corruption preceded his stay in India. This involved, amongst other things, bribery during the election he contested against Mortimer. After a court case against Rumbold, Mortimer was awarded £11,000 in damages in 1776 and also gained the parliamentary seat that Rumbold had tried to win by cheating (bribery). It is a sign of the East India Company’s wobbly ethics that a man as corrupt as Rumbold was appointed the Governor of Madras so soon after losing his case of corruption.
Mortimer spent a great deal of money acquiring property in Shaftesbury, his constituency and also in London.
The land, which Mortimer bought that had been the Capper’s farm, became known as ‘The Mortimer Estate’. Some of this estate was later sold and became the site of University College (‘UC’) London, which established in 1826. Mortimer Market began to be built on the western part of the estate in 1795. Old maps of the area show that in the 19th century Mortimer Market was like a piazza containing two parallel rows of small shops. This can be seen in a photograph published in 1949 and reproduced on a British history website ( www.british-history.ac.uk/survey-london/vol21/pt3/plate-27).
By 1963, the shops in Mortimer Market had been demolished. In that year, a purpose-built structure standing where the rows of shops had once stood was opened as University College Hospital Dental School (‘UCHDS’). It was this architecturally undistinguished building that I used to visit during the clinical years (1977-1982) of my studies of dentistry. The building is so non-descript that it does not get even a tiny mention in Pevsner’s detailed guide to the buildings of north London. Prior to 1914, what was to become UCHDS was known as the National Dental Hospital, founded in 1861 and located at 187-191 Great Portland Street (see: https://ezitis.myzen.co.uk/uchdental.html). In 1894, the establishment relocated to 59 Devonshire Street. Twenty years later, it amalgamated with University College Hospital. From 1963 until its closure in 1991, 9 years after I qualified as a dentist, UCHDS was housed in Mortimer Market. The former dental school building still stands and looks very much like I remember it, but now it houses a centre for the treatment of sexually transmitted diseases.
As mentioned earlier, I used to reach the entrance of the dental school by way of the passageway from Tottenham Court Road. However, the hospital could be reached via the network of underground passageways that linked various building of the hospital both with each other and UCL itself. To the right of the passageway if you face it from TCR, there used to be the premises of the Iraqi Cultural Centre. I went in there several times. On one occasion, I mentioned to one of the friendly men who worked in their shopfront office that I am fascinated by folk music from all over the world. He told me to wait and within a few minutes he returned and presented me with an album containing two LPs of recordings of Iraqi folk music. For years after this, I enjoyed listening to them.
During several of my brief lunchtime visits to the Iraqi Cultural Centre near Mortimer Market, I noticed something strange in it. Men would suddenly appear from what seemed like nowhere, maybe from doors hidden in the shop’s internal walls. When Saddam Hussein’s regime (1979-2003) began to attract western military attention, I remembered these curious appearances, and wondered whether there was something other that cultural promotion going on in this place so near my dental school. My suspicions have been confirmed: according to the writer Said K Aburish (born in Palestine in 1935), writing in 2004:
“Years ago Saddam Hussein used the Iraqi cultural centre in Tottenham Court Road to conduct intelligence against dissident Iraqis and to eliminate political opponents.”
Also, The Guardian newspaper noted on the 30th of April 2002:
“The Iraqi government also used some of the students on its scholarships as spies, and set up a London surveillance network based at a “cultural centre” on Tottenham Court Road. There were sporadic assassination attempts against dissidents: in 1995 Latif Yahia, a defector previously employed by the Iraqi government as the official double of Saddam’s brother, alleged that he had been attacked with knives by five men speaking Arabic while stuck in traffic on the capital’s Edgware Road.”
My time studying in Mortimer was quite exciting but not as much as what must have been going on nearby in the cultural centre. Thinking back to my years of study, we had some lectures given us by a young Iraqi dentist, who was working on his PhD – something to do with denture fixatives. He seemed very pleasant, but now I wonder…
While I was studying at UCHDS, I had wanted to write about the history of Mortimer Market. In those days before the Internet, although I looked at several books in UCL’s very well-stocked library, I did not find anything about the story behind this little-known part of London. So, what you have just read is what I was hoping to write more than 38 years ago.
SAINT APOLLONIA WAS born in the 2nd century AD. She was one of a group of virgin martyrs who was killed in 249 AD during an uprising against the Christians in the Egyptian city of Alexandria. Prior to being murdered, she was tortured by having her teeth pulled out and damaged. Since then she has been regarded as the patron saint of dentistry and those suffering from toothache and other dental problems.
When I was a dental student back in the early 1980s, I did some research with a view to writing an article about Apollonia for the dental school’s journal. While carrying out my investigations, I came across an article (I cannot remember where) which described a sacred relic, one of Saint Apollonia’s teeth, which is held in a church somewhere in northern France. I cannot recall where this tooth resides, but I have not forgotten something that was written about relics in general in that article. That is, according to the writer, one of the miraculous properties of sacred relics is that they can self-replicate.
Since working on that unfinished article, I have hardly given Saint Apollonia a moment’s consideration until today when we visited an exhibition based around the works of the German artist Lucas Cranach the Elder (1472-1553). This wonderful exhibition is being held at Compton Verney, a fine old house built 1714 in Warwickshire and set in gardens very capably designed by Lancelot ‘Capability’ Brown (c1716-1783), until the 3rd of January 2021.
One of the rooms of the exhibition is devoted to works of art inspired by Lucas Cranach the Elder. Two such works by Pablo Picasso are on display alongside various other fabulous modern artworks by slightly less well-known artists. One of these pieces is a mechanised sculpture by Michael Landy (born 1963). This was inspired by the depiction of St Apollonia in a painting by Cranach which is held in London’s National Gallery. In Cranach’s work, Apollonia, dressed in a long, pleated dress coloured red, stands beside St Genevieve (martyred in what is now France), dressed in green.
Landy has created a wooden sculpture, a three-dimensional version of what appears in Cranach’s painting. In the latter, Apollonia is depicted with her hands clasped together around the long handles of a pair of pliers whose beaks are wrapped around an extracted tooth. Landy’s three-dimensional version, which is about twelve feet high, looks remarkably similar to Cranach’s. A foot pedal is attached to the sculpture by a cable. When a viewer presses the pedal, Apollonia’s hands move the pliers towards her mouth and then fall back again. It appears as if she has just pulled out her tooth. I wonder what Cranach would have thought about this rather gory adaptation of his original image.
You have now been warned. If you are a dental phobic and happen to visit this marvellous exhibition, do not, I repeat, do not press that pedal beside Landy’s sculpture. Also, try not to miss visiting this superbly curated show.
LIKE MANY OTHER YOUNG BOYS, the idea of being a train driver appealed to me. I am pretty certain that my parents would not have been ecstatic had I ended up in the driving cab of a railway train. Once my father told me that he did not mind what I studied or what profession I took up eventually, so long as it was not economics (he was a professor of economics). He had no need to be concerned about that, as what I could gather about economics made it sound unappealing to me. So, what did I consider after my urge to drive trains diminished?
From an early age, I used to spend much of my spare time drawing and painting, pursuits encouraged by my mother, who was an accomplished, but lesser known (and not self-promoting) painter and sculptress. In addition, in my early teens, I began to develop an interest in ‘modern’ architects including Le Corbusier, Mies Van der Rohe, and Frank Lloyd Wright. I read books about them and the idea of studying architecture, to become an architect, entered my head. My hope was to create structures as beautiful and innovative as those, which I had read about. After a year or so, I was walking back to school from our dining hall when I was struck by a depressing thought. If I studied architecture for the required seven or so years, there was a good chance that I would not be undertaking major, exciting projects like those which had made my architectural heroes famous. Instead, I might very well have ended up designing loft rooms, domestic garages, garden room extensions, and similar important but mundane structures. This thought dampened my enthusiasm to pursue architecture as a profession.
My next idea was to become a schoolteacher like those who taught me at my secondary school. I am incredibly pleased that this idea was short-lived because over the years the conditions that many schoolteachers have had to endure have deteriorated continuously.
My father, now long retired, was a university teacher (he became a senior professor at the London School of Economics). From my young vantage point, his lifestyle looked good. Despite working hard, which he did, he had lovely colleagues and many pleasant students as well as long holidays. His profession appealed to me and set me on the path of pursuing studies which I hoped would lead to an academic career. After completing my BSc, I worked on a research topic that led to me being awarded a PhD.
As I reached the completion of my doctoral work, two things began to worry me. One was that none the other British-based workers in the field that I was working (connective tissue physiology), whom I met at conferences and seminars, seemed like people with whom I would enjoy working. The prospects for obtaining post-doctoral work abroad were not good, and at that time I had no yearning to live outside the UK. Another thing that worried me, which I only realised after I left research, was that it was a lonely pursuit.
To cut a long story short, I began studying dentistry. I had an idea that with a clinical qualification, a wider range of research possibilities would become available to me. However, I discovered during the clinical dentistry course that I enjoyed working with people, members of the public, who were willing to risk their teeth in the hands of students. So, when I qualified as a dentist, instead of going back into research and academia, I began working as a practising dentist. I did this for 35 years with varying degrees of enjoyment and satisfaction. Overall, it was a valuable life experience for me, as I hope that it was for my patients.
I have been retired for over two years now and love it. Jokingly, I often tell friends that my main reason for going to work was to retire eventually. But there is an element of truth in this. Even now, so many decades since my childhood, I still enjoy railways and rail travel. I have not yet completely lost that juvenile desire to drive a train. Maybe someday, I might get to ‘have a go’ at the controls of a train. I have heard that these days drivers of London’s Underground trains make quite a good living. The money would be satisfactory but, more importantly, the thrill of controlling the train would be a fine reward.
Have you, dear readers, been satisfied with the tracks along which your working lives have travelled?
DURING THE 1980s, I lived and worked just over fifty miles south-east of central London in Gillingham, one of the Medway Towns in Kent. Usually, I drove to London on Saturday afternoons after my morning dental surgery session ended at 1 pm. Then, after buying innumerable gramophone records and later also CDs and seeing friends, I would spend the night at my father’s home before returning to Kent late on Sunday evening.
One winter Sunday evening, after visiting friends, who lived in South Hampstead close to the Royal Free Hospital, I began driving towards Kent. When I reached Lewisham in south-east London, snow began falling lightly. I thought nothing of it. By the time I arrived at the start of the M2 motorway, the situation had changed considerably. The motorway was under several inches of fresh snow. The few vehicles travelling at that late hour drove on a pair of groove-like tracks made in the snow by vehicles ahead of me. It was rather like the page in the song “Good King Wenceslas: ‘Mark my footsteps, my good page, Tread thou in them boldly … In his master’s steps he trod, Where the snow lay dinted’.
The snow continued to fall and by the time I reached the motorway exit west of the Medway Bridge, I decided that it might be better to drive through Strood, Rochester, and Chatham rather than along the motorway that by-passed these places along a hilly exposed rural route, which I believed might have been badly affected by the snow.
It was about 2am when I left the motorway. I joined a line of cars that was crawling slowly towards Rochester – a traffic jam at 2 am. Eventually, I drove across the River Medway on the bridge at Rochester. The traffic was slow moving and dense despite the time. I decided to leave the main road and follow a back road that wound around Rochester Castle and avoided the city centre. I drove about fifty yards upwards along a steep snow-covered lane and then the car would go no further. Its wheels were unable to grip the road and I slid down to the bottom of the hill where I had started. There was no choice. I had to re-join the slow procession of traffic crawling through the interlinked Medway towns.
When I reached Gillingham, it was long after 3 am. I turned off the main A2 road and drove, or rather slid, downhill along Nelson Road which was covered with deep snow. At my street, Napier Road, the snow was even deeper and had not been compressed by passing vehicles. I headed towards my house but could not reach it because my car became wedged in a drift of densely packed snow. It remained locked in the snow for over three weeks.
The following day, the Medway Towns were almost paralysed by the snow. However, the only stretch of railway that was still operating was between two neighbouring stations, Gillingham and Rainham, where my dental surgery was located. I managed to reach my surgery by train in my Wellington boots and wore these whilst treating the few patients who decided not to cancel their appointments. The only patients who struggled through the snow that day were elderly people who considered that cancelling appointments was disrespectful to the professional. All those brave souls, who made it through the hazardous snow, were seeing me about false teeth.
Although the snow did not disappear from the Medway Towns for over three weeks, the rail service to London resumed quite quickly. So, I continued to make my weekly visits to the capital. Fifty miles from snow-covered Gillingham, London was free of snow. Exaggerating slightly, visiting London was like travelling from the Arctic to the Mediterranean. Few of my friends in London could believe that my home in Kent had sufficient snow to keep most skiers happy.
The spectacular change in climates that I experienced that winter when shuttling between London and Gillingham occurred long before the concept of ‘climate change’ became widespread in the public eye.
DENTISTS ARE FRONT-LINE workers, risking their lives for you. We put our fingers in people’s mouths and risk inhaling their expired breath and droplets of saliva and infected material. This has been the case ever since the start of human endeavours to resolve problems related to dental and oral pathology. I began hands-on dentistry in 1977 during the second year of my course in dental surgery undertaken at University College Hospital Dental School (‘UCHDS’). I qualified in early 1982 and worked in general practice until September 2017.
At UCHDS we never wore gloves or masks while treating patients. The exception was for extractions that required minor oral surgery (cutting the gum etc.) when we were required to wear disposable latex gloves. For extraction that only needed forceps (‘dental pliers’) and elevators (wedge-like instruments), gloves were not required, but we did wash our hands between patients. When using the dental drill, we were required to wear safety googles over our eyes. What I have just described was what was considered correct practice at one of Britain’s leading dental schools. In those days, as in the future, any patient we treated was capable of harbouring nasty pathogens that could cause diseases such as tuberculosis, herpes, hepatitis B (and other forms of this virus), mycobacteria, fungi, and rarer diseases, all of which could have proved very detrimental to the clinician or his or her assistant.
The first practice I worked in was rightly considered to be one of the most ethical in the area. Once again, gloves and masks were not worn. Patients rinsed from a proper glass that was washed between appointments before being re-used. Instruments that had been used on a patient were placed in a bath of Savlon disinfectant for a while until they were needed again. All needles and local anaesthetic cartridges were single use only. At lunchtime and at the end of the day, all our metal instruments were sterilised in a hot air steriliser. It was not every practice that bothered to do this. Horrified? Well, you might well be if you are old enough to have had dental treatment in the UK before the second half of the 1980s.
After I qualified, I subscribed to the New England Journal of Medicine with a vague idea of keeping up to date with medical science. Most of the articles were beyond my comprehension. However, in the mid-1980s, I began noticing many articles were being published about t-cells (a kind of white blood cell). What I only realised later was that these were being published because of the arrival and proliferation of a new threat to health: HIV (‘AIDS’). This epidemic prompted a dramatic change in how dentists operated. Almost overnight, we were required to wear gloves; advised to wear masks; commanded to sterilise instruments before re-using them; giving disposable single-use paper or plastic mugs for patients to use for rinsing.
What amazes me is that during the 35 years that I worked as a dentist, I never heard of or read about more than a handful of patients who were infected following dental procedures. There have been some newspaper reports of patients contracting HIV after seeing a dentist, but in some of these cases the mode of transmission was other than from clinical procedure. Over the years, I attended several lectures on the latest developments in cross-infection control. After each of these, I always asked the lecturer whether there was any scientific evidence that showed whether cross-infection controls in dentistry significantly affected patient mortality. Not one of these academic clinicians could provide an answer. One of them said to me:
“That would make a very good topic for a PhD.”
Whether they make a difference or not, modern cross-infection protocols make both the patient and the clinical team feel safer. I hope that everyone will feel sufficiently safe to be treated now that the atmosphere is infiltrated with particles of the Covid-19 virus. The nature of this highly contagious airborne pathogen justifies the many advances in cross-infection control that the profession has made since HIV appeared on the scene and will require further refinements especially in the field of air purification.
When I think back to my days of providing dental treatment with my bare hands and uncovered face, I am amazed that I and most of my colleagues never succumbed to anything much worse than fatigue and frustration caused by awkward patients.
While I was undertaking research for my PhD in physiology at University College London (‘UCL’), there were no daily time constraints. I could turn up at the laboratory whenever I felt like it and leave whenever I wanted. My timings were entirely up to me. I used to arrive at UCL at about 10 in the morning. At 11 o’clock, I went upstairs for coffee and biscuits in the Starling Room (a departmental meeting place for post-graduates and academic staff; named in honour of the physiologist Ernest Starling). By noon, I had returned to the lab. However, there was not much time to do anything because I liked to have lunch at just before 1 pm. And, after lunch, I often sat in the Ladies Common Room, chatting with Margaret, my supervisor’s wife who also worked in the lab. You can be sure that we never discussed scientific matters over our cups of sub-standard institutional coffee.
By just after 2 pm, I began getting down to work, setting up an experiment. However, everything stopped at 4 pm, when one of us would put the kettle on to boil, the heat being supplied by a gas flame from a Bunsen burner. Tea and biscuits involved me spending another hour chatting, mainly with Margaret. The other PhD students and workers in our lab took tea but were not distracted from their work. At 5 pm Margaret and my PhD supervisor, Robert, set off homewards, followed soon after by the rest of the lab. Between 5 and about 8.30 pm (and on some weekend days) is when I managed to do some ‘solid’ work. Miraculously with this lackadaisical schedule, I managed to do sufficient experimental research to be awarded a doctorate. Then, my life changed dramatically.
Soon after becoming ‘Dr Yamey’, I enrolled in the Dental School of UCL to train to become a dental surgeon (‘dentist’). Compared to my BSc and the PhD studies, this course leading to a Batchelor of Dental Surgery degree was far more demanding of my time. Five days a week, my presence was required at the Dental School at 9 am sharp. The day, which included a lunch break and two brief coffee breaks (if you were lucky), ended at about 5 pm. This seemed to me as bad as being sent back to junior school.
At first, I found this rigorous routine difficult after the relatively laxer times I had enjoyed during my BSc and PhD courses. I remember waking up at 7.00 am on dark autumn mornings and looking out of my bedroom window to see if there were lights on in any of my neighbours’ windows. Often, there were none. To arrive at the hospital by nine in the morning, I had to board the Underground at the peak of the morning rush hour. The tube trains were always crowded, standing room only, at that time. However, in those days in the late 1970s each train had two carriages in which smoking was allowed. Because many people were going off smoking or did not smoke, these carriages always had plenty of empty seats when they pulled into my station, Golders Green. Ignorant of secondary smoking, as I was then, I always travelled comfortably in the smelly, smoke filled carriages. However, by the time I had travelled the thirty minutes to Warren Street, I was always in great need of a quick coffee in the Dental Hospital’s basement canteen before classes began. After qualifying, the early morning routine continued. It lasted for thirty-five years until, at last, I retired.
Waking early in the morning was not confined to dental studies and practice. It is a feature of life that I have got used to in India. Many people in India wake early to take advantage of the cooler early hours of the day. I learned this very soon after arriving in Bangalore during my first visit to India in 1994. For the first few weeks, my wife and I stayed in my in-law’s home. On the second or third morning of our stay, I woke up in darkness. I could hear people rushing about in the house. I woke up my wife and said that I thought that the house was being burgled or attacked. She reassured me that all was okay and told me that the family liked to rise early. It was not quite 5 am. Day after day, my father-in-law tried to encourage me to join him on his early morning walk, to see the sun rise. Eventually, I gave in and we walked around a nearby open space in semi-darkness. It was only when we had returned to the house that we noticed the sun was beginning to rise.
Since those early days in India, I have just about got used to getting up incredibly early if there is a good reason to do so. Driving out of a city as large as Bangalore is one of these reasons. Before 7 am, there is hardly any traffic on the roads, which are usually choc-a-bloc during working hours. Flights to London are another good reason. They often leave India at early hours of the morning so that they can land in Western Europe at an hour that will not disturb those asleep in the UK, where late night/early morning passenger flights are forbidden. Although I can see the benefits of doing things early in the morning in India, I still miss being permitted to sleep until my built-in biological clock gives me its wake-up call. And for those of you who are by now thinking that sleep is all important to me, let me tell you that of late, despite not having any work or travel obligations, that clock of mine is waking me up much earlier than it used to years ago.
Back in the early 1990s when I was practising as a dentist in Kent and owned a house in Gillingham, my future wife and I visited the local superstore, the Savacentre. Its name has nothing to do with the River Sava that meets the River Danube near Belgrade in Serbia. The shopping mall in Kent is pronounced “saver-centre”.
We wanted to buy some flowers and approached a florist within one of the wide corridors of the mall. He had some blooms of a kind we had never noticed before. We asked him what they were, and his answer sounded like “owlstromeriya”.
We bought a bunch of these attractive flowers and asked him how long we should expect them to survive in a vase. He answered: “No worries there. They’re good lasters.”
And, he was right.
Alstroemeria, or Lily of the Incas, are native to South America but I guess many of those on sale in the UK are grown elsewhere.