Nick Black

I am professor of health services research at the London School of Hygiene & Tropical Medicine where I have spent the last 35 years studying and teaching about health care policy, evaluation of services and how to improve them. I have extensive experience of writing non-fiction - research papers, editorials and policy pieces and several textbooks. I learnt to write when co-authoring eight books on Health & Disease for the Open University. This proved to be the second most popular course they ever produced (after the nineteenth century novel). I am well-known nationally and internationally in the world of health policy and health care. (https://www.lshtm.ac.uk/aboutus/people/black.nick)
One of my passions has always been history and this culminated in a book ' Walking London’s Medical History', published in 2006 with a second edition in 2012 (CRC Press). It received good reviews and won two national awards.
I have now turned to fiction with a historical novel based on true events.

Award Category
Screenplay Award Category
Based on true events, the story of James Lambert, the apothecary who, two hundred years ago, taking on the incompetence and nepotism of the medical establishment, helped change doctors and hospitals forever but died young and reviled. The untold story of the birth of modern health care.
The Honourable Doctor
My Submission

Chapter 1: Apprenticeship

1819

Much as he loved his young cousins, James couldn’t wait to get back to the workshop. Hemmed in on one side of the long breakfast table, all he could think about was the compounding he needed to get done. He’d been up since dawn, packing his uncle’s saddlebags with everything needed for visiting patients – surgical instruments, ointments, lotions, bandages, plaisters.

His cousins were chattering away as Aunt Sarah, her curly hair tied back from her chubby face, bustled about, clutching the youngest on her hip. Throughout the three years James had been living with them, his aunt had either been nursing a baby, expecting another or both.

He suddenly realised she was trying to make herself heard over the hubbub,

‘James, they won’t stop pestering me about getting a dog. Alice Perkins has three puppies to get rid of. Would you go over to Earl’s Fen and get one?’

‘Oh, please James,’ cried Emma.

‘Can I go with you?’ asked Will.

‘Maybe,’ said James, ‘if I have time.’

‘’Oh,’ said Sarah, smiling, ‘I’m sure your uncle can give you some time off on Saturday. All work and no play…’

‘It’s not that easy,’ said James. ‘People need their medicines. And I’ve planned to clean the furnace.’

‘Of course,’ she sighed. ‘I’m sure you’ll do what’s best.’ As she was turning away she stopped and looked back at him. ‘It’s not far. You won’t want to disappoint the little ones.’

That Saturday, walking along English Drove, was like crossing a green sea. Potatoes and sugar beet were sprouting in the fields. Still thinking about the compounding he had to do when he got back, he barely noticed the primroses and clumps of daffodils along the verges. As he and his two cousins approached the farm, two girls came running up to greet them.

‘What you doing here?’ one of them asked Emma.

‘We want a puppy.’

Their mother appeared at the farmhouse door, wiping her hands on her apron.

‘Mama, they’ve come for a puppy.’

‘Hello Emma, hello Will,’ said Alice with a big smile. She turned to James. ‘I think I saw you at Christmas in the Abbey. You must be James.’

He brushed his hand through his hair, flustered that she knew who he was. ‘Yes, I go most Sundays with my aunt and uncle.’

‘Oh dear. Afraid we don’t go much.’ She turned to her children. ‘Jane, go and get your big sister.’

Jane ran off calling, ‘Eliza’. She soon returned with her sister who was shaking her hair free from an old bonnet as she strode across the yard, her pink floral dress swinging freely. He noticed she was wearing an old pair of men’s boots.

‘Hello, I’m Eliza,’ she said to James, shielding her eyes from the sun with her hand. The directness of her look disarmed him.

‘Oh... I’m James.’

‘Come on,’ she said to the children, ‘the puppies are in the barn.’

As she led the way, she glanced back over her shoulder and smiled at James. ‘There’s three to choose from.’

In the barn, the children crouched down and started playing with the puppies.

‘So you’re learning to be an apothecary,’ said Eliza.

‘Yes.’ He fiddled with the length of rope he’d brought to use as a lead for the puppy.

‘I’ve seen you on your horse, visiting people.’

Still watching the children playing, he mumbled, ‘Yes, sometimes I go out for my uncle.’

The rope slipped from his hands. As he bent down to get it he added, ‘He’s called Sapphire…. my horse.’

He wondered if she could see his face flushing.

‘What a lovely name,’ said Eliza. ‘Mine’s called Bonfire. My brothers found him one Guy Fawkes night roaming free and no one ever claimed him.’ She looked out through the barn doors. ‘I love riding.’

‘So do I,’ said James, straightening up and finally managing to look at her, ‘especially on summer evenings. The shadows get so long and the sky has so many colours.’

Eliza was staring at him, her head tilted slightly. Her lips were ajar revealing her sparkling teeth. There were some bits of straw in her golden shoulder-length hair which he wanted to reach out and remove.

As she smiled, he saw dimples appear. ‘It’s even better at dawn,’ she said. ‘The birdsong’s blissful.’

‘Have you ever ridden at night with a full moon?’ he asked. ‘All you hear are owls and the rustle of animals in the corn.’

She hadn’t stopped gazing at him, smiling in a way no one had ever done before. He could feel his heart pounding and feared he was blushing again. To his relief, Emma and Will interrupted.

‘Can we have this one?’

‘Of course,’ James said, handing Emma the rope.

As they made their way back across the yard, Alice reappeared. ‘That’s a lucky dog to be going to the doctor’s house. Now remember, anytime you’re passing, call in and say hello.’ She turned to James. ‘That goes for you too, James.’

At the top of the track, as they were about to turn onto the drove, James looked back. Eliza was standing watching him. She smiled and waved. As James waved back he felt strange in a way he’d never felt before.

Back home, all thought of the workshop had vanished. He needed time alone, to collect himself. That evening, all through dinner, he found he wasn’t really listening to what was being said. A couple of times he saw his aunt looking at him quizzically.

*

That summer, the sun seemed to shine every day. Ever since visiting the Perkins farm in the spring, he’d often thought of Eliza. On more than one occasion, as he’d ridden past, he’d considered stopping but didn’t know what he’d say, so he’d carried on hoping that he hadn’t been spotted. That just confused him more as he wasn’t sure why he didn’t want her to know he’d not called in.

On the hottest days, the workshop was stifling, even with the door and window open. One afternoon, he’d just finished grinding hollyhock and cascarilla bark, when Emma appeared in the doorway.

‘Mama says we can only go to the river if you take us.’

He put down the pestle he’d been using and mopped his brow. ‘Maybe later but I’ll have to ask your Papa when he gets back.’

‘Hoorah, we’re going swimming,’ she shrieked as she rushed off to tell the others.

The bell in the nearby Abbey had just sounded six when uncle William strode in.

‘James, you won’t believe it. That cut on young Crane’s leg, healing beautifully it is. All because of that mustard plaister I put on it.’

His uncle took off his jacket, revealing a brightly coloured waistcoat. Stout, with a ruddy complexion and a great mane of hair, he groaned as he lowered himself into his well-worn chair. ‘You know, I really think it might be better than stitching. I’m going to try it again.’

He picked up his pipe and started to clean it. ‘Got to try new things. Only way we’ll learn.’

‘I suppose so,’ said James.

William looked up. ‘What?’

James shrugged. ‘It’s just…Papa always told me it’s best to keep to the rules.’

His uncle laughed. ‘Ah well, I suppose that’s best if you’re an excise man.’

James emptied the mortar, wrapping the medicine up in paper. ‘Is there anything else you need me to do tonight?’.

‘No, don’t think so. In a hurry to get away?’

‘Aunt Sarah says the young ones can only go to the river if I take them.’

‘Well, better not keep them waiting.’

The river was just across the village green. His three cousins ran ahead and were already splashing about when he got there. Lying in the cool water he could see his bedroom window at the top of his uncle’s house. The yellow stone of the fine three-storey building glowed in the late afternoon sun. Away to his left, through the willow trees, he saw a flag fluttering on the top of one of the towers of the Abbey. He still found it astonishing that there was such a huge church here, in a small village.

He felt so lucky. From the moment, as a child, he’d first seen inside an apothecary’s shop, this is all he’d ever wanted to do. At the time it had seemed like a magical cave. In the darkness, he’d been entranced by the strange white pots with their Latin names and intrigued by the exotic scents that hung in the air. He was only nine at the time but his mother must have noticed the effect it had on him for within a month, her brother William had offered to take him on as his apprentice when he turned fifteen.

He was still thinking of his schooldays in Harwich when he heard the Abbey bell strike seven. His cousins didn’t want to leave the river but, as ever, the offer of a piggy-back was enough to persuade the youngest to clamber out. As they crossed The Green, the other two ran around him chanting.

‘Bet you can’t carry me.’

He just smiled. He’d always been skinny, like his father. At school he’d got used to being teased. He didn’t care. It was how he was.

*

James loved visiting patients. It made him feel like a real doctor. On his return, he and his uncle would settle down in the workshop with mugs of tea and he’d report what he’d seen and done.

‘Went down to Middle Knar,’ said James. ‘Mrs Provost’s ulcer is looking much better. Then over at Stone Bridge, Mr Sisson hasn’t recovered from that attack of apoplexy a few weeks back. Bleeding him last week hasn’t helped so I gave him an emetic. Hope that was all right.’

‘Good idea. What d’you use?’

James hesitated, then picked up a book lying on his uncle’s desk. ‘One from this new herbal.’ He opened it and read. ‘Fifteen grains white vitriol, an ounce ipecacuaha wine and 20 drops tincture of foxglove.’

His uncle chuckled. ‘You know, sometimes I think you know more than me. And to think how worried you were when I first sent you out on your own. Sure you’d never cope. Now look at you.’

‘It was just…I hadn’t realised how much I’d learnt from just watching and listening to you.’

His uncle nodded slowly as he filled his pipe.

‘On the way back,’ said James, ‘I called in at Singlesole Farm. Mrs Leahair’s getting so much pain in her joints, can hardly get about. I wondered if willow bark might help.’

‘James, you must do what you think best. I trust you, else I wouldn’t send you out.’ William picked up his friction light and lit up. ‘You’ll be more than ready for London next year.’

James put the herbal back on the desk. ‘I’m not sure I ever want to leave here.’

William blew a great cloud of smoke up towards the ceiling. ‘Got to get your licences. We all had to do it.’

‘But if I can help people and they’re happy with that…’

‘What? So you’d be happy to be a quack?’

‘No, of course not…’

William picked up the Stamford Mercury lying on his desk and handed it to James, pointing at an advertisement.

‘See that? Someone from Edinburgh who calls himself a ‘water doctor’. Set himself up at the Black Swan. Says he’ll treat any complaint just by looking at their morning urine. Ha! Can you believe it? Dangerous nonsense.’

James nodded slowly as his uncle leant back in his chair.

‘Can’t say I won’t miss you,’ said William. ‘It’s been a long time since I had the chance to talk about medical matters. There was a surgeon in Whittlesea but I haven’t seen him in ages. And I hardly ever see the doctors in Peterborough and Wisbeach.’

‘But you’ve always had apprentices to talk to.’

His uncle smiled. ‘Hmm…they didn’t think the way you do.’

*

On Fridays, after dinner, William would retire to the drawing room where he was joined by several men - Tycho Wing who managed the drainage works for miles around, John Girdlestone the curate, George Collins the school-master and two farmers, Jacob Morland and Edward Leeds. The sound of their raised voices and laughter could be heard throughout the house.

James had always wondered what they talked about. Then, one day, his uncle invited him to join them.

‘I think you might find it interesting,’ he’d said, with a mischievous smile.

On Friday evening, when James pushed open the drawing room door, he found most were already seated, enjoying glasses of brandy in front of the fire. He had to peer through the smoke as everyone, apart from the curate, had a pipe.

‘Come in,’ said his uncle, standing up and putting an arm round James’s shoulders. ‘Now, gentlemen, some of you know my nephew and apprentice, James Lambert. The future of medicine! I thought he might help us put the world to rights.’

‘We could do with some young blood,’ said Leeds.

‘Come and sit here,’ said William, indicating the stool beside his armchair.

His uncle picked up a newspaper in which, James could see, he’d marked some passages. As William started reading out loud, James saw it was called Cobbett’s Political Register. He’d heard of it, but couldn’t think when and where?

Suddenly he could hear his father’s voice. ‘Cobbett. Rabble rouser. Danger to us all. Before you know it, they’ll be mob rule.’ He worried what his father would think if he knew he was with men who, from their reactions, were clearly in awe of Cobbett. They all seemed to think the government was to blame for everything. He wondered what they’d say if they knew his father worked for the Crown.

‘It’s their damn Corn Law, no one else’s,’ said Collins.

‘They’ve done nothing for the soldiers and sailors,’ said Morland. ‘After all they did for this country.’

‘There’s two in the workhouse over the way,’ said William. ‘One of them’s hardly spoken since he arrived months ago.’

‘Meanwhile Wellington gets showered with rewards,’ added Wing.

‘Things might get better,’ said the curate, smiling at everyone, ‘now a Whig’s been elected in Peterborough.’

‘Scarlett!’ said Morland, sitting forward. ‘Just another of them big land-owning lawyers. Got a huge estate in Surrey.’

‘And a dreadful reputation as a lawyer,’ added Wing. ‘Said to be despicable to witnesses and juries. And he hates the idea of a free press.’

‘No doubt worried it’ll expose him and his like,’ said Leeds.

‘I read he made eighteen thousand last year,’ said Collins. ‘That’s without whatever he got from his plantations.’

‘Come on gents, perhaps another drink will help,’ said William handing Wing the brandy decanter. ‘Help yourself and pass it on.’

‘Nothing’ll happen till we’ve changed who has the vote,’ said Morland. ‘Till then, it’s hopeless.’

‘And if they don’t do something soon,’ said William, ‘we’ll have our own revolution, just like France.’

‘I was over in Wisbeach last week,’ said Morland. ‘Some farmers were telling me how the yeomanry cavalry were called out last month when some labourers rioted.’ He was shaking his head. ‘The cavalry…can you believe it?’

‘Same at Ely. They used the Royal Dragoons,’ added Leeds. ‘They’ll stop at nothing.’

James had been so absorbed, he hadn’t realised how late it was until the men started to get up and pull on their coats. After they’d gone his uncle sat back down and poured himself another brandy.

‘So, young man, what did you make of that?’

He was confused. He couldn’t square what he’d been hearing with what his father had taught him.

‘Lots of it I didn’t understand. Everyone was so passionate.’

His uncle laughed. ‘I have to say, you looked a bit shocked at times.’

‘It’s just…you’re all so critical of the government. Papa works for the government and he’s honest and fair and tries to help people. It’s not his fault that people are poor or soldiers have been abandoned.’

William pulled himself forward in his chair. ‘No one’s blaming people like your father. I know he’s a good, kind man trying his best. It’s the government that he serves that’s the problem.’

James thought for a while. ‘So do you think he shouldn’t work for them?’

‘No, I’m not saying that. He needs to make a living like all of us. But that doesn’t mean we shouldn’t fight for reform.’

William stood up and put a guard in front of the dying embers in the grate. ‘Come a few times before deciding if you want to join in. I think you might come to enjoy it.’

*