The Official Website  for Carol Margaret Tetlow


1st of April ·

A little bit about the author!

I was a GP in Harrogate for thirty years and during that time have also done a lot of maternity and police surgeon work. I've met some remarkable people, as patients and their families and I've laughed and cried and agonised with them.

Out of Practice and Faith Hope and Clarity are the first two books in a series of four (though I'm working on the fifth). I love series of books where you can get to know characters and follow them through and to me, what better setting than that of a busy medical centre, so I can truly write about what I know and have experienced.

My funniest moment? So many but the day a mother and daughter came in with a shopping trolley and unleashed two cats that they thought I'd like to see stands out.

My worst moment? Attending a local aircrash as police surgeon. Horrifying beyond my worst nightmares.

My most unusual consultation? A young man bringing in his girlfriend and asking for my blessing on their engagement.

Is there anything you'd like to know about me? Feel free to send me a question and I'll do my best to answer.

Please- have a look at my novels, get to know the characters, find out what happens to them and spend some time in the beautiful town of Lambdale and surrounding Yorkshire Dales.

2nd of April ·

Notice to be displayed in reception, waiting areas and also in practice information leaflet-

The doctors are always keen to improve the service they provide. To this extent:-

1) A patient participation group is being formed and we need volunteers of all ages to join this so that we can meet together and discuss issues that concern us all.

If you are interested in this, please leave your contact details with the reception staff.

2) Patient satisfaction questionnaires will be given out to all patients who attend in the week April 7th-14th. There are two parts to be filled in, firstly about your overall experience at the surgery and secondly about the doctor you visit that day. All information will be strictly confidential but please note that inappropriate comments and defaced questionnaires will be considered invalid.

3) A box for suggestions has been made available at reception for comments. Please feel free to use but please- this is not a depository for unwanted tablets, samples, sweet papers etc

Thank you for your help.

3rd of  April ·

A holiday weekend and for the doctors, four days off. Sometimes it's easy to forget that they are normal people too, with home lives, problems and worries because they are professional people who never let their professional persona drop during work.

So what are they doing this weekend?

John Britton is spending the time at home, with his wife Faye. They have family visiting and Faye is reknowned for her cooking, especially those meringues. Weather permitting, he'll be out doing some gardening and walking his dog (though the latter will happen whatever the weather).

Ellie Bonnington is going to be at home too, with her husband Ian and their twin girls, who have entered in the gymkhana advertised in a recent post. So they'll all be in wellies and ankle deep in mud.

Clare Jennings is delighted because her husband David, a psychiatrist is not on call and they're heading for the East Coast, a small hotel, windswept walks along the beach, delicious dinners in the evenings with a glass of good wine.

Ed Diamond didn't even bother going home after his last patient left. He'd already packed his car so that he could set off immediately for some serious rock climbing with his friends near Malham.

Faith Faber is also going away for the weekend. But if I told you who she's going with, then that would spoil the plot!

Happy Easter!

4th of April

The medical centre is indebted to Mr Gordon Campbell, one of our patients, for these lovely photos of in and around Lambdale in the spring. These, plus more can be seen on display in the waiting areas.

5th of April

Happy Easter everyone.

We hope you are enjoying a peaceful and joyous weekend. What lovely weather we're having. Quite a change for a Bank Holiday! We also expect that many of you are enjoying chocolate eggs, large family meals and generally eating perhaps more than you should. This of course is fine on the odd occasion but it seems a good moment to remind you all about the diet advice service that both the doctors and practice nurses are happy to give.

Maintaining a normal weight has many many health advantages, lowering risk of serious diseases such as heart disease, stroke and diabetes to name but three.

Moderating what you eat and taking plenty of exercise is the key to weight gain avoidance. The doctors know that this can be easier said than done and that is why they are happy to help.

Diets are a bit of a minefield. What's good for one thing, isn't good for another. Weight loss diets are not the only thing we can help with. Ask our advice about gluten free diets, high fibre diets, low fibre diets, high calcium diets, in fact ask about any sort of diet. We can even help with weight gain!

Information leaflets are available from the carousel in the corner of the waiting area (next to the children's play zone) and please don't be afraid or embarrassed to make an appointment for extra support and guidance.

Signed -the partners

6th of  April ·

A bit more about Out of Practice....

The idea for the plot of my first novel came to me when I was on a training course. Quite out of the blue and we were all sitting in a very tight and uncomfortable circle in a tiny circular room. Ideas for the central characters developed quite quickly as soon as I started writing but then, to my amazement, as I got further into the book, they started to take over, told me that what I had planned for them was not the way to go forward and before I knew it the plot had changed significantly! But for the better, I feel. So thank you David and Ellie and particularly Clare for guiding me.

My sister thinks there is a lot of me in Clare but my novels aren't autobiographical and everyone is totally fictitious.

It took about a year for the novel to be completed. It was hard juggling writing and a busy job, plus all the usual things you have to do in life.

Long before the end I had developed a genuine love for the characters and knew that I wanted to bring them back again as I had a lot more to say about them.

Why not have a look, tell your friends, enjoy!

7th of  April ·

Preview of the next edition of the Teviotdale Telegraph -the practice newsletter to the patients....

A sunny Bank Holiday weekend has had, sadly, predictable results and today, on our first day of opening, the doctors have been inundated with cases of low back pain from athletic gardening activity, cut thumbs from overenthusiastic DIY and home improvements, sunburn from the unexpected change in weather, diarrhoea from the first barbecues of the season and rashes from contact with plants and mown grass.

The hay fever season has started now that the first blossom is out and asthma sufferers should be on the alert. The sudden urge to be active has also seen cases of tennis elbow and sprained ankles from jogging.

All the above are preventable with the use of a little common sense. Please pick up a leaflet from reception or the nurses entitled 'Look after your body and it will look after you.' Written by the partners it covers many aspects of how to prevent common conditions associated with everyday life.

The local veterinary practice has asked us to add that it is not just humans who have fallen foul of the holiday weekend. Dogs should not eat chocolate, hot cross buns or daffodils. Humans should limit their intake of the first two and not eat the third.

Signed....the partner

8th of  April ·

Extract from the local guidebook.....

Don't forget that Wednesday is market day in Lambdale. This is a traditional Yorkshire Dales market that dates back many, many years and is held come rain or shine. Stalls are set up in and around the square and all manner of produce is available, from leather belts, hot water bottles and woollen bobble hats to dog beds and second hand paperbacks and CDs. Locally sourced fruit and veg is the best value around and only the very strong-willed will get past the home-baking stall without making a purchase.

On a fine day, sit outside Delicious or the local pub, have a coffee or something stronger and drink in the atmosphere. Then treat yourself to a new shirt, a climbing plant, a bag of stuffed olives or some bird food! The list is endless. You might even find a long lost antique at the bric-a-brac stall and if you want a new rug, then look no further.

On the three Wednesdays in the run up to Christmas, stall holders dress in traditional Victorian costume, which gives an authentic and festive feel to the market. Hot snacks are available.

Owing to the stalls, no parking is available in the square on markets days but there are nearby car parks, which are seldom completely full. Please do not block the entrance to the medical centre, for obvious reasons

9th of April ·

Dr John Britton is the senior partner at the practice. He's a traditional GP, who is not overly enamoured of all the changes that have taken place since he started and is looking forward to a well -earned retirement. He favours cord trousers, tweed jackets with leather elbow patches and checked shirts. Despite the current trend not to wear a tie, he continues to do so but makes a concession to the latest guidance by tucking it between two buttons. He was not happy when the CQC (Care Quality Commission) suggested that his desk was cluttered by photographs and they should be removed.

As senior partner he has to deal with many aspects of running the practice, decision making and dealing with complaints; though the latter are few, they have increased a little over the past few years as patients' expectations have changed. Somehow, though disillusioned at times, he manages to cope and avoid stress, unlike some of his partners.

Married to Faye (famed for her meringue making) for many years, they have a grown up family, a cat and a dog. He values his family time enormously and enjoys gardening.

10th of April ·

Extract from the practice information leaflet....

House calls

Please make every possible effort to attend the surgery to be seen. This is very helpful for the doctors. The practice area is very large -remember we are a rural practice- and in the time it can take to do a house call outside of Lambdale, several patients can be seen at the medical centre.

However there are instances when patients genuinely cannot attend and then the doctors are more than happy to undertake home visits.

You may like to speak to a doctor first to see if a visit is necessary. The receptionists can arrange this for you.

Requests for house calls should be received, preferably, before 1030 hours, enabling the doctors to plan their day. You may request a specific doctor to ensure continuity of care. After this time there is one doctor (duty doctor) on call for urgent requests for the rest of the day.

Please remember that the doctors time is precious and not to be wasted. An example of when not to ask for a home visit is the lady who rang asking for her young child to be seen as he was too ill to come to the surgery. When the doctor visited, the child was out playing in the garden.

Also remember please that when the weather is bad or in the height of the tourist season when the traffic is heavy, the doctors have just as much trouble getting to you as you would have getting into the surgery, so these are not reasons to request home visits.

Teviotdale Medical centre thanks their patients for their continuing support and understanding

11th of April ·

Dr Eleanor Bonnington has been working happily at the practice for some years. Unlike Dr Britton, whose preferred choice of clothing has a rural feel to it, Dr Bonnington likes smart, well cut, fashionable clothes and well, in all honesty, would look good in an old sack.

Happily married to Ian, who is not medical in any way, shape or form, they have twin daughters, two ponies and a variety of other animals. The number seems to be ever increasing. She is a good cook and is one of those enviable people who seem to be able to juggle work and home seamlessly.

Though offered the post of trainer to young doctors pursing a career in general practice when Dr Britton decided that the time was right for him to stop, she turned this down and was delighted, as were the others, when Dr Clare Jennings jumped up to take on this particular challenge.

Her particular interests are women's health, contraception, dermatology and mental health issues.

She works full time Monday to Friday apart from Tuesday afternoons

12th of  April ·

A bit more about the author...

As a child, I was always writing stories and plays. My first full length novel, completed when I was fourteen was entitled 'The Team of Britain' and was all about a group of children and their ponies - the sort of books that I read by the dozen and the lifestyle that I would have loved. I still have it, in a folder in one of the kitchen drawers.

Studying soon become all-embracing. Medical school held me captive, as did the first jobs after qualifying. In those days (which makes me sound ancient) working in excess of a hundred hours a week was the norm, but funnily enough, I loved every minute of it and learned more than I can say.

Hell bent on being either a bowel surgeon or an obstetrician, I had set myself a challenge but changed my mind as I rose higher in the ranks because I realised I was moving away from the aspect I loved best - that of talking to the patients and getting to know them, warts and all. Hence the move to general practice and the good fortune to be offered a partnership in Harrogate, North Yorkshire.

Like John Britton, Ed Diamond and Clare Jennings, I was a GP trainer for many years, working with a younger doctor who was training to be a GP as well. A stimulating role which I thoroughly enjoyed and many of my trainees still keep in touch, which is lovely.

It was time to leave though, last summer. GP has slowly been eroded around the edges, taking away many of the parts of the job I enjoyed most. Better to quit while I was ahead of the game and I haven't looked back. Now I have time to write, think about things other than work, enjoy life, my animals and other hobbies

13th of April ·

Dr Clare Jennings was so excited when she was offered a partnership at the Teviotdale medical centre, one of the reasons being that her husband David had also been offered a post at the local hospital as consultant psychiatrist. Everything seemed to be falling into place at the right time.

She is a victim of her own success. A perfectionist, she puts work above everything else, going in early, coming home late. Always worrying, with a tendency to lack of self esteem, she goes above and beyond for her patients, fearful of complaints and criticism.

David would love to have a family - their life plans always included this - but Clare worries how she could combine this with work.

Buoyed up by positive feedback, she was delighted when Dr Britton asked her to take over from him as trainer but would this new role just add another dimension to her worries?

In Out of Practice, Clare's personal and professional lives start to implode simultaneously.

How will she cope?

14thfof April ·

One day, some years ago I was on the verge of taking a cervical smear (pap smear) from a patient who was clearly very nervous. To put her at her ease, I commented that this was a procedure that I hated to have done to me, as most women would agree. With genuine amazement, she asked if I really had to have smears too, being a doctor.

Doctors are no different to other people. They are human, vincible, weak at times and just as prone to ailments, worries, obsessions, doubts. There is nothing superhuman about them. Without a doubt though, they are masters at putting on a facade however they feel, ever the professional.

My characters are just as fragile and fallible. Their lives are by no means perfect. They struggle with stress, personal problems, comfort eating and marital worries. What their patients see is only a tiny part of the jigsaw.

Why not have a look at Out of Practice and also Faith, Hope and Clarity and find out more?

16th of April ·

Dr Edward Diamond, Ed to his friends, is the newest partner at the medical centre. Brought up in the Lake District, he is tall, slim and athletic. He lives in the town though with every opportunity that arises, he's off into the Dales or further away climbing or/and cycling. He has the enviable ability to cope with what life throws at him, managing situations as best he can, rather than letting stress get to him.

He works hard, as do all the partners and has a particular interest in rheumatology, sports medicine and dermatology and is the only partner who does joint injections. He sometimes wonders why his female partners take so long with some patients but, having said that, he is empathic and understanding.

He shares the training of young GPs with Clare.

At the time of writing, he is single but then things change, don't they? After all, he's a very eligible young man.….

17th of  April ·

Notice to patients

Please note that a routine appointment with a doctor is 10 minutes long. Emergency 'on the day' appointments are only five minutes long. This time is precious, so please use it wisely.

Please do not use the emergency appointments inappropriately. They are for urgent, acute conditions only. Bringing chocolates in to bribe the receptionists (as happened last week) does not work!

Nowadays, the expectations of patients are not directly proportional to the amount of time the doctors can give. For example, it is not possible in ten minutes to perform an 'MOT' or full medical examination. Often it is not possible to discuss more than one problem within this time either. Start by telling your doctor what it is you wish to discuss and be prepared to be asked to make further appointments so that you may be given the best possible attention.

We endeavour at all times to see patients as soon as necessary and offer convenient appointment times in but please remember that some flexibility is vital on both sides.

18th of April ·

A bit more about the author....

When I first qualified as a doctor, I was working on a surgical ward. Quite honestly, one of the best jobs I did. The hours were very long, I was on call every other night and alternate weekends - a weekend being from Friday morning until Monday evening. But I didn't care. I saw so much, learned more than I could ever have hoped and was lucky enough to have inspirational seniors to teach and help me that I didn't mind feeling tired. I wore a long white coat, the pockets weighted down with reference books and notebooks so that I could record the consultant's instructions every ward round.

Being the first point of contact for the patients, I was the doctor who got to know them best. I met the weird and the wonderful. The retired ambulance driver who put his thermometer in his tea so that he could stay in hospital longer, the woman who put purple makeup around her eyes to look more ill than she was, the man whose appendix I removed -my first operation, the elderly lady who hadn't cut her toenails for many years and had what appeared to be curly ram's horns intertwined around each other as a result. And who can forget the young man on his stag night who ended up with something rather unusual up his bottom which had to be removed?

Wonderful days and nights too. I drove an ambulance down the ring road at 0200 one night while my patient was being settled in bed, I ate jam sandwiches made with doughy white bread from the ward kitchen to keep me going and was affectionately known as Dracula when I approached patients to take blood.

A happy and delightful start to an all-consuming career and the job inspired me at that point to pursue a career in surgery.

Watch this space to find out more.

19th of April ·

Faith Hope and Clarity

Dr Faith Faber works at Teviotdale as a locum, filling in for a doctor on sick leave. Rather shy, insecure and lacking in self-confidence she is desperate to be liked and fit in.

She lives at home with her overbearing mother, who takes every opportunity to dent what little self-esteem Faith has.

Like many women, Faith believes that happiness equates to being slim and beautiful and if she can attain this status then love will surely follow. Food to her is both a reward and a punishment and comfort eating features high on her agenda.

Despite her own personal demons, she's a good doctor and cares about her patients, determined to help one in particular, who also has weight issues.

Away from work, she likes to wine and dine, cook and ride calm, well behaved horses.

Want to know more? Why not read the novel?

20th of April ·

More author memoirs!

Having done the statutory six months on a surgical ward, where every minute was wonderful, I was then catapulted onto a medical ward, specialising in diabetes, run by two scary consultants. If I thought they were bad, the sister in charge of the ward gave a new meaning to the word terrifying. With a large bosom trying to escape from a uniform that was too tight, she worshipped every move one of the consultants made but had no time for junior house doctors who were still wet behind the ears. It was a much harder six months that the surgery as I felt less well supported and found the complexities of diabetes (we only saw the poor souls with terrible complications, which gave me a completely skewed idea of the condition) baffling. I had already decided that I wanted to pursue a career in some sort of surgery and longed for the job to end. Half way through we moved all the patients from one hospital to the brand new one, where the corridors were miles long (in the dead of night, it was useful to resort to a bicycle) and the on call room had no windows so you had no idea when you woke up if you got any sleep which wasn't often) of whether it was night or day - a disorienting feeling.

I decided it was time to move on for my next job - now was the time to start to specialise and much to my amazement (because I was female and surgeons were traditionally male) I got a job in London, six months teaching anatomy to med students (giving lots of time to study for vital exams) and six months in Accident and Emergency.

More soon.…

21st of April ·

So, bags packed into my trusty little yellow Renault 5, off I went to London, to seek my fortune. First mistake - having a car in London. But it did mean I had an escape route at the weekends, for it rapidly turned out that living in the capital held little appeal.

The first six months were spent as something called an anatomy demonstrator. Essentially, this meant you taught that subject to first and second year med students, while you studied for your initial surgical exams, without which, nobody took your career choice seriously. They were notoriously difficult to pass but by being in London, it meant I could enrol on a course that ran every evening and Saturday mornings by two erudite, elderly professors, who were amazing. Even to this day, I can still recite some of the things I learned and my parents, were they still alive probably could as well, as I used to revise out loud at home. Wonderful are the parents (not medical in any way) who support their daughter by letting her talk through the intricacies of the intestines while eating lunch.

The students were hilarious. From the brash, confident ones to the shy and naive eighteen year olds who had no idea of the anatomy of the opposite sex -yes, really. One told me (after I had explained) how he had been on medication at school to help with the stress and I just felt so sad for him, knowing what was yet to come in his life. I often wonder if he finished the course.

Of course there were two rather eerie men who wore long white coats who looked after the cadavers. They seemed to be able to move round the room without making any noise and had a habit of creeping up on me to make me jump.

I don't think I have ever studied so hard in my life but at least there was no worry about working overnight on the wards. I missed the patients though. Fond as I was of my cadaver, they don't answer back and exams passed (yes!) it was time to move into A&E..

22 April ·

Memo from Elliott Douglas, practice manager to all partners, doctors, nurses, reception and administration staff......Please put the accompanying posters in prominent places in the the waiting areas, reception area, nurses area and on the front door*

New health and safety rules have meant the following changes. No magazines, books or newspapers in the waiting areas.

All the children's toys have had to be cleared away as they are deemed to be an infection risk.

We apologise for any inconvenience caused.

*secretaries please contact Mr and Mrs Kimblewick and say there is no need for them to bring in any more old copies of the Knitting Gazette and Fishing for Compliments (the local angling club newsletter).

Additional memo to partners and doctors, practice nurses.

Please remember, male doctors, no ties because of the infection risk. Ladies, no engagement rings or other jewellery. Simple wedding bands are acceptable. Please roll sleeves up to the elbow

Secret PS from Elliott -what is the world coming to?

23 April ·

Back to the author's memoirs!

Accident and emergency was fun. Perhaps not the most traditional of departments as, being in the centre of London, we saw virtually no road traffic accidents. Plenty of other, rather stranger cases passed through the doors however - the patient with a Victoria plum stuck in an intimate part of her anatomy, the patient who was covered in blood, who, it turned out had just sacrificed a chicken and a TV newsreader with a sprained ankle (I have had very few brushes with fame.)

Two, or rather three patients stand out.

A large part of our clientèle were vagrants who lived in cardboard boxes on the neighbouring streets. They would come along, mainly to get warm, with a variety of unlikely complaints, hoping for either thick bandages on their limbs (good insulation against the cold) or, if their luck was really in, a bed for the night. They knew all the tricks - it was remarkable how many had left sided chest pain...

One morning it was ferociously hot in the department. The sun was beating through the windows and the nurses had put some large fans on the floor to keep the air moving. One of the afore-mentioned vagrants was sitting in a chair with his trouser legs rolled up to his knees, complaining of ulcers on his legs. As I walked to see him, I could see his legs were covered with scaly, dry skin, which seemed to be fluttering in the breeze from the fans. However, when I bent down to examine him, I found that this was not the case and his legs were covered in writhing maggots (I hope nobody's eating while reading this). We picked them off one by one -hundreds of them and lo and behold, beneath them the ulcers were spotlessly clean with no sign of infection. An unusual treatment but one used to this day. In his case - well, he was just lucky. He referred to them as his 'little friends'.

My other memory is rather sadder. A very well known person was brought in after a cardiac arrest. On occasions like this the junior doctors would attempt resuscitation, the junior anaesthetist on call would come down to the department to help and the medical registrar on call would appear also. Not so that day. Word spread like wild fire and before I knew it, consultants were pushing us lowly mortals to one side and arguing between them about how to bring this patient back to life. The patient, who had died, was kept 'alive' on a ventilator and transferred to intensive care, where needless heroic acts were performed, all to no avail. Reporters swarmed in and out of the hospital, most having borrowed white coats and stethoscopes so they could get nearer the action. And all because this patient was famous.

The following week, someone collapsed at their grand-daughter's wedding. The usual team of junior doctors attended and were unable to resuscitate, despite their best efforts. I can still remember the string of pearls around her neck. RIP.

But why, oh why, one rule for the famous and another for someone who was not famous but doubtless adored by family and friends. There's something wrong, very wrong there.

24th of April ·

To patients:

Thank you to all of you who helped us by filling in patient satisfactions questionnaires during the week 7-14th April. We have now had a chance to look at these in detail. A total of 491 questionnaires were received. 3 were spoiled and could not be used (ink blots, spilt urine sample, writing illegible). Full results are available on our website but we are proud to be able to say that

95% of you think our service is excellent

92% of you think it is very easy to get an appointment on the same day

94% of you say it is very easy to see the doctor of your choice

89% of you were totally happy with the reception staff

97% of you were totally happy with our house call system and duty doctor system

We have taken note that four of you would like a vending machine in the waiting area so that you can have a cuppa while you wait to see the doctor. Some of you think the chairs are uncomfortable. One of you would like Dr Jennings to be cloned and one of you thinks that Dr Britton needs a new jacket.

Overall our results were of a very high standard and we are delighted though we are aware that there is always room for improvement.

During the month of May, individual doctors will be asking you to fill out similar questionnaires with respect to your consultations.

We thank you for all you assistance. Without you as patients, this practice could never hope to be as hard working as it is......

Signed The Partners

25th of April ·

As the surgery is closed (well, it is the weekend), here's a bit more about me. Now where had I got to?

A year in London was more than enough for me. For the last few months, I was escaping back home to Hampshire with every opportunity I had and my next job was on the south coast, at a teaching hospital, as senior house officer in obstetrics and gynaecology. I still wasn't sure whether I wanted to be a bowel surgeon or an Obs/Gynae consultant so this seemed like a good post to do for six months. It was a busy unit and I was run off my feet but because of this I learned so much very quickly. I loved the maternity work. Every delivery was magical -even when a Mr and Mrs Barr called their son Mars. Yes, really.

Working for two consultants who specialised in infertility was fascinating. Poor women with a history of recurrent miscarriage brought into hospital and made to lie in bed from the moment they had a positive pregnancy test until they were past the 12 week stage. Not many of them made it so there was a lot of sadness and breaking bad news.

At Christmas, I was informed that it was traditional to dress up on the 25th. A motley crew set off on the ward round. In charge -the senior registrar dressed...predictably as Father Christmas. Next (because of course we all had to walk in order of importance) the very good looking registrar, dressed.....predictably as a nurse. Boy - do men have it easy. Then the two senior house officers -my friend as a show girl in sparkly leotard and tights, plus feathers adorning her derrière. The effect was spoiled somewhat because her husband insisted that she wore a cardigan on top to cover her modesty! And finally me as ....The Pink Panther, complete with tail.

So, imagine you are in the final throes of labour, your contractions are coming thick and fast, you're sweaty, cross, excited, exhausted, wanting to push and in comes this bizarre entourage who ask you how you're doing. Enough said.

I rented a room in a rather nice house while I was working there, having had enough of doctors' accommodation to last me a lifetime. It was owned by a personable, well to do young man, whose girlfriend used to do his ironing while clad only in her underwear. Well, at least it wasn't his underwear. I think they both thought I was an odd being as after a 36 hour shift I would arrive back and go straight to bed, sleep for 12 hours and go back to work, while they sat and drank G&T or went out in his smart car.

I was offered a post for a further six months, as senior senior house officer (read carefully -promotion!) but I was keen to go back to Nottingham, where I still had a lot of friends. I had decided that Obs and Gynae was for me and managed to secure my next job as SHO in gynae, so (good job all my possessions fitted into my car -I'd now moved onto a little red VW Polo) I packed up again and moved North.

26th of April ·

Back in Nottingham -what a great city. Ye Olde Trip to Jerusalem for some culture, Yates Wine Lodge for a glimpse of real life, The Bell for Sunday jazz. It was good to be back. Even though I was still a senior house officer, people were taking my career intentions seriously and my consultants were hugely supportive. I finally started doing more surgery - laparoscopies, sterilisations and various minor procedures which were the bread and butter of the operating lists. On the Labour ward, I was allowed to perform Caesarian sections, various types of forceps delivery, vacuum extractions and breech deliveries. Even one set of twins.

Nail-biting moments, one after the other for delivering babies is a heart in the mouth job. You're dealing with two lives (maybe three or more), not just one.

It was a ferociously busy unit with over 7000 deliveries a year. I would crawl into bed, thinking the unit was quiet only to be woken 30 minutes later to find that another bunch of women had been admitted in various stages of labour. I was either asleep or awake. My social life was at a standstill. I would go home to my parents and fall asleep mid-sentence but still I loved every minute and thought that this was what I wanted to do for ever. But I wasn't one hundred percent sure and on a whim, applied for a surgical job on Orkney, thinking that it would be something completely different and at the same time not believing that I had any hope at all of getting the job.

At then end of one antenatal clinic (Stevie Wonder's 'Isn't she lovely' was playing in the waiting area) I was paged and my colleagues joked that it was Orkney calling. I laughed at them but it was.....and they were offering me the job. I accepted but wondered if I had done the right thing when I looked at the weather map that evening and saw how far away it was.

That Christmas, all the junior doctors got bottles of wine from their consultants. I got a pair of thick, striped socks. They turned out to be very useful.

27th of April ·

The medical centre is indebted to one of our more frequent attenders, (obviously we cannot divulge any further medical details but he is well known in the area) Ian Watkins for his fabulous aerial shots of Lambdale. The more observant of you will be able to spot the medical centre roof just to the right of centre plus other notable landmarks that make where we all live so perfect. Thanks again Ian (ps your prescriptions are ready for collection.)

28 April ·

Author's ramblings continued.....

The end of January is not the best time to cross the Pentland Firth. Actually, I wonder when the best time is as my return crossing at the end of July was not a lot better. Curled up in a ball on a bench (nobody was allowed on deck because it was too rough), eyes tightly closed, that was a long, long four hours. I had few human fellow travellers but more four legged ones and some vehicles.

Orkney is beautiful but not what you'd expect. Suddenly the dramatic scenery of the Highlands of Scotland is gone, replaced by far flatter terrain and a mysterious absence of trees.

The hospital is at Kirkwall, the capital of the largest island. There was one consultant surgeon, me and a junior house officer. On call every other night continued. We had one female surgical ward and one male, plus a three bedded obstetric unit for GP deliveries only. Anything we couldn't handle (which wasn't very much) was flown to Aberdeen. All the food for the patients was home baked on site and the afternoon snack was either scones or cake and as most patients were post-operative and too sleepy to eat, the doctors gobbled up most of these mouthwatering treats. I was told that most doctors left the island considerably heavier than when they arrived!

The most outstanding memory is that although we got through just as much work as we had done in a teaching hospital, nobody got stressed, cross or worried about time. Which says a lot, I think, about the way we work today. So much harrumphing and growling and angst simply isn't worth it.

Orcadians are wonderful, friendly people. There is little crime on the islands and everyone would help you out, or if they couldn't,they'd know someone who would. They are also incredibly generous and donated money to buy equipment for the hospital. I had the honour of being the first person to perform athe first laparoscopy ever on Orkney.

One weekend, I flew over to one of the smaller islands to do a GP locum. I arrived at the plane, had to be weighed and then sat amongst groceries as we hopped over to our destination whereupon we promptly landed on the beach, picked up some more cargo and then set off again, this time landing at a more recognisable landing strip. I was given my instructions. 'Just do what you want. Borrow our car. You've a surgery to do this evening but after that, patients will leave a message on the answering machine. Oh! And if you need to go over there' cue pointing to remote island, 'just ring this number and he'll take you over in his boat!'

Surgery was easy. Nobody was ill. They'd all just come to see who the locum was.

That night the wind howled and it lashed with rain and I lay in bed willing nobody to be ill on that island as, if I'd had to go over there, I'd have arrived in a state far worse than my patient.

Fortunately nobody did. I had one visit all weekend. Maybe this was where I started to get the urge to do general practice.…

29th of  April

Still on Orkney...

What's not to like about place where every corner you drive around, you are greeted by stunning views of the sea? Sparkling blue on sunny days, dark and treacherous in the rain. Dramatic cliffs, beaches, harbours full of fishing boats and everywhere steeped in history. Days of almost 24 hours light in the summer.

Fabulous seafood, lamb that tastes of seaweed because the sheep live on the beach, home baking wherever you go and Highland Park whiskey.

My medical experience there was unique. With a consultant who was prepared to try anything (he was often found in his office, reading up what to do before we started), this was the most general of general surgery. I removed a cyst the size of a tennis ball off someone's scalp (he'd been hiding it under his woolly hat), we did dental extractions (all that super-sweet tablet has its drawbacks), amputated limbs (aaaagh -smoking), rummaged in amongst the bowels and had a go at some basic urology and prostate surgery. Not many jobs would offer such training, in such relaxed atmosphere and I was sorely tempted to stay for another six months. In those days, when you compiled your own surgical training jobs, it was so fiercely competitive that I knew I had to move on, get back, albeit reluctantly, into the cut and thrust of a teaching hospital. I started applying for jobs, suffered the indignity of being turned down for a post in the South at interview because I was female (but being offered a lower grade post as a sop -grrrrr) and then amazed everyone - not least myself - by getting onto a surgical registrar rotation in Bradford -orthopaedics, general surgery and thoracic surgery.

So I had to say farewell to the beautiful views, the yummy cakes, the lovely lifestyle and head south again, with trepidation, to an environment that could not have been more different.

30 April at 18:35 ·

The medical centre is delighted to introduce you to our invaluable reception team. As your first point of contact when you either telephone or come into the building, they are extremely important members of our staff, without whom we would not be able to manage.

Joan is our head receptionist. Many of you will already know that she has been working for us for many years and has a wealth of experience in dealing with patients' queries and requirements. She is responsible, together with Elliot Douglas for training the younger receptionists and does a great job.

Elizabeth also has been with us for some years now. Before she became a doctors' receptionist she had parallel posts with the local veterinary group and nearby dentist. Her husband is a leading light in the amateur dramatic society.

It may be something of a surprise to you that we have a male receptionist, Gary, somewhat going against tradition but in the short time he has been with us, his people skills have proved him to be reliable and popular with everyone.

Gemma is our latest recruit. She's still learning the tricks of the trade but has taken to the job like a duck to water. She may have only just left school but her approach to the job shows maturity beyond her years.

We are very proud of them all. We hope that you like their new uniform -navy trousers or skirts and floral blouses (though Gary has a plain navy shirt with a floral tie).

Please treat them with the respect they deserve. It is not their fault if appointments are not available when you want them. Please do not try to intimidate them into doing what you want. This practice has a zero tolerance policy towards any aggression or rudeness. Patients who do not comply with this will be removed from the practice list without delay.

Thank you

Dr J Britton and partners