Facing forward

Heart Beat/Maurice Neligan: JM Barrie wrote that "God gave us memories that we might have roses in December".

Heart Beat/Maurice Neligan:JM Barrie wrote that "God gave us memories that we might have roses in December".

Some days are better than others. Some days are forward looking with scarcely a backward glance. But the past comes unbidden, exposing our frailty and hurt. Such may happen unintentionally by those who wish only to assuage your loneliness and grief and may assume that you are far stronger than you really are. Yet such assertions of love and support and hope actually make your passage on the road that bit easier, knowing that you are not alone in your sorrow and that friends are there for us all at the difficult faltering times.

Last Wednesday was that kind of day. The community and staff of the Mater Hospital held a memorial Mass to celebrate the life of our Sara. I cannot adequately describe how deeply we were touched by the dignity and beauty of this occasion.

We were strengthened and comforted by the loving and happy reminiscences of her colleagues who had known and worked with her during her all too short life.

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In this beautiful chapel, surrounded by ghosts of colleagues and Sisters who had gone before and among them our little Sara, amidst the music and songs of hope, grief was not the motif, but rather the faith and expectation that is so important to us. We were touched, healed and inspired by you all.

Reflection of course was inevitable. No fewer than five of this family worked in this great hospital; The Highest Authority and I, who married while working as registrars here, Maurice jnr and Lisa and Sara.

Sara indeed spent her entire working life here as student nurse and staff nurse. We're very proud of the association, and the loyalty and love with which they remembered you Sara, further strengthened the bond.

I'd like to express our gratitude to the thousands of people who supp- orted us through this time; many previously unknown, now friends for life. Known or unknown, close at hand or far away, we are grateful to you all and we will not forget.

"And time remembered is grief forgotten

And frosts are slain and flowers begotten

And in green underwood and cover

Blossom by blossom, the spring begins."

Algernon Charles Swinburne

Last week I referred to Minister Hanafin's proposals for changing entry into medical school. While I made the point that our current system works pretty well, several correspondents have pointed out to me that the present entry system is not quite as fair as might be assumed at first glance. They made the point that maximum points may be obtained over a wide range of subjects that are not necessarily comparable in degree of difficulty.

I still harbour doubts about graduate entry as presently organised. Medicine is increasingly a scientific subject in all its disciplines. A grounding in science to a reasonable standard is only the application of common sense. You might as well have engineers without mathematics or even, God forbid, lawyers who cannot understand or speak plain English.

Reading the Buttimer and Fottrell reports on aspects of medical education was hard going. Each had a particular strength in pious aspir- ation. I wondered if the respective groups had talked to each other. On the one hand we were increasing the number of medical school places (Fottrell), on the other (Buttimer), we were reducing the number of Non Consultant Hospital Doctors (NCHDs). Did it occur to anybody that these aims are incompatible?

There was nonsensical claptrap about the European Working Time Directive (EWTD) and the reduction of the junior doctor working week.

Mention was made of proper rest periods and structured study leave. Right now it is a very rare NCHD who has attained this Utopian working week. To the contrary, many are forced to work longer hours and are denied the overtime payment earned in so doing.

The latest diktat from the Gauleiters of the HSE states that no locums should be employed. Thus in the absence of a doctor through illness or study leave, their colleagues should simply shoulder the additional workload, unpaid of course! This is despite the fact that the hospitals have a contractual obligation to supply locum cover.

These same NCHDs remain totally unprotected in the event of contracting an illness from a patient such as HIV or Hepatitis C. They are then unemployable in the clinical sphere. Ten years ago I sat on a group containing representatives of the Department of Health to address this problem. Guess what happened?

This health service remains a disgrace to a civilised country. Congratulations to Prof Drumm on his €80,000 bonus.

Maurice Neligan is a cardiac surgeon.