BOOK REVIEW

Baskett T. The Dog Comes with the Practice: Tales of a Junior Doctor in Ireland and Canada. Clinical Press Ltd. Bristol, U.K., 2020.

Having been associated with the medical school of Queen's University Belfast for over 55 years, I read the little book by Professor Tom Baskett with great interest. Drawing on his extensive diaries and records, it is an account of some of his noteworthy reminiscences gathered during his medical education as a student of medicine in Belfast over 60 years ago, his time as a residential junior house doctor in the Royal Victoria Hospital Belfast in the early 1960's and then his post-graduate experiences as a trainee in obstetrics in Belfast and Canada. Shortly after his year as a house doctor Tom married a nursing sister, and consequently she was required to resign from her post and take a substantial cut in her salary. In order to supplement their income Tom took on various locum posts in general medical practice. The title of the book “The Dog comes with the Practice”, is derived from his first locum GP position in a country town to enable the incumbent doctor to take his family on their summer holiday. The proceeds of that locum paid for Tom's honeymoon.

After gaining fellowships in surgery and obstetrics during training in the Royal Maternity Hospital Belfast Tom and his young family emigrated to Canada. In the NHS, promotion to the rank of consultant was slow in the 1960's and 70's, since there was little expansion in the number of senior posts. Excellent trainees were obliged to wait for senior consultants to retire or die in post - or to emigrate.

Having arrived in Canada, Tom describes some of the situations that he encountered in Winnipeg, Manitoba and an outreach service in Churchill on the edge of Hudson Bay, largely populated by members of Inuit tribes. Tom went on to have a successful career in academic obstetrics and medical education in Canada finishing as a professor in Halifax, Nova Scotia. The current narrative does not cover his later career.

In the early 1960's the NHS was less than twenty years old. The education of medical students had scarcely evolved from the systems and practices that were prevalent in the early part of the twentieth century. In the second half of their course, students lived and worked in the wards of the teaching hospitals as unpaid apprentice doctors. On the basis of “see one, do one, teach one” they learned their skills largely from more senior trainees who were progressing slowly towards consultant posts. Surgical skills were gained from assisting in operations, performed by registrars and consultants.

While attached to the cardiology unit run by the influential innovator Frank Pantridge, Tom learned the novel techniques of CPR (cardiopulmonary resuscitation) and external cardiac defibrillation to revive patients who otherwise would surely have died. Later he worked with the Professor of Medicine. Having witnessed Tom and nurse successfully resuscitate a patient who had been admitted to his ward with a myocardial infarct, the Professor stated he would rather be allowed to die in peace.

Medical students and house doctors, while living and working closely together for long hours formed bonds of friendship that have sustained them and endured over the decades. Of the 59 graduates in the year of 1964, nearly 40 met up in Belfast in June 2014 to celebrate 50 years since graduation. I had the honour of meeting up with the group during that event.

Tom's description of life as a medical student and young doctor is authentic, told with humour and laced with direct quotes from colleagues and patients, often in the colourful Belfast vernacular, though I suspect some of the expletives have been toned down. The book is a valuable account of a system of training that is now part of history. That system produced competent, resilient Belfast graduates who practiced successfully throughout the world.

Dr Stanley Hawkins, Honorary Archivist, Royal Victoria Hospital, Belfast BT12 6BA