Tag Archives: surgery

Cattle in Cornwall and Denmark

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THE EARLY MORNING sun was shining over the hills surrounding our holiday cottage near Wadebridge in Cornwall, and we decided to take a stroll along the narrow country lanes nearby. The air was crystal clear, and we could see far-off grassy fields dotted with grazing sheep. Wind turbines with slowly turning blades punctuated the northern horizon. After crossing a small, fast-flowing stream, we ascended a steep hill. Every now and then, gaps in the walls bordering the roadway afforded us with splendid views. We reached the entrance to a field, I was reminded of a holiday I enjoyed in 1962 when I was ten years old.

Cows in Cornwall

Early in 1962, I underwent surgery to have my inflamed appendix removed. A few weeks after this, we set off for Denmark in our family Fiat 1100. It was just before Easter and the weather was cold. After traversing West Germany, we crossed into Denmark and headed for our destination, a farm near Toftlund in Jutland. The farm was owned by Lis, one of our former au-pair girls, and her husband. One thing I remember about Toftlund was something pointed out to me by Lis’s father. He showed me that each house had two different numbers: one was on a red background, and the other on blue. I cannot remember which was which, but one numbering system was that of the Danish authorities, and the other was that of the Germans, who had formerly occupied this part of Denmark.

The most memorable and enjoyable aspect of our weeklong stay on the farm was being able to mingle with the farm animals. The cattle and pigs were housed in sheds because it was too cold for them to graze outside. All day my sister and I enjoyed watching and stroking the animals. I think that the time we spent on the farm was so much fun because it was far more ‘child friendly’ than most of our other family holidays, which were centred around my parents’ fascination with artworks in Italian churches and museums.

Some of the cattle had horns. There is nothing unusual about that. However, my mother, who worried about most things and saw potential danger everywhere, was extremely concerned about these horns. What made her anxious was the possibility that one of the creatures might gore me and thereby cause my appendicectomy scar to burst open. Luckily, I survived to tell this story.

Returning to our walk in Cornwall, you will recall that we had reached an entrance to a field that sparked off my memories of Denmark more than 60 years ago. The gate to the field was the entrance to a small pen, The pen contained several cows waiting to be moved somewhere, or maybe to be milked. Seeing them staring at me staring at them reminded me of my wonderful holiday near Toftlund.

Swimming at the White House

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MY PARENTS, ESPECIALLY my mother, were keen that I learned to swim. It took me a long time to learn this activity. For many years, I was taken to various indoor pools to take lessons with a variety of swimming teachers, some professional and others not. One of the latter was a young Asian lady, who gave me a few lessons in the pool at the White House. This was not the famous establishment in Washington DC but a 1930’s apartment block, now a hotel, near Great Portland Street Underground station in London.

The White House, London

The teacher, who had no success with getting me to swim, lived in the White House and was recommended to my parents by another resident, a family friend, whom we knew as ‘Sakki’. Like my parents, Sakki was born in South Africa and my father told me that his family and Sakki’s were either remotely related and/or in business together. Both Sakki and my father were on the academic staff of the London School of Economics (‘LSE’). Sakki was the anthropologist Professor Isaac Schapera (1905-2003). He had become an expert on the anthropology of indigenous people of Botswana and South Africa. Amongst his many published works was “The Khoisan Peoples of South Africa”, published back in 1930.

Apart from providing me with one of my many swimming instructors, Sakki took a great interest in my sister and me. He gifted me several books, amongst which was several books about the adventures of Hergé’s cartoon character Tintin. These were in French and were volumes that were at the time neither available for sale in the UK nor translated into English. When I graduated with my PhD in 1976, he presented me with a two-volume book about magic, myths, and science.

In the very early 1960s, Sakki joined us on a family driving holiday in France in our smallish Fiat 1100. My mother, who had been involved in a serious car accident in the 1930s, had installed seatbelts in our car, a rare thing for the time. Sakki had to travel in the rear seat with my sister and me. Sakki had his own seatbelt (lap design), and my sister and I were strapped together in the other belt, separated from each other by a pillow. It soon became obvious to my parents that Sakki was not enjoying being confined in the rear of the car with two young children. My parents solved the problem by stopping at regular intervals at roadside cafés so that Sakki could enjoy a glass of cognac. This seemed to help him tolerate the journey, about which I remember little else.

During my childhood, Sakki was a regular visitor to our family home. He used to amuse us kids with comical verses, only one of which I can remember. It sounded to my ears something like this: “Olke, bolke, reeby, solte. Olke, bolke, knor.” While writing this piece, I looked for this on the Internet, and now know that what he was telling us was the words of an Afrikaans song that goes:

“Olke bolke Riebeeck stolke, olke bolke knor…”

Well, now, many years since I last saw Sakki, I know that what he was telling us was not his invention, as I had always believed as a youngster.

Sakki underwent surgery on his vocal cords. This affected his speech badly and drove him to avoid socialising in his later years. However, he did visit our home on at least one occasion after his voice had been affected. I was a young teenager then and I can still remember that when he spoke, all that one could hear was a hoarse, rasping, whisper. After conversing with me for a few minutes, he said to me:

“You don’t have to whisper just because I am talking so softly.”

And then he added:

“I have noticed that everyone with whom I talk gradually lowers their voice to a whisper whilst they converse with me. It is strange how the loudness of my voice affects that of people who are talking with me.”

That people unconsciously adjust their voices to match that of their interlocutors made a great impression on my young mind, and I have never forgotten it.

I do not believe that I ever met Sakki again between 1976 and 2003, when he died. By then, the White House had almost completely changed from being an apartment block to becoming a hotel. Sakki lived there until he died and was one of the place’s last full-time residents from the time before it became a hotel with a few flats.

And, just in case you are wondering, I did learn to swim eventually, not at the White House but in the pool of the old YWCA near to Tottenham Court Road station.

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.

Confined in Japanese occupied Manchuria

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PARTICLES OF SNOW, whisked by the breeze, were whizzing about in the air in random directions and eventually reaching the ground this early February afternoon in London. I had just finished my midday meal with some nutritious fermented cabbage and was wondering what to write. Maybe, it was the kimchi that helped me remember an old friend who spent some of his working life in Manchuria, which is close to Korea, the home of this weirdly delicious fermented food substance, or was it something else that has brought him to mind?

Sir Norman had already retired from Britain’s diplomatic service when I first met him in the mid-1970s. An accomplished musician, a string player, he used to perform in concerts given by a fine amateur orchestra based west of London, whose treasurer was both a player in it and a friend of mine. Usually, after concerts, my friend and her husband hosted a coffee party at their home for the conductor and selected patrons of the orchestra. Sir Norman was a patron, and it was at these parties that I first got to know him. The few tales that he related about his years as a diplomat fascinated me.

On graduating from university, Sir Norman had a good command of several modern European languages as well as Latin and Greek. He told me that it was typical of the diplomatic service that they decided that his first posting was to Japan, where he was to have a role in the interpreting of a language he did not know: Japanese. Being a good linguist, he was able to learn it.

During the late 1930s, he was sent to Shanghai in China for a year (1937-38). When he arrived, a war between China and Japan was in progress. He told me that every afternoon, he would sit taking tea on the roof of a building in the European cantonment of the Chinese city. As he sat there, he could see shells shooting overhead. They were being fired at the Chinese on one side of the Yangtse River by the Japanese artillery on the other side. This went on day after day for several months. Then one day, the shelling stopped suddenly and for good. Sir Norman wondered why.

Soon after the shelling ceased, he met some senior officers of the victorious Japanese forces. He asked them why the fighting that had been dragging on for so long had ended so abruptly. The officers explained that the Chinese soldiers were mostly mercenaries. Once the Japanese had ascertained how much to pay them to stop fighting, they stopped.

Later, Sir Norman was transferred to Manchuria, where he was the Acting Consul General in Dairen (now ‘Dalian’).  He was serving there when the Japanese attacked Pearl Harbour. After that incident, the Japanese authorities in the city of Dairen ordered him not to leave the consulate building, in which he lived. They cut off his telephone and forbade him to use his wireless to listen to radio broadcasts. Frequently, Japanese officers used to visit his premises to check that the radio was inactivated. Sir Norman, who told me that he had never been much of a technological wizard, told me more about the radio. He said that he had unscrewed a wire in the radio, which rendered it inoperable, and left it disconnected whenever he did not want to use the apparatus. With a smile on his kindly face, he explained to me that whenever he wanted to listen to a news broadcast, it was a simple matter to reattach the wire. During the time that he was being held under house-arrest, none of the Japanese officials who had visited to check on him had ever bothered to examine the radio properly.

In about 1942, the Japanese transported Sir Norman to Tokyo and eventually he was transferred into Allied hands. He said that at no time was he treated badly by the Japanese. In fact, he was looked after by them very well.

The last time I saw Sir Norman was not long before he died. We went to visit him at his home, whose lovely garden ran down to the bank of the River Thames.  He was in good spirits, recovering from a hip replacement. He told my wife and me that both of his hips had prosthetic joints and that every few years they required replacing.

“It’s like changing a car’s tyres, you know,” he explained cheerfully, “except that it lays you up for a few weeks each time.”

Although I did not meet Sir Norman as nearly as often as I would have liked, I feel privileged to have been able to hear about historical events from someone who experienced them first-hand.

Sir Norman died in 2002. Sitting at home today in early February 2021, watching whisps of snow swirling in the air, whipped up by a strong cold wind, had brought him to mind. I am not sure that it was because of the kimchi I had just eaten that made me think of him. I wondered if I had recalled him because just as he was confined in Manchuria, we are also being confined, or at least being restricted in our freedom to move around. Unlike him, we have plenty of access to communications from the outside world, much of which arrives in ways that Sir Norman did not live long enough to experience. However, like him, we are currently limited in our movements. We can leave home, which Sir Norman could not, but we cannot travel as far from it as we had become accustomed to doing before the onset of the covid19 pandemic. Sir Norman used to sit out the several weeks of recovery from his hip surgeries patiently. I suppose that we must also wait patiently, but for far, far longer.

Uganda and me

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UGANDA IS ONE OF many countries that I have not yet visited. Yet, I can relate some personal anecdotes related to it.

When we had our Hindu wedding ceremony in Bangalore (India), several of my wife’s aunts, whose families originated in Kutch (now part of Gujarat State in western India) were present and quite concerned that there were elements of Kutchi marriage traditions incorporated into our three-hour long ceremony. I cannot remember what these were. One of the aunts had lived with her family in Uganda until they saw the ‘writing on the wall’ and left for India before Idi Amin forcibly expelled all of the other Asians from his country. Her son, who lives in the UK, introduced me to Uganda’s national alcoholic drink ‘waragi’, brewed from bananas, which did not appeal to me as much as other drinks with 40% alcohol content.

Soon after I went to India for our wedding, I began working in a dental practice near Portobello Road in west London. It was there that I worked with ‘A’, who was the best dental surgery assistant I have ever worked with. She was resourceful, bright, friendly, polite, efficient, and never lost her cool. When equipment went wrong, I used to want to ring Andy, our repairman, but A would say:

“Let me fix it, Mr Yamey, I saw what Andy did last time.”

And usually, she fixed whatever had broken down.

Occasionally, A worked at the reception desk. Patients used to come up to the desk, often impatient and desperate to obtain dental treatment immediately. Instead of getting flustered, as other receptionists might easily have done, she used to say calmly something like:

“Good afternoon, Mr Brown, how are you today? And how is your family?”

When the patient had been calmed down by her questions, she would get down to the business of making arrangements for the patient’s treatment. She had a civilising influence on others.

A was born in Uganda after Idi Amin had given up ruling the country, but she lived through the troubling times that followed his downfall. She told me that she had witnessed a member of her close family being shot while she hid in a bush nearby. On another occasion, she told me:

“I heard some soldiers coming to my home, and, Mr Yamey, I jumped out of a window at the back and ran into the fields. I ran and ran and ran.”

Despite these and other horrific experiences, one would not imagine that A had had such a traumatic childhood.

A was an evangelical Christian. She kept a small edition of the New Testament in one of the drawers in my surgery alongside tubes and bottles of dental materials. It was printed mainly in black but with some words in red. These were, A explained to me, the words that had been uttered by Jesus. Every day, she used to say to me in her gentle voice:

“Mr Yamey, all you need to do to be saved is to accept Jesus into your life.”

This did not bother me, nor did the evangelical Christian radio station that she liked to hear while we were working. However, one day a particularly nervous dental patient, a frequent attender who had been born in the USA, was lying in my treatment chair, when he lifted his hand and said politely:

“There are two things that upset me. One is having dental treatment and the other is having religion thrust down my throat. So, A, will you please turn off the radio now.”

A did as asked, and we never listened to that station again. Often, A encouraged me to try ‘matoke’, a Ugandan dish made from a type of banana. She thought it was delicious, but I have not yet sampled it. I have not seen A for a long time now and hope that she and her husband are thriving and enjoying a life far better than she experienced in Uganda.

Long before I became a dentist, in my teens (in the second half of the 1960s), I loved collecting travel brochures: leaflets, maps, and booklets issued free of charge by travel companies and national tourist offices. My friend ‘F’ shared this passion. One day during the summer holidays, F suggested that we, that is F and his brother, me, and ‘H’, another close friend, should have a brochure collecting competition.  F and H formed one team, and F’s brother and I the other. The plan was that we start together at Oxford Circus and then work our way down to Trafalgar Square, collecting as much free travel literature as we could gather. The winning team would be the one which had collected most material, but taking duplicates was not allowed. Speed was also important, so we tried to waste as little time as possible in each place.

My team entered one travel agent or national tourist office after another, taking whatever was on display and asking the people working in them for any material that was available but not on display. We piled our ‘loot’ into the rucksacks we were carrying and moved from one location to the next. Our loads were quite heavy when F’s brother and I arrived at the locked door of Uganda’s tourist office on the south side of Trafalgar Square. We rang the door and were admitted by a man who led us upstairs to his office. There, we were asked to sit in front of his desk. He chatted to us politely, passing the time of day, whilst we sat there anxiously as the minutes, which we could be using more profitably, slipped past. Eventually, we got around to asking him for travel literature. He handed us three thin coloured brochures, which we considered to be a poor haul given how long we had spent with him.

Passing the Ugandan tourist office, which is still where it was during the 1960s, today in January 2021, soon after a recent election in that country, brought back memories of our brochure collecting dash and made me wonder whether at that time I should have been chasing after girls in my spare time, as many of my schoolmates were doing, rather than picking up leaflets about exotic destinations. By the way, F and H won our competition by a narrow margin.

So, finally, this is almost all I have relate about my somewhat tenuous connections with Uganda. All I wish to add relates to my father’s regular purchases of the satirical magazine “Private Eye”, which gave the term ‘Ugandan discussions’ a new meaning in March 1973. If you do not know what I mean, then I will leave you to search for the term on Google.

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.

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.

BLOG GLOVE Silvi_1024

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.

BLOG A Hospital_of_St_John_and_St_Elizabeth_(geograph_3306120) wikipedia

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)

 

Eye wash in Sarajevo

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In the late 1970s and throughout the 1980s, I used to visit the former Yugoslavia, where I had and still have many friends. Often, I stayed in Sarajevo (now in the Republic of Bosnia and Hercegovina), with Marija and her family. Here is something that happened on one of my visits. The account comes from my book about Yugoslavia, “SCRABBLE WITH SLIVOVITZ”.

Cross eyed_500

Marija, my host in Sarajevo, lived alone in her flat. Her husband, although an ardent communist, had fallen foul of Tito’s regime. Since the late 1940s, he had spent most of his life in prison. Many years after my last visit to Sarajevo, Liljana told me that her father used to be released from jail occasionally for short periods only to be re-arrested and re-incarcerated soon after. I was not clear about what he had done to deserve this. He must have been the ‘wrong kind’ of communist. Maybe, he had been a Stalinist and/or a supporter of Cominform. This organisation’s headquarters were in Belgrade from 1947 until 1948, the year when Yugoslavia’s relationship with Stalin’s Soviet Union began to go sour and the country was expelled from Cominform. It is possible that it was Stalin’s militant antagonism to Yugoslavia in the late 1940s that helped Tito to unify his ethnically diverse population.

During one of my visits Sarajevo, I noticed that the white part of one of my eyes had become completely red. It was a little uncomfortable as well. I hoped that no one would notice it; I wanted to avoid any fuss. So, I set off one morning to find a pharmacy, hoping to buy an eyewash, something like the British product ‘Optrex’.

As there was no way that I could possibly have explained what I wanted using my rudimentary knowledge of Serbo-Croatian, I decided that I would have to try to act out what I wanted. I wandered along the chilly snow covered streets, puzzling over how to do this. In the end, I felt too shy to try to attempt the necessary charade. I hoped that with the passage of time my eye would heal.

When I returned to Marija’s flat that evening, she immediately noticed my eye. In French, and sounding worried, she said that I might have caught something that sounded to me like ‘retinit’, a disorder about which I knew nothing. She succeeded in alarming me greatly by saying that there was an epidemic of whatever this was in Sarajevo, and that many people were being blinded by it. Next morning, she told me, she would take me to see a friend of hers, an ophthalmic specialist, at the university hospital. This also worried me. I remembered the depressing looking hospital that I had seen many years earlier when I was visiting Peć in Kosovo. My enduring image of that place was of its pyjama-clad inmates leaning out of upper-floor windows and hauling baskets of food up on ropes from their relatives, who were waiting outside the building on the ground below. The hospital in Sarajevo was nothinglike that.

I was introduced to the lady ophthalmologist, who then seated me in a special high-backed chair. A white-coated nurse approached me, carrying a syringe fitted with a long, broad-gauge needle. I must have winced in anticipation because Marija said,
“Ne t’inquiétes pas. C’est seulement une piqûre.” (Don’t worry. It’s only an injection)
An injection … in my eye: I did not like the thought of that. She
laughed again, and said,
“Regardez, le dentiste a peur d’avoir une piqûre!” (See, the dentist is afraid of having an injection)

Eventually, the nurse managed to squirt some liquid onto the surface of my eye, rather than into its interior, as I had feared was going to happen. The ophthalmologist examined it with her special equipment. It turned out, to my great relief, that I had an attack of conjunctivitis, which could be easily cured with the eye-drops that she gave me. After the clinical examination, we retired into her office. She rang for an assistant, who returned with cups of Turkish coffee and a dish filled with little cubes of lokum (Turkish delight).

 

I have lost touch with Marija and her family. All I know is that her daughter and son-in-law along with their child emigrated to the Seychelles shortly before Yugoslavia erupted into a self-destructing civil war.

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.