* * * * *

My work at the Royal Victoria was practically stress-free, which was just as well because now Eddie was making arrangements to come home and we intended to get married as soon as possible. There were numerous long distance phone calls from Malaya which created a fair amount of interest among the staff - after all, it was a very small hospital and telephone systems were manually operated in those days.

Anyway the day came when he was to arrive home and I was to meet him at 11pm at Waverley station. I felt very nervous and shy, and to pass the time while waiting, Sheona met me and we went to a little picture house in Stockbridge (which is no longer in existence). I have no idea what the film was but the time did eventually pass, and after the show was over Sheona left me and I went to the station alone. I did feel apprehensive - how would he look? Would I feel the same for him? Would he feel the same for me? All these questions were going through my mind. I need not have worried. When I saw him he looked just the same apart from a slightly ruddy complexion, and I still loved him and he loved me.

The question now was: "when shall we get married?" and the mutual answer was: "as soon as possible". To do this, Eddie had to find employment. This was not difficult and in a few weeks he had a job as manager of the well-known shoe shop, Bairds the Bootmaker. After that it was a question of fixing a date and making all the usual arrangements. My family had not been too enthusiastic about my engagement to Eddie, but when the time came for marriage and they saw that was what I really wanted, Mother put aside her opposition and did all she could to help.

You might well ask: "why the opposition in the first place?" Well - he was a Catholic, but then so was Cyril who had married Moira. No, it certainly was not religion. He came from a respectable lower middle-class family, but then so had Eric, Nicola's first husband, so it was not entirely that. He was not very intellectual - which he could not help. You either are or you aren't. I think it was that.

Anyway the great day came and I thoroughly enjoyed myself. I did not feel in the least nervous. What is there to be nervous about? If you have made your choice and you are doing what you really want, you put the past behind you and all your energies into the present and the future. I hope other people enjoyed themselves as much as I did. One girl cousin arrived from Lochmabon on her motorbike, and I remember Eddie Goater selling me a wireless set as we were preparing to leave. My Eddie had one moment of utter panic when we arrived at the Hotel from the church. "What will we do? What will we do?" "Go into the Hotel of course" was my laughing reply. Apart from that, my memories are all a bit hazy and we were soon on our way to Cornwall for our honeymoon.

* * * * *

When we came back from Cornwall we stayed at Mother's flat in Arden Street for a month or two, and then moved into a furnished flat of our own in Mentone Terrace. Anne came with us and I continued at the Royal Victoria for another six months, but no longer as a resident. That flat was one of the coldest houses I've ever been in. Not a window fitted and the icy wind came swirling round the rooms. We had electric fires and paraffin stoves to no avail. The only warm place was the kitchen, where there was an old-fashioned range. Anne slept there in a recess, so in the evenings we moved through to the freezing sitting room.

It was while we were in that house that Anne developed further trouble with her ears, with a persistent discharge from both ears, and soon we were told that she would require operative treatment - a bilateral mastoid operation. She was in hospital for a month over Christmas and was allowed home on New Year's Day. We were all in a celebratory mood that day but, of course, her hearing was now impaired (although we did not yet know to what degree and how much it was to affect her life and indeed all our lives).

Anyway we were all happy, and after nine months of marriage I found myself pregnant again. How different were my emotions from the first time, but I was still very sick. By this time I was working in the City Hospital in the chest unit. I would do one ward round, dash to the toilet and vomit, and then on to the next. Also I was supposed to act as 2nd or third assistant in the operating theatre but I kept feeling faint and sweaty, so I was not much use there.

For junior non-resident medical staff it was a most peculiar hospital to work in . Because I did not live in, I was not allowed in the residents dining room but had to eat in the nurses dining room. I did not mind this in itself but, as I was the only Doctor there and had not been there long enough to know the staff, I felt rather isolated and alone. They changed this ruling just after I left. I still went to the Royal Victoria evening clinics to pump air into the chests of our out-patients. I enjoyed that as it was rather like going home to see old friends.

At the end of my six months there I did not seek another post as I was well on in my pregnancy and my main concern was now finding somewhere permanent to live. There was no hope of finding unfurnished accommodation and we would have to live on one wage - and not a big one at that - for some time to come. After much discussion of ways and means, it was finally decided that Harry would sell the Arden Street flat (which he had bought for Mother) and put the proceeds towards a larger house which we would share with Mother, and this is what we did. We would, of course, make a formal agreement and pay the mortgage back like any other. After looking at numerous houses we eventually decided on a large, rambling house in Morningside. There were two large rooms on the ground floor for Mother, and a kitchen and dining room which we shared through to the back. The first and second floors were ours and included a sitting room, five bedrooms, and numerous large cupboards. I could do with some, or even one, of them now!

We moved in for Christmas '52. It was a cold winter and the half-furnished house difficult to heat but I did not feel the cold being heavily pregnant and very happy and contented. I enjoyed going to Auction Sales to buy furniture for the house, which we did very cheaply but managing to get some nice pieces, all the same. Very soon we were comfortably, if not grandly furnished, and I settled down to await the birth of my baby.

And in the early hours of 11 February 1953 he started to arrive. I woke Eddie who was in a deep sleep, having been in bed with a fever for 2 days, and he was feeling rather grotty. I called a taxi and we set off for the hospital. As soon as the Night Sister came to admit me, Eddie turned on his heels and walked back to the taxi, forgetting to say goodbye. He was still in a trance-like state, but the look on Sister's face was one of blank astonishment. I won't bore you with details of the labour - suffice it to say that the 2nd stage took me completely by surprise. I had expected it to be almost painless like the first one. It seemed to go on and on and I kept repeating - "it wasn't like this the first time". Anyway, eventually it did end, and the large baby boy was hurried away for oxygen and recussitation, but after what seemed like an age, I heard a lusty cry. I lay back, relaxed and contented.

There followed a most peculiar 5 days because, although Eddie was highly delighted to have a baby son - Nicolas was his name - he refused to look at him until the fifth or sixth day. I think it was partially embarrassment at having to go along to the nursery and ask to see him and partly fear of what he would find. He had this exaggerated notion that all babies were like red wizened old men but when he did eventually pluck up courage he found a plump baby with golden hair and smooth pale skin, which was a very pleasant surprise to him and a great relief to me. It had been a difficult PR job for me with the staff, who could not reconcile the fact that he was an attentive visitor to me yet would not look at his baby son.

The next few months passed pleasantly enough. It was a fine spring that year and my main memories are of sitting in the garden, drinking morning coffee with Mother while the golden-haired baby slept in his pram. In fact though, I was pretty busy. I had plenty to do with three adults, two children and a large house to care for.

I suppose Nicolas must have been around six months old when I decided I would like to do some work and the money would be more than a little useful. The BMA put me in touch with Dr Munk, a Polish lady GP, who had a single handed practice at Tolcross. I sat in with her for one or two surgeries and then she trusted me enough to leave me in charge while she went off on a 2-3 weeks holiday. Thus began a friendship which lasted for many years as I did all her locums, either for holidays or sickness. As I got to know her patients it was like meeting old friends every time I went back. Especially Mrs George, Dr Munk's caretaker/receptionist, a wonderful Irish lady who bullied the patients with one hand and spoilt them with the other in the same manner as she did Dr Munk. She loved the children and would stuff them with homemade scones and jam and tinkers tea while I was in the surgery. I shall never forget that tea - very strong, dark brown in fact, very sweet - and at the end of my three weeks stint I always had severe indigestion. But never mind, it was worth it to drink that delicious tea.

* * * * *

On 5 February I got an urgent call from the BMA, asking if I could possibly help out a GP in Rankeillor Street who was ill. Ever obliging, I said 'Yes' and, hastily making arrangements for meals etc., I set off by bus to the surgery. It was a bleak February day, cold and snowing - not deep, but enough to make everything slushy and horrible. I arrived at the surgery, a Georgian terraced house, narrow and tall and cold. There was no one there to tell me where anything was or what was the normal routine. There was a caretaker who was totally uninterested and, although I did not know it, was preparing to do a moonlight flit. It was an inauspicious beginning to say the least. I tried phoning the Doctor's home but there was no reply. So, after searching around, I managed to find a prescription pad and a book of certificates and off I set - through the slush to visit a few patients in the St Leonards area. This was before most of the old tenements were demolished, and the majority of patients lived in the high density area of the Pleasance, Dumbiedykes, and St Leonards or out at Craigmillar and Niddrie.

Somehow I managed to get through that day, including an evening surgery, and arrived home in the evening tired but curiously satisfied. By the next day Dr Dougall, (that was the doctor's name), had been in touch and I had been able to make more satisfactory arrangements at home, so after that things got a little easier. I can't remember how many weeks I did for Dr Dougall on that occasion, but when he came back to work he asked me if I would do regular part-time work for him. I jumped at the chance and worked at Rankeillor Street in different capacities for the next 35 years.

From then on I was pretty busy - not exactly full-time but neither was I a lady of leisure, dabbling in a little part-time work. I had Dr Dougall's two evening surgeries and night calls every week, and all Dr Munk's locums. Usually Dr Dougall would release me from my evening surgeries when Dr Munk was away, but sometimes that was not possible and it would be a mad rush going to Dr Munk's surgery early in the hope of finishing early and then dashing across the Meadows to Rankeillor Street where the waiting room would be full of incredibly patient people. I also stood in while Dr Dougall was away on holiday which, as time went on became more frequent and also while he was off sick - and these occasions too became more numerous as the years passed. He would ring me up in the wee small hours and say, "Can you take over the practice as from now?" Sometimes I would say "Yes", but frequently I would say, "I can't". "Why not?" "I've no one to look after the baby", or "I've promised Dr Munk", or "The baby's got bronchitis", whatever the case might be. But he would not take 'No' for an answer and would talk and talk for hours trying to persuade me. Occasionally Eddie would wander downstairs to see what was keeping me. He would see me hanging on to the phone; I would whisper "It's Dr Dougall", and he would pad upstairs again and be fast asleep when I arrived back to bed, having more than likely agreed to help out Dr Dougall yet again. The funny thing was that although we had long telephone conversations we very seldom saw each other - maybe once or twice a year at social occasions.

The most difficult time of all was after the birth of my second daughter Vivienne in August 1957. She was only 6 weeks old when I got the usual S.O.S. Dr Dougall was very unwell and could I take over? Like a muggins I said "Yes". It was right at the beginning of the most severe flu epidemic of my experience. I was still breast- feeding and continued to do so despite working all hours of the day and night. Luckily she was a super baby and I had a wonderful lady, called Isa, to help in the house. I would be giving her a final top- up when Isa arrived just before 9 o'clock. I would then leave Viv and young Nick with her and dash off to the surgery and calls - dash back at lunch for a quick snack which I would eat while feeding Viv - out for more calls - back around five for another quick snack and feed Viv - back to surgery and more calls - home anytime between 8-10 to give Viv her final feed of the day and, hopefully, have a rest myself, but as I was on call 24 hours a day I was sometimes called out at night as well. Mother was still fairly active at that time and was able to keep an eye on Nick, peel the potatoes etc. I could not have done it without her presence. Luckily Nick was a very contented child who would play for hours with modelling bricks and little cars and loved looking at books.

This went on for several weeks until one evening, while preparing myself a snack - French toast it was - I had to lean against the kitchen wall to prevent myself slowly sinking to the floor from complete exhaustion. After that Dr Dougall arranged for another Doctor to do two evening surgeries a week for the next 4 weeks until he came back, so it wasn't quite as bad. No matter how busy I was in the future nothing ever seemed impossible after those hectic 7 weeks. And through them all Vivienne remained happy and contented.

For weekend calls and sometimes on weekday afternoons I would bundle the kids into the car with me - Anne, Nick, Viv in her carry cot, Brownie the dog - and off we would go; a bit like a Sunday school outing with comics, lemonade and crisps. On very busy days I might even buy fish suppers and lemonade on the way home and have a picnic on the living room floor before bed. As we didn't often have fish and chips this was a great treat.

The kids always behaved well and the patients seemed to like it - waving to them from the windows or even inviting them into their homes for a biscuit or some such treat. There was one old lady Miss Brownlie that I remember particularly well. She was in her late seventies and had been bedridden for nearly sixty years. As a young girl she had contracted tuberculosis of the spine which left her paralysed from the mid thoracic region. She lived in a ground-floor flat with a live-in housekeeper. Despite her infirmities she was lively and intelligent, with friends all over the world to whom she wrote numerous lengthy letters. She loved to have Anne in to see her, allowing her to play the Pianola, while the housekeeper supplied a dainty tea on a little round table with lace cloth and beautiful delicate china. Miss Brownlie lay on an amazing bed which she had had especially made for her many years before. It opened up to allow her bodily functions. Of course, special beds are not uncommon nowadays but when Miss Brownlie was young it must have been quite unique. Just before she died Miss Brownlie gave me a lovely little gold Victorian brooch which I treasured for years, until a few years ago we had a break-in and Miss Brownlie's brooch was one of the items that were stolen.

I never had any qualms about leaving the children in the car, even in some of the least salubrious districts of Edinburgh. I am sure the advantages of giving my children the benefit of my company and not isolating them from my work, outweighed the possible risks. It also let them see that many people did not live in the same comfortable surroundings as themselves. They got used to seeing scruffy little boys crowding round the car saying, "Gie us a hurl Doctor, gie us a hurl". I had been very naughty in the past and succumbed to this suggestion, so I would often let two or three kids into the car and drive round the block a couple of times. It was a great thrill for them and only added ten minutes or so onto my day.

* * * * *

CHAPTER 8

I think this might be a good place to say something about the practice and the patients. The premises were situated in Rankeillor Street which is a residential street with flats and two Georgian houses connecting a busy shopping thoroughfare to St Leonards and the Pleasance, then comprised of streets of old, some very old tenements, criss-crossing and extending down to the Dumbiedykes and Holyrood. When I say that some of the tenements were crumbling I mean that quite literally - they did in fact collapse. When I was doing my calls in daylight I had to carry a torch in my pocket. If I didn't, I had to feel with my hand along the walls to find the door of the little flat - the passages opening off the stairs were in such total darkness. Once found, however, they more often than not opened onto a surprisingly welcoming scene. Many of the flats or single ends still had the old ranges or even gaslight but this changed rapidly with the removal of ranges and the installation of tiled fireplaces and electricity. Some of the older people hung on to the old ranges until the tenements were finally demolished. There was something comforting about those old ranges despite the hard work and the dust they made. I have memories of visiting one impoverished family in the middle of the night on many occasions - the father was suffering from left ventricular failure. I would give him an injection and then his wife and I would sit by the fire with our feet on the fender, drinking a cup of tea, waiting for the injection to take effect which, I'm happy to say, it always did. The bed was in the kitchen where there was hardly space for a small table and two small fireside chairs. The light from the small range relieved the all pervading gloom even on the brightest of days. The three children slept in 'the room' which was little bigger than a boxroom. They had one small sink and cold water only, and shared a toilet in the lobby with the next door flat where another family of the same size lived. Some of the tenement flats, of course, were a lot better than this - while some were even smaller and more cramped. Some familes would live in one room, sharing a cold water tap on the landing and a toilet with three or four other families. If this room was light and airy it seemed almost preferable to the two small dark rooms of so many but then I didn't have to live in any of them. It has never ceased to amaze me how clean and comfortable most women made them, but it was no wonder they would come crying to me asking if I could help them to get a new house in one of the many housing estates which were being built round Edinburgh. Familes were overjoyed when they were allocated a new house in Pilton, Granton or elsewhere. It is ironic that for the last ten years or so I have been writing letter after letter trying to get these same families out of their new homes back into town.

* * * * *

Many women had their babies at home, not through choice but because unless it was the first baby or there had been some complication of the first delivery, it was difficult to book a bed for a hospital confinement over the first few years. This was to change to the extent that virtually no one had their babies at home until the mid Seventies when "natural childbirth" came into vogue and rather more intellectual and/or hippy young women came asking for a home delivery. Somehow these always seemed very different from the earlier ones. The patient would be more vocal for one thing and, for another, determined to do it their way. Also they frequently, for some reason best known to themselves, insisted on lying on a mattress on the floor - cold and draughty I would have thought but they seemed to find it comfortable - I did not.

I loved doing home deliveries - you got so close to the mother through the shared experience and the baby became to a degree 'your baby'. The whole family seemed to draw closer together with smiles on every one's faces although I don't think I was ever offered anything stronger than tea to wet the baby's head but I drank gallons of that. I remember well my last delivery - it had been a long drawn-out affair and then there was a retained placenta so that I had been up most of the night and, when seven am came and it was all over with the mum sitting up in bed drinking tea and eating biscuits, looking the picture of health, I felt like death warmed up. Realising that I still had a whole day's work in front of me, I said to myself: "Pamela. This is too much. It is time you gave it up" - and I did. I missed it for a while but, as it had been increasingly difficult to get a colleague to stand-by for you if you wanted to go out anywhere, it was the only wise thing to do.

* * * * *

Another aspect of the work which differed greatly over the years was heating, especially during winter calls. When I first started doing GP work (and for many years to come) it was quite an ordeal doing calls in severe winter weather. For one thing there was no heater in the car - thank God for fur-lined boots. And then when you were taken to see the patient, there he or she would be lying or sitting in bed in an unheated room with the window wide open to the elements. Remember that fresh air and hardiness were the order of the day. My hands were always like blocks of ice and I would have to borrow the patient's hot water bottle for a minute or two before attempting examination. After that was completed I would be sure to be offered tea and biscuits or sometimes even soup and sandwiches. People, even the needy, are so so kind and grateful for such little help you can give. I could not often accept but if people had it all laid out neatly with their best china it seemed unkind to refuse, and many a time when really busy it kept me going - Hurrah for caffeine!

For the last few years it has been very different. For one thing the car has a very efficient heater and a great many of the houses have central heating, even in areas such as Niddrie and Craigmillar. I find now that the first thing I do is fling off my coat before I melt - the houses are so warm. I have been quite alarmed by the plight of several babies, lying there in their cots or prams in the warm sitting room. On their cots are 2 or 3 folded blankets and they are wearing a vest, babygro, jackets and leggings, wrapped in a shawl with their little faces red and sweaty, obviously far too hot. The instinct seems to be to keep them warm at all costs, especially after all the publicity concerning hypothermia. I wish one could persuade the elderly to follow the advice regarding heating just as assiduously, but on a limited income it is well nigh impossible and I think many remember our advice of years gone by: 'plenty of fresh air', which is also getting difficult to come by, but that is a different story.

Patients' expectations have also varied enormously over the years. When I first went into practice antibiotics were still very new and people still remembered the days without them. Therefore if a child had bronchitis the parents would expect their child to be ill for at least 2 weeks, so imagine their delight and astonishment when their child was well and running about within a couple of days. But now patients expect an almost instant cure and if a child isn't better in 2 days there is great anxiety all round. It isn't unusual to have a patient complain if their child isn't better after two doses of the magic medicine. I will admit there have been occasions when I have had to bite my tongue while a patient, usually middle class and semi-intellectual with possibly a hippy lifestyle, has been going on about the dangers of modern drugs in general and antibotics in particular. Time permitting I would try and explain what it had been like in the days before penicillin but I don't suppose they heard what I was saying. Nevertheless it is true that antibiotics and other drugs should only be used with care and discretion. And that leads me on to drug addiction.

Initially there were virtually no addicts of any sort in Edinburgh and then - it would be in the late Fifties or Sixties I think - one began to see the occasional barbiturate addict. These could be roughly divided into two types - the middle aged housewife who had unwittingly become addicted to sleeping pills, or young men who had started taking them deliberately for their cerebral effect, or the 'buzz'. One noticed this particularly during the Festival when students from down South, visiting Edinburgh, would go round various doctors trying to obtain a supply of their favourite pills.

Gradually in the Seventies I became aware of an increasing use of hard drugs (such as heroin and its derivatives) and became involved in trying to help some of these poor unfortunates, but I will enlarge on this in a later chapter.

Finally, there is the problem of benzodiazepines of which there has been so much publicity. This had the desired effect among the thinking, responsible adult community - making them realise that Valium was not a 'Happy Pill' and once you had been taking them for a while they could be very difficult to stop. But unfortunately, among the drug-orientated young the publicity had entirely the wrong effect. Realising the mind-bending properties of the benzodiazepines and, heroin being harder to come by, they seemed to turn to them in increasing numbers. This was my general impression which was confirmed when several of my patients told me that, after seeing such programmes on TV, they decided to try them. Other doctors working with drug addicts had the same experience and it soon became common practice for addicts to inject Temazepam intraveneously with the complications of thrombophlebitis, abscesses and other infections.

* * * * *

Over the years, of course, there were many advances in treatment and management of many diseases; in particular I think of the active treatment of heart disease, but these are not within the scope of this little book of reminiscences. What never changed was the amount of pilfering that went on - you needed eyes at the back of your head to be on the look out for all their tricks. From the toilet everything went - soap, toilet rolls, towels, the plug from the washhand basin, electric light bulbs and even the little mirror off the wall. From the waiting room the antique brass bell-pulls were taken off the walls and my beautiful antique brass fender diminished in size piece by piece. About ten years ago I bought a blue Axminster rug for the waiting room and that too disappeared - through the window where a fellow conspirator ran off with it.

The front door initially had old brass fittings, a door knob, a deep sheet of brass along the bottom, and the front step also was covered with a sheet of brass - all vanished. One morning I replaced the door knob with a 'new' old brass one. When Mrs McCann, the receptionist, left at 12 noon it was still there but when I left at 12.15, it had gone.

And then there was the occasion of the gas heater which I had acquired to heat the hall. One evening I heard unusual scuffling noises coming from the hall while I was trying to listen to a patient. Unable to bear it any longer, I said "Excuse me a minute" to the patient and went to see what was happening. There were several patients in the hall shoving the heater along. When asked what they were doing, the reply was: "A man came in from the street and was trying to wheel it out to his van and we are bringing it back again". I suspect the man was one of themselves but preferred to give them the benefit of the doubt.

One New Year, when both No's 14 and 16 Rankeillor Street (the only terraced houses in the street) were empty, the people in No. 16 came back to find their roof had been stripped of lead, but No. 14 was untouched. I like to think that the perpetrators of this crime were patients of mine who said: "We won't take the Doctor's lead - she is so good to us". It is a nice thought but most probably just wishful thinking.

When I said earlier that the pilfering had not changed, I was wrong. It has. True it always went on, but over the years it gradually increased until it became a real problem - yet strangely over the last year it has seemed to die down again.

That leads me on to the question of the patients: "Have they changed?". The short answer, after much thought and due deliberation, is: "Not a lot". There was always a good mix from all social classes: no aristocracy or landed gentry although a fair number of professional and business people at the top and a few vagrants and down-and-outs at the bottom. But the majority of patients were honest hardworking decent people, working at all sorts of occupations - at the local breweries, shops, offices, schools; drivers, telephone engineers - indeed anything, but not many in heavy industries because there weren't many opportunities for that in Edinburgh. As we all know, the numbers in work declined dramatically several years ago and many people, especially the young in certain housing estates, were out of work and - sad to say - a fair number of these seemed quite happy to accept this situation. To me this was the saddest aspect of the whole situation. I had known these youngsters since infancy, seen them grow into attractive, often intelligent adolescents, seen them leave school and then - nothing. Just sitting around all day in this house or that house - watching telly, washing their hair, talking to their friends, waiting for their next Giro cheque.

Unfortunately, the girls often ended up pregnant and I sometimes wondered if this was a delilberate, albeit subconscious decision enabling them to get away from their parents, have a home of their own, to be someone. This is not in any way meant as a criticism. It is only that when I saw this happen I felt so sad to see such wasted potential - young lives with so little ambition. I have heard this discussed on the radio but there was such a political bias to the content that I was not impressed. I do not know if any sociological research has been done in depth, taking into account the psychological aspect of pregnancies in the young unemployed, but it would be interesting to see the results. I deliberately did not say 'unwanted' pregnancies because almost all unemployed girls in my experience who became pregnant opted to keep their babies, whereas young girls who were working nearly all decided to have a termination.

There are signs that unemployment is falling and we can only hope that it continues to do so and that this particular problem, if it is a problem, will diminish. I certainly hope so.

There are also problem patients. They come from any social class and it would be true to say that I had more than my fair share of these. I had occasion to attend a refresher course at the Royal Edinburgh Hospital and while we were waiting for it to start, one of the teaching consultants stood up and said "Would Dr White please stand up"? I duly did as I was told, whereupon he said: "I had to see what you looked like. You have such horrendous cases on your list!" His words - not mine.

Generally speaking, I suppose you could divide PP's (problem patients) into two main categories - those whose lives, socially and otherwise, are in a mess, and those whose problems are mainly medical but who, for some reason or other, are difficult to handle. I had many in both categories. I'm not quite sure how this came about. I certainly did not set out to have problem patients but equally I did not determine to avoid P.P's, as I know many doctors do. I was always willing to listen - at least I hope I was and, truth to tell, PP's are what made work interesting. Indeed it is those that one remembers. On the other hand they add to your work load and occasionally - very occasionally - I had to ask for them to be removed from my list, mostly with a little regret and some sense of failure. Anyway I suppose word gradually got around that I was tolerant and sympathetic, and anxious social workers would phone me asking if I could possibly take on a certain problem family or a difficult patient who could not find a doctor. Usually I would agree to their request even if only for a trial period. I think I saw it as a sort of challenge and I felt so desperately sorry for some of these unfortunate people. Hearing their stories I would say to myself: "My God, if that had happened to me how would I have coped?" or: "If my son had done that, I could not have borne it." How do we, the more privileged people, know how we would have turned out if we had been born in Niddrie with a drunken father and useless mother? We don't know, but I have always thanked God that I chose my parents carefully. It might sound old fashioned, which I can't help, but I have always felt it to be the duty of we lucky ones to try and ease the burdens of everyday life for those less fortunate than ourselves. I don't want this to sound like a sermon but really it is so easy to be polite and considerate, and even an aggressive patient will respond to a pleasant smile and a nod of agreement. I know how easy it is to be impatient with someone who has done something stupid for the umpteenth time, but then I say to myself: "How can you expect him to behave in an intelligent fashion when he has not got the necessary nunce?" That line of thought may not be very flattering to the patient but it certainly eases your own tension.

A common type of PP (of whom, I am sure, most GPs have their fair share) who falls into the Medical category is the one that suffers from 'verbal diarrhoea'. One such that I remember very well and of whom I was very fond was an elderly lady, whom we called 'The Babbling Brook'. She was a single lady who had worked hard all her life and who lived by herself in a single end in an old Victorian building, now demolished. She was of limited intelligence but had a very caring elder sister and niece and an extended family. She was very sweet and had only one fault - she just would not stop talking. She normally attended evening surgery and was frequently the last patient - which was fortunate for the other patients as, otherwise, they would have had a very long wait.

After obtaining a history - a very difficult procedure because I was terrified to ask a single question, each question letting forth a stream of words, so that it would be ten minutes before I got an answer and completed the necessary examination - I would then sit down to write a prescription and make a few additions to her notes - all this accompanied by a constant flow of words. I would then stand up as a sign that the interview was over. But no; there would be no cessation to the flow of words. I would sit down again, tidy my desk, put away her notes and my pen, get up again, go to the door and hold it open for her to pass through, and say Good-bye. No luck; the stream just flowed and flowed. I would go back to my desk, pick up my pen, start writing a letter, get up again, hold the door open, all without uttering a single word. Eventually I would have to take her arm and gently, very gently, guide her through the door, and then I would dare to say good-bye and, when the door was closed again, heave an enormous sigh of relief.

Another type of PP which I found more difficult to manage - and certainly more worrying - was the one who had a multitude of symptoms and for whom all tests proved negative. This would not bring reassurance but, rather, disappointment. Sometimes I would be sure that the symptoms were absolutely genuine but the cause unknown, or supra-tentorial - in other words, "in the mind". In other cases the genuineness of the symptoms would be less obvious and the sneaking suspicion would arise: "Could there be a motive for gain behind this patient's symptoms?" In fact I cannot remember any patient in whom an obvious single motive could be found. Usually the causes were complicated and anything but obvious. The main worry with this type of patient is knowing that sooner or later they are going to develop genuine symptoms of organic disease, and so the ever present question is: "Investigate or not investigate?" It is not surprising that both the patient and the doctor experience a sense of relief when evidence of organic disease is found, but what I did find surprising is that frequently these difficult patients often became much easier and possibly happier once a diagnosis was made, even if the diagnosis was of a serious nature. I don't think this type of patient either increased or decreased in number as the years went by.

I must include here a brief description of a patient who fits into this category, but who, I am happy to say, is not at all typical. She had a multitude of symptoms too numerous to mention and, when she met a new doctor, would give them a long story about suffering from diabetes and kidney trouble. This was not true, yet the story was realistic enough to alarm the doctor and she was always ending up in the Royal Infirmary for a night or two. She was more than a little fond of the bottle and had a live-in boy friend whom she ruled with a rod of iron. Both of them were of limited intelligence. Needless to say, her house was always a mess - to put it mildly. One day I had a request to visit the boy friend. I rang the bell as usual and waited. After a few minutes the door opened and there before me stood an apparition. I felt I had gone back a million years in time. There she stood - this large fat woman in a tight fitting mini dress which was extremely grimy; her hair coarse, unwashed and unbrushed, hung to her shoulders and over her face. She had a lot of dark facial hair which did not enhance her appearance. Her legs, like dirty tree trunks, showed beneath her short skirt, but it was her feet which really astounded me. They were black with dirt and surrounded by an inch-long fringe of hair. To begin with I thought she was wearing slippers - but no. It was only dirt with dog hairs embedded in it. When I went into the sitting room I could hardly breathe for the stench, and the poor young man was lying on the bed between blankets which had not been washed since the year dot and which were covered with vomit. They both seemed remarkably unconcerned. I won't go into any more details but from then on she was called the Neanderthal Lady - with apologies to the Neanderthals.

And then there were patients who did not fit into any particular category but whom one remembers because they were characters. For instance there was the 'Capitalist' (or as he pronounced it - 'the Ca-pit-alist') "You and me, Doctor. We're 'ca-pit-alists' was his favourite remark which he repeated at least once during every consultation - these being fairly frequent. He was a middle-aged working man - a bachelor who lived in a ground floor room and kitchen in one of the tenements behind St Leonards Street. There was no linoleum on the floor, only bare boards, a small deal table, several wooden chairs and a dresser in the room. The sink was at the window with one cold tap and the heating was from an old fashioned grate - not even a proper range. The table was covered with clean newspaper on which always stood an opened tin of condensed milk and a copy of the Evening News. All the signs of poverty (with apologies to the Evening News), but in the bank he had several thousand pounds - a lot in those days. His needs were simple - he didn't smoke or drink and every week since starting work he had put several pounds into the Savings Bank.

He died suddenly, so never had any use of his capital which all went to a brother with whom he had had little contact. I did miss my fellow ca-pit-alist, although at that time I was far from being a capitalist (with usually only an overdraft as a reward for my labours), but I never disillusioned my friend.

I could describe many more such characters; indeed I could write a book about them, but that is not the object of these memoirs and it is time I went back to my own life.

* * * * * *

CHAPER 9

Our family at Morningside Drive now had a new member with the birth of Vivienne in August 1957. Apart from the usual nausea and sickness in the early months, I had kept well during the pregnancy and was doing surgeries and evening calls up to the last few weeks. I don't want to dwell on my own medical experiences but Viv's birth influenced and reinforced my feelings about trust and belief in my patients.

The early part of labour went smoothly and uneventfully but when the second stage started the pain became intense, with one pain running straight into the next with absolutely no respite. As I had been left alone in the delivery room for quite a while, I rang the bell and Sister came in.

"How long between pains?" she asked. "None", I gasped in reply, "one pain is going straight into the next".

"Nonsense," she replied, and walked out of the room.

By this time I was in real agony and after what seemed like an eternity, but in reality was probably under five minutes, the consultant, Miss Paterson, came in and noticing my distress said, "My goodness child, you are having a bad time", and immediately set about an internal examination. There was one excrutiating piercing pain and then enormous relief, and after a few strong but normal contractions, Vivienne was born, a vigorous healthy baby. The reason for the abnormal contractions was that the lip of the cervix had been caught between the head of the baby and the pubic bone, and if Miss Paterson had not come in when she did I might have suffered a torn cervix, if not a ruptured uterus. Anyway it confirmed my belief that it is always wisest and kindest to believe what patients say unless, or until, you have real grounds not to trust them and this, I'm happy to say, is a very rare occurrence.

Whatever the manner of her birth, Vivienne was certainly a wanted child - not exactly planned but wanted - by everyone. Anne had been in minor trouble at school because they didn't believe her when she told them I was pregnant and when we took Viv home, her brother Nicolas nearly smothered her with love - as soon as he came near her she started blinking, because she knew she was in for a session of kisses and cuddles.

Now we were a family of three children and three adults and, on the whole, a happy one. It was a large house and so there was room for all, including most of the children in the neighbourhood. The front door opened into Morningside Drive and the back door into Morningside Gardens, where there were blocks of flats and numerous children who used to walk in the back door and through the house looking for one of the family, usually letting the dog out in the process. The dog was only one of our collection of pets which included a cat, a rabbit or two, guinea-pigs, pigeons, a grass-snake and white mice. The latter two I must admit did not last long. One day after a visit to the Ideal Home Exhibition, Anne came home with this small grass snake in her pocket. I must say that I detested it and had very mixed feelings when I heard it had escaped from its glass container. We hunted high and low for several days until I found it curled up in a corner of one of the bedrooms, well and truly dead. The white mice belonged to Douglas who was born 18 months after Vivienne. They were the only pets in which he took a real interest but unfortunately one of them was of mixed blood and gave off a strong smell. Much as I loved animals I couldn't tolerate it and they had to go.

The dogs, especially the second one, seemed to play a large part in our lives. The first was a brown cross-collie which we bought at the Cat & Dog Home for the vast sum of £1.26. She was somewhat hyperactive and would have retrieved a ball or stick all day if you had been fool enough to throw it for her. She was also a bitch and very sexy. Unfortunately there was no equivalent of the Pill for dogs in those days and when she was in season there would be a queue of dogs at our back door, especially a little mongrel who lived across the road and used to sit at the door, howling, serenading Brownie who, needless to say, was desperate to get out. We did our best to keep her in but, as I mentioned earlier, the local children just walked in and, of course, Brownie dashed out. It was awful and not at all surprising that Brownie had pups - ten of them I think there were. Another time, out of sheer frustration, Eddie let her out when he left for work and very soon I had neighbours at the door, complaining that Brownie was in the little field beside the house surrounded by very active admirers! After that we had her sterilized. This seemed to alter her personality and she became over excitable and harder to control, and developed a nasty habit of rushing up to anyone carrying a stick, and barking madly. Much as we loved her we decided she would have to go and luckily we found her a new home through the Dog Rescue Society.

We did without a dog for some time but the house felt empty - though in fact it was always full - and Viv and Nick saved up their pocket money and once again we visited the Cat & Dog Home. After looking at all the puppies we noticed a little brown puppy sitting forlornly in the back of the enclosure. Our hearts were immediately won over and we took the little brown bundle home. He remained very woebegone for several days, whimpering and crying and refusing to eat. On the third day we were having spaghetti bolognaise for our evening meal. I dished it up onto plates, took them to the dining room, and went through to call everyone to their meal. When I came back there was the pup up on the table having a delicious meal of spaghetti in the best Italian style. After that he was well and truly established as a member of the family.

We called him Toro (after a local group in which Anne was interested at the time) and he became as macho as Brownie was feminine. Inside the house he was the gentlest and most placid of dogs, but outside he would swagger along and snarl at any male dogs who passed by. Even as a pup he would lie placidly on the bed while Vivienne dressed him up in various articles of clothing, loving all the attention and joining in the make-believe game. It is a wonder he did not become confused because in Mother's sitting room he was not allowed onto the chairs but lay in front of the fire. In the evenings when Eddie came home I would go upstairs to our sitting room and there Eddie did not like him in front of the fire but he was allowed up on a chair. He never got it wrong.

One of his favourite occupations was raking in rubbish bins, and late one fateful evening we heard whimpering along with a peculiar clattering noise, and there at the back door was Toro looking very sheepish, with his tongue stuck inside a half-opened but empty tin of beans. There seemed no way we could get his tongue out without cutting it on the lid, which was bent inside the tin. I felt quite panicky. Luckily Eddie arrived home at that minute and, with Toro and myself in the back seat, he drove us to the Dick Vet Hospital. Every time we turned a corner the tin seemed to bite further into his tongue. I held his head with one arm and the tin in the other hand to try and take the strain of his poor swollen tongue. When we arrived at the hospital they decided the only thing to do was to give him an anaesthetic and cut the tin off. They did this; it was all over in a few minutes and we were able to take a very dopey- looking dog home. I'm afraid I would never make a vet - I find it too upsetting to see an animal suffer.

And then there were those truly awful occasions when a neighbour's bitch would go into season. We spent numerous sleepless nights listening to Toro who was shut up downstairs in the dining room, howling for hours on end, night after night. I tried giving him sleeping pills but they didn't really work - in fact they made him howl all the more. He would fall asleep for half an hour and then wake up refreshed ready to howl again. Eventually, of course, some careless person would let him out and we would have an irate neighbour complaining he was at their door and jumping up on their wife or children. Oh dear, I think dogs are a good way to fall out with your neighbours! I remember years later, when we had moved to another district, an irate neighbour complained that Toro was being a pest at their door. As we had had two sleepless nights listening to his howling, my husband suggested politely: "Why don't you go to the vet and ask him to give you some contraceptive hormones for your bitch?"

"I'm not going to give my dog the Pill", was his gruff reply.

"No", I thought to myself, "but I bet you are quite happy to let your wife take the Pill for years".

It was not the first time I had felt that some men value their dogs more than their wives. I hope I am wrong.

But it was not all lust with Toro. Oh, no, he truly had a heart, and had a real love affair with a little grey rough-haired bitch called Sparkey. Sparkey lived in one of the flats opposite our back door. Every day after breakfast he would go and lie quietly at the tenement entrance waiting for Sparkey and her mistress to come down stairs. I would keep an eye on him from the kitchen to see he was not being a nuisance, but he just lay there placidly waiting in all weathers. Around 10 o'clock usually, Sparkey would come down with her mistress and the three of them would be off to Craighouse Hill where the dogs could get a run-around. This went on for day after day, year after year. The sad day came when poor Sparkey died, a few days after giving birth to Toro's pups, but dear old Toro continued to look for her every morning for a long time to come. He looked so forlorn lying there that our hearts went out to him.

* * * * *

When Viv was only 9 months old I found myself pregnant once again. I did not mind having another baby in the least, but I was worried from the financial aspect, as we needed my income to feed and clothe the growing family and heat the large house. I kept on my part-time work with Dr Dougall and even did some full-time locum work but it was a struggle, as this time the vomiting did not stop after the early months but persisted, and I began to develop recurrent abdominal pains and felt constantly tired and weary. When I was around 7½ months pregnant I vomited some blood. I remember the occasion well. I was in our sitting room and Eddie had just returned from the local hostelry and was talking away, telling me some story, when I began to have this most peculiar feeling. I was trying to keep my mind on what he was saying, when suddenly I had to rush to the bathroom and was violently sick, bringing up bright red blood. Ten minutes later the same thing happened, and then I felt fine and went to bed. Two weeks later the same thing happened and so, when I next saw Miss Paterson the Gynaecologist, I told her about it. As she said, the third time may not be so lucky, and she admitted me to hospital where I remained until Douglas was born; uneventfully but leaving me very exhausted. At first we did not know what to call him, but when we saw him with his mop of black hair, lying beside this little fair baby with white hair and white skin, there was only one name for him: Black Douglas - black in everything but nature.

After Dougie's birth I was soon back helping out Dr. Dougall despite breast feeding him, as I had done all the others. From the very start he had a huge appetite and loved his food. He was soon demolishing pudding bowlfuls of cereal in no time at all - like a little bird with an ever-open mouth. I well remember taking him with me in a carrycot in the back of the car when he was a few months old, while I did a locum for Dr Munk. Mrs George (or Georgie as the children called her) would give him his porridge, laughing all the time, as she could hardly spoon the food in quickly enough. He would soon be laughing too and I would hear their chuckles from the surgery. If Vivienne was there as well, she too would join in the fun and games, and it would become quite a party.

Douglas of the hearty chuckle and red apple cheeks became famous for another reason as well. As soon as it started to rain he would say: "Oh good, it's raining". On would go his little red wellies and grey hooded raincoat; he would grab an old brush and out he would go to sweep the gutters at the back of the house, which were by now running with water. He made friends with the local street cleaners, who often took their break sitting on the stone steps at our back gate, sharing their 'piece' with Dougie, who sat between them.

Life continued much as before but I gradually began to feel not so well, and developed pelvic pains which became more and more persistent. But being a female-medic and terrified of being thought neurotic, I did nothing about it for at least a year, until in 1961 or 1962, I forget which, I noticed some intermenstrual bleeding. That did it. "Pamela", I said "you will be a damned fool if you don't seek advice". So I did and was told I should have a hysterectomy, and within 6-8 weeks I was admitted to Bruntsfield Hospital for that purpose. I remember telling Mother I was to have a hysterectomy. We were sitting having lunch together in the dining room and her first remark was: "Oh dear, what shall I do when you are in hospital?" I felt very hurt as she seemed so unconcerned about my health, and it was the first and only time I felt really disappointed in her. It was a long time before I truly recovered from that feeling of hurt.

Initially I was a little disappointed I couldn't have any more children, but as that was an impractical idea anyway I put that feeling aside. It was only after I had fully recovered from the operation that I realised how ill I had been feeling for the previous few years.

The immediate post-operative period was rather stormy as I had chest complications, but what I remember most clearly was the agonising pain in my coccyx. There was no way I could sit comfortably, either in or out of bed, and one evening about the 5th post-op day, after they had stopped the analgesic medication, I was in tears when Eddie came to visit me. The pain in my tail was so bad I could bear it no longer and as they had refused to give me a rubber cushion to sit on, I asked Eddie to go down to Boots and buy one. Only then did Sister relent and she bring me one - what a relief it was, and I will never know why I wasn't allowed to use one before. It certainly gave more relief than the codeine and Paracetamol tablets I was asked to swallow.

During my convalescence I was cossetted and fed until I began to feel like a lamb being fattened for slaughter. But in my case it wasn't to make me plump and tender to eat, but to make me fit to go back to work, which I did 6 weeks after the operation - and what a day that was! It wasn't to help out my usual Doctors, but an S.O.S. from a Dr Pole, or rather his wife. Dr Pole had been taken suddenly ill and admitted to the Royal Infirmary. He had a large single- handed practice in the Polworth, Gorgie and Dalry area. It was a Tuesday - the day after a Monday holiday, and Mrs Pole had managed to put off most of the Monday calls until the Tuesday when I took over. It was chaotic, with the waiting room filled to overflowing morning, afternoon and evening, and calls in between the huge surgeries. Somehow I managed to get through the day but by night time felt like a washed-out dish cloth. The following day was only a little better but by the next, things were settling down and soon everything was running smoothly. And I was feeling stronger every day and very soon I was feeling extremely well - better than I had for several years.