Journal of the New Zealand Medical Association, 09-October-2009, Vol 122 No 1304
A Physician In Spite of Himself
DW Carmalt Jones (autobiography), edited by Brian Barraclough. Published by Royal Society of Medicine Press Ltd, July 2009. ISBN 9781853159053. Contains 268 pages. Price £35.00
This is the autobiography of Dudley William Carmalt Jones (who used the monogram CJ to sign his drawings and some published work).
Mary Glendining, the widow of businessman Robert Glendining gave 8000 pounds (equivalent to 320,000 pounds in 2007) to the University of Otago to endow two part-time chairs in medicine and one part-time lectureship in medicine. The Government matched the gift pound for pound.
In England senior hospital medical staff had been private practitioners acting as unpaid consultants to the residents. On repatriation, CJ found that his small pre-war practice was gone, and not relishing a return to that way of life, he aspired to join a “Clinical Unit”. About that time, five London Hospitals established “Clinical Units” with paid staff, but since his Westminster Hospital was not one of them he went to Oxford to ask Sir William Osler if the unit system was likely to spread. Osler responded, “Oh, you want an appointment of that kind. Do you mind going abroad?” “Well there is an appointment going in New Zealand (NZ)”, and he went on to speak very highly of the New Zealanders, and of their hospitals which he had visited during the war.
When the three Otago posts were advertised in the UK, Australia and NZ, CJ applied with the expectation that there must be a large department of Medicine there, but grounds for disappointment soon became apparent. “I had not so much as a peg of my own on which to hang my hat.”
We are indebted to Brian Barraclough for garnering from far flung sources CJ’s vibrant, penetrating, colourful descriptions of his background, education, life and times, the freshness of which reflect his education, familiarity with the classics, and acute perception. The editor’s footnotes are a feature, providing lively guidance to the conventions, personalities, relationships, and jargon of bygone times.
There is something here for everyone. He considered his service at a shell shock centre in World War 1 as, “the most useful clinical work I ever did,” and in an appendix the editor explains how the forces’ unpreparedness for the psychiatric neurosis casualties caused a serious loss of front-line troops.
At first his family history appears daunting, but later it enlightens his tolerance, good manners, values, and challenges. UK readers will gain pleasure from his descriptions of Uppingham school, Corpus Christi College Oxford, the London Hospital environment at the turn of the century, and his work with Almroth Wright, “Who was the greatest intellectual influence under which I have ever come”. “The personality which keeps a team of young men out of their beds as a regular thing till long past midnight is a remarkable one, and it was exercised in a remarkable way. I never heard Wright give an order, or ask a favour that any kind of work should be done. The work was there, and no one asked any questions, but just got on with it.”
On arrival in NZ, CJ was met by a bevy of notables and great hospitality from Dr, afterwards Sir James Elliot, “And as I have many times told Lady Elliot, the dinner she gave us remains in my memory, after 6 weeks at sea, as the best I have ever eaten”. “On Sunday he took us all to his country house up the Hutt River, where we got into the native bush for the first time. Little houses of this kind are very frequently used in NZ, I think perhaps particularly by doctors.”
He was forcibly impressed by the amount of sunshine in NZ, the extraordinary clarity of the atmosphere, and the sombre character of the evergreen native bush. “NZ is a country of great beauty,” he said but, “it is not “pretty” but “fine”, and “grand” and “magnificent” are rather the epithets that come to mind when its landscapes are in view. Some of it is very monotonous and even repellent.”
In Dunedin he did not meet with universal support, though he found his professional colleagues were always with him. When he and Dr Frank Fitchett, an Edinburgh graduate who held the chair of Clinical Medicine were called upon to submit a scheme for the teaching of medicine the differences between Scottish and English teaching traditions became apparent but, “Never once in all those years did Fitchett allow any friction to arise. I think there are few people of whom as much could be said”.
His deliberations about the role of the University are premised on the argument that all higher education must have a bearing on two separate objects, culture and vocation, and he found the contrast between Otago and Oxford arresting, concluding that, “The two institutions are called upon to discharge very different functions”. On the intellectual side the emphasis at the old English Universities was traditionally on culture and some impatience was displayed with any insistence on vocational interests. University lives were devoted to pure scholarship and young men came to know that scholarship was a reality and had its value.
In NZ he found that conditions were quite different, the university’s first duty was vocational, any scholarship that it could convey had to be thrown in as a make-weight, and many students were frankly unconcerned about it. “And the longer and more exacting vocational studies become, the less interest is taken in non-compulsory decorations”.
On holiday CJ read Homer’s Iliad in the Greek, and on the voyage out he read Macaulay’s history.
In NZ he found that anyone taking a class of students would meet a body of young people who were genuinely keen to get qualified and he found that these students, both men and women, usually made capital house physicians after a very few week’s practice. “They are very dependable, their work is seldom neglected, and they are as keen as can be on their clinical, bedside work: no doubt this is the result of responsibility”. NZ students, who often came from working class homes and farms, had shared the work that artisans do for a living, knew more about family budgets than English students, and were a good deal closer to the hard facts of life than were their opposite numbers in England
His experience of working-times reform was confined to the effect on the Fernhill Club (of which he was the president) of the “forty hour week”, which had “recently been introduced by the government, together with a steep rise in the rates of pay of most employees, including club servants, and adjustments are not easy to make”.
Anglers and Southlanders familiar with Five Rivers will enjoy CJ’s fishing expeditions and descriptions of the little up-country township where he stayed. “It consists of one little street of the essential shops, butcher, baker, draper, and the rest with “COMMERCIAL BANK” across the front of a tiny shack which will hardly carry the name-board. His lodgings there were unpretentious, and the “sanitary arrangements, fortunately outside, must be maintained in pious memory of Captain Cook, who certainly might have designed them”. Nonetheless the bed was comfortable, the food was excellent without stint, and if the evening rise had been prolonged, and the fish had taken well and you came home hungry long after hours, there would be a meal ready for you in 10 minutes. “I have fed in Government hotels where the waitress looked as if she would have much preferred to sit at the foot of the Guillotine than to attend to my small requirements.”
These fragments from this outstanding publication ill serve the extension of CJ’s reach, his fluent honest expression, the sincerity with which he reports on NZ, and the modesty with which he assesses his contribution to Medicine and the Otago Medical School. Throughout this book his cultural decorations sparkle in the adopted sunshine, but his etchings are not displayed.
In bringing CJ’s writings together, with illustrations, footnotes, appendixes to the text, his verses, trout fishing terms, a chronology of the life, a record of the published and unpublished work, memorials, and an outline of the history of the Chair of Medicine Dr Barraclough has edited a book that should be in every library. It provides gripping reading for those interested the history of Otago University, Medicine, and NZ medical education, and a sympathetic, charming record of NZ life, landscape and people as seen through the eyes of a discerning English newcomer in 1919.
Canterbury District Health Board
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