Day thirty-nine - Thursday

Amazing weather, first time since I've been here!

Sun streaming through my window greeted me in the morning, as I threw open the curtains to reveal the best day of weather since I've been on the island! Made my way into A&E, bit of a morning lull before two cases in quick succession, a young one with possible bronchiolitis and an older one with a nose injury. Had to quickly look up how to do a nose exam, not something I've covered so far! Was interesting following the paediatrician on the first case, got some good teaching and they had a great manner with both the baby and the parent. Another lull before an ankle injury came in, which on examination looked like it might have been fractured. Xray proved otherwise however, so they were discharged with a support bandage, crutches and physio advice. This is something I picked up in Fort William, after doing a fracture clinic. The consultant there was really good at talking people through physio exercises and giving them crib sheets - it can make a lot of difference to the speed and quality of their recovery, and many people will not have time to seek proper physio advice afterwards so the A&E consultation provides one of the few opportunities to instill some practical tips.

After that the treatment rooms were empty, waiting room was empty, sun was shining... Yep, hit the road for a run! Drove down to near the Scaladale outdoors centre on Harris, took about 35mins. Awesome driving, such good weather and really nice roads, plus empty! Had my sights on the An Cliseam horseshoe, a ridge walk culminating in the highest mountain on the island at 799m. Set off around 1515, decked out in my running kit. Good thing about running is that you don't have to worry about getting wet feet - it's going to happen so you just get on with it! The shoes are designed to shed the water too. Good job, as the approach up Gleann Sgaladail was INCREDIBLY wet and boggy! The type of ground if you were wearing walking boots and wanted to keep your feet dry it would have taken an age to navigate pools of water and saturated moss, but in running shoes you just plow your way straight through, trying to avoid plunging knee deep into the softer areas of bog. I still get a bit edgy on bogs, used to have a mini-phobia (I think in part inspired by the dead marshes in Lord of the Rings) but slowly getting over it. There's a place in the Lakes called Great Moss on the approach to East Buttress on Scafel - have to properly work up the courage to walk across that, haven't yet done it on my own, always gone round the side!!

Passed a lone fisherman dressed in tweed, fishing the river. Onwards to Loch Mhisteam then straight up the east flank of Mullach an Langa, 614m. Punishing. The combination of wet ground and no paths meant I was already pretty knackered. I only pretend at the fell running stuff anyway! Once on the ridge the views were fantastic, quite cloudy but all above the tops and good visibility over the island.

The horseshoe ahead of me, no paths

Shameless selfie

Onwards over the ridge to Mulla bho Thuath, 720m. I was accompanied for some of it by some sort of bird of prey riding the thermals coming off the west side of the ridge, heard the call before I spotted it, amazing! The ridge was pretty cool too, steep drops on both sides down to little lochs shimmering in the afternoon light. It was cold - definitely felt like the start of autumn, hands were going numb in the wind!

Looking back at some craggy outcrops on the west side of Mulla bho Thuath, some potential for new routing

The next top of Mulla bho Dheas, 743m, was gained before too long. From here I could see the entire outline of the island, with the exception of the far north. Surround by sea, it was an awesome feeling! Could clearer make out the Cuillin on Skye, and in the far distance a hazy view of the mainland, with the mountains of Torridon rearing straight out of the sea. To the north west I could just make out the brooding outline of Sron Uladail, home to one of the steepest cliffs in Britain and the scene of the live televised 'Great Climb' a few years ago. A further chance glance to the west gave me a massive rush when I set eyes for the first time on St Kilda - semi-mythical place that I'd finally seen! Looked incredibly lonely and isolated. I could make out the main island and then the mind-boggling stacks of Boreray and Stac an Armin...

Looking back at the horseshoe, went up the right hand flank then all along the top

The highest point on the island of An Cliseam, 799m - great summit shelter around the trig point!

Free whiskey you say?

It wasn't long before I'd reached the highest point of the island at 799m, the summit of An Cliseam. There was a sturdy summit shelter enclosing the trig point, to which was tied an orienteering marker for the Isle of Harris Mountain Festival. Without a card to stamp I settled for a photo, hopefully that'll get me the free dram of which they speak! Superb views. Cold. One last glance at St Kilda before launching down the steep descent to the east.

Stumbled upon a herd of deer after rounding a corner, bit of a stand off as I watched them for a few seconds before they galloped off round the hill. Small top of Tomnabhal at 552m before the long flank down to the car, finished off with more incredibly boggy ground which at one point I did disappear down to my knees in muddy slurry. Nice! Waded in the river to wash my shoes before hurridly setting off in the car - the 14km route had taken me just over 3hours and I'd agreed to go to the Hebridean Search and Rescue team's medical training at 7pm at the hospital, was gonna be a bit late!!

Driving back on the at times bullet straight roads my mind once again turned to the black box sitting behind my dashboard. Ah well! Arrived back to the flat dot on 7pm, rushed fresh pasta eaten on the way to the hospital and arrived for 1915. Antonio was leading the session, with five other team members who had come along. The turnout was pretty small as apparently alot of people are away in the summer. The session took the shape of basic casualty assessment, with consideration of team roles, DR ABC, secondary survery, SAMPLE history (symptoms, allergies, medications, past medical history, last meal, events). I was the casualty for one scenario, and helped out with some tips I've picked up over the years on courses/through the medicine course. Mountain rescue is something I'm definitely keen to get involved with, I really enjoy the teaching side and would have skills to offer from a medical point of view but equally I'd have lots to learn on the technical rope work side which would be great fun. Session finished by 9ish and they packed up the land rover as I chatted to Jonny, one of the team members. He runs a bike hire business in Stornoway, and we made some plans to go mountain biking in the Lews Castle grounds the next day, awesome!

One of the HebSAR team's two landrovers

Back to the flat I was wasted after the run and training session, tried to rehydrate by necking a pint or two of water! Scrambled egg/toast and a brew took my mind off my aching muscles, started to get a bit of cramp in my right calf towards the end of the run. Quick bath to soothe them before collapsing for the night.

Day thirty-eight - Wednesday

Had a chilled out morning, went in for 10ish. Bit busier today, with two ENPs on. Got straight in with a collapse, query cause. I had the job of trying to get a collateral history from some witnesses, on the phone too various employers trying to get mobile numbers. Had to stop and think before leaving a message, making sure I didn't break any confidentiality about the patient in case I had the wrong number! A while later they phoned back and were able to give a good account, resulting in an admission to hospital. So important in cases of collapse to get a decent collateral history as the patient often doesn't remember it, and things like fitting are really important to know but the patient themselves may be unaware it happened. Next up a limping child, followed by a very complex psychiatric case. So difficult to know where to start, especially as I didn't know the full history, and with psych stuff it's just impossible to get a true idea of what's going on in an A&E consultation. Luckily a consultant who knew the patient was in the hospital and kindly came down in their lunch break to see them. Good for revising 3rd year psych history stuff, mental state exam and all that. Got some good teaching too, the consultant was super helpful!

Bit of a break, had a brew with two new med students on surgery, Tim and Andrea from Aberdeen. I filled them in on A&E life, they're here for an 8 week placement. Mugs washed/back in cupboard before seeing my last patient of the day, an injured wrist after tripping over some shoes. Dangerous things footwear! Was a good day, full of interesting patients and lots of revision, haven't covered psych stuff in ages so good to dust off the cobwebs.

Back to the flat fairly early for a change. Went to start cooking dinner in the kitchen to find the Irish nursing student in my flat having tried to 'season' a cast iron frying pan = filled the kitchen up with smoke! Could barely breathe in there, let alone cook so rustled up some pesto/pasta in the adjacent flat's kitchen, proper comfort food. After that hit up the pub with Tim/Andrea and the other med student on medicine, Laura. Tim drove us down to the Sea Angling Club, apparently the place to go in Stornoway... After standing at the bar for 5mins we decided to just have a seat and get some drinks when some bar staff turned up! Again, no ale on tap. Yet to find anywhere here that does it, sad times. And their whiskey selection was all blended. It was like a working men's club, loads of dart boards, tv's on the wall, pool tables. We chatted over beers before heading to Tesco for a spot of late night shopping - Andrea needed some stuff so we all traipsed round! Tim found some reduced muffins - really nice ones for 3p each, simple things! Picked up a local paper too, interesting to read about the census figures for the islands. The graph below shows the change in population from 2001 - 2011 Census. Took me a while to realise the y-axis was numbers of people, rather than percentages!!

Population change, in actual number of people not percentage!

Day thirty-seven - Tuesday

Lazy morning saw me catching up on some sleep after the late night the previous evening (/morning). Entered A&E around 11am to see the department well staffed, with 3 nurses and Agnes as well as a paramedic student. The only thing missing were some patients!! Very quiet morning. Caught up on some emails and browsed amazon looking at medical textbooks for next year, so expensive! Before long it was 1230 and I nipped off to lunch with Antonio, the Hebridean Search and Rescue guy.

Met at An Lanntair, tracked him down due to his bright green goretex jacket - a give away sign. He'd brought his young son along, he was on baby sitting duty - very good of him to meet me for lunch on a precious day off! Discussed HebSar - they're a very new team at only 3 years old with around 20 members, fully ratified by the Mountain Rescue Council of Scotland (MRCS), and have 3 vehicles. Unfortunately they don't yet have a base, and had only 4 call outs last year. Still, it's good to have the service available, and the more highly trained they become and the more other services become away of their existence I'm sure that number will increase.

An Lanntair, the arts/cinema complex, tasty nachos...

After lunch Antonio took me for a tour round his GP practice up the road, after leaving his son in the temporary care of the receptionists! Very nice place, purpose built building, with around 7,000 patients on the list. He was explaining how Stornoway is no longer really a remote/rural place - the Western Isles Hospital is apparently the largest Remote/Rural hospital in the world! There are plenty of equally remote places in rural mainland Scotland. That said, some of the areas on the other islands in the Outer Hebrides are very isolated, and definitely qualify for remote/rural status.

Antonio's practice, nice place!

Back to the hospital by 1500, there were still no patients... The paramedic student was very disappointed, having chosen a very quiet day to come into the department! Consequently one of the nurses took the opportunity to demonstrate the automated CPR machine to the ambulance man, and yet again Steven was the unlucky candidate for a spot of quadraceps resuscitation. Is an amazing machine, kicks out some force apparently, although I didn't notice Steven limping too badly afterwards!

Steven's legs took a turn for the worse during the afternoon, required a bit of automated CPR

Headed off around 1700, hadn't seen any patients in the department but had been a fun day. Quick bit of cous cous before Skyping Alice! Then jogged down to the leisure centre, only took 10mins, to check out the swimming pool. Quite fancy signing up for a triathlon at some point as my cycling is fine, running ok but my swimming is terrible! I can swim and have done my 5km once upon a time, but this was all breaststroke. I find front crawl a bit challenging, breathing is my problem! Only cost £1.80 to swim, so spent an hour or so doing lengths. By the end was managing to do 2x 25m  lengths of front crawl without stopping, definite improvement. Experimented with a nose clip but felt a bit weird so ditched it pretty quickly. Going to have to keep working at it, I'm sure it will get easier at some point! Rewarded myself afterwards with 10mins in the sauna - really great facilities at an awesome price!

Back to the flat via Co-Op for some essentials and cooked big bangers/mash/veg/gravy - pile the calories right back on! Sticky toffee pudding and chilled out before hitting the hay.

Day thirty-six - Monday

Checked out by 10am, packed all the bags in my car. For breakfast we headed over to the Woodland Centre in the grounds of Lews Castle. Very nice fry up cooked to order in a little kitchen, great coffee with nice views across the harbour to Stornoway town centre - if you ignored the waves of drizzle blowing in! Following food we wandered around the town, I bought some cheap binoculars for wildlife spotting out and about. One of the gift shoppy shops had a decent looking replica set of the Lewis Chessmen, although the price disuaded the purchase. Popped into An Lanntair again as the exhibition space had reopened, showcasing a central installation of a huge peat cutting pile, with the surrounding walls adorned by historical photographs of the peat cutters and their lives. An information panel took us through the process, espousing the benefits of the various different stacking techniques that were/are traditional in various parts of the island. We also explored a veritable tweed dungeon - a fantastic almanac of Harris tweed, a treasure trove of reels of herringbone cloth, flatcaps and waistcoats.

One day I'll have one of these!

The peat cutting exhibition at An Lanntair

A must for tweed lovers - the fantastically quirky cellar of tweedy delights!

A quick dash up to the impressive war memorial rounded off the morning - unfortunately the weather was still a bit grim so the promised views over Stornoway weren't at their best. The memorial was built in 1924 to commemorate the disproportionate sacrifice of Lewis lives in the Great War. Funded in part by the enigmatic Lord Leverhulme it was called into service again following WWII. The legacy of Lord Leverhulme on the islands of Harris and Lewis is a fascinating one and worth checking out!

Then it was time to head over to Stornoway airport and bid my folks/sister farewell - they were catching a plane to Glasgow before driving back home to Lakes. It had been great to have them here, ticked off the main tourist sites on the island!

Feeling a little guilty about the long weekend I'd had off from the hospital I went back into A&E at 5pm, intending to stay for a few hours - didn't leave until 2am! Great evening (/morning), started off with a very sick patient who after stabilisation went straight into the CT and onto HDU. Throughout the rest of the evening saw loads of key presentations - cryptic chest pain, ambiguous abdo pain and perplexing pulmonary pain! My patient list ended up sounding like the first 3 chapters of Medicine at a Glance - great revision of lots of core knowledge. After 8pm the department came under the care of a superb GP, if slightly enigmatic! Their stethoscope was a contraption that wouldn't have looked out of place in a medical history museum - a Leatham stethoscope purchased in 1981! If it ain't broke... (Although if it does break there aren't any companies around any more to repair/replace them!) The GP is also involved in the helicopter service up here, so hopefully be able to arrange a flight for me - if truth be told that's one of the main reasons I stayed in so late ;) Carried on seeing lots of good stuff, a well paediatric patient with a worried mother brought back some things from my paeds placement earlier in the year. The whole evening was good revision, and didn't feel slow at all although I started to take my eye off the ball after 1am due to tiredness/hunger. Time to go to bed!

Day thirty-five - Sunday

Lazy morning at the hostel, had some breakfast before hitting the road. As it's a Sunday everything is shut again, with the exception of Engebret petrol station – I'm surprised it hasn't been burnt to the ground yet for being blasphemous! Must do great business, indeed there was not space on the forecourt and had to queue for about 10mins inside to pay. Seriously ridiculous.

Eventually hit the road west, going past Callanais stones again en route to Great Bernera, an island off the northwest coast of Lewis. It's connected by a small bridge, only wide enough for one car. On the other side most of the roads are single track with passing places, and took another 20 odd minutes to reach the northerly tip of the island, the location of the fantastic Bosta beach. More golden sand, more beautiful sea and yes, even a little of the now expected rain! Incredibly windy too, although once down on the sands we were sheltered from the worst of it. Good bit of history on the beach too, as it's the site of an Iron Age house which was discovered following a storm that blasted apart some sand dunes, exposing the ancient site beneath. Sadly this was not open. Sunday, sigh.

Bosta beach, Great Bernera

Followed some wooden posts signing a path to the nearby settlement - the route went over the rocky higher ground to the west of the beach. Once up on the top the wind was incredibly strong, the type you lean into with arms outspread trying to get it to support your weight as you lean forwards. Never really works! Bit boggy too, I'd brought my walking boots again = dry feet! Wandered north onto the outcrop which gave some great views back towards the beach, and also down onto the sea where some seals were playing in the surf, bobbing up and down. Definitely looking at us. Probably amused by how we were staring back at them! Due to the wind/rain we did the holiday classic of a car lunch, radio on, windows steaming up due to wet waterproofs. It's just not a British holiday without a car picnic!

Refuelled we drove through the rain towards Uig, first returning to the mainland over the bridge before heading west again. Long drive and a number of times I was cruising along at 60mph only to round a corner and suddenly face the road going from two lanes to single track without any road sign warning! Windy, single track road took ages, but was pretty spectacular. Sadly the rain also increased in intensity too, so much so that when we did eventually arrive at Uig Sands my folks stayed in the car whilst my sister and I went for a short wander on the beach! Navigation was a bit complicated too, took a few false turns on the way before unearthing the OS maps in the boot to get us there.

The sands themselves were very impressive, massive stretch of flat sand - would be great for a spot of beach cricket in good weather/less wind! A boisterous dog was running around, it's owners sheltering in their trendy VW Transporter pimped out camper, so we played a bit of fetch before retreating to the shelter of the Polo and leaving it to enjoy the wet sand!

Finally defeated by wind and rain we turned tail and drove back to Stornoway, took just under an hour from Uig. Good to get a feel for distances on the island, gives me more of an insight into how difficult access to health care must be for some of the more remote residents on the island. With limited ambulance crews, if there's a call out to somewhere like Uig it takes the crew out of action for at least 2 hours - hopefully another call doesn't come in at the same time! Picked up some food supplies from my accommodation before heading back to the hostel and cooking up a massive spag bol, great comfort food after a wild and windy day exploring. Relaxed in the evening with a spot of shithead with 2 Edinburgh students - they were up here cycling round the Hebrides. It's a card game for those who haven't heard of it - although the rules seem to be different each time I play! Enjoyed having the folks here, got out exploring some of the more touristy things on the island. Shame the weather wasn't a bit better although did get out to most things, and we're from the Lakes so used to a bit of wet weather!

Day thirty-four - Saturday

Had a fairly light breakfast at the hostel – cereal and toast. Packed up and set off by 10ish, although having learnt the lessons of yesterday I stopped off at the hospital to pick up my walking boots and waterproof trousers! First stop on the planned tour of the west coast was the “Clach an Truiseil” – the tallest standing stone in Europe at over 6m. In a strange position, with a house right next to it and surrounded by dry stone walls. Great views down to the bay at Siorrabhaig, which we then walked down to. The sea was incredible, churned up with big waves coming in from the Atlantic.

The tallest standing stone in Europe

Incredible sea down at the coast, straight in off the Atlantic

Back in the car we headed south to the Blackhouse museum at Arnol. Looking at the village on an OS map it’s a blur of black lines, dividing the land into small crofting areas. The museum described the traditional crofting house next door, where a central fire kicked out loads of smoke that waterproofs the roof, preserves the timbers and supposedly fights infections... The warden described how the sphagnum moss that makes up some of the peat has medicinal properties – this part was true, as it was used as a dressing in WWI for this purpose. Not sure however about these properties remaining when it’s burnt into smoke and then inhaled! The residents were meant to have lower rates of TB due to its therapeutic cleansing effects. Down the road is the whalebone arch at Bragar, the jaw bone of a blue whale that washed up on the beach nearby and is now propped upright in somebody’s garden as a local landmark.

Next stop was the blackhouse village at Garenin – restored traditional blackhouses with a small museum and excellent cafe. In one of the buildings a film was playing showing the process of weaving traditional Harris tweed and cutting peat, the only fuel out here. As there are no trees nowadays the only local fuel source is peat. It burns with an incredible amount of smoke, and not very much heat! Not sustainable at all, despite being traditional. In one of the larger buildings they’d just opened a very well equipped hostel, would be a great place to stay, can accommodate up to 16 people. The rest of the blackhouses were self-catering accomodation. Nice bay at the bottom (Geodha Ruadh), would be nice to swim in, weather permitting. Pretty isolated place!

Onwards to Carloway Broch, an incredible building which functioned both as a house and a defensive structure from which to shelter from marauding hoards. The thick double walls contain staircases used to gain the upper floors, some of which were still preserved and were fun to explore. Sadly a lot of the stone had been ‘recycled’ by the local community before the structure became protected – the broch would have been much more impressive if it was more complete. Understandable that they wanted to re-use the precious stone resources, but perhaps lacked the foresight to realise that one day the building would have the potential to bring money and jobs to the local economies – easy to say now when not such a struggle for survival.

Carloway Broch

The crown jewel of the west coast archaeology tour, also the last stop, was Calanais stone circle – a set of very atmospheric standing stones in an incredible position on the coast. Originally a stone circle, after the arrival of Christianity the layout had been added to, converting the pagan site into a symbolic cross with offshoots of more standing stones. We briefly toured the mini visitor centre before calling it a day and heading back to Stornoway.

Showers all round at the hostel then into town for a meal. Had envisaged going to Digby Chick, where I’d been earlier in the week, however they were fully booked, along with a lot of the other restaurants with it being a Saturday evening. We decided to check out the local Indian Balti House which turned out to be excellent, good food at good prices with friendly staff. A whiskey at An Lanntair on the way back to the hostel capped off a great day of sightseeing! Back to the hostel I chilled out in the common room with May and got chatting to two London lads doing a week’s cycle tour of the Hebrides. One of them had spent time in Barrow so there was plenty to talk about!

Day thirty-three - Friday

Late start, decided to do some work in the flat as not worth going into A&E for just an hour or two. Before long it was time to pick up my parents and sister from the airport – they’ve come over for a long weekend to visit and see some of the island! The airport’s only 10mins away by car from the hospital, and the road goes right past the end of the runway. Unlike Barra, where the plane lands on the flat sands of the beach, Stornoway has a proper tarmac runway! Stopped in the carpark and waited to watch the plane come in to land. Wondered over to the airport building, pretty swish! Watched the pilot taxi the plane into position - would be such an awesome job. Funny bit when one of the high vis airport people went to the front of the plane with a tied up roll of paper and knocked on the bottom of the cockpit. Then the pilot stuck his hand out through a hole (which I hadn’t noticed, presumably has a cover for when they’re flying) to pick it up – maybe the flight plan for the next flight...

Mum and Dad coming down the steps of the plane

Everyone arrived, piled into car and drove back to the hospital accomodation. Food, coffee and then headed up the east coast of Lewis to Tolsta, and the famous Traigh Mhor beach. Weather was pretty gloomy but dry – that is until we pulled up in the carpark when right on time it started raining! Wasn’t going to put us off though, and after a few minutes waiting it cleared up. The beach was incredible – long stretch of perfect golden sand, backed with machair grassy dunes, all facing the turquoise blue ocean. Windy! Walked along the tide line trying not to step on the numerous colourless jelly fish marooned on the sands. Further up some people were flying a kite, but other than them we had the beach to ourselves.

Wondering along I was watching my feet for jellyfish until Mum’s shout alerted us to a pod of porpoise about 50m out from the beach! Watched them surfacing for a while, swimming parallel to the beach, gracefully appearing out of the waves to show off their fins and get a breath of air. Wildlife watching was interrupted by impending rain however, and despite cutting the walk short we were still caught out in the rain on the way back to the car. Pretty heavy, so by the time we got back to the car we were soaked! Driving back to Stornoway it intensified into a torrential downpour, windscreen wipers on max for a time...

Porpoise!

Checked into Heb Hostel, the place my family were staying for the next 3 nights. Seemed like a really nice place, clean and friendly. The guidebook they’d brought said that once you’d visited the tourist info and stocked up on food at a supermarket there wasn’t much more on offer in Stornoway, so after ticking off the first we took a trip round the massive Co-Op to pick up supplies for the weekend. Ate some fantastic fish and chips from the Church Street Chip Shop, delicious batter and buttery mushy peas! After a few beers back at the hostel everyone was pretty shattered so turned in for an early night.