Beyond the Colonnade

By Tom Vaughan

This book follows a previously published selection of poems and pictures by the children of Terezín and Osvtím, the ‘camp of lies’ of the Theresienstadt Ghetto and the ‘camp of death’ of Auschwitz.

‘Beyond the Colonnade’ is a selection of notes on situations and individuals encountered over decades of community-based primary care practice, starting in the East End of London and terminating in Chicago.

From medical school on, the lifetime of learning required by the ethical practice of medicine presents an introduction to humanism unsurpassed by any other discipline; and, by its implicit connections to other areas of scholarship, scientific, social and literary, a first-rate general education. Such learning is reinforced daily by the diversity of human contact.

The exercise of the craft affords the practitioner an entrée to large communities, small homes and to the privileged communication of individuals. It offers a unique vantage point from which to observe the broad spectrum of human motivation, emotion and response and to become acquainted with the impact of societal and economic realities on the enjoyment of health and the experience of disease.

Of this wider view of the medical life, the lines which follow may stand in evidence of such a claim.

For every physician who maintains an unrestricted practice, consider:
that, when the whole world can walk in at the door, the unusual and fascinating are always to be expected!



Cover picture: The Colonnade, Guy’s Hospital, London, 1972

• Language: English
• Publisher: Xlibris US
• Release date: May 21, 2009
• ISBN: 9781465317247

Book preview

Copyright © 2009 by Tom Vaughan.

ISBN:      Softcover      978-1-4363-6425-6

                eBook            978-1-4653-1724-7

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Rev. date: 09/25/2020

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Contents

Occasional Notes: Beyond the Colonnade

Beyond the Colonnade

Occasional Notes: The sciences ‘basic’ to medicine

Deconstructing Gray’s Anatomy

Occasional Notes: The clinical years

Changing Perspectives: From the Colonnade

On the Boro’ High Street

Night Scene: When there is but a little life left

Occasional Notes: from medical school to practice

So long ago

Presence of mind: ‘as naked as a jay bird’

‘Dying of names’

Welcome death

Love... is...

Bessemer Ward

Un coeur simple: ‘as good as gold’

Occasional Notes: At the Medical Center, Chicago

Lost for words

Supercat

This sickness

AIDS: rage despair and love

The smile the surgeon gave her

‘So wonderful today’: Nos morituri...

The unquiet spirit

Noises off

Oh! why are doctors so short on words?

Itemized recovery

First, the bad news

Marion C.

The blame game:

‘Brain food’

Rhetorical questions

On any day of dying

A puzzling case

Autopsy as biography

A Vermeer on the wall, a reflection

Practice picnic

A modest retreat (to Dr G— N—)

I shall miss our little chats

A death in the family

(i) mirror image:

(ii) when a man dies

(iii) in a beloved family member: sickness and death

From Senilia, verses for old age

Ageing Alternatives

Occasional Notes:

Beyond the Colonnade

Beyond the Colonnade

If there was one place, common to our year and to the times of our predecessors, from which it might be said that we had ‘gone out’ into so many branches of the same trade, that place was not the examination halls of London, Cambridge or Oxford, where we had taken our finals. It was the Colonnade at Guy’s Hospital.

As to the avenues of medical practice selected in that year, we already knew of one future Medical Officer of Health, who would decide on the public health priorities of a great urban center; and of intended Medical Superintendents, one of a jail, one of an asylum, their chosen patient populations criminals and lunatics. Another had apprenticed himself to the rigors of surgical training solely with the intention of inventing new surgical instruments. The majority would enter either specialist, hospital-based practice or community-based general practice. At this point in their careers, they shared a common language.

As to the ultimate encounter of finals, in the clinical (or ‘case’) component at Oxford, where the examiners asked questions about long and short cases, there was surely an abundance of adrenaline to discover in the pre and post-test assays, to which in that year all candidates were subjected. As to this sampling of our venous blood, there were no consent forms to sign; hardly an experience to select for a beginning. The ordeal over, we awaited our results the summer long.

The Colonnade was altogether different, a daily place, a social place of rendezvous and assembly, where we crowded to see our assignments, our course grades, the results of finals¹ posted on a board beside the lodge door. It was to the same door that family members came hurriedly from neighbouring streets and estates to present the pink cards which summoned a Guy’s midwife and one of us to a booked confinement in the Boro’. In terms of place, this was where our practice lives might be said to begin. Beyond the Georgian forecourt, still bearing the scars of the first Blitz, beyond the statue of our founder and benefactor, those, from this moment, diverse professional lives awaited us.

To earlier versions of this manuscript, I gave the title ‘Medical Notes.’ They included jottings from medical school and teaching hospital, from practice years in London and at the Medical Center in Chicago. With these, I have now included reflections on life and death in our families on both sides of the Atlantic; and on ageing.

Occasional Notes derive from moments in a working life which were not so busy as to leave no time for reflection. Though other moments may have been more worthy of record, they were either too fleeting to register or, some element of urgency requiring concentration, slipped by unrecorded. To such a series of casual observations a Roman writer might have assigned the title Commentaries.

Their original drafts would find no place among the treasures of English Literature housed in the British Museum, where they may be viewed in glass topped display-cases under UV-protective covers: letters in a variety of elegant or cramped scripts; handwritten and typed manuscripts with their fading inked corrections. Among them, the ms of these notes, and their content would be singularly misplaced. Barring a few sheets of a yellow note-pad or blue-lined exercise book, their shabby and improbable array would include: paper napkins, pocketed beer-mats, paper coasters from continental and inter-continental flights, tissues and paper handkerchiefs, pages from prescription pads and message slips, torn sheets of theatrical or concert programs and the occasional fortuitously blank page