A Sociological Autobiography: 15 – My First Medical Students

By | September 17, 2013

As my allotted three year stint as a research officer at St Bart’s neared its end, the Dean of Charing Cross Hospital Medical School contacted George Brown to enquire about any suitable candidates for a half-time lectureship in sociology. The appointee would join David Blane who already occupied a half-time post there and had no wish to become full-time. George asked me if I was interested. My reply in the affirmative had two results. First, George persuaded a potential rival not to apply, a fact I only uncovered later. And second, I was invited to give a seminar to a group of Charing Cross medical students under the watchful eye of David Blane. Opting to talk about epilepsy and stigma I clearly confused the group, although they remained polite, even applauding at the end. It is still a mystery to me how David saw any ‘positives’. Far less challenging was my interview with the Dean. It all seemed done and dusted before I stepped nervously into his office. ‘You live in Epsom’, he noticed from my meager CV, ‘I hear there are a lot of foxes on the prowl round there?’ This observation introduced the principal topic for our brief conversation. He clearly knew even less about sociology, even perhaps why he was in the process of appointing a practitioner, than I did about teaching his students. But I got the job. I had at this stage, I think, given a solitary conference paper, and I had published nothing.

I am not sure I have ever in my career experienced the elation I felt on being appointed to my first university lectureship: I remember walking on air through Rosebery Park on my return to our flat in Sandown Lodge, Epsom. Ok it was a half-time post, and one located within a new and enigmatic subculture, that of medicine. And my qualifications for the post now seem laughable. But I do think some of us ‘lucky’ babyboomers did in the event do the business.

As for standing in front of serried ranks of pre-clinical students … well! I must have been somewhere between a shy only-child for whom speaking up in class was a nightmare and a more self-confident adult, but I suspect more the former. As for David, he eased me into this novel world. Medically qualified, he had taken the Bedford College M.Sc to explore better ways of addressing the material and psycho-social circumstances that underpinned many of the putative medical problems he had encountered in clinical practice. He was an active ASTMS shop-steward as well as a lecturer. As a teacher he had the gift of presenting complex ideas economically: Occam’s Razor comes to mind. His throw-away lines could be acerbic, but he was a sensitive and imaginative teacher. In those pioneering days of confronting medical students with sociology the obstacles were immense. Sociology was unique in focusing on social relations rather than individuals for example. Students commonly fell back on the slightest of adjustments to common-sense. Moreover while clinical specialists tended to ask germane questions like ‘what relevance does what you teach have for clinical practice?’, a perfectly reasonable query, many of the basic medical scientists we encountered held fast to crass prejudices (many today continue to think positivism in general and RCTs in particular the epitomy of good scientific practice). ‘I can never see you two’, an elderly professor in pharmacology said to David and I by the lifts one afternoon, ‘without thinking of anarchy and bombs’.

In those pre-textbook days (Tuckett’s Introduction to Medical Sociology, published in 1976, was tough going for medical students) we set great store by a collective project backed up by peripatetic tutors. In our early days together the 100 or so students were divided into small groups each headed by one from a truly outstanding group of colleagues: Mel Bartley, Ann Bowling, Annette Scambler and Richard Compton were among those recruited from the kick-off. Pairs of students were briefed before knocking on doors and interviewing adults in the local community about their recent illness and help-seeking behaviour. This afforded survey responses from several hundred participants. The data were processed and analyzed by the students with the aid of their tutors and with additional input from the lecturer in statistics. Almost as instructive as the reflexive and engaged conduct of such a study, and it certainly caught students’ attention, was the crassness of its demise. GPs in the proximity of Fulham Palace Road objected to the Dean that their patients were being interviewed without their – yes, the GPs – consent. As if none of we citizens can be sensitively and confidentially quizzed without the permission of our GPs! Apologetically, the Dean opted for untroubled relations with his local GPs and the project was summarily halted. After I left Charing Cross in 1978 David initiated another collective project, this time involving students constructing life-histories, again dissected and analyzed courtesy of tutors contracted in for the purpose.

One of my favourite stories: only the delightful and totally chilled Ian Aldous, our companion lecturer in (social) psychology, could actually fall asleep while teaching. His Charing Cross seminar group slipped quietly out and away, leaving him to regain consciousness in his own time (some hours later).

I entered Charing Cross via the Department of Physiology, my desk a lab bench; but I ended up, alongside David, in Psychiatry. Steven Hirsch, later President of the Royal College of Psychiatrists (I think), was our new boss. We had the odd clash. He told me one day that he didn’t know what I did and that I should keep a dairy. My riposte – ‘I don’t know what you do either, so I’ll keep a diary if you do’ – brought a half-smile and I got away with it. When David and I defended a secretary against intemperate dismissal by a senior lecturer/consultant psychiatrist, he sympathized but predictably took the easy option. This psychiatrist was later to re-emerge in my career. But my main memory of Steven was a phone call before 8am one morning: ‘Hello, who is this?’ ‘Graham.’ ‘Why am I ringing you?’ ’Give me a clue’. But he was ok.


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