Tag Archives: medical

A benevolent dentist

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BEING A RETIRED dentist, I could not resist viewing a special exhibition held at the Museum of Freemasonry in Freemasons Hall in London’s Queen Street near Covent Garden. As a curious Londoner, visiting an exhibition in this imposing building had an additional attraction: a chance to see inside an edifice I have walked past many times, always wondering about it without ever entering it. I was alerted to the special exhibition by a message from a friend in Bombay, who keeps a close eye on current cultural events both in Bombay and London. She thought that this show would interest me because it is about the activities of a dentist, Bartolomeo (also known as ‘Bartholomew’) Ruspini (1728-1813).

Born near Bergamo in northern Italy, son of a minor member of the aristocracy, Ruspini was recognised as a surgeon by The College of Physical Sciences in Bergamo in 1758. He decided to specialise in dentistry and to further his skills, he travelled to Paris, which was then recognised for its training in this field. In those days, dentistry was not a recognised profession as it is nowadays. Most people who had dental problems, sought the assistance of hairdressers, blacksmiths, and others without any professional training. To distinguish himself from these untrained people, he called himself a ‘surgeon dentist’(https://en.wikipedia.org/wiki/Bartholomew_Ruspini). Today, the people, whom you might call ‘dentists’ are in fact ‘dental surgeons’.  I was qualified to practise dentistry, and one of my dental degrees was ‘Batchelor in Dental Surgery’.

Ruspini arrived in England by May 1752. He married his first wife, Elizabeth Stiles, in 1757, five years before he was accepted as a member of The Burning Bush Lodge of the Freemasons in Bristol. Later, Ruspini went on to establish several new Freemasons lodges (https://rmsghistoryextra.wordpress.com/tag/elizabeth-orde/).  By 1766, he was practising in London under the patronage of the mother of King George III. He had already treated royalty, so great was his reputation as a healer of dental problems.  His acceptance into high society was no doubt facilitated by his renunciation of Roman Catholicism and his second marriage, in 1767, by which time his first wife had died, to Elizabeth Orde. The couple were to produce nine children, five of whom survived infancy. Two of his sons became surgeon dentists.

In an England, which was then not particularly friendly to foreigners, Ruspini was accepted well because of his good nature, excellent clinical skills, and great ability to get on well with people and to ‘network’ in high society. He was highly regarded as a Freemason. His skills on the dance floor, delight in display, and flamboyant character made him a wonderful masonic master of ceremonies. In keeping with the ideals of Freemasonry, Ruspini exhibited much benevolence: hospitality, generosity, kindness, and charity. An example of the latter was his important involvement in the founding of the Royal Masonic School for Girls (in 1788).

Ruspini had his main residence at 32 Pall Mall in London, but also visited Bath frequently. He was famed for his patented styptic, a substance that stemmed haemorrhage. He also created a dentifrice as well as an elixir for easing toothache.

In 1768, Ruspini published the first edition of his “Treatise on Teeth”. I found a copy of its eighth edition whilst searching online. The book is well-written and easy to read and, in many places, not too out of date. It would do first-year dental students no harm to read this informative book, well at least as far as the sections on “The Disorders of the Teeth”.  This section has become somewhat dated, but not altogether so. For example, the author advises that disorders might arise from:

“… any particles of food that stick between the teeth and putrify … the excessive use of smoking and chewing tobacco … sugar, when used immoderately, is another enemy of the Teeth … All mineral exhalations are also very pernicious, as we see by daily experience in all those persons who work in any of the quicksilver, lead, or copper mines etc…”

Of the causes of caries (tooth decay), Ruspini gives several, but does not mention sugar in connection with this common problem, despite what he wrote in the quote above. However, he did consider that sugar was important in another disorder:

“Children who eat too much sugar, or sweetmeats, generally have their gums corroded; confectioners and chemists are subject to this disorder …”

Although much can be criticised as being out of date in his book, Ruspini did a wonderful job of describing concisely and clearly what was known about dental anatomy and pathology in his time. Part of the book is dedicated to clinical case studies. One of these concerned:

“…Captain Nelson, of the Royal Navy, whom I accidentally met at Portsmouth…”

Ruspini cured him of a painful fleshy growth in his mouth, which other surgeons had wrongly diagnosed as syphilitic.

The book ends with adverts promoting Ruspini’s styptic balsam, elixir, and dentifrice powder. A copy of this book and another about his styptic are on display at the special exhibition in the beautiful library at Freemasons Hall. Other exhibits included documents, drawings, cartoons, and a few other objects. For me the great thing about the exhibition was not its contents but introducing to me a truly remarkable member of my profession.

Members of the public visiting Freemasons Hall in Queen Street are encouraged to see the magnificent collection of items and documents relating to freemasonry before seeing the exhibition dedicated to Ruspini. The museum contains a rich variety of exhibits, many of them displaying the Freemasons’ passion for the use of symbols, and most of them objects of great beauty. Not knowing anything about Freemasonry, this first visit to the museum was for me more a dazzling visual experience than a learning opportunity. On a subsequent visit, I hope to spend much more time examining the artefacts and their informative labels.

The Freemasons Hall is a ‘larger-than-life’, exuberant work of architecture and construction. It is the headquarters of the United Grand Lodge of England as well as the Supreme Grand Chapter of Royal Masons of England. The present building was designed by the architects Henry Victor Ashley (1872-1945) and Francis Winton Newman (1878-1953). It was built between 1927 and 1933 to commemorate the 3,225 Freemasons who died whilst on active service in WW1. Some say that the building is art-deco in style. This is the case, but there are also many elements in the design suggestive of a modern version of neo-classicism.

I am grateful to my friend in Bombay for introducing me to Ruspini and by doing so, giving me a reason to visit the remarkable London headquarters of the Freemasons.

After effects

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MY FIRST TRIP TO TURKEY was in 1960. I had just finished primary school and was about to start preparatory school (8 to 13 years old) after the summer holidays. That summer we were travelling to Turkey, to Istanbul, where my father was a delegate at a conference. It was deemed necessary to have vaccinations to reduce the risk of contracting typhoid and cholera.

Our family doctor’s surgery in London’s Golders Green was close to my primary school. I had decided to get my ‘jab’ and then to go to school to help organise the annual sports day. When I arrived, I was assigned a task related to the high jump competition. At first, all went well. Then, after a few minutes, I began shivering and felt lousy. I excused myself and made my way home. I spent the rest of the day and the following in bed and the arm in which I was injected felt both painful and heavy. A few weeks later, I was given the second of the combined cholera and typhoid jabs. However, there was little or no after reaction.

Since that jab back in the summer of 1960, I have had numerous, indeed an uncountable number of, vaccinations. Each of these was accompanied by a small amount of discomfort at the site of injection, but no more than that. This was the case until early February 2021.

In February 2021, I was given the first of the two doses of the Oxford Astra-Zeneca vaccine to counter covid19. Within hours of the jab, I began feeling unwell. I did not feel as sick as I did after the first typhoid/cholera jab, but I was not at my best. I did not lose my appetite, nor did I develop an elevated temperature. This feeling of being a little bit ‘below par’ lasted no more than 36 hours. So, it was with some apprehension that I attended the clinic for my second jab in mid-April.

My general medical practitioner, whom I had consulted for another matter, advised me to take two paracetamol tablets (2 x 500mg) just before the jab and another two later in the day. Her advice seems to have been good. Now, nine hours after the jab, I am writing this piece and feeling far better than I did after the first shot of the vaccine. I had been told that just because one has had a reaction after the first injection, it is a matter of pure chance whether one has any reaction after the second. Maybe the paracetamol is working or perhaps I have just been lucky. In any case, I feel happy that I have had the full vaccination as is currently advised.

At the sharp end

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“THIS WON’T HURT A BIT” are words that I never used when I was practising as a dentist. However careful and gentle one is when giving an injection, the recipient is bound to feel at least a tiny bit of discomfort. So, I never uttered those words because to do so would be telling the patient something untruthful and that would have risked undermining his or her confidence in me. So, today, when I went to our beautifully well organised local clinic (at St Charles Hospital in London’s North Kensington) to receive the first of my vaccination ‘jabs’ to protect me from covid19, I was pleased that the clinician, who administered it did not say those words which I always avoided, but instead told me that I might experience some discomfort. Despite the needle being of a larger gauge than usual, my jab was not at all painful.

Years ago, a friend of mine, ‘X’, who was married to ‘Y’, a medical doctor involved in biological research, related her experiences of receiving vaccinations and other injections. Until she went into hospital to have her first child, she had always been given injections at home by her husband.

On arrival at the hospital, X was terrified when she was told she needed an injection. However, after it was done, her fears evaporated, but was left with a question in her mind. After she returned home with her baby, she asked her husband the question that had occurred to her in hospital. She said to Y:

“It’s really strange, dear, but the injections I had in hospital were completely painless unlike those you give me. I wonder why that should be.”

Y did not answer immediately, but after a short while, said:

“That’s easy to explain. I always inject you with the type of needles that I use for injecting, or taking samples from, experimental animals, the rats and so on.”

It is no wonder my friend found her husband’s injections painful. The syringe needles he used for laboratory animals were of a much wider bore than those normally used for administering jabs to humans. They were wide enough to be cleaned by pushing a wire along their length prior to sterilizing them.

This reminded me of the somewhat painful injections that our family doctor, Dr C, gave us when we were children in the early 1960s and before. Even though this was long ago, I can remember that his surgery had a gas fire, and its gas pipe had a small branch that fed a burner that heated a container in which he boiled his glass syringes and reusable needles between patients. These needles, like those used on animals and my friend, X, had to be wide so that they could be reamed out prior to being boiled. Furthermore, repeated boiling in water, blunted the needles and made them increasingly likely to cause pain when penetrating the skin. It was lucky that when we were vaccinated as kids, we did not come away with some infection as bad as whatever we were being protected against. There was no HIV in the 1960s, but there were other bugs, which were certainly not inactivated by boiling water.

Today, at the vaccination centre, a beautifully laid-out facility in a Victorian hospital building, I was shown the wrapped disposable syringe and needle, and felt confident that the vaccinator at St Charles had done a good job of jabbing.

Extracting the truth

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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.

Smoking drums

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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.

Seated above a cow

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I HAVE WALKED PAST IT OFTEN, noticed it, but had never examined it carefully until a few days ago. I am referring to the statue of Edward Jenner (1749-1823) that surveys the formally arranged pools and fountains in the Italian Gardens at the north end of the Serpentine Lake. This body of water was created in 1730 at the request of Queen Caroline (1683-1737), wife of King George II.  Originally it was fed by water from the now largely hidden River Westbourne and Tyburn Brook. Now its water is pumped from three bore-wells within the confines of Hyde Park.

 

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Jenner is depicted seated in what looks like an uncomfortable chair, resting his chin on his left hand, his left arm being supported on an armrest.  The bronze statue was created by the Scottish sculptor William Calder Marshall (1813-1894). He also created the sculptural group representing ‘Agriculture’ on the nearby Albert Memorial. The Jenner sculpture was originally located in Trafalgar Square, where it was inaugurated in 1858 by Prince Albert, the Queen’s Consort three years before his demise. In 1862, the sculpture was moved to its present location in the Italian Gardens. Incidentally, the design of the gardens was based on those at Osborne House on the Isle of Wight and were created in 1860 to the design of the architect and planner James Pennethorne (1801-1871).

Jenner, a qualified medical doctor, is best known for his pioneering work in developing protection against smallpox. This derived from his experimentation based on his (and other people’s) observation that the pus from blisters that milkmaids received from cowpox protected them against the far more serious disease smallpox. Justifiably, Jenner has been dubbed the ‘father of immunology’. So great was his achievement that Napoleon, who was at war with Britain at the time, awarded Jenner a medal in 1803, the year Napoleon was planning to invade Britain with his recently formed Armée d’Angleterre. The French leader said:

“The Sciences are never at war… Jenner! Ah, we can refuse nothing to this man.” (see: https://www.nature.com/articles/144278a0).

Maybe, these words of the great Napoleon can still teach us something about international cooperation generosity of spirit.

His fame in the field of vaccination overshadows Jenner’s other achievements in science and medicine. He was a first-rate zoologist. For example, his observations, dissections, and experiment established for the first time that the baby cuckoo is born with a depression in its back that allows it to displace the eggs of the  bird whose nest the cuckoo has colonised. The baby cuckoo ejects his or her host’s eggs without the help of the adult cuckoo, which has deposited her eggs in the nest of another species. Jenner published his findings in 1788. This was a few years before he established the effectiveness of vaccination in the late 1890s. He self-published his results in 1898 after his most important paper was turned down by The Royal Society.

Getting back to his statue in the Italian Gardens, there are two features that I had not noticed before examining it carefully recently. One of these is a depiction of the Rod of Asclepius on the backrest of Jenner’s seat.  The serpent entwined helically about a rod is traditionally associated with medicine and healing. Beneath the seat, there is a depiction of a cow’s head. This is appropriate symbolism given the importance of cows in the discovery of smallpox vaccination. The word vaccine is derived from the Latin word ‘vaccinus’, which in turn is derived from ‘vacca’, the Latin for ‘cow’. There is an object depicted below the cow’s head, which I fancy, using a little imagination, might be a stylised depiction milk maid’s cloth hat.

Jenner was not the only person experimenting with inoculation against smallpox, but he is the person best remembered for it because his results and reasoning convinced the world of the concept’s validity and applicability.

Although I do not find the monument to Jenner to be particularly attractive, it is one of London’s statues least likely to arouse anger as its subject had nothing to do with slavery. In contrast to many other well-known figures of his era, Jenner should be remembered for his important involvement in a development that has benefitted mankind for well over two centuries. I hope that his scientific descendants currently working around the world in laboratories will be able to create a vaccine to counter the Covid-19 virus as soon as possible.

What? No gloves!

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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.

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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.

 

 

Of doctors and Denmark

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ONE OF MY TWELVE FIRST cousins, having just read my recent piece about Finchley Road in north London, reminded me about a hospital close to that road,  where she and her parents had received medical care. This reminded me that I had also been treated at that hospital many years ago. So, here is what you have all been waiting for: undergoing surgery in St Johns Wood.

One night early in 1962, I decided to see what it would be like sleeping on the floor with only the carpet between me and the floorboards in my bedroom. I have no idea what made me want to try that. I woke up the next morning, feeling a mildly uncomfortable sensation in my abdomen. It was not a feeling that I had ever experienced before. At first, I imagined that it had something to do with spending a night on the floor, but something made me decide to tell my mother about it. She was concerned about it and made an appointment to see our GP, Dr Clough, who had his consulting room in the ground floor of his home on Finchley Road, close to Golders Green Underground Station.

Dr Clough was a kindly man, a family friend. His waiting room had a large fish tank as well as the usual collection of well-thumbed magazines. His home was directly beneath an outdoor section of the Northern Line. Trains rumbled overhead every few minutes.

The doctor examined me and rapidly concluded that I had a ‘grumbling’ appendix. He told us that it should be removed, but there was no hurry to have the surgery carried out. He recommended a surgeon, who operated at the private St John and Elizabeth Hospital (a Roman Catholic institution) in St Johns Wood, not far from its Underground Station.

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This station, which had, and still has, scraggy palm trees growing near its entrance, was close to the ground floor surgery of our ageing Jewish dentist, Dr Samuels, who was a refugee from Nazi Germany. His waiting room did not have a fish tank, but its floor was covered with luxurious oriental carpets, and the magazines in it were issues of the glossy paged Country Life. Dr Samuels’ surgery was in a block of flats, Wellington Court on the corner of Wellington Road (part of Finchley Road) and Grove End Road, on which the St John and Elizabeth Hospital is located.

I was installed in a private room with, to my great delight, a television for my exclusive use. My delight stemmed from the fact that we did not have a television at home. There were also chairs for visitors. The seat of one of these, which was nicely upholstered, could be removed to reveal a commode.

On the day before my operation, I was taken to a bathroom and told that after I had bathed, I was to call for a nurse by tugging on a cord attached to a bell-pull. There were several cords dangling near the bath. I pulled one at random. Then, I peered out of the slightly open bathroom door and saw a frenzied scene. Nurses were running hither and thither, some of them carrying oxygen cylinders. My nurse returned to the bathroom and told me that by mistake I must have pulled a cord attached to the fire alarm.

The operation went without hitch. I do not recall feeling much pain after it. I was kept in my private room for almost a week. Everyday, I watched as much television as I could. As I had been instructed not to get out of bed unless nature called and the television was far too old to be equipped with a remote control, I had to ring for a nurse each time I wanted to watch a different TV channel. When I pressed the bell button, a nun with a white apron (many of the nurses were nuns) would arrive and switched the channel. (The first time I ever saw a television with a remote control was in December 1963 in a hotel in Baltimore (USA). The controller was attached to the television by a long cable).

Many people including my parents and close family, visited me in hospital. Although this was very kind of them, I always hoped they would not stay long because while they were in my room I had to have the television – the best thing about being in hospital – switched off. It always amused me when a visitor sat on the seat that concealed my commode. I wondered what he or she would think or do had they known what was beneath them.

During the Easter holiday, which occurred a few weeks after I had left the hospital and gone back to school, we set out on a driving holiday to Denmark. We drove to Harwich, where I watched our car being loaded into the hold of the ferry in a rope basket lifted by a crane on the quayside.  We drove through Germany, a country in which my parents preferred not to linger longer than needed. We spent one night in a German hotel. It was there that we experienced sleeping under quilts (duvets) for the first time in our lives. We all thought they were a marvellous alternative to sheets and blankets.

In Denmark, we spent several days on a farm near Toftlund, which is about 23 miles north of (formerly ‘West’) Germany. The farm was owned by one of our former au-pair girls and her husband. My sister and I spent several glorious days mingling with the animals on the farm, mostly cows and pigs. This experience made this holiday one that I remember with great fondness. My mother, who saw danger everywhere, was most concerned that I should not be injured by any of the cows’ horns. She was worried that should a horn impact me, it might cause my recently healed surgical scar to split open. She had no need to be anxious. The weather was so cold that we were wrapped in several layers of clothing including thick duffel coats held closed with wooden toggles.

Our hostess’s father was an interesting fellow. He showed me houses in Toftlund that bore two kinds of house numbers, one blue with white figures, and the other red with white numerals. Between 1864 and 1920, Toftlund had been in what was then German ruled territory. One kind of house number had been affixed by the German authorities, the other by the Danish.  This made a great impression on my young mind. Since then, I have always looked out for small details, souvenirs of historic eras, like these.

My mother was so impressed by the duvets (‘dune’ in Danish) under which we had slept both in Germany and Denmark that she bought four down filled duvets in Denmark along with covers for them. These were transported on the back seat of our Fiat 1100. My sister and I sat on them for the rest of our holiday, which took us to Odense and Copenhagen before we returned to London.

We spent the Easter weekend in Copenhagen. Almost everything was closed and the temperature outside was very low. We wandered around trying to keep warm. The only warm place that was open were the tropical houses in a botanical garden.

Our return trip was not without incident. We broke down in the German border town of Flensburg just after leaving Denmark. Some electrical component needed replacing. We had to wait about four hours for a replacement part from a company I had never heard of before: Bosch. Well, I was about to become ten years old. So, perhaps it was not surprising that I was unfamiliar with the names of German companies. Whenever I hear the name Bosch or the French word for the German invaders during WW2, Boches, I always remember our four hour wait, parked next to an inlet of the sea in an industrial landscape.

We returned to London. My scar had not burst open. Our four blue cloth covered duvets filled with duck down were intact. After our return to London,  we never again used blankets and the hitherto tiresome job of laying beds was replaced by the relatively simple task of spreading the duvets over the beds. I believe that we were amongst the first households in the UK to use duvets.

Of the four duvets we brought to London from Denmark, I kept and used one of them for about 48 years. Reluctantly,  we disposed of it because over the years it had lost most of its feathers. I have got so used to sleeping under duvets that when I stay somewhere which had tightly tucked sheets and blankets, I have to untuck them fully.

Since my youthful experiment of sleeping on the floor, I have only repeated it when camping. And, when in a tent, I like to separate myself from the ground with a fully inflated air mattress. On the one occasion when I had no air mattress, I barely slept and barely escaped contracting pneumonia, but that is another story.

An appendix usually follows a story or text but in this case, it is at the start of my story. I have lost a short and, apparently, useless evolutionary intestinal vestige, my appendix.  Thinking about its loss and the good time I had at the St John and Elizabeth Hospital, has triggered a chain of memories of an era long past. I hope that I will not be deprived of any more parts of my anatomy, especially whatever keeps alive my recollections of the past, many of which I enjoy sharing with anyone who is interested.

 

Picture of Hospital of St John and Elizabeth (from Wikipedia)

 

Annoying and rude

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During the last few years that I practised dentistry, most of my patients brought mobile telephones into my surgery.

You would be surprised how many patients tried to answer their ‘phones when my fingers were in their mouths or their mouths were filled with impression (mold taking) material.

Worse still, were patients who were ‘texting’ constantly when I was trying to explain their treatment options to them.

Once, a patient arrived late, speaking on his mobile phone. He muttered to me that he was in the middle of a telephone job interview. I had no choice, but to let him continue. After half an hour, he told me he was ready for me. I told him that he had wasted my time and his appointment and had to book another one.

In the end, I put up a large sign in my surgery forbidding the use of mobile phones, which was rude and inconsiderate. This solved the problem because, to my surprise, most people obeyed it.

Going viral

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Two bees or not two bees_240

I hope that I am not tempting fate by writing this!

I am puzzled by the excessive anxiety over the coronavirus outbreak, which is encouraged by politicians and the press.

On the one hand, the public is informed that the virus outbreak will lead to dire consequences on a global and local scale.

On the other hand, we learn that apart from a couple of susceptible groups at the two extremes of the age range, being infected by the virus is highly unlikely to cause the infected person to suffer much if anything at all.

What are we to believe? Should we be panicking as our politicians seem to be suggesting, or should we not let the coronavirus affect our mental harmony?

Whatever the answer, it is best to be careful!

 

Finally, here is a thought provoking article to read:

https://www.psychologytoday.com/gb/blog/culture-mind-and-brain/202002/the-coronavirus-is-much-worse-you-think