Ladies and gentleman, I would like to take this opportunity to thank Lorna and the family for giving me the great honour of saying a few words on behalf of many about one of the most important doctors and role models of my professional life (and that of many other’s professional lives) . We all have our own stories and memories of John and I think that the measure of the man was in his ability to be many things to many people.
We will hear from Ian MacAuley about his role as a community leader in North Uist and as an exemplary citizen but I want to tell you about the myriad of roles that he held in the medical world which make him what many would call. The complete doctor, the universal doctor in a time when medicine’s obsession is with the detail rather than the bigger picture of professionalism, advocacy, holistic care and leadership. John Macleod was all these.
I last saw John this summer at the 9th WONCA World Rural Health Conference in Crete. I had worked with Professor Christos Lionis (the conference organiser) to construct a programme that reflected the rural issues to be found in the Greek Islands. It was of course natural that we should have a keynote on the topic of Island Health. There was only one candidate who could give such a presentation and that was John. In his lecture he inferred that he had been dragged out of retirement and with his usual wicked sense of humour started the speech by thanking the Greeks for giving the UK 12 points in last years Eurovision song contest! (I don’t think that we had any more!)
We were all delighted. Here was a man who had retired 9 years ago but had still retained his wit, intellect and his passion. It was like the old days once more. We had John back at our helm.
What makes a really great rural doctor? There are many factors but most important is about how one engages with the community that you serve. The Macleod family have given to their community in Lochmaddy for 77 years. North Uist was always the most important but John had many other communities and he engaged and gave tirelessly to all of them.
John was born in North Uist and grew up there. His father and mother were both doctors and the tales abound about their courage, dedication and the service that they gave to their community. They had a crucial role in the establishment of effective health services in the Highlands and Islands and were involved in the founding of the first Scottish Air Ambulance Service. John took on their work and championed better care for the remote communities of Scotland and he continued to support the air ambulance service with all his usual vigour and perseverance. Another of his many communities!
His education took him from primary school in North Uist to schools in Stornaway and Glasgow. With such role models and experience it was not a surprise that he should choose to follow a career in medicine and he entered this medical school here in Glasgow. He maintained this bond with his old medical school throughout his life.
Following graduation in … John spent his National Service in the Royal Navy and returned to Glasgow to do his house jobs. He subsequently took up jobs at London Teaching Hospitals including my Alma Mater, Guys hospital.
He returned to Lochmaddy in 1973 to join his father who retired the following year. With him he brought his Wife, Lorna. It must always be difficult to return to your childhood home as a GP when everyone knew you as a little boy. I also wonder how distant and different this new home might have looked like to Lorna when she first arrived. Despite this they made such a success of their island lives.
John worked as a single handed GP initially and at the same time running the local hospital at Lochmaddy before taking on a partner.
My memories of John have always been of a man with high impeccable standards and he applied those high standards to how he worked. He was passionate in the Hippocratic tradition that we have a responsibility to mould the next generation of doctors. He was ahead of his time welcoming local sixth formers from the island to experience general practice with him, he had medical students from all over the world visiting him in Lochmaddy and he was a GP trainer for many years. He organised courses so that young doctors could understand rural issues and rural problems.
John believed that being rural and remote did not mean the GP to should take a less rigorous or less critical approach to medicine. He applied an academic rigour to his practice of medicine. He believed that if we were to change attitudes to rural health, rural GPs should conduct original research. John was very modest about his research but he conducted work on topics such as hypertension, radioactive contamination and wrote a number of papers and chapters in books.
The plight of rural communities and their health services in a modern technological urban-based society (or as John referred to as City Slickers) continued to worry him. He travelled to conferences. As Jim Douglas said in his obituary, John was never happy to be just a delegate, he gave papers, presented posters and delighted in meeting and supporting doctors from all over the world. Professor Jim Rourke, Dean of Memorial Medical School, Newfoundland said of John in meetings around the world “John always made friends with both the high ranking dignitaries and regular folks as well. This was a big part of John’s magic as a leader”. It was at one of these meetings that John met with a group of young rural doctors who in Johns own words represented “ a level of unrest and disenchantment amongst rural doctors throughout world”. These rural physicians met at the International Congress of the World Association of General Practitioners (Otherwise know as WONCA) in Vancouver in 1992. This small group which included John, Roger Strasser, Neithia Naidoo, went on with 4 other original members to form the Wonca Working Party on Rural Practice and produce their first publication “ Policy on Training for Rural General Practice” with no face to face meetings at a time when there was no email but just fax and the telephone. (This document is referenced now in any paper concerning rural medial education. It is the seminal defining document on rural training) The working group went on to become the most successful and prolific of all the WONCA groups publishing papers, running conferences and changing attitudes to rural health and training for rural practice.
In fact the recent historic declaration passed at the World Health Assembly on the importance and pivotal role of primary care worldwide, started with the Wonca Working Party’s initiative, Health For All Rural People (HARP). Much of this can be put down to John’s support, guidance, leadership and wisdom. He was always there in the background guiding & nurturing us. John commissioned a special Wonca composition on the pipes. We could not in future forget the Scottish influence that lay behind Wonca rural’s progress around the world
There was a steady stream of international visitors to Lochmaddy. To us as rural GPs, none had made it as a true rural doctor until we had received the coveted BLM award (For the uninitiated Been to Lochmaddy). John and Lorna were the greatest of hosts. We would be given a tour of the islands, go fishing on Suala and fly fish for the hardy small brown trout in the multitude of Lochs that cover the island and John was sure to have your national flag flying from his flagpole. John was unselfish in this generosity. I remember when I saw him in Crete and told him that I had been unwell. He immediately invited me up to spend time at Lochmaddy. He showed genuine concern despite that fact that we now know that he himself was significantly unwell. This was the kind of gesture that we all came to expect from John.
I have a list of messages to you all but in particular to Lorna and the family from all over the world. Messages from Australia, New Zealand, Canada, USA, Europe, India and many other places. (Lorna, I have a special message from your great friend Di Wyatt from Brisbane who would give anything to be with you today) Many of my international colleagues are watching this on the webcam, many more are here in spirit.
He was a great doctor and a great man. Witness to this are the numerous honours bestowed on him which include, Fellowship of the Royal College of General Practitioners, Honorary Fellowship of The Royal College of Surgeons of Glasgow, Life Member of Wonca, Special Award at the 6th World Rural Conference in Santiago de Compostela, Visiting Professorships at the University of North Carolina and Western Ontario, Member of the British Empire, Lifetime achievement award (Fishing News 2007) for his campaign to make fishermen wear floatation devices etc….
I must finally say something about Lorna. I truly believe that John would never have been able to achieve all this without your special help and support. You are also a remarkable person.
Lorna and the family, we hope that you will find the strength to live without the man but with his memory and achievements.
He was a great guy and we will all miss him.
To finish I would like to quote from Mark Twain’s Obituary in the Boston Globe 23rd April 1910
“Nor can death come between him and the world. He will live in his works”
January 16, 2010