Am Bratach No. 216
October 2009
editor@bratach.co.uk

Studying medicine in the north
by Daniel Racey

I am in my fifth and final year at the Peninsula Medical School based in Plymouth. We are given the freedom to choose a block of study at the beginning of our final year. The purpose of this elective part of the course is to broaden our experience of medicine. Many students choose to go abroad to Africa or India or the Caribbean.

I live on Dartmoor, having married a Devon lass, but my grandmother owned a place in Skerray. I have been coming up to the north coast for twenty years now. My usual view of the north coast is from the top of Hope or Loyal. For my elective I chose the view from the consulting rooms of the north coast. I was hosted by Dr Herfurt in Armadale but visited the practices in Durness and Tongue.

I’ll struggle in the rest of my life to better the commute from Skerray bay to the surgeries of the North. I drove out to views stretching from the scree skirts of Foinavon to the black cliffs of Hoy. And no traffic jams! However, I have frequently been held up by my own curiousity. On my journeys, I have stopped to look at deer, foxes, sand martins, sparrowhawks, peregrines, gannets... The landscape may seem empty at first but it is full of life.

Health care on the north coast presents some challenges, the population being sparse and the hospitals distant. Any expectation I had that standards of care might be affected because of the geography were soon dispelled. The service offered on the north coast impressed me. Firstly, doctors and nurses have more time for their patients. On average, consultations and home visits last significantly longer than in other areas.

Across Sutherland, medicine is still personal and this is something to prize. Health workers know their patients well and can tell when they are out of sorts. They are more aware of the family and social context of their patients and can anticipate the kind of support they might need. Importantly, staff know each other well and talk together as a team. Imagine how a patient can get lost between nurses, health visitors, physiotherapists, reception staff, doctors, chiropodists, health care assistants, care staff. If the team is close knit then the care of patients is continuously being discussed among the different professionals.

Another advantage is that some of the practices dispense which allows a single trip for a consultation and treatment. Many of the doctors still provide an out of hours service. This has almost disappeared down south and, out of hours, patients will be seen by doctors who are entire strangers to them.

Being a doctor on the north coast has its own flavour. I have seen things I won’t see elsewhere: otter bites, scalds from boiling lobsters, a child with spinner buried in his face from an ill judged cast…. It is no lie that the folk are hardier here. In Devon, when a patient complains of shortness of breath, we measure daily activities such as how many flights of stairs they can climb. A crofter, asked about exercise tolerance, replied in terms of how many fence posts he can knock in during a morning. A patient recovering from a serious operation asked whether was he well enough to calve the cow.

I loved medicine on the north coast. I was familiar with the beauty of the land and the warmth and gentility of the people. I have learnt on my elective how a doctor has a privileged role in helping to support communities. We have gained much in our technological age, better health being one reward. However, we have lost much of our community mindedness. In many places where I usually work, community has diminished to a slight thing. It still lives at 58 degrees North.

My thanks go to all the patients who allowed me the opportunity to learn from them. It is much appreciated. Tapadh leibh.