By Jean Foster
|He closed his eyes, and sat back against the hard seat of the train. |
Behind his eyelids, he could still see them, and a hot wave of embarrassment flooded over him. His parents, standing on the platform of Perth Station, wreathed in smoke and steam, waving him goodbye as he set off for Adelaide to start his 4th year of Medical studies. They were neatly dressed, but their clothes seemed drab and unfashionable. Certainly, they had possessed them for a long time: they were their Sunday Best outfits, and the memory of them seemed to stretch back into his childhood. He hadn’t really noticed it before, but now, next to the well to do and well turned out parents of some of his fellow students, he was only too aware of their sartorial shortcomings. And his mother was wearing white gloves!
It was only natural that they were proud of him. After all, he was the first in their family to have gone to university, and to top it all, he was studying Medicine. A Doctor in the family was something to be really proud of. Well, that was all very well for them, they could bask in the glow, but what did they know of the hard work and sacrifice that it took for him to do it? They had always had quiet, simple lives, and that was the problem. They had never tried to extend themselves. They had been happy to stay as they were, never having to make difficult choices, never having to sacrifice anything. The more he thought about it, the more he felt that they had let him down. How could he take his friends home? He had been to their homes, and he’d been impressed by the large houses they lived in, furnished with taste, and often with family heirlooms. He had heard whispers from various Aunts and Uncles, and he knew that his Grandparents had left his parents some expensive furniture. What had happened to it? How could they have exchanged it for the cheap furniture that now graced their loungeroom? He loved his parents, but at the same time he had to admit that he was embarrassed by them. No. It was more than that. He was ashamed of them.
He hoped that none of his friends had noticed them. So far, in his career as a student, his blond good looks, quick sense of humour and football playing ability had assured his popularity, and he didn’t want to risk a fall from grace. He had been careful to stay down one end of the platform, and had asked them not to come right up to the train, saying that he preferred to say goodbye properly, away from the train. He felt sure they simply thought he was too upset. This did raise an uncomfortable twinge of guilt, but he quickly put it to the back of his mind. He took a deep breath, and decided not to think about these things any more. He had a busy year ahead of him, and he had to keep his mind clear for it.
“Now. Therein lies an interesting story, one that shows that people may not be quite as the world sees them.”
Dr Anderson was taking them on their ward tutorial. The four medical students followed him, like ducklings behind the mother duck. They were now in their 2nd
term of 4th year, and as ducklings were expected to be able to swim, so they were now expected to be able to take a history, examine a patient, formulate a diagnosis and discuss treatment. None of them had a clue how ducklings felt, but it was fair to say that the students still felt very nervous wondering if they would be the one picked to present a case. Today, Mark was the duckling that had been pushed into the water, clutching his case notes. The others, however, did not escape: there was always the fear that a question would be suddenly directed at a student who wasn’t presenting, and so alertness was important at all times.
Fortunately, Dr Anderson was a benign tutor, with none of the alarming characteristics of some of his fellow specialists. He was a General Physician, and had worked for some years as a General Practitioner. This had served to make him more understanding of his students’ frailties. Not for him the sarcastic comment and withering glance directed at the student, helpless before him like a rabbit caught in the glare of car headlights. His method was to explain the error with kindliness and humour, often illustrated with one of his famous anecdotes.
On this occasion, Mark had reached the point in his patient’s story where, as a soldier in the 2nd World War, he had been one of the first people to receive the new wonder drug, Penicillin. As a consequence, he was now alive to tell his tale to medical students, a task he accomplished with great relish.
“Yes,” said Dr Anderson slowly, stroking his beard and looking up at the ceiling as he always did when gathering his thoughts for a story. “The famous Dr Alexander Fleming. Hero of the modern world.” He paused.
Mark strove to look very interested, raising his eyebrows in mute query, eager to hear the story. It was well known that encouraging Dr Anderson was a useful way of using up time in the tutorial whilst avoiding answering questions, or having to do something difficult like demonstrating mastery of examination of the cranial nerves. Alan, a conscientious and detailed note taker, had his pen poised ready to get the story down in case it came up in the exams. Richard, a student with a rather supercilious air, and a disdain for any information that wasn’t strictly relevant, tutted under his breath, convinced that it most certainly wouldn’t come up in the exams, and was therefore a waste of his time to listen. He found Dr Anderson’s tendency to circumnavigate the curriculum very irritating. James and Mark exchanged amused glances. Of the two, Mark was the happier, having just won his bet that Dr Anderson would launch into a story before they had finished discussing the first patient.
They had reached the Doctor’s Office on the ward by now, and they perched on desks and chairs to listen to Dr Anderson.
“As you know, Sir Alexander Fleming is famous for having discovered Penicillin. But how many of you know that it was a case of serendipity?” He stopped to glance around the room, wondering if they knew the term. His gaze was met with three blank looks and one frowning brow. The brow belonged to Alan, who was sure he had heard the term and noted it down, but couldn’t remember which notebook it was in.
Dr Anderson continued, not unduly disappointed that he would need to explain what it meant. “Serendipity being the discovery of something by a fortunate accident. Now, far from Penicillin being a discovery brought about by hard work and persistence, it came about because of sloppiness. Dr Fleming was going away for the weekend, and the culture plates in his laboratory were just left in the sink, with an open window above. Some fungal spores blew in through the window, and landed on the culture plates. When they all returned the next week, they were surprised to see that there were clear areas on the culture plates, where the bacteria had failed to grow. These areas coincided with the areas contaminated with the penicillin fungus, and an antibiotic was born.”
“Dr Anderson, does that mean we shouldn’t clean up after our next Micro Lab?”, said James, grinning. The group laughed, Dr Anderson smiling with them.
“No it does not! And before you run off with that idea, let me tell you that it would never have become a useable antibiotic if it hadn’t been for Sir Howard Florey taking up the work and bringing it to completion. Many feel that it was most unfair that Fleming got the lion’s share of the fame, when it was Florey who did most of the hard work.” He looked at his watch “Now, we must get on. Mark, continue the story of your Veteran.”
Mark had only got as far as reiterating that his patient had been one of the first to be treated, when Dr Anderson broke in again.
“Of course, Penicillin was in very short supply in those days, as it had to be grown in vats. Almost all the supplies went to the armed forces, there was a war on, and that was where it was needed. Even after the war, it was still very hard to come by. Small supplies could be obtained for the very ill, but it was incredibly expensive. I had some personal experience of this. That was in the days when I was working as a GP in Perth.”
The students all sat back on their perches again, for the next instalment. Mark snuck a look at his watch. Yes, this should just about do it, the tutorial would be over before it was discovered that he had forgotten to check on his patient’s latest results. Richard pointedly closed his notebook and screwed the cap back on his pen. He would save his ink if they weren’t going to be taught anything of value.
Dr Anderson continued. “I was called to the house of one of my patients one night. I knew the family well, a decent hard working couple, not rich, but they were a happy family. They had one child, a five year old boy, who had been suffering from abdominal pain for the last 3 days. It had started in the central abdomen, but for the previous 24 hrs, it had been located in the right Iliac Fossa, and he was extremely tender to palpation.” Dr Anderson looked around the group, and fixed his eye on James. “What is your Diagnosis?”
James was caught off guard. This wasn’t part of the plan. He was happy to just
listen, not answer questions. He recovered quickly, however, as it was a question he
felt confident about. “Appendicitis!” was his triumphant reply.
“Exactly what I thought, and as it turned out, we were both right. I arranged for him to be admitted to a small local hospital, where the surgeon operated. Unfortunately, it had ruptured before he could get to it, and he developed peritonitis. This was an extremely serious matter. It usually meant a death sentence.
“You can imagine how distraught the parents were. I talked to them about treatment to control his pain and keep him comfortable, but they pleaded with me to do something to save him, kept saying ‘There must be something that can help him’”.
“The Penicillin!” interjected Alan.
“Correct! The new wonder drug. We had all heard about it’s miraculous ability to fight infection, and one of my colleagues had even seen it used, but that was as far as our knowledge went.
“I hesitated. I looked at this little boy lying in his hospital cot, his mother clasping his hand in hers, as if she could physically stop him from slipping away. I felt I had to do whatever I could, but I didn’t want to falsely raise their hopes, only to have to dash them. I didn’t even know if any was available, and I feared it would be prohibitively expensive. In the end, I told them that there was just a possibility something could be done, but warned them it was a slim chance, and that I would have to go away and find out about it.
“Having committed myself by saying something, I then had to track down my colleague and find out if and where it was possible to get some. I can tell you, I was starting to doubt the wisdom of my actions. As I left the ward, the father took my hand in both of his, and looked at me as if I was the second coming of Christ.”
James nudged Mark, and they exchanged barely visible grins. Dr Anderson frowned slightly before continuing.
“To cut a long story short, and after quite a number of phone calls, I found that there was a supply available: very limited, very expensive, but available. I went back to the parents and explained the situation. I felt I was putting them in an untenable situation. Here was a drug that could save their son’s life, but it was so expensive, they couldn’t possibly afford it. However, to my surprise, they didn’t hesitate, just told me to go ahead and they would get the money. I couldn’t get it until the next morning, so I arranged to come back then, just hoping the boy would still be alive. After a frustrating 2 hours chasing around, I finally had the Penicillin, and raced to the hospital, convinced I would be too late. Fortunately, I wasn’t, and we started him on the treatment.”
Now, even Alan was starting to get a little restive, and glanced at his watch. Richard, however, seemed strangely quiet and detached.
“There’s an interesting addendum to this story. Some weeks later I was called to the
house when the mother was unwell. Her husband let me in, and as I walked down the
hall I glanced into the loungeroom. To my surprise, the room was bare. The furniture
was gone, the paintings on the wall were gone, and the ornaments were gone. They had some nice stuff, nothing very expensive, but it had obviously been in the family for some time. And now it was gone. As I stopped in my tracks, the father commented, with simple dignity ‘I said we would get the money to make my boy well, and we did.’”
Dr Anderson paused to let the dramatic moment have its full impact. He looked around the group. Alan took the opportunity to say, “Excuse me, Sir, but we have a lecture in 10 minutes.” He always liked to be a bit early so that he could get a seat at the front of the lecture theatre. It was the best position for asking questions at the end of the lecture without being disturbed by the other students packing up and leaving.
With a sigh of regret at having to truncate his story, Dr Anderson nodded and made a shooing motion with his hands. “Yes, you’d better all be off. Professor Hardwicke isn’t as forgiving as I am!”
As the others all trooped out of the office and down the corridor, Richard hesitated. Alan looked around in surprise: his fellow student was usually as keen as he was to get to the lectures on time. Richard just waved him on. He didn’t feel like joining in the general chatter that wafted back as the group disappeared around a corner. In fact, he was feeling strangely out of sorts, with a dry mouth and an unpleasant knotted feeling in his stomach.
He cleared his throat. “Dr Anderson…” He wet his lips. “What happened to the boy in the end?”
Dr Anderson raised his eyebrows in surprise. It wasn’t often that Richard asked him questions. “I gave him the Penicillin, and he slowly recovered, with nothing to show but a rather untidy appendix scar. As to what happened to the family after that, I have no idea, as I moved to Adelaide shortly afterwards. I can’t even remember their surname, but I have often thought about them. To me, this whole story was such an interesting juxtaposition of two very human but very different attributes. On the one hand, laziness, slovenliness, whatever you like to call it, allowing the discovery of a life-saving drug, and on the other hand, the devotion, care and sacrifice that enabled that drug to be used.”
Richard seemed to be deep in thought. Dr Anderson laid a hand on his shoulder. “As you go through your career, you will come across such examples of sacrifice and devotion, and you will start to understand the extraordinary things ordinary people are capable of.”
Richard nodded. He still felt strange: a little light headed, pulse a little high, and still that knot in his stomach. Even his puckered appendix scar seemed to burn.
He couldn’t seem to find his voice, but in his mind, an emphatic voice said ‘Oh but I do. Finally, I understand.”
Copyright 2021 Jean Foster
Published by Kenneth R. Vickery