Book No 6 (2021) : Close to Where The Heart Gives Out

Another Scottish island experience, this time of a GP who moves from his Glasgow city practice with his wife and children to Eday, one of the Orkney islands. Written retrospectively, the book recounts Dr Alexander’s time on the island.

At the time of starting work on Eday, Malcolm and his wife, Maggie (also a doctor) have four young children, all boys. As you’d expect, life is a bit crazy as everyone adapts to the new lifestyle with wild and windy weather, a slightly rundown cottage and dramatically different lifestyle. The GP’s surgery attached to the cottage isn’t well equipped and takes a while to get organised. Supplies come by boat, weather permitting.

The islanders leave the new arrivals alone for a while, not wanting to bother the doctor while he settles in. Gradually though, the new GP gets to know his patients, consulting in the surgery and visiting them in their homes. The recollections of these home visits allow the reader to learn about Eday life – cottages with no running water, peat fires, hard working islanders – straight talking, uncomplaining and stoic. Doctor quickly earns the respect of the locals and is asked to step up as a preacher, teacher and vet: very few people have only one job!

What I loved about this book is that it has heart. This isn’t a medical journal or textbook. Dr Malcolm Alexander seems genuinely modest and he treats people, not ‘cases’ or symptoms. His writing is reflective and insightful – about his own part in his marriage difficulties, being a good dad, serving his community and where he seeks fulfilment as a medic. When Maggie encounters difficulties in her fifth pregnancy, her husband’s anguish rises from the pages, as all the while he cares for the boys and his patients.

As you’d expect, the book is also shot through with observations about the landscape and wildlife on Eday; wind and sky, otters, owls and gulls. Tempered with the author’s gentle philosophy about the sanctity of life and his duty to do no harm, embracing the pace of island life instead of resisting it, I found this book enchanting.

The irony of me reviewing a book called ‘Close to Where The Heart Gives Out‘ when my partner has died of a heart attack, is not lost on me! Hearts do give out between these pages, and death itself isn’t euphemised, as you would expect from a doctor. But I was touched by the author’s refutation of the view that as death is commonplace for medics, it becomes almost meaningless to them, part of the job. ‘Patients sometimes think they are just one among many but they aren’t. Each life stays with us.’ I imagine this is why Eday took Dr Alexander to their own hearts. How lucky they were.

Malcolm now lives on Bute, having spent a while working in Stromness before leaving the Orkneys. I’ve started following him on Twitter, where he continues to offer comment on landscape, home comforts, vaccines and duck eggs. In the meantime, I’ve added Eday to my list of places to visit.

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