Remembering the Past: Memoirs of a Psychosexual Doctor

 

Dr Ruth Skrine

16 March 2015

 

Dr Ruth Skrine, who lives in Bath, gave this talk following an earlier one in 2014 at Topping’s Bookshop. The title of her new book uses the last part of the talk’s title, but is headed by the words ‘Growing into Medicine’.

Ruth, born in 1929, was the eldest of three children born to two Chippenham GPs. Her parents were Dr Eric Hickson (1895-1972) and Dr Joan Hickson, nee Whitelock, (1899-1988).  Ruth’s late husband, Ralph Skrine, was a Prison Governor who was, she says, probably happiest in male company, and who was a passionate defender of the underdog in society.  He died in the late 1980s; the couple had a daughter, Helen, to whom Growing into Medicine is dedicated. Her full subtitle is ‘The Life and Loves of a Psychosexual Doctor’.

In 2014, Ruth gave another talk, at the Chippenham Civic Society, on her mother’s memoir of life as an active GP in wartime Chippenham, entitled Carry on Coping. This is a quite remarkable document in its own right, and complements Ruth’s own autobiography admirably. The family lived comfortably in a long-demolished house in the town, Green Gables, and were very well known throughout the district. Ruth emphasised that though they were a professional family, they were not conspicuously wealthy. She also said that while her parents had been doctors in a past period, her daughter Helen and son-in-law were doctors in the present era, with all the differences that this implies. She quoted the biographer and commentator Ian Thomson’s remark that ‘the good memoirist makes life more interesting than it is, blending truth with untruth.’  Remembering the past, for her, also involved body memories, memories as story or narrative, the dramatisation of events, and the question of professional content and confidentiality. She commented that it was the taste of Proust’s madeleine (a small sweet cake) which brought back memories of an earlier time for Proust in his great novel In Search of Lost Time, not its appearance or tactile quality.

The second housemaid at Green Gables, Daisy White, came into Ruth’s life when she was only three, in 1932. It seems that Ruth did not speak to Daisy for three full days. Her older brother Arthur (b.1925) was seven, and her sister Elizabeth had not yet been born.  On page 1 of Growing into Medicine, she says: ‘my general practitioner father had a few landed patients, including one titled family, but at some establishments, he was expected to use the servants’ entrance. He worked long hours. Morning surgery ran from 9 ‘till 10am, but frequently went on ‘till 11am, and then again for 6 ‘till 7 or 8pm, with emergency visits afterwards.  The queue of patients often overflowed the waiting room and spread into the drive, where they perched without complaint on the coping slabs which lay at the top of beautifully built dry-stone walls with holes for the patches of aubretia.’

A photograph was shown of the marriage of Joan Whitelock, Ruth’s mother, to Eric Hickson, her father, in the early 1920s.  Ruth was very frank about her mother’s dislike of the Church and all it stood for, and also about her mother’s refusal to attend Ruth’s wedding in Sheffield in the 1950s, because it was a conventional white wedding, held in church.  In the event, Ruth’s grandmother (Joan’s mother) stood in for her.

As a child, Ruth was always surrounded by many adults, and said that she could still hear their adult voices, and the continual buzz of conversation. In the 1940s there was much discussion of Ruth and Elizabeth’s future. A big argument took place about whether Ruth would be a nurse or a doctor. I due course, she went to Bristol University Medical School, and as part of her training, dissected many human corpses (see also Rembrandt’s famous picture, The Anatomy Lesson of Dr Tulp). Very frankly, she admitted to having nightmares at the time about eating human flesh.

The core of her memoirs consists of the process by which she ended up as a psychosexual doctor, beginning with her time in Sheffield and then in Pontefract, Yorkshire, in the latter part of her medical training, after her marriage to Ralph. The earlier part of her studies had been at Bristol University. The couple lived in the village of Pollington, and she drove from there to Doncaster to catch the train to Sheffield.  Ruth quotes the dismaying facts about Ralph’s Austin Seven, which often did not start, and had no heater.  Ice on the car’s windows in winter was a perpetual problem. She says that ‘the energy needed to get me into the city did not leave enough to do justice to my new university, where several members of staff took trouble to accommodate my needs. The syllabus did not match the one at Bristol in every detail. Smallpox vaccination had been covered in Sheffield before I arrived. The professor of infectious diseases arranged for me to have a private session with him. He attacked me with the scratch needle to demonstrate the technique, before insisting that I do the same to him. We both survived.’

There was something else which Ruth had not bargained for.  Sheffield, on the edge of an extensive coalfield, and itself the centre of a great steel industry, produced medical problems quite different from those in Bristol. ‘One of the great differences’, she says, ‘ between the patients in Bristol and those I was now meeting was in the inmates of the medical wards. The lasting image of Professor Bruce Perry’s beds (in Bristol) is of rows of women with heart murmurs, whereas in Sheffield it was the huge men’s wards that remain stamped on my memory. Almost all the patients were suffering from bronchitis and emphysema, or full-blown silicosis, as a result of life-long exposure to coal dust. The hacking and coughing went on day and night.’ Few of these men can have reached old age. She goes on, unflinchingly: ‘A cup-like covered spittoon, which must have held at least half a pint, sat by each bed. In the bottom, a small quantity of water prevented the sputum sticking. These containers could be filled with deeply stained phlegm before the end of the day. ‘ After that experience, she crammed for her final exam in Bristol, which took the form of several papers and a midwifery practical.  Because of the odd body language of the external examiner, Will Nixon, a great friend of her father, she thought she had failed the practical test. In fact, she was tested a second time, and when the book A Guide to General Obstetrics, by Will Nixon and her father (Dr Eric Hickson) was published in 1953, it bore the inscription ‘To Ruth, who after reading this book should have gained a distinction in the Obstetrics Finals examination in Bristol! ‘Far from possibly failing, she was actually being considered for a distinction’ (pp. 66-67).
Psychosexual medicine, her own eventual field, grew out of family planning. Ruth begins Chapter 12 of Growing Into Medicine with the following frank statement, showing how attitudes have changed over her professional lifetime: ‘A network of family planning clinics had been started by the National Birth Control Trust, which changed its name to the Family Planning Association in 1939. The sessions were held in premises designated for maternity and child welfare, and owned by local authorities. The FPA fought a fierce battle to get the importance of family planning recognised, but although the NHS had been introduced in 1948, it did not take over the running of the service until 26 years later (1974). Doctors were surprisingly uninterested in this vital aspect of health…’.  For years she was not allowed to prescribe anything but contraceptives, and had to deal with hostility from various quarters. ‘One GP’, she says, ’complained that too many women doctors were being lost to medicine by doing nothing but working in FP clinics, that they had opted out of their duty to heal the sick. In our hearts, some of us might have agreed with him, for the choice was, to some degree, a soft option. The volume of knowledge was manageable, and we were spared the responsibility of caring for sick people.  Yet I was meeting doctors who had spent their lives in the field, and who filled me with awe-struck admiration for their dedication and their understanding of human suffering.’ (pp. 131-132)

Towards the end of her very honest and often disturbing memoir, which creates a picture of an era in which so much changed, and not only because of improvements in technology, Ruth makes the following observations: ‘Despite the ubiquitous way that sex is displayed in our culture, it remains, for many individuals, a delicate, personal matter, so the choice to talk about it to a doctor in privacy is not surprising. For me, the openness of my parents in their bathroom did not remove an inborn shyness about my own bodily functions.  In the first few years of my professional life, I would not have believed anyone who suggested that my career would culminate in working and lecturing in the sexual field.  I had chosen family planning because the hours fitted my domestic arrangements.  The pressing misery of patients then drove me to listen to their stories of their sexual despair.  However, the discipline of listening, and discussions within the IPM (Institute of Psychosexual Medicine) have given me a superficial ease about such matters. When my grandchildren were small, I was discussing the possible sex of the fish in my small pond, thinking that I was being usefully zoological.  Helen (her daughter) burst out ‘Oh Mum, can’t you think of anything but sex…?’ It was difficult for my family to tolerate the work I did. My mother in particular, despite her own emancipation, did not like to use the word ‘sex’ to her elderly friends. I too would hesitate, and talk about medical gynaecology, unsatisfactory when an increasing number of patients were men.’(p. 168)

Ruth Skrine’s book Blocks and Freedom in Sexual Life: A Handbook of Psychosexual Medicine, was published by the Radcliffe Medical Press in 1997, and Ruth also quoted Libby Wilson’s Sex on the Rates : Memoirs of  Family Planning Doctor (Argyll Publishing, 2004).

Bristol Royal Infirmary before the war

Ruth provided some very relevant quotations during her talk. Among them were the following:
The experience of childhood is irretrievable. All that remains is a handful of brilliant, frozen moments, already dangerously distorted by the wisdom of maturity. - Penelope Lively (b.1933) in her memoir of her childhood in Egypt, Oleander Jacaranda (1994)

Memory is not a record of the past, but an enduring myth of understanding of the psyche, which spins from its engagement with the world. - John Daniel: Looking After: A Son’s Memoir (Counterpoint, 1996)

Truth….is a reality that exists between two people seeking it. Truth can be seen or glimpsed, not possessed. - Neville Symington, British psychologist and specialist in narcissism

Each one of us should speak of his roads, his crossroads, his roadside benches; each one of us should make a surveyor’s map of his lost fields and meadows. - Gaston Bachelard (1884-1962), French philosopher of science

Dr Robert Blackburn, former Principal Lecturer in Music, School of Music and Performing Arts, Bath Spa University

Park Street Bristol – mid twentieth century