Madam, - Recently, in quite a remote Cuban town, my host found me semi-delirious at midnight on a Sunday, suffering from severe heat-stroke. Hyperpyrexia, which can be fatal, needs immediate treatment.
Fifteen minutes later the family doctor arrived, on his bicycle, to provide the appropriate isotonic saline and administer other treatments. Eight hours later he telephoned to check on my progress, which was satisfactory.
Were I to fall ill (or have a serious accident) in my home town of Lismore, Co Waterford, between 6 pm on a Friday and 9 am on a Monday, someone would have to telephone Caredoc, a nurse in Carlow, 80 miles away, describing my symptoms or injuries and leaving it to the nurse to decide whether or not a doctor was needed. This grotesque arrangement assumes that the person contacting the nurse is knowledgeable enough accurately to interpret the symptoms. Should the nurse guess (it can only be a guess) that a doctor is needed, the Lismore patient must then be transported, by whatever vehicle his or her helper can provide, to the nearest doctor - 15 miles away in Dungarvan.
If the nurse in Carlow has somehow been persuaded that the patient in Lismore cannot or should not be moved, a doctor will be driven to Lismore by a chauffeur who knows the territory so that no time is lost. But so much time has already been lost that were I, in Lismore, afflicted by a condition comparable to hyperpyrexia (a stroke, a heart attack) I might well be dead before the doctor arrived.
Viva Fidel! - Yours, etc,
DERVLA MURPHY, Lismore, Co Waterford.