A Career and a Life, Lived to the Fullest

Clonakilty was my downfall. Just one week and I was hooked, never to recover. What a week. Student elective with a GP. Living in his house. Breakfast with his wife, young son and daughter. Sitting in on his consultations. Ward rounds in Clonakilty hospital. Home visits to frail elderly living in small cottages down lanes off side roads. The directions were detailed. No sat nav. No mobile phones. Detailed directions! Everyone waving at the local GP as he drove around: he seemed to know everyone! I still remember that child. Father burning plastic fertiliser sacks in the farmyard. Gust of wind. Burning plastic sack sticking to human flesh, burning, melting, screaming. Some patients never leave you, even decades later.

Summer elective in Tanzania. Snakes, elephants and zebra. Cacophony of crickets in the tropical night. Medical student in a deeply rural mission hospital. Nothing wasted. Every scrap recycled and recycled. Images imprinted on my cortex: a world of haves and of have-nots. The lottery of my birth within fortress Europe: Health, education and (relative) affluence: our birth-right. Our final student days in Tanzania. Zanzibar. Coconuts, palm trees, silver sand, aquamarine water. Cardamon and clove groves fragrant at dusk.

Final med. Cycling very fast along the ‘Carrigrohane Straight’ behind a lorry. Didn’t see the pothole. Crash. Fractured clavicle. Next day slowly losing consciousness. CUH Emergency Department. Dilated pupil. Recently installed first ever CT scanner in CUH. Neurosurgeons evacuated my extra-dural haematoma. The stars aligned. Better born lucky than rich. Very lucky. Our tenuous grasp on life.

Early 90’s. Ireland in deep, dark recession. Intern 1991. Start work on Saturday morning. Finish Monday evening. Sometimes sleep, sometimes none. Not good. GP training in Royal Tunbridge Wells, Kent, England. Incomparable wealth. No rusty Ford Escorts or clapped out Opel Corsa’s. Brilliant 3y GP training in Kent. Junior hospital doctor on medical take, wholly unsupported, rough nights. “Learning on the job Old Chap”. Steep learning curve-not to be recommended. Mostly fantastic colleagues & great mentors. First day in paeds-meningococcal meningitis. Paediatric ICU Flying squad blue-lighting down from London. Intubation, ventilation, cannulation, neurologically intact: Happy days. Bleary eyed. Canulating 26 week premature neonates at 4am. Working in ED: teenagers camping. Lightning. Tent struck. Multiple electrical burns. No deaths. Very Lucky. Woman with sub-arachnoid haemorrhage. Transferring to London neurosurgical centre. Talking to the neurosurgeon. He’d evacuated my extradural haematoma in CUH years earlier. Saved my brain. Saved my life. Small world.

MRCGP. World’s your oyster. Gotta get your BA. Been 2 Australia. Newlywed. New continent. Big rural town in Victoria. Hot & dry. Summer40+ degree. Work hard. Play hard. First time eating pesto, gnocchi, olives, parmesan. Victorian Alps. Learn to ski. Southern Atlantic. No salt crocs. Great Whites. Learn to surf-still surfing. Six months delivering babies. Loving every minute of it. Thrumping of the big whirly bird, flying victims of motorway collision to our rural ED. Adrenaline rush. Apply simulation-learned clinical skills. High stakes. Real-life environment. Death ever present. High pressure. Hospital accountant dreading the big whirly bird: thousands of dollars off his annual budget. Same view. Different perspectives.

Driving home from Melbourne. Late one night. Truck vs car. Head on. Me, first on scene. Total carnage. Husband crying, arms around his now-dead wife. Talking to her, talking and talking, in vain.. Our gossamer grasp of life.

Adios Australia. A year-long honeymoon! Plan to return…someday. Six weeks slow boat home across SE Asia: Bali, Hong Kong, Singapore, Malaysia.

General practice in Cork and Glanmire. Children, schools, holidays, work, a heady mix. Now kitesurfing. Savage adrenaline rush. Vaccinating babies. One of those babies recently had her first child. Mum and baby both now attending me. Must be getting old(er).

General practice. Loving every minute of it. Clinically challenging. Exploring the broad and deep medical ocean, oft uncharted waters. Intellectually demanding. Stimulating. Socially immersed. Vast global network of friends and colleagues. Previous medical students now peers. Some now professors, brilliant.

Three decades later. Still developing special interests. Dermatology in Cardiff. Diabetes in General Practice. Sepsis in Primary Care. Medical Education. Lifelong Learning. Travel medicine. The more I learn, the more I realise how little I know. Medicine the ultimate team sport. The sum of us vastly exceeds the parts. A life immersed in medicine. Still loving my job. Possibly the most intellectually demanding medical specialty. Definitely the most satisfying. A career and a life. Lived to the full.

Your horizons await. Go forth. Have fun. Practice General practice.