Pete's Bogus Journey

The following sections are included:

• Dedication
• Contents

These are the famous lines uttered by chief surgeon Sir Lancelot Spratt ( James Robertson Justice) and medical student Simon Sparrow (Dirk Bogarde) while on a pre-op ward round at the fictional St. Swithin’s Hospital, London in the 1954 film Doctor in the House. Even though this movie predates my entry to a London medical school by a mere 35 years, the teaching experience and ward rounds epitomised in the movie draw very similar parallels to those experienced by myself as a student…

1980s music buffs will recognise these words from the track Russians, sung hauntingly by Sting in 1985 whilst I was in high school. Having grown up during the Cold War in the 1970s and 1980s and with the terrifying film Threads, an apocalyptic drama depicting the devastating effects of such a war on Britain released a year earlier in 1984, I was fearful of a nuclear war. The song by Sting also left me wondering if the Russians loved their children too…

This is the Fat Man’s Law Number 8 from the book The House of God by Samuel Shem. For those that have not read this book, it tells the story of Roy Basch, an intern at a hospital called the House of God, a fictionalised version of the Beth Israel Hospital in New York and set in the early 1970s. It describes, with humour, the trauma of Roy’s residency training. His mentor is a senior resident called the Fat Man, who imparts his wisdom in the form of a survival guide for the interns comprising 13 laws. In his law “they can always hurt you more,” the Fat Man was essentially saying that everyone in the hospital is out to get you and things can always get worse…

This is the slightly altered opening line to Miami Sound Machine’s 1984 hit Dr Beat. Pop pickers may remember that in this song, Gloria Estefan is afflicted by a problem — whenever she hears a beat, she cannot control her feet and is desperately seeking the help of the mysterious Dr Beat to stop her from going insane. Fortunately I was not working in Accident and Emergency at the time she sought attention for this, as I don’t think I would have been able to come up with any treatments for her peculiar akathisia (inability to stay still) apart from maybe suggesting that she try listening to ambient music instead…

In this scene from the TV comedy Peep Show, Jez, a 20-something layabout and talentless but aspiring musician explains to his uptight and conventional flatmate Mark that he has met the defendant in a fraud case, on which he is serving as a juror, in a café and is planning to take her out for a drink. Mark suggests that this may affect his impartiality on the jury, to which Jez justifies his intentions with one of his philosophies on life: “if it feels good, do it.” Whilst most of Jez’s ideas on conducting his chaotic life are misguided, this is actually one of the rules of my own hidden curriculum…

In this memorable scene from Trainspotting (1996), Spud successfully fails to get a job at the leisure centre, which he had been obliged to attend by the Department of Employment, by messing up his job interview whilst high on speed. In a similar fashion, although not high on drugs, I half-heartedly interviewed for a Senior House Officer post in Neurosurgery on the South Coast of England as I really could not stomach treading water in that job for another six months before getting into my preferred career in Ophthalmology. The following day, with a spring in my step following my successful rejection by Neurosurgery, I travelled the length of the country for an Ophthalmology Senior House Officer interview in Glasgow. This time, however, I put my heart and soul into it and thankfully managed to persuade them, like Spencer did for his barman interview in the TV comedy Phoenix Nights, that “I’m your man!”…

In this scene from the film Rogue Trader (1999), Nick Leeson (Ewan McGregor) describes Singapore to his wife, shortly before he singlehandedly brings about the collapse of Barings Bank (one of England’s oldest merchant banks) from a series of unauthorised and risky trades resulting in losses of a billion dollars…

In this memorable scene, the monotonous voice of the Economics teacher continues during his lesson to a very bored class in the movie Ferris Bueller’s Day Off. One has to feel a bit of sympathy for Bueller’s Economics teacher as it can be difficult to deliver a dry subject, such as a piece of US import duty legislation from 1930 to a bunch of bored high school students. Unfortunately, you are only as good as the material you have to work with. In a similar fashion I find it hard to keep lectures such as “retinal vascular disorders” and “optic neuropathies and glaucoma” interesting and exciting for the medical students…

As declared by Jordan Belfort in a motivational speech to his staff in the film Wolf of Wall Street (2013). Unfortunately, medicine as a career does not lead to the obscene levels of wealth achieved by Jordan Belfort and his staff, but it does lead to a secure and comfortable level of income as my parents encouragingly reassured me, with an invisible arm twist, when I was deciding on what degree to put on my university application (UCAS) form…

This is how the general manager David Brent (Ricky Gervais), with his inflated ego, described working under him at the Wernham Hogg paper company office in Slough in the TV mockumentary sitcom The Office. I can safely say that I have never been in a workplace that could be described as brilliant and never had a boss who was a chilled-out entertainer. Harry, my surgical colleague and boss for a brief period many years ago, is an unintentional comedian at times but not an all-round entertainer. My career, like many, has had many ups and downs along the way. On this journey I have learnt a great deal about dealing with bosses and hopefully the account that follows will prevent others from making the same mistakes that I have made.

The Spaghetti Western The Good, the Bad and the Ugly (1966) is considered one of the greatest movies ever made, and for good reason with a reputation for its wonderful and easily quotable dialogue between the three main protagonists Blondie (Clint Eastwood) — the Good, Angel Eyes (Lee Van Cleef ) — the Bad, and Tuco (Eli Wallach) — the Ugly. The narrative of the film centres around three gunslingers with their individual character traits, each separately competing to find a buried treasure of Confederate gold during the backdrop of the American Civil War. In this scene towards the end of the film, the cache of gold has been located to a particular grave in a Civil War cemetery, and Blondie, the one holding the loaded gun, explains to Tuco that because of this fact, there should be a division of labour and that he should be the one who does the digging…

Obviously this is an old joke, but for many surgeons I have met, especially as a medical student and in the early stages of my training, it is very true. There are also sub-type surgeon personalities determined by their particular specialty that can similarly be summed up by respective jokes:

I guess the first time I had an idea that I might want to be a surgeon was as a seven-year-old. Play dates with school friends in the mid-1970s, before the home computer era, involved many diverse and wholesome activities. These included setting booby traps in the house to annoy friends’ older brothers and sisters, unsuccessfully trying to emulate Evel Knievel-style jumps and wheelies on a push bike, and watching passing cars squash plums which had been pre-positioned in the middle of the street (who knew this could be so much fun?). When it was raining, there were of course board games to play inside, and each friend had different ones to bring to the table…

On a transatlantic flight, an air stewardess puts a call out over the Tannoy system. “Is there an anaesthetist on board this flight? Please make yourself known to one of the flight attendants.” An anaesthetist thinks this request is a bit unusual for actually requesting a particular type of doctor, but assumes it must be because it is a serious emergency. He raises his hand. The air stewardess hurries along the aisle and says: “Come quickly, we need help up in first class.” The anaesthetist follows the air stewardess to first class and she leads him to a middle-aged gentleman sitting comfortably reading a newspaper. The anaesthetist looks confused and the air stewardess explains: “It’s a surgeon, he needs his light adjusted”…

James Cameron’s movie The Abyss (1989) tells the story of a deep sea diving team called in to rescue the stricken submarine USS Montana which has sunk near the Cayman Trough, but in doing so encounters extra-terrestrial beings. In this scene, Lindsey gives her estranged husband Bud words of encouragement as he descends into the abyss as part of the dangerous mission to disarm one of the sub’s Trident missiles. These words could also have been used by Harry, my surgical colleague 25 years ago, during my first afternoon Postgraduate Teaching (PGT) presentation in Glasgow when I was a Senior House Officer and he was my Registrar. Except he didn’t; instead, he unhelpfully disappeared out of the rear door of the lecture theatre at the start of my presentation, leaving me all alone to flounder in the cold blackness under an intense grilling by one of the senior Consultants, without any “Goose” wingman backup to help answer any difficult clinical questions…

A common saying is that “laughter is the best medicine” and there is plenty of scientific evidence to back this up. However, I believe that a close second to laughter is music. Music has had a significant impact on my life and played a part in my career in medicine, and the above lyrics from Sister Sledge’s 1979 hit Lost in Music are perfectly true for me. Many songs will trigger memories and feelings and instantly transport me to a different period of my life. So, join me on my jukebox time machine through my life and career and revisit some of the songs that have shaped it.

I can play video games, but unfortunately not well enough to not have to work for a living. As a kid in the early 1980s I became obsessed with playing arcade games. Many hours back then were misspent in the arcades by the seaside with a rapidly emptying pocket of 10 pence pieces playing classics such as Donkey Kong, Asteroids, or Millipede. The journey home from school usually involved a brief diversion to the Kebab Machine shop on Finchley Road in London to play whatever the incumbent machine was at the time. My love for these games has continued into adulthood and I will happily take any opportunity for a regression session to immerse myself in pixelated nostalgia. A trip to an international conference will invariably result in me dragging some colleagues to a retro arcade bar for a mini tournament. But whilst these games represent for me a brief period of escapist hedonism, believe it or not they also contain some important life lessons for us all. At least that’s how I can try and justify devoting my time to what some may see as such a trivial pursuit…

This story represents events that took place 30 years ago when the world was a very different place.

This exchange is from the 1980s TV series Minder, a comedy-drama about the London criminal underworld, starring Arthur Daley (George Cole) as an unscrupulous “businessman” con-artist and Terry McCann (Dennis Waterman) as his honest bodyguard. Little did I realise as I watched this programme as a teenager that it would ultimately be the reason why I am still alive today, with three kids to my name, who would also not exist if it were not for Minder…

The 1993 comedy movie Groundhog Day tells the story of Phil Connors (Bill Murray), a television weatherman who is sent to the small rural town Punxsutawney in Pennsylvania to cover the annual Groundhog Day festivities. He dislikes the small town, its inhabitants, and his assignment, but unfortunately he becomes trapped in a time loop and has to experience the same cold winter’s day, February 2nd, over and over again. In the above quote he has realised he is stuck in this dreadful, repetitive time loop…

Jimmy Read is on his death bed and all his family are gathered around him. He gazes out into the darkened room and says in a weakened voice: “Is my wife here?”…

This is how the bungling, accident-prone Parisian Police Inspector Jacques Clouseau (Peter Sellers) explains his detecting technique to the family of billionaire Benjamin Ballon when he is called to investigate a murder at their country home in the movie A Shot in the Dark (1964). Despite being completely incompetent, Inspector Clouseau eventually solves the case and his philosophical quote above about trust, which at face value in the movie is laughable, is actually sound advice for life…

In this chilling quote from The Social Dilemma (2020), Tristan Harris, Google’s former design ethicist and Co-Founder of the Centre for Humane Technology, explains how social networks generate profit when the product is free. They make money selling data they have gathered about you to advertisers who then tailor their adverts according to your profile…

Film buffs will recognise this chilling quote spoken by Ash from the classic sci-fi horror movie Alien (1979). Ash (spoiler alert) is a Hyperdyne Systems Artificial Intelligence (AI) android who acts as an antagonist and sleeper agent throughout the movie, breaking quarantine to allow a member of the crew who is infected by an alien lifeform back on board the space cargo ship Nostromo. In this scene, he reveals to crew member Ellen Ripley (Sigourney Weaver) that his secret mission on the voyage is to bring back the alien intact at all costs, and the crew and the cargo of the ship are “expendable”…

These are the rules that one must abide by in order to successfully survive a horror genre movie, as described by Randy to his friends in the movie Scream (1996). In a similar way, my number one rule for surviving a career in medicine is: “Don’t get struck off by the General Medical Council”…

When I was growing up as a lad in the 1970s, Sundays were a very quiet day where almost everything was shut, including most shops except… newsagents. A normal Sunday for me would involve cycling around the local play park on my Raleigh Grifter and trying to avoid the skinheads, followed by a trip to the newsagent to spend my pocket money on sweets (usually a quarter of sherbet lemons, some flying saucers, and a few aniseed balls) and a couple of comics. Back then there was a good selection of comics for kids and one of these was Jackpot…

In this scene from Ken Kesey’s novel One Flew Over the Cuckoo’s Nest (1962), McMurphy, a new patient at a mental institution, is talking to his fellow patients and says that the first thing he noticed is that no one was laughing. Well, I lost my laugh in early 2009 and this is an account of the most bogus chapter of my life so far, but I will still try and narrate it with a modicum of humour. I had mulled over whether I should tell this chapter of my story, but I decided to proceed as hopefully the advice I have from my own personal experiences may be of benefit to someone, somewhere…

My first introduction to the digital age was at school in 1982, queuing at break time to use the school’s one and only ZX81 computer. Just before the bell went, I seized my chance and typed in “10 PRINT PETE, 20 GOTO 10” to see my name scrolling down to screen. That was in fact both the start and end of my self-directed computer programming education…

In this scene from the movie Four Weddings and a Funeral (1994), Tom explains to Charles (Hugh Grant) his thoughts on how he imagined finding a life partner would be. Charles expounds on this and suggests that Tom is perhaps right and “maybe all this waiting for one true love stuff gets you nowhere.” As mentioned previously in the chapter “Rainspotting,” I believe there are three main modifiable factors to get right in order to try and achieve happiness in life: your career, where you live, and your partner. Without any qualifications apart from my own anecdotal experiences, in this chapter I will attempt to give my own advice on romance, potentially finding a life partner, and indeed whether the quest for the one true love is a worthwhile venture.

I managed to body swerve COVID-19 for nine months since the start of the pandemic. The Pfizer vaccine had just started rolling out and I had my first inoculation in three weeks’ time booked. I had survived the stressful Christmas rush of buying and delivering presents, the obligatory writing of cards to relatives who have frustratingly not yet embraced social media or email, and clearing the magically replenishing piles of work admin. I had experienced that wonderful feeling which is hard to beat: turning the out-of-office email assistant on. A week of annual leave beckoned. Christmas was a frustratingly quiet affair as per the lockdown rules, but I had other plans for the post-Christmas period…

This isn’t actually a song lyric or a quote from a film but was said to me previously by my mentor and colleague Professor Dhillon. Several years ago, at the start of my midlife crisis (I am now at the peak) and midway through watching Ewan McGregor’s motorcycle adventure TV series The Long Way Round, I explained to the Professor that I wanted to buy a motorbike to gain perhaps at least the illusion of a sense of freedom. “It’s all about longevity,” was his advice. He was concerned that I would die in an accident if I started motorcycling — and he was probably correct, with my penchant for reckless activities such as hurling myself down slopes on skis or a mountain bike as my friends can attest to. A new motorbike combined with Tom Cruise’s Top Gun line “I feel the need, the need for speed” floating around in my head would most likely have brought about my early demise…

In this scene from the TV series The Hitchhiker’s Guide to the Galaxy (1981), adapted from the book by Douglas Adams, the supercomputer Deep Thought explains to its programmers that after 7.5 million years of computing, it has calculated that the answer to the question of “Life, the Universe and Everything” is 42. When I watched this series in the early 1980s, I was as dissatisfied with the answer as the programmers were. Many people tried to explain the answer “42” but Douglas Adams rejected them all. He eventually explained that when writing this scene, he decided that the answer should be “something that made no sense whatsoever — a number, and a mundane one at that.” It was clear to me in 1981 that unfortunately Douglas Adams had not provided me with any answers to the question, “What is the meaning of life?”…

The following sections are included:

• Acknowledgements
• Chapter 31 Hit-Squad Hill
• Final Words
• About the Author
• Index