1 00:00:12,980 --> 00:00:21,360 Right, so, um, so what I've done with the book is for each person, I've done sort of biographical details, 2 00:00:21,360 --> 00:00:27,630 and then I try to select an area which I think would be a particular interest to Oxford. 3 00:00:27,630 --> 00:00:36,660 And so I sort of feel happy to talk about the Institute of Molecular Medicine, that, 4 00:00:36,660 --> 00:00:47,220 first of all, sort of what made you interested in haematology or pure chance, really? 5 00:00:47,220 --> 00:00:58,170 I had to I was one of the last to do national service after the, um, uh, 6 00:00:58,170 --> 00:01:06,300 they used to let doctors finish the clinical training and then do their national service. 7 00:01:06,300 --> 00:01:12,810 And for some reason, I think they lost my address. 8 00:01:12,810 --> 00:01:17,860 So I didn't even get the usual call about doing the house job. 9 00:01:17,860 --> 00:01:24,260 And so I thought, well. 10 00:01:24,260 --> 00:01:38,170 A bit pompous to remind them, so I took charge of cleaning house office a job in Liverpool and decided to have the membership. 11 00:01:38,170 --> 00:01:48,200 They then did catch up with me during and after about six months, and they said I could have one go at the membership and just through in the home. 12 00:01:48,200 --> 00:01:56,600 And we got the membership on the way to being in their there. 13 00:01:56,600 --> 00:02:09,910 And then I volunteered to do my national service in the UK because I'm terrified of flying and insects and snakes. 14 00:02:09,910 --> 00:02:17,600 And so they sent me to Singapore, typical army, 15 00:02:17,600 --> 00:02:25,580 because that had no experience in paediatrics and they were in deep trouble and this huge paediatric ward in the military 16 00:02:25,580 --> 00:02:38,910 hospital and looked after the kids of diverse Commonwealth forces and the Gurkhas and all that the war was going on in Malaysia. 17 00:02:38,910 --> 00:02:48,680 So I know that it wasn't just me who got to the children's ward for the first year and said, 18 00:02:48,680 --> 00:02:56,930 I'm one of the I grouped into a child who is what turned out to be thalassaemia after me. 19 00:02:56,930 --> 00:03:06,360 And so I really switched on an interest in genetics and blood disease. 20 00:03:06,360 --> 00:03:12,840 So I went off and got training and I was straight after the. 21 00:03:12,840 --> 00:03:32,250 I kept pushing general medicine all these miles between the states I went to, Johns Hopkins and Liverpool had a connexion because Cyril Clark, 22 00:03:32,250 --> 00:03:42,330 who is the professor of medicine and one of the first things after the setting up to realise 23 00:03:42,330 --> 00:03:50,210 that genetically he went into genetics because he was healthy breeding butterflies, 24 00:03:50,210 --> 00:04:06,610 and then said that the genetics and started a kind of a partnership with Johns Hopkins would take the famous German guy, 25 00:04:06,610 --> 00:04:18,610 got Hopkins and one of the founders of medical genetics. So I went I went over to Hopkins and spent four years, 26 00:04:18,610 --> 00:04:31,540 the one couple years in genetics and a couple of years I was born in haematology and was also a part time appointment in biophysics. 27 00:04:31,540 --> 00:04:37,580 And they were trying to learn some protein chemistry and some. 28 00:04:37,580 --> 00:04:45,230 What do you think of Johns Hopkins? I mean, the kids my age, I think he was one of the founders of the Johns Hopkins. 29 00:04:45,230 --> 00:04:53,150 Yeah, um, well, Hopkins was, of course, the first modern medical school. 30 00:04:53,150 --> 00:05:01,840 So it was the model that Flexner faced with all these reforms of the medical state, 31 00:05:01,840 --> 00:05:09,710 um, largely because I think the founder, um, had spent time in Germany. 32 00:05:09,710 --> 00:05:18,800 They had already got these kind of strong patients based in medical education and training. 33 00:05:18,800 --> 00:05:26,150 And it was in the late 50s, early 60s. 34 00:05:26,150 --> 00:05:30,140 It was, um, it was very good. 35 00:05:30,140 --> 00:05:34,790 Um, it was a bit like Oxford, extremely self-satisfied. 36 00:05:34,790 --> 00:05:43,990 And it's a really good looking and probably at that time, not as great as it had been. 37 00:05:43,990 --> 00:05:50,220 They had these great figures like Blakelock in charge of the first kind of heart operation, 38 00:05:50,220 --> 00:06:05,270 congenital heart technicians and that kind of thing, and then knows about himself and the founders of those early three big names in America. 39 00:06:05,270 --> 00:06:10,040 But, um, and then it had this ring back in the 60s. 40 00:06:10,040 --> 00:06:15,030 I think it's probably one of the top medical schools in the States. 41 00:06:15,030 --> 00:06:29,610 And, you know, I was and I'm on the external review board for Harvard Medical School, and I was there last week reviewing them and. 42 00:06:29,610 --> 00:06:36,660 A couple of people from Hopkins were there. I think it's going very strong. 43 00:06:36,660 --> 00:06:43,170 But it was pretty much in the 60s, early 60s, 44 00:06:43,170 --> 00:06:55,350 a funny mixture of chemical and science and various young and being rather overt, kind of rather overstating it. 45 00:06:55,350 --> 00:07:06,110 So it's kind of the level of research and clinical teaching was actually as well. 46 00:07:06,110 --> 00:07:14,640 The, um, the best clinical teachers were the guys who came in at gun rights in the hospital. 47 00:07:14,640 --> 00:07:20,000 They were in private. She wanted to teach. 48 00:07:20,000 --> 00:07:32,480 And but, um, the kind of students, you know, the clinical the research that's dropping them, you've got a quick rejuvenation. 49 00:07:32,480 --> 00:07:40,980 In the late 60s, when I was going to ask you, who is your most memorable patient? 50 00:07:40,980 --> 00:08:58,000 Would it be that thalassaemia that you. 51 00:08:58,000 --> 00:09:11,040 We knew that there was going to be no facilities for. Transfusion and that she was going to survive very long and then they had this wonderful 52 00:09:11,040 --> 00:09:20,280 picture of the Lady Mountbatten with their own lady back in State of the Union. 53 00:09:20,280 --> 00:09:29,010 So roadmap. Wonderful, wonderful. This picture was taken by local press photographer. 54 00:09:29,010 --> 00:09:33,780 And I'm sure it was the last photograph of my wife. 55 00:09:33,780 --> 00:09:43,230 We had a local Indian artist to make a big drawing on the ground. 56 00:09:43,230 --> 00:09:49,710 What I learnt was a story of disappeared in the press many years later, completely wrong. 57 00:09:49,710 --> 00:09:59,960 Know all about this girl with leukaemia. And so I wrote the story and then read a very nice letter back. 58 00:09:59,960 --> 00:10:10,920 That was just before I already blew him up. But the more I got there, they sent me a copy of the picture. 59 00:10:10,920 --> 00:10:19,680 Recently, I was writing a small history of the thalassaemia and beautiful picture. 60 00:10:19,680 --> 00:10:46,500 So I suppose she was the patient that started me off that research. 61 00:10:46,500 --> 00:10:52,100 Of all the things you've done in your career, what are you most proud of? 62 00:10:52,100 --> 00:11:01,860 I know this place, perhaps this place. 63 00:11:01,860 --> 00:11:12,120 Um, yeah, I think this is going quite well. The. 64 00:11:12,120 --> 00:11:25,720 Probably this place and the the road we've done in lots of years in setting up all these partnerships in the developing country and my party, 65 00:11:25,720 --> 00:11:44,890 I mean, in my own mind, when we started these partnerships in nineteen seventy nine, which leads to go to places like China and India, 66 00:11:44,890 --> 00:11:56,970 I think I think that is a successful model in an economic way to help the developing countries right now. 67 00:11:56,970 --> 00:12:01,560 So something like that. And then. 68 00:12:01,560 --> 00:12:10,680 Oh yes. I was going to ask you about the taste, but let's that's how did that come about when I came about? 69 00:12:10,680 --> 00:12:16,310 That gives you a vivid memory, because I've only been in office for about two weeks. 70 00:12:16,310 --> 00:12:21,120 And then that strange secretary, 71 00:12:21,120 --> 00:12:35,370 because I realise inherited from my predecessor who came in the office of the old Rackley for when he was a young man wants to see you. 72 00:12:35,370 --> 00:12:48,400 You better see him quickly because you think he's been in charge a bit on this coming from Liverpool, nail nails, as usual. 73 00:12:48,400 --> 00:12:58,810 So anyway, he did look a bit depressed as he was a university press and. 74 00:12:58,810 --> 00:13:11,270 A staff member doesn't exactly he was one of the editors anyway, and he said that they just published, 75 00:13:11,270 --> 00:13:18,080 I think it was the 13th edition that checked the prices of textbooks much. 76 00:13:18,080 --> 00:13:26,750 And it did come out to a rather lukewarm reviews, to put it mildly. 77 00:13:26,750 --> 00:13:36,590 So he banged some of these reviews on the desk and the first reviews in the Annals of Internal Medicine. 78 00:13:36,590 --> 00:13:51,130 And this was a review that said, when I opened this textbook, I noticed that the senior editor is a physician to her majesty the Queen. 79 00:13:51,130 --> 00:14:02,040 Have you read the book? I only saw God Save the Queen and help. 80 00:14:02,040 --> 00:14:09,070 The reviews are all about that. And it was quite clear this is not going to be a bestseller. 81 00:14:09,070 --> 00:14:20,590 So he said that they just really needed a new textbook and, I don't know, stupid enough. 82 00:14:20,590 --> 00:14:24,820 I talked to John Ledingham, and the only thing that the idea, 83 00:14:24,820 --> 00:14:37,930 any idea directed me was that if we could produce a textbook of medicine that was much more global coverage rather than the standard Western. 84 00:14:37,930 --> 00:14:49,870 And so we got hold of David Rowe. You had a lot of tropical experience and the three of us did it. 85 00:14:49,870 --> 00:15:00,970 But I think it was I mean, the question of whether there was a place for journalists. 86 00:15:00,970 --> 00:15:12,690 I mean, it was. I think some of the other reviews of the and maybe the first position and 87 00:15:12,690 --> 00:15:23,720 Reiser and Joni Mitchell when she was the first professor of medicine not to. 88 00:15:23,720 --> 00:15:33,410 So, so, so dinosaurs. I think it is biological knowledge on the minds of dinosaurs. 89 00:15:33,410 --> 00:15:41,640 They said that they died because they fell under their own weight, which is not exactly what happened as far as I know. 90 00:15:41,640 --> 00:15:53,570 But and these books will do exactly this. And then there is no place really for walks of that type anymore. 91 00:15:53,570 --> 00:16:04,870 But I always thought that was really because I think if you practising any speciality in medicine, we do need a general guide. 92 00:16:04,870 --> 00:16:14,420 Um, anyway, it went OK and it's still going, but they're revising it online and you know, 93 00:16:14,420 --> 00:16:25,200 things like I got an email from them just this week saying they don't think revising 94 00:16:25,200 --> 00:16:33,980 a lot of the chapters for online versions anymore has had an intellectual appeal. 95 00:16:33,980 --> 00:16:41,870 I'm sure, because students like to say that it's the one thing that they're to to. 96 00:16:41,870 --> 00:16:45,830 So I think it is in practise disseminated news. 97 00:16:45,830 --> 00:16:51,410 The big problem is caused in the first two editions, I think. 98 00:16:51,410 --> 00:17:01,400 Well, you had this the British government had this kind of aid system, 99 00:17:01,400 --> 00:17:11,550 which was a system whereby one could get books printed for reduced price and dissemination in the poorer countries. 100 00:17:11,550 --> 00:17:19,660 That programme finished. So I think we got to watch the first and second edition. 101 00:17:19,660 --> 00:17:37,090 Gone that way, but after that, it's finished. And it's very difficult now because we knew this was a major textbook, I think, on thalassaemia. 102 00:17:37,090 --> 00:17:42,610 And the fourth edition that came to. 103 00:17:42,610 --> 00:17:57,030 2001, when I went back a couple of years ago, what was then Blackwells, the fifth edition, 104 00:17:57,030 --> 00:18:04,100 I said it would only do it if they would produce a cheaper copy from the developing countries because that's where it's needed. 105 00:18:04,100 --> 00:18:14,170 It's very kind. They told me, why don't you do that before 80000? 106 00:18:14,170 --> 00:18:23,860 And she's still thinking about it is very difficult. 107 00:18:23,860 --> 00:18:30,700 I've got a copy of your book, and I've also got is this six edition, which 96 one. 108 00:18:30,700 --> 00:18:34,570 And I find it fascinating to see, obviously, what things they cover. 109 00:18:34,570 --> 00:18:44,650 And, you know, the pages and pages on TV. We see this most recent, um, you know. 110 00:18:44,650 --> 00:18:50,200 Yes. Yes, you've got. And the original. 111 00:18:50,200 --> 00:19:05,250 And of course, the Johns Hopkins people read the issues that they put together and seen a copy of that recently, 112 00:19:05,250 --> 00:19:11,150 McGee, how Harvey did it, I and a couple of others. 113 00:19:11,150 --> 00:19:20,930 Now, I was going to ask you about your society leaving do about the money for the hospitals in Sri Lanka. 114 00:19:20,930 --> 00:19:25,330 Instead of your retirement policy, I wasn't the only one. 115 00:19:25,330 --> 00:19:34,780 Know, I was a trustee of the wealth and I try for about 10 years. 116 00:19:34,780 --> 00:19:42,800 And when you finished the well, they gave you a rather splendid dinner. 117 00:19:42,800 --> 00:19:56,840 And I would like Michael dextrously. And I would suggest to him at the time and I told him that I wanted to leave him alone if they 118 00:19:56,840 --> 00:20:03,210 could give me a bit of money towards building this treatment centre for the kids in Sri Lanka. 119 00:20:03,210 --> 00:20:10,730 So they gave me a bit of giving. 120 00:20:10,730 --> 00:20:18,710 I was given the time that I way you can do a lot in Sri Lanka for that amount. 121 00:20:18,710 --> 00:20:28,470 So I found a retired architect and former British architect who said you would do it for nothing. 122 00:20:28,470 --> 00:20:33,830 And so with the welcome that we got off the west. 123 00:20:33,830 --> 00:20:41,150 But it was the welcome. Oh, right. Yes, yes. You know, we said we just forgotten how much money it was. 124 00:20:41,150 --> 00:20:47,930 I mean, obviously, this programme worked and it was a few thousand, right? 125 00:20:47,930 --> 00:20:52,470 Yes. Yes. And you still go back to Sri Lanka quite often. 126 00:20:52,470 --> 00:21:00,290 Yeah. Yeah, I'm going back. But I'm on average about four times a year. 127 00:21:00,290 --> 00:21:14,050 And it started really by chance I was giving a lecture that must really be just like these kids die, 128 00:21:14,050 --> 00:21:21,890 a paediatrician only paediatrician who try to set up the new treatment for them. 129 00:21:21,890 --> 00:21:30,470 And then they sit in the middle of the island for poor neighbourhoods that could negative stereotypes and high spirits. 130 00:21:30,470 --> 00:21:35,660 Had the disease. And she asked me to go and help them out. 131 00:21:35,660 --> 00:21:42,710 And so I. 132 00:21:42,710 --> 00:21:53,690 We've got a lot of samples back to find out what type of disease is somehow and I started going at first year with awful people that 133 00:21:53,690 --> 00:22:05,960 had no facilities and the kids used to come in for a transfusion and there was no work for the mothers news to lie on the floor. 134 00:22:05,960 --> 00:22:15,010 They couldn't get the blood ready, so they had to spend the night being transfused. 135 00:22:15,010 --> 00:22:23,200 Who? The patient population, obviously. 136 00:22:23,200 --> 00:22:33,970 So we tried to fill in for the story, first, broke the story, and then the second floor. 137 00:22:33,970 --> 00:22:46,440 For the older patients, the idea, the role of the patient through these very complicated set of cases, 138 00:22:46,440 --> 00:22:54,960 so many different forms, different from treatment and then. 139 00:22:54,960 --> 00:23:05,730 And then we train the boy here, we did this deal with me, but I didn't do that on this issue like disease problems. 140 00:23:05,730 --> 00:23:13,920 And and then he went back and managed to get to know the British dead and to 141 00:23:13,920 --> 00:23:22,110 give us the money to go with the Diagnostic Centre for DNA Diagnostic Centre, 142 00:23:22,110 --> 00:23:26,320 not just the thalassaemia from infectious diseases. 143 00:23:26,320 --> 00:23:42,480 So they've got to get it done and then gradually work just a national programme and screening programme or watch pretty slow. 144 00:23:42,480 --> 00:23:48,060 And then with the war places we couldn't go to. 145 00:23:48,060 --> 00:23:55,500 But now we've just done a complete set of. Twenty seven percent is on the island. 146 00:23:55,500 --> 00:24:05,040 Seven thousand children face amazing diseases even on that relatively small island. 147 00:24:05,040 --> 00:24:18,160 It's very patchy investigation. And so just checked in wanting to give you no idea that so much. 148 00:24:18,160 --> 00:24:23,920 But know it has been an story. 149 00:24:23,920 --> 00:24:28,690 Do you think is the life expectancy and improve it? 150 00:24:28,690 --> 00:24:35,090 Oh, yes, yes, yes, very much. 151 00:24:35,090 --> 00:24:49,630 And that's why my big problem has been that they have a kind of union this week to be in charge of the commission now that it's 40. 152 00:24:49,630 --> 00:24:55,420 I mean, you know, it must be no overlap. The unions don't like it. 153 00:24:55,420 --> 00:25:06,260 And so no training and paediatricians was OK, but it was never going to work out. 154 00:25:06,260 --> 00:25:12,100 Any problem getting they have to be based on the British system. 155 00:25:12,100 --> 00:25:22,240 They have these kind of call. If you help, if you have had recent college, you even don't have a college of pathology. 156 00:25:22,240 --> 00:25:33,050 They have a college, haematology college or college of microbiology has five members and haematology about 12. 157 00:25:33,050 --> 00:25:39,140 But college is not very effective. 158 00:25:39,140 --> 00:25:50,100 You just have to break through it with the grade and go straight to work up to these kids to. 159 00:25:50,100 --> 00:26:02,250 So there's quite a lot of people to wait to jealousy, the usual thing, 160 00:26:02,250 --> 00:26:21,930 but probably if you imagine somebody from Sri Lanka coming in and telling you, you know, so, yeah, it's it's only natural, I think. 161 00:26:21,930 --> 00:26:30,330 And things like blood transfusion and bone marrow transplants, is that easy? 162 00:26:30,330 --> 00:26:43,560 Well, you know, they it's used a lot in many countries now, particularly marrow transplants. 163 00:26:43,560 --> 00:26:50,160 If there's a compatible donor being fairly successful, 164 00:26:50,160 --> 00:26:59,370 but they've not got the transplants to be achieved in Sri Lanka would be a lot of talk about it. 165 00:26:59,370 --> 00:27:11,730 But they done some of the other places I've worked on in Thailand, for example. 166 00:27:11,730 --> 00:27:21,570 There's a huge problem, but they have just fairly recently developed a mother's marrow transplant programme. 167 00:27:21,570 --> 00:27:37,170 And certainly in India, there was a very good programme, a couple of very good programmes, but it's been a bit slow getting off the ground. 168 00:27:37,170 --> 00:27:50,790 And it's only you know, it's only valuable if if they do have a day and by and large, they are really much more successful, 169 00:27:50,790 --> 00:27:59,880 often early in life size, once the results decline quite dramatically in the older patients. 170 00:27:59,880 --> 00:28:15,000 So it's not the answer, you know, and and what do you think will be pizza developments that thalassaemia? 171 00:28:15,000 --> 00:28:18,000 Well, probably like a lot of single gene disorders. 172 00:28:18,000 --> 00:28:35,010 I think I'm fairly confident now that gene therapy will be successful if it's been incredibly slow and has been unsuccessful. 173 00:28:35,010 --> 00:28:53,010 Well, let me rephrase that. There's been one case where what's been done and the donor haemoglobin has been produced and at least to year. 174 00:28:53,010 --> 00:28:56,910 But it's a funny case and I think about it. 175 00:28:56,910 --> 00:29:03,600 But my guess is it goes to the French and got that system going quite well 176 00:29:03,600 --> 00:29:10,230 for one of the genetic immune disease is known as the outbreak of leukaemia. 177 00:29:10,230 --> 00:29:19,630 And the kids have been treated and they found this gene, that protein that moved in right next to a kind of oncogene. 178 00:29:19,630 --> 00:29:25,350 And they did a very good job in sorting that out. 179 00:29:25,350 --> 00:29:34,770 And to do the recent genes that are being portrayed, I know go kind of fail safe regions around them, 180 00:29:34,770 --> 00:29:43,020 which make it very unlikely that they would, in fact, change was too high. 181 00:29:43,020 --> 00:29:53,100 Yeah, but I think I think the secondary technical details are grossly underplayed in nature. 182 00:29:53,100 --> 00:30:08,400 But it will happen. And it's just there's another big trial going starting earlier this year from the group in New York. 183 00:30:08,400 --> 00:30:18,450 But it's great. I think people have grossly underestimated the complexity of sticking genes into people. 184 00:30:18,450 --> 00:30:25,950 I mean, something in your area and they're really in the conventional. 185 00:30:25,950 --> 00:30:30,210 Yeah, it's and it's looking quite promising. 186 00:30:30,210 --> 00:30:35,310 Yes. And I suppose because the reality is. Yeah. 187 00:30:35,310 --> 00:30:41,130 And you can also test to see haematology, you would lend itself to that, 188 00:30:41,130 --> 00:30:50,450 knowing whether you've got success and the ability to study them and you can get. 189 00:30:50,450 --> 00:30:58,030 I really it's not like having to put something in the living room or anything, 190 00:30:58,030 --> 00:31:03,130 but there must be an inherent tension between having a disease that's common in less developed 191 00:31:03,130 --> 00:31:08,470 parts of the world and having that technology to do things like bone marrow transplants, 192 00:31:08,470 --> 00:31:16,700 or do you have to be in a much safer environment? You have got the resources to use them for safety. 193 00:31:16,700 --> 00:31:23,200 The problem of knowing how to use things. 194 00:31:23,200 --> 00:31:27,100 A unit such as yours must bridge that gap to a certain extent. 195 00:31:27,100 --> 00:31:33,430 Well, we have to, and that's why we need lots of places. 196 00:31:33,430 --> 00:31:49,510 We've really focussed on prenatal diagnosis because just simply the cost effectiveness of HIV and AIDS and the fact that it does give the family, 197 00:31:49,510 --> 00:32:02,680 if they wish, on the certainty of knowing that child can explode and probably turn have not only one child. 198 00:32:02,680 --> 00:32:08,550 That's been one of the tragedies in Sri Lanka, for example. 199 00:32:08,550 --> 00:32:25,600 The first of all, however, due to genetic counselling, you cannot persuade Sri Lankan male to child any part of him. 200 00:32:25,600 --> 00:32:41,650 It's always the woman who followed the family's journey to break up these very high suicide rate families and the counsellor and the principal, 201 00:32:41,650 --> 00:32:47,050 actually, because they've got very few trained counsellors. 202 00:32:47,050 --> 00:32:57,370 And that's been quite a big part of our effort in trying to improve the kind of social that to change. 203 00:32:57,370 --> 00:33:06,140 And then in Sri Lanka, they were not allowed prenatal diagnosis yet. 204 00:33:06,140 --> 00:33:22,310 It's not. It's interesting, I got to remember the Buddhists, by and large, accepted it, enjoy the same brand of Buddhism, but they say not true. 205 00:33:22,310 --> 00:33:34,500 I think. I think what's happened in Sri Lanka is that Buddhists have been a bit of a Christian religion, 206 00:33:34,500 --> 00:33:42,620 Jewish Catholicism, and they've pushed very hard against it and it's still not. 207 00:33:42,620 --> 00:34:04,100 But it's now developed in most countries in Asia and huge effect on the raw numbers in place in the Middle East and the Muslim religion, 208 00:34:04,100 --> 00:34:15,120 except for the. And the fascinating. 209 00:34:15,120 --> 00:34:28,560 Talk to these people, I've been to several community meetings and listening to the Islamic view, which is a fantastic, 210 00:34:28,560 --> 00:34:40,410 beautifully illustrated, potentially a dreadful day, but they believe that the soul enters the future thinking about 14 weeks, the breathing. 211 00:34:40,410 --> 00:34:58,230 So if you go in before that and the benefit to the family, then we don't know. 212 00:34:58,230 --> 00:35:02,310 What about any changes in medical school? 213 00:35:02,310 --> 00:35:13,770 I mean, we just don't have anything interesting happening or anything. 214 00:35:13,770 --> 00:35:24,850 I don't know. My overall view is that when I first came to the, um, 215 00:35:24,850 --> 00:35:42,870 the clinical side of the Department of Medicine is really quite strong and decisive and clinical about both courageous, I guess. 216 00:35:42,870 --> 00:35:49,400 And it was a little bit. 217 00:35:49,400 --> 00:35:57,170 I'm not a little bit silly, no, but quite strong on the political side, 218 00:35:57,170 --> 00:36:15,470 and then I was lucky enough to have a readership before I even got in and want to join a very strong teacher. 219 00:36:15,470 --> 00:36:28,950 And what the findings seemed to me to be your this the research done. 220 00:36:28,950 --> 00:36:45,620 So we started building that to go on to people in different fields from my own field. 221 00:36:45,620 --> 00:36:52,730 And then the mostly came along and offered me a unit as a unit. 222 00:36:52,730 --> 00:37:08,690 And it soon became apparent that medical research was going to take on more cellular and molecular biology. 223 00:37:08,690 --> 00:37:15,380 A lot of these men were injured and people in the medical school constantly coming to 224 00:37:15,380 --> 00:37:22,670 us to borrow equipment or was quite clear that there was a need for somewhere where 225 00:37:22,670 --> 00:37:32,990 clinicians could get trained in this kind of technology and also a place where young 226 00:37:32,990 --> 00:37:45,020 scientists wanted to practise something or their research could be in the medical direction. 227 00:37:45,020 --> 00:37:47,270 And there was no way for that either. 228 00:37:47,270 --> 00:38:04,320 So that's why eventually we went to the NRC and tried to what this building was originally set up shop corridors. 229 00:38:04,320 --> 00:38:11,240 Who was that? People the geologists worked with sheep. 230 00:38:11,240 --> 00:38:30,010 Extraordinarily, when I first came to the place was a ship building where Wellingtons, you know, we started in the real John Radcliffe in the area. 231 00:38:30,010 --> 00:38:38,420 And the observatory used to carry these and this fire was stuck. 232 00:38:38,420 --> 00:38:42,440 And then they built this building for it here. 233 00:38:42,440 --> 00:38:51,080 And then for some reason, the university was going through another period of financial depression anyway. 234 00:38:51,080 --> 00:39:00,350 So they couldn't afford to when he retired, they couldn't afford to live in the region and then they're going to just shut it down. 235 00:39:00,350 --> 00:39:20,750 So I suggested that we try and develop a building with this type of work that we've done a strong accent really on training, 236 00:39:20,750 --> 00:39:29,990 not making it too rigid in this kind of research direction, just using this technology. 237 00:39:29,990 --> 00:39:38,460 And I went to the emergency and. 238 00:39:38,460 --> 00:39:49,020 Jim James Jones was running them at that time, and he was very enthusiastic about this, but he didn't have quite enough money. 239 00:39:49,020 --> 00:40:09,040 So they put in some money. And then we went to the University of Virginia and then we set up a two story building right at the last minute. 240 00:40:09,040 --> 00:40:13,590 It was headed down to research funded. 241 00:40:13,590 --> 00:40:22,790 So they'd like a bit of it. So they put in some money. 242 00:40:22,790 --> 00:40:33,800 So that's how it all started. I think we come back to the medical school and I think the other interesting 243 00:40:33,800 --> 00:40:45,950 thing was that we started this graduate programme and my last days and three, 244 00:40:45,950 --> 00:40:49,460 that's been public service success when the graduate in three months. 245 00:40:49,460 --> 00:41:00,750 Yeah. Oh, yeah. In fact, we had a lot to worry about and really very quickly. 246 00:41:00,750 --> 00:41:08,900 And it's now when the price the. 247 00:41:08,900 --> 00:41:28,280 Yeah. I mean the big problem here was, was with the with the reform and GMC reforms, they were obviously desperate for us to go and were, 248 00:41:28,280 --> 00:41:36,940 I'd say, dilute the science a bit and make sure these kids were exposed to patients. 249 00:41:36,940 --> 00:41:40,160 They one but private friends. 250 00:41:40,160 --> 00:41:59,860 And, you know, it seemed to me that medicine was to this place for a diversity of medical students who will probably end with first degree, 251 00:41:59,860 --> 00:42:08,930 a strong base in science, which we had some interesting discussions, 252 00:42:08,930 --> 00:42:25,070 discussions, but I think we managed to compromise with them and the danger of closing the place now, 253 00:42:25,070 --> 00:42:33,010 because it's expanded to a certain extent, it's not a large amount of 60 each year, which 30 in 2010. 254 00:42:33,010 --> 00:42:37,400 And that balance might shift. It is going to be a good idea. 255 00:42:37,400 --> 00:42:48,170 Yeah, yeah. But the the final on a school element, which I think is still recognised as being very important. 256 00:42:48,170 --> 00:42:59,330 Yeah. You need to do this. I mean I, I know the external review board for Harvard Medical School. 257 00:42:59,330 --> 00:43:09,800 I was there last week and the losses are really to remember the first degree. 258 00:43:09,800 --> 00:43:17,300 And even the the in that sense it's rather similar. 259 00:43:17,300 --> 00:43:27,860 But I think you would have been right there. 260 00:43:27,860 --> 00:43:42,090 And then, of course, we're that as the research spread and be expanded, expanded you. 261 00:43:42,090 --> 00:44:03,200 And so all in all, it a fairly successful and I think the medical sciences division is the biggest one and it's the size of it. 262 00:44:03,200 --> 00:44:13,190 Last year there was absolutely no new. 263 00:44:13,190 --> 00:44:22,370 I mean, they thought we were a complete idiot. So this is you know, we do the science and you do the clinical medicine. 264 00:44:22,370 --> 00:44:28,480 Yeah, that's. It was amazing, but it was the same. 265 00:44:28,480 --> 00:44:36,150 That wasn't unique to me when I came back to Liverpool. 266 00:44:36,150 --> 00:44:43,660 They had no teaching in college and there wasn't a professor of physiology at 267 00:44:43,660 --> 00:44:57,180 Liverpool who regularly discovered the gastro he has from the physiological blood. 268 00:44:57,180 --> 00:45:02,980 But he told his people don't really trust me. 269 00:45:02,980 --> 00:45:12,970 So it was pretty cool. So he had all my first three tapes and feedback. 270 00:45:12,970 --> 00:45:26,700 That's not to say about the sort of scientific treatment to the present atmosphere right across the country, I mean, the division between the field. 271 00:45:26,700 --> 00:45:32,410 So I think it's improved a lot. 272 00:45:32,410 --> 00:45:35,290 What's interesting, reading Flexner, 100 years old, 273 00:45:35,290 --> 00:45:44,590 to see how that to what extent we have held on to that in England as well as the United States and comparing it with Europe is quite interesting, 274 00:45:44,590 --> 00:45:50,190 I think, because the German students that come to us see this as a major general, 275 00:45:50,190 --> 00:46:06,010 to say that the clinical aspects of emotional and physical medicine, well, I think exclude those aspects of the United States. 276 00:46:06,010 --> 00:46:16,990 And certainly when our elective students go to major institutions, they come back on their clinical skills, involvement with patients. 277 00:46:16,990 --> 00:46:25,230 So that must be satisfactions at the bedside end of the bench to bedside and the bench. 278 00:46:25,230 --> 00:46:37,390 And what we're preparing for the future is another matter. 279 00:46:37,390 --> 00:46:48,070 I told you that. But at the year I've been doing the. 280 00:46:48,070 --> 00:46:54,170 Master's course in the Harvard Business School at the same time. 281 00:46:54,170 --> 00:47:07,070 And when I had my breakfast with them all these meetings, and I thought it was because they were all going to be administrators. 282 00:47:07,070 --> 00:47:21,370 And so, you know, no, I didn't practise medicine in the States without having some proper training in business to make a big difference. 283 00:47:21,370 --> 00:47:28,880 And is that so that they can go out and set up boring institutions in some ways and become independent? 284 00:47:28,880 --> 00:47:33,010 Well, to some degree, they're good. They're very proud as [INAUDIBLE]. 285 00:47:33,010 --> 00:47:37,960 But you they've got the primary rate goes up your prime rate. 286 00:47:37,960 --> 00:47:55,750 But in fact, it's kind of like just a big extension of the kind of office and know I'm real 287 00:47:55,750 --> 00:48:07,630 good comes the concept of family doctors next year or any time criticising it. 288 00:48:07,630 --> 00:48:23,190 But, you know, they're just generalists who work in offices and they call that primary care, which seems to me to be the same as, say. 289 00:48:23,190 --> 00:48:38,670 And just the last thing the ladies have any projects happening in this institute I could talk about in the last year or to some of the projects? 290 00:48:38,670 --> 00:48:42,690 Well, you know, the mixture. 291 00:48:42,690 --> 00:48:52,010 These the. There you go. 292 00:48:52,010 --> 00:49:03,010 And when I retired, then I would see a unit going under Douglas Haig and the military molecular biology, 293 00:49:03,010 --> 00:49:09,350 and they and they are less politically orientated than I was. 294 00:49:09,350 --> 00:49:23,060 But I mean, their major goal was to try to understand how basically they had the elements of the blood to form and the kind of 295 00:49:23,060 --> 00:49:34,990 regulatory mechanisms in the formation of blood and that is being applied to certain forms of malignant disease. 296 00:49:34,990 --> 00:49:48,500 Well. Some of the groups yeah, I think the the genetics with Andrew Wilkie has been extremely strong as well. 297 00:49:48,500 --> 00:50:04,090 And they're continuing to try to understand the major through that and understand the genetic basis for some facial deformities. 298 00:50:04,090 --> 00:50:14,060 Jose. I think that probably as good as anybody, you know, did not feel very, very good. 299 00:50:14,060 --> 00:50:18,620 But then they're gone. 300 00:50:18,620 --> 00:50:29,780 They're still the kinds of strong kinds of groups that work in various aspects of cancer. 301 00:50:29,780 --> 00:50:41,220 Then the immunology group and Andrew MacMichael took over from the director of the institute. 302 00:50:41,220 --> 00:50:51,530 And his group has been and still is very much involved with community AIDS, HIV. 303 00:50:51,530 --> 00:51:03,110 And I think they've done a lot of really important fundamental work on understanding HIV of 304 00:51:03,110 --> 00:51:13,340 Raksha immune system and the fact that he was the first interview in science last year. 305 00:51:13,340 --> 00:51:24,220 It's nice to see that the group in here had the highest citation index and any. 306 00:51:24,220 --> 00:51:41,950 More than all, these big American needs might be related to work on the board looking at things outside the European Union. 307 00:51:41,950 --> 00:51:48,220 Oh, I think so, yeah. And particularly the relationship of HIV AIDS, tuberculosis. 308 00:51:48,220 --> 00:51:55,480 And, you know, the other thing that's interesting, that's less it is more global we're looking at. 309 00:51:55,480 --> 00:52:01,030 Yeah. Yeah. Because of the relationship to peripheral units based in the US. 310 00:52:01,030 --> 00:52:10,180 Yeah. Well that's that's also been the same this we had have a very strong parasitology 311 00:52:10,180 --> 00:52:19,190 group in here as well with this new poll and the link to Cambridge recently, 312 00:52:19,190 --> 00:52:32,840 we're doing these big mapping of the genome to show the world that they can't afford in the laboratory back up for the people. 313 00:52:32,840 --> 00:52:39,250 And and that will typically in Thailand. 314 00:52:39,250 --> 00:52:47,030 And he joins us now from. 315 00:52:47,030 --> 00:53:02,900 And there's also some very interesting work going on in the video, particularly in relation to malaria as well, 316 00:53:02,900 --> 00:53:09,260 because iron deficiency is a huge problem in the developing countries, as you know. 317 00:53:09,260 --> 00:53:24,890 And but resistant malaria makes it really very complicated to kind of manage on deficiency and that they've 318 00:53:24,890 --> 00:53:39,210 been involved in some very important work suggesting that the body's response to malaria makes it. 319 00:53:39,210 --> 00:53:47,870 This encourages the and absorption. And that's what you really need to do with these children in the developing countries, 320 00:53:47,870 --> 00:54:00,040 is modify your periods of replacement to the low malaria transmission seasons and so on to get this type of thing. 321 00:54:00,040 --> 00:54:08,990 A practical point of view. Very important. You know, just a few thoughts. 322 00:54:08,990 --> 00:54:17,200 I think there's always the question is, can you think of anything else? 323 00:54:17,200 --> 00:54:31,870 I think the idea was very appealing, but it has in general worked outwards and it's in its endeavour scientific. 324 00:54:31,870 --> 00:54:42,370 And I would see your role in bringing together the clinical and scientific in setting up units such as the ones you Lanka as being a very important. 325 00:54:42,370 --> 00:54:45,220 Is this a sort of combination of rigour, 326 00:54:45,220 --> 00:54:55,730 but also an understanding of what's possible both within and I suppose if you have a good cadre of people who are clinically very. 327 00:54:55,730 --> 00:55:01,980 Well trained, then you're more likely to get good results for the amount of money that you spent wisely, 328 00:55:01,980 --> 00:55:14,690 if the critical underpinning is success, which lets the financial side of this is really very important to get this message over to a good one. 329 00:55:14,690 --> 00:55:17,990 In fact, may maybe they're slowly getting it. 330 00:55:17,990 --> 00:55:27,020 But if you throw these partnerships and you do have control over the difference 331 00:55:27,020 --> 00:55:32,200 and throwing aid into a country and throwing aid to foreign governments, 332 00:55:32,200 --> 00:55:36,620 I know what happens to a lot of that and places over there. 333 00:55:36,620 --> 00:55:43,830 And we do have some control over the situation with the genuine partnership and. 334 00:55:43,830 --> 00:55:52,070 And you can control the kind of cash flow in your life. And but they've done extremely well. 335 00:55:52,070 --> 00:56:01,580 I mean, you don't want to live in a nation with this malaria programme. 336 00:56:01,580 --> 00:56:05,300 And he's coming back to give the second Wetherall Lecture in May. That's right. 337 00:56:05,300 --> 00:56:09,170 You have been delighted that you were able to come to the diary. 338 00:56:09,170 --> 00:56:17,890 Well, and the other fascinating one is tuberculosis, because as he was mentioning, TB was an important component in this. 339 00:56:17,890 --> 00:56:22,880 And it's hugely important to me. I feel it sort of knocking at the door. 340 00:56:22,880 --> 00:56:32,900 And you hate seeing some of the cases in relation to my own HIV work in London to see the impact of this very, 341 00:56:32,900 --> 00:56:39,370 very sick and the interplay of malaria with HIV and population. 342 00:56:39,370 --> 00:56:43,880 And I think that's a very isolating. Oh, yeah. 343 00:56:43,880 --> 00:56:59,360 The vaccine programmes here are. I haven't I haven't seen the latest reports of Adrian, and he didn't say anything. 344 00:56:59,360 --> 00:57:05,960 I think they're going into the next stage of trance. Yeah, we'll be going into Q1 and I've done some early work. 345 00:57:05,960 --> 00:57:11,480 I think we're going into human with with with the malaria vaccine. 346 00:57:11,480 --> 00:57:18,870 And I think it started with TB. TB, yeah. It's promising early days, but I think will be on. 347 00:57:18,870 --> 00:57:33,390 Yeah, well, there's all this noise made about a malaria vaccine last year, but we got to know that The Guardian had a piece of this meeting. 348 00:57:33,390 --> 00:57:42,340 This was saying the scientists were in tears and on the Web, which really is this. 349 00:57:42,340 --> 00:57:53,930 This is. You give me partial protection for up to six months, rather early days. 350 00:57:53,930 --> 00:58:04,150 It's been a huge problem and I don't know anything else to say about the school 351 00:58:04,150 --> 00:58:07,270 is the one very amusing story that you always tell about your appointment. 352 00:58:07,270 --> 00:58:13,140 I don't know whether you want to go on record that, oh, you had to contact them. 353 00:58:13,140 --> 00:58:26,600 Yeah, that's right. It really was bizarre in the sense that I got an invitation to come down here 354 00:58:26,600 --> 00:58:36,470 and talk about this job and then I went back to it and it was a big set up, 355 00:58:36,470 --> 00:58:47,030 actually. I mean, it's probably not publishable and it should dull the office. 356 00:58:47,030 --> 00:58:53,360 This job, though, is much more or less without telling anybody. 357 00:58:53,360 --> 00:59:02,990 And they go to Big Boss. And so they wanted to have a quick look at a few of the people. 358 00:59:02,990 --> 00:59:15,530 And I was invited down you nothing. I told you I'd only been here one day trip with my parents as a kid. 359 00:59:15,530 --> 00:59:22,460 But, um, so about a week after I've been down here, I got these phone calls. 360 00:59:22,460 --> 00:59:29,450 And you were unanimously elected not to be a professor of clinical medicine. 361 00:59:29,450 --> 00:59:42,440 Please give us an answer in 24 hours. So I did chat with my mates in the pool and decided they didn't seem to do better ones. 362 00:59:42,440 --> 00:59:47,280 We didn't need to bring this research group to theirs to move. 363 00:59:47,280 --> 00:59:59,410 And so I said, OK. And they said that well in advance to say I wouldn't be taking a job for 18 months, but. 364 00:59:59,410 --> 01:00:07,910 Building on John. I have some say in what they're doing anyway. 365 01:00:07,910 --> 01:00:26,750 I literally did not hear anything for a year and then I to tell you about it, at least to the vice chancellor who might be leaving. 366 01:00:26,750 --> 01:00:39,380 And so I. I contacted his office and he said he knew Alex would become worried. 367 01:00:39,380 --> 01:00:45,170 So you better find out if it's all a mistake. 368 01:00:45,170 --> 01:00:50,780 Keep a place for you. So I didn't have the courage to ring them. 369 01:00:50,780 --> 01:01:00,470 I got my dear little secretary, old lady, Mrs. Coughlin, and I say, bring them up. 370 01:01:00,470 --> 01:01:05,940 Nice with you. She came back from the phone. 371 01:01:05,940 --> 01:01:14,110 She's such a dear old character, the real Liverpool. 372 01:01:14,110 --> 01:01:19,940 She was away and she came back. You can't go to. 373 01:01:19,940 --> 01:01:24,710 I said, why? But what did they say? 374 01:01:24,710 --> 01:01:29,000 Well, I said to them, Principal, you thought you been to that. 375 01:01:29,000 --> 01:01:35,220 You were assured that nothing from me. And there was a long silence. 376 01:01:35,220 --> 01:01:39,470 And then this woman came on the phone. 377 01:01:39,470 --> 01:01:45,620 She says, Oh, my God. Um, what does he want? 378 01:01:45,620 --> 01:01:52,430 It was announced in the Times, wasn't it? What more does he want? 379 01:01:52,430 --> 01:02:01,430 I never had anything on paper all over the region. 380 01:02:01,430 --> 01:02:12,400 Now, let me just tell you that Margaret Thatcher said, I have it in mind. 381 01:02:12,400 --> 01:02:17,990 She had to. And that kind of language, 382 01:02:17,990 --> 01:02:24,180 which is mind to put your name forward to the queen as though it would be quite easy for you not 383 01:02:24,180 --> 01:02:32,930 to have a chance to get nothing from nothing in his office or the university or from you know, 384 01:02:32,930 --> 01:02:41,900 it's not his thing. So there's no record of is that going to be at least two times in your life where you've taken 385 01:02:41,900 --> 01:02:51,230 a deep breath and just gone or come on arrived and found that you were greeted with open arms, 386 01:02:51,230 --> 01:02:54,320 open mouth to say, oh, no. 387 01:02:54,320 --> 01:03:08,630 And my grief, my first reaching and walking up the long corridor in the right place in the moment circle with little man running out at me. 388 01:03:08,630 --> 01:03:16,280 But I think I told you that before I turned right into the country. 389 01:03:16,280 --> 01:03:29,560 And then my mind rushed out and said, You must be better off in the service. 390 01:03:29,560 --> 01:03:33,740 Is your predecessor gave me space the. 391 01:03:33,740 --> 01:03:37,880 And then I replied, Can I assume you're not going to take. 392 01:03:37,880 --> 01:03:45,050 You don't mean I got it right. 393 01:03:45,050 --> 01:03:56,330 You know, I didn't want to as I said, I'm sure I didn't write something, not realising and I'd just given away half my research. 394 01:03:56,330 --> 01:04:03,950 Oh, good. He said and stumped off down the corridor. And then he turned round and he said, Oh, by the way, I should have introduced myself. 395 01:04:03,950 --> 01:04:34,220 My name's Hans Krebs. And so indeed I remember the first story is Seven told me later that he was desperately worried about me coming in case he had. 396 01:04:34,220 --> 01:04:43,470 Fascinating. This is fascinating to this, the old boy was. 397 01:04:43,470 --> 01:04:49,740 Actually, not really doing very much, but he had this huge working, 398 01:04:49,740 --> 01:04:58,800 so she had to be in the lab on Saturday and Sunday and in the end they were running a trying to keep him company. 399 01:04:58,800 --> 01:05:03,990 Yes, that's true. I remember coming to the end of the corridor and only going up to the boards. 400 01:05:03,990 --> 01:05:08,880 And there's always something going on in that little room with lots of glassware. 401 01:05:08,880 --> 01:05:21,930 Right. So, you know, it's always somebody that was just paperwork and all of that now completely. 402 01:05:21,930 --> 01:05:31,550 There was no stranger to get anything for the things people walked up cause. 403 01:05:31,550 --> 01:05:43,690 And all the people who were looked up for your drummers training and teaching you is not isolated spot. 404 01:05:43,690 --> 01:05:46,971 He's got what you need. I have great hope for.