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At the heart of general practice since 1960

A doctor in the armed forces

Surgeon commander Roger Thomson returned to the armed forces six years ago. Here, he describes the exciting challenges of being a navy doctor – including a stint in Afghanistan earlier this year

Surgeon commander Roger Thomson returned to the armed forces six years ago. Here, he describes the exciting challenges of being a navy doctor – including a stint in Afghanistan earlier this year

The big helicopter banked at an impossible angle as the pilot wrenched it round into a steep curving descent. Through the hatch in the belly I could see snapshots of the ground and sky – a slash of red poppy fields, mud buildings and then choking dust as the aircraft settled on to the ground.

Seatbelt off, I tightened the straps on my body armour and rifle and joined the 30 others pushing out the back. Grabbing my rucksack on the way, I staggered into the jetwash of the exhaust, down the ramp and on to the stony ground.

The helicopter wound up again and climbed quickly to thump off out of sight.Once the dust had cleared I took stock and was approached by a tall, gangly, ginger-haired figure. He brushed the dust off the rank slide on his midriff. He was a surgeon lieutenant. 'Welcome to Gereshk, sir. This is the best base in Helmand province – you're going to have a great time!'So how did I end up in Afghanistan earlier this year?

Back in uniform
In May 2001 I handed in my resignation at my west Somerset practice. I had come back to the NHS eight years earlier after a spell in the army where I had trained as a GP and worked in England, Cyprus and Germany. I had also been on operational tours to Northern Ireland and then Kurdistan in the aftermath of the first Gulf War.

I loved where I lived – indeed there is no better place for a family to be – but my enthusiasm for general practice was gradually fading. I had seen all I was going to see in our practice and the days were much the same. The pay was okay but there were a lot of expenses and the new GMS contract looked rather ominous.

I joined the navy that November, aged 42. I answered an advertisement in Pulse, had several long discussions and an interview with the medical recruiters and was then helped through the transition from partnership back to uniform.

I learned the basics of the navy quickly on the New Entry Medical Officers course, some aviation and diving medicine and spent some time at sea with a more senior navy doctor. Soon I was principal medical officer on the aircraft carrier HMS Invincible. Here began two of the most memorable years of my career, looking after up to 1,500 sailors and airmen at sea and alongside in Naples, Barcelona and New York.

One day we would be launching jets and the next we could be hosting UN drinks on the flight deck. I was also making medical decisions completely unlike anything I made when working ashore – do you send a helicopter out in bad weather 60 miles over the Atlantic to a hospital because a female sailor might have an ectopic pregnancy?

From Devon to Afghanistan
After my stint on HMS Invincible, I returned to the UK and my current job is at the training base for the Royal Marines in Devon. I am now in charge of a sick bay of 30 staff including four doctors, three nurses, four physiotherapists, a radiographer and navy medics of all ranks.

Sports medicine was a steep learning curve and we have some microbiological challenges as our trainees are prone to deep-seated skin and subcutaneous infections from all the trauma they receive. It was from here that I volunteered for the tour in Afghanistan in spring this year.

The preparation was excellent. There is a new trauma and life support course that has distilled the 10-15 years' experience of caring for battle casualties into effective, simple drills and routines. This training is proving its worth repeatedly in the military operations that Britain is involved in. The military training is also impressive, covering everything from weapons and landmines to cultural awareness and working with interpreters.

Coping with trauma
My ginger-haired one-man welcome committee was not wrong. On arrival in Gereshk I found it was a basic camp, tented but with electricity, hot showers and its own shop. There was an excellent gym, good fresh food and even the internet.

I was a GP for 300 Royal Marines and soldiers, who were conducting fighting operations against the Taliban in the Sangin Valley, Helmand Province. With a nursing officer and four medics we provided primary care and pre-hospital trauma facilities.

We also helped run a local clinic for the civilian population, treating everything from sick babies to terminal care for cancer. We had our share of trauma, caused by engagements with the Taliban, and we saw several gunshot and fragment wounds. But the training proved its worth and the team worked well.

We got very slick at treating the wounded and getting them ready for helicopter evacuation to the main hospital. My tour over, it was back to west Somerset for three weeks' leave in April, with lots of stories for the family and one stone lighter.

So if any GPs are thinking of a change, consider the navy. Your medical skills will be valued, and you will have experiences outside of medicine that will last a lifetime.

Surgeon Commander Thomson is principal medical officer at the Royal Marines Commando Training Centre in Lympstone, Exmouth, Devon

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