My Father’s Footsteps

I am a daddy’s girl, there’s no denying it.

My earliest memories are formed of the sights, smells and sounds of my father’s clinical practice. My endless fascination with the ancient leather examination couch in the study and the fascinating contents of his soft leather medical bag. Although we weren’t supposed to enter the room, I recall sneaking in and exploring the drawers within that sacred room, filled with the stuff of fantasy; metal syringes, plastic and rubber tubing, sterilising equipment and books filled with the goriest images a small child could imagine. And the smell of antiseptic and medicinal potions that still transports me to the study to this day. During the winter I remember the rattle clang of chains as they were applied to the wheels of the emergency van to enable my father to gain access to remote houses on the mountains otherwise inaccessible during the snow. One of my favourite pastimes was to go on Dad’s calls with him and visit the flotsam and jetsam of humanity that lived in Mourne at that time. From newborn babies to dying ancients, my father would visit each in turn and provide what help and support he could. He would always warm the diaphragm of his stethoscope before applying it to patients’ chests and tended to keep it tucked in the pocket of his waistcoat so it would be at the right temperature. In retrospect, I don’t think I ever really had a choice about studying medicine. There simply wasn’t anything else I wanted to do but follow in my father’s footsteps

Yet the medicine I entered was already changing. Evidence based medicine was the way of the future and I recall my father wondering how any Family Doctor could keep up with all this guidance. As my career has progressed, it has often felt like our paths have diverged and that we are part of 2 very different professions and I have often found myself shaking my head at the practices of my father thinking what a poor evidence base there was for GPs doing minor surgery, home deliveries, dental extractions and anaesthesia. Likewise, my father shakes his head with sadness as he feels modern medicine has lost it way and travelled a path away from the patient.

Recently, as is our way, we had another long chat about the state of medicine. My father was a young medical graduate 70 years ago at the beginning of the NHS and felt then, as he still does, that GPs got it wrong. He believes that General Practice is the true generalism and is rightly the gatekeeper to specialist care. It is a matter of pride to him that everything that could have been done had been done before a patient of his was admitted to hospital. As a receiver of his referrals, I remember how they came with a full work up and a correct differential. He was and is, an excellent physician. He recalled how his patents always appreciated how they knew he had done his best when someone died and I reflected on how it seems today that death is either an unacceptable outcome or a commodity. My father cannot understand my decision to go into management thinking I’m “one of them” and wondering when I’m going to be a ‘proper doctor’ again. He has an ingrained distrust of managers as many doctors do and cannot understand my belief that only by working together will we see the healthcare system we seek. Together, I believe anything is possible.

My father taught me that practicing medicine is a privilege. It is a privilege to be invited into people’s lives and to help carry the burden of physical, mental and social issues with the trust of generations. My father taught me that the patient is the beginning, the middle and the end of all we do. Despite the intervening years and the impact of innovation, that is as true today as it was 70 years ago at the birth of the NHS. Everything else is noise.

Correspondence:
A Carroll, National Rehabilitation Hospital, Rochestown Avenue, Dun Laoghaire, Co. Dublin.
Email: Aine.Carroll@NRH.IE

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