Inverness Meeting – Oct 2023

Review by Dr Tim Reilly

Inverness 2023a comment by Dr Tim Reilly

The autumn AFMS meeting at the Kingsmills Hotel in Inverness this year was bracketed by unnamed torrential downpours the week before, and Storm Babet the week after, but somehow contrived between 11th and 15th October to find the Highlands clothed in a windy but mostly dry autumn beauty. 

What, we wondered as we crossed the famously bouncy footbridge over a swollen River Ness, as it flowed past at an alarming rate beneath our feet, was the French for “shoogly”? Bancale? Rebondissant? No matter, the bridge, like all structures in Inverness that week, held firm and did its job. 

The Kingsmills Hotel, our venue, turned out to be supremely reliable and delivered us board, lodging and conference facilities all to a standard universally agreed to be exceptionally high. After our president had welcomed us all, in Gaelic, on the evening of the 11th, there was a chance to catch up with auld acquaintance over a buffet supper, before the meeting began in earnest the following morning. 

This year for the first time we were delighted to hear entries for the newly created Hertford British Jean-Pierre Gotlib Prize, named after the late distinguished past president of our French sister society, and generously funded by the Hertford British Hospital of Paris. Aimée Lawton explored the question of how climate change is facing health around the globe, and equally importantly, what healthcare services should be doing to avoid contributing to the problem. Philippa Davies and Marcus Goodlad presented unusual clinical cases, the first of a case of weakness preceded by headache and facial nerve palsies which turned out to be a variant of Guillain-Barré syndrome (yes, nerve conduction studies can be useful), and the second of an orbital swelling which turned out both to be caused by the rare lymphoproliferative disorder myeloid sarcoma, and to belong to the speaker, who was able to confirm his complete remission. Aimée Lawton carried off the laurels. 

After coffee Stéphane Deluermoz gave a psychiatrist’s point of view on whether or not James Joyce was mad, coming down after sifting the evidence on the side of sanity, although the extracts from Finnegans Wake ably read by Rex Melville left some room for doubt. Corinne Matussière, urgentiste, brought us all back down to earth by telling us what we should be packing in our emergency evacuation bag, the thing you grab as you head through the front door after the dam bursts. I’m definitely going to get a ‘life straw’ which allows you to drink safely from muddy puddles, though whether I can lay my hands on it when the hour comes.… Such was Corinne’s infectious enthusiasm, we all went away thinking “Disaster? Bring it on!” 

The morning concluded with the first of two James Tudor Lectures, given by an invited speaker. Rob Reid, lately a captain in the Royal Army Medical Corps, recounted his experiences as the MO delivering prehospital care at a forward medical station at Kabul airport. Many of the casualties were civilian, and we were left with a mingled sense of admiration at what can be achieved in the face of overwhelming demand with minimal and dwindling resources, by a team with good morale and a sense of pluck and improvisation, and exasperation at the political failures that had left them so exposed in the first place. 

Accompanying delegates had enjoyed the morning with a walking tour of Inverness, exploring landmarks and history, and they joined the main group for the afternoon visit to a distillery to learn about the Water of Life which irrigates the Scottish economy. While Bus A headed off to Glen Moray, Bus B learnt 5 minutes before departure that their distillery had been flooded. No matter, our resourceful guides had a replacement up their sleeve, complete with a master brewer and distiller who had worked in France for eight years, and was able show us round in fluent technical French. Only problem, the distillery itself was so new they couldn’t actually let us taste their product, which has to be three years old before you can call it whisky. But I shall be looking out for a bottle of Uile Bheist to try in 2025. You heard it here first. 

On the Friday morning we heard the students presenting their entries for the James Tudor Prize. It has been a pleasure over the years to see both the number and quality of presentations from both sides of the Channel continue to grow, with more than ever students speaking in their non-maternal language. This year there were seven entries. We heard about post-mortem organ donation in France, and about the differences between the French and British systems of choosing career specialty amongst newly qualified doctors. A French Cambodian student gave us a comparison of healthcare systems in France and Cambodia, and a British student talked about about the experience of misogyny and racism and we had two reports arising from electives which the society had supported through the Miss Ford Prize, one about the French SMUR system of paramedic response teams and the other a reflection on the experience of living and working in a second language. The overall winner was Joseph Albou from France who presented a case of a young man whose sudden collapse was found to be due to profound hypokalaemia caused by underlying thyrotoxicosis. 

After coffee the second James Tudor lecture was delivered by Hamish Myers, who as well as being a specialty registrar at Raigmore Hospital in Inverness, training in Emergency Medicine, is a working farmer. He kindly spared time from the livestock to tell us about Remote and Rural Medicine, illustrating his talk from his personal experience. Here, should we ever need to know, was how to manage an unstable patient on an island when the sea is high in the Minch, the ferries are not running, and the choppers can’t fly. The session concluded with our president giving us an overview of the Ghaidhealtachd and how it is doing, and while the ever-retreating front of Gaelic-speaking Scotland towards the North and West looked depressing, he was able to point to a few green shoots. 

In the afternoon the entire group took to the water, bound for Urquhart castle. If you had wanted Loch Ness to show itself at its romantic best, you’d have requested a bright blustery afternoon when the headlands down the lochside receded in a succession of lightening tones, a dark cloud above throwing from its underskirts a shaft of sunlight to silver the distant water, and maybe a rainbow as a backdrop to your Jacobite ruin when the cloud finally shed its load. Which was exactly what we got. Home in time to spruce up (everyone) and don the plaid (some of us) before we were piped by our military speaker of the day before, revealing hidden talents, into the gala dinner. A ceilidh band, as patient as it was excellent, took the uninitiated through the steps of Strip the Willow, and our French guests rapidly understood that Highland dancing is perfectly possible with an ounce of determination, a large smile and a lively appreciation of the principle of centrifugal force. Although it’s fair to say there were still debates over breakfast about when to use ‘le bras gauche’, and when ‘le bras droit’. 

The scientific programme concluded on the Saturday morning with an update of the status quo in France with regard to COVID-19 by Thierry Baudelet of the French society, a run-down by Helen Mackay on how to make sure that payments due to you from your NHS trust are in fact paid, and a case presentation by Rex Melville of an unusual parasitic infection in an immunocompromised man. Those who stayed in the afternoon visited the battlefield at Culloden to be reminded that there are worse ways of deciding the future of the country than a referendum, while the rest of us departed to reflect on a wonderful meeting when old friendships were renewed, new ones forged, and fruitful discussions had for future meetings and directions. We look forward to Orléans next year. 

— Dr Tim Reilly