A view from the medical compound
Andrew Lycett
FOOL OR PHYSICIAN: THE MEMOIRS OF A SCEPTICAL DOCTOR by Anthony Daniels
John Murray, £11.95
Doctors used to enjoy themselves abroad. The Duke of Pirajno may have been a fascist, but his book, A Cure for Serpents, first published 32 years ago, clearly and uncomplicatedly portrays his enthusiasm for his colonial ministry. He got involved, living in close contact with Berbers in oases and Abyssinians on safari. He learned their languages and respected their customs. Professionally he delighted in the banter of Arab prostitutes as he inspected them for the pox. His tale of the lioness who fell in love with him, refusing to leave his bedside when he was ill in Eritrea, is one of the most delightful animal stories ever told.
Anthony Daniels eschews the traditional doctor's travelogue with juicy medical bits. His Fool or Physician works on three levels: an indictment of conditions in hos- pitals in Britain and abroad; an analysis of a sceptical young Briton's voyage of self- discovery; best of all, an account of the way different cultures and classes come together, misunderstand each other, and clash in a post-imperialist world. In this respect, it is a view not from the bush, but from the medical compound and the jacaranda-surrounded verandah. It only dawns towards the end when Daniels quotes from the short story 'Rain': his intellectual mentor is, of course, that ear- lier, sour, clinically precise medic and keen observer of men, Somerset Maugham.
Daniels is a psychiatrist, not that this eases his passage. He only studied medi- cine because he is middle-class and his father insisted. He would rather have been a philosopher. His real and his ideal vocations pull him tantalisingly in different directions. He cannot even decide whether to treat us to an account of his frustration working in the National Health Service, or, when that becomes too much, the bleak- ness of expatriate life in government hos- pitals overseas.
His confusion is justified. Despite its stand-offish tone, the literary result trans- cends mere reportage. Through mental and physical striving for new vistas, Daniels has produced a gripping medita- tive study — an intelligent, moralistic, just occasionally pompous 'Liberal Conservat- ism and the Art of Motor Neurone Mainte- nance'.
His personal and emotional life is little commented on. There are no reports of sexual encounters during the period (the mid- to late-1970s) covered in this book. When Daniels has a pleasant recollection of someone, it is quirky. In his first job in a small hospital in the Midlands (the Medical Directory tells us Birmingham), he meets `one of the best men I ever knew'. Dr Mehta, a squat, equable Indian, puts up with the petty racism of examiners and junior doctors, saying it is natural for Britons to feel antipathy to outsiders. He admires them for their hypocrisy in trying to conceal it. When it comes to observing, Daniels' dispassionate eye misses little. In Birmingham he quickly tires of patients who treat doctors as mere curative devices. Bored by their complaints, he reads Rus- sian novels in a corner whenever he has a spare moment.
He repairs to Bulawayo, in pre- independence Rhodesia, to work in a township hospital. With curious detach- ment and fascination Daniels is drawn into settler life. He notes white Rhodesian women discussing the Servant Problem in front of their houseboys. This is accepted because African servants are not consi- dered to be fully human. When Daniels writes, 'If they understood English, it was only in the same sense that a dog under- stood an instruction to sit,' it is not clear whether he is speaking for himself or the Bulawayo matrons. Initially shocked, he finds himself following the white custom at the butcher's of asking for first his own meat and then 'ration meat' — an accepted euphemism for gristle fed to servants.
Occasionally he tries to relate his experi- ences to the unfolding of historical events. This is not successful; viz his puerile observation that the nationalist factions were soon 'once again sending each other letter bombs and other tokens of high regard'. A meeting with Nkomo confirms that Daniels is not meant for political journalism. His forte is social commentary, noting, for example, what he calls the heroism and the tragedy of an African family in its Sunday best, trying to be respectable 'according to the lights of another people for whom the African race was forever excluded from respectability'.
After six months Daniels decamps to South Africa. Down to his last seven rand, he finds work as a locum in a Natal practice, standing in for a Dr Van der Merwe, temporarily indisposed by drink. He is obliged to use different stethoscopes for white and black patients. Mrs Van der Merwe asks him what the natives are like in England. 'Friendly, but getting cheeky,' he replies. (The book does not lack humor- ous touches.) Returning to Britain he resolves to write a novel about South Africa. When this proves impossible, he reluctantly takes a job in a down-at-heel hospital in London's East End. Daniels waxes Dickensian about the eccentricities of his colleagues and patients. Meet the bickering doctors from East and West Bengal and the hypomaniac Dr Pascal whose favourite form of enquiry is 'How many times did you have sex last night?' Sylph, the deformed giant on the switchboard, formerly worked for MI5. He listens in to telephone conversations, occa- sionally, when a patient is getting difficult, butting in to tell Daniels he has another call. 'I thought you needed some assist- ance, doctor,' he says later. Inevitably there are the idle, slovenly, dour, sullen, miserable and stupid (all adjectives used in the course of one paragraph) porters, whose main ambition is 'to find new interpretations of the union rules to make the smooth running of the hospital impossi- ble'. Not that this ever seemed likely in the first place. When a roof leaks, a bureaucrat suggests it won't matter putting an inconti- nent patient's bed there. In the psychiatric ward, the brown carpet-tiles are designed to absorb urine. Regular sub-standard feeding makes the patients chronically constipated (the staff have pinched all the fresh vegetables). Combine the two smells and you have the characteristic odour of the mental hospital — piss and chips.
Daniels' cases seem perennially to be trying to kill their marital partners. He comes to accept the efficacy of electro- shock therapy. Faced by repeat overdos- ers, he wonders whether they should not be fined for wasting his time. He concludes that the variety of human misery is infinite. Occasionally verging on up-market medic- al soap-opera, Daniels' sotto voce study of this particular British hospital is damning. Somehow his ramblings round the lesser lights of former Empire reinforce this picture, indicting a system, a culture, which conducts medicine uncaringly. No panaceas are offered, however.
By contrast Daniels' last chapter, about the Pacific islands of Kiribati, the pidgin approximation to the Gilberts, is an anti- climax. The usual expatriate professionals are 'trying to escape a stultifying life at home'. The interfering bureaucracy of the WHO provides an easy target for invec- tive. The main indigenous medical prob- lem is alcoholism, the main social problem the missionaries (shades of Maugham) trying to provide a spiritual cure. On nearby Nauru, life is so boring that some locals have 'forsworn their degenerate and pointless existence for the false certitudes of cheap religion . . . At times there are matters more important than the truth.'
It is easy to overemphasise Daniels' world-weary philosopher's point of view. Generally his style is terse and entertain- ing. Fool or Physician is a tract for these times and as such deserves to be widely read.
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