Tuesday, 25 Feb 2020

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Review: A Book Trilogy About an Irish Country Doctor

My original agreement with Jack was to review a serious scientific book.  Halfway through, though, I was bored - despite friends who’d told me the book made statements and drew conclusions that put physicians in a bad place.

Thankfully, I decided to head to my very nice public library in Sewickley, PA to donate books for their book sale.  I hope to move soon and want to lighten the load.  Since it was March, the library featured a display of books written by Irish authors.  On the table with Joyce, Wilde, Yeats and Beckett were two books by Patrick Taylor, which turned out to be the second and third in a trilogy I had started years ago. Taylor is an Ireland-born physician who practiced for many years in Canada.  He wrote a great book I read several years ago titled “An Irish Country Doctor.”  This entertaining novel took us through Fingal Flahertie O’Reilly’s medical school training at Trinity College in Dublin, and his early career as a county GP. This book shows the challenges of being a rural GP in the 1940s and 1950s in the imaginary town of Ballybucklebo in Northern Ireland, with Belfast being the closest academic center to refer complex patients.

I had the pleasure of being on faculty early in my career with some Trinity-trained physicians who had come to the US to practice. They were excellent clinicians and teachers. Their presence on our faculty resulted in the recruitment of many Irish house officers in our internal medicine program and some of the fellowships.  While it may be simple stereotyping, I found the Irish physicians were generally better at history and physical exam and less dependent on MRI, echocardiography and serologies to make a reasonable differential diagnosis list and come to the correct diagnosis in comparison to the US trained physicians.  They knew how to perform a musculoskeletal exam and ask the patient important historical questions.

The second book of the trilogy is “An Irish Country Village”, set in the early to mid 1960s.  Now Fingal Flahertie O’Reilly is an experienced GP in the later stages of his career, and he has taken on young Barry Lavertie as his junior associate.  Barry is a recent graduate from Belfast, not certain he should be a rural GP or go back to university to specialize.  Much like the television program Doc Martin, which is set in rural southern England, some of the joy in reading Taylor’s books is the description of the local characters who are his patients and the challenges of really being in isolation as a GP in a small rural village.  The third book, “An Irish Country Courtship”, continues the saga of the senior physician mentoring young Patrick Laverty and some of the joys and challenges of being the GP in a rural community.  Both young Laverty and not-so-young O’Reilly are smitten with lasses, which provides a nice narrative and lots of humor.

Like many Americans, I partially come from Irish roots.  Half of my family is Irish, and there was a Swede and a German mixed in as well.  I grew up in a small town in North Dakota, which may be more like Lake Wobegon than Ballybucklebo, but I really enjoyed the dialogue between the trusted GP and the villagers.  I can imagine a similar dialogue being routine with an upper Midwest accent in my hometown.  


I am writing this review from New York where I am visiting a son attending Columbia and going to the St Patrick’s Day parade.   As I make the life transition from industry back into clinical practice with EMR, prior authorizations, RVUs and many other challenges, I think it was really refreshing for me to read these three books and remember why I chose to follow the steps of my own local GP Lowell Boyum who served my little town for about 50 years and delivered most of my friends and their children.   

Make sure you read the books in the correct sequence to fully enjoy the story.  Read slowly and try and pick up a little of the Ulster dialect that Taylor uses.  He has nice appendices and a glossary to help with the translations.




The author has no conflicts of interest to disclose related to this subject

Dr. Kelly Krohn is a rheumatologist at the CORE Institute, a private orthopedic practice, and the University of Arizona College of Medicine Phx Dept of Orthopedics. His primary interests are metabolic bone diseases, non-surgical management of knee osteoarthritis, fracture healing, spine fusion and rehabilitation in the elderly.

Rheumatologists' Comments

Hi Kelly, Good story. I agree with you about how doctors from other countries are adept at the physical. I would love to hear more about your transition into practice. I would love Jack's take on RVUs and Press Ganey surveys