31 years has seen a fair amount of change! The area has changed, as has the population and the NHS. I'm glad to say that there are still among us those who can still be truly termed as "locals". Some of them, mere babes in arms when I arrived, are now parents of growing families. Then there are those who moved away seeking better opportunities elsewhere, but who have crept back, realising what a special part of the country this is. In the early days there were damp, un-renovated cottages that were gladly relinquished for peanuts, with local owners preferring to move to new housing . . . what a mistake!

On the medical front, I can remember at Pat Luffman's retirement him proffering the observation that the biggest advance that he felt he had seen was the emergence of successful treatment for TB. We were still picking up the odd case even then, and indeed we even found a case of tertiary syphilis. However the significant advances that I have seen include the emergence of scan technology and the use of fibreoptics, both of which have taken a lot of guesswork out of diagnosis and treatments. Also, dare I say it, but IT has also made a huge contribution, and if it were better used would make an even bigger one. In this practice the whole prescribing and dispensing operation is so much safer and reliable because of it. In my early days, the world of therapeutics in rural practice was emerging form the era of the green, blue and red mixtures, basically coloured and flavoured water using these characteristics to enhance Their placebo effects. These were rapidly being replaced by therapeutically active agents, the early antibiotics, beta-blockers and powerful loop diuretics to name but a few. The significance of this advance was lost on many of especially the older patients who continued to present to the dispenser proffering an empty bottle and asking for a refill of something that they had felt had done them good some weeks or months before. Unfortunately, an ethos of permitting this to occur without a Dr check in each case, meant that some were taking the most horrendous combinations of drugs, and wondering why they felt not too good.. Even more alarming was the fact that was no record kept in the patient -records such as there was of them, of any of these repeated issues. This was at the old surgery, the current Day Centre, which in its time was one of the first purpose built surgeries in Norfolk. We had a single phone line "Burnham Market 207", and no ability to talk between rooms in the building. There was no practice nurse, and a single district nurse-cum-midwife. The GP was a jack of all trades, treating, dressing, administrating. There was no appointment system..everyone queued up. Running late was not in the vocabulary. If you turned up, you would be seen, but with no guarantee as to when. Everyone got the time they needed. If you needed sewing up, it would be done (and yes, we did have local anaesthetic then!). You might have had to wait while the instruments were sterilised in the small kettle steriliser.

And then there was the visiting. For my predecessors, it was really a sophisticated socio-medical enterprise where timing was all that the appropriate venue was reached for a drink or tea. The visit requests would often be via messages left at the various drop off points from which medications were collected in the rather more numerous village shops than currently exist. Thus when setting out with the list of phone requested visits, one had no idea as to how many more would be picked up en-route. There were even times when you would be intercepted in the street with a request to "pop-in-while-you're-here". On one occasion I even had a man anxious to take his trousers off to show me his leg, right there on the side of the road! And then there was the bunting! Seemingly the idea was that if an urgent call came in after your drug drop at a given shop, and it was known that you had yet to return past it, they would go into celebration mode and hang out the bunting as an indication of your bei needed.  Unfortunately, no-one had briefed me as to this arrangement, and I had no insight as to what this exuberant flag waving signified.

It was after a missed bunting call that I investigated and we proceeded to install our first car radio system which then expanded to become a pan-Norfolk set-up with links to the ambulance service. The arrival of reliable mobile phone reception spelt the demise of this, but in its time many miles of travel were saved, many patient seen in a more timely manner and a life or two saved. The money for the system was raised through local fund raising and heralded the start of our current equipment fund, into which all donated monies are put for the purchase of pieces of equipment that might not be justifiable from a business viewpoint, or be front end of technology with an unsecured place in mainstream medical care. The move to this building was a significant milestone releasing us from cramped, low ceilinged accommodation with its windowless waiting room. This had to be traversed to go to any other room including the loo. This should explain this waiting room, which was described by the first patient to enter it as a church-cum-crematorium! The fact that the building is fundamentally the same as it was then, is a testament to the huge investment in time over an 18 month period that we made in the planning stage.

Does anyone remember how the local doom-and-gloom merchants predicted that we would sink into a boggy hole, such was the state of this site, with its many seasonal springs? What many have failed to realise is that the increased frequency of flowing of the Goose Bee through the village has been in part due to our draining this site and pushing this spring water downstream rather earlier than had previously been the case.

And now to the present time: we no longer are responsible for the provision of the out-of-hours service..a mixed blessing depending from whose vantage point you view it. For you the patients, it is probably a retrograde step..you no longer get to talk to or see a familiar a doctor that you know and hopefully trust, in the practice area. For the GP and his/her family, it has been a definite blessing. No longer do we have to be on-call (and a spouse/partner be on hand to message take) and be available to attend patients on interminable nights and weekends and then have to continue through the next day, however disturbed the previous night might have been. You have no idea what a luxury it is to retire into your own bed knowing that you will not be disturbed by anyone on the phone. It takes only two critically timed calls to ruin a nights sleep. I estimate that in my time up here that I have worked some 2160 nights and 364 weekends.

One enormous plus has been all the fascinating people that I have had the privilege to meet and know. And what surprises...an old lady regaling me with her exploits as an English nanny in an aristocratic family in Russia at the time of the revolution, and how she proceeded to smuggle them out via Turkey back to this country. There are the now mostly departed old men who were Japanese POW in the war. Such was their experience that not a single one would talk about it. The true Norfolk characters, with a wealth of anecdotes and observations regarding life in this area pre-war..local history which unfortunately is getting buried with their passing. The many pleasurable hours spent in local pubs when they were locals' pubs. The Thornham lifeboat before all its current expansions and extensions, was the most delightful place frequented by local fisherman and other characters. Its income may be better now, but a unique atmosphere has gone forever. The local flavours and features have now been so diluted that they can be difficult to find.

I cannot omit to mention our beloved Cottage Hospital. It is a reflection of local unity and determination that it is now proceeding to a new life. The N. Norfolk PCT was patently wanting the place to run down and then be quietly shut.  Little did they realise!  I hope to be in there making a contribution to its future services which should be innovatory, comprehensive