Malcolm Alexander - Close to Where the Heart Gives Out: A Year in the Life of an Orkney Doctor

CLOSE TO WHERE THE
HEART GIVES OUT

This edition first published in 2020
First published in Great Britain in 2019 by
Michael OMara Books Limited
9 Lion Yard
Tremadoc Road
London SW4 7NQ

Copyright Malcolm Alexander 2019,2020

All rights reserved. You may not copy, store, distribute, transmit, reproduce or otherwise make available this publication (or any part of it) in any form, or by any means (electronic, digital, optical, mechanical, photocopying, recording or otherwise), without the prior written permission of the publisher. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

A CIP catalogue record for this book is available from the British Library.

ISBN: 978-1-78929-236-7 in paperback print format
ISBN: 978-1-78929-124-7 in ebook format

The title of this book was inspired by the poem, Orkney: This Life in Into You by Andrew Greig, published by Bloodaxe, 2001.

Some names and identifying details have been changed to protect the privacy of individuals.

Cover design: Natasha Le Coultre

www.mombooks.com

To my eldest son, Martin,
who knows more about writing than I ever will
and
The people of Eday,
who helped me understand the important things in life.

Contents

I am who I am and I will be who I will be.

For a young boy to know this before leaving primary school is unusual but this one did: not only did he know what he wanted to be but he knew who. He had seen the man walking down the main street of his village for many years. He had watched his confidence enter the room ahead of him, saw it part the smoke from the coal fire, brush aside the smell of paraffin and ignore the scent of the crisp cleanliness of a newly made bed. This boy carefully observed the nuances of the mans conversation, the details of the examination, his use of percussions, of lookings and listenings with strange instruments. He had marvelled at the strange writing on the pad of paper drawn from the worn leather bag placed at the foot of the bed.

Penicillin V susp 250mg per 5ml

Mitte 300ml

Sig 5ml QDS

Visiting the man, he was both fascinated and afraid. Throughout an anaemic childhood he would endure the pain of repeated needle pricks in the lobe of his ear. He was captivated by the dilutions and measuring of his own blood in glass tubes, the smearing and viewing of it under microscopes. This would be followed by further strange writing on the pad of paper drawn from behind the polished leather desk.

Fear and fascination mesmerized him, captivating him, until one day he said, I want to be a doctor because I like helping people.

In time, he would become this man but along the way he would forget why. He would forget the people and try only to solve the puzzles they presented. Hypnotized by the process of illness, by the twists and turns of symptoms, he would forget the effect the manifestations of disease had on real lives. Entranced by medicine, it would take illness and its associated fear to remind him of the reason he wanted to become a doctor all those years ago.

I am Eid-ey,
The isthmus isle, the connector of tidal lands.

My birth is deep in the river of time.
My northern rock drawn down from the great
Devonian river
feeding ancient Lake Orcadie.
My southern half compressed from the flooded Lake.
I am hybrid and yet one.
Deposited on the face of the earth and held.

Through time I have travelled.
Leaving the haven of the ancient Lake.
Following the North Star slowly, carefully,
Into the fierce northern seas.

The little plane cut its engines and descended slowly on to the remote island fifteen miles out in the North Sea. As its wheels touched the rough grass airstrip the pilot opened the throttle once more, roaring the engines into life to control the landing. Rumbling and shaking across the rabbit-burrowed sandy soil of the isthmus that nearly slices the island in two, the plane came to rest alongside the peeling red paint of a wooden shed. An incongruous black and white sign, battered by the wind and rain, said London Airport.

We had arrived on the island of Eday Eid-ey in Old Norse the isthmus isle, a place of linking the disconnected. The island was nine miles long and only two miles broad at its widest. Rugged, they said bleak was a better word. The northern half was brown, covered with brittle wind-blown heather and black peat bog. The southern end was green and treeless, pounded by the sea and scoured by tidal flows. We were there with another young family at the start of a two-day interview for the post of sole general practitioner on the island.

We were watched, carefully observed as the island was presented to us by the interview panel, who highlighted the shop, the eight-pupil school and the surgery. The doctors house, sitting in a bog of peat with no sight of the sea from any of the salt-coated windows, failed to make it on to the list of notable things.

We said nothing to each other as we sailed back to Kirkwall. The return journey by sea in a chartered passenger boat making sure we had the full experience of island life. In the cabin, still under the eye of the members of the next days panel, Maggie and I only exchanged glances, smiles with minute unhappy inflections at the corners of our mouths. Her blue-green eyes were dark, and she held her head in a way which made her long, brown pig-tail appear rigid, as it transmitted her unhappiness. After eight years of marriage, many of them working together in hospital, we dont need words to communicate with each other. We wouldnt apply for the post. The job was challenging enough as a single-handed doctor on the island twenty-four hours a day. The place was awful, the house and surgery ancient and uncared for by the Health Board. The medical equipment was non-existent. We needed to move away from city-based practice but not that much.

That evening we spoke openly, frankly talking through the reasons for wanting to move. The bickering dissatisfaction of my current practice; their failure to give me a full partnership after four years; the overwhelming sense of sinking into mundane repetitive routine that was nothing like the life either of us had wanted. Deep down I hated what I had become. A technically competent doctor who had lost sight of the people he was treating. Only now and then minor glimpses of the family general practitioner I saw as a child broke through. Maggie would have to give up her part-time work in a neighbouring practice as well, perhaps only occasionally working for me, if that was possible. In the end we decided that I would go to the interview the next morning and allow the panel to decide for us. I would take the job if they offered it and they did.

August and we were nearly ready to go, leaving Glasgow for Orkney and the island of Eday, which would be our home. Four boys, Martin, Matthew, Michael and Murray, the eldest six years old and the youngest just a year. All preparing for an adventure that none of us really understood. The haunting difference between working with a hospital, ambulances, colleagues all nearby, and working alone on an island with only a tenuous plane link to anywhere in an emergency. The dramatic change from a school of three hundred pupils to one of eight. The challenge of only one shop and supplies that come once a week on the boat. The isolation from all the people we know in our support network. All this we knew but didnt realize how unsettling it would feel until we started to cut the cords holding us to the city.