A Newry General Medical Practitioner by Myles Shortall

Based on an interview carried out by Noreen Cunningham with Dr Myles Shortall in December 2019.

During my career as a GP in Newry from about 1968, I have seen many changes over the years, not just with how GPs are trained, but how care is delivered to patients as well as changes in disease, and how many once common conditions have now been eradicated.

After attending the Christian Brothers School, Newry, and Clongowes Wood College, county Kildare, I studied Medicine at Queen’s University, Belfast, graduating in 1964. I spent my ‘Houseman’s year’ at the Mater Hospital, Belfast, six months of which were spent in the Obstetric and Gynaecology unit. The next year I worked at the new Ulster Hospital Obstetric and Paediatric departments, six months in each. In 1968 I graduated from the newly created General Practitioner Training Scheme, Northern Ireland, having done an extra year at the Belfast City Hospital, rotating through Cardiology, Respiratory Medicine, and Psychiatry. This was followed by a year attached to a GP Training Practice in Lisburn. I was the first and only trainee for that period but within a couple of years the Scheme became mandatory for those wishing to enter General Practice.

Following this there was a period in which I did locum work in England and both the north and south of Ireland. Each summer

I worked with the practice in which I was later to become a partner, that of Doctors Mearns, Faloon, and Donaldson, 11 Trevor Hill, Newry. In the early 1970s all the Newry practices were relocated to the Newry Health Centre at John Mitchel Place. Of the fourteen doctors who started there, I am the only one left. They were: Drs Wilson Mearns, Sydney Faloon, Gerald Donaldson, Paddy Byrne, Derek Flood, Val Blaney, Seamus McAteer, Neil O’Reilly, Frank Mallon, Patrick Lane, John McVerry, Michael McVerry, Paddy Ward (whose base was in Bessbrook, but he also did surgeries in Newry), and myself. The move was not without problems, one of the main stumbling blocks being that the different practices employed their own clerical staff at varying rates of pay and with different holiday arrangements. At first, administration in Daisy Hill Hospital wanted us to hand all our staff over to them as regards pay rates and holidays. The GPs had a meeting at 11 pm, the night before we were due to move in, and in view of our opposition, administration capitulated and we were able to carry on as usual. Once installed we were very happy there.

As regards post-graduate education we had occasional meetings of doctors from Newry and the surrounding area (they included Drs Arthur Mitchell, Wilma Hanna, Jack Crummie, Paddy Fee, Donal O’Tierney, Malcolm Redman, and Brian McLoughlin).

The meetings took place at the Ardmore Hotel, Newry, hosted by a drug company, and featuring a Hospital Consultant who would give a lecture on the latest medical innovations. This informal education would later give way to changes in our terms of service requiring us to provide an annual report and attend courses and lectures in Northern Ireland hospitals. I remember attending a lecture given by Professor Frank Pantridge who promoted the cardiac ambulance network and use of defibrillators throughout the six counties. He was advocating the installation of ECG machines in GP surgeries. One GP at the lecture said, ‘this is wonderful, we can do an ECG, send it to the hospital for reading and have the report with us the next day’. Frank in his usual laconic manner replied ‘Hmmm, a report the next day – you might as well stand the patient up against a wall and take their Polaroid photograph,’ Frank was not impressed!

Lack of car ownership meant a much higher rate of home visiting in the 1960s and 70s. When I worked in Trevor Hill we could have up to fifty house calls in a day. We were giving triple and oral polio vaccines to children in their homes as well as doing the occasional home delivery of babies. There were no mobile phones and very few people had land lines, so communication was a problem. No practice could exist without good reception staff, and in more recent times a good practice manager. In this respect we were exceptionally fortunate over the years.

In a practice of three or four GPs you did one in three or four nights ‘on call’. This meant doing your day’s work and then covering your practice until the next morning when the day’s work started again. After a Saturday morning surgery and house calls, you would be on a one in three or four rota for the weekend (including nights) and then on Monday until late afternoon. My longsuffering wife took the phone calls when I was on duty and during the night if I was away on a home visit. On the plus side, traffic was lighter then, though when the Troubles came we had problems with road blockages, explosions, and military check points, which interfered with traffic flow.

House visits were sometimes very useful for diagnostic reasons. One patient used come repeatedly complaining of headaches.

They had been extensively investigated in various hospitals to no avail. Fortunately, the patient requested a home visit and as soon as I entered the house I said ‘Don’t anyone light a match’. There was a strong smell of gas coming from a leak outside their front door. Once the leak was repaired there were no more headaches!

Poor living conditions existed in those days. I remember one man who lived in a corner of a room, the rest of the house having fallen in. He was in his forties with a heart condition and lay on a mattress on the floor.

With the expansion of air travel, diseases spread more rapidly worldwide. Polio, diphtheria, and tuberculosis (TB) have become rare in these islands but now we are beginning to see antibiotic resistant TB being brought in from countries where the vaccination programmes are not as good. The advent of penicillin and sulphonamides eliminated a lot of diseases such as rheumatic fever, renal nephritic syndrome, erysipelas, and bacterial endocarditis. In the past we would have seen hundreds of cases of measles, whooping cough, mumps, rubella, all now relatively rare due to vaccination.

In the 1960s I remember vaccinating people against small pox. This disease has fortunately been eradicated worldwide. The vaccination was done either near the ankle or on the upper arm. It came in a little plastic tube and a bleb would be squeezed on to the skin. A very fine needle would be repeatedly jabbed into the skin through this bleb. This carried the material into the skin surface and if the vaccine had taken a reaction would occur resulting in a raised area over the following week. Eventually a scar would occur. I still have one. Other diseases I encountered among our farming patients were, brucellosis, Q fever, and farmer’s lung. These are still with us. To those pigeon fanciers out there I would remind them of the dangers of psittacosis.

I cannot leave without mentioning the part played by our local public health officers in improving air quality in Newry. For years Newry, on account of its location, had been prone to smogs and poor air quality. Every time I met my old school friend, Mr Hugh O’Neill, who was the Chief Local Public Health Officer, I would raise the problem with him. He was instrumental in getting out to the local Council to install air monitoring stations in the town, and when the results showed how bad the problem was, they brought in clean air regulations so that only smokeless fuel could be burnt. Traffic emissions remain a problem.

In 1994 all the Newry doctors were relocated from John Mitchel Place to the ‘Health Village’ off Monaghan Street. At this stage I was the senior partner with the Shortall, O’Neill, Radcliffe and Torney practice. I retired in 2009, having had a very satisfying career working with excellent colleagues, both medical and non-medical, and not least of all, wonderful patients.