Dr Cyril Scurr qualified at Westminster Hospital at the age of just 21. He was pioneering in his use of new technologies and techniques, though rarely discussed his achievements. He later became Dean of the Royal College of Anaesthetists and the President of the AAGBI. In this except, Dr Scurr discusses his experience in the Royal Army Medical Corps during World War Two and what it was like to work on the troop ships heading out to the Middle East.
In 1938, I got into Westminster Hospital in the old building… I was a first year clinical student. We had a great year you see, we had a most enjoyable year. It was like my first year at university… And everybody was having a great time in 1938, you know the hospital ball and all that sort of thing.
I couldn’t qualify until I was twenty-one. I could have qualified by passing the exams when I was twenty, but the GMC wouldn’t allow it and so I had to wait for another term… before I was allowed to take the last bit… which was two or three months after I was twenty-one.
“For a little while, we thought that peace in our time was going to be real”
When people are learning anaesthetics they sit in on and give a hand to someone who is actually giving the anaesthetic and then there’s a bit of a hand-over takes place. And they’ll stand over you while you’re doing all the manoeuvres if you take on another case. So I’d had quite a lot of really well-known people: with Sir Ivan Magill, he wasn’t a Sir then of course, with Geoffrey Organe… with Robert Machray who anaesthetised the King later, with Ronnie Borad and Michael Nosworthy. All very well known anaesthetists at that time.
I don’t think we knew [what was coming]. But we should have known because we’d had the Munich thing in the year 1938 when my brothers were evacuated down to Somerset and I was still up in London. And I think we were very frightened them that there was going to be a war on us in 1938. It was then of course that old Chamberlain went across and got his famous bit of paper and it was such a relief, and of course I think for a little while we thought that peace in our time was going to be real.
When it actually came about, a number of us, about three or four of us, students were particularly trained in anaesthesia more intensively in case people were short-handed in that respect. So one sort of fell into that I think at that time. I found it interested and had learnt in 1938 how to give anaesthetics. And of course when the Blitz came later, we did a lot of it, and resuscitation and so on.
We all had to do fire-watching whether you were a medical student or not, but of course when the causalities came in one was often working through the night at Westminster.
“I think Hitler has bitten off more than he can chew this time”
I had one idyllic interval really and that was just after Christmas 1940. They were looking for student house surgeons at Salisbury which is a most delightful city as you know and I went down there for about six months. I was there when Hitler invaded Russia as a matter of fact. I remember my batman who was an ex-Mauritania steward coming into my room with the morning tea and saying “I think Hitler has bitten off more than he can chew this time”.
Once I was called up I was out of hospital and into the Royal Army Medical Corps. I suppose the bombing and the casualties [were the major experiences], getting hands-on experience I suppose you might say were enormously valuable. When I went into the RAMC, they said “What would you like to do?” I said “I would like to go to a field surgical unit”, which consisted of a surgeon, an anaesthetist and other ranks. And they said “Oh no, no you’re far too young” and so on. So they posted me to troop ships for which they were asking for men over the age of forty, so I realised that the higher command in the RAMC was a bunch of idiots in many respects.
“I was the only doctor who could do anything”
There were two, four thousand on this troop ship which was The Batory, the famous Polish ship, four thousand troops going to Algiers. And the second medical officer was
a very elderly psychiatrist who know nothing about anything except psychiatry, so I had to do it all myself. And I had to decided when we were in convoy what were the surgical emergencies that arose that I could or could not cope with. I thought I could cope with the odd appendix and things, but things that I had to cope with were mainly dental extractions which I’d had not training in at all, so that wasn’t much fun… We managed to muddle through until we got to Algiers… I went back to Algiers again in March and went through the first army battles up to Tunis.
We had quite a good gang of other ranks to do all the hard work of cleaning and staging the thing, but I was the only doctor that could do anything. The old psychiatrist had seasickness all the time and he filled himself up with Luminal and wasn’t really of much use. The other thing is that being an American theatre of war, it was a dry ship and so there was no drink. And this was a great handicap and hardship to a lot of people on the ship I think. But coming back or course all was let loose, because we only had the ships staff of about half a dozen officers and drinks ad lib which was very nice… Quite a holiday for that bit.
“You didn’t stop and pick up survivors, you were like a bat out of Hell”
I saw in the papers when I got back to my parents’ place that I’d come back through the worst hurricane in fifty years. And it used to cheer me up because the ship was so up and down that I reckon any torpedoes would go well underneath. It was really rough, it was absolutely frightening. Fortunately I wasn’t seasick, but we did lose one or two escort vessels. Coming back through Gibraltar I saw one afternoon at teatime, the sharp end of destroyer out of water as it was going down… You [didn’t] stop and pick up survivors… you were like a bat out of Hell… that was for the Royal Navy to deal with, not for the civilian ships.
We were behind the lines, but we took enormous numbers of casualties to treat. Again I was anaesthetising for a long time, and eventually I got graded as a specialist anaesthetist in the army when I was in Tunis. But the day I was graded I got diphtheria which we caught from soldiers with desert sores which were in fact caused by malignant diphtheria organisms. And so I was ill for two or three months, during which period they quite kindly posted me to Anzio beach-head which was a real Hell-hole, so I missed that by virtue of having diphtheria.
We had Pentothal, ether, we had Oxford vaporisers, we had a field service patent Boyle machine which was capable of giving gas, oxygen and ether, and we had spinals. We had a very poor selection of local anaesthetics, the RAMC was very bad on that, and of course the relaxants didn’t come in until really after the war. We didn’t have relaxants at any time during all the time I was working on battle casualties until 1945.
“We got almost a hundred per cent survival”
With hindsight, if we had had curare and so on it would have been much better than having to give deep ether anaesthesia for abdominal procedures. On the other hand it’s interesting to look at the medical history of the war and to see that in our theatre of war at any rate, in Italy and North Africa, once abdominal wounds reached the Field Surgical Unit or Casualty Clearing Station, practically none of them died. I think we got almost a hundred per cent survival. You couldn’t say that for head injuries of course, they were the things that killed.
The Indian Army
I was in Taranto with the Indian Army and I was sent to Bari to pick up a hospital ship The Lenester. The hospital ships which took us up… was lit up at night. I can tell you that to go out at sea, having been in other convoys dodging submarines all the time, to go out at sea with all the lights on at night, you felt very, very exposed, albeit you had a red cross on the funnel illuminated brilliantly. Nothing happened but one felt very vulnerable I can tell you.
[My prime role with the Indian army] was dealing with casualties. I was with an Indian surgeon and I was the anaesthetist. And when the battles were going hard, we had two attached surgical teams, so you had three operating theatres fit to go, not usually working together, but working eight hour shifts. Battles are a little bit episodic. They don’t go on forever as it were. You have a week or two of real hard fighting, a lot of casualties, and then things die down for a bit with only dribs and drabs… And I got posted to Greece because we had the British Army in Greece to try and keep the Communists out while they had their elections. So although I’d been abroad for years and years as it seemed to me, it seemed a bit hard to have to put another year in abroad in Greece. I was pretty cross about that… I went in at the beginning of September ’42, I was five years altogether in the RAMC of which two years were after the war was over.
By that time I was a specialist. I was a major specialist anaesthetist in the RAMC. I did originally want to do surgery and I did quite a lot of surgery in Tunis… When I got into Italy they didn’t like this very much, the other surgeons on the unit. They wouldn’t let me touch a case even if it was an easy one… They were still thinking that an anaesthetist should be separate.
Anaesthesia & The King
You were pretty well guaranteed a job when you were demobbed from that situation and you got a thing called a supernumerary registrar’s job at £650 a year. I took the opportunity then to pass the DA because I hadn’t been able to sit any exams while I was abroad. Then I got a job back at Westminster as a registrar… but within a year there was a consultant post which I was appointed and I was there ever after until I retired.
“We operated on the King in Buckingham Palace”
Robert Machray… was a great thoracic anaesthetist who… eventually came to anaesthetise the King, and I went along with him which was another leg-up really that I received. [We] operated on the King in Buckingham Palace [and took] all the equipment there on a Sunday morning. All these things happen on a Sunday morning!
I anesthetised Attlee, on numerous occasions.. When he had a mortal illness he was distinguished by all the people in his brood, and they never said thank you for anything that you did for them. Never ever. He was a miserable character I thought. But I got a lot of the politicians. I anaesthetised for the cancer expert of the time, Sir Stanford Cade, eventually. And this is why we got Brendan Bracken and Attlee. Being at Westminster which was next to the Houses of Parliament, we got all the parliamentarians. For example, Lady Churchill I anaesthetised twice because she fell down and broke her hip more than once. She was a bit confused! When I used to go to see her she used to say “Hello Randolph”. I’m not sure that was the thing to do really.
With the King, I sat with him while he was waking up from his anaesthetic until he came round and looked after him entirely on my own for about two or three hours. But he died before I saw him again. I was due to have had a private investiture and he died just about a year later. I think the most touching thing was that when we went to put him to sleep in the morning, he had all the Sunday papers around him and they all had grisly details of the operation that he was likely to have. They were all hazarding a guess that he’d got carcinoma of the lung. And I thought as he was a timid sort of person who I think was very apprehensive of the operation- more perhaps than most people- because he had a biblical quotation in his own hand on his bedside table, ‘Put your trust in the Lord’ and that sort of thing.