In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). This month, I am joined once again by Kassie Ball to discuss the influence of two urologists on a famous literary and film character.
In 1952, Dr Gordon Ostlere (1921-2017), an anaesthetist, writing under the pen name of Richard Gordon, published a best selling comedy novel based on his time as a medical student and junior doctor. Within two years Doctor in the House was made into a film, a classic British comedy.
Figure 1: James Robertson Justice (1950’s publicity photograph; author’s collection).
One of its most notable characters was the terrifying, loud, bullying consultant surgeon Sir Lancelot Spratt, played by actor James Robertson Justice (1907-1975) (Figure 1). On viewing a 1966 BBC interview with Robertson Justice we became suspicious that he had based his character on a well-known British urologist, Frederick ‘Snorker’ Barrington (1884-1956) (Figure 2).
Figure 2: Frederick Barrington (by kind permission of the Trustees of
University College London Hospitals NHS Foundation Trust).
Frederick James Fitzmaurice Barrington was born on 1 March 1884 in King’s Lynn, Norfolk where his father was a medical officer to the local hospital. Barrington trained at University College Hospital London where he later became consultant in genitourinary surgery as well as surgeon at St Peter’s Hospital. He was known as much as a scientist and physiologist as a surgeon and between 1914 and 1941 he published a series of classic papers on the physiology of the bladder including the description of the Pontine Micturition Centre (Barrington’s Nucleus). Described sometimes as harsh, terse, mordant and abrupt, he was also known to use “vocabulary enhanced by his service in the Royal Navy”. But, equally, he was described as shy with an essential kindness, and was beloved by his students, patients and friends once they appreciated his skill and knowledge.
He acquired the nickname ‘Snorker’ – a ‘snork’ was the name given to one of his scathing put-downs and one assumes it was preceded by an audible snort. He was a friend of James Robertson Justice and a fellow ornithologist, and the actor said he based the character of Sir Lancelot on him. In the film, the short tempered and acerbic surgeon also turns out to be more caring and beloved than his angry manner initially suggests. Barrington was a member of the British Ornithology Club and the Physiological Society but rarely attended Royal Society of Medicine Urology Section meetings, even though he lived locally. It was said he was happiest enjoying fine food with friends and was a generous host. He died suddenly whilst dining with friends at the Athenaeum Club on 23 March 1956.
Figure 3: Sir William Girling Ball (courtesy of Barts Health NHS Trust Archives and Museums).
Interestingly, it would appear that the original book character of Spratt was also based on a urologist, Sir William Girling Ball (1881-1945) (Figure 3). William Girling Ball was born at New Barnet on 9 October 1881 and educated at Merchant Taylors’ School. He trained at St Bartholomew’s Hospital where he subsequently became a demonstrator of pathology in 1907 and was elected assistant surgeon there in 1912. Ball was warden of the residential college for students and later dean of the medical school.
Girling Ball took a particular interest in urology and especially endoscopy. He was a clinical assistant to St Peter’s Hospital from 1907 to 1911 and became president of the Urology Section of the Royal Society of Medicine in 1926-27.
Girling Ball was a great teacher and lectured faultlessly without notes. It was said he lectured with a “direct style” and like the fictional Sir Lancelot was a great supporter of the college rugby club. Richard Gordon was certainly at Bart’s when Girling Ball was dean and likely on the receiving end of his direct style. However, Sir William’s obituaries (unlike Barrington’s) don’t portray the explosive temperament of Sir Lancelot. Although it was noted he had a “strength of character” and “strong personality” which generally meant he got his own way in the powerful committees dealing with the medical school and later medical departments of the War Office. Referring to the medical students, he is quoted as saying, “I will do anything for my boys and my boys will do anything for me” and it appears he was loved by his students.
Suggestions that Ball was Gordon’s model for Sir Lancelot appear in the 2011 obituary of cardio-thoracic surgeon Geoffrey Flavell who trained under Ball, and in legendary urologist John Wickham’s autobiography, as well as a personal recollection by a retired urologist (who incidentally knew Barrington well). However, unlike the clear link between Barrington and James Robertson Justice, we do not have direct evidence of this. The book and the film paint a slightly different picture of Sir Lancelot. In the book, although direct and clearly a frightening senior figure, his love for the hospital, medical school and its sporting students was clear.
The fictional Sir Lancelot also stuck with the students operating during the Blitz as the bombs rocked the theatre; the real St Bartholomew’s was damaged by enemy action during the war. During the First World War Ball was a captain in the Royal Army Medical Corps. He served in France in a Territorial General Hospital and then commanded the Military Wing at Bart’s, which formed part of the Number One London General Hospital. It was said he constantly wore his service cap “at a jaunty” angle in all hospital departments except theatre. During the Second World War he played a major part in the organisation of the Emergency Medical Service.
The year before he died Girling Ball gave the Bradshaw Lecture at the Royal College of Surgeons. For the first time, he stumbled over his presentation; this was the first intimation that his powers were failing. He rapidly deteriorated over the next few months and was admitted to Hill End Hospital where he died on 16 July 1945.
Gordon Ostlere, also known as Richard Gordon, created one of the most memorable surgeon stereotypes in literature and British cinema, albeit one who is now used in medical schools to demonstrate how not to behave. It appears that this character was based on Sir William Girling Ball, an early urologist with a forthright teaching manner but a deep regard for his medical school and students. The research of FJF Barrington was key to the understanding of the neurological control of the bladder and yet he is little remembered in the history of urology. His unusual manner inspired his actor friend to imitate him in films, creating a character who became synonymous with the pompous consultant surgeon and unlike Barrington, recognised by millions.
Urologists, in general, are seen as relatively benign characters, particularly when compared to some other specialities (allegedly!). I can’t decide if knowing that Sir Lancelot Spratt was based on two urologists makes me feel disappointed or rather proud.