It was a long, tiled, semi-basement place, lit by small windows high in the walls, smelling strongly of carbolic and always crowded, like a public lavatory at a busy crossroads. As St Swithin's had to find money to buy all the latest antibiotics and isotopes, it saw no point in spending it on a department where the therapeutic technique had hardly changed since its patients were brought on shutters from beneath the wheels of hansom cabs. Everything in casualty was old: there were old horsehair examination couches, sagging screens of old sacking, dull old instruments, battered old dressing drums, and steamy old sterilizers. Even the porter was past retiring age, and all the nurses seemed to be old ladies.

As we entered, the rows of old wooden benches were already filled with people-one-quarter men, and a quarter each women, children, and policemen. There were policemen everywhere, as thick as tom-cats in a fish market. They stood in the corners holding their helmets, they hid behind the screens with open notebooks, they drank pints of free tea solemnly round the sterilizer, they peered across stretchers and requested eternal 'particulars.' Policemen are inseparable from casualty surgery, and it was well known at St Swithin's that anyone falling over in the district and not getting up damn quickly was immediately seized by the police and enthusiastically borne into the casualty-room.

I sat down at an old desk in one end of the room, which held a large brass ink-pot and a pile of different coloured forms. My job was simple. I handed one of these forms to any patient who I felt 'was beyond my own professional ability and thankfully disposed of him for ever into some inner department of the hospital. As my only post-graduate guidance from St Swithin's was a leaflet on what to do in case of fire and another describing the most fruitful way of asking relatives for a post-mortem, I was at first worried about matching the correct form to the case. Fortunately, the old porter had long ago accepted the responsibility of running casualty himself, and tactfully brought me the right document to sign after selecting it with the infallible diagnostic instinct of a St Swithin's employee.