Hugh Tunstall-Pedoe
Dundee, Scotland, United Kingdom

In the late 1960s, I was non-resident neurology house physician in a hospital in central London when we admitted a prominent citizen as a private patient. He was suffering from a catastrophic cerebral hemorrhage—he was moribund, but the decision was taken to perform cerebral angiography (it was before the days of less invasive imaging such as MRI). I was not party to the rationale for doing so—whether any management decisions depended on the result—but it would have given the relatives graphic evidence of the disaster that had occurred, the hopelessness of the situation, and that “everything possible had been done,” besides any other considerations. I was peripheral to what was going on, but, in attendance, I was delaying my return home that evening until the procedure was completed.

Whilst it was proceeding, the relatives approached me. Their priest had arrived, and they were wanting him to carry out the last rites according to the Roman Catholic Church, while the patient was still alive. I interceded with a member of the radiology team. In a gap in the proceedings to reload the X-ray camera with film, we trolleyed the patient into an empty adjoining radiography suite where the ancient, brief ritual was then observed. Investigation was resumed and completed, after which I returned home. The patient, as expected, died some hours later.

Next day there were urgent messages left in three places in the hospital demanding that I report at once to the head of radiology—but also, confusingly, their cancellation. I gathered second hand that he was apoplectic at his theatre, a temple of science, being violated by “superstition” (maybe, I now wonder, whether in addition he saw his own sacred work being temporarily delayed by the priest of a rival outfit). His anger, as so often happens, was arguably both unjustified and anyway misdirected. He had been put straight by his courageous registrar, who told him that I had conveyed the relatives’ wishes to her. It was she who had sanctioned their earnest request. I narrowly missed a roasting, thanks to her intervention.

It was an interesting clash of cultures. You could believe in the value of one or the other procedure, even both, otherwise neither. Perhaps the relatives got the best of both worlds anyway, whatever the outcome for the patient, knowing that “everything possible had been done.”

This was my first experience of the conflicting prejudices that were to convulse part of the United Kingdom in succeeding years with tragic consequences. The head of radiology came from a Northern Irish “no surrender” Protestant tradition—he had failed to shed his natal bigotry against Roman Catholicism while pursuing his career elsewhere—he was, apparently, inextricably rooted on one side of the Ulster sectarian divide, which was about to explode.