I have never believed in didactic lectures and hence I spent most of my time working in hospitals, attending operations and helping generally. In 1905, Sir William Osler, the great physician of world-wide repute had said in his inaugural address at Oxford when he was appointed Professor of Medicine, that God had given human beings two ears and one tongue and therefore, while examining a patient, the most important thing to do is to listen to him. Seventy-five per cent of the diagnosis of a case will be given out by the patient in his description of the illness.

The final Fellowship examination showed how important it is to take this history and then do a physical examination. Only one or two per cent of the diagnosis may require such aids as radiograms, laboratory tests and now the whole rigmarole of ultra-sound, CAT scan, NMR etc.

To illustrate this, let me quote an incident. On every Thursday at 12.30 p.m. at St. Bartholomew Hospital, on the surgical side (surgical conference), a clinical meeting used to be held where one or two cases of interest were brought. At the surgical conference would be all the surgeons of that hospital, all the residents and all the senior residents. One day an assistant surgeon brought a patient who had a swelling of the upper end of the leg bone.

The custom was that the senior surgeon gave his views first and then the rest of us would follow. He examined the patient for half a minute and palpated the swollen area. Even without seeing the x-ray plates brought by the assistant, the senior surgeon diagnosed it as hydatid cyst of the bone and said that it gave a double thrill. We thought the old man had gone potty. How the dickens did he get a double thrill—one cyst hitting another small cyst through the bones, we wondered. The next day Dr Girling Bell whose case it was, operated. After the operation it did turn out to be a hydatid cyst. The senior surgeon had developed his fingers to such a nicety that none of us could feel what he felt.

I got through my final Fellowship in 1930 at the first attempt.