Summer visitors

BMJ 1994; 309 doi: (Published 24 December 1994) Cite this as: BMJ 1994;309:1740
  1. Christina Scott-Moncrieff, GP and homoeopathic practitionera
  1. aGlastonbury BA6 8JJ

    Here in Somerset the start of summer was once marked by the first swallows arriving. These days, summer starts when the New Age Travellers take to the roads. Their dilapidated buses and vans, complete with makeshift chimneys and tatty curtains, suddenly fill laybys and passing places. Farmers block the entrances to fields to protect their land. Rural general practitioners brace themselves for some challenging encounters.

    Travellers search for the “natural” life, but still cling to modern expectations of health that are difficult to achieve in living conditions reminiscent of the Dark Ages. They are surprised that infection is a natural consequence of poor hygiene, cramped living conditions, and dubious water supplies. Although they demand a medical opinion immediately they are ill, all too often they reject the advice given, because they do not regard modern medicine as natural.

    In my practice we watched, helplessly, a young man dying from lobar pneumonia. He had refused penicillin, which is perhaps the most natural of all antibiotics. When his resistance to treatment was overcome by sheer exhaustion he was admitted for thoracotomy to drain his empyema and was given large doses of synthetic antibiotics.

    Conventional contraception is not regarded as natural. Traveller lore has it that conception can occur only at certain phases of the moon, regardless of the menstrual cycle. The inevitable pregnancies lead to a demand for natural childbirth which, for travellers, means a home delivery regardless of what or where home is.

    One woman, aged forty-something, lived in a “bender” constructed from black plastic supported by hazel branches. It was two miles up a muddy footpath and 30 miles from the nearest district general hospital. Her belief that childbirth is totally safe, because it is a natural event, was unshakeable. She insisted on her right to be delivered at home and called us in at 30 weeks because of regular labour pains. Fortunately, her contractions settled once she stopped her large doses of raspberry tea. This is widely taken as a natural uterine tonic.

    As she approached her delivery date our only option was to alert the ambulance service and the obstetric flying squad, photocopy maps for everyone, and keep our fingers tightly crossed. We nearly lost the baby shortly after delivery, when his temperature dropped alarmingly, but he survived as his mother triumphantly told us that she “knew” he would.

    But she was unprepared when her baby collapsed four months later. Answering a night call, I donned my wellies and trudged through the rain, hoping that I was not a target for the local poachers shooting in the surrounding woods. A difficult clinical assessment by candlelight suggested meningitis. Threats to involve social services were needed before the parents would agree to the baby being admitted, and legal steps to make him a ward of court were needed before they agreed to a lumbar puncture.

    The baby was lucky. Not only did he survive unscathed but his parents learned from their experiences. Like the swallows, they went somewhere warmer for the winter.

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