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It was with great sadness and a sense of nostalgia that I learned recently of the death of Prof Sean Blake. In cardiology circles, Sean Blake was a legend in his own lifetime. For me, as for many other junior doctors over the years, he was a fantastic teacher and mentor. It was my great privilege to work with him on my very first six months as an intern in the Mater Hospital, almost 35 years ago, in August 1980.
In those days, the cardiology main ward was the aptly named the ‘Sacred Heart’ ward. Located in the basement of the old Mater building, its barred windows looked out on the pavements of Eccles Street.
Rows of old steel beds, hoisted on rubber wheels, lined each side of the ward, separated by tiny bedside lockers. Privacy was maintained by curtains that drew around to waist level only and that were so thin they barely sustained the illusion of privacy.
At the top of the ward, with her own desk, stood ‘Sister’. You caught her eye at your peril and her starched wrath was more feared than that of any despot. Her ward was always spotless; her nurses ran around on squeaky white tennis shoes, making sure every patient had their every need met. The only dust ever seen was that suspended in the rays of late sunshine that shone through the basement windows in the evenings, lighting up the white coats of the cardiology team as they waited in line for Prof Blake to start his rounds. The only time we ever saw Sister melt was when Professor Blake entered the ward. Greeting Sean Blake, Sister’s voice contained a hush very akin to reverence.
There were no computers then. But we did have voluminous hand-written charts, usually with worn cardboard covers curling up at the edges, barely held together by thick elastic bands. Finding the latest ECGs, bloods or x-rays among these piles of loose-leaved charts was nothing short of impossible. Before every ward round, there would be panic stations because one result or other was apparently missing and the hapless intern would have to fly up to the lab, which was two flights upstairs; the ECG department, which was upstairs and down a long slippery corridor; or over to x-ray, which was in the bowels of the basement.
Returning breathless and red-faced, the art was to slip the offending item back into the chart before Prof Blake, or God forbid, Sister, could spot your mistake!
Prof Blake, on the other hand, was always calm and punctual and polite. He was always immaculately attired and very dapper. He spoke kindly to patients and staff alike and even the lowly intern was included in his teaching gift.
He would go over the history of typical angina, of angina at rest and of fulminating or crescendo angina. He asked each patient to tell their story over and over so that there was no doubt that this was cardiac pain and it did not have its origin in the chest wall, the pleura or even below the diaphragm. He explained to us about heart sounds and extra heart sounds and murmurs and jugular venous pulses and peripheral oedaema. He made it all so simple, as all great teachers do. But he also made it simple for the patient, as all great doctors do.
Often, his kindness was greeted with some tears because patients were rightly terrified of the diagnosis that would lead them to move upstairs to the surgical ward and the prospect of a triple-bypass operation.
Because, in those days, despite the wonderful work of Maurice Neligan, who was also ahead of his time, at least 50 per cent of patients did not make it.
There was a solemnity therefore to those late ward rounds. After Prof Blake left the ward, Sister would pull the curtain around the patient’s bed, who we all knew was going for a triple-bypass the next day, and she would have a chat. Soon after, the priest would arrive to administer “extreme unction”.
As the team dispersed to write up their notes or order tests for Prof Blake’s early-morning ward round, you could almost hear the whole ward murmuring a silent prayer.
There were no echocardiograms in those days. There were no stress tests or angiograms or cardiac stents, never mind drug-eluting stents. There were ECGs and x-rays and bloods and there were amazingly dedicated surgeons and physicians who were brave enough to make diagnostic breakthroughs and perform ground-breaking surgery, so that now we have commonplace miracles every day where over 99 per cent of patients survive. Much credit for this amazing achievement can be attributed to the utter dedication and professionalism of Prof Sean Blake and many others, who gave their lives to the progress of medicine as we know it today.
Prof Blake was a true professional, utterly dedicated to his patients and to the art of cardiology. His memory will live on for a long time, not only in the survival of so many of his patients and of generations of patients to come, but in the legacy he left as a great teacher of clinical medicine.
Ar dheis De go raibh a h’anam.