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Remembering good and bad doctors


Choosing medicine despite indignity visited on patients
Harold Lambert Physician
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It did make me realise that I had a difficulty that I wanted to do medicine very much. I realised that medicine's so big you can never never encompass it and in fact you don't understand a lot of it, but there was another element which I wanted to go into things in greater detail, focus down on them, and I suppose that's why I decided to do medicine as opposed to surgery or whatever as a speciality. We... on, on the sort of personal side one realised the difference between the doctors who taught you, who really were on the side of the patients really, who felt what, what they were up against and the people who didn't. And we're all children of our time, but things like children's wards where, I don't remember the visiting hours, they were probably one hour three times a week or something, and now that would seem to us totally horrifying, but the paediatricians they weren't nasty people, they were kindly people, but we're all... we need some person who says, 'This is awful, you shouldn't do this', and then it changes.

[Q] But, presumably, it was how all sorts of things were being done? I mean, people being taken to... evacuated and such like, it wasn't, there wasn't a feeling that, that the children should always be with their parents like they, they were now.

I suppose that's right, yeah, yeah. I mean... I mean, Joan, my wife, was an evacuee with her twin, with a little box with a gas mask and a label round their wrists saying... and a postcard to send to your parents saying, 'We have arrived at somewhere', but there were other things. I remember in surgical outpatients there might have been 30 students sitting round this surgeon and then he said, 'Oh come with me', and we swept into a room, one of the cubicles and a woman was lying there naked to the... to the waist with a, she had a lump in her breast. I remember thinking, 'This is a terribly, terribly bad thing to do'. I was obviously much too cowardly to say to the surgeon, 'Get out of here, we shouldn't be here'. Obviously I didn't do that. I mean not... I don't know, but obviously anyway I didn't, but I remember thinking at that time there are, there are things that are really wrong about this, about how we're doing it and rather strangely, going to the very end of my clinical career, I got more and more impatient of ward rounds as I got near retirement. You... the people, your juniors and the people who are visiting, very much wanted to be in on the discussion, and I didn't think it was wrong to go in like everyone these days I went in and said to the patient, 'I've got some students on a visit, would you mind if I bring them in to see you?' and, as you know very well, if you involve the patient in the discussion they're usually only too delighted to be in on the act and tell them, tell people what they think about it. But I, I began to think it was just bad manners. I just thought going in with about ten people just was a kind of... it used to irritate me despite all those caveats and that, in a way, goes back to the beginning, doesn't it?

[Q] And did you find that actually stopped you wanting to teach at the end or... did...

No, I always wanted to teach. I just loved teaching, but that particular bit of it I just, I sort of went against. I didn't like the idea of going into a room with a lot of people.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: paediatricians, visiting hours, medical practice, caveats

Duration: 3 minutes, 23 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008