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A view from the edge: professionalism in an island practice
  1. D Jeffries
  1. Correspondence to:
 Dr D Jeffries
 St Mary’s Health Centre, St Mary’s, Isles of Scilly, UK

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28 July 2003
 Last Saturday night was interesting. One of our expectant mothers had a sudden and massive haemorrhage at 32 weeks and 1.30am. With two more births due at any time our midwife couldn’t leave the islands, and so an hour later—with two large bore intravenous cannulae pouring fluids into her veins—I found myself in the back of a Royal Navy Air Sea Rescue helicopter, feeling the woman’s pulse and forehead and listening to the laconic conversation of the pilot, navigator, and ground control as they flew us through the clouds and mist and up the River Fal from Falmouth to Truro: “I’m just going to swing a little right here after the trees …Look out round this bend, there was a tall ship moored here when I was over last week …Mind the power lines, maximum height 220ft …Should be a red light at 11 0’clock …I have visual…” As we approached the landing pad at the hospital the crew member in the back slid open the side door, and, sitting half in and half out of the aircraft, shone a powerful torch towards the ground and gave the pilot instructions for the last hundred metres’ descent.
 We bundled into the waiting ambulance, and were in a labour room five minutes later. After what seemed far too long but was probably about three minutes the obstetric registrar walked in, assessed the situation in a few seconds, and ordered anaesthetist, paediatrician, four units of blood, and immediate transfer to theatre. The father was shepherded into a recovery room, fearing the worst, but they let me—also fearing the worst—stay and watch the quickest and slickest caesarean section I’ve ever seen. Out came the baby, surprisingly pink, and after about a minute and a sniff of oxygen, in went its first …

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  • All excerpts are from the author’s unpublished personal diary. It was written in part for a lay audience of family and friends. Details of individual cases have been disguised to reduce their likelihood of identification; the patients concerned have read the excerpts and agreed to their publication in this form.