Describes attending school in cold substandard buildings. Preferred self-directed learning to rote memorizing. Her love of nature and science was evident early and evolved into her passion to follow medicine as a vocation and career, despite the opposition of her parents and GP who feared it would be a hard life especially for a woman.
Reflects on the deficiencies of medical training in University College Cork, especially the deliberate use of fear and humiliation in teaching which has left a negative mark on her and other colleagues. Suggests that the need to imprint so much information through humiliation is no longer necessary due to improvements in technology.
Outlines her career path through various roles, experiences and responsibilities including working in Accident and Emergency and time in New Zealand.
Discusses her impressions of Grattan Street Medical Centre both as a physical building with leaks and in disrepair and as a unique workplace with a community of multiple disciplines which function well together.
Speaks about her current work as an Area Medical Officer, the kind of patients she sees and typical issues that arise including developmental checks on babies and following up with parents.
Reflects on attitudes towards medicine and the HSE especially among parents, and how as a doctor she has to deal with this in order to achieve best outcomes for child patients.
Outlines the problems with Grattan Street staff car parking and the issues it cause.
Talks about the outlines of the history she has gleaned about Grattan Street Medical Centre Building as a Quaker Meeting House and as a public dispensary.
Speaks of the marriage registry office which is part of the Grattan Street building, where weddings happen during her work day creating a strange but joyous contrast.
Discusses the amount of paperwork and documentation required for all the work in Grattan Street that remains from past decades which fascinates her.
Reflects on her hopes and the possible futures for the Grattan Street Medical Centre building, and the fate of services that will move to St. Mary’s Primary Care Centre in Gurranabraher. Compares the two locations and emphasizes the importance of a good workplace culture within a building. Talks about possible patient attitudes to the new building. Hopes it will have a communal staff canteen.
Outlines the importance of administration staff in contributing to positive experiences for patients and facilitating the efficient work clinical staff.
Reflects on the difficulties of a medical career including 90 hour weeks, missing out on parties and travelling, and having to tell mothers that their babies have died.
]]>Edith grew up in Youghal where she recalls playing childhood games including Red Rover, chainey, a makeshift tennis and sandcastles on the beach.
Describes attending school in cold substandard buildings. Preferred self-directed learning to rote memorizing. Her love of nature and science was evident early and evolved into her passion to follow medicine as a vocation and career, despite the opposition of her parents and GP who feared it would be a hard life especially for a woman.
Reflects on the deficiencies of medical training in University College Cork, especially the deliberate use of fear and humiliation in teaching which has left a negative mark on her and other colleagues. Suggests that the need to imprint so much information through humiliation is no longer necessary due to improvements in technology.
Outlines her career path through various roles, experiences and responsibilities including working in Accident and Emergency and time in New Zealand.
Discusses her impressions of Grattan Street Medical Centre both as a physical building with leaks and in disrepair and as a unique workplace with a community of multiple disciplines which function well together.
Speaks about her current work as an Area Medical Officer, the kind of patients she sees and typical issues that arise including developmental checks on babies and following up with parents.
Reflects on attitudes towards medicine and the HSE especially among parents, and how as a doctor she has to deal with this in order to achieve best outcomes for child patients.
Outlines the problems with Grattan Street staff car parking and the issues it cause.
Talks about the outlines of the history she has gleaned about Grattan Street Medical Centre Building as a Quaker Meeting House and as a public dispensary.
Speaks of the marriage registry office which is part of the Grattan Street building, where weddings happen during her work day creating a strange but joyous contrast.
Discusses the amount of paperwork and documentation required for all the work in Grattan Street that remains from past decades which fascinates her.
Reflects on her hopes and the possible futures for the Grattan Street Medical Centre building, and the fate of services that will move to St. Mary’s Primary Care Centre in Gurranabraher. Compares the two locations and emphasizes the importance of a good workplace culture within a building. Talks about possible patient attitudes to the new building. Hopes it will have a communal staff canteen.
Outlines the importance of administration staff in contributing to positive experiences for patients and facilitating the efficient work clinical staff.
Reflects on the difficulties of a medical career including 90 hour weeks, missing out on parties and travelling, and having to tell mothers that their babies have died.
0.00.00 - 0.00.23 |
Intro |
0.00.23- 0.02.04 |
Games Played as Child in Youghal Grew up in Youghal. Children’s games: chasing games, Red Rover, What Time is it Mr Wolf?, Chainy. Elastics game: Long piece of elastic tied into a loop with a person at each end with complex rules about how to jump in and out and over and back. Played tennis: in the tennis club and also “over the gate”. It was the era of John McEnroe, Martina Navratilova and Bjorn Borg. Played a form of football. Made mud pies. |
0.02.04- 0.02.26 |
Describes game Chainy or Chainey in more detail Still played in her child’s school. One person catches another and they must keep holding hands and keep catching people until they are all holding hands in a long chain. |
0.02.26- 0.03.06 |
Describes Red Rover or Bulldog She didn’t like Red Rover. Stand in chain and chant “Red Rover, Red Rover, we call over X” Begins with 2 children holding hands and the person who is called over must try to run through their hands and break the link, which Edith says always hurt and as she was “quite small” she was usually the weak link. If someone didn’t break the link they had to join that chain. |
0.03.06- 0.03.47 |
Games on The beach Not much time in the water/sea because it was too cold. Made sandcastles, sand tunnels, forts, dams to keep the sea out or bring the sea in. These plans never worked and Edith says “you learned about futility as a smallie”. |
0.03.47- 0.04.38 |
Playing Without Adult Supervision Spent a lot of time quite bored in fields or on bikes. “We’d just head off on the bikes for the day: I don’t really know where we went or why we went.” Only television was RTE 1 and RTE 2- “Poverty 1 and Poverty 2” there was nothing to watch. Call to friend and come back when felt like it. No phones. Improvised ways out of problems. Reasonable amount of time without adult supervision. But there were always watchful adult eyes: “if you were doing something you shouldn’t be doing your parents would usually hear about it.” |
0.04.38- 0.05.00 |
Where not allowed to play Places not allowed to be on bikes when little: out the front on the main road where cars were quite fast. Not supposed to go on the back fields where there was a bull. (Suggestion in her response is that they may have not always obeyed!) |
0.05.00 - 0.05.16 |
Home Mum, dad and sister 3 years older. Mum was primary school principal. Dad worked Monday-Friday 9-5. |
0.05.16- 0.06.51 |
Primary School Remembers being cold and very bored. Went to school in “Park” on a crossroads on the top of a hill in the middle of nowhere. Where her mum was teacher. 2 teacher outside toilets and no central heating when she started school. There was a stove to heat the classroom very like the school in Muckross Farms. Two “boot rooms” or cloakrooms. Inside toilets eventually installed. Very few students. |
0.06.51- 0.09.50 |
Secondary School Went to Loreto in Youghal it was also very cold. Some years were in prefabs. The school was near the lighthouse. When you were bored you could look out to the sea from an old redbrick house which was left to the nuns. It was very exposed to the weather- wind, rain and salt spray from the sea-wall. Enjoyed maths and science. Lots of repetition in the schoolwork. Would prefer self-directed learning not just learning by rote. For people with other kinds of intelligence it wasted their potential and opportunity. Heuristic learning- learning through play and experience. She learned how to sew a button, balance a cheque book and pay a bill. Skills for living in the world: how to cook how to clean how to look after your physical health, mental health should be taught. |
0.09.50- 0.11.19 |
Love of Nature and Science leading to Medicine. Was always interested in nature and biological sciences: “mad about nature”. When 13 or 14 a friend brought a roadkill mink to science class to dissect it. The teacher was a bit squeamish, but Edith said she would do it “no bother”. Remembers “pure awe” at how remarkably perfect the insides were, “how it all fitted, and it all worked”. Had dissected earthworms before. Drifted then to wanting to do medicine. Set her heard on it. |
0.11.19- 0.14.09 |
Medicine as a Vocation, the Determination Required Mom and dad really didn’t want her to do medicine at all. They called in the local GP to tell her not to do it- which had the opposite effect. She applied for medicine at 16 when she sat her leaving cert for the first time and had to repeat it because she didn’t get enough points. In some ways in hindsight her parents were probably right. It is a hard life and requires working very hard for a very long time. Edith was a premature baby and was always physically small and thin and her parents were concerned. Her colleague with an Italian grandmother described the need to do medicine as being like a holy fire [Note: “sacro fuoco” maybe?] similar to a vocation but perhaps not spiritual. If you have this fire nothing else will do. She also applied for computer science. If she hadn’t done medicine in college, she thinks she would have gone back to do it later in life. Local GP told her it’s a very hard life for a woman- which is not the thing to say to a 15-year-old. Thinks the nuns that taught her was feminist in their way as they were ambitious for their students. The GP said that you don’t want to do nightshifts when pregnant or be on call when you have small babies. The cards are very much stacked against you to make it in medicine as a consultant as a woman. Edith says he was right but that you don’t want to hear that at 15. |
0.14.09- 0.15.17 |
Nuns’ Ambition for the girls Only one in school to do medicine. Many of the students did honours maths. There was competition between the boys’ school and the girls’ school. They’ve now combined. Some schools didn’t offer honours maths or honours science subjects to leaving cert for girls. |
0.15.17- 0.18.40 |
Medical Training in UCC University College Cork Didn’t love medicine in UCC. Didn’t find the training easy- a culture of throwing people in to it. Students told that most of them would become GPs and that medical students learn themselves they don’t need to be taught. Lectures often had little relevance to what was in the book. Clinical training involved bullying, teaching by fear, humiliation. Consultant was seen as god. Lots of waiting around for people who didn’t turn up. Mental fallout for some of the people in her class. And the system may not have made them better doctors. Saw how students were taught differently overseas. Students were getting sick in the morning with nerves before clinics. Had friends who weren’t doing medicine. Met her now husband at 19. Always had something outside of medicine to stay grounded. Always liked the clinical work and the patients. |
0.18.40 - 0.23.40 |
Clinical Training Book learning- through lectures. Clinical placements for students with a particular service for a time follow their team and learn how to take a patient history and examine a patient. Initially must ask about everything when taking patient histories until you know what to look for. Lived in nurses’ home in Limerick for six weeks. Consultant would take you to see an interesting patient to ask you questions. Some were fine but some were set up so that you would definitely fail so that you know that you know nothing and be humiliated. It was done to everybody no one was singled out. Describes how the consultant asked students questions. Thinks that the experience has left a mark on her and otherwise confident colleagues as they sometimes have difficulty answering questions in group settings, or when in a particular tone. Describes it as like being triggered. Edith didn’t go to one consultant’s clinics because she found she wasn’t learning from him. No one would notice if she wasn’t there. Jokes that she hopes UCC doesn’t as they’ll take away her degree! |
0.23.40- 0.25.25 |
Why this teaching system was used in UCC Consultants wanted to imprint the exceptions and rare cases on their minds so they wouldn’t forget. It was basically the Socratic method. They were once told that they weren’t good enough to be medical students. Then not good enough to be the vets in Ballsbridge and lastly that they weren’t good enough to be the medical correspondent in the Irish Times! Sounds funny now but at the time they were devastated. But Edith still remembers the name of the particular type of amputation due to this scene. This system of teaching & learning was designed when people need to remember a lot of information. Now things have changed as “all the information is there” now you need to learn how to use it. An interesting patient is one which had something which was rare. Edith describes it as something with four legs, a tail and neighs but is a zebra not a horse. |
0.26.05- 0.30.07 |
Career Path for medical students SHO- senior house officer. After qualifying you become an intern. After a first year as an intern you can become an SHO. Then become a Registrar, then a Senior Registrar, Specialist Registrar and eventually a Consultant. SHO could be 2-4 years long. SHOs are the general grunts they do all the hard work. Edith did 6 months surgery in Mercy Hospital, 6 months of medicine in the South Infirmary Hospital and really enjoyed them. Every thirds week in the Mercy they worked 110 hours. In hindsight they had “ridiculous levels of responsibility”. Then did the 2 year specialist paediatric training scheme in Dublin. Then did paediatrics in New Zealand, then accident and emergency. Did GP training in New Zealand. Returned to Ireland when her eldest daughter was 1. Worked as GP in Cork. After her twins were born Edith went back to work when they were 8 months old. She worked for Swiftcare for 5 years. Husband stayed at home to mind children and was going to go back to work. She was clinical lead with Swiftcare which included corporate, management and clinical. Looking to reduce her hours and her friend asked if she would be interested in a job in Grattan Street and she started March 2013. |
0.30.07- 0.33.44 |
Enjoyed Accident and Emergency work in New Zealand Edith says A&E in New Zealand is fabulous. It was real doctoring. The immediacy of it. See lots of different things. Got her clinical confidence- could deal with anything. Security removed anyone who was abusive. There was always enough resources, staff, beds. People weren’t burnt out in the way they are in Ireland. Requires being on call on nights. Did A&E in the Hutt outside wealthy Wellington CBD Central Business District and Porirua. Deprived areas around the Hutt so there were cases of self-harm, domestic abuse and patients from lower-socioeconomic areas. Gravitated towards those areas, similar in her time in Temple Street. In Cork Edith works mainly in the Northside. The social supports either weren’t there or didn’t work in her experience in Ireland. Children unable to access basic dental care was unheard of in New Zealand where they have better primacy care. |
0.33.44- 0.36.36 |
Early Memory & description of Grattan Street Medical Centre A woman working downstairs said it was like coming to Colditz [German WW2 Prisoner of War Camp]. Arrived with a friend. Everyone was so nice. An old Quaker Meeting House. In busy urban areas between a school, busy road, houses, church complex. Hodgepodge! Kind of Victorian road frontage. Older building at the back made of cut stone. Higgledy-piggledy. Different types of signage. There’s a bit of a railing and bit of a ramp. Building kept together with duct tape and bits of binder twine. It’s a bit sad looking. But it has been here a long time and will be here in the future. A building that’s seen use and is embedded in the community. In keeping with Middle Parish. |
0.36.36- 0.39.02 |
Services in Grattan Street Medical Centre Health centre which provides community-based services for people based in Middle Parish, inner-city area, eye clinic provides community eye services for all of the North Lee HSE area- from Blarney to Carrigtwohill. Community podiatry clinic. Community medical doctors: child development clinics and vaccination services for North Lee. Public Health Nurse (PHN) services based in Grattan Street. Home Care Services Unit. Community dental services has moved out. Girls at front desk do European Health Visit Card and stamp forms- eye clinic etc. Community Welfare Officer used to be there as well but they have moved. Vaccination services. Similar but disparate services. Serve different populations within the community. Community based services are geographically decided rather than by your condition. |
0.39.02- 0.40.40 |
Engagement with a Community Based Service Hopes that services run in the community for the community get a better engagement rather than traveling to a tertiary centre. More likely to engage with a PHN who you may have been to before than an anonymous person in an anonymous clinic that changes each time you go. Community knowledge of Grattan Street in a way that there isn’t for CUH. Grattan Street doesn’t deal with life and death so expectations are different to a hospital. Physically less distance for people to travel in the community. |
0.40.40- 0.43.44 |
Working in Grattan Street Communal Building Uses Grattan Street for office-based work. Some clinics in Grattan Street but the demographics have changed and there are fewer babies and young children in the area. Primarily paper-pushing and renewing the connections that you have with the people who work in Grattan Street. Clinics in South Doc so it’s possible for Edith not to meet any other healthcare professionals only patients so Grattan Street is a social hub and important part of the job where information is transmitted in a more informal way not through writing. Importance of feedback. And Grattan Street facilitates that. Communal building. Can see people walking past and talk to them if you leave your office door open. Facilitates those networks. You will know who is in the building and check in with Celine in the office to see who else is there and what is happening. AMO- Area Medical Officer now Community Medical Doctors. |
0.43.44- 0.51.20 |
Clinics and Patients in Grattan Street Afternoon clinic downstairs in room 4 in Grattan Street. 6-10 patients in an afternoon clinic from 2:30-4pm. Anything referred in by the PHN or the assessment of needs- the disability services, and early intervention- concern with an ongoing developmental delay in child in the community. Checks for vision, head checks, hip checks. Partly routine partly not routine. Patients tend to be very early or very late. People will turn up 30 minutes early or 15-20 minutes late. Other places people turn up on time or a few minutes late. But with small babies delays happen for parents. Staff has high tolerance for that. Sometimes a mum will come with other children as well, or with a granny or granny will come with the children or there will be a friend or helper there too. Majority of patients come from PHNs. Form from PHN saying who their GP is and why they’re being referred. Always checks their names especially as more and more patients don’t have a typical Irish name. Some of them change mobile numbers often so checking those details is important. Change of address is also a problem. Some come from Edel House a women’s homeless service. Takes a background history or birth history- where they were born, birth weight, past medical history. Discuss risk factors, examine patients and how to proceed and be very clear with follow up instructions with the parents. We only remember 30% of what we are told. Usually don’t see patients again- not a follow up, ongoing service, don’t provide therapeutic intervention. “Good at normal”- this is within the range of what we expect. Much of medicine is about the abnormal. Most usual medical issues she deals with: Vision checks for squint, hip checks- concern about deformation, head checks. Developmental assessment- concern about autism or global developmental delay or intellectual disability. Preschools are good at spotting developmental concerns and referring them. |
0.51.20- 0.54.53 |
Attitudes of Parents towards Health & Medicine and HSE Parents want the best for children and are happy to do the best what it takes. Rare case where parent is in denial about their child’s situation- Edith doesn’t hassle them so as not to sour therapeutic relations down the line. Most people engage unlike adult medicine. Some parents may have complicated or chaotic lives and social workers may need to get involved. Advocate for the child’s best interests and is represented in the family. Even parents with most complicated lives can address the child’s needs. HSE is different. Expectation of a bad service especially where Grattan Street looks a bit rough and ready, but surprised that they get a good service and Edith is pleasant and doesn’t rush them out. Difficult conversations about telling parents of long waiting lists. Edith cannot speed up assessments. |
0.54.53- 0.58.43 |
Most Unusual Cases come across Doesn’t like unusual. Should not be seeing anything acute or sinister. A child staring into space could have autism sometimes it could be an absence seizure which needs a difficult treatment. Genetic abnormality which causes a developmental delay. Acute cases usually picked up by the paediatricians. Be careful about not scaring parents. Sometimes parents are reluctant to go to hospital. Acute cases are the ones that you think about when you go home and are not at work. Acute is something which cannot wait. Less concerned about something which is stable and isn’t going to change eg if someone is fragile X a chromosomal condition which causes developmental delay, commonest cause of intellectual disability- if a patient has this it is not going to go away. But if there’s a child you think has a brain tumour which has given them an acute squint which has come on over 24 hours out of nowhere then you don’t want to wait. |
0.58.43- 1.01.44 |
Dealing with Parents Reluctant to go to Hospital Most parents want what’s best for child. Sometimes parents can sometimes be preparing to fight to get what they think their child needs, and be adversarial. Can spend much of consultation time to get the parent onside. Have to be careful to not reinforce the idea that the parent thinks they need to push harder to get what they want. Explains that she wouldn’t do for someone else’s child what she wouldn’t do for any of her own. That can be a powerful message for a parent. If that doesn’t convince them then she has to start thinking about social workers: is there child abuse, is the parent drunk or stoned. |
1.01.44- 1.02.30 |
Why People may be reluctant to go to Hospital Down to resources: can’t afford taxi, no one to mind children, don’t want to go to CUH Cork University Hospital. Often single mums, mums without social supports, or trying to work and mind children. Physical upheaval is difficult. Logistically and economically difficult for parents. Example from Gurranabraher. |
1.02.30- 1.04.58 |
What it is like to work in Grattan Street Unique. Communal building, sense of community. Even people that you don’t deal with clinically you get to know which is important. Buildings are about the people in them not just the services they provide. Physicality of the building- open gallery- you can see & hear who is there. Would prefer it if was a warner building. Survivor bonding over the deficiencies of the building. Problems with parking. People say they work in Grattan Street not in podiatry. |
1.04.58- 1.06.24 |
Parking Small area for parking, not big enough for all the people who work there. Have to move your car to let people out. Didn’t park in the car park when working a half-day because wouldn’t be able to get out. School and houses also use the parking area and they can get cross if they are blocked. |
1.06.24- 1.09.12 |
Past of the Building Quaker meeting house. Building is set up like a church- entrance with arch and sweeping staircases, ceiling roses, curved picture rails. Awareness of the thickness of the walls and windows, not the typical shape for an office building or healthcare centre. Stone plaques outside in the parking area which commemorate the building. Was a dispensary from the 1940s one of the school nurses on the list of interviewees has a friend whose father was the dispenser or pharmacist there. Some of the came to Grattan Street as children for speech and language therapy. No anecdotes about when the lights went out or when it flooded. Cultural understanding of dispensary is that it was a publicly funded pharmacy but that they were fairly grim places for the ordinary not the great and the good. Lots of rooms and big building. |
1.09.12- 1.11.37 |
Weddings in the Registry in Grattan Street Other part of the building is the registry office at the front where people get married. Weddings out the front when coming to work. Children crying and elderly people. Swathe of human life. Unusual to see weddings in the urban work environment which makes everyone smile. And she will miss that when they move. Thinks other employees will have stories and anecdotes. |
1.11.37- 1.15.00 |
Paper & Documents in Grattan Street No one would believe how much paper is in the building. No one removes paper because no one knows who it belongs to. Paper based system for records. Accretions of paper. Shared office space where very little is thrown away. Extraordinary volume of paper created and used. Referrals done on duplicate books with carbon copy. Referral books for services which no longer exist- going back as far as the 1970. Old computers unused. Random boxes of leaflets. |
1.15.00- 1.18.10 |
Words to Describe Grattan Street and its future Community. Resilience. Service. If it was a dog it would be a Labrador, and old smelly one with bad teeth that farts a lot! A pet that everyone loves. Would hate to see the building closed and empty. Sense of spirit in the building. Understands that Quakers signed over the building with the view that it would be used for health services to the community. There’s no disabled access or toilets at present. Buckets in kitchen when it rains. Won’t do well if it is left empty and cold. Community based health resource rather than offices and admin. |
1.18.10- 1.22.13 |
Future of Services moving from Grattan Street Services moving to St Mary’s health campus. Podiatry moving to St Mary’s. PHN have moved already. Vaccination will move to St Mary’s. Eye clinic will move to St Finbarr’s. Dental has gone to Finbarr’s. Unsure about European Health Cards. Home Care may stay here. Marriages will stay. They have had little information about the services. Understands the complexity of project managing the move. Eye clinic will be physically remote from St. Mary’s. Lose sense of networks even though you can still pick up the phone. Lose contacts and networks and personally knowing people in other services. Personal knowledge of how other people work. It gives you more information about how to triage or perceive a referral when you know the people. Anything that interferes with getting information relevant to the patient and decision-making will make her job slightly harder. |
1.22.13- 1.25.19 |
Sense of Patients’ Perspectives Some clinic space may have to be kept in Grattan Street because of the most vulnerable patients in the area eg. from Edel House and newly arrived immigrants, and people who have moved out of direct provision. Families where English might not be first language and from backgrounds where there might be poor healthcare. Travel may be difficult for these patients, especially going “up the hill” to St Mary’s. Will advocate strongly to keep a clinic in Grattan Street- it’s easier to move 1 doctor to see 30 patients than vice versa, and do not need any specialised equipment. Grattan Street is a disaster for people with cars- St Mary’s is much better it has parking, space and coffee shops. Ensure that better services elsewhere don’t leave more vulnerable patients behind. |
1.25.19- 1.27.47 |
Comparison between Grattan Street and St. Mary’s St Mary’s will have: heating, lifts disabled toilets, large waiting areas, easy access. [Edith’s phone vibrates during this section] In Grattan Street if you are on crutches you can’t come to work. St Mary’s will fix these problems. Change is hard. [Edith’s phone vibrates during this section] With a new start if gives the staff a chance to effect the culture of the new building. Everyone in the building making small inputs. Christmas lunch potluck and baby showers in Grattan Street for which there is no policy or permission required people organised it themselves- autonomy and power. |
1.27.47- 1.31.31 |
Culture of the New Building & Importance of Admin People need to feel they have some autonomy of their workplace eg. the signs in Grattan Street which people put up without needing permission. Every clerical and admin staff can hear the patients who come into Grattan Street so they understand that they are not a piece of paper or a number. Further away people are from the person they provide the worse the service provision. Service lives and dies on its administrative staff. When admin staff goes on holidays the clinical staff are bereft! Importance of admin staff even though their role can be minimised. But in Grattan Street there is a good balance. St Mary’s may be isolated in separate rooms. |
1.31.31- 1.33.02 |
What Makes Good Admin Support? Patience. Being able to spin so many plates. First point of contact for people who use the service. People who understand that it’s really important. Although HSE gets a bad reputation every admin staff has been helpful and gone above and beyond. Celine in Grattan Street is very patient. |
1.33.02- 1.35.14 |
Patient Expectations of St Mary’s Big scary, bewildering building. Hope that people will be made to feel welcome. Scale of foyer area is colossal and may be overwhelming. Community should have some autonomy over the building in the same way the staff should. Comfortable seats and accessible baby changing facilities may be enough to make people feel welcome. |
1.35.14-1.38.08 |
Centralised Canteen Would like to see centralised canteen for the staff with access to healthy food. Small things become important. Easy to walk around and access healthy food. Sense that the community can use the space- not much green space on the northside. Chance to look at a different model of healthcare. Moaning is easy and can create a toxic culture if things never change. Small kitchen room on St Mary’s health campus. St Finbarr’s has a centralised canteen but CUH doesn’t. Give people healthy options on site. |
1.38.08-1.40.43 |
Community connection with Grattan Street more generally Edith has little interaction with Middle Parish community. Sees people coming and going from Middle Parish Community Centre and from the SHARE Centre, may help them across the road. Very little interaction which she finds quite sad. Would know some of the support workers in Edel House through working with them and phone calls. Reality of life is everyone is very busy. No funding for other community outreach projects. May run ante-natal classes in Grattan Street which would be good. The more engaged the community can be with the building the more likely they will be to turn up to their GP appointment or diabetic nurse appointment. |
1.40.43-1.43.40 |
Reflection choosing Medicine Would not want any of her children to do medicine. Comes at a big cost. Have to work 90 hour weeks and tell mother that their babies had died while her friends were traveling and going to parties. Have to go through hard parts of job to get to a role that you like. Came first in paediatrics in UCC please don’t tell Prof Carney/Kearney that she only went to about 2 paeds lectures! But spent a lot of time in the wards. Children are direct and Edith likes that. Interview Ends |
He describes his routine on school days, attending St Aloysius school and awareness of tenement houses en route. All the family except his father who was traveling returned for a big meal at lunch time prepared by a local woman who worked for them. Always ate fish on Friday. Recalls respectability being very important.
He recalls the Haggart or “Haggy Field” at the bottom of Wyses Hill where “ponnies” or chamber pots were emptied.
He remembers family adversities: death of his mother, father’s heart attack and his brother’s autism.
He outlines more of his family history: paternal grandfather involved in construction of Fitzgerald’s park and the 1902 Cork Exhibition, maternal grandfather Cronin was a cattle dealer, Cronin’s Field at the top of Cathedral Road may be named after him.
He mentions pawn shops and how the family christening cups would “go missing” and be located in the local pawn. Also recalls a “shawlie” asking him to fill her a jug of porter from a bar as she did not want to be seen going inside herself.
He describes his Christian Brothers secondary school, the violence of corporal punishment, the teachers and cycling to and from school. Discusses the emphasis on rugby at the school, the elitism of this and the uniform. Reflects how in retrospect the school failed to address personal or emotional problems the pupils had. Mentions the one-day-a-week school nearby. Describes the Eglinton Baths.
Talks about studying for the Leaving Cert at Holy Trinity College with “Doc Payne” before attending UCC. Recalls studying and socialising at university before outlining his further medical training, specific cases in hospitals (North Infirmary, CUH (Cork University Hospital) and St. Finbarr’s) and ultimate career trajectory towards becoming a GP.
Reflects on improvements in medical care including vaccines, nutrition, public health and improving survival rates for many diseases. Remembers delivering his first baby and reviving a child who died from cardiac arrest.
Describes ultimately working on Grand Parade as a GP in the surgery of Dr Michael Cagney who had fought in the Spanish Civil War.
Discusses making house calls in “The Marsh” area, and the treatment of psychiatric problems.
Finally, Derek reflects on his career, the sense of guilt and hypervigilance instilled in his medical training, and how mistakes are made when not following your intuition.
]]>Originally from Winter’s Hill, Derek describes his home and family: siblings, grandmother, his GP mother and his father who worked in insurance. He outlines his mother’s tasks and equipment as a GP.
He describes his routine on school days, attending St Aloysius school and awareness of tenement houses en route. All the family except his father who was traveling returned for a big meal at lunch time prepared by a local woman who worked for them. Always ate fish on Friday. Recalls respectability being very important.
He recalls the Haggart or “Haggy Field” at the bottom of Wyses Hill where “ponnies” or chamber pots were emptied.
He remembers family adversities: death of his mother, father’s heart attack and his brother’s autism.
He outlines more of his family history: paternal grandfather involved in construction of Fitzgerald’s park and the 1902 Cork Exhibition, maternal grandfather Cronin was a cattle dealer, Cronin’s Field at the top of Cathedral Road may be named after him.
He mentions pawn shops and how the family christening cups would “go missing” and be located in the local pawn. Also recalls a “shawlie” asking him to fill her a jug of porter from a bar as she did not want to be seen going inside herself.
He describes his Christian Brothers secondary school, the violence of corporal punishment, the teachers and cycling to and from school. Discusses the emphasis on rugby at the school, the elitism of this and the uniform. Reflects how in retrospect the school failed to address personal or emotional problems the pupils had. Mentions the one-day-a-week school nearby. Describes the Eglinton Baths.
Talks about studying for the Leaving Cert at Holy Trinity College with “Doc Payne” before attending UCC. Recalls studying and socialising at university before outlining his further medical training, specific cases in hospitals (North Infirmary, CUH (Cork University Hospital) and St. Finbarr’s) and ultimate career trajectory towards becoming a GP.
Reflects on improvements in medical care including vaccines, nutrition, public health and improving survival rates for many diseases. Remembers delivering his first baby and reviving a child who died from cardiac arrest.
Describes ultimately working on Grand Parade as a GP in the surgery of Dr Michael Cagney who had fought in the Spanish Civil War.
Discusses making house calls in “The Marsh” area, and the treatment of psychiatric problems.
Finally, Derek reflects on his career, the sense of guilt and hypervigilance instilled in his medical training, and how mistakes are made when not following your intuition.
0.00.00 - 0.01.58 |
Family and House Grew up on Winter’s Hill between Blarney Street and Wyses Hill on northside of Cork. The third of 4 children all delivered by caesarean section. His mother was very small and the local GP, one of the first “lady doctors” of which there were only 4 or 5 at the time, and they covered for each other. Father worked in insurance and had a good job as assistant manager of insurance company. Mother worked full-time. Always family member in the house to help out, including a grandmother. An old male relative lived in the 3rd floor of the house. That wasn’t unusual, it wasn’t always one room per person. But it solved childminding issues. |
0.01.58 - 0.02.20 |
Grandmother Remembers grandmother’s lap, her dark blue apron with designs on it and knitting needles. She died when he was about 3. |
0.02.20 - 0.04.33 |
House and Mother’s GP Surgery 3 storey detached house, a bit unusual. Further back from the road than others, with passage in called “the passage”, hen house in front and back of house, which was normal at the time. Mother did house calls in the morning. In the evening they had to go to the dining room because the front room became the waiting room and she had her surgery upstairs. Learned young how to answer the phone. People might arrive with urine in a Paddy whiskey bottle. In retrospect she was checking pregnancies or urinary infections. He was frightened of her steriliser- an electric pot with instruments in it. Syringe needles were sharpened on an oil stone before being put in steriliser, and no one seemed to get infections. |
0.04.33 - 0.07.59 |
Routine/ Typical Day at Home & School Walked down Wyses Hill to school in St Al’s (St Aloysius) which was a girl’s school. Teachers Miss Brett, Miss Curran (Chris Curran’s sister maybe), Sister Aloysius in first class which was more challenging because she didn’t like the boys. There was two thirds girls in the class. At that time this was normal practice. Walked across Vincent’s bridge across by the Mercy Hospital and across by lark’s bridge. Recalls where the labour exchange is now (Intreo Centre Hanover Street) there were beautiful Georgian Houses (tenement houses) in terrible condition with lots of washing out and women out talking to each other and several generations playing, and that was normal. No one thought there was anything right or wrong with it, it was just the way it was. Went home for lunch, and often had soup and a main course especially in the winter time. A lighter meal in the evening. All the family returned home for lunch except his father who might be traveling to Bantry or Skibbereen which was a long way at the time. A lady prepared the meals for the family. People who worked in the house lived locally and were like members of the family. They might work for 2 or 3 years and move on, often when they got married. Someone else would come then, often by word of mouth, perhaps through his mother’s GP practice. Always ate fish on a Friday which he didn’t like. Suspects there was a rota for meals. ‘Meat and two vegetables’ was always the meal. Felt privileged to have that as not everyone could, and there was a good bit of poverty around. Recalls a “soundbite” from Blarney Street: “Johnny come in for your rasher and two eggs!” There was a great respectability, everyone respected everyone else and there wasn’t any talking down to people- it wasn’t acceptable.
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0.07.59 - 0.09.49 |
Playing near Home & the Haggard Didn’t get out of the house all that much. Played football outside the door for a while. Area called “the Haggy” across from where they lived, the Haggard* which was a kind of wasteland roughly where fancy apartments at bottom of Wyses hill are now. People used to dump their “ponnies”** in the old days. It wasn’t regarded as a place you’d go, it was just a steep hill. But people went there with their (chamber) pots. But the stigma of it not being a clean place remained even maybe 100 years after running water and sewage came in. So when playing football if the ball went down the haggy no one wanted to fetch it. Was not allowed to go out to play football, mother would have had a “conniption fit” had she known they were out doing that. [*Haggard or Haggart: A farmyard or small enclosed field; a vegetable patch or kitchen garden. Or area adjacent to the farm yard or what once was a farm yard. Traditionally this was an enclosed area on a farm for stacking hay, grain or other fodder. (sources: Wiktionary, meathfieldnames.com] **[ponny or ponnie: earthenware or metal pot or mug (Source: A Dictionary of Hiberno-English: The Irish Use of English ed. Terence Dolan)] |
0.09.49 - 0.12.43 |
Family, Changes and Adversity Mother died when he was 13. Dad had had 1st heart attack previous year and he had retired from work and started an insurance brokerage as a hobby. Sister Catherine did medicine and went to America and didn’t want to return. Different doctors tried to keep mother’s GP practice going. Older brother in insurance now retired. Younger brother Michael born hypothyroid and had severe autism slept in his room and found it normal to share a room with a practically non-verbal brother. Remarks on how people what people can accept as normal even if inconvenient and that people are strong in the face of adversity. Discusses the resentment and rage which is normalised by the internet which has also contributed to the polarisation of politics “it’s as if only extremes are correct”. History suggests consensus is what works. The manipulation of social media has contributed to this phenomenon. |
0.12.43 - 0.14.47 |
Mother, her GP work and her car Mother was very bubbly. Black hair with white stripe in the centre very careful about appearance hair was always done properly. Very hard worker with patients and at home. Expected high level of neatness and cleanness. She had a bubble car maybe 200cc with a door in the front. She covered other GPs. She went to Hettyfield and left 10 year old Derek doing his homework in the bubblecar. A 13 year old girl asked what it was and said “ours is a Consul Cortina”. The first time Derek felt his car might not be adequate. Bubble car had two seats at front one at back entered from the front. Recalls 4 children and his mother in the car! That was normal. |
0.14.47 - 0.16.53 |
Mother & Father: Backgrounds and relatives Mother and father put great store in education. She was youngest of 11 and one of the first to go to university. Dad was youngest of 17 children many in the family had been engineers. Derek’s grandfather had been married twice. Derek’s paternal grandfather died in 1917 before his father was born. Paternal grandfather was a builder/engineer/contractor had a lot to do with building of Fitzgerald’s Park, he has photographs of the grandfather with his workers dressed in Victorian outfits for the Cork Exhibition (1902 probably). Maternal grandfather was cattle-dealer Cronin. They lived up in Fair Hill which was subject to a compulsory purchase order in the 1960s by Cork corporation. Google maps lists Cronin’s Field at the top of Cathedral Road, assumes that this was the same field. Knew relatives at top of Hollyhill who were farming until Hollyhill as we know it was build. |
0.16.53 - 0.18.04 |
Pawnshops and stolen goods Two pawnshops on Lavitt’s Quay and one at bottom of Patrick’s Hill. Doesn’t recall who ran them. The Christening Cups were stolen a few times by the same person from the waiting room in the house and were located by the Gardaí in the local pawn shop. |
0.18.04 - 0.21.36 |
Secondary School: transport, teachers, shawlies, baths Went to Christian Brother’s College (CBC) after St Aloysius, his grandfather, father and brother had gone there. One teacher Mr Richard McCarthy known as Dicky Rashers called Derek by his father’s name because he had taught him as well. The story with Dicky Rashers was that he had dietary issues and after Christmas an announced that he had had rashers. He was a nice man. If it was raining they got the number 14 bus down Wyses Hill which came every 20 minutes. They used to hide because Dicky Rashers would offer them a lift which they didn’t want from a teacher. Also cycled to school. Got wheels caught in railway track going to Eglinton Baths. Those railway bridges opened until the 1970s. Goods trains and Guinness trains used to cross over them. Cycled up Patrick’s Hill to get to the Christian’s rugby field (Landsdowne). Cycled down the hill when it was raining, breaks failed and stopped where Brown Thomas is now. Only 4 or 5 cars on Blarney Street at the time. When 15 a shawlie stopped him near the Templeacre Bar (Gurranebraher Road) and she gave him a pint jug and asked him get her Guinness from the snug. She would not be seen going into the pub but wanted her Guinness. |
0.21.36 - 0.24.09 |
Secondary school teachers Christians was somewhat elitist which a lot of people were not comfortable with. Many teachers were old and not qualified teachers. Mr Murphy taught him art for leaving cert, but he had been teaching junior infants. He was very small his feet would not touch the ground when sitting on a desk. Mr Townshend music teacher and great musician. All characters. Violence of corporal punishment, queuing around the classroom to answer questions on Geography or Latin. If you weren’t very academic you got a lot of beatings on the hands. Some of those less academic pupils became very successful businessmen. The Christian brother told the boys in the B class to be nice to boys in the C class because they might need to get a job from them later. |
0.24.09 - 0.26.04 |
Secondary Schools in general, elitism & ‘One Day a Week School’ The uniform was part of the school’s elitism. There was a school nearby “the Wana” (one day a week) and there was a clear difference between them and CBC. CBC had disciplined and scheduled classes all day. The one day a week school pupils were obeying the law, 12 or 13 years old selling papers to make money. They had to attend school until a certain age. People with dyslexia were beaten and treated with contempt. Scoil Mhuire girls private school was nearby and quite posh. Around the corner was St Angela’s was less posh. Rivalry between Christians and Pres (PBC, Presentation Brothers College). |
0.26.04 - 0.27.22 |
Secondary School: lack of empathy, attitudes towards sports Was in first year of secondary school when mother died. There was no recognition of that in school and he dropped from A class to B class. A little help would have gone a long way. In retrospect there were probably a number of pupils with ongoing issues which were never addressed by the school, while the emphasis was on playing rugby. Rugby in Cork was elitist then too. Derek joined Tramore Athletic soccer club. A cousin played tennis quite well and a Christian brother said “why wouldn’t he take up a boy’s game?” |
0.27.22 - 0.28.44 |
Eglinton Baths, swimming, chipper Eglinton Baths had a boys’ pool and a girls’ pool. Probably 25 yards. White tiles with balcony around each pool. Communal hot showers, but the pool itself was freezing and stinking of chlorine. “It wasn’t unusual to be blue and wet!”. Went home via Maylor Street and went Matt Kiely’s chip shop to warm up a bit. |
0.28.44 - 0.29.30 |
Changes after mother’s death, father’s career Younger brother went into full-time care when his mother died. And his dad was involved in local politics and trying to run a business. He was a Fine Gael councillor for over 20 years in the North Central part of Cork which would have been unusual. He was involved in the health board and the building of the regional hospital. He was chairman of the hospital board for years and of the health board. |
0.29.30 - 0.31.36 |
Repeating the Leaving Cert with Dr Paye Derek always assumed that he would be a doctor. He was offered a place in dentistry in college which he declined. His dad got him into the Holy Trinity College on Washington Street “Doc Paye’s” which was a military camp for getting your leaving certificate. He is grateful to Dr Paye and Miss Paye. For this school your hair was cut very tight, you wore a humiliating uniform, “you arrived on time or you didn’t arrive at all”. Mixed class, boys wore black, girls wore red with tartan. Every class was structured 45 minutes and took serious notes. They had studied the leaving cert papers and knew what needed to be learned. Still sees Dr Paye around and she must be a good age. |
0.31.38 - 0.34.15 |
First experience of University: courses and social and sport life After he resat the leaving cert he went to UCC in a course call First Common Science. This was an experiment when Pre-Med and Pre-Dent courses were done away with. In First Common Science you competed for your course. Had little experience of social mixing, and enjoyed going to the Kampus Kitchen (Campus Kitchen) to smoke cigarettes and drink coffee, and drink beer in the evening if you could afford it. First Common Science was not a problem because of the work done in Dr Paye’s. 60 got into medicine, 20 into dentistry and the rest did other science degrees maybe dairy science and science. Glad he got to mix and get to know more people. Thinks that his son who went to Trinity to do medicine probably missed out on that aspect of social life as he went straight into medicine. Small group of people in his course. There used to be rugby matches in the quarry in UCC where the Boole Library is now. The pitch was very muddy in winter. Dentistry were not able to field a team as there were not enough men doing the course. Playing the quarry you were just as good as everyone else because everyone was terrible. |
0.34.15 - 0.37.39 |
University: playing cards, betting, debating society, studying For the first year or two Kampus Kitchen was the place to play cards and a lot of money was won and lost there. He stopped playing cards because he saw people lose their grants. He once lost the money to be spent on a shirt for the Med Ball and had to attend with a pink shirt. As regards clubs and societies looking back he thinks he should have attended the Philosoph (UCC Philosophical Society, college debating society). People who were from Cork probably got less involved in clubs and societies, whereas those living on or near campus would have become more involved. Thinks the Philosoph would have broadened his education, mentions how Theo Dorgan was there during his time in college and thinks that Theo got a broader education compared to the narrower field of medicine. His education was greatly advanced in 2nd Year Medicine while in the library fretting about a physiology exam maybe 2 weeks before the exam. A mature student around 35 years old told him “the information in a book is inversely proportional to its size”.
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0.37.39 - 0.39.37 |
What’s needed to become a doctor and to practice No one asks him as a doctor where he came in his class, and it wouldn’t make a difference anyway. Many people who were academically gifted would not have been suited to being doctors. Is concerned that a medical education which requires strong left-sided brain skills to remember and regurgitate material may not produce great communicators and not great doctors. Someone with an average IQ could be a very good doctor. The economics of being a doctor suggest that maybe it should not be so attractive for people and they would be better in IT or science. Once you qualify in medicine that is only the beginning: you have to graft for jobs, get relevant experience and only then try to make a living. It’s just a primary degree unlike dentistry where you are a qualified dentist once you complete the degree |
0.39.37 - 0.42.48 |
Working in North Infirmary: learning, some memorable cases Went to the North Infirmary. Lovely hospital to work in, was very well-treated. Very hard work. 3 medical interns, 3 surgery interns, maybe 2 SHO (Senior House Officer) and 2 Registrars. Recalls first night he was on for surgery when a patient from motorbike accident was to arrive in and the SHO left before the patient arrived. Nurses were excellent. Learned how to do things. Learned how to recognise cases that were too hot to handle. When on call started 9am Friday finished Monday at 5. There were very few GPs out of hours so got big queues in North Infirmary. Went to bed 4am one Sunday morning and he was told there was a young man with chest pain. The young man looked pale and sweaty and was wearing ex-army jacket which was “all the rage” at the time. Discovered that the man had been playing darts, had gotten a dart in the back and had a chest full of blood. Learned to be careful and not take things at face value. Another night a man was brought in by his friends. At the time Match of the Day (football highlights and analysis TV programme on BBC) was at 7pm or 8pm. The man had been in the pub and “his leg was swinging in the breeze”, he had fallen off a bar stool and broken his hip around 7:30pm but had stayed in the pub until Match of the Day was over before coming to hospital. |
0.42.48 - 0.51.04 |
Changes in healthcare: preventative medicine, vaccination, alcohol Suggests people may have been tougher in the past. Then reflects on the improvements in medicine and that “the good old days weren’t so good”, people didn’t live as long, not vaccinated, poor nutrition. As nutrition improved children became taller than their parents. Improvements in prognosis. Enthusiastic about preventative medicine. Although the medical card system did not take that into account, doctors were not paid for vaccinations on the medical card but they did it anyway. Gay Byrne encouraged people to get the measles vaccine. And there was a change in the demographics of the measles incidents over two years after that. Didn’t see cases of measles for 15-20 years, and it only reappeared when anti-vaxers (anti vaccination campaigners) appeared. Thinks it’s a scandal. Vaccination for measles is not individual it is based on herd immunity it requires 80-90% of the population to be vaccinated or the vulnerable will get it: people with immunodeficiency, leukaemia, chemotherapy. Discusses the changes in gender demographics in relation to cardio-vascular diseases and risk factors. There had been an economic difficulty with alcohol-you could only afford a small amount of alcohol (or cigarettes). But now alcohol is cheaper and cigarettes are more expensive. Mentions the trend of pre-drinking. Suggests problems of alcohol appear to occur further north of the equator. Discusses the off-licenses in Sweden where you had to order alcohol a bit like the system of ordering products in Argos. If your order for alcohol exceeded accepted level you were not served. This didn’t prevent people drinking as they made their own. Discusses the positive effect of smoking ban and the way people use the “nanny state” argument to oppose basic public health measures. Talks about the improvements in treatments and survival rates particularly for cancers and cardio vascular diseases. Compares this to reactions of indignation. Points out the hidden nature of preventative health care which can be effective but is rarely seen of credited. Preventative care is also less well understood compared with waiting times for doctors or ambulances, number of hospital beds. Thinks the question should be about quality of life and what can be done to improve it. |
0.51.04 - 0.52.47 |
North Infirmary working routine, cost of hospitals In north infirmary there was a doctors’ room and dining room where you had your own seat and there was a colour television which was unusual at the time. 6 interns. You worked every day and every third night as well and every third weekend. But if someone was on holidays you had to work every second one. The cost of a bed per night in the hospital was £80 and when it was closed the cost in other hospitals was £200-£300 per night. Discusses the merits of centres of excellence and lower-tech hospitals. |
0.52.47 - 0.57.07 |
Further training in St Finbarr’s & CUH, reviving a child, CPR After North Infirmary did obs and gynae (obstetrics and gynaecology) in St Finbarr’s Hospital and CUH (Cork University Hospital). Great training, lovely, practical and kind obstetricians. A small nurse Sister Tutor called him at night for a mother giving birth. The nurse cleverly directed him in delivering the baby with a forceps while making it seem like he was the one doing all the work. “Without the nurses we’d be nowhere”. His daughter is a nurse and sees how knowledgeable and capable they are at the coal face. Unwise for doctors to ignore what nurses say. The importance of everyone being on the same team. Recalls an A and E (accident and emergency) nurse who had all the equipment ready while the doctor was looking up what was to be done. Recalls a child around 7 years old who was dead from cardiac arrest after getting electrocuted on a Saturday afternoon. They used intubation, put up a drip, drugs, cardiac massage, and defibrillation. They didn’t have time to look up dosages they divided them amounts by 4 for a child. They had a good success rate at reviving dead bodies in North Infirmary- community response is key today. “an ambulance on its way doesn’t keep your heart beating.” Believes everyone should learn the basics of CPR. Recalls CPR in his GP practice. |
0.57.07 - 0.58.50 |
Further medical training and useful A & E experience After obs and gynae he did paediatrics, psychiatry, and a year in A and E where he learned that a little smile went a long way. Talked about how to politely and carefully deal with cases which were not serious enough to be in A and E. Public who might be waiting all day did not see the very serious cases that were happening out of sight. It was good training for a GP practice. |
0.58.50 - 1.04.21 |
Own GP practice, Dr Cagney’s GP practice & Spanish Civil War, Set up own GP practice on northside in their house. Found it lonely because there were so few patients coming in. He then practiced with Dr Michael Cagney until he got a stroke. Dr Michael Cagney was a remarkable man, big burly, chain-smoking man very kind to people. He would tell people to give up cigarettes while he was smoking at the same time. He was doing surgery and he returned to GP practice because he father had been running a practice but became ill. When Dr Michael Cagney sat his leaving cert he was too young to go to college so his dad and General Eoin O’Duffy decided to send him to fight in the Spanish Civil War. He rarely spoke about his time in that war, and must have been traumatised by it. He probably thought he was going out “to help the raped nuns.” Many people from Ireland went to fight in that war. And it was not that long ago. Reflects on children today being used as soldiers in other countries, and being involved in drug gangs in Ireland and on those who leave to fight for Al Qaeda today and crusaders in the past. Dr Michael Cagney was probably born around 1920. The practice was in 51 Grand Parade, 2 floors up. It was a very good practice, he was very ethical and kept very good notes on large A4 file in alphabetical order which was probably unusual for the time. They used the Merck Manual which was an encyclopaedia of therapeutics. You could ring surgeons for advice. There was a great sense of responsibility and great collegiality. Refers to the changing ways of doctors referring patients to hospitals. |
1.04.21 - 1.06.09 |
First day in new GP Practice, changes in care, responses to bad cases Remembers first day in Dr Michael Cagney’s practice which was in a back room and patients wanted to see Dr Cagney rather than Derek: “With respect to you doctor I’d like to see the doctor!” After time people came to see him specifically. Did everything, including: antenatal, postnatal and smears- it was perfectly normal for a male doctor to do a smear in those days before there were headline cases of doctors who did the wrong thing. Derek became deskilled in that area because it was too much of a risk. Suggests that new practices are often introduced in response to hard cases. Mentions the response to the Dr Harold Shipman murders in England where GPs had to list the number of patients they had who died in one year to prevent a similar case. One GP made a mistake in their statistics and rang up to clarify them, but was told no one would ever read the statistics so it didn’t matter. Says that lots of information is gathered but never really used. |
1.06.09 - 1.08.05 |
Learning on the job, diseases not disappearing Dr Michael Cagney learned surgery but had to learn paediatrics on the job. Thinks most people of average intelligence can learn very quickly when put in a situation. Recalls a patient with a rheumatic heart and the hospital intern found it hard to believe. Derek says “diseases don’t go away they’re just waiting for you to forget that they happen”. Thinks there will be more outbreaks of diseases due to lack of vaccination. Polio outbreak in Amsterdam 20 years ago. “diseases don’t go away because you are sophisticated or rich or white.” |
1.08.05- 1.09.51 |
Attitudes to vaccination, TB Treatments in Cork Discusses the positive attitude towards vaccination in the past. People had seen children with whooping cough and adults who had holes in their lungs because of it. Doctors had patients who had limps from polio epidemic in Cork in 1950s, knows of a patient who died of post-polio syndrome in their 70s. TB was common but few admitted to having it- stigma associated with it comparable to leprosy or HIV. Mentions Mr Hickey in Sarsfield’s Court who was able to collapse lungs and do pioneering surgery to treat TB. Thinks vaccination is question of statistics not opinion. |
1.09.51 - 1.12.20 |
Routine as GP: house calls, pager, patients not going to hospital Typical day started around 9am. Might do 10 house calls in a day because people didn’t go to hospital or if they did not for very long. House calls were also more common back then because of the lack of transport options for patients. Discusses the pager service, finding a public pay phone and how getting in contact with a patient an hour after they used the pager was considered fast. Dealt with a lot of pathology at home if patients did not wish to go to hospital. Could visit a patient at home every day for a week or two if they had a serious condition. It was very gratifying when patients recovered. |
1.12.20 - 1.15.06 |
Public Health Nurse care Had little contact with the Grattan Street dispensary and health centre. Mentions the dental service there, ophthalmologist Dr O’Sullivan and public health nurses (PHNs). When doing the membership of general practice in London he was not believed when he said there were only 2 PHNs for Cork city centre. PHNs medical care had a physical, psychological and social side. Knows that dispensary doctors had limited treatments: “blue tablets, red tablets and liquids”. They worked before the medical card system, which he thinks came in the 1970s. When Derek became a doctor the system was ‘fee per item’ you were paid a small amount for each thing you did as a GP. Everything had to be written in a duplicate book. |
1.15.06 - 1.17.52 |
‘The Marsh’ memories. Case of anaemic man Dad was in the St Vincent De Paul and many in the Marsh were living with 2 or 3 families (in some case 5 families) living in the same big Georgian Houses. Many of these were knocked down in the 50s and 60s and many moved to Cathedral Road and Fair Hill. Some families had lived for generations in the Marsh. Recalls visiting a man a PHN was concerned about. Man lived with his dog and had a picture of Elvis on one wall and Jesus on the other. He was very anaemic but wouldn’t go to hospital. The remedy was some injections of B12, iron and oral folic acid and Meals on Wheels. Believes the problem was nutritional- living on spam sandwiches. |
1.17.52 - 1.20.35 |
People with psychiatric problems lived in the community in the past, now are being hospitalised Some people who lived in the city centre had come from elsewhere where may have been rejected. Some had mild schizophrenia or personality problems. They came to live in the anonymity of town. Many muddled along living in bedsits and had as much company as they wished. Now similar cases are put in hospital maybe in situations that do not suit them. Discusses the idea of putting anyone with psychiatric problems into the same category. Compares how we treat other illnesses- there is no “abdominal ward” which would treat a huge array of different illnesses, these are catered for separately. Similarly he thinks it doesn’t make sense to put people who are depressed or hearing voices in the same place as those with an eating disorder. Does not think the problem will be solved by additional money alone. |
1.20.35 - 1.21.40 |
Ability of people to cope. Publican ran bar walking on her knees Highlights the extraordinary ability of people to cope. Recalls an elderly lady (who probably had polio) and ran a bar walking on her knees on a bench behind the counter. Thinks that today there is more a demand for everything to be perfect and this can lead to unhappiness. |
1.21.40 - 1.24.15 |
Reflects on career, mistakes and medical training Thinks that when he made mistakes it was because he had ignored the inner voice that suggested something didn’t smell right. One of the things that was instilled in learning to be a doctor was basic guilt. The default was guilt, the sense that if something went wrong it must be your fault. That is the downside of medicine: trained into a guilt-trip. Makes you vigilant all the time which can be tiring. Wouldn’t change anything, felt privileged and happy to meet people and make a connection and friends. It wasn’t possible to be friends with your patients, there had to be a dividing line, though he is friends with them now. You couldn’t do business with or have a relationship or a social life with a patient. Peggy Cronin O’Connell and Vincent O’Connell were his parents’ names. Interview Ends 1.24.15 |