Pat Harrold | Doctor, Writer, Broadcaster and Musician

Tell me how it all began.

Pat Harrold: I was always a big reader. I grew up in a house full of books and I never really stopped reading. I like writing and I realized when I was young that it was one of the few things I got any credit for at school.  I remember around the time of the ‘Celtic Tiger’, the Irish Times health supplement was really thick and there was loads of articles.  Newspapers were very big in those days, with big property sections, and I remember reading it and thinking- this is all very enjoyable but it could do it a bit of humour.  So, I started writing articles about … mainly driving around Donegal with the dog in passenger seat of the car.  They liked them, and they published them, and I’ve been writing opinion pieces ever since.

DMacA: How does that fit with your life as a GP? Do your patients read your articles, do they comment, do you take inspiration from what they say?

PH: They come out with some great stuff. I write it down when they’re gone.  They very rarely read it.  They hear me a bit on the radio – I do a bit of broadcasting for the local radio station, which is a kind of public service. Stuff like… now is the time to get your flu jab, what to do when you have a bad back as this is the time of year where people will be pulling out lawnmowers and things, and that sort of advice . That is really well listened to but the writing, it sort of disappears out there and you never know what effect you have on people.

DMacA: Do you feel its a medium to get the health message across or is it purely for entertainment?

 PH: I think it’s nice to put a message in without beating people over the head with it because, you see,  it depends on the context.  If I go on Tipp FM radio as a doctor, you have to toe the party line and give proper scientific information in a very clear way.  And you always remember, doctor means teacher, and I see it as a kind of a teaching role, without being boring or didactic about it. This was really important during Covid as I was sometimes on the radio three times a week. It wasn’t that I was an expert in virology or public health or anything like that but, I think I did learn one thing-  how to absorb information quickly and distil it down into a message that’s understandable. Even though, at the end of a long day at work, you wouldn’t feel like it, I’d go home and I’d look to see what Mike Ryan (WHO) and people like (Professor) Luke O’Neill in Ireland was saying, what the evidence was and what Tony Holohan (CMO Ireland) had to say, and get it down to a sound bite. There wasn’t much entertainment in that as you can imagine.  I get a lot a lot of dermatology.   People ring in with dermatology problems and you never know what to do.

DMacA: Let me stop you there Pat …how do you do dermatology on the radio?

PH: That’s something I’d love to find out!  (People phone in saying ) ” I have a thing in my leg, what is it?”  It’s potentially very serious medicine and its important to be careful what you say. I might say “this is something you need to see your own doctor about” and then you extrapolate it into a general message about sunburn, moles, and things that change, or how to manage psoriasis or something like that.  You can get a message across that isn’t particular to that patient.  There are little rules and you’re careful to keep a safe path. But, sometimes it’s hard to keep a straight face, even on the radio.

DMacA: What about your colleagues?  Do your colleagues smile at this? Do they enjoy it? Do they ever comment that maybe you got that wrong?

PH: They’re surprisingly nice about it. You know the way your predecessor as a doctor was always supposed to have done something, and it took me a few years working to realize that this wasn’t always exactly the truth.  They might come in and say “he always gave me sleeping tablets” or “he always gave me morphine for my back” and “he always told me I was fine to smoke five a day” and you’re thinking, if he said that kind of stuff he’d be struck off. You realize he didn’t say that at all.  So I’m sure they come in and say, you know, doctor so and so said I should be on such a thing and he said it on the radio.  I’m sure there’s probably a lot lost in translation.  They (my colleagues) are surprising nice about it ….(but) I don’t know what they’re saying behind my back!

DMacA: You are a very experienced rural GP and very active in the rural GP Association. One of the concerns in general practice, right across the world, is the death of rural general practice. It seems very difficult to recruit doctors into rural general practice. Where do you see the future of rural general practice?

PH:  I think rural general practice could be lovely because, when I was training about 30, 40 years ago, a GP was socially and professionally isolated.  They had to live in whatever small village and they were on call nearly all the time.  The work wasn’t as onerous and there are  great stories about them being found in the pub, and the kind of things you wouldn’t get away with now.  But, they’ve brought in co-ops and ‘out of hours’ is much more organized and they don’t have to live there. I can see the tide turning.  Younger doctors tend to be more interested in keeping fit than we used to be, there are more triathletes and surfers and sailors and they’re into outdoor living. Rural practice can be very viable and very enjoyable. It’s easier to get a house now during the housing shortage, and your children would probably be in better schools, small country schools that have a mix of kids. There are a lot of positives about living in the country and the whole healing power of nature.

I don’t know that rural practice worldwide sells itself that way. 

Now there is a more cooperation. I think the (model of) a person in an office on their own isn’t very sustainable and it might not be very healthy. If there are three or four doctors in an area then I think it would be an absolutely lovely life.  You do lose something, a village does lose something, when it loses the school, and the policeman, and the doctor, and the library, and all that sort of thing and becomes just satellite town of the city. You want that community emphasis and the people who can do every little job.  There are a lot of people waking up to that. I just hope that it’s filtering through to medicine.

DMacA: One of the problems is how general practice gets bad press.  You’re a wonderful rural GP. Can you sell general practice to me.

PH: We’re doing our best, you know. We didn’t pick this because we couldn’t become consultants.  We didn’t pick it because we wanted to make a load of money. We’re  perpetually trying to keep the show on the road with very few resources.  Sometimes we feel that getting people into hospital can be darn nearly impossible.  The supports to keep people at home aren’t there.  We know that, we don’t have to be told it. I don’t think in Ireland there’s the same kind of bad press that GPS are getting in the UK.  It’s very much a case of blaming the person who delivers the pizza because it wasn’t cooked properly.  It isn’t our fault that the health services is in crisis.  We have been shouting the alarm for years and years and telling people this isn’t good enough.  We are the advocates for our patients, we’re the ones who ring consultants, ring secretaries and ask ‘what’s going on’. We’re advocating on a constant basis but there is a danger with that bad press.  It’s a danger that doctors won’t want to do it, and will resign, and will immigrate, and retire early, and they’ll do other things, because we have plenty of other options.  I just think it’s sad and it’s  illogical to blame GPs for the state of the Health Service because nearly every GP I know, can’t do any more, they can’t work longer hours than they’re working, they can’t see more patients than they’re seeing,  they can’t up their game anymore . They’re at capacity and they’ve been at capacity for several years and they’re not doing themselves any favours by working flat out all the time. You know….its something that maybe you might not miss till It’s gone.