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Those who entered the
medical profession in the Scotland of the inter-war years did so against
a background of considerable change and competing claims.
Related to the pride in
the achievements of Scottish education were the plaudits offered to the
supremacy of Scottish medical practitioners and their education and
training.
History, to some extent,
bears this out.
The medical faculty
attended by Robert McIntyre in Edinburgh had a record of achievement
going back to 1726 and, in the 18th century, it played an important part
in Scottish supremacy in medical education.
Other nations, including
England, were to catch up in the 19th century and, in the early years of
this century, there was clear evidence of Edinburgh and other Scottish
medical schools falling behind.
The catching up process
was to be expedited as nations like the US and Germany came through
their industrial revolutions and their wealth and productivity
increased.
Notwithstanding these
events, statistics show that, in the mid- 1930’s, Scotland accounted
for 35 per cent of the UK’s medical graduates and was still able to
attract a substantial portion from overseas.
Part of the relative
success was related to living on past reputations but there can be
little doubt that a school such as Edinburgh had begun to put its house
in order.
Views as to the relative
merits of the medical and surgical aspects of the training of future
doctors differ, but it seems that, in a rather macabre manner, the
surgical side gained in expertise due to the influx of lecturers and
practitioners who had served in the 1914-18 War, and who had ample
practice in real life situations and were able to pass on their skills.
In December 1938, Robert
McIntyre graduated in Medicine from Edinburgh University and the looming
international crisis found him journeying to England to join a general
practice in Warwick as an assistant.
On making this excursion into England, he was
following advice given to him by one of his University lecturers, who
told him to learn his trade, "at the expense of one who had already
mastered it".
Learning his trade did not prevent the newly lettered
Dr McIntyre travelling to France for a short holiday to gain direct
knowledge and information about the political situation in Europe.
After brief spells in
practices in Musselburgh and Polmont, the early months of the Second
World War found Robert installed as a house surgeon in Stirling Royal
Infirmary. During this period, he made contact with Dr Edward Neil Reid,
and this meeting, by accident, began a long and mutually beneficial
association.
Dr Edward Neil Reid was born in Dundee in 1899 and
qualified in Arts and Medicine at Dundee and St Andrews in 1927. He had
been Medical Officer of Health in Dumbarton before moving to Stirling
County in 1937. In the early days of the "black out", Dr Reid
was involved in a car accident in which he sustained a leg wound which
required stitching. When he arrived at Stirling Royal Infirmary for this
treatment, the doctor on duty was Robert McIntyre. This fortuitous
meeting was to have implications for Robert’s future medical career.
This initial role at Stirling Royal was of a mere six
months’ duration and Robert moved off to become House Physician at
Bangour Hospital. In this period, he developed an interest in the area
of public health which was to require a period of further study to gain
the Diploma in Public Health which he undertook at the University of
Glasgow.
During this time of study
at Glasgow University occurred another of the chance incidents which
marked changes in Robert McIntyre’s life.
His description of a meeting with a Dr Herbert Brash
in Sauchiehall Street, Glasgow, more than fifty years on, is extremely
matter of fact. The two met at a time when Brash was looking to move
from his position as Resident at Ruchhill Hospital, Glasgow and was
hesitating about the transition in the absence of a suitable
replacement. Having taken his Diploma in Public Health, Robert was
seeking a position which could extend his knowledge and experience in
diseases of the chest, particularly tuberculosis.
This harmony of interest brought Robert well and
truly into the sphere of public health, which was to engage his future
professional interest.
Ruchhill Hospital was
itself a creation of the increased concern and knowledge about public
health in Scotland at the turn of the century. It first opened its doors
in 1900 and, in its time, with 408 beds, was one of the largest and most
advanced medical institutions in Europe dealing with infectious
diseases.
The improvements had a
considerable legislative basis which brought new responsibilities to
local authorities for the provision of new hospitals and produced a
decline in the relative importance of the voluntary sector maintained by
bequests, fees and public subscriptions. By the 1930’s, two thirds of
hospital beds in Scotland were provided on a
statutory basis.
Pivotal to these advances
was the role of the Medical Officer of Health. From the middle of the
19th century onwards most progressive local authorities were appointing
Medical Officers of Health. These endeavours were given additional
incentive by various statutes which were passed giving local authorities
responsibilities for the isolation, treatment and obtaining the
important power of compulsory notification of infectious diseases.
Poor housing, inadequate
sanitation and dirt, as well as inferior quality of water and air,
played their parts in producing the miseries of the poor health of the
Scottish people. Important steps were taken to counteract some of these
problems by, for example, improvements in water supply exemplified by
Glasgow’s Loch Katrine scheme, which went ahead despite objections,
including those from the Royal Navy who argued that the taking of water
from the Loch would lead to the silting up of the Forth and endanger,
"The British Navy’s only anchorage north of the Humber".
These improvements were
matched by the increasing political awareness of the need to improve the
low earnings of the poor, particularly when exacerbated by old age,
unemployment and ill health. The dramatic advances brought about by the
Liberal Governments at the turn of the century are well recorded, in
terms of pensions and unemployment and sickness provisions.
What is often forgotten
is the fact that Lloyd George’s 9d for 4d Scheme, included the
provision of sanatorium benefit for tuberculosis patients and, while the
development of the concept was slow, under the spur of the Astor
Committee in 1912 steps were taken to invite local authorities to submit
schemes to control tuberculosis.
Ruchhill Hospital had
been established initially as a fever hospital but had expanded to deal
with tuberculosis, and its staff were amongst the pioneers in their
efforts to introduce new techniques in the control of the disease.
However, almost
immediately, Dr McIntyre found himself thrown into the battle to combat
the dreadful infection of diphtheria - not in Glasgow but in
neighbouring Paisley at the Burgh’s Hawkhead Hospital.
The early years of the
War witnessed a dramatic increase in the confirmed cases of diphtheria
in Scotland, rising from just under 10,000 in 1939 to over 15,000 in
1940.
Robert McIntyre, who was
virtually in charge of the Hawkhead Hospital in Paisley in the early
1940’s has vivid recollections of the ravages of the infection. He was
Senior Resident at the Hospital and played a leading part in the
immunisation campaign directed at Paisley’s schoolchildren -visiting
every school in the area to persuade the children and their parents to
have anti-toxin administered against the lethal disease.
His gratification came in
the success of the campaign which exceeded all expectations. He recalls:
"When we immunised the children in a particular area, we could
immediately see the results in that ambulances ceased to bring in the
patients."
Overall Scottish
statistics show that the Paisley pattern was part of an intensive
national effort. By June 1941, 440,000 children in Scotland had been
immunised, 40 per cent of the age group, and, by 1942, the figure had
risen to 792,000, 69 per cent of the group. |
