The Circle of Life 

Here’s a wee slice of medical history as we mark 75 years of the NHS.

A step back 40 years to 1983…

For the last week of my 17 days in hospital, I found myself as a patient in the exact same ward where I started my medical career forty years ago. 

1983

Having done several locums on the cardiology wards at ARI as a 5th year medic, (known then as wards 19/20) I was invited by the Cardiolgy Professor to then work there as a junior house officer when I graduated in 1983. 

Prof became a consultant cardiologist at ARI in 1960- the year I was born. For many years he was the Royal physician whenever the Queen was in Scotland. He was also known for his research into certain types of cardiac arrhythmia. Prof was a great role model in whole person care. Having worked for him at the very start of my medical career, I later had the honour of being his GP in his retirement and caring for him at the end of his life. 

During my JHO year (also known then as ‘residency’ – due to the fact that after day shifts we were then on call overnight and weekends in hospital accommodation above the wards so frequently that we virtually lived there! ) I also worked with the two other consultant cardiologists. One introduced cardiac pace-making in Aberdeen and also pioneered telephone transmission of ECGs from the Scottish islands. The other consultant cardiologist instituted the development of acute coronary care medicine in Grampian and established the CCU. He introduced coronary angiography and initiated coronary angioplasty in Aberdeen.  During my 6 month residency, when the Prof retired, a new young consultant was then appointed, and it was interesting introducing him to the workings of the ward. It was very much a team – doctors, technicians, nurses and support staff, albeit a small busy team with one aim. Together we delivered our best care to all our patients at the time. Several patients came from the Islands and were with us for days and sometimes weeks as their care was being optimised. On Christmas Day, the consultants even carved and served the Christmas turkey for the patients on the ward! 

2023

And now 40 years later, having had a very clear run of health until 2010, I find myself having come full circle and now being under the care of the Aberdeen cardiology team, back on the ward where I started my medical career (now renamed wards 402/403) . Not only that but availing myself of the investigations and management first developed by the very consultants I used to work with. I still find it incredible to think that the world’s first whole-body MRI scanner was built in Aberdeen in the early 1980s. 

My observations from the other side? The open ward structure and layout hasn’t changed much, with a wee bit of modernisation since the building was opened in 1936. Toilets could be doing with further redo! The medical team is vastly larger – with many more consultants etc- and there are several sub specialties within the department. The technology has advanced hugely and there is a much greater emphasis on surgical intervention as the preferred early method of management. In fact cardiology feels more like a surgical specialty now in many ways- cardiologists classing themselves as either ‘electricians’ or ‘plumbers’.

 Nurses and support staff are more empowered (and maybe across the board as a result, the doctors less visible) There has been the welcome development of nurse specialists and also highly experienced technicians. 

The aim of clinical care continues to be top-notch despite the massive pressures on the NHS. These pressures have pushed the NHS towards development of long waiting lists, increased protocol driven care, a paucity of skilled generalists, and fragmentation of continuity of care on some levels. Longer life expectancy & technical medical advances combined with gross underfunding is a recipe for something having to change. There is a huge amount of money being spent on agency nursing staff to fill manpower shortfalls. And we’ve narrowly dodged junior doctor strikes… Despite this, morale remains surprisingly high amongst regular staff, thanks largely to their goodwill and genuine caring nature. The NHS continues to try to deliver expert care day after day by individuals on all levels despite the challenges. Cardiology advances and developments are thriving and Aberdeen continues to be a centre of excellence. 

And most notable of all, that irreplaceable and vital human touch – the beating heart of the NHS and whole person care – is still alive and kicking. 

We owe it to those who serve and are served, to rightly respect and resource the NHS in the ways it deserves.