Domhnall MacAuley: Lasting memories

Domhnall MacauleyMemory is short. I learned this early when, as a junior doctor, my consultant retired.

He was a legend, irreplaceable, the backbone of the hospital. But, it takes less than a year to be forgotten. You soon become that nameless old buffer at the cocktail party- remembered only by former colleagues and a few senior nurses. The junior staff have moved on and any residual links are lost with the second crop of replacements. The new consultant is already established, has put their stamp on the department, and systems have changed. It’s a little sad to see the old tyro lurking around the hospital corridors, picking up locums to recapture past glories and struggling with their self esteem. Now history, they don’t see it that way and would be horrified to be thought of as yesterday’s men or women. No matter how deep our footprints, the next tide leaves no trace. There is a time to move on.

Perhaps, for this reason, I find myself grappling with the huge gap left by the recent death of Kieran Sweeney, a GP academic in Exeter. We trained together, almost thirty years ago and, linked by our shared GP training, involvement in general practice and common friends, our careers overlapped at various stages. I watched the course of his life and career with great interest and admiration; his commitment to patients, creativity, courage of his convictions, his use of language, innovation, intellectual dexterity. But, above all, his humility. He worked in France at a time when I could barely work out schoolboy verbs. He pronounced Goethe while I strangled it. In the light of his talents, I could only smile at my own inadequacies

When he died, part of me died. That belief that everything is possible, there will always be tomorrow, the future is endless and that everything will work out. He always retained the optimism of youth, our life’s delusion. He was a role model. Not in the modern superficial sense but in his values, the way he thought, and in his actions. Exeter was a hothouse of bright intelligent high achievers, many of whom became great leaders. He was part of that time and place where great ideas and bright people converged and he thrived on the intellectual stimulation. And yet, at the centre of everything was his care for people. Dedicated to patients, he once took time out of practice because he could not face another one of his patients dying. Part of him suffered with every loss.

I watched with excitement how he experimented with new ideas and challenged current thinking. He created a different practice model, explored different concepts and ideas, published academic papers, wrote books. He was well ahead of current thinking in his work on complexity. Someone will later rediscover his work, and become celebrated in his wake. His professorship, awarded late in his career, was eventual though inadequate recognition of his achievements. Life was unkind in the end: fate gave him a disease without hope, and he watched his own life ebb away.

Another memory kept alive is that of Madeleine McCann. One thousand days have passed since the start of her parents’ worst nightmare. They cannot let us forget as, while her memory remains, there is some hope. When I see her dad, and his terrible anguish, I recognise another outstanding colleague whom I have had the privilege to know. When our paths crossed, he stood out; his wit and humour, commitment to his work and his concern for his students. I hate to see him suffer like this. Memory, legacy, reminders, loss. Life is cruel, faithless, unfair.

Read an obituary of Kieran Sweeney on bmj.com here.