It’s rarely plain sailing being an island GP
When Malcolm became an island GP, he did not realise he’d have to double up as a vet and stand-in minister, Anna Burnside reports
IT WAS 1988 and a Glasgow GP was about to discover what being a general practitioner really meant.
Malcolm Alexander had accepted a job on Eday, on the edge of the Orkneys. Just him, a rickety surgery with a dilapidated house attached and 125 residents. All relying on him for all their 24/7 medical care.
First of all, he had to get there with his wife Maggie, their four boys aged under six, three geese, six ducks, a rabbit, a guinea pig and a dog.
Then, he had to get the hang of life on a tiny, sparsely populated island where everyone had several jobs and knew everyone else’s business.
The urban practice where he saw children with coughs, the worried well and referred anyone with a serious condition was soon a distant memory.
Malcolm recalled: “It really felt like the top of the world.
“At night it was completely dark, there was no electric light at all. We could watch every star rise on the horizon.
“It gave me a huge amount of confidence medically, I learned an enormous amount.”
Take away the threat of attack and it’s not unlike being a battlefield surgeon, alone in a tent facing whatever comes through the door.
He said: “The emotions are the same – I don’t want to fail, I will not fail, I will do the best I can for this patient based on what’s around me.”
Malcolm, now 62 and retired, has written a book, Close To Where The Heart Gives Out, about his first year on Eday.
It was about as steep a learning curve as the Old Man of Hoy on a snowy day.
Some of the things he had to learn were practical.
How to light a Tilley lamp when there’s a power cut. How to spin a plasma sample in a centrifuge before sending it to the lab in Kirkwall for testing. The nuts and bolts of running a medical one-man band on a remote island.
Others took a bit more figuring out. In the run-up to Christmas, he had a run of calls to road traffic accidents.
The drivers, invariably the worse for wear, had gently come off the road and into a ditch.
They were never hurt and the doctor’s main job was to give them a run home.
Eventually, it dawned on Malcolm that the way out of becoming Eday’s free taxi service was to tell the distressed drivers that he could charge their insurance company for an emergency call-out and that he should also inform the police what had happened.
Mysteriously, the “accidents” stopped.
On an island where everyone multi-tasks, all eyes were on the doctor to see what else he could turn his hands to.
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The first one, a dog with a fish hook in its nose, looked straightforward but defeated Malcolm. She had to go Kirkwall for a general anaesthetic.
A stranded baby seal was an even more demanding case. While half of Eday’s population watched from the pier, the slippery customer was tied into a couple of fish boxes and loaded into Malcolm’s van.
None of his medical training and experience in the suburbs of Glasgow had equipped him to diagnose marine mammals.
On its makeshift straw bed in the shed, even a veterinary novice like Malcolm could see it was not well. But that was as far as he could take it.
The sea rescue centre in nearby Burray advised that the seal probably had flu. Malcolm should take its temperature ASAP, using a rectal thermometer. He should also feed it with herring broth, using a nasogastric tube if possible.
Malcolm did not have a nasogastric tube or a ready supply of herring broth. With great difficulty, he got the thermometer up the seal’s butt and he and Maggie got up at four-hourly intervals through the night to force-feed it a rehydration solution.
The next day, to the GP’s huge relief, the little seal was shipped off the island.
But even this most accommodating doctor had his limits. The folk of Eday discovered Malcolm’s when they requested he perform a Caesarean section on a cow.
Malcolm, now living on Bute, has gone from positively disliking islands to only feeling at home when he can see the sea.
He said: “Before Eday, I hated islands. Maggie was brought up on Bute but the first time I came here I thought I was going across to America.
“I was brought up in the Borders. The biggest boat I’d been in was on the pond in Moffat. I really was a landlubber at that point. To choose to go to Orkney was just bizarre.”
But it didn’t take Malcolm long to realise that Eday was not as far away from home as he imagined.
He said: “I’d gone back to my childhood.
“I was brought up in West Linton, population 600. We could get cut off there as well – there were big snows in the 60s.
“I was used to these small communities. I hadn’t realised I was travelling back to the best bits.”