If you continue without changing your settings, we’ll assume you’re happy to receive all cookies from the BMA website. Find out more about cookies
When you visit any web site, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalised web experience.
Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms.
You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.
These cookies are required
These cookies allow us to know which pages are the most and least popular and see how visitors move around the site. All information we collect is anonymous unless you actively provide personal information to us.
If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
These cookies allow a website to remember choices you make (such as your user name, language or the region you're in) and tailor the website to provide enhanced features and content for you.
For example, they can be used to remember certain log-in details, changes you've made to text size, font and other parts of pages that you can customise. They may also be used to provide services you've asked for such as watching a video or commenting on a blog. These cookies may be used to ensure that all our services and communications are relevant to you. The information these cookies collect cannot track your browsing activity on other websites.
Without these cookies, a website cannot remember choices you've previously made or personalise your browsing experience meaning you would have to reset these for every visit. In addition, some functionality may not be available if this category is switched off.
Our websites sometimes integrate with other companies’ sites. For example, we integrate with social networking sites such as Twitter and Facebook, to make it easier for you to share what you have read. These sites place their own cookies on your browser as a result of us including their icons and ‘like’ or ‘share’ buttons on our sites.
Perhaps it was occasional weekends spent as a boy at Tarbert, Loch Fyne, with my uncle who was the sole general practitioner in that village that made me determined to follow his career path if I was fortunate to qualify in medicine.
Therefore, in the early 1950s, after two years of junior hospital posts, I tried to obtain an opening in general practice in Scotland. However, because of the glut of doctors returning from war service, assistantships, even with no view to partnership, were difficult to obtain and over 100 applicants for such posts were not uncommon.
Today, an acute reversal has occurred and partnerships in city practices attract few or no applicants. In rural areas in Scotland the situation is dire, and many practices are filled with a succession of locums.
Rather than being someone who fell off Lord Moran’s ladder*, I was glad to obtain an assistantship with a doctor in a mining village in central Scotland. This was the lowest rung on the ladder and I had to stay in the doctor’s home with his family, accept one half-day off each week and be on duty 24 hours a day for the remainder of the time.
After my first few days as a family doctor I was asked to cope with an emergency. I had to visit a young miner who was in considerable pain. On arrival at his cottage I was greeted by his young wife who appeared to be in a state of acute embarrassment.
‘Doctor,’ she said. ‘I must have accidentally kicked him in bed last night.’ She paused and blushed deep red. ‘I’m afraid I must have injured his privates.’
She showed me into the bedroom and fled the scene when her husband turned down the bedclothes and showed me the site of his pain. We both gazed at his testicles which were both swollen, inflamed and very tender.
I ran through in my mind the possible causes of bilateral orchitis and then looked at my patient while trying to conceal my confusion. I had never come across such a clinical picture. Then suddenly the diagnosis was quite obvious.
My patient’s face was swollen around each parotid area. He had mumps, and a minority of adult males who have the illness will also develop orchitis. Now that MMR vaccine is routine, the chances of seeing this in our country must be remote.
Had I referred this case to our local hospital for a surgical opinion, I would not have increased my clinical credibility with the staff.
Evan Cameron is a retired GP. He writes under a pseudonym.
* Lord Moran, an eminent physician whose patients included Winston Churchill, dismissed as ‘absurd’ the notion that GPs and consultants were equal. He said in 1958 that the most talented doctors competed for hospital positions whereas for GPs, ‘it was a ladder off which they fell’. His words so angered GPs that they are credited with helping to galvanise the development of general practice.