Medicine and Other Topics E-Book

Alistair, Dr Tulloch

• Herausgeber: novum pro Verlag
• Kategorie: Gesellschafts- und Liebesromane
• Sprache: Englisch

Seitenzahl: 262

Veröffentlichungsjahr: 2023

Beschreibung

Medicine and Other Topics is the story of Scottish-born GP AJ Tulloch, from his two-year RAF National Service in the 1950s, which took him to Egypt, through to his becoming a partner in a practice in Bicester, Oxfordshire. Along the way, we learn of his interest in Structured Records Systems, Geriatrics and Obstetrics. A mix of political and social commentary from a retired doctor, steeped in the traditions of the National Health Service, this book comes at a time when the issues discussed could not be more relevant. NHS underfunding, tax-cuts for the rich and Brexit, have contributed to the crisis in health that Britons today face, in Dr. Tulloch's opinion. Dr. Tulloch offers a personal, vivid, warm-hearted autobiography, coupled with an examination of life in Britain, past and present.

Leseprobe

Imprint

All rights of distribution, also through movies, radio and television, photomechanical reproduction, sound carrier, electronic medium and reprinting in excerpts are reserved.

© 2023 novum publishing

ISBN print edition: 978-3-99131-561-2

ISBN e-book: 978-3-99131-562-9

Editor: Roderick Pritchard-Smith

Cover images: Richard Cote | Dreamstime.com

Cover design, layout & typesetting: novum publishing

Images: Dr Alistair Tulloch

www.novum-publishing.co.uk

Introduction

The idea of writing a book in the form of an autobiography crossed my mind several times in the last fifteen years only to be discarded despite the fact that I had done quite well at school. I had later written a number of medical articles and a chapter in several textbooks, but I did not feel confident about this task.

Nevertheless, it was my wife Christine who set the ball rolling again by pointing out three years ago suggesting that I ought to write a small booklet describing the variety of interesting tasks I have handled as a doctor. It was designed to entertain offspring, grandchildren and close friends. I gave some thought to this view, but I remained uncertain and as a result took no action.

However sometime later I read a book by Adam Kay, an obstetrician, called “This is Going to Hurt” which was an interesting read and a bestseller. He has much more talent than me but I am indebted to him as he changed my mind and I started to write the book. It set out to be purely an autobiography.

My career and lifestyle have been unusual to say the least and six months after graduating I was in the RAF which took me to Egypt and the Sudan. I was then a bachelor and I decided to spend two years on three hospital appointments. I never once met another GP who had done this length of postgraduate training at this stage. GPs today however would be unimpressed since they spend around four years or so in hospital and general practice while in postgraduate training. The result is that they are better trained today.

During my career I also wrote a thesis for my MD on structured records which seemed to interest only a few GPs. Subsequently, at a conference, I met the director of a computer company who said that if all GPs had introduced a structured record system the National Health Service could have saved millions. I advised the Ministry of Health about this but they took no action. I was twice invited abroad to speak on records – at a Conference of the Italian Epidemiological Society in Rome and at the University of Los Angeles on Care of the Elderly. In the last quarter of my career I began to take a special interest in care of people in advanced old age along with a colleague, Dr David Beale, a very able clinician. We approached all the relevant Colleges but were unable to provoke any interest. Retirement came when I was 61 years of age and we bought a house in Spain which we retained for fourteen years. Thereafter we have enjoyed a variety of foreign cruises. Finally the book touches on political affairs.

I have now been retired for 31 years as compared with 37 years in practice. I still kept fit playing tennis and golf and I believe that there is still a little petrol left in the tank. Now at the age of 96 I am really quite fit despite my having aortic stenosis (a leaking heart valve). However, I am much more forgetful these days though I am still enjoying life and am still playing golf.

On the other hand the final curtain cannot be too far away. I really cannot complain as life has been very kind to me from my early days with my parents and sister. Later and most important of all with my dear wife Christine, my three children and five grandchildren. Finally I have had a circle of friends whose company also gave me great pleasure although most of them are now dead.

So the reader can see how fortunate I have been working in general practice and on retirement my wife and I visiting so many fascinating foreign countries as well as delightful cruises especially on the rivers of Europe. Now the holidays are scaled down for obvious reasons.

Chapter 1 Brief Ancestry of the Tulloch Family

My ancestors, whom I traced back to 1790, were based in the village of Kiltarlity, near Beauly in Invernesshire. They were poor Highland crofters who eked out a living from their modest plots of land. However, when my grandfather, Alexander Tulloch, married towards the end of the 19thcentury he moved to a croft called Ballachraggen in Kirkhill, a scattered village some seven miles from Inverness. There he built the family house himself and raised three children, the eldest of whom was my father, born in 1900. The tradition in the Highlands of Scotland at that time was that the first-born son took his father’s name and thus my father was also called Alexander to conform to this custom as had the previous three generations.

He had one brother and one sister, both close to him in age. Father was quite the most able of the three and having passed his exams he wanted to be a doctor but the family could not afford the costs involved. Instead he started training as a bank clerk with the Commercial Bank of Scotland (CBS) in Muir-of-Ord near Inverness, in 1916.

Then, in 1918 near the end of the war he was called up for military service and spent over two years mainly with the Army of Occupation in Germany. 

On his return from the army he was transferred to a branch of the bank in Castletown, near Thurso in Caithness as a medium level bank clerk. Castletown was a pleasant little village laid out, unusually for Scotland, in a modest grid pattern. Father was very happy there although the work was scarcely demanding – he started at 10 am and usually finished around 3.30 to 4pm, after which he might have some bookwork to do. However the social life in the village was very lively. Remarkably the village had two halls with plenty of scope for village social events, dances and sports such as badminton, while the Bank Manager had a private lawn tennis court – courtesy of the Commercial Bank of Scotland. 

Soon after father arrived he met Bill McKenzie and they became friends. Bill ran a village butcher’s business and was also an auctioneer. He lived in Castletown and was well off even if he was rather laid back about business affairs. He confided this to my father and asked him to help with his financial affairs. Dad was delighted and he soon re-organised them but refused to be paid as ‘the bank wouldn’t like it’ which became a family joke. However Bill, who was a very generous man, insisted in rewarding father with sides of beef, lamb and chicken breast and legs etc. He also introduced father to his sister Mary and they soon began courting. She was the daughter of the now retired village butcher John McKenzie – my grandfather – who had a thriving butcher’s business delivering meat to people living within a 30-mile radius of Castletown as well as supplying the village itself. Grandpa (then retired) was a real character with a great fund of amusing stories which made him excellent company for my cousin John McKenzie (son of Bill) and myself. When not at work he often wore a grey Homburg hat and a black coat which made him look more like a city gent than a village butcher.

Grannie was much more serious but nonetheless devoted to her children. They had a family of six – four sons and two daughters, the elder being my mother Mary, a woman of strong convictions, a wicked sense of humour and who was something of an entertainer. She also used a number of local dialect words, many of which I had never heard before – she said that they were “old Caithness words” which in most cases was true but she would occasionally simply fashion words of her own. The younger daughter was called Margaret – always known as Mag – also a woman of strong convictions and the brightest intellect in their home. She wanted to be a doctor and she had qualified for Edinburgh University before she was 17 but they did not take applicants aged below 18 so she deferred. She had always been good at sports and she played hockey and tennis and ultimately reached near county status. However she kept deferring the medical course and ultimately gave up on the subject. Instead she turned to gym teaching which was a surprise to everyone but she enjoyed the work and did a bit of coaching as well.

Two of her brothers, Bob and Jack emigrated to the USA and later Canada some years before the First World War. They ended up running a thriving cattle dealing business in Lacombe, Alberta, Canada. By the middle twenties they were very prosperous. Another brother, Bill (mentioned before), took over the running of the butcher’s shop with a manager and he also served as an auctioneer as well as managing two farms, Castle Hill and Greenvale. Mind you, with his various forms of work he had to delegate much of the day-to-day farm work to employees. Thus he acted rather like a gentleman farmer.

The last brother had a serious accident before the Great War which left him almost permanently in pain and, as a result, he was declared unfit for military service. However he insisted that he was fit and he persuaded the Army to accept him. The Army however was to make no concessions to his disability except that that he was not to be a fighting soldier. As a result he was obliged to do long hours on the parade ground ‘square bashing’. In addition, he was not exempt from having to carry around heavy equipment and keeping fit just like a fighting soldier. As a result he suffered much more pain and he was a sick man on discharge from the service. As a result, tragically, he was to die in 1922. He had always been known as the ‘iron man’ of the McKenzie family.

My mother, Mary Mackenzie and her parents had been crofters, but one of my grandfather’s brothers drank the family out of the croft. However, her father, John McKenzie, immediately set up as a butcher, serving Castletown and about 30 miles around. He quite steadily built up the business across the years and by the time I was going there in the late twenties he had retired. Of all my grandparents he was the one I liked most although my grannie was very kind to my cousin John McKenzie and me as well. We were up to all sorts of mischief but she saved us from punishment time and again.

Chapter 2 My Early Years

In due course Father married Mary McKenzie and within a year I was born on May 31st, 1926, in Manu House, a big house built by a retired sea captain years before – the rather odd name came from somewhere in China as he had worked mainly in the Orient. The house was divided into flats, one of which was all my parents could afford in the twenties. The great event of this era was the General Strike, which had created an upheaval some weeks earlier in 1926. There was also the matter of what name I was to be given since Mother had found Alexander ‘rather a mouthful’ but she did not want to offend the Tullochs. So she settled for Alistair – the Gaelic for Alexander and only a little less of a mouthful.

Perth 1927

A year later in 1927 Father was transferred to the Perth branch of the Bank and promoted from bank clerk to ‘accountant’ which was a bank ranking in those days rather than the financial affairs professional of today.

Stow, Midlothian 1928

After a year there we moved to Stow, a lovely village on the river Gala about 26 miles from Edinburgh. There Dad was to be a bank manager and he was told he was the youngest in the CBS, but to begin with he was under the surveillance of the manager from a bigger branch in nearby Galashiels – it was however a largely nominal supervision. Father incidentally was aged 27 at this point and we came to live in a bigger house than either of my parents had experienced before, part of which was the bank office. They thought they had landed in clover, especially as they had a large garden and father was a keen gardener. We were to spend twelve happy years there and looking back I feel that no children could have been more fortunate than my sister and I to live in such an attractive area with devoted parents and a lively social life. I joined the village gang of boys and we soon got up to the usual forms of mischief. We were also very interested in football, rugby and tennis which I started playing at the age of nine.

Primary School Stow, Midlothian 1933

I recall clearly starting school in Stow and I particularly remember the first day at school for two reasons. There was a world map on the wall, almost half of which was coloured in red to identify parts of the British Empire and of course at the age five I had no idea what an empire was. After school I also tripped on the kerb later that first day and gashed my knee which required stitches not given in most cases at that time. I can recall this episode quite clearly today nearly ninety years afterwards because of the acute pain when the needle went through the skin on each side of the cut. Nonetheless I really enjoyed my time at Stow school and I nearly always came first in the class, which led me to believe I was more able than was the case. Of course most of my fellow pupils came mainly from a more modest background than me and were rarely strong performers, probably as they did not have parents encouraging them to ‘stick in’ as mine did. Stow was a commuter village for those who worked in Edinburgh and there were a good few more affluent families there than ours. Their children were usually privately educated in Edinburgh and so we saw them much less often than the locals. Incidentally the private school system in Scotland differs from the English public school system since most of the private pupils are non-resident and based mainly in the bigger cities or nearby. However there are also some four or five residential private schools in various parts of the country based on the English school system, which catered for wealthy families, the aristocracy and even the odd member of the Royal Family. Incidentally I knew very little about the English educational system before I came down to England in 1950 to do my National Service in the RAF. I was simply bewildered by the cost especially of the most expensive ‘public schools’ like Eton and Harrow – I put the term in inverted commas as nothing on earth seemed to me to be less public than a public school.

Stow was in the middle of a fertile area of Scotland and my impression was that the farmers in the district were more prosperous than in many other parts of Scotland. However my father claimed that the Black Isle (near Inverness) provided the best farming soil in Scotland, a view contested by several other Scots friends. Dad was a proud Highlander and not always highly objective on matters of this sort but he was the most encouraging of fathers.

I was active in the local group of boys and we were up to every mischief under the sun but sometimes things went too far. On one occasion I was the perpetrator and to this day I feel a sense of guilt when the subject comes up. Although I was a small boy I suffered very little from bullying at school but one boy in the class used to ‘ping’ my ears, which was very humiliating in company. I asked him to stop but he paid no attention and since he was much bigger than me there was little I could do about it. So I decided to give him a good soaking in the hope that he would end the ‘pinging’. This was to be achieved by dropping a flat stone near him as he emerged from under a bridge on which I was seated. He had been fishing for minnows with four of our friends. Now as the stone left my hand, to my horror he moved to the right towards the falling stone which clipped him on the side of the head opening a cut which bled freely and friends on the spot came to his assistance. To my shame I rushed home hoping that I would avoid retribution but my Mother soon recognised that something was amiss. So I had to explain what had happened and by this time the boy had turned up at our house seeking help. Mother dressed his wound and took him to the doctor who put in a couple of stitches. On her return she gave me ‘two of the best’ on each hand adding ‘you deserved more’. Next day came the second half of the punishment – the headmaster hauled me out in front of the school and criticised me for cowardly behaviour in dropping the stone and (even worse) departing the scene after the accident. He then added: ‘You might easily have seriously injured or even killed Archie’, which was of course quite true and I felt terribly guilty. I even considered running away as I did not seem to have a friend in the world at this point. So I had nobody to run to for support. Mind you, in another three days I was back in favour as one of the boys again.

We were a lively class, given sometimes to whispering or even occasionally chattering in lessons, which did not go down at all well with the teachers and occasionally they resorted to punishment with a thick leather belt with thongs, known to the pupils as “the belt” or “the tawse” or “the tug”, administered to the hands. Of course nobody wanted this punishment but anyone who had it became a class hero and thus it did have the desired result. In due course teachers recognised this and resorted instead to expelling the offender from class which was much more effective. The reason for this was that one felt very lonely outside the class door and there was always the fear that the headmaster would come along and ask why the expulsion had been ordered.This often led to the importance of not making the teacher’s job more difficult but if he felt that the offence was more serious the belt was used as punishment administered sometimes by the headmaster himself in his room.

My time in Stow, from 1928 to 1940, was, in retrospect, a real pleasure to me and I made a series of friends with whom I played a variety of sports – football and a rather tame form of rugby in the winter, and in the summer a crude form of cricket as well as fishing for minnows in the Gala River, which also deepened in one place enabling us to use it for swimming. We even started to play tennis in 1935 and I was to play the game for the next 70 years. As I now look back down the years, my impression is that the summers in the thirties were almost eternally warm and sunny enabling us to enjoy these pleasures: Or is it simply distance lending enchantment to the view? 

The arrival of my sister Margaret 1935

Nineteen thirty-five saw the arrival of my sister Margaret after a difficult pregnancy for Mother who had severe and persistent sickness known to the medical profession as hyperemesis gravidarum – doctors have a weakness for imposing names. Then she went from bad to worse and the doctors warned my father that she may die unless she was admitted to a private ward in hospital. There the doctors tried everything and they did slow the rate of decline. However Mother was becoming concerned about the steadily mounting costs of private inpatient hospital care, which Father could ill afford. As a result she suddenly announced that she was going home, to the dismay of the doctors including her GP, in whom she normally had great faith. They told her that if she did go home she was much more likely to die. Her response was simply to say: ‘If I am going to die I would prefer to die at home rather than in hospital’. Poor Father by this time was broken hearted since there was no sign of improvement and he felt sure she was going to die. However she proved both him and the doctors wrong as she turned the corner and began to improve slowly some three to four days after her return. Thereafter the recovery continued slowly but steadily and she had a normal delivery some six months later, a baby girl weighing eight and half pounds. I fear it must be said that I viewed her arrival with mixed feelings since I alone had been the centre of attention for the previous nine years and this state of affairs was now coming to an end. She was a large noisy baby who howled blue murder if she did not get her way and this did not help to endear her to me at first. Indeed, we fought tooth and nail for several years, after which she became much more amenable and grew into a charming young woman. We remained close friends for the rest of our lives. In the end she was to die sadly a very unpleasant death as a result of a neuro-degenerative disorder, rather similar to motor neurone disease.

At this time another pleasure was going to ‘the pictures’ as the cinema was then called in Scotland and even today seventy years later I can recall the most popular films of this period clearly. Humour came from American films starring Stan Laurel and Oliver Hardy, with Stan nearly always looking gormless while Oliver was pompous and self-righteous but nearly always wrong in the end. Then there was Mickey Rooney in the Andy Hardy series with Judy Garland as his girlfriend before she became primarily a songbird. However the most memorable film of that era was “Gone with the Wind” starring Clark Gable and Vivian Leigh, which reached Britain in 1939.

Summer Holidays in Caithness 1928–40

Each summer we went as a family to the home of my mother’s parents in Castletown, Caithness, although we seemed to spend most of our time at Manu House where I was born. This was now a family home again since my Uncle Bill had bought it. He was always busy and had a well-developed sense of humour. His son John was my main sparring partner among the local lads and he had a sister called Lilian. There was almost no foreign travel for ordinary families at this time therefore some of my mother’s contemporaries from her schooldays brought their families up to Caithness each year for their holidays. So John and I had plenty of company each summer playing the same games, lounging on the beach and fishing from a small boat called ‘The Girl Pat’ belonging to an experienced sailor called Ittle who was full of tales of life at sea – to our great delight.

One evening John and I went out fishing alone and we began to find we were further offshore than we had planned. So we decided to row back and we found it hard work. Well, at that point fins began to appear around the boat which, we thought to our dismay, were from sharks. Of course we did not know then that sharks rarely appear in the Pentland Firth, especially inshore. So we were extremely frightened and we decided to row back very slowly so as not to annoy the ‘sharks’. They were however in no way aggressive and after a relatively short period, to our great relief, they departed. Next day we reported our experience to Ittle who said, with a smile they were almost certainly not sharks but were far more likely to be friendly dolphins!

What made this holiday crowd so congenial was that they were parents who had been to school with my mother – mainly female but there were a few males. They made it clear that we had to observe the rules and one of these was ‘no smoking’. Otherwise we had carte blanche and for most of the time we did observe the rules but not all the time. These summer holidays were always a great source of pleasure to me each year and they cost my parents very little. It is a quite different story today.

I look back on these Caithness holidays, especially in the thirties, with great pleasure although sometimes John and I got ourselves into hot water. John always had much more pocket money than me which enabled us to buy cigarettes – Wild Woodbines to be precise. When we smoked them there was a wonderful feeling of defying authority in doing something which had been forbidden by our parents. However when we were caught the pleasure gave way to dismay at the thought of punishment. On one occasion, for example, while we were smoking, one of us carelessly threw away a lighted match which set several raspberry bushes alight (it had been a very hot summer) and we were caught in the act. A long lecture followed on the evils of smoking and the threat of physical punishment if we smoked again. On another occasion later, I well remember that Cousin John and I were having a few days sleeping in a tent on the links beside the beach in Castletown. We had not smoked for some weeks although we did have a few Wild Woodbines left. The question arose whether we could allow ourselves just one ‘fag’. In the end we decided that one each was acceptable, and as you might imagine this soon became five or six each and the interior of the tent became just like a bar room in those days. We were utterly relaxed and at peace with the world when to our horror the flap of the tent was cast back and a familiar face appeared – it was my Dad and he played things very cool. He remarked that: ‘Your Mother required me to drop in and ask you whether there was anything you needed.’ I replied, ‘No, not really’ and with that he departed saying, ‘See you in the morning.’ We, of course, were very anxious as to whether he had noticed that we had been smoking. This was utterly ridiculous in retrospect as Dad could hardly miss the pungent smell of smoke which also permeated the inside of the tent. Nonetheless we managed to persuade ourselves that he just hadn’t noticed the smoke in the tent.

Next morning we felt that it might be wise for us to stay away from the house until lunch and when we did arrive no mention was made of smoking. However Dad raised the subject after lunch and he added that he was very disappointed that I had not kept my promise to give up smoking. As a result of this misbehaviour I was unable to go to a picnic to which I was looking forward very much. I was quite convinced I would never smoke again.

A period without smoking then followed after which the temptation was too much and John and I shared a fag in the butcher’s van when the van man had finished his work. However unfortunately he returned to retrieve something from the vehicle and caught us in the act.

The van driver was a heavy smoker himself but he was emphatic that we should never smoke and to drive home his point he inhaled from his cigarette and blew the smoke through his white handkerchief leaving a dark brown stain on it. That he said in a sepulchral tone was what is left on your lungs each time you smoke and inhale. I was most impressed by this and as a result I never developed the smoking habit again. John went on smoking and developed emphysema at the end of his life but he did live into his middle eighties. Geordie, the van man, also carried on smoking and he was to die from lung cancer when he was in his seventies. 

Cousin John and I looked forward with keen anticipation to our annual summer holidays each year. This phase of life is one that most children enjoy and we were no exception. Football was the main sport but we also played rugby, tennis and occasionally badminton. Summer saw us bathing in the River Gala and fishing for minnows. On the other hand in the Autumn and Winter we would swim in the indoor pool in Galashiels some seven miles away.

The Thirties

The cinema came into my life in the late thirties first with Mickey Rooney playing Andy Hardy and Judy Garland as his girlfriend. Judy also starred in the ‘The Wizard of Oz’ at this time which sent us all singing ‘Somewhere Over the Rainbow’. Then, shortly before war broke out, there was ‘Gone with the Wind a smash hit with Clark Gable, Vivian Leigh and Leslie Howard. At this stage of my life I was, like most schoolboys, unaware of the gathering storm in Nazi Germany, although I had heard of Hitler who was being lampooned in the “Just William” series of books by Richmal Compton– another great favourite of mine at the time. William was forever in mischief and he served as a model for Cousin John and I. Then, in 1939 came the first National Black-out dummy run and only then did I realise the seriousness of the situation. In 1938 I passed the Qualifying Examination (equivalent of the 11 Plus in England) and started my secondary education at Dalkeith High School, near Edinburgh, which involved a 36-mile round journey by rail each day. I was somewhat surprised to find that I was no longer first in the class in any subject, my best subjects being History, French and English. The star pupil in my year was called Tony and he was the son of a railway signalman. He was remarkable as he never failed to get 100% in mathematics at school. I once beat him in a history exam and I could not wait to get home to tell my parents about this success. He was also a mid-to long-distance runner of national standard and who became a professor of mathematics.

At Dalkeith we were introduced to organised sport for the first time and I soon enjoyed it very much. To this day I can remember the first rugby match I played in as scrum half for the third school team at the age of thirteen years. I would like to report that it was a glorious victory but alas it was a mismatch and we were thrashed!