It's in my blood

People often ask me where I’m from. It’s usually that first friendly exchange while traveling. “I’m from Northern Ireland, ” I say. I sometimes get the reply, “But you look Spanish or Portuguese”. Here, in Morocco, I’m told I look Moroccan; in the Philippines, I looked Filipino.

This is a story about my grandmother, Rosie; how my mother came to Northern Ireland and how medicine finally chose me. The story begins in Quetta, Pakistan.  

 

My grandmother was born in the city of Quetta, along the northern edge of what is now Pakistan. Situated at an altitude of over 1600 metres, and surrounded by mountains, the air is thin and clear and the plains fertile.  My grandmother still talks about the lush orchids where the pomegranates are the size of cantaloupes and red-apricots cover the earth.  She says, “Everything was fresh.  The chickens were killed and eaten the same day. Milk and eggs were straight from the animal. We had no cold storage like today. Everything was abundant: pistachios, wild almonds, figs.” 

My grandmother isn’t exactly sure how old she is because her birth certificate was lost during the large earthquake in 1935. Her rough guess is that she was born in 1923, which would make her 92 years old.

Grandma married my grandpa, Rock - or Rocky as she called him - at the age of 16. After having three children, she moved the family to the capital city, Karachi, on the south coast, where she began her training as a midwife. My grandfather left for Bahrain to work as an engineer and Rosie became the head of the family. She was set on making sure everyone’s brain was in optimum working order, starting with a handful of almonds each day - soaked and peeled, putting fish on the dinner table and emphasising the importance of education.

My mother, Regina Raphael

My mother had followed my grandmother’s instructions closely; she had eaten her almonds, worked hard and, at the age of 17,  been accepted to study medicine.  The King Edward Medical College in the city of Lahore is situated in the northeast of Pakistan, 800 miles from Karachi and 10 miles from the Indian border.  My mother made the train journey there alone. Until then, she and her siblings all had worn tailor-made ‘European clothes’, with patterns taken from the latest Vogue catalogues. At university, where my mother was the only Christian in her year, she chose to wear the traditional salwar kameez, which was the fashion among her fellow students.

After finishing her medical studies, my mother started her first job as a house doctor in the Seventh Day Adventist and Holy Family missionary hospitals in Karachi. There, she trained with an English doctor who encouraged her to consider working in the United Kingdom. So she did.

She had spent three months in London happily sightseeing, eating jam sandwiches, and living in a convent, when she heard about a job vacancy somewhere in Northern Ireland and arranged a telephone interview. It was 1969. Civil rights marches and riots had begun to dominate the news, marking the beginning of The Troubles. One week later, my mother was standing with a small suitcase in Alder Grove Airport, Northern Ireland, ready to begin work in the cardiology and medical unit of the Waveney hospital.  She was to work under the physician Dr. R J Kernohan who had interviewed her. Her arrival came one year after Professor Pantridge, in the Royal Victory Hospital, Belfast, had designed the world’s first portable defibrillator. Before this invention 60% of patients with heart attacks did not make it to hospital alive. With the defibrillator on board, Dr. Kernohan initiated the first cardiac ambulance service in the Waveney, and my mother was called out almost every day to treat patients with chest pain at home or on the street.  Deaths from heart attacks were decreasing; it was an exciting time to be in medicine.

Over the next ten years, my mother completed her training to become a general practitioner (GP), married my father and gave birth to my older brother Steven and myself. It was then 1979. We were relocating to the small market town of Cookstown, where my mother took over Dr. A. McGlynn’s family practice when he retired. I was three. It was another five years before Christopher would arrive.

When Christopher was born, I had already run my second cross-country race. I was eight. That year I became captivated, not only by my new little brother but also, by the Olympic barefoot runner Zola Budd. I had found my first sporting hero and wanted to become a runner. 

“I don’t want to be a doctor because you work too much,” I said to my mother.  By 8-years-old, I had accompanied her on many house calls late into the evening, driving along dark country roads and waiting in the car while she tended to a patient. In those days, “on-call” meant 24 hours a day, 7 days a week, with patients regularly calling at our home.

The question of “ What will I be when I grow-up?” was a tricky one. I loved sports. When I wasn’t traveling around Ireland playing the Gaelic sports handball or rounders, I was playing football outside our house in Cookstown or hockey at school. I dreamed of being a football player but also loved drawing and building things. My father had told me when I was young that artists don’t make any money until they’re dead. That was a bit of a shock. I also wanted to be an undercover SAS soldier who rescued people held captive in foreign countries while surviving under extreme conditions. I regularly read the SAS survival guide by John Wiseman.  Among many things, it taught me how to perform emergency first-aid, to identify poisonous plants and how to prepare for nuclear fallout.

 My Grandma Rosie & Christopher

My Grandma Rosie & Christopher

I was surrounded by medicine:  my grandmother’s natural remedies, my mother’s modern practice and Christopher’s own medical conditions.

 My grandmother talked about the ability of the papaya fruit to rid the bowel of parasites and turmeric’s potential to reduce inflammation.

My mother often treated my brothers and me as patients; I watched and learned attentively.  By the age of nine, I thought I knew the signs of appendicitis and meningitis. For example, she would press my abdomen when my tummy was sore, palpating deeply where the appendix is and then releasing her hand quickly; if it wasn’t sore on release, I knew I didn’t have appendicitis. If I had a sore head, she would ask me to bend my neck forward towards my chest; if it wasn’t sore – excellent, no meningitis! My mother also warned me against using deodorant containing aluminium and eating processed meats. I had never eaten a processed beef-burger.

Sometimes I played the doctor. I remember one morning when I was preparing for school. My mother was sitting at the kitchen table nursing her two swollen knees the size of those pomegranates my grandmother talked about. She was crying; I had never seen my mother cry.  I heated up some Chinese oil that my grandmother had sent and rubbed it gently into her knees hoping to ease her pain before she went to work. It was a dreary morning, but I had never felt closer to my mother.

I was always hoping to come across a cure for her Rheumatoid Arthritis. I had read about alkaline foods and why those flax seeds that my grandmother kept sending might help. I even read my first journal article - sent by the parents of my German friend Susi Klein in 1990- about a new drug called Methotrexate, which was not then available in Northern Ireland.

My brother Christopher was a medical textbook.  As I cared for him, I learned about Down syndrome, open-heart surgery, glue ear, the thyroid gland, and tacheostomy tubes. Medicine was fascinating.  Surely, I wanted to be a doctor. Didn’t I?

When it came to choosing secondary school subjects to prepare for a career, I opted to drop Biology. I was certain I was never going to be a doctor and had taken my strongest subjects- Maths, Physics and Chemistry. My mother was still working as had as ever. I was thinking of being an engineer, architect or mathematician. Despite my interest in art, I didn’t have space for it in my timetable.

One Sunday morning, at the age of 17, I was sitting in church, when a lady ran in the side door and shouted, “ Is there a doctor in here?” My first thought was, “I want to help her”, but I couldn’t.  In that moment, I realised that I wanted to be a doctor.  Then, I watched my mother get up quickly and go outside. She was gone for the duration of the Mass as she treated the woman’s father who had collapsed in the car park. The next day I arranged to start the biology night classes, which would set me on my way.