As the RCP Charter Cycle continues, RCP registrar Dr Andrew Goddard overcame wind, rain and a rusty bicycle chain before visiting Uganda with CEO Ian Bullock for the East Central and Southern Africa College of Physicians conference.
This was always going to be a relatively easy ride. From my home hospital along roads that I have ridden many times before and in good weather to boot. But I do have a confession – I took the bike to the Royal Derby in the back of the family car (hardly promoting active transport for that bit I know). I did have a reasonable excuse – I pulled my right hamstring the week before whilst on holiday in Croatia playing my once-a-year tennis match. I blame Mrs G as I was running to get to a ball that she should have hit (I hope she doesn’t read this).
Back to the charter cycle though. Janson and Lindsay, the two college tutors at Derby, had done a great job spreading the word about the charter and we collected a fair few signatures before I had to head off and do a quick bit of teaching before getting on the bike. I must apologise to the nurses who had to listen to my talk with the distraction of my lycra kit. Teaching complete I then headed off to Loughborough.
The trip was relatively uneventful. It started off cloudy and I had to make a sun block stop when the clouds parted but otherwise I was able to cycle non-stop. The only minor hiccup came when there was a ‘road closed’ sign on my route. I thought I’d give it a go but it turned into a fool’s errand as I was met with a large JCB digger and no way through. I then had to get onto a reasonably busy road to get further but survived this. Loughborough has almost as many roundabouts as Milton Keynes and the signage is not the best. However, there are cycle lanes aplenty so it was a fairly safe, if stop-start, passage to the conference centre. I had another argument with a (much larger) digger on the university campus. There was obviously a relatively new/young builder who had been given the traffic control job as building traffic was directed to the building site on campus. He wasn’t very good at his job and it was only because the digger driver saw me that I could get past. ‘You had one job’ sprang to mind.
I got to the regional update just as people were breaking for lunch. I was intrigued that the university seems to have lots of smoking shelters but not many places to put bikes (we have a way to go with improving public health it seems). I caught up with lots of local colleagues and went to a very interesting talk on acute neurological problems. Well that was the title if not the subject of the talk. CPD seems to stand for continuing political discourse in some speakers' minds.
After the update I’m afraid the bike went in a car again as I had to get to Market Harborough for a meeting but don’t worry I made up for it the following day. Importantly my hamstring had survived the day.
There was a signing of the charter planned for 9am in Kettering so I had an early start (after breakfast with the president who was also going to Kettering) and was on the road by 7.45. Both Market Harborough and the countryside around are beautiful and the sun rose across the dew-covered hills in a stunning way. The road I had chosen seemed quiet at first but it soon became clear I had picked a rat run for local drivers and had some interesting flybys from hot hatches. I fared better than the local wildlife though and was struck by the large amount of roadkill, the product of fast roads and rural life. I spotted the 'big five' of pheasant, fox, badger, rabbit and squirrel. In one of those weird synchronous events the first patient I endoscoped after this leg had a culinary interest in roadkill. I’m not convinced.
Flattened wildlife mourned I arrived at Kettering before the president (bikes beat cars!) and set up the charter signing in the education centre. I met some very impressive clinicians who were doing some really innovative things (eg chest valves instead of chest drains to allow early discharge of patients with pneumothoraces and effusions). There was a slight air of anxiety though as the CQC were visiting that day. A CQC visit is a bit like going to the dentist – you rarely get praised for your hygiene and often need work doing which is expensive. I tried to be upbeat (and think they deserved praise for managing to keep things going with multiple medical vacancies) and hope that the CQC were happy. I climbed back on the bike and headed for Leicester.
As I left the car park I saw lots of dark clouds and thought ‘I hope I can get a few miles under my belt before it rains’. No sooner had the thought crossed my mind when it started to rain. I also then hit my first proper headwind of the cycle ride so far. Not fun. I struggled my way north and stopped in Husbands Bosworth for a snack and drink. I left a phone message for Gill, the regional manager helping to organise the Leicester Royal Infirmary grand round, to say where I was and hopefully I would be there on time. It was only when I reached the LRI that I realised I had left a message on someone else’s phone. Oops. The signing of the charter before the grand round was the biggest yet (38 signatures) and it was really well received. Most were pleased to be doing medicine but the stresses of the acute take were the main demotivator. It was also great to have the chance to chat to lots of trainees about the issues facing them. Once again thanks must go to the local college tutor, in the LRI’s case Dheya, for helping raise awareness of the charter. The grand round was on Parkinson’s disease (I have shared my thoughts on that in my registrar's reflections).
The cycle back to Derby was uneventful and hilly but the rain had stopped and the only issue was getting the miles out of my legs. I arrived home to an empty house but a full bath and all was well with the world (until I read the BMJ in the bath – it does raise my blood pressure sometimes).
I had planned to cycle from the Belfast regional update near Shaw’s Bridge in the south of the city up to the Antrim Area Hospital (about 45 miles there and back). However, the logistics of trying to sort out a bike to hire that was good enough for the journey and allowed me to get back to the airport in time for my flight proved beyond me. I therefore had to settle for an early morning ride on a bike from the hotel up and down the Lagan river towards Lisburn in the pouring rain. The trail was part of the national cycle network (NCN 9 as it happens) and I am slowly ticking them off around the country.
The bike was shocking, and was sorely in need of some love. After demolishing my beautiful hands trying to unjam the (rusty) chain I set off only for my seat to assume a vertical position a mile later. I knew I wasn’t going to get too far anyway but would have gone a bit further if I had been able to sit. Good for my climbing muscles though. I got some interesting looks from commuters on much better bikes but enjoyed the (very) green scenery and the babbling river for company.
I have now sorted out a route that will allow me to take in some more hospitals and have got some intelligence on bike hire shops in the city so I will return next year to give Northern Ireland the attention it deserves. My next leg is in Uganda – now that is going to be really different.
This is what the Charter Cycle is all about. After a couple of days of attending the second ECSACoP (East Central and Southern Africa College of Physicians) conference and visiting potential sites for the training units the ride is raising money for I had the opportunity to do some cycling in Uganda. Enormous thanks must go to Liam Fisher-Jones for arranging the bikes and Justice, a local bike shop owner and rider for the Ugandan national team, for sourcing them. We had a group of eight cyclists and a professional photographer (keen to help out the Physicians for Africa charity) accompanying the ride to record the moment.
We started on the shore of Lake Victoria near Entebbe and braved the main road towards Kampala. Motorbikes and minibuses were the main dangers but potholes and showers of dubious liquids being thrown from washing bowls from doorways were other hazards that needed careful attention. We survived this to reach a turn off onto a promontory into the lake towards a small town called Kasenyi. The roads were tracks and we passed through ramshackle villages full of life and noise. The children in particular found us a novel distraction from the norm and were welcoming and a fantastic support. We were on mountain bikes which coped admirably with the rough terrain and suffered no major mechanicals. Jeff, one of the local cyclists, did have an argument with a ditch but suffered no more than a bruised ego.
We stopped off at the edge of the lake to marvel at the local wildlife and a fishing hamlet. The beauty of the moment was rather spoilt by the cheers emanating from a local social club as Man United scored a goal a couple of thousand miles away. Thanks Jose for tainting the memory of an otherwise magical place. As the sun started to head towards the horizon we braved the main road again and returned to our hotel and a welcome drink.
We had planned to do 15.18 miles (the year of the college’s founding in case you didn’t know) but as usual we went a little further than planned. It was well worth it though as this was the most spectacular of the rides so far. Thank you Uganda.
420 miles done, 1,598 to go.
Read previous entries of the RCP Charter Cycle blog to catch up with what has happened already during Dr Goddard's journey. You can follow updates and find more photos on Twitter by searching for #RCPCharterCycle and #RCP500.