Meet Dr Nisbet
September 2017
I remember spending a lot of happy years in Scotland as a young child. Remember horse-drawn bread vans, milk vans and butcher vans, and paying for goods with plastic discs bought at the Co-op.
Not surprising. My father, James Gardner Simpson Nisbet, was a Clydeside Scot, Managing Director of a Marine Electrical Wholesaler. But my mother, Joan Harrison Nisbet, was from Wallasey, a town on the Wirral Peninsula, opposite Liverpool at the mouth of the River Mersey, and I was born there in West Kirby, Wirral, on 30th October, 1945. A brother, born in 1948, is my only sibling. He studied law, leading to an illustrious career with the CPD - Crown Prosecution Service, sometimes sarcastically labelled Criminal Protection Society.
My school years began at Pensby County Primary. More happy memories, now of long slides in the Playground, carefully crafted from ice and snow. My post War shoes with their green cardboard soles wore out in a week or so. Dad got seriously angry.
From 1957, now aged 11, I moved to Birkenhead School, a Direct Grant Grammar School. We attended for 6 1/2 days a week during term time, and I really enjoyed my time in the RAF Cadet Corps. We were being prepared to be officers in a war which, fortunately, hasn't happened. Besides which we also played lots of rugby and went mountaineering. We sat 'O' levels at 15, and at 17, 'A' levels. Birkenhead was an 'academic pressure cooker' school, and nearly all of us went on to University, with about 40% going to Oxford or Cambridge.
With about 12 doctors in our family, I have been exposed to the medical profession for my entire life. Two of my uncles were single-handed dispensing GPs in Yorkshire. The consulting rooms and dispensary were part of the house, and each house was permeated by the smell of Vitamin B. As a boy, just after the NHS began, I was impressed by their dedication, their distress when treatment was not going well, and their joy at successful outcomes.
In each case, the wife, my aunt, was the strength behind the throne and the whole set up used to fascinate me. My uncles would take me across the moors on house visits and invariably I would be fussed over and plied with lemonade and biscuits. Not surprising that from the age of about 4 years I'd wanted to be a GP, and everything in my education took me towards that destination.
After 'A' levels, I gained a place at Cambridge to start in 1964 to be followed by clinical studies at The London Hospital from 1966. So, in September 1963, I returned to Birkenhead School to prepare for Cambridge. But a week after the start of term, The London Hospital asked if I'd like to start there straight away, and in October 1963, shortly before my 18th birthday, I left home in a bit of a rush, started at The London Hospital, and qualified in spring, 1968, at the age of 22 years.
After qualifying, I spent time at The London Hospital as Orthopaedic Houseman. I enjoyed this mightily and spent most of my theatre time helping to install artificial hips, operating on hands, looking after the wards, and the occasional private patient.
Next, I became Houseman in Cardiology and General Medicine at Redhill General Hospital and got used to the 24/7 'on call' system. I even had a bed on the ward! My consultant would telephone me at 0600 every morning to ask, 'How is everybody today, Ian?' This usually found me in the bath, having nipped back to my flat after the night on call, so I took to phoning him at 0545 with the latest news.
During this time, there was a Jumbo crash at Gatwick airport, a short distance away. We started treating survivors on Saturday afternoon and I didn't get back to my flat until Wednesday evening. An Air India flight, most of the victims were Indian, stripped of their skin by the flames and covered in kerosene and mud from the crash site. Many of our patients couldn't be saved. We found it a harrowing experience and the sights and smell of the event still live with me.
My next job was as Senior House Officer in Obstetrics and Gynaecology at the same hospital. This was a stressful time, as I was on my own whilst the Registrar was at Crawley Hospital, 8 miles away. It, too, was a 24/7 job with most of my time spent looking after pregnant mothers, doing forceps deliveries, stitching up after delivery, assisting at Caesarian Sections, and - regrettably - performing terminations of pregnancy. Termination was not legally available until the late 1970s.
At this time, I earned £70 a month, and paid £15.7.6d a month for my flat.
After Redhill, I spent seven years as a GP in Crawley, took further qualifications, and acted as local consultant in the Family Planning Clinic. The contraceptive pill had not really found favour yet, and most of my time was spent fitting diaphragms, or caps, training the ladies how to use them. Altogether an unpleasant method of contraception disliked by doctors, and the patients who had to put it in. No doubt many older readers will have memories of this time.
Six years later, to earn money for a holiday, I did a locum for 2 weeks in Glemsford and Cavendish near Bury St. Edmunds. This taste of country practice so enthralled me that I set about finding for myself a single handed dispensing practice. Which is how I ended up in Feltwell in September 1977.
Moving to a new house and starting a new practice was quite an upheaval. I was on call every night and worked all day. The favourite greeting at the time was - 'We get rid of our vicars and kill our doctors!' Unsettling, but I soon got used to it.
On my first night I visited patients at 1.30 am, 3.15 am, and 5.15 am. The rule then was that if you needed a visit, you should telephone before 7.30 am. Every morning at 8.0 am I would go to the Garden House in Methwold, where Mrs. Ruth Goddard hosted the branch surgery. Fortified by a really strong cup of tea I would do several visits before morning surgery which started at 9.0 am, and went on until it finished.
During the surgery, I did all my own dispensing from the small dispensary. I did repeat medications during the day, making up bottles of white medicine (getting them to mix was a nightmare), cough mixture, and so on. I remember using a lot of Lin Meth Sal (like horse liniment) for musculoskeletal problems. The favoured cough linctus was 'Covonia' and High blood Pressure seemed to have only one treatment - Aldomet - the dose of which was increased progressively until control was achieved. If we failed to achieve control, the condition was called Malignant Hypertension and was often fatal. There were none of today's carefully refined therapies.
Evening surgery started about 6.0 pm and went on until it finished - usually towards 9.0 pm. All the repeat medications were left in the porch for patients to collect, with an honesty box for the prescription charges - 2 shillings an item in those days, equal to 10p today.
All telephone calls came into the house and either the doctor or, during the day, his wife, would answer the patient and deal with the matter. In my early days, there was a very small waiting room which would hold about 10 patients. This was luxury as, beforehand, there had been no waiting room and patients had to wait outside. In the early 80s, we built on a large waiting room, a secretary's room, a nurse's room and a WC for the patients' use.
I have one serious regret about the extension. Under the far corner of the building, on the side nearest the house, there was a beautiful chalk-lined well. Because it was exactly where the corner of the new building was to be, we had to fill it in and build over it. If we'd had time, we'd have redesigned the building, kept it, put a light down it, covered it with thick glass, and kept it as a wonderful feature.
Gradually, the new premises became inadequate. As a result, in 1991, Deannie and I designed a new surgery. Joe Bamford from Mundford built it. Of course, there was an Architect involved, and Alan Bunyan, a Quantity Surveyor. The new surgery is still in use, modified and extended to fulfil today's needs, but fundamentally the same building.
General Practice in the 1970s and 1980s was a way of life, not a job. The GP had to live in the village and to be available 24/7 for callouts and we were often 'first attender' at road accidents. Most of the time, I was exhausted. It was a great relief when we took on partners and, as they would say now, 'grew the practice' for the future.
I retired from the practice at the end of 2005, after 28 years. It was a terrible wrench as I had so many wonderful patients. It's a great pleasure to meet them around the village, as many are great friends. Between 2005 and 2016 I did locum sessions, mostly at Boughton, but also at Feltwell, Brandon, and Lakenheath.
This came to an abrupt halt in June 2016. I took six weeks leave for hip surgery. The replacement, followed by recurrent dislocation and yet another hip replacement, and more surgery to 'tidy things up', stopped me working because the anaesthetics had blown my memory and my faculties in general. I had to take myself off the medical register. I miss the work terribly and I still feel that I have let down many of the Boughton patients. My hip is still very troublesome and incapacitating. Must say, though, that 96% of total hip replacements are completely successful. Its only about 4% which go wrong.
Whilst in practice, I had always thought that acupuncture could be really useful. About 20 years ago I took the qualifications and, as expected, it proved to be a very powerful form of therapy, much appreciated by many of the patients.
One of the fun things I've loved to do is to travel in anything that floats, from Cruise Liners to little ferries. We shared a cabin cruiser with close friends for nearly 40 years. And I love anything powered by steam.
For some years, Fred Olsen Cruise Lines used panel doctors - that is fully qualified and experienced doctors who had to do further training to practice at sea - including sea survival training. The doctor was paid half the fees collected from the patients and Deannie and I enjoyed several cruises with a lot of hairy moments thrown in. The tales could fill a book and could form the basis of future articles.
I've been very happily married to Deannie, otherwise known as Management, Head Office, Lollipop - from her time leading tours on the Fred Olsen ships - or Bluebell lover, for 31 years. We have seven children and eighteen grandchildren, all of whom are absolutely fantastic and a pleasure to be with. I could write about them all for hours. Sounds like the basis for another batch of articles!
I have loved living here in Norfolk, this beautiful area of the country. But my favourite parts of Norfolk are those places with a steam railway. I'd like to visit the Isle of Man, a land full of steam trains and trams. In 1960, my father in his capacity as marine electrical wholesaler, fitted out The Manxmaid with a sprinkler system. She plied between Liverpool and the Isle and I shall never forget the look on his face when he answered the telephone to be told that during its maiden voyage all the sprinklers had 'gone off' half way across the Irish Sea, soaking everyone on board.
Mind you, Thursford and Bressingham are good for a day out for steam train enthusiasts. Our new house in Worcestershire is very near the Severn Valley steam railway, and we are both hoping to become volunteers. Anything powered by steam fascinates me. Driven by paddles powered by steam, the Waverley floats down the Clyde. My father first took me on it to Tighnabruich when I was 5 years old. My last trip was a year ago from Felixstowe to Tower Bridge.
One thing I wish I'd done was learn to play the organ properly. My brother learned at school and I have spent the last 55 years sorry that I didn't. However, I did have a good choral training which has given me a lot or pleasure through life. I was choirmaster and churchwarden at St George's Church in Methwold for many years. However, I must confess that I have strenuously avoided joining the parish council!
Eating out? I must say I've most enjoyed eating at a restaurant in Soto Grande where they cook massive lumps of Argentinian steak - my favourite food - in the corner of the room. They do say that if you eat steak every night for 13 nights, you will be unable to face it on the 14th. I tried it in Madeira and its true! On the 14th night, I had to have pasta.
Close to home, I like the Wellington in Feltwell.
Pets? I've had several golden retrievers, the pride of the bunch being Jemma. She was a superb dog and, since she died about 20 years ago, I haven't been able to replace her. No other dog would come up to her standard. Management and I have had two cats, both really good companions. But their deaths made us really sad and we have not replaced them.
We love the theatre, but only visit once or twice a year, the same with the cinema. I'm a very selective TV viewer. I still like a good read. As a child it was Arthur Ransome and the Hotspur comic. Now I enjoy Lee Child (Jack Reacher), Ian Rankin (Rebus) and Andy McNab and others.
Generally, I hate shopping. Mooning about in a store just looking to see what we might buy is anathema to me. However, there is one exception to this. I like the Brandon Aldi. I always walk slowly past the ever-changing variety of tools, wonderful workwear, electrical tools and metal paints. They often convince me that I really need them, especially as the prices are so reasonable, and they do make good Christmas gifts for the family. And when I pop in for something, it’s an hour or two before I come out having met many of my old patients and stopped for an enjoyable chat.
You all know my pet hate - Spanish bluebells! The bluebell saga has caused much fun over the years. People have 'taken the mick' without mercy, even sending me pictures of bluebells and - heaven forfend - actual plants. Dr. Giselle Sagar, my medical colleague, hung a massive picture of bluebells in her consulting room. As I'm sure you know, English bluebells are floppy, about 6 inches tall with minimal greenery. They are welcome in our garden.
Spanish bluebells try to take over, and left to their own devices they succeed. They can grow to 3 ft 6 ins (as confirmed by Management when I gave her one together with a tape measure). Roundup, weed suppressant membrane and digging up have kept them under control. The English are flourishing!
My other pet hate is bindweed - convolvulus. It tries to climb everywhere, Its white roots must be dug up intact. An inch left behind will sprout a new plant. Our garden has about two feet of soil over solid chalk. I have dug out all the soil, sifted it of bindweed and replaced it. On the whole this has been successful, but the wretched stuff still tries, and gets rapidly bashed with weedkiller.
Well, enough is enough - and I think I have come to that point for now. But you have seen the hints. There is still time for more stories as yet unpenned, to fill 'Village Pump' issues as yet unprinted. Watch out for them!
Ian Nisbet
Edited, on behalf of The Village Pump, by Jean Marler