Nelson Norman will be well known to the older generation of British Antarctic personnel. He was the doctor at Halley in 1959 which he has described in his book “In search of a penguin's egg” (Norman Reference Norman2009) and later, as an academic surgeon, was a consultant in Aberdeen in the early 1970s when the North Sea oil bonanza started. He took an interest in the injuries and other problems associated with the North Sea oil rigs and diving and this led him to change the focus of his career from surgery to remote healthcare and environmental health and he spent a lot of time trying to form an institute to combine healthcare, teaching and research. After links with both the University of Aberdeen and Robert Gordon University, the current incarnation is the Institute for Remote Health Care. Links with the oil industry in Aberdeen led to work with the industry elsewhere, especially in the Gulf States and from there, to work with universities in the Gulf. Telemedicine is an essential component of remote healthcare and Aberdeen was a pioneer in this. The closeness of Aberdeen to the Cairngorms led to links with mountain rescue teams and research into hypothermia. The problems of providing medical care on North Sea oil rigs with having to manage casualties at a distance, difficulties in evacuation of casualties due to bad weather, severe risks of hypothermia and the medical problems associated with diving are not dissimilar to the problem of providing care in the Antarctic and almost inevitably this ex-British Antarctic Survey (BAS) doctor started providing medical training and assistance to BAS, initially on a relatively informal basis and, later, formally, with the formation of the BAS Medical Unit (BASMU) in 1986. This, too, involved the provision of medical care, teaching and research. He was awarded the Polar medal in 1998.
Biomedical research in the Antarctic is very varied and while much revolves around the problems that occur in that environment and how best to provide care at a distance, Antarctic bases with a small captive population are a perfect laboratory for research which is of wider relevance. For example Antarctic bases have been used as a model for long distance space. Understanding how bacteria spread from one individual to another is vital for the understanding of how infections spread in hospitals but it is almost impossible to study in a hospital because of the huge number of variables including the large but transient population of patients, staff and visitors: an Antarctic base may provide the ideal environment to study this.
The book is well written and is an interesting description of the development of the specialty of offshore medicine and remote healthcare, with some amusing anecdotes. He describes the difficulties of dealing with university bureaucracy but this was nothing compared to the problem of getting agreement between universities, the NHS, oil companies and government!
Although interesting, the book is frustrating and, in many ways, disappointing. As a historical document, it suffers from a lack of dates. We are told of the closure of the Medical Research Council Division of Human Physiology and the creation of the National Hyperbaric Centre and many other events but, more often than not, we are not told when these occurred. As a self-published book, it is not surprising that its focus is the achievements of Professor J Nelson Norman in developing this new specialty rather than a history of the specialty, though (unlike many self-published books) he does give fulsome praise to his colleagues. However it is not an autobiography in that it starts in the early 1970s and we get no idea of his career before then or his activities outside work. There is an appendix listing his own publications and while a list of publications coming from his unit might be too lengthy, one longs for more detail of what his and his colleagues’ research found and achieved. As an example, he briefly mentions the links with Professors Pennington and Arendt who supervised (and one continues to supervise) the work of generations of BASMU doctors in microbiology and chronobiology respectively with no mention as to the outcomes of the research and whether it has been of practical benefit.
It is an easy read and, at £9.99, it is not going to break the bank. Those who know Prof. Norman or with connections to the remote health care organizations based in Aberdeen will want to read it and this will include those with connections to BASMU when it was based in Aberdeen. However those who want the history of remote healthcare or who want to understand what has been achieved by the researches will not find it here.
