A writer’s confession

HIG 2 BLOG

NOBODY IS PERFECT, not even yours truly.

I was a pupil at London’s Highgate School when I was studying to take state examination, then known as ‘O Levels, taken by 16 year olds. I was studying for 9 subjects, but decided to drop one of them, German. Its grammar was beginning to defeat me and to jeopardize my chances of success in the other 8 subjects.

German was not the only language that was causing me trouble as I approached the O Level exams. Unknown to me and possibly unnoticed by our English teacher, Mr B, my command of written English was insufficient for me to pass the English Language O Level exam. It was the only O Level that I failed. I passed the other subjects, but without displaying much academic excellence.

My failure to achieve the pass marks in English Language cannot be blamed on anyone except me, but there were factors that predisposed me to downfall.

During the examination, I attempted an essay that asked the candidate to discuss whether or not it was fair that pop musicians often earned more than nurses. Being by nature somewhat contrarian, I decided to write an essay in defence of the high remuneration of pop musicians. This idea, to which I no longer subscribe, expressed with poor grammar and spelling, cannot have made the person marking my paper feel sympathetic to me.

The other predisposing factor was our teacher Mr B. He was far more interested in using class time analyzing the poetry of Ted Hughes and Philip Larkin than ensuring that all of his charges were proficient in basic skills such as grammar and essay writing.

Failing English Language did not prevent or delay my commencing the subjects in which I was to prepare for the A Level examinations that were required for admission to university.

One of my three A Level subjects was biology. The senior biology teacher was Mr S, affectionately known by his first name George. He set us three essays per week. On Saturday mornings, we had a double-length period (one and a half hours) with him. During this, he went through our essays, pointing out their good points and bad ones. The essays of one student, ‘P’ were particularly dreadful. His spelling was awful as was his punctuation: there was none except a full stop at the end of each foolscap page. And, to my annoyance and surprise, P passed English Language O Level at the same time as I failed.

Six months after failing my English Language O Level, I took the exam again. I passed with a good grade. I believe that I had learnt a great deal about essay writing from George’s Saturday essay critiquing sessions. I shall always be grateful to him.

On Saturday mornings, parents thinking of sending their sons to Highgate were shown around the school. The biology laboratory, where the essay classes were held, was on the tour. George, who was a genial old fellow, allowed us to relax during the Saturday morning classes. However, he always told us that if we heard the door to the laboratory being opened, we were all to act as uf we were concentrating on something serious while the parents peered in.

On Friday afternoons, we had a three hour practical class during which, for example, we dissected the parts of dogfish not required by fishmongers. Friday lunchtimes found George drinking in one of Highgate Village’s numerous quant pubs.

George used to arrive at the Friday afternoon practical classes having drunk far too much. For the first hour of the class, he was a menace, arguing with anyone unwise enough to approach him. After about an hour, he used to sit down and fall asleep. The last two hours of the class were supervised superbly by George’s deputy, Mr Coombs.

George was a wonderful teacher. He inspired his pupils’ enthusiasm for biology. Like my PhD supervisor, Robert Harkness, his range of interest extended from microscopic intracellular detail to the whole organism. Once, when walking to the Dining Hall with George, he stooped down and picked up a fallen tree leaf. He asked us what kind of tree had produced it. None of us knew. He said:

“That’s the trouble with you youngsters. You know all about DNA, but you cannot recognise a leaf from a plane tree.”

George was, as far as we knew, probably celibate. When we reached the part of the biology syllabus that dealt with human reproduction, he told us:

“You know all about this. You can read up the details in the book.”

I have wandered from my starting topic somewhat. Maybe, you were beginning to believe that I was trying to distract you from my sad performance in English and from thinking that, given my record, I have great ‘chutzpah’ writing and publishing books.

Picture shows coat of arms of Highgate School, founded in 1565

A bit too far

Drill a bit,  not too far.

In the tooth is a nerve:

do not disturb it

 

DRILL 1

 

It would not have been fair to my patients if I had written what follows before I had retired from practising dentistry. If I had been one of my patients, I might have lost confidence in my dentist after reading this.

Before dental students are allowed to drill teeth on living patients, much training is required. A great deal of this is done using plastic teeth mounted in the jaws of the heads of a mannequin, known as a ‘phantom head’. The plastic teeth are held in the artificial jaws with metal screws. The screws fit into holes on the undersides of the teeth so that the crowns of the teeth appear intact. As a dental student, I spent many hours each week practicing cutting standardised cavities. The cavities had to be cut to very precise dimensions, which were neither to be exceeded nor the opposite. I recall that certain parts of the plastic teeth had to be cut to exactly two millimetres deep and much the same width. At first, I found this extremely difficult. Not only was I not yet used to using dental drills, but also the plastic cuts in an awkward way.

Eventually, the time arrived for a practical test. Unsupervised, we were required to cut one of the several cavities that we had been learning to prepare. Disaster struck. Within a few seconds of starting my tooth, I had cut too deep. The metal of the screw retaining the plastic tooth in the phantom head was staring me in the face. I called over the examiners. They studied the tooth carefully, and then one of them said to me:

“I think you have exposed the nerve, Mr Yamey.”

“We might be looking at a root treatment, here, don’t you think?” asked the other examiner.

I could not believe what I was hearing.

“I think we’re looking at a failure here,” I replied.

They agreed.

I spent another few weeks in the phantom head room, and retook the exam, which I passed with flying colours, you will be relieved to learn. Now, I was deemed ready to treat dental cavities on real teeth in real patients – under supervision, of course.

The first tooth that I had to work on had only a little decay. Nevertheless, after the intense training, which emphasised cutting teeth should be done as conservatively as possible, cutting only as little of healthy tooth tissue as was strictly necessary to retain the restoration (‘filling’), I approached my first ‘real’ tooth with much trepidation. After boring down to the two-millimetre depth that was ingrained in my mind, I could see nothing but healthy tooth – no sign of decay. I summoned the clinical teacher (the ‘demonstrator’). He looked at the tiny hole I had created with great care and laughed.

“You have not yet cut through the enamel. Keep going,” he said.

The enamel, for those who are uncertain about dental anatomy, is the outer covering of the part of the tooth that is visible in the mouth. Beneath it, is the dentine, and below that the dental pulp chamber, which contains nerves and blood vessels. Decay spreads much more rapidly through dentine than through enamel.

I looked at the demonstrator, and said:

“But in the phantom head room we were told never to go deeper than two millimetres.”

“Those were just plastic teeth,” the demonstrator replied, “forget all that.”

 

[Picture from “Der Zahnarzt in der Karikatur” by E Henrich]

Do exams maketh man?

STUDY 0

Today, getting a place to study a clinical subject (medicine, dentistry, and veterinary science) requires the candidate to achieve very high grades in the state university entrance exams (the ‘A Levels’). Grades lower than A or A* (the highest) greatly reduce a candidate’s chances of obtaining a place on a course to study for any of these three professions.

Note: in the A Levels, the top grade is A or A*, the lowest is E. Thus, A is better than B, and B beter than C … and so on

In 1969, I applied to study physiology at University College London (‘UCL’). In those days, most departments at the college required applicants to attend an interview session before they gave the candidate an offer conditional on the person achieving specified A Level grades. The Physiology Department invited prospective students to spend a whole day at the college. I turned up, not knowing what to expect.

During my day at the department, I was interviewed one-to-one by two different sets of staff members. They did not ask straightforward questions that could be answered if you had learnt the A Level syllabus by rote. For example, I was asked: “What would limit the size of the largest insect?” This is not something covered by the A Level syllabus. To answer this, I had to think ‘out of the box’, using my knowledge of insect anatomy and physiology. Another interviewer asked me about my hobbies. One of them was, and still is, collecting maps. “How interesting,” the questioner answered a bit dubiously, “It is also my hobby. What exactly interests you about maps?” I cannot remember my answer, but it seemed to satisfy him.

In addition to these intimate interviews, there were group sessions, during which small groups of candidates discussed topics with some of the academic staff. We were also given coffee, lunch, and tea. At each of these refreshment breaks, we mingled with students and academic staff, all of whom engaged each of us in conversation. By the end of the day, the members of the department must have gained a fairly detailed impression of the candidates they had met.

After a few days, I received a letter (there was no email in 1969) offering me a place conditional on my achieving at least three E grades (lowest grade of pass) at A Level. The Physiology Department and others at UCL made this kind of ridiculously low offer if they wanted a candidate. They knew from the extensive interview process what kind of student they were going to get and did not want him or her to have to worry about achieving high grades. Of course, they preferred their students to obtain high grades at A Level, and we all did. They would have accepted us with lower grades, but this was rarely necessary. Most of the graduates of the Physiology Department eventually moved on to completing higher degrees (masters and doctorates).

Until the early 1980s, candidates wishing to study dentistry or medicine were interviewed and offered places providing they achieved a minimum of C grades in their A Levels.

During the 1970s, I became friendly with someone who used to interview prospective dental students at UCL. She sat on an interviewing panel with the then Dental Dean, Mr Prophet, and another senior dental clinical academic. Each candidate was asked about aspects of his or her life, anything to get them talking. Each candidate was also asked whether they either played a musical instrument or did some kind of handicraft (for example sewing or model-making). Anyone who did either of these things was likely to be sufficiently dextrous to be able to practise dentistry. After the candidate left the room, the interviewers asked themselves only one question, providing the youngster they had just seen had satisfied them that he or she was dextrous. The question they asked themselves was: “Would we be comfortable being treated by him or her?”

Candidates, who had satisfied the interviewing panel, were offered places on the dental course conditional on them achieving mid-range grades at A Level: three grade Cs. The admissions panel were quite lenient. If someone they wanted under-achieved at A Level, say they only manged to get two Cs and one D, they admitted the candidate. It is worth noting that of all the dental schools in London at that time, that at UCL produced a higher proportion of dentists who went on to become dental academics than any of the other dental schools, all of which asked for students to achieve grades higher than Cs for admission.

I qualified as a dentist in March 1982. A couple of years later, I re-connected with ‘Mr G’, the technical tutor, who taught me the art and science of removable prosthetics (i.e. making dentures). I used to see him regularly because he carried out some prosthetic laboratory work for my patients.

In the mid-1980s, things had changed at UCL. To gain admission into the dental course, candidates were required to achieve top grades (all As) at A Level. The first year of the dental course was then, as it had been in my time, not clinical: it was taught in departments other than those in the Dental School. The subjects studied were academic (rather than clinical): biochemistry, general anatomy, physiology, and special dental anatomy. In the second year, the students moved into the Dental School, where they began clinical their studies on patients without teeth – in the Prosthetics Department, which is where I first met Mr G.

During the second year, we burnt our fingers and got covered with plaster of Paris while making dentures for our toothless patients. We also studied dental materials, both practically in the lab and theoretically in the lecture theatre. The materials course involved some essay writing, as did most of the other courses we had to take. Nobody in my class year struggled over these. We might have resented spending time on them, but we managed.

One day in the mid-eighties, by which time all the students in the second year of the dental course had achieved high grades at A Level, Mr G told me something that surprised me. He said that many of the students entering the second year, were incapable of writing essays. So much so, that the Prosthetics Department had to put on a course of essay-writing to teach these high achievers how to write. Worse than that, when the students were told to look up things in the library, they turned around to Mr G and said things like: “Why should we? You do it. You’re paid to teach us.”

With such an arrogant attitude, how were these people going to handle the often-nervous patients in their dental chair?

STUDY 1

When our daughter and her class-mates applied for (non-clinical) undergraduate studies, the criterion for getting considered at all, was predicted A Level grades. If the predicted grades were low, universities would not even begin to consider a candidate. If they were high enough, then the chances of being given a conditional offer increased. Few universities bothered to interview candidates. They tended to rely on grade predictions, teachers’ reports, and ‘personal statements’ written by the candidates. It is said that a picture is worth a thousand words. I would say that a face-to-face interview  far more  valuable than any grade predictions or ‘personal statements’ as a means of selecting people seeking admission to a university, or even a job.

Photographs of students in Coimbra (Portugal), taken by Adam Yamey

Examining a recurring dream

The sleeping brain

powerhouse of fantasy

fertile playground of   dreams

 

Dreams

 

Many of us experience dreams that recur periodically, not necessarily every night, but from time to time. Here is mine.

I dream that I am about to take a mathematics exam. I know that I have had a year to study for it, but have done nothing about it. Maybe, I can ‘wing it’ without study, but I am sure that I cannot. There are only a few days left to study, but something tells me that neither will there  be enough time, nor will I ever get started. I will tell you how the dream ends later on.

Ever since I was about 8 years old, I have been writing examinations. First, there were simple tests to enter preparatory school. At the end of each school year, we sat a series of written tests. Then, there were more (and much more difficult) papers for admission to secondary school to be attempted when I was 12.  At age 16, I had to write state examinations in eight subjects, the Ordinary Level (‘O Levels’, now ‘GCSE’).  A year later, a few more state examinations, and then when I was 18, I had to take the difficult Advanced Level exams that could make or broke a candidate’s chances of entering a University.

At the end of each year of my BSc course in physiology, there were examination papers, the results of each of them counting towards the quality (grade) of the degree I would be awarded. 

Following that, I had a three year break from exams while I researched and then wrote up my PhD thesis.

I entered dental school, where for five years I had to pass endless numbers of examinations of all sorts: practical, written, and viva-voce.

Eventually, I graduated as a dentist. However, there was one more examination to be taken: the driving test!

I have never found writing examinations stressful.

My recurring dream ends as follows. After pondering the hopelessness of my prospects via-a-vis the forthcoming mathematics exam in my sleeping brain, it occurs to me that it does not matter after all, because already I had a BSc, a PhD, and a dental degree. Then, I wake up.

This dream ending might have a basis in reality. When I was ready after completing the dental course, I took the set of dental qualifying examinations arranged by the Royal College of Surgeons. I passed them.

Three month’s later, after I had been working with patients in practice for most of that time, I returned to the dental school to take the university dental examinations. I was already qualified, and did not really need the extra qualification, but I went along nevertheless.  The university exams required me sitting a number of written papers along with a clinical test. While sitting on an uncomfortable chair, scribbling exam essays at high speed, I paused for a moment. As in my dream, I asked myself why was I bothering  to waste time on attempting to attain this superfluous  qualification when I had so many already.

Why I practised dentistry

UCL 1 University College London Portico

University College London Portico

I retired from dentistry exactly one year ago. This is how I got started 36 years ago…

I began studying dentistry after I had completed my PhD in physiology in 1976. My original intention was to obtain a clinical degree so that I would be able to widen the choice of post-doctoral opportunities beyond the field of specialisation relating to my doctoral thesis.

I entered the dental school at University College London (‘UCH’) ‘armed’ with a doctorate. There were two kinds of teaching staff at the school. The academic staff were attached to the University and the clinical ‘demonstrators’ were dentists who came into the hospital on a part-time basis to assist with teaching in the clinics where the students learned to treat patients. All the demonstrators used to address me as ‘Doctor Yamey’, but the academic staff, many of whom did not have PhDs, used to address me as ‘Mister Yamey’.

At the end of each course we studied, we would have to pass an examination. This consisted of a written paper along with a practical examination. All of the examinations included a face-to-face spoken test, a ‘viva-voce’ (or ‘viva’).

During my pharmacology viva, I was asked several questions by a pair of examiners. One of the examiners told me that I had answered one question incorrectly. I was sure that I had answered correctly, so I said: “I am certain that what I have said is right.” The two examiners looked at each other, and I began to worry. Then, the examiner who had not contradicted me said: “You know, he’s right.”

During another viva, the task was to look at a microscope slide, and then to comment on it to the examiners. When I had looked at the slide, I turned to examiners, and thought I heard one of them saying: “Where is it from?” Absentmindedly, I said: “It’s an unusual surname. It originates from Lithuania.” I had thought that I was being asked about my name, rather than the slide. Fortunately, I was able to give a satisfactory account of what I had seen under the microscope.

At the end of the first year, we were examined in general human anatomy. I entered the room where my viva was being held and sat down with the two examiners. One of them, an external examiner, said to me: Do you remember me?” I looked at him blankly before he said: “I used to meet you walking on Hampstead Heath with your parents. Please give them my regards.” At that moment, I knew that I had passed the examination.

The final year examinations, which determined whether you would or would not be awarded a degree in dental surgery were quite harrowing. Most people considered that the viva conducted by the dean of our dental school and a dean visiting from another dental school was the most frightening part of the finals. And, when I took the finals, we learnt that the visiting dean, the external examiner, had a fearsome reputation. So, I was somewhat nervous when I entered the room to face the deans. After answering a couple of questions evidently satisfactorily, the dean of our dental school said: “Well, of course we’re looking forward to you joining our staff when you qualify…” At that moment, I realised that I must have qualified.  I said that during the five-year dental course, I had discovered that I enjoyed treating patients, and that I would enter practice rather than academia.

One of the many things that appealed to me about practising dentistry is the constant contact with a huge variety of people. This is not the case in academic research. It can be a lonely business. The other appeal of practising dentistry is that often, but not always, a problem can be identified and solved. Someone loses a filling. The dentist replaces it: problem solved. In academic research, as each question begins to be solved, many others present themselves: it is never-ending.