Doctor doctor

What’s in a title?

For many years I had an unresolved discussion with my father as to the validity of the term “Doctor” as a form of address to academics, medics and otherwise. My father, a physician (MD), held that the term Dr was reserved strictly for the medical profession and that the only way to earn the title correctly was through several gruelling years of medical school. I the other hand, being a doctor of philosophy (PhD), argued that historically the term was applied to academics and philosophers and only used as an honorary term with the medical profession, in deference to their long period of training. Needless to say the matter went unresolved and we shall doubtless take it up again when we meet next.

I earned the title through several years of tough research, a doctoral thesis of 75,000 words and a highly challenging  viva voce examination by two notable academics (who I shall not name except by their initials GC and DS). It was cut and thrust for 2 ½ hours. This was in the mid-80s when oral exams rarely lasted more than an hour. The discussion was friendly and engaging but also challenging and at times teetering on confrontational. At the end of the examination they asked me to leave the room while they reflected on their opinions. I remember at the time thinking that was a bad omen but it turned out to be nothing of the sort. After 10 minutes or so of hushed chatter – I tried to eavesdrop unsuccessfully – I was called back into the room. The examiners asked me to sit down again which automatically raised my stress level a notch or two. Then GC told me that it was a very good thesis and an excellent defence, words which stick with me even to this day. I remember asking them why, if they felt it was such a good thesis, had they given me such a grilling in the examination. DS replied “if we had not done so, you would have had less respect for the degree”. He was right, I felt I’d earned it.

It was the convention in those days for the examiners to make their recommendations to Senate who would then in turn and in the fullness of time notify the candidate of their decision. University administrative machinery was painfully slow in those pre-fax, pre-email days. There were various codicils and caveats in the legislation which allowed Senate, theoretically at least, to overturn or modify an examiner’s opinion. In practice none of these applied. Unless there had been malpractice, the examiners opinion was taken as read. However because of this ratification by Senate, examiners were specifically asked not to pass on their opinion to the candidate in case Senate chose to reassess the matter. In theory, the examiners were not allowed to tell the candidates of their opinion. Needless to say nobody took a blind bit of notice. Examiners routinely told the candidates on the spot. I remember the wording DS used to tell me. “We are not allowed to tell you the result of your examination, Dr Stamford…” GC chipped in “…but if we were, we would tell you that you have passed”. I have been at pains over the years to repeat the very same words to candidates I have had the pleasure of examining.  

So I know what it takes to get a PhD. And in my opinion, that makes me every bit as worthy to be called Dr as any stethoscope wielding white coat!

In my case the situation is slightly more complicated. Not only do I have a PhD but I also have a DSc. This probably takes a bit of explaining. The DSc is both an honorary and earned degree. It is commonplace for universities to award a DSc as an honorary title to a senior academic or to someone who has made a significant contribution to an academic discipline whether through the University system or outside. The other category of DSc is earned and on the basis of a large body of published research in a given field along with submission of a substantial thesis. I was awarded mine in 2000 on the basis of 75 published papers on the dynamics of neurotransmission and a thesis (of my published work with introduction and discussion) of around 700,000 words. A doctorate is considered to be a higher degree. In the same way, a DSc is considered a higher doctorate. Relatively few people with a degree go on to do a PhD. A tiny fraction of PhD holders go on to do a DSc. It carries no value in terms of promotion or of career prospects. It is merely an acknowledgement by the very best of your peers of your standing within the academic community. A vanity in many ways.

A DSc is also a degree largely unknown outside the UK and the UK influenced academic communities worldwide. Very occasionally I meet people who recognise the significance of a DSc but, for the most part, people assume it to be a typo.

Not so in Germany. Germans are sticklers for detail and for achievement and will always err on the safe side. Whereas the French will always refer to even a head waiter as boy (garcon), Germans will elevate even the lowest food server to head waiter (Herr Ober…). In academia, and for absolute certainty, they will throw in Professor for good measure. I have more than once been addressed at conferences in Germany as Herr Professor Doktor Doktor Stamford.

Within medicine, the terms doctor and mister are further confused. Whereas in the outside world doctor is considered the higher term of respect, not so in medicine. Surgeons are referred to as mister or, in the case of female surgeons, Miss. This is of historic origin. Back in the 18th century or so doctors still had to undergo extensive training before they were allowed to minister to the sick. Surgeons on the other hand were largely unrelated to medicine and could practice without the need of medical training.

All you needed was adequate premises and the ability to amputate a limb as swiftly as possible. There were no anaesthetics before 1840. Speed was of the essence – the record for the fastest amputation of a leg was by Joseph Liston who performed the task in 28 seconds. Liston also held the dubious honour of being the only surgeon to have a 300% mortality from one operation. So swift was he on that occasion that not only did he remove the patient’s leg but also three fingers of an assistant and a member of the assembled crowd (operations were public events – why do you think they are called operating theatres) who had a heart attack. The patient and assistant died of subsequent infections.

This was not the only time when Liston’s penchant for speed came at a price. On another occasion whilst taking up a patient’s leg, he also removed his testicles. For these reasons surgery was felt to be not the specialisation of a highly qualified physician but as a career path entirely unrelated. Surgeons were often barber surgeons. The mind boggles. But it accounts for why, to this day, surgeons are referred to by their peers as Mr. I think I’ll stick with the German version. Just call me Prof Dr Dr Jon. I thank you.

V Day

It’s barely 6 am and I’m wide awake.  It feels like Christmas. I am jittery. I can’t sleep properly because today is the day I am to be vaccinated. Well the first jab at least. I’m that excited. My appointment is at 9:05 and I am sufficiently fearful of oversleeping that I have set no fewer than three alarm clocks to ring at staggered intervals and at different distances from the bed to ensure  that I am not only awake but out of bed. This cunning plan works well. Too well perhaps as one of the alarms is still ringing intermittently four hours later when I return to the house. In my haste I have pressed ‘snooze’ rather than ‘cancel’. Still it has served its purpose. I am out of bed albeit without the slightest idea of where I am. Or who I am for that matter. But the clocks have fulfilled their part of the bargain. I am up at 5:58, standing bewildered on the landing and wondering where the the last alarm clock although it’s surely loud enough to wake the neighbours. They don’t call them thunder clocks for nothing.  I briefly entertain the notion of going back to bed for an extra few winks but fortunately am sufficiently compos mentis to acknowledge the folly of such action.

For a minute or two I stare blankly into my wardrobe in search of inspiration. What is the etiquette for a mass vaccination? It’s not exactly black tie. A bit like going to work then – commuter train chic? Perhaps more casual? Or should one try to scale sartorial pinnacles? I plump for a pair of forest green cords, my t-shirt with the joke about the 2010 Icelandic volcano and a Fair Isle jumper. A quick glance outside and the sight of my crisply frosted car adds my father’s Crombie and a dark blue trilby/fedora to complete the ensemble. Throw in my brown suede Chelsea boots and I am good to go. I blow my reflection a kiss, instantly embarrassing myself. 

Out of the front door and into the car. Then out of the car and back into the house when I realise it is still only 6:30 and my appointment, only some 5 miles away, is not until 9:05. Even allowing for the most event-ridden journey – avalanche in Sevenoaks, escaped panther at Capel, plague of frogs in Southborough – this is still not going to take me over 2 ½ hours.

Cornflakes and coffee I decide.

It’s still only 7 am even after a couple of weapons-grade espressos.

I turn on the wireless to catch the news and just as quickly switch it off – more Royal family shenanigans. I have a limited interest in such nonsense at the best of times. Royal intrigues simply do not hold my attention. More than I can handle at this hour. Whatever happened to the shipping forecast? 

I find myself pacing the living room. Until I remember that these are the boots I was wearing the previous week when I trod in some undisclosed cat poo in the garden. Probably not my best thinking to pace the living room. I hastily check the living room carpet. Fortunately all is well  with the rug and the shoes pass a brief olfactory inspection.

7:30 a.m. It suddenly dawns on me that the schools are back today and therefore the roads will potentially be choc-a-bloc with school buses, cyclists who haven’t cycled in months and schoolchildren with the road sense of hedgehogs. Plus the usual monday morning mayhem. Better get on the road I decide.

Ten minutes later I am in Tonbridge, parked at the vaccination centre and wondering how I’m going to kill 90 minutes or so in the Sports Centre car park. The cafe is closed –   obviously – and it has never dawned on me to take a thermos or a book. Not that it would have done anyway. My bladder is on a hair trigger these days. Challenging it with a flask of coffee would be supremely ill judged. 

The only reading matter to hand is the car handbook. It turns out to be one of the least compelling reads ever. Not exactly a page turner. On the other hand it fills the time until the vaccination centre opens. And I now know how to do a full annual service, refill the aircon and change all the bulb units. Still a little bit shaky on the electrics.

Still half an hour before my my allotted time slot. I overhear one elderly gentleman saying that there is no strict regulation of appointment times. Sheepishly, I join the queue hoping nobody will notice my early arrival. It turns out they notice but evidently do not care. As long as the system has you detected, directed, consented and punctured, all is well.

Ralph and his iPad identifies me, logs me into the system and then passes me over to Celine whose role is to point left or right depending on which is the shorter of the two queues. I turn out to be a Lefty and am greeted by Jean whose job it is to consent me and satisfy herself that I really want the vaccine. She starts by asking me if I know why I’m here. “Is this not beginners yoga?” I ask. Eventually she is satisfied that am a safe bet on anaphylaxis and passes me on to another pointing person. “Cubicle number 8” she announces in a tone that fleetingly reminds me of Argos. I’m greeted by Janine, the nurse, in a manner that is disproportionately enthusiastic for such an early hour of the day. “Which arm?” she asks “We need to leave you with one good arm”. I quickly check that we are talking about vaccination and not amputation. My meds have not really kicked in this morning and I am slow in baring my arm. Janine wrestles me out of my coat with the kind of fevered urgency of newlyweds. I toy with the idea of mentioning this to her but fortunately think better of it. She is after all holding a syringe. “A little scratch” she says and it’s all done. Nurses no longer say “a little prick”. Apparently some patients take it personally.

Janine’s assistant passes me a card with my next appointment and a sticker saying “I’ve been brave”. OK I made the last bit up. A quick thankyou and I am I shown out via the tradesman’s entrance so to speak, past huge skips of rodent-riddled rubbish with the instruction not to drive for 15 minutes ringing in my ears. Fair enough – I can brush up on the car’s electrics.

Home 10 am. Job done.