After discussion and further reflection, Dr Dunning wrote again:

Despite all my experience in GP surgeries and hospital settings I was surprised how affected I was by the experience. I’ve had some thoughts since that might be helpful for the future especially if the RNLI liaises with fishermen through angling clubs.

Neither of the casualty’s friends knew exactly which part of the cliff they were on so the coastguards went to Tater Du lighthouse first rather than the next promontory, Boscawen Point. This delayed attendance considerably. Could anglers be advised to carry maps?

The friends had a mobile phone signal and had it on loudspeaker with the call handler giving instructions about CPR. One of them went across the fields to our house looking for help. It was probably 30 minutes before we got back and doing CPR for that length of time on one’s own is pretty exhausting. It might have been best to stay put.

Lastly, as we waited for the rescue helicopter to winch the man up I heard that he had been feeling unwell and had had to stop several times as he walked up the steep incline from sea level. If only he had called NHS direct or the emergency services for advice.

What might have been …