GP Interview - The English National Ballet doctor

Southampton GP Dr Chris James provides primary care to the English National Ballet.

Dr James (left) with Max Westwell, currently appearing in Le Corsaire
Dr James (left) with Max Westwell, currently appearing in Le Corsaire

How did you become company doctor for the ENB?

In 1995, the company doctor at the English National Ballet (ENB), Dr Peter Skew, wrote to our practice to ask if one of us would be a point of contact for the company for the two or three weeks in the year it toured to Southampton.

I had an interest in sports medicine and volunteered. The local theatre in which it performs was on my way home and only five minutes from my practice, so I popped in regularly.

In 2002, when Dr Skew left the company, the ENB asked me to be its substantive company doctor. Although it meant a commute to London to do sessions, I was delighted to take the post.

The company is blessed with an excellent physiotherapist, Jackie Pelly, who pretty much takes care of all of its musculoskeletal needs. We use medical insurance for all secondary care advice, imaging and procedures.

I meet Jackie whenever I am with the company, to discuss injuries and recovery, and provide input as needed. I spend a lot of my clinical time dealing with primary care matters, because any injuries are so well dealt with as they happen. I meet the wider team of sports masseur and sports scientists about once a month.

When I am not there, I try to make myself available to the company by phone or email, whether it is in London or on tour, a level of access that has never been abused.

What are the benefits of your role at the ENB?

Well, I have not paid to see a ballet since 1995. But the perks are much wider than that. My ENB role brings variety to my working week and the opportunity to work with a fantastic team of staff and dancers.

One person with whom it was a particular pleasure to work was David Wall CBE, a highly respected gentleman who I knew as one of the ballet masters.

It was partly through his encouragement that the company asked me to be its doctor. He is the only dancer to have a statue in London and it was a great loss to the world of ballet when he died last year.

Have you had to treat any dramatic injuries?

I remember two related injuries during a performance of Romeo and Juliet at the Royal Albert Hall. ENB's productions are done in the round, so the whole central stage area has something going on.

During a complex sword fight scene, I spotted the dancer playing Mercutio discreetly limping off stage with a twisted ankle. There are a number of cast lists for each performance, so a character is played by a variety of dancers.

As Mercutio was a central role in the fight scene, within seconds, another dancer took his role in the scene. Part of that scene requires the dancer to be pushed onto a table, slide across it and get caught on the other side of the table before dropping off. Unfortunately, the person who was supposed to catch Mercutio was the dancer who had taken over Mercutio's role after he had retired injured.

Nobody thought to cover that now empty role and the new Mercutio slid straight across the table and fell off the other side, landing on his head. He carried on, but had a split in his scalp, which we treated during the interval.

How do you combine the ENB role with your job as a GP?

I have supportive partners at the University Health Service in Southampton. Outside interests are encouraged, bringing in extra skills and interests.

My ENB role is squeezed into Tuesdays, with a surgery starting at 8am that must run to time. I am on the train by 11am and at the ENB offices near the Royal Albert Hall by 1pm.

I am usually home by 6pm.

The roles are comparable, because my practice is a university campus practice and most patients are young and active, and present with similar problems. However, the dancers are much more intensively investigated and rehabilitated than ever happens in the NHS.

I had the privilege of being vice-chairman of the NHS Alliance during the early evolution of commissioning. Once you are in one leadership role, others seem to present themselves. In 2009 I took a break, moving to Australia with my family for a year, and promised myself I would not get involved in CCGs when I returned. That lasted about three months.

How was your sabbatical?

I worked as a GP locum in a practice north of Perth. It was interesting to compare models of primary care; the most notable difference to the UK is that there were no registered lists of patients. People could go to whichever practice they wanted to, compromising continuity.

Standard practice was two four-hour surgeries a day, with no home visits. Income was generated only if you had the patient in front of you, creating a disincentive to do telephone or email consultations.

Do you have other interests?

I played the trumpet, tenor horn and tuba at school, then had a long break until picking up the clarinet more than 10 years ago. That led me to play the saxophone and I expanded the types of clarinets and saxes that I played, forming a collection.

I asked an instrument repair technician to teach me about his work and we spent an intensive couple of days overhauling an old soprano sax. I have been doing my own repairs and renovations since then. I have a music room in the basement of the house and a workbench for repairs.

My main performance outlet is Southampton Concert Wind Band, a (more than) 50-strong community band. I became chairman when I returned from Australia. It will play in the finals of the National Concert Band Festival in April this year, at Birmingham Conservatoire.

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