'Why donating my kidney has made me a better doctor'

[okarol]

'Why donating my kidney has made me a better doctor'

By JENNY JOHNSTON -
 8th April 2008

Next week, one of Britain's leading GPs joins the mail with a column everyone will want to read. Here, he explains why donating one of his kidneys to his ex-wife helped make him a better doctor...

On the wall of Dr Martin Scurr's surgery is a card bearing one of those messages that can't help but make you smile. It reads: 'Life's journey is not to arrive at the grave safely in a well-preserved body, but rather to skid in sideways, totally worn out, shouting, "Holy cow ... what a ride!"'

It is this kind of attitude - as much as his medical credentials - that will make Dr Scurr, the Mail's new medical expert, such an intriguing columnist. More than three decades after he qualified as a GP, he still fizzes with enthusiasm about the job.

When I arrive at his clinic in London's Notting Hill, he is about to see a child with a rash that has defied diagnosis. He flicks through a medical text book, full of zeal for solving the conundrum.

During our chat, his mobile phone alerts him to a string of text messages from patients. One man e-mails to tell him that the drugs he prescribed seem to be working. Another texts to ask if an appointment is possible.

It all seems rather peculiar: a GP who routinely gives out his mobile number and encourages his patients to call him at any time? 'I know it isn't the done thing,' he says.

'These days, it's seen as quite deviant to take calls from patients while you are at home, never mind offer to pop over to theirs to see their sick child. But when you come from the era I do (he's 58), you realise that patients need to have access to you.

'Yes, it plays havoc with your private life - but I didn't sign up for a job which was nine-to-five and involved five-day weeks. The sort of GP I wanted to be never clocked off.'

Press him on what makes a good family doctor - as opposed to a mediocre one - and his own life comes spilling out.

'I think your understanding of patients is enormously improved when you have children of your own,' he says (he has four, as well as a stepson).

'That's not to say you can't be a good doctor if you haven't had children, but you understand a parent's anxiety when, say, their toddler spends a night in agony with an earache.

'It also makes a tremendous difference if you've undergone major surgery yourself.'

He jumps to his feet when I ask what he had 'done', and lifts his shirt to show a long scar snaking round his torso.

'I donated a kidney to my ex-wife,' he says.

'It was 14 years ago and was one of the first transplants of its type, between a married couple. Unfortunately, though, six days in, her body rejected it, which was a huge disappointment.

'She went on to spend 12 years on dialysis before she had another transplant — which did work.'

Gosh. Was he a good patient when the tables were turned? 'Oh no,' he laughs. 'I had the kidney out on the Tuesday, was discharged on the Thursday and was driving again the following Tuesday. After an operation like that, you're not supposed to drive for four weeks.

'But how else was I going to get back to the hospital to see my wife?'

In truth, Martin Scurr was never going to be anything but a doctor. His father was a 'very eminent' anaesthetist, and pretty much expected his children to follow suit.

'He was one of the first to reduce children's body temperature so you could operate on their hearts,' says Dr Scurr. 'Pioneering stuff.

'It was this that my father lived for - the science of it all, the infinite possibility of what could be done. He was amazed when I told him I wanted to work in general practice because it was the people I cared about, rather than the science.

'In his day, being a GP was something you did only if you weren't talented enough to specialise. He has never been able to understand my passion for it.'

Of equal historical merit, Dr Scurr's father was part of the medical team which operated on the late King George VI for lung cancer.

'They took out his lung in the drawing room at Buckingham Palace,' Dr Scurr says.

'It was September 23, 1951. My first birthday.'

A former chairman of the Independent Doctors' Forum (the private doctors' representative organisation), Dr Spurr runs his private GP practice near London's Portobello Road, cutting quite a dash in his three-piece suits.

The 'private' aspect sheds light on how he can afford to be at his patients' beck and call, as well as offer the luxury of half-hour appointment slots.

If today's royals are patients, he is too discreet to say so - but he does acknowledge that he and his colleagues get household names through the doors, even if they aren't automatically recognised as such.

'A famous Eighties pop artist came in to see one of my colleagues one day and he asked what she did. "I'm a singer," she said.

"Oh, what do you sing?" he asked her. "Should I have heard of you?"'

Dr Scurr isn't averse to dipping his own toes into the showbusiness world. The ex-wife who acquired his kidney is Glynis Murray, a film producer who worked on Waking Ned and Nanny McPhee, while he himself has worked as a medical adviser on the hit TV dramas Doc Martin and Cranford.

Dr Scurr is a doctor whom patients feel they can trust - even with their darkest secrets. 'A husband and wife came to see me and told me that they were planning to kill their son.

'The husband was dying, and they were afraid that the son - who was a violent, nasty piece of work - would hasten his end and try to get his hands on all the family money.

'It was a hideous dilemma. Could I stand back and do nothing - knowing that this man's life was in danger? Or was I morally obliged to act, breaking patient/doctor confidentiality?'

In fact, the son was sectioned under the Mental Health Act, removing that difficult decision, but the experience was a reminder that being a family doctor can be tough.

And it is the thorny issue of what we expect from our GPs these days - in terms of hours worked, accessibility and accountability - that inflames such passion in Dr Scurr, and will be the subject, no doubt, of some of his columns.

Dr Scurr believes that working outside the NHS, yet coming across so many patients who have fled to him because of disillusionment with the system, gives him a useful perspective.

'I don't think it is apparent yet what has been lost in the restructuring of the primary healthcare system,' he says. 'By rescinding responsibility for 24-hour care, GPs in the NHS have relinquished something quite unique.

'To me, it is the same as saying GPs no longer offer cradle-to-grave care, and that's a terribly sad thing. It was one of the cornerstones of the NHS.

You had a family doctor for life - in much the same way that you had a lawyer and a bank manager.

'Now, it has all changed. We can all foresee the day when you go to Tesco and queue up for your healthcare.

'You won't even know the name of your doctor, much less anything about him.'

Is this a bad thing? Dr Scurr thinks so. He shows me some letters from patients, many who have known him all their lives. Some are expressing gratitude for the biggies - lives saved, final days made more comfortable, children brought safely into the world.

Others say simply: 'Thank you for listening.'

'Patients want to feel listened to, and you can have that level of trust only with old-fashioned one-to-one care,' he says.

'I don't see how systems like NHS Direct can replace that.

'I have done this job for more than 30 years and I find it really hard to talk to people on the phone and ascertain what is going on. Imagine doing it as a nurse who has been on a training course. I can't see how they do it - not with any confidence.

'It is terribly worrying, because for many people this kind of healthcare is all that is on offer.'

That Dr Scurr will be a controversial addition to the Good Health team is clear. He is unashamedly outspoken about failings in the current system.

Take his views on Lord Darzi - the surgeon appointed by the Government to review the structure of primary healthcare.

'Having him reporting back to Government is like putting someone who is very good at changing exhaust pipes at Kwikfit in charge of manufacturing for BMW worldwide,' he says with incredulity.

What does he know about general practice? No more than I do about taking out gall bladders through a keyhole - which is what he does brilliantly.

'It's a perfect example of being in the right place at the right time, then getting elevated to the Lords and made into a junior minister.'

He mistrusts some alternative therapists who woo patients with their 'brass nameplates and air of authority', believing that they hoodwink the vulnerable into 'treatment before proper diagnosis'.

But he does believe osteopathy, hypnotherapy and acupuncture can work.

Dr Scurr, of course, knows what happens when medicine gets political, and is no stranger to controversy.

Last year, he resigned from the board of the fashionable Hospital of St John and St Elizabeth in North London in protest after Cardinal Cormac Murphy-O'Connor, the head of the Roman Catholic Church in England and Wales - and the hospital's patron - weighed in on doctors' clinical decisions about contraception, abortion and sterilisation.

He's at pains to point out that his columns won't be the ramblings of a 'sad, jaded old-school doctor'.

He maintains that there has never been a more exciting time to be a doctor in Britain today. Part of his continued professional enthusiasm comes from seeing the tangible differences medical advances are making to his patients' lives.

In his own life, Dr Scurr is watching the past and future diverge. His son is at medical school, continuing the family tradition - 'although he will probably sign up for a 40-hour week and think it is quite normal. I'll always beg to differ'.

Meanwhile, his 87-year-old father is ailing, and it pains Dr Scurr to watch him decline.

'In January, he had a small stroke and fell over and broke his spine. In the end, he will probably fall down the stairs and break his hip and die of it,' he says - a doctor's pragmatism touched by a son's sadness.

'I don't know if I want to last that long, not if it means going like that.' Dr Scurr is as obsessed as any of us about this life-and-death stuff. The other day he found himself doing some calculations on the back of an envelope.

'I worked out that if I lived to be 100, I had 100,000 hours to go. It was food for thought. If you had £100,000 to last you your days, and you knew that you couldn't get a penny more, you'd think twice before you spent £2 on a Starbucks coffee.

'It made me think about time and how precious it is. You'd think I'd know that, in this job. But sometimes you need to be reminded, you know?'

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