Keeping it in the family

GPST editor Dr Peter Livingstone recalls growing up as a ‘son of the surgery’ in rural Northern Ireland

FOR those of you who don’t know me I am a third-generation doctor in my family. This is not a unique phenomenon, particularly in remote and rural areas where medicine as an “art and skill” is handed down from generation to generation. Therefore it was only natural that what was handed down to my father should in turn be handed down to me.

The rural area that I grew up in during the Northern Ireland Troubles was a place where certain elements of the law were not always adhered to. Violence was a regular occurrence and could be seen both locally and on the news. Yet my house was a tranquil and stable place set apart from the harsh realities outside. My father was the local GP who had established himself following my grandfather’s retirement some 10 years before I was born. The practice covered a radius of 20 miles so the majority of my school friends and neighbours were all my father’s patients.

My earliest recollection of general practice was when I was six or seven, lying in bed hearing the back door closing and the car speeding off in the middle of the night as my dad went to a sick or dying patient. He may not have returned until I was getting ready for school but still would have made it into his morning clinic where 40 patients awaited him. At that time there was no appointment system in place and patients would just turn up. It puts the present GP working day into context.

There was one particular episode I remember when my father returned home from a full night of doing calls, during which he had delivered an expected home birth that had turned into a difficult case. He looked grey and old as he came in that morning and was muttering to himself before he got washed and went on to work. Years later during a conversation about home births he mentioned that this particular episode had been his last ever delivery and recalled the difficulties that it had presented for him, his partner and the community midwife. There are clearly some memories that never seem to fade.

While I was growing up the house was always busy either with patients attending during on-call periods or the phone constantly ringing. Naturally the children were never allowed to answer the phone but I was always intrigued to know why people were calling or visiting.

Occasionally my father would allow us to watch minor procedures being carried out – with the patient’s consent – which included things like the removal of small foreign objects from eyes or fishing hooks from hands or ears. My siblings and I would all gather around and gleefully watch my dad carefully and painstakingly carry out the procedure before erupting in sheer delight as the offending object was finally removed.

My schooling in medical practice began early as my father would often talk to us about his work. There were evenings spent around the dinner table when he would tell us all about the interesting illnesses or diseases he had come across while treating patients that day. He would give us the interesting facts about the patients and explore the management of their conditions. This also included informal lessons on where certain medications came from, such as digoxin (digitalis) from the foxglove leaves that were blowing in the garden outside.

From an early age he always quoted the Hippocratic Oath to all his children to underline the importance of his duty to ensure that he passed on his vocation to future generations. The seed had been planted and throughout school I worked towards a career in science that would hopefully lead to medicine. My father knew I wasn’t academically the brightest and that any decision to pursue a career in medicine was ultimately one I had to make for myself.

Growing up, I learned how varied the role of a GP is and experienced first-hand the vital part they play in their patients’ lives, in both a physical and emotional capacity. It was this experience that ultimately influenced my career decisions and inspired me to choose primary care. While I was aware that the job could sometimes be demanding and challenging for my dad, on the whole I could see it also gave him a great deal of joy. I have no doubt in my mind that without his nurturing and the experiences I had growing up around general practice that I would not be where I am today.

Dr Peter Livingstone is a GP and editor of GPST

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