Month: September 2020

• 

• 

OUR ARRIVAL IN PAPUA NEW GUINEA

Towards the end of 1974 I obtained a job with the PNG Government Legal Department. We travelled to the capital Port Moresby in April 1975 – a journey from the UK of about 33 hours, with two changes of plane (at Singapore and Brisbane). I was sent some information with the plane tickets before we left, which informed us that when we arrived at the airport we would be met by someone from the recruiting department.

The Qantas flight from Brisbane arrived at Port Moresby at lunch time. We emerged from the aircraft somewhat bleary-eyed into the tropical heat and humidity, and successfully navigated our way through immigration and customs, and then out into the airport concourse. This was much like any other airport – although the ceiling fans were something of a novelty to us, with a lot of people milling around – both PNG nationals and expatriates. We looked around hopefully for someone to take an interest in us but we were completely ignored by the throng.

After a while, I noticed that a couple of British men who I had seen on our flight were talking to an Australian man who had evidently gone to meet them at the airport. (He, as I recollect, was from the Department of Agriculture). I went over and asked him if he recognised anyone in the concourse from the Department of Law, which he didn’t. However, he must have taken pity on us and said he would go off to a pay phone and let them know that we had arrived (no mobile phones in those far-off days!).

He reappeared a few minutes later and said that he had spoken to the Department of Law and that someone was on the way out to meet us.

We found some seats and sat down to wait, and to try and stay awake. After about 30 minutes, two Australians showed up – little and large  – and they turned out to be the admin. officers for the Department of Law who should have been there to meet us. Their first words to us – which I still remember – were “That plane’s always late!” Well, it wasn’t today we thought. In the best Australian tradition we were taken off to a bar for a beer – luckily we had managed to dissuade them from taking us on a tour of Port Moresby! We had to endeavour to make polite conversation, when all we really wanted to do was have a shower and a sleep. After that they took us to an hotel, where we finally achieved the much-needed shower and a sleep.

When I started work, the reason why we had not been met became clear. At lunch time in the Department, a group of people met up to play cards. Two of the leading lights in this card game were the admin. officers. They were evidently not prepared to interrupt their lunch hour and give up their card game to meet a couple of Poms off a plane! Looking at it positively, it was good training to expect the unexpected for the next three years.

PLUS: A STORY OF A DEAD PARROT (OR, LIFE SORT OF IMITATES MONTY PYTHON)…. (not a Norwegian Blue!)

We had some friends in the New Guinea Bird Society who had a licence to ring birds, which they caught in mist-nets. Having been ringed, weighed and measured, the birds were then released to go about their business. Occasionally birds died in the nets – probably of a heart attack due to stress. This was clearly unfortunate and somewhat embarrassing.

Some months before my contract came to an end, our friends had been on a bird-ringing trip to the New Guinea highlands, where the day before they were due to return to Port Moresby, a Fairy Lory (now apparently known as the Papuan Lorikeet) – a type of small parrot with a long tail – died in the net. In the hope that some good might come of this unfortunate event, they put the parrot in a plastic bag and brought it home, and put it in their freezer, with the intention of taking it to the University of Papua New Guinea Zoology Department as the bird might be of interest to them.

Inevitably the parrot worked its way to the back of the freezer, and was forgotten. Our friends were due to return to Australia a few months before my contract ended, and when they cleared out their freezer, they found the parrot. Not wishing for it go to waste, they called us and asked us if we would have custody of the bird, and when we were next in the direction of the University, to give it to the Zoology Department.

We were happy to help out, and so the unfortunate parrot was delivered to us and deposited in our freezer, where it languished at the back, and was duly forgotten.

When my contract came to an end, it was arranged that the Australian lawyer who was to take over my job, would also take over our flat. I had known him from when I first joined the Department of Law as he was employed there until his contract ended and he returned to Australia. It was quite hard to return to what may be termed normal life after the “PNG experience”, and when my job was advertised, he must have seen the opportunity to return, and applied and was appointed. He arrived a couple of weeks before my contract ended, so that there was a hand-over period, and he told us not to bother to clear out the fridge and freezer as he would eat his way through what we had left.

Thus we departed leaving him a freezer containing unknown excitements.

A couple of weeks later we were travelling in the Philippines, and it occurred to me that the deceased parrot must have been in our freezer when my successor took over our flat. Quite what he made of it we shall never know – I suspect it was something of a disappointment if he had arrived home from work and was looking through the freezer for something to cook for dinner. The Fairy Lory was unplucked and would not have had much meat on it anyway! Probably it just confirmed whatever doubts he may have had about me.

Here are copies of the publicity achieved in the September editions of the local magazines. And it is pleasing to see all these magazines have returned to having a physically printed publication. Nine appearances is very encouraging, helped, in the main, about something close to our hearts (and wallets), namely the subject of bank notes.

Due to understandable space limitations, it is a pity that the magazines are never able to utilise more of the pictures provided to them, nor, indeed, to include a caption. The inclusion of either would provide their readers with a little more appreciation about the subject matter. At least this is not a concern when I post these reports on our web site.

You will note that the Villager magazine (Sherborne St John) also featured a previous report about the Battle of Britain. However we failed to appear in Popley Matters and in the Basinga (Old Basing & Lytchpit)  and despite the magazine advising its readers that the Probus article could be seen on the Basinga Extra web site it failed to appear here as well. On checking with them they blame a new web master. They have tentatively offered to run our report within their October magazine.

• 

• 

• 

• 

• 

• 

• 

• 

• 

 

I must start with my father. He left school at 14 and became an office boy in a local firm making surgical needles. Redditch, where we were living is/was renowned for needles of all sorts as well as fishing tackle and springs. Anyway he climbed the greasy pole and became office manager and left and set up his own company.

As a boy he had joined St John’s Ambulance brigade and got more involved with this when as a key worker he was not called up during the war. With his exposure to ambulance work and the making of different needles for the full range of surgical operations he had always wanted to train as a doctor but coming from a poor family there was no chance of it. I was clearly influenced by his experiences and with some difficulty was accepted into the Welsh National School of Medicine in Cardiff in 1966.

As a student things were pretty hectic with few free periods and once on the wards we spent lots of time hanging around in the evenings to see as much as we could. It was then you learnt how to suture and do a lot of the procedures you would need later on. Yes the patients were practiced on! There was a saying “see one, do one, teach one” it was during such an evening session that I had the chance to assist at my first operation. About 10pm a surgeon came into casualty saying that he needed two assistants for a renal transplant later that night. It was about 3am by the time we were all gowned up and hanging onto a retractor terrified we might do something wrong. The amazing thing was that the new kidney was inserted under the skin in the groin rather than the abdomen – a real learning experience.

Another very memorable time was when I had to clerk (take a history) from a Mr Bell who was an octogenarian but when aged only 3 had been operated on by Lord Lister who introduced antiseptics. It really shrank the history of modern medicine into a lifetime. Another such occasion was when our professor of bacteriology told us that he had once been tasked with transporting the “world” supply of antibiotics in his brief case.

The first baby I delivered as a student arrived on a very hot and humid evening (no air con then) the day man landed on the moon. It was a boy and no prizes for guessing what they called him!

My first paid post after 5 years training was very fortuitous. I saw an advertisement in the British Medical Journal for 3 jobs in Southampton. I was invited for an interview to find that 2 of the positions were to work for professors. One was Prof Donald Acheson who, unknown to me, was a founder member of the Faculty of Community Medicine of the Royal College of Physicians as well as being the first Dean of the new embryonic Southampton medical school. During the inquisition I mentioned for some reason that I was interested in community medicine and amazingly he hired me. He subsequently became the national Chief Medical Officer and went on to work for WHO.

The system of training then was 2 years pre-clinical, 3 years clinical, and a year split between house jobs in a medical and surgical speciality. You were then fully registered and could set up as a GP straight away but the concept of vocational training was being developed. This involved another 2 years in various jobs in hospital and a year as a trainee. If you were lucky you then were accepted into a practice where you wanted to settle and after about 3 years of working up to parity you became a full profit sharing partner. Very few GPs were then salaried or part time or indeed female.

After Southampton, where I met my wife, I had 3 jobs in Cardiff and a stint in Wrexham before returning to Cardiff for a trainee year.  So why did I choose general practice? I had spent a year in children’s medicine and thought that was my future but in Wales, at least, there was huge competition for consultancies in paediatrics and even then very little support with lifelong rotas of one in two, or worse, of evening and night work after a full day’s work. Together with that there were difficult exams to navigate and I had just got married and we had our first daughter.  General practice seemed an altogether better option and I have never regretted it.

In 1976 when I started in Basingstoke as a GP a book had just been published titled “Six minutes for the Patient” This was revolutionary as very few doctors spent more than 5 minutes on a consultation and much of that was trying to find your way round the old brown, hand written, Lloyd George records. Those records had been first conceived by the Germans and were employed by the then British government.

Our practice was coping with the rapid influx of patients from London; my personal list growing from 0 to 3500 in about 18 months. In addition, our consultation time was about double the national average initially as quite a few had no local extended family so all problems came to our door. In those days, of course, we did all our own on call on a I in 5 rota. When on duty we would be on for the evening and night following a full day and followed by another full day. We were also covering our maternity patients about half of our pregnant ladies delivering under our care. It always surprised me how many went into labour in the middle of the night! We had no mobile phones so out of hours calls came to us from our partners at home via a bleep. We then had to find a phone and re-plan our route around the patch. The change to the out of hours service with the Hantsdoc co-op came just in time as most of us were on our knees.  My low point was probably when I was called out of bed five times after midnight.

 

Things had to change, and the changes have been massive, largely enabled by the advent of computers as in so many areas of activity. We were able to build on our use of A4 paper records with enhanced coding and that in turn allowed us to tailor our provision of services to improve care. The NHS payment system also made data collection imperative. For a few years we were legally obliged to record everything on paper and the computer which was a big time waster.  We became a bit paranoid about the millennium bug which we successfully avoided only to be caught out on the following 29^th February.

All of the above has unfortunately meant that patients have less continuity of care seeing their own family practitioner only rarely as ancillary staff take on more of the traditional roles forced by increasing work load. It is a very different job to one I started with.

A postscript – since retirement and more time spent the other side of the desk I have become increasingly aware of how difficult it is to know when to seek help. If I feel that way with my experience then I am sure that others feel it more so. It is a constant dilemma as to how society can best use the service responsibly. Educating the public about when to present and when self- care is more appropriate is an area that requires more consideration but it is better to call unnecessarily than to not call when you need to.