Memoirs

Editor’s note: The course in “Writing Your Memoirs,” offered at Abbotsford House and taught by Anne Le Dressay, has brought out some wonderful stories by local residents. We share two of these stories by John Last.

A home birth
By John Last

The family came to Adelaide from the north of England about the time I graduated from medical school in 1949. Alan was an engineer, Mary had been a nurse-midwife before they married and began making babies. They lived across the lane behind our home in my last three years in general practice in Adelaide in the 1950s. The oldest of their children, a girl also called Mary, was 14. Young Mary was mature beyond her years, an outstanding student who radiated competence and social skills. Her mother told me that young Mary had first said she was going to be a doctor when she was six, and had never wavered from this ambition. She asked if she could read my textbooks and I willingly consented. She became our babysitter, and I soon got used to seeing her absorbed in my medical books.

Her mother, Mary senior, was pregnant again, her sixth, and all was going smoothly. She asked me to arrange for a home birth. I had to tell her we didn’t do home births in Australia, and a few days in hospital would be a pleasant rest. I booked her into the nearby cottage hospital. She shrugged, smiled, said nothing. When she came for her routine prenatal visits she often brought young Mary, and asked me to let the girl listen to the baby’s heart. I showed her also how to identify the parts of the growing baby’s body.

One afternoon young Mary knocked at our back door: could I come to see her mother? I went across the lane from our back garden to their home. Mary senior was in labour. She and young Mary had cleaned the room, perhaps the whole house, meticulously. There wasn’t a speck of dust anywhere. The bed had a rubber sheet over the mattress and extra lights from other rooms lit it up like a sports arena. A baby’s cot stood ready for the new arrival. A bowl of water mixed with disinfectant, and clean towels were laid out on a bedside table, on which a pressure cooker also sat. Young Mary told me this held sterilized scissors and tape to cut and tie the baby’s umbilical cord. She stood calmly at the bedside, wristwatch in hand, timing her mother’s contractions. She told me these were coming every two minutes. My examination revealed that the birth was imminent. I suggested it was time for her to go to the hospital a few blocks away, but I knew as I said it that I was wasting my breath. She was determined to have this baby at home. What’s more, she wanted young Mary to assist me.

I accepted the inevitable and asked young Mary to nip across the lane to tell my wife what was going on. Alan was at his company’s offices in Melbourne and was due home next morning on the overnight train. We’d have to manage without his help. I remembered a few other things that might be useful so when young Mary came back, I too made a quick dash through our back garden to pick up my medical bag.

I was gone less than five minutes, but events move fast during childbirth. When I got back, young Mary was holding the baby’s head, gently turning its shoulders so these would deliver smoothly – Mary senior’s expertise was guiding young Mary. I took over as the rest of the baby, a boy, slid out, bellowing lustily. Another push squeezed out the placenta. Young Mary opened the pressure cooker to get the sterilized scissors and tape. I nodded for her to go ahead. She tied and cut the umbilical cord, sterilized the cut end, her hands moving confidently as if she had done this many times before. She had tucked her hair into a headscarf but she didn’t have a facemask and I saw her expression change from concentration and determination to delighted pleasure. I put drops in the baby’s eyes, young Mary draped a blanket around him and passed him to her mother whose outstretched hands steered him to her breast.
Mary senior confided how she’d planned it all. She wanted to have the baby while Alan was out of town because he would worry about risks and would side with me about sending her to the hospital. She’d had three home births in England and much preferred these over going to the hospital – “medicalizing childbirth,” she called it.

Young Mary told me a week after baby Liam was born that she had decided to specialize in obstetrics.

John Last is an Australian-born physician who has been a professor of epidemiology and public health at the University of Ottawa since 1969. At the age of 88, he is still teaching, or as he terms it, “corrupting the minds of innocent young students.”

Pushing teeth

By John Last

In the 1940s when I was a medical student, I had a card with a long list of procedures to perform under supervision and get signed up by clinical tutors: reducing and plastering a fractured wrist, performing a lumbar puncture, passing a catheter and so on. Included on the list was “extract two teeth.” Why two? I never discovered, but like some of my classmates, I extracted many more than two. The dentist who supervised us had a sensationally beautiful dental nurse. On hot days, of which there were many, she discarded her dress and worked with a white coat over her underwear, which added considerably to her allure. We went back again and again to gaze at her longingly and attempt to invite her to our parties (to no avail; she disdained sex-starved medical students suffering from arrested adolescence). But thanks to her, I soon excelled at extracting teeth. The dentist knew well why I was there, and ensured that my time wasn’t entirely wasted.

The secret of dental extractions is not to pull the tooth, but to push it out: push the wedge-shaped points of the dental forceps well down alongside the roots of the tooth so the wedge loosens the roots; extraction then is usually easy.

This skill came in handy a few years later, in 1954. I was hitching a ride across the world as ship’s surgeon on a cargo ship. Shortly after we had rounded the Cape of Good Hope en route from London to Adelaide, the chief engineer, a curmudgeonly tyrant, bit savagely into a bread roll and broke the cusp off a bicuspid. He was in agony. I had to deal expeditiously and well with this acute dental emergency or my life in this small, closed and highly critical community wouldn’t have been worth living. The casualty room on this ship was very well equipped; I could have done a C-section or brain surgery. And of course there was a full set of dental forceps.

First I pre-medicated the Chief with a tumbler of brandy. The hard part was injecting local anesthetic; even semi-stupefied, the Chief didn’t like this at all. The heavy seas of the “roaring forties” were no help; nor was my choice of a dental chair without adequate support for his head and neck (I hadn’t planned this part as thoughtfully as I ought to have done).

The rest was easy. I carefully positioned the dental forceps blades beside the broken tooth, and pushed down as hard as I could. The tooth popped up and out like a pea out of a pod. It was so simple I felt like clearing the rest of that side of his mouth while it was numb, but self-restraint prevailed. For the rest of the voyage across the Southern Ocean perhaps it’s as well that my reputation for competence wasn’t tested further. I’ve never again been called upon to extract teeth. Pity, really. I think I could have become a master of the art, thanks to those hours of unfulfilled dreams and useful experience in the dental clinic behind our teaching hospital.

This anecdote was first published in the British Medical Journal in 1993.