ENJOYABLE JOURNEYS

By Lesley Morrison and Ian Morrison
Contact the author via Chris Johnstone by e-mail at christopher.johnstone@ntlworld.com

Last Saturday, on the way to a home visit to an elderly gentleman, I picked up a programme on the radio about the energy implications of cheap air travel. When I arrived at the visit, I experienced traditional Scottish energy conservation in action. It was 11am on a dull January day, the house was devoid of any artificial light, and, after I'd located the patient hovering dimly in a corner and embarked on an attempt to establish the problem, he came out with the predictable, ”I'll throw some light on the problem”.

As a child of the coal-fired fifties, the scenario was familiar. Light, other than that essential for activities of daily living, was deemed luxurious and surplus to requirements. The coal fire which my father lit every morning before he walked to his job at the infant Prestwick airport was the main source of heat although electric heaters featured in other rooms. Waste not, want not. An ethos which, fifty years on, we are again being encouraged to adopt. At the airport, the planes which, at the start of the age of aviation, were a source of pride and pioneering pleasure are now increasingly viewed as mega-producers of carbon dioxide and environmental baddies. Air travel, then exotic and exciting, is now routine and even boring. There is a trend to return to terra (and agua) firma. A recent front page article in a Sunday magazine travel supplement entitled, “Why we won't fly again”, gave figures about the “true cost” of flying. Travelling to Meribel for a ski holiday by air takes 7 hours, costs £150 and produces 206 kgs of CO2. The same journey by train takes 13 hours, costs £214 and produces only 30kgs CO2. And you don't arrive with the uncomfortable feeling that your journey has contributed to the melting of the snow that you're about to ski on.

To be involved at the birth of commercial aviation was an adventure. My father tells wonderful stories of the pilots who gathered up groups of slightly nervous passengers from the departure sheds at Prestwick airport, informed them which route had been chosen for their journey to New York and led them out across the runway, flying helmet ear pieces flapping in the Atlantic breeze. Every Transatlantic flight was met by a piper and the passengers set foot on Scottish soil, or tarmac, with some relief and a sense of achievement. In the infancy of air traffic control the pilots took responsibility for their routes and their passengers and the ground staff lined up at the departure gate to salute them. They were often real characters with a sense of fun. On one flight from Prestwick to Islay the captain boarded anonymously and sat with the passengers. When everyone was becoming concerned that the pilot had not arrived he rose from his seat and walked to the front of the plane saying, “Well, I suppose someone has to fly this aircraft”……

Today's pilots do a good, efficient job. They sit anonymously in the cockpits occasionally exhorting us to look to right or left, telling us when the gin is due to arrive and providing us with technical data describing the progress of our flight. Occasionally they can cause alarm (a recent Ryanair arrivals announcement requested the passengers to fasten their seatbelts for takeoff…) but generally we feel confident that they will do the business, fulfil the safety criteria and get us where we want to go. But with what degree of satisfaction and at what long term cost?

Just as the pendulum is beginning to swing back from mass ”cheap” (in individual but not environmental terms) air travel to more satisfying and more sustainable forms of transport, so more sensitive, human and humane health care is back on the radar. A return to what pertained in an era when access to health care and travel were generally determined by income is not desirable. Safety should, of course, be paramount and patients want their “pilots” to have the benefit of the best protocol maps, technology and air traffic control. But do we want to completely lose the characters, the art of medicine, the fun? As Cecil Helman says in his newly published book about the art of medicine, “Suburban Shaman”, perhaps modern medicine lacks soul.

We want to eliminate unnecessary risk but uncertainty is a fact of medical life. A friend of mine, Hector Cameron, who has just died aged 83, earned and deserved the trust of everyone who met him. An eminent pathologist, he deviated from the route plan and risked his career by taking his family to Africa when his oldest child was 17. He set up labs, taught and, on his return to Scotland, was a founder member of the Medical Foundation for the Victims of Torture Medical and Amnesty. At his memorial service, his son described how his measure of a good person, a good doctor was their humanity, how the most valuable qualities are imagination, creativity and curiosity.

Perhaps our medical journeys and our patients' illness journeys would benefit from less attachment to certainty, more individual creativity. They might be slower, they might, in the short term, cost more but they might also be more meaningful and more enjoyable.

Other hoolet online articles by Lesley Morrison can be found at:
hoolet edition 49 - Review: Reflective Practice Writing and
Reflective Development
hoolet edition 49 - Enjoyable Journeys
hoolet edition 45 - Read All About It
hoolet edition 43 - Whistle-Blowing
hoolet edition 38 - Hope For Palestine?
hoolet edition 36 - Letter To The Editor
hoolet edition 32 - Letters To The Editor
hoolet edition 27 - The Bag Lady
hoolet webextra - Edinburgh Restival Review

Other hoolet reviews by Lesley Morrison:
Reflective Practice Writing and Reflective Development

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.