Next to the door

Issue: BCMJ, vol. 48 , No. 5 , June 2006 , Pages 242 Back Page

In memory of the splendid Mr M.


W.M. (Bill) was a surgeon. He was one of the senior members of staff in the unit to which I had been appointed as a house surgeon, or intern as such are called here in Canada.

This unit was the Professorial Unit and, as such, was headed by the professor himself, aided by several academic staff. Bill was not of that ilk, but, was a clinical surgeon and, at times, was somewhat looked down upon by the ivory tower dwellers, as he called them.

This did not trouble him, or indeed anyone else in the hospital, because he was far and away the best and most dexterous surgeon on staff.

Bill had been in the war and at war’s end was discharged or, as the expression went, was de-mobbed. Such individuals had almost nothing but their experience, skill, determination, and the so-called cardboard suit that had been issued to them upon discharge from the Forces.

Bill had worked hard and was an established consultant when I met him. Naturally I never called him Bill, but in the then-current tradition, settled for “Sir” or “Mr M.”—British surgeons being referred to as mister.

Bill came from a farming family and was of medium height and had broad shoulders and large, square hands. The latter, like the rest of him, looked as if they had been scrubbed with a wire brush. He wore impeccable gray suits, striped shirts with hard white collars, and an expensive watch.

Having a keen, puckish sense of humor, he liked to relate the history of the watch.

Seemingly, in his impecunious days, a relative had bequeathed a certain sum of money to him. Cardboard suit notwithstanding, he had bought the watch.

He used to chuckle as he described how, on stretching out his wrist and hand over some flinching abdomen, the nervous patient might say to himself “Christ, he must be good if he can afford a watch like that!”

Bill was always in a hurry—which is why he drove a Jaguar; in fact, a series of them as he was wont to crash them.

On entering a hospital ward, a comet’s tail (myself included) struggling to keep up with him, he would stride down the space between the beds, rubbing his hands booming, “Good morning! Good morning!” to all present. He was immortalized in my memory by the late actor James Robertson Justice in the film Doctor in the House.

Coming to the bed of one of his patients, he would ask “Well Brown,” (no mister!) “How are we today?” Whatever the reply, even “I think I may be dying, sir,” Bill would exclaim “Splendid! Splendid!” and be on his way.

However critical or snide his colleagues might be behind his back, if they or their precious relatives looked as if they even might need an operation, the request would come to me, “Fraser, find Mr M. at once!”

For all his apparent ebullience, he was extremely caring with regard to his patients, who covered the spectrum from the very wealthy to the most down and out.

This empathy was particularly evident when he had to deal with the hopeless, the inoperable, and the terminally ill. He would say “Graham, put them in the bed next to the door, give them privacy behind screens and give them X milligrams of morphine. If they show any distress give them some more and keep on for as long as it’s needed.”

Came time for Bill’s retirement. He had always been a keen angler and, given his wealthy clientele, he had access to some fine stretches of the famous salmon river Dee.

Accordingly, the hospital presented him with a full set of Hardy fishing fods—the Rolls Royce of equipment. However, before he had the chance to enjoy them, he became ill with abdominal pain, lassitude, and pallor. Lacking the now available esoteric diagnostic aids, the answer was obscured and delayed until it was apparent that he had an advanced inoperable cancer of the pancreas.

Bill took the news with characteristic fortitude, dignity, and pragmatism. He then summoned his junior staff, and, fixing them with a steady gaze, said “Well chaps, you know what to do.”

And we did.

hidden


Graham C. Fraser, MD

Dr Fraser is retired from pediatric general surgery at BC Children’s Hospital, where he was head of surgery. He enjoys reading, writing, and erratic golf.

Graham C. Fraser, FRCS, FACS. Next to the door. BCMJ, Vol. 48, No. 5, June, 2006, Page(s) 242 - Back Page.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.