Medical school madness and the role played by Foyles
Steve Westaby is a celebrated world-famous heart surgeon who is renowned for being the first surgeon in history to fit a patient with a new type of artificial heart. During his 35-year career as a surgeon he worked at several of the UK's top hospitals and performed over 11,000 heart operations. He won the Ray C. Fish Award for Scientific Achievement (2004). In 2004 he was featured in the BBC documentary Your Life in Their Hands, which is a long-running series on the subject of surgery. His new book Fragile Lives, now available in paperback, offers an exceptional insight into the exhilarating and sometimes tragic world of heart surgery, and how it feels to hold someone's life in your hands. Below, exclusively for Foyles, Steve looks back fondly on his years of training in London, and at the part played by Foyles in helping him qualify.
Watching Fragile Lives rocket to the top of Sunday Times bestsellers list has triggered a wave of nostalgia. Fifty years ago, the lad from the backstreets of Scunthorpe gained a place at Charing Cross Hospital Medical School – the first in his family to attend university. I was already determined to be a heart surgeon.
The old Charing Cross hospital sat behind Coutts Bank on the Strand, Nestled between Trafalgar Square and Covent Garden Market. There were still fine old gas lamps in Covent Garden and zebra crossings in the Strand. I lived in an old Victoria hall of residence in Notting Hill Gate and came into the city on the Central Line to Tottenham Court Road. Ambling down to Trafalgar Square, I would pass Foyles daily. I bought all my text books here, many of them secondhand. The second-hand service was a boon to impoverished students like me who spent more on beer than books! It was 1966 and I remember Foyles as an austere and antiquated shop staffed by rather formal middle aged gentlemen. There was never a speck of dust on the regimented wooden shelves. Every academic subject was carefully labelled. For me it was anatomy, physiology and biochemistry at first. Human Embryology was written by our own irascible Scots Professor of Anatomy W J Hamilton, who would stand before a tiered lecture theatre with a rolled linen towel demonstrating ‘rotation of the gut’. Recycled dissecting room manuals were greasy from their resting opening on the cadavers. What stories they could tell.
One of the older assistants who sold me my half skeleton (human in those days) rented a room close to the hospital. He would sit me down whilst waiting to pay and reminisce about my hospital’s distinguished war history. It was 1941 and Gala Night at the Café de Paris. The battle of Britain was over and air raids over the West End had tailed off. Many of the hundreds of dancers were smart young officers in khaki or slate blue, dancing with their girls in pretty dresses. A lone raider came in under the radar, a single Heinkel bomber lost over London. No one in the café heard the sirens. The bomb came crashing through the skylight and exploded next to the band. The conductor ‘Snake Hips Johnson’ was killed outright. Most of the bandsmen and dancers were seriously injured. Many gallant men and bright eyed girls died that night. Young Charing Cross nurses rushed from triage to the scene. The surgeons were called in from home. In the dark and the dust it was difficult to extricate the living from the dead. The operating theatres worked continuously for 72 hours. Amputating limbs. Removing shrapnel, fragments of wood, glass and crockery from the wounds. Some of those surgeons were my teachers. Only two weeks later, two rocket bombs fell close by again with many fatalities. More than 200 injured were brought to the small casualty department. Again all the off duty nurses rushed in to help. It was that sort of hospital - I was proud to be there.
I would watch operations through the leaden glass of a theatre viewing gallery known as the ‘Ether Dome’. That same operating theatre used after the bombing. Less frenetic perhaps but the same life and death struggles. Heart surgery was still in its infancy. As Lord Brock used to say at Guys Hospital across the river, “I have three patients on my list today. I wonder which one will survive?” At Charing Cross, autopsies were carried out in a pathology laboratory on the 4th floor of the medical school in Henrietta Street, conveniently next to the anatomy dissecting room. A tin coffin on rails would bring the bodies under the road from the hospital itself. They emerged next to the medical school refectory in the basement and a few of us rugby stars worked out that we could get into the Friday night dances free that route. One paid then we hauled others through the hospital one by one, occasionally two at a time if his girlfriend was petite.
In those days few of us were straight ‘A’ students. Many applicants were interviewed and the school took those that they thought would make good doctors. That takes more than academic achievement particularly in surgery. Many of the years above had been in the Forces and to Oxford or Cambridge. Few were women. The ‘Oxbridge’ crew jokes that if you could catch a rugby ball you could get into a London medical school. There was an element of truth in that, though I was following in the footsteps of the evolutionary biologist Thomas Huxley and the explorer Dr David Livingstone. The major event of the year was the fiercely contested Hospital Cup played at the Richmond Athletic ground. One year the England rugby captain played for Guys hospital. One year I got to tackle the legendary Welsh fullback JPR Williams when he was playing for St Marys. Their team brought a live elephant to the ground implying that the Charing Cross side were mice in comparison. We said that like Hannibal they would need an elephant to beat us. These hospital games were fierce bloody battles followed by superhuman volumes of beer. In those days the railway carriages had individual compartments without a toilet. I recall one Saturday evening with the team relieving itself through the window as the train sped through Clapham Common station. And a rugby club dinner on Fleet Street about which I remember nothing before being hauled out of the fountains of Trafalgar Square. Professor Hamilton extracted me from Bow Street nick the following morning and I was forced to re-sit anatomy in retribution.
So medical school was very different in those days. As social secretary, I would arrange famous visiting lecturers – politicians, sportsmen, stars of stage and television, then entertain them at Rules Restaurant on expenses afterwards. When arranging the annual hospital ball I would trawl through the stage doors of the West End theatres looking for stars to give us a free cabaret for the price of a free ticket. I never failed. Derek Nimmo, Dame Anna Neagle and others gave their time after the show. Covent Garden market gave us free food, wine and flowers. Everyone loved the old hospital and in turn we looked after them when they needed us.
As a backstreet kid from the North, I always felt I was coming from the back. Perhaps I overcompensated. Six years passed in a boozy haze. We were occasionally allowed to do locum house jobs as a student and I did one in surgery. I was in my element in my starched white coat, stethoscope dangling out of my pocket. The nurses were smoothly pressed blue uniforms with elaborate white hats and silver belt buckles the way hospitals should be. Then I took out my first appendix – rivetingly exciting at the time. I celebrated by taking the nurses to the American Bar. From Scunthorpe to the Savoy! Then I couldn’t afford to eat for a month. I took my preclinical textbooks back to Foyles and sold them on.
Perhaps for my efforts as Social Secretary, captain of cricket and vice-captain of rugby, I was awarded the prize for “most promising student”. Then followed a National Scholarship to study for a while at the Albert Einstein Medical College in New York before my final exams. Gershwins Rhapsody in Blue took on a new meaning for me in the Big Apple. I worked with the heart surgeons by day and went to an ‘Emergency Room’ in Harlem at night. This was my defining time in medicine. I got ‘attitude’ in America.
One night a crazed drug addict went for a nurse with a knife in the emergency room. I saw it coming – she was holding the keys to the drugs cupboard and he was a regular. I tackled him as if on the pitch and got stabbed for my trouble. The security guards hit him with a riot stick and he went up for brain surgery. I went to have my lacerated right hand repaired. But the Englishman had made his mark. The hospital were proud of me and let it be known back in London.
I became that heart surgeon I had dreamed about. But in a way, I never left Scunthorpe. I was never a Harley Street man. I looked to help the sick and disadvantaged, never to profit from them. Eventually, I did almost 12,000 heart operations for the NHS, most of them in Oxford. But I never forgot Foyles and my second-hand skeleton. They gave me the start I must needed. But they don’t do used books now!