Martin Tattersall

DISSECTING ROOM

LIFELINE Martin Tattersall After Cambridge and University College Hospital, Martin Tattersall backpacked for 2 years, including working as a doctor in the Yukon. He completed physician and research training at the Royal Postgraduate Medical School, The Institute of Cancer Research, and Harvard Medical School. He has been Professor of Cancer Medicine at Sydney University since 1977. Who was your most influential teacher, and why? Sir John Dacie who taught me the diagnostic importance of pattern recognition and attention to clinical and laboratory detail. Which event has had most effect on your work, and why? I dissected my right carotid and vertebral arteries in a skiing accident 6 years ago, and learned much from being a patient. What would be your advice to a newly qualified doctor? Travel and work in different medical institutions and contexts; there is no rush to settle down. What is the best piece of advice you have received, and from whom? Avoid being a patient in the hospital where you work. My father. How do you relax? Single sculling on Sydney Harbour in the mornings when it is still dark. What alternative therapies have you tried? Did they work? Exercise is a wonderful antidepressant. What is your favourite film, and why? Borsalino—I proposed afterwards, but I don’t remember much about the film. What are you currently reading? The Spectator every week. What part of your work gives you the most pleasure? Taking a history. Describe your ethical outlook. Sydney Harbour. What is the least enjoyable job you’ve ever had? A coroner’s postmortem in the Yukon; only God knows how he died. Do you believe in monogamy? Yes. One mother-in-law is enough (I have cleared this answer with her), but my wife is an identical twin.

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My oldest patient am 100 years old . . . and one year”, she added cautiously, invoking unknowingly the infinite series suggested in the Arabian Nights, where Scheherazade attains immortality, and avoids an early death, by telling one more story every night. The tales of Scheherazade convey how life is really made up of a series of incidents, and open up a subject so subversive that the Greeks finally considered it taboo— the infinite. It is a book my patient will probably never read now, for her eyesight is beginning to fail, and I doubt if anyone in her family would have the patience to read it to her. Sitting up straight as a rod, white hair tied tightly back into a bun, at 103 she is easily my oldest patient. Her dark eyes, set in an expressive face deeply furrowed by the rivers of time, scan around until she locates us in the gloom of the old house. “She is lying about her age of course”, says one of her granddaughters as she comes into the room and gently reprimands her grandmother; the old lady chuckles at having been caught in this small vanity. Oldest patient is also a bit of an exaggeration, for she has rarely had a day’s illness in her life. She had consulted me about her hearing just before her 98th birthday; more to humour the family, for she had not noticed any problems, and could still talk the ears off anyone in the room with perfectly lucid conversation and embarrassing family anecdotes. When I first met her she had walked all the way to the consulting rooms, on what was probably her first medical visit in half a century, and had been indignant about my refusal to charge her any fees. I told her an invitation to her 100th birthday party would more than cover the costs, and anyway there was nothing wrong, so what was there to charge. The logic of my decision seemed to appeal to her, and since then I have received regular invitations to supper. On this occasion, we had been invited to the feast of Candelaria, to take the

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traditional fare of tamales with atole. Tamales are a typical Mexican delicacy, a maize flour mixture filled with meat, herbs and exotic chillies, steamed in a maize leaves. The tamales are taken with atole, an ancient Aztec drink of thin maize meal flavoured with chocolate, tamarind or guava. Both maize (elote) and chocolate (chocolatl) originated in Mexico and were eaten long before Columbus set foot there. The old lady has, however, refused to leave her room for this celebration, because she is mourning the recent death of her younger sister, who had died after a long illness at the age of 98 years. The rest of the family accept her decision and gather in the kitchen. It strikes me that this household would be more at home in one of the novels of Gabriel Garcia Marquez or Isabel Allende than in 21st century Mexico. A fierce matriarchy composed almost entirely of women ranging from the ages of 103 to 1 year; men are rarely seen and once they are old enough to walk they seem to be banished to some distant part of the house. An occasional boyfriend or brother would cautiously look in before making a hurried retreat. I never discovered how many men lived in the old house, but it was the women who ran things—walking in and out, talking, arguing, cooking, preparing and serving the abundant food, as they moved around each other in a complex slow-motion dance. As one woman disappeared another would appear, seemingly from nowhere, to pick up the conversation where it had left off. A slightly surreal atmosphere perfused the evening as it wore on, in this curious little enclave of feminism within the vast macho society of modern Mexico. The matriarch of this household may have remained in her room, but her influence on the family was always palpable. If only more of my patients were as intriguing and welcoming as this formidable centenarian. Johannes Borgstein

THE LANCET • Vol 360 • October 26, 2002 • www.thelancet.com

For personal use. Only reproduce with permission from The Lancet Publishing Group.