Half a century ago I arrived, hopeful and scared, at a large district hospital for my first job as a junior doctor. In those days protocol in hospitals was often rudimentary and as long as someone with a medical qualification was around, it didn't much matter who it was, especially at weekends and, most especially, when there were other attractions.

It was Friday afternoon. My new colleagues seemed delighted to see me and I soon learned why. A young resident showed me round perfunctorily and told me that, for the weekend, I would be in charge of three surgical and four medical wards as well as the telephone line from external doctors seeking advice and beds. The other junior doctors, medical and surgical, were going to watch the motor racing at Silverstone (I still shudder when the place is mentioned).

Seven wards with 36 beds each, all classified as 'acute' cases. There was no pathologist on duty. If I needed laboratory tests done, I would have to do them myself. At that time, ward doctors were not covered by insurance for doing this and sometimes, as in cross-matching blood for transfusion, one could save a life only by risking one's professional existence. The key to the lab was in Casualty. A consultant was on call but he didn't like to be disturbed unnecessarily. Good luck to it. Oh, there was one thing. The girl in the far corner of Ward 3 was pregnant and dying. If she died, I should do a post mortem Caesarean section to rescue the child. A sterile scalpel for the purpose was in the ward cupboard. And off they all went.

Lily was 16, married and nearly nine months pregnant. She was a sinister dark blue colour and was gasping for breath. Six months before, she had walked into the hospital, coughing and wheezing, and had deteriorated slowly ever since. Everyone knew she was dying. This was years before the existence of intensive care units or special provision for the dangerously ill. Patients like Lily were nursed in the general ward and either died or survived.

I was terrified of that scalpel and wondered why they bothered to keep it sterile if she was going to be dead when I used it. I was frightened of having to do the operation, though I knew I could do it if I had to. But Lily herself had other worries. She was terrified of childbirth because, only a year before, she had been alone with her mother giving birth to her tenth child on the kitchen floor.

With only a student's experience I was in charge of 250 patients. I ran around the hospital all weekend, doing this, doing that, making decisions, trying to look as if I knew what I was doing. My lights flashed constantly - there were no bleepers in those days, only coloured wall lights and mine was flashing orange. I admitted patients. A few old people died. I was called to Lily several times by nurses who thought she was breathing her last, but each time Lily came round and went back to worrying about childbirth. An obstetrician came to see her and wanted to take her to the theatre and operate to save the child, despite knowing that this would kill her. I resisted and rang the consultant, who also resisted.

I survived the weekend and so did Lily. A few days later she gave birth easily to a boy as blue as herself but otherwise healthy. He soon turned normal pink. From the moment of his birth Lily's health began to improve. Six weeks later she walked out of the hospital, carrying her baby. By that time we knew each other pretty well and I was on the way to becoming an experienced doctor.

This article first appeared in Wellcome History, a newsletter for medical historians available free from the Wellcome Trust.

External links

• The Trouble with Doctors by Ann Dally: Book and order details