Back in the day

I picked up an old medical biography recently, the life story of Dr G E Waterworth. (People didn’t have full names, back in the day, just initials.)  It gave me in interesting perspective on how far my profession has come. In short, the good old days weren’t. While it might sound exciting to operate on patients on their kitchen tables and to battle through the night on horseback to get to a remote farmhouse, the fact is that scientific medicine was in its infancy a hundred years ago. Much of what they did wasn’t effective.  And G E went through both World Wars, the 1918 flu epidemic and the Napier earthquake.  Patients died regularly of TB, pneumonia and typhoid, goitre was prevalent, and childbirth was still a risky proposition.   Some of the equipment is now unheard of.   I wouldn’t even a recognise a “probang”. This was a long thin instrument, originally made out of whalebone, which was shoved down the gullet to dislodge blockages.  It sounds ghastly, but I guess in the pre-gastroscope era it would have seemed like a reasonable strategy for the patient in extremis.

It was also the time of the generalist, GP’s who administered anaesthetics, did surgery, had a private practice and were police surgeons and goodness knows what else as well.  I even trained with a GP who was a port medical officer and a prison doctor to boot.  There were real “characters” in medicine, not always conventional but certainly memorable.

So how does that compare with the present day? I think we have a better evidence base for what we do.  Young GPs are more systematically trained, whereas I learnt most of my medicine after I qualified, often by painful experience.  They come to us with have a heap of knowledge, so our training can be focussed on practical application and exposure to real life situations.

They also have a better understanding of self-care and work/life balance.  Previous generations of doctors have thrown themselves on the “altar of general practice”, often at great cost to themselves and their families.  The new breed do a good job, but will appropriately limit their work hours and avoid after hours call.

Some things are the same though.  It’s a privilege to be trusted with people’s secrets and concerns, and we have the honour of becoming a medical friend.  The language and technology of medicine have changed, but not its heart.