Heart Beat: Over the past few days I have had as house guests two English cardiac surgeons and their wives. We were contemporaneous in our careers in the good old/bad old days. Needless to say, such gatherings always open the floodgates of memory and remembrance of times past.
As we had all served through the great days of cardiac surgical expansion and lived to tell the tale, it was interesting to note that our perceptions of the past and our careers were broadly similar.
I suppose that telling my tale, with innumerable forays into the world of contemporary medicine and life, is what I am about in these columns.
My friends had served their careers in the National Health Service, whereas I, having worked there during my training, returned here, to our, in some ways, similar service.
Differences there were indeed, but I think the similarities were greater, and that in the delivery of medical care we were nearer to Britain than to Boston.
In our wide ranging discussions we were all agreed that we had enjoyed and found satisfaction in our professional lives. Some members of the rising generations who were present informed us that it was not considered "cool" to admit to liking your job.
It occurred to me that this may explain some of the demoralisation within our service, noted by Prof Drumm. I am equally certain, however, that such ennui is not universal, and that there are still many bright-eyed and bushy-tailed individuals in the system, anxious to achieve, and idealistic enough to hope to make a difference.
In our reminiscences, candid enough and certainly unaided by rose-tinted spectacles, we shared the same point of view on two other salient points.
Money, at the time we were non-consultant hospital doctors, was not remembered as a major issue. I think that was because there was so little prospect of us having any, we banished consideration of riches to the realms of fantasy.
The second point, in some ways allied to the first, was that long and anti-social hours did not impinge greatly upon us. All this was made bearable by the fact that in our junior days we were resident in hospital and based our social lives accordingly.
It also helped that in these early days we were nearly all single. Difficulties with hours and money came with marriage. That happy state didn't improve the money or the hours, but it sure introduced the difficulties.
We found that we were as one on the problems of training and experience then as compared to now. For us, virtually unlimited hours and smaller numbers of junior doctors meant constant exposure and the rapid acquisition of experience and, in our cases, surgical skills. You wanted to become competent and you wanted to do so as quickly as possible. We did not feel that exposure to branches of surgery other than our own were unnecessary diversions from our paths; rather we felt that they made us more rounded as surgeons.
So to the vexed question: how can those subjected to the European Working Time Directive, with its initially mandated 58-hour week, acquire the same experience as us grizzled old timers who spent so much time in the mines?
It would appear the unpalatable truth is that they will have to spend more years in training. The alternative is that hospital consultants be appointed earlier, with less experience and training. There is no easy way around this.
Interestingly, we all felt hospital structure and managements, be it lay, medical or religious, were more caring and personal than now. The hospitals, we felt, were more user-friendly, both for patients and staff. We also felt that the situation had deteriorated steadily on both sides of the Irish Sea, owing largely to political ineptitude and the mushroom growth of often poor administration.
The caring interface had become less important, rather than taking its rightful primary place.
Inevitably, we concluded that we were glad to have gone when we did. None of us had any regrets as we moved into the next stage of our lives, and none of us felt, rightly as it transpired, that our hospitals would simply collapse without us.
Until now, it has been axiomatic that the generations after us must be better than we were, otherwise there is no progress.
We worry, however, that this progression could be delayed in the future if the experience and training required could be diluted by nonsensical political correctness.
One is conscious of idealising the past and contrasting it favourably with the present. Memory, Goldsmith's "fond deceiver to former joys recurring ever" and Rene Dubos in his Mirage of Health - "Utopias are often but the memories of Arcadias" - point this out clearly. All right then, it wasn't Arcadia, but sure as hell this isn't Utopia.
Meanwhile, as I write this I have banished my good friends to circle the Dingle Peninsula in the gales and rain. Should they return safely, we may still be on speaking terms.
Mind you, they got to the Skelligs, courtesy of Richard Flinn, on a completely calm day, so things can't be all that bad.
Maurice Neligan is a cardiac surgeon