The SR holiday edition

Daydreams

Francis O Young

A recent television documentary showed the graduating class at an American high school. There were two co-valedictorians, a white girl and a black boy. The girl gave her speech, delineating the dreams she had for the future. The boy, who had been extremely reluctant to attend the event at all, was ultimately persuaded to come by a teacher with whom he had some rapport. He stepped up to the microphone and said: 'I don' have a dream' and described his absence of expectations or hopes. That to me is real deprivation. 
     In the early 1930s I was going to elementary school in Clydebank. The silent, unfinished and rusting hulk of the 534 (subsequently to become the Queen Mary) seemed to dominate the sky above the school. The shipyards were idle as was almost the entire population. Preparing for a depression-immune job was the preoccupation of most of my classmates. One idea was to be a bookie: people would find money to play the horses or the dogs no matter what. Everyone in Clydebank seemed to be breeding greyhounds. The richest boy in the class was the son of a bookie. At Christmas he gave everyone in the class a crocodile-like wallet, an advertisement for the 'Turf Agent'.  
     One boy's enthusiastic suggestion was to be a barber. Hair would grow, no matter what. The aspiring barber eventually became the manager of a grocery. People eat too, no matter what. My father did not work in the shipyards but had steady work baking bread, working nightshift, and earning four pounds a week. We counted every farthing. I remember the prices. Ground beef was 4 pence a pound, as was sliced sausage. I remember when a loaf of bread went from thripence three farthings to four pence farthing. I was probably more materially deprived than the black valedictorian, but I never felt deprived. I had dreams.
    
My mother occasionally took me to a movie theatre, usually the Bank Cinema or the Empire, and later the Paramount. I saw a movie 'The Red Sheik of Araby'. At my request for a red cloak my mother dyed a square of muslin red and I was the Red Sheik. My father told me stories of T E Lawrence and I dreamed of leading Arab armies, on horseback, through the Arabian desert. An upturned table with a sheet draped over the legs became my Bedouin tent.   
    There were movies about pirates of the Barbary Coast. I don't remember who was the Johnny Depp of the 1930s – Errol Flynn perhaps? The upturned table became my square rigged ship, the sheet my sails. 'Stand by to repel boarders!'.
     In 1935 I started science classes at school. My mother said she visualised me as a mad scientist living in a castle on a hill. We must have seen a Frankenstein movie. I daydreamed a lot.
     My schoolteachers ranged widely in their motivational abilities. Some initiated extracurricular activities such as a science club, magazine projects, track and field events or summer camping trips. Others seemed discouraged, but they too contributed to our education, their scepticism teaching us to question: 'Is everything what it seems?'. School-teaching was a leading available choice. 
     I liked music. I listened enraptured to Enrico Caruso on the gramophone. I listened to the Quintet of the Hot Club of Paris on the wireless. I thought Django Reinhardt and Stephane Grappelli were the greatest. One of my uncles (disabled by chronic osteomyelitis and unable to work) could easily play anything on any instrument. I did not inherit that gene. After two years of violin lessons I found I had to practise every day just to avoid getting any worse than I already was. I was clearly not going to be a musician.
     The legendary violinists like Millstein, Mischa Elman, Heifetz or Oistrakh did not even seem to realise that what they were doing was difficult. They lived in a different universe. Of course they played on Stradivarius instruments worth millions. My violin cost a pound. I did not delude myself into thinking I could be as good as they were if only I had a Strad. Itzhak Perlman knows that what he does is difficult and I appreciate his playing the more for it.
     My athletic talents were strictly limited. I could run 100 yards very fast but that was it. I could have been a wide receiver but I didn't live in America and soccer does not have wide receivers.
     The Queen Mary was eventually completed and I absented myself from school without official leave to watch from Blythswood Meadow as it moved down the Clyde on 24 March 1936. No vessel so large had ever gone down the Clyde before. National Geographic magazine had an aerial photograph of the event, including the onlookers at Blythswood. Mud banks had been dredged but it was still dicey. The ship went aground twice. Next day at school I was chastised for my absence. On the maiden voyage one of my classmates stowed away.
     I easily learned the physics and maths of ballistics and I thought of using my skills in the military. In Bellahouston in 1938 the Empire Exhibition was inspiring: the flags, the fountains, the music, the tower. The former stowaway was arrested for climbing the tower. I made a linocut drawing of the tower for the cover of the school magazine. I saw a Spitfire and thought that looked promising. I was intrigued by the ship models at Kelvingrove. 1938 was a very good year.  

When the Luftwaffe attacked Clydebank on 13 March 1941 a stick of high explosive bombs straddled our house, blowing it up. My mother had herded my sister and me into the Anderson shelter at the foot of the garden. The local first aid post took a direct hit, killing the nurse who was a neighbour. One of the bombs made a crater between the wickets of the university cricket ground behind our house, the best tended grass patch in the west of Scotland. When dawn broke my mother lined up my sister and me on the sidewalk in front of our ruined house so my father could see that we had survived as he walked back home from his night shift at the bakery. My sister still has nightmares of Hitler pursuing her. Two days later the looters appeared and stripped the ruins clean of everything salvageable.
     We had to leave the Clydebank area temporarily and I completed high school in Motherwell where the teachers were outstanding. My maths teacher told me my options were open – the choice was mine to make. It was he who introduced me to Sylvanus P Thompson's book on calculus which was clearer to me than anything else I had ever read. The headmaster told me I should seriously consider medical school, but I knew I couldn't afford it. Still I had enjoyed the stories of 'Rab and his Friends' which I read at school.
     The naval architecture department at the university seemed the creme de la creme. One of my uncles was a naval architect at Yarrow's and later at the Anglo-Iranian Oil Company. Another uncle had been a first engineer in the merchant navy. They were the most prosperous members of my family. I don't know if they were the happiest. Perhaps the musician was, if one can judge by the joy of his music. Complications of the osteomyelitis eventually killed him. A grandfather had been a demolition expert and taught me how to demolish but I saw no future in that. Building seemed more forward-looking than demolishing. The Queen Mary was by now a troopship. 
     I unexpectedly won a competitive Hutcheson Trust scholarship to university which would support five years of study. Just before Pearl Harbour I applied for admission to medical school and was enrolled the following year. I had a part-time job at the public library that paid 30 shillings a week plus all the books I could read. I read how to make a small wooden boat. I learned how the hydraulic servo steering mechanism works on a diesel bus. From 'The Collected Papers of Wilfred Trotter, FRS, FRCS'  I learned how a scientist thinks.
    
At medical school I was immediately inspired. The most wonderful outcome I ever saw was when an attending surgeon, Mr Schoolar-Buchanan, showed us a patient who had operated a paper-cutting guillotine and who had accidentally severed his right thumb. Reattachment was not an available option in 1942. It was explained that loss of a thumb is equivalent to a 50% loss of hand function. The prospect of living a life but being deprived of the ability to earn a livelihood seemed to me worse than death. Restorative surgery involved a multistage reconstruction with formation of a tubular pedicle skin graft, transfer of attachment blood supply and insertion of a rib bone graft. The ultimate result was a functioning opposable thumb though lacking a nail and interphalangeal joint. Spectacular. Reconstructive surgery seemed the best job on earth but I could see no open pathway to becoming a reconstructive surgeon in wartime Scotland.
     Then I found neurology wonderful too. A patient, a housewife, was presented who complained of loss of sensation in all her fingers. A prize was offered for the student who gave the best analysis of the problem. I was motivated to win it. I knew that a doctor has to explain all of a patient's symptoms with a single diagnosis if possible so I demonstrated that there was no known physical neurologic entity which could fit and that therefore the problem was hysteria, as had been reported by Freud. I won the prize for my analysis of the case but the professor told me nevertheless that my diagnosis was wrong. I had failed to ask what the patient had done before she became a housewife – a mistake I never made again. She had in fact been a trapeze artist and it was asserted that she had suffered multiple traumatic injuries to her digital nerves. Carpal tunnel syndrome was unknown at the time but I now know that that was the real diagnosis. 
     Another influence was John Glaister Jr, professor of forensic medicine and medical jurisprudence, who had previously been a forensic pathologist in Egypt and who vividly described his experiences there.
     Diagnostic medicine fascinated me; I loved the challenge of solving problems but pre-antibiotic medicine too often lacked the resources to intervene successfully. Then I saw the first patient ever to recover from subacute bacterial endocarditis at the Western Infirmary, Glasgow. He was my former science teacher. Limited amounts of penicillin were becoming available and he was treated with what were then massive doses, 100 units at a time, now considered minuscule. Although penicillin had been discovered by Dr Alexander Fleming, a Scottish bacteriologist, only America had the resources to manufacture and use it. The penicillin available to us had to be recovered from the urine of American soldiers who were on treatment.
    
I kept finding myself more attracted to the scientific basis of medical practice and after medical school I went south to London in 1949 where I was eventually recruited by the Foreign Office to join a medical team in Arab Africa under a United Nations mandate as the pathologist. My assigned region stretched from El Aghela on the Gulf of Sidra in the west to Tobruk and the Egyptian border 350 miles to the east, and inland as far as Chad and I was able to pursue scientific medicine within those confines.       My work included medical forensic science so I came into frequent contact with the police and legal authorities. The crimes I encountered were of the usual varieties, assault, murder, bullet wounds, poisoning, sex crimes, robberies, but the spectrum of poisons used differed from experience in the west, more exotic, and the ingenuity of the sex crimes is better left without elaboration.  
     I found Glaister's writings a great help. Ten years earlier I had applied for permission to take a law degree concurrently with medical school but had been refused on the supposed grounds that I didn't know enough Latin, without having been tested; I did not have an engraved embossed Latin diploma although I knew more Latin than many (most?) attorneys do. My first experience of a courtroom had been in 1942 when a law student had invited me as a spectator to a session of the High Court. The case was of alleged political graft and corruption but the prosecution's case was so poorly prepared and presented that the defence counsel demolished it in one sentence. The accusation may well have been valid but was dismissed on a technicality. Made me wonder!  
     I have given medical forensic evidence many times and have frequently been satisfied when my evidence was taken seriously and contributed to a just outcome. Juries always received my evidence respectfully but too often I have known of judges and juries ignoring evidence, facts and the law with disappointing results. Frequently I have been amazed that submitted evidence was of such poor quality, or even transparently fabricated. I believe however that incompetence greatly exceeds malfeasance.  
     A friend in North Africa who was a captain of police suggested that my wife and I assist in exercising the police horses on weekends so we got to go horse riding on the desert arrayed in pith helmets and jodhpurs: we eschewed Arab robes and headdress in deference to our hosts who might not have had such sanguine memories of T E Lawrence. I enjoyed the waning days of empire.
     In 1961 I became the director of a laboratory in Cambridge, Massachusetts, and the following year my wife and I bought a European-style house with a stone tower and walled flagstone terraces on a hill outside Boston. After buying it we found out that it was known to the locals as 'The Castle'. After some years I began to miss the Mediterranean climate and I did not particularly care for the politicised pursuit of power in Cambridge. I had the great good fortune to be invited by a physician who had achieved renown for his contribution to scientific medicine to join him in Miami, Florida.
     Soon after arriving in Miami I acquired a 41-foot boat so I became the captain of my own vessel on Biscayne Bay. Not quite the Spanish Main but close enough. I seemed to be touching all the bases, except perhaps for 'mad' – or maybe I should let you be the judge of that.
     The next act? I don't know. I didn't get to fly a Spitfire yet. I hear there is still one around somewhere. Well perhaps on flight simulator? That reminds me: there's still a computer programme I need to write. I don't remember seeing any movies about computers in the '30s. 

Dr Francis O Young was a lecturer in pathology at the University of Saskatchewan, professor of pathology at the University of Miami, Florida, and for 60 years worked in the fields of academic, hospital and forensic pathology in several countries

SR returns on Tuesday 3 August