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36 the post and the impending interview with the other candidates. It will only increase your apprehension and probably convince you that all the others are better than yourself. It is better to be silent or to chatter nervously about general topics. ’ Lastly, remember that the average committee is a good deal more discerning than you think. There are stories of incompetent candidates bluffing their way into high positions, but they are mostly untrue. Inarticulate and inadequate as a candidate’s behaviour at an interview may be, the committee will probably make due allowance for it and form a shrewd idea of the personality and potentialities that lie in the background. PROTEUS. Disabilities . 20. CORONARY THROMBOSIS IT was on a grey, dull, Sunday morning at 7.30, three years ago, that it hit me ; and hitting is riot a bad description. I was 48, and in the last twenty years I had not had a single day in bed. Two months before, I had woken early in the morning with pain in the front of the chest, behind the second and third costal cartilages ; it lasted about ten minutes. This was something new to me and I consulted one of my local colleagues, a very good doctor. The result of an exhaustive overhaul was completely negative: " Can’t find a thing the matter, old boy ; probably some indigestion ; ;’ cut down the smoking," and so on. In the last five years my job as a G.P. surgeon had not been too easy : the house had a direct hit; the family were evacuated five hundred miles away ; the practice had just vanished ; and there were lots of worries, financial and domestic. Still, between periods of being frightened to death or bored stiff I had a happy enough time ; a long operating session on the ghastly bomb or shell injuries would be followed by a day with the Home Guard, tearing over the downs and initiating them in the use of the Vickers machine-gun. Just my private army. What fun it was and what an antidote. To revert to that Sunday morning: the pain was severe, very, centring on the middle of the chest over the second and third costal cartilages ; it did not radiate down the arms. It was a gnawing, screwing pain-as if some- one was applying a vice behind the sternum ; and it gradually got worse. I was alone ; my general factotum had not yet arrived. I got out of bed and walked up and down, but it was no use ; any drugs were down- stairs and I could not, or would not, go and get them. "Besides," I thought, " can do nothing": and as I had never taken anything except aspirin and alkalis ifl my life and was going to die in any case, why bother ? ‘ But I wished it would hurry up ; "and why should I go out this way when I missed the bombs and shells in this war and got away with the Salient and the Somme in the last one " All these thoughts passed through my mind. I hugged the side of the bed, and then I must have passed out, for the next thing I remember was seeing my old factotum with the morning tea. She took one look and grabbed the telephone. My partner arrived and pushed some morphine into me, a big dose. I had never had morphine before what a joy and relief ! In the meantime I had sweated right through a large woollen dressing-gown. Afterwards I had a vague notion of being trundled down into an ambulance in a canvas carrying stretcher. That evening the nearest consultant, first-class at his job, arrived from twenty miles away and gave the gravest prognosis to my partner : " he will probably be dead by the morning." (I have no doubt that at the time he was perfectly justifies ; but since then he and I have often laughed about it.) I gathered later that my pulse was all over the place, with a systolic blood-pressure well under 80, and terrific left-ventricle dilation, the apex-beat being somewhere near the backbone. But all the pain had gone and I was comfortable. I had more morphine again that night, for which I was very grateful. The next day a very distinguished general consulting physician arrived from London (thank God there are still some left) ; and quite properly, I think, he also took a grave view. I was in no pain but had the most frightful flatulence-fore and aft, chiefly fore. I was nursed sitting up and watched my epigastrium fluttering with sickening cardiac irregularities. Another annoyance was my tongue ; it was red and clean from tip to base, but very sore. The pulse was still nobody’s -business, and an electrocardiogram done that day indicated a large block in the left coronary artery. My memory of the first week is rather vague ; I was having morphine and hypnotics at night and digitaline gr. 1/so" three times a day. The days passed in a dreamy haze broken only by the confounded flatulence. After using the bedpan twice I flatly refused to have anything more to do with it and insisted on being lifted out and assisted to the commode. This created an uproar, as strict orders had been given that I was not to be moved at all for at least a month. " Well," I said, " if I am going to die I am going to die on the commode and be damned to everyone ; don’t tell me that there is less cardiac strain on the bedpan-it just isn’t true." I got my own way and still lived. One other annoying thing : I had to be catheterised several times because I simply could not urinate lying down. It took me a week to learn the trick, and I advise everyone over 50 to practise it. I was seven weeks in bed and have nothing but praise for my nurses. It didn’t take long to find that the art of nursing is simply knowing how to nurse, not adopting the attitude of a half-qualified doctor. It was the little things that mattered, and in these I was highly served. My appetite was poor but that did not worry me, and I started to smoke cigarettes after the first three weeks. Extrasystoles were a nuisance, and I took rather a morbid interest in the slow rise of my systolic blood- pressure, which gradually crept up to over the 100 mark. I read all the literature of coronary thrombosis I could lay my hands on, from Tom Lewis downwards, and was neither enlightened nor amused. " Heavens," I said, " we know nothing about it apart from post-mortem appear- ances," and so I turned to P. G. Wodehouse. I got up in the eighth week and went out convalescent in the ninth. One’s mental outlook at this stage seemed completely to overshadow the physical disability. All the gloomy ,prognostications came to my mind : " Oh yes, old So-and-So had a c.T., you know. He’s finished for keeps-such a pity. He was doing first-class work and was just on the top of the wave, and now he’s retired to an old lighthouse and just does some quiet prawning," or " he’s gone to the Ministry of Pensions." Multiply such statements by ten and that is how one felt. I found there were three physical disabilities-insomnia, flatulence, and inability to walk any distance without pain in the legs. The first two could be coped with, but the cramp in the calves was an infernal nuisance. It was not a claudication ; the pain was centred over the tubercle of the scaphoid of both feet. I simply could not make it out, for my muscles were quite well developed. Curiously enough I had no dyspnaea and no precordial pain, and my extrasystoles had gone ; but the pain in the feet and calves went on. I drove the car 200 miles at a sitting without any effort, but as soon as I got out and set my feet to the ground it all started again. This went on for two months without a let-up. I was getting quite worried about it when suddenly on getting out of bed one morning it vanished and has never come back again. That just made all the difference and my remain- ing month of convalescence was straightforward. During these months I took no drugs except -occasionally a mild hypnotic. I carried a ’Tubonic’ ampoule of
