Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.
A normal day for Dr. Pierre Pili may involve being helicoptered up to a glacier in the Alps, and then lowered by cable 30m down into a crevasse to assess and treat casualties. Few of us see patients in such a difficult and unforgiving environment but this is Pili’s consulting room. A mountain rescue doctor based in Chamonix, he is involved in about 1500 rescues per year, and when not on the mountain, he works as an emergency medicine doctor.
On his first rescue he was called to help two skiers who had fallen deep into an Alpine crevasse. One was dead and one was seriously injured. Pili talks about the mixed fear and excitement of doing this work ...continue reading
Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He is currently attending the North American Primary Care Research Group (NAPCRG) annual meeting in Colorado Springs, CO.
Not many primary care doctors have an 8 billion dollar budget. Mitch Katz, who gave the opening keynote address at NAPCRG 2016, is director of the Los Angeles County Health Agency which combines the Departments of Health Service, Public Health and Mental Health into one service. He continues to see patients and described how he had become so specialised in his career in a primary care AIDs clinic in San Francisco, that he found returning to generalist practice extremely difficult. When he focused on AIDS he was on top of his topic like any specialist, but, as a generalist, he had to cope with anything from a heart attack to broken heart.
Los Angeles, until recently, had no ambulatory care ...continue reading
Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
We expect Nobel Prize winners to be high profile researchers of almost celebrity status, pioneering cutting edge science that changes the world at a stroke. And, then I heard that one of this year’s winners was William C Campbell, a fellow Irish man. I didn’t recognise the name, was unfamiliar with his work, and knew nothing of his background. But, as the media story broke, I learned more about him. He came from Ramelton, a small village in County Donegal, far from the bright lights and, like many Irish doctors, undertook his graduate work in the US. His research was in worms - not the type of glamorous cutting edge clinical science that features in glossy magazines but, from the messy world of vials and dishes and parasitic roundworms kept in the freezer.
“You must be kidding!” was his reaction, when telephoned with the news.
But, his findings did change the world. ...continue reading