Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table. Stephen Westaby

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СКАЧАТЬ wooden door that led directly into the autopsy room but when I reached inside I couldn’t find the light switch. I’d been given a torch and its beam danced around as I plucked up the courage to go in.

      Green plastic aprons, sharp instruments and shiny marble sparkled in the gloom. The room smelt of death, or what I expected death to smell like. Eventually the torch beam settled on a light switch and I turned on the overhead neons. They didn’t make me feel any better. There were stacks of square metal doors from floor to ceiling – the cold store. I needed to find a fridge but wasn’t sure which ones were empty.

      Some doors had a piece of cardboard slotted into them with a name on it, and I figured that they must be occupied. I turned the handle on one without a name, but there was a naked old woman under a white linen sheet. An anonymous corpse. Shit. Try again on the second tier. This time I was lucky, and I pulled out the sliding tin tray and pushed the creaking mechanical hoist towards my stiff. How to make this thing work without dropping the body on the floor? Straps, crank handles and manhandling. I just got on with it and slid the tray back into the fridge.

      The mortuary door was still wide open – I didn’t want to be shut in there alone. I sped out and pushed the squeaking mortuary trolley back to the main hospital ready for the next customer. I wondered how pathologists could spend half of their career in that environment, carving entrails from the dead on marble slabs.

      Eventually I charmed an elderly female pathologist into letting me watch the autopsies. Even after witnessing some disfiguring operations and terrible trauma cases this took some getting used to, young and old sliced open from throat to pubis, eviscerated, scalp incised from ear to ear and pulled forward over the face like orange peel. An oscillating saw removes the cranium, as if taking the top off a boiled egg, and then the whole human brain lies in front of me. How does this soft, grey, convoluted mass govern our whole lives? And how on earth could surgeons possibly operate on this, a wobbly jelly?

      I learned so much in that dingy, desolate autopsy room: the complexity of human anatomy, the very fine line between life and death, the psychology of detachment. There was no room for sentiment in pathology. An ounce of compassion there may be, but affinity with the cadaver? No. Yet personally I felt sad for the young who came here. Babies, children and teenagers with cancer or deformed hearts, those whose lives were destined to be short and miserable or had been terminated by a tragic accident. Forget the heart as the source of love and devotion, or the brain as the seat of the soul. Just get on and slice them up.

      Soon I could identify a coronary thrombosis, a myocardial infarction, a rheumatic heart valve and a dissected aorta, or cancer spread to the liver or lungs. The common stuff. Charred or decomposed bodies smelt bad, so Vicks ointment stuffed up the nostrils spared your olfactory nerves. I found suicides to be terribly sad, but when I verbalised this I was told to ‘Get over it if you want to be a surgeon’ and that it would all be easier when I was old enough to drink. I sensed that alcohol was high on the list of surgeons’ recreational activities, and this seemed more obvious when they were called in at night. But who was I to judge?

      I began to wonder whether I could really get in to medical school. I was no great academic, and I struggled with maths and physics. For me these subjects were the real barometer of intelligence. But I excelled in biology and could get by in chemistry, and in the end I passed a lot of exams, stuff I would never need like Latin and French literature, additional maths and religious studies. These I saw as a function of effort, not intelligence, but hard work bought me my ticket out of the council estate. In addition, the time spent in the hospital had made me worldly. I’d never been out of Scunthorpe, yet I knew about life and death.

      I started to search for a place at medical school, and returned to the hospital during every school holiday. I progressed to working as an ‘operating department assistant’, becoming an expert in cleaning up blood, vomit, bone dust and shit. Humble beginnings.

      I was surprised to be called for an interview at a magnificent Cambridge college. Someone must have put in a good word but I never learned who it was. The streets bustled with lively young students in their gowns chatting loudly with public school accents, all seeming much smarter than me. Erudite, bespectacled professors cycled down cobbled streets in their mortarboards off to college dinners for wine, then port. My mind flashed back to the grimy steelworkers silently making their way home in flat caps and mufflers through the smog for bread and potatoes, and then maybe a glass of stout. My spirits started to sink. I didn’t belong here.

      The interview was conducted by two distinguished fellows in an oak-panelled study overlooking the main college quadrangle. We sat in well-worn leather armchairs. It was meant to be a relaxed atmosphere, and nothing was said about my background. The anticipated question, ‘Why do you want to study medicine?’ never came. Wasted interview practice. Instead I was asked why the Americans had just invaded Vietnam and whether I had heard of any tropical diseases their soldiers might be exposed to. I didn’t know whether there was malaria in Vietnam so I said, ‘Syphilis.’

      That broke the ice, particularly when I suggested that this might be less of a health problem than napalm and bullets. Next I was asked whether smoking cigars may have contributed to Winston Churchill’s demise (he’d only recently died). Smoking was one of the key words I was waiting for. My mouth fired off in automatic mode: cancer, bronchitis, coronary artery disease, myocardial infarction, heart failure, how the corpses of smokers looked in the autopsy room. ‘Had I seen an autopsy?’ ‘Many.’ And cleared up the brains, guts and bodily fluids afterwards. ‘Thank you. We’ll let you know in a few weeks.’

      Next I was called down to Charing Cross Hospital, between Trafalgar Square and Covent Garden on the Strand. The original hospital was built to serve the poor of Central London and had a distinguished war history. Although I arrived early I was always last alphabetically, so I twiddled my thumbs anxiously to while away what seemed like hours. A kindly matron received the candidates with tea and cakes, and I made polite conversation with her about what had happened to the hospital during the war.

      The interview took place in the hospital board room. Across the other side of the boardroom table from me was the chief interviewer – a distinguished Harley Street surgeon wearing a morning suit – together with the famously irascible Scottish professor of anatomy upon whom the Doctor in the House films were based. I sat straight-backed to attention on an upright wooden chair – no slouching here. I was first asked what I knew about the hospital. Thank you, God. Or Matron. Or both. Next I was asked about my cricketing record and whether I could play rugby. And that was all, the interview was over. I was the last of the day, they’d had enough and they’d let me know.

      I wandered out into Covent Garden past the colourful market stalls and bristling public houses. All life was there: tramps, tarts, buskers and bankers, the Charing Cross Hospital clientele, and the black cabs and scarlet London buses that drove up and down the Strand. Meandering between the crowds and the traffic I came to the grand entrance of the Savoy Hotel. I wondered whether I dared go in. Surely I looked smart enough in my interview suit and Brylcreemed hair. But the decision was swiftly made for me when the immaculate doorman pushed the swing doors open and ushered me through with a ‘Welcome, sir.’ The seal of approval. From Scunthorpe to the Savoy.

      I strode purposefully through the atrium, past the Savoy Grill, hesitating only to scrutinise the menu in its gilt frame. The prices! I didn’t stop. A sign pointed to the American Bar. The hall was lined with signed cartoons, photographs and paintings of West End stars, and when I reached it there was no queue as it was only 5 pm. Perched on a high stool I furtively devoured free canapés and perused the cocktail menu. Devoid of insight – this was my first alcoholic drink – I was pushed to make a decision. ‘Singapore Sling, please.’ Like flipping a switch, my life had changed. Had I ordered a second I’d never have found King’s Cross station.

      Within the week a letter arrived from Charing Cross Hospital Medical School. СКАЧАТЬ