Many Changeful Years

Many Changeful Years might well have the subtitle The Moulding of a Surgeon for it tells of the early life of a man who became one of the first dozen or so microsurgeons to reattach amputated limbs (as outlined in the prologue, the story of an injured infant).
Throughout the main theme, the author interjects, as a counterpoint, tales and commentaries from his later life as an established surgeon, dealing with unique patients and colleagues, the working life of an emergency surgeon, errors and their causes, nursing practice, the adverse impact of managed care, changes in discipline and surgery in the less developed world.

The formative times that are the theme of the tale gave little hint of where Lister was going, for he grew up in a working class family in wartime Britain, a family that for several years lived in one room, often in straitened circumstance.
The memoir describes a Britain long since gone, a Britain still wedded to ancient measures and currency, confident of its Empire and its preeminence, but whose inhabitants suffered blackouts, night bombing raids, smoke screens, gas masks, and austere rationing not only of food but of clothing and household wares. And it was a Britain whose menfolk, such as the author¿s father, were absent, often not to return. If they did return it was as strangers, many bitter about the cards life had dealt them.
Many Changeful Years follows the author through these war years, examines life in the back streets of Glasgow, describes the pursuits of the times, carries him through school and on to an ancient University, supplementing the family budget throughout by working delivery trucks, cleaning guesthouses,cutting grass, delivering the Royal Mail, chicken farming, laying sewage pipe, serving as a hospital porter, a bus conductor and a mortuary attendant.

The British National Health Service is a daring innovation, appealing to the author, then both a nationalist and a socialist. Glasgow Royal Infirmary, where Joseph Lister developed antiseptic surgery, has a 200-year history; its casualty department is the busiest in Europe; in it physicians learn of the ways of gangland, managing wounds inflicted by chains, razors and sharpened metal combs.The nursing staff of the 1950s, which has a proud legacy, rigidly controls the open wards. Obstetric training requires that the undergraduate perform deliveries; the author goes to a working class London hospital where he learns much from the mothers and midwives. Prejudice is strong in Glasgow society, similar to that in Northern Ireland. He works as a substitute doctor in the back streets of Glasgow and around Britain.

Five years in the Royal Navy commence with basic training; instructors attempt to create "leaders of men" from physicians, dentists and pastors. The author joins a frigate bound for the West Indies; officers and training exercises are described. Damage control at sea demands a strategy for tending multiple casualties
The frigate was designed for 120 but carries over 200. The author's report shows that it is unfit for habitation with conditions worse than those prescribed in the Poor Houses Act of 1887. The frigate acts as guard ship at the talks between Macmillan and Kennedy in the Bahamas in December 1962; the author remarks in his journal on the lapses in the President's security. Riots break out in British Guiana; the frigate assists. During the Cuban missile crisis the vessel encounters the U.S. blockade.

Studies at the Royal College of Surgeons of England follow. At the Naval Hospital he serves under a surgeon who first used antibiotics in the military on HMS Hood in 1938. The author treats the Admiral who saved the British Far Eastern fleet from a fate similar to Pearl Harbor.
The author goes to the island of Mauritius for three years; there are multiple ethnic groups in one of the highest population densities in the world. The Navy occupies a re