1 00:00:01,770 --> 00:00:09,690 Derek Hockaday interviewing That Is Splendid Home on the twenty sixth March 14. 2 00:00:09,690 --> 00:00:15,090 Nick, you were just telling me that you came to Oxford as a registrar in 68. 3 00:00:15,090 --> 00:00:23,090 What made you advise it? What made you want to come? Um. 4 00:00:23,090 --> 00:00:27,860 I had a very old friend who was on the consultant staff, Joe Smith, 5 00:00:27,860 --> 00:00:34,070 but we had worked together at Bart's when I was a housewife and he was the senior registrar. 6 00:00:34,070 --> 00:00:39,920 Right. Um, and we had kept up, uh, over the years. 7 00:00:39,920 --> 00:00:43,990 And when the Post came up in Oxford, I thought, that's pretty good. 8 00:00:43,990 --> 00:00:57,060 It's pretty good news. And that was registrar to whom? Um, well, I was, uh, there were three there were four surgical firms in those days. 9 00:00:57,060 --> 00:01:02,750 Uh, and the first the first surgical firm was on with Ted Ted Maloney and Malcolm Goffstown. 10 00:01:02,750 --> 00:01:06,770 And as a registrar, you spent most of your time at the church. 11 00:01:06,770 --> 00:01:21,140 So I was mainly attached to Malcolm Golf. And then I did a um and I think it was six months we did maybe in the, uh, with Tim Tintern and Joe Smith. 12 00:01:21,140 --> 00:01:37,460 Um, and then I went to the Professore unit, Alison and outgunning um and then in due course the senior registrar came up which I got, which was in 72. 13 00:01:37,460 --> 00:01:46,640 And then I worked pretty well exclusively for Ted Maloney, Tim Tebow and David Tibs, not with Malcolm Duff now. 14 00:01:46,640 --> 00:01:54,980 Right. Because now was Malcolm doing the paediatric surgery when he was and is that when you first got into paediatric that, 15 00:01:54,980 --> 00:01:58,850 you know, I had always wanted to be a paediatric surgeon, 16 00:01:58,850 --> 00:02:11,990 um, and, uh, but there were a subsequently I got a scholarship to go to the Royal Children's Hospital in Melbourne to do a whole year's research. 17 00:02:11,990 --> 00:02:18,710 Um, and I'd already worked Great Ormond Street. Um, but there were it was very interesting. 18 00:02:18,710 --> 00:02:23,880 But all my contemporaries, a Great Ormond Street, um, ended up in person abroad. 19 00:02:23,880 --> 00:02:28,550 They were very, very few openings in the UK. 20 00:02:28,550 --> 00:02:33,350 And, you know, all the people who had been appointed as pure paediatric surgeons were relatively young. 21 00:02:33,350 --> 00:02:43,140 So there were no vacancies coming up. So you either went to Liverpool or Great Ormond Street or Bristol, I think, in those days. 22 00:02:43,140 --> 00:02:49,220 And so I ended up, as you know, as a general surgeon with a paediatric interest, 23 00:02:49,220 --> 00:02:55,490 like Malcolm Gough himself had told you that one day that might be to paediatric surgeon. 24 00:02:55,490 --> 00:03:02,090 And I said, no, no, no. And I think he rather hoped I might be a urologist. 25 00:03:02,090 --> 00:03:14,100 We had both worked on a urology firm in London, um, but it didn't take my dogs to, um, and in the general said everybody sort of memories of Lazreg. 26 00:03:14,100 --> 00:03:19,400 Yes. Well, I mean, you can't help but reflect on the change. 27 00:03:19,400 --> 00:03:29,450 And, um, uh, it as a registrar, you were on take, um, two days a week or one day a week. 28 00:03:29,450 --> 00:03:41,210 And the weekend I went, um and now I think they can take about one day in a fortnight and then it's totally changed 29 00:03:41,210 --> 00:03:48,530 so that the work intensity was just totally different and everybody was a generalist. 30 00:03:48,530 --> 00:03:54,170 Yes. Okay. You know, Joe Smith was a urologist who did quite a lot in general, so he went on general surgical take. 31 00:03:54,170 --> 00:04:08,360 Um, David Tibs, vascular surgeon, went on general surgical take, said the degree of specialisation with hand and. 32 00:04:08,360 --> 00:04:14,450 And occurred back in those days, did you feel you were supervised enough? 33 00:04:14,450 --> 00:04:19,250 Uh, yes, I was very lucky. I was very fortunate indeed. 34 00:04:19,250 --> 00:04:27,500 When I when I came, uh, I wasn't supervised by my consultants, but, um, 35 00:04:27,500 --> 00:04:34,100 I had a very good close working relationship with the senior registrar, who was my guess who you will remember. 36 00:04:34,100 --> 00:04:37,400 Yes, I do. And I really hit it off with my gear. 37 00:04:37,400 --> 00:04:42,650 And he took me through a lot of my first surgical procedures. 38 00:04:42,650 --> 00:04:48,740 You know, I'd seen the boss doing them, but it was the boss wasn't supervising me, doing them. 39 00:04:48,740 --> 00:04:56,750 And that wasn't exclusive. But I think I probably more for my gear as seen as a senior registrar teaching a junior than anybody else. 40 00:04:56,750 --> 00:05:01,610 But then, you know, we did all the all the emergency takes were done with the senior registrar. 41 00:05:01,610 --> 00:05:05,480 Um, and you trained about that, right? Yes. 42 00:05:05,480 --> 00:05:07,610 And the great great on the street. 43 00:05:07,610 --> 00:05:15,440 Now, after you've been in Oxford, say, three months, what did you think of the standard compared to the London hospitals? 44 00:05:15,440 --> 00:05:21,770 Well, it was you know, I was the first generation of, um, 45 00:05:21,770 --> 00:05:27,740 I think it's true to say I think I was the first generation who did not aspire to stay in London. 46 00:05:27,740 --> 00:05:34,250 Right. You know, the pinnacle of one's ambition is back in the 60s, 47 00:05:34,250 --> 00:05:41,690 50s and 60s was to be a London concert at a concert in London teaching hospital and have a Harley Street practise. 48 00:05:41,690 --> 00:05:52,190 And it was it was just beginning the transition was just beginning that the centres of excellence were building up outside of London. 49 00:05:52,190 --> 00:05:57,080 And, of course, in terms of lifestyle with a family that really influenced me. 50 00:05:57,080 --> 00:06:04,340 And I mean, I was the first surgical job I did in general surgery was in Bristol. 51 00:06:04,340 --> 00:06:09,770 And and that was every bit as good as about where I trained. 52 00:06:09,770 --> 00:06:14,060 Um, and then when I came to Oxford, what it was really, really, 53 00:06:14,060 --> 00:06:21,830 really fired me up at Oxford was that if you actually spoke to individuals about where they had trained, 54 00:06:21,830 --> 00:06:29,980 they were from all over the country, but everybody on the staff was both trained and the same would have been to Thomases and guys. 55 00:06:29,980 --> 00:06:38,330 But, you know, if you look down the names, you know, there was Ted Malone in New Zealand outgunning South African, 56 00:06:38,330 --> 00:06:42,350 Alison from from Leeds, you know, go on down the line. 57 00:06:42,350 --> 00:06:49,820 And that was really I thought that was really good, that people had come from so many different centres with their own ideas. 58 00:06:49,820 --> 00:06:56,850 But it wasn't just with the boss way. Yeah, because you're too young to have done national service, is that right? 59 00:06:56,850 --> 00:07:03,530 I was called up for national service, but got deferment because I got a place at medical school. 60 00:07:03,530 --> 00:07:10,370 Oh yes. By the time I'd finished my medical course and was eligible to do national service, they they just stopped it. 61 00:07:10,370 --> 00:07:14,330 Great. But literally I was just on the cusp years now. 62 00:07:14,330 --> 00:07:29,200 I mean he was a slightly eccentric er I would do that. 63 00:07:29,200 --> 00:07:34,640 He just loved doing big operations, you know, the bigger the operation, the more he liked. 64 00:07:34,640 --> 00:07:42,370 But actually it was he wasn't you know, I'd been a Great Ormond Street working with two particularly good surgeons, 65 00:07:42,370 --> 00:07:49,060 you know, who had been very dextrous in here, whereas Ted was, you know, he used to borrow. 66 00:07:49,060 --> 00:07:57,130 So but in terms of it, he had a heart of gold. And if anything went wrong with his patients, he was absolutely devastated. 67 00:07:57,130 --> 00:08:02,830 So his heart was absolutely in the right place. And he was a tremendous supporter, you know, supportive of me. 68 00:08:02,830 --> 00:08:10,000 So I'm very grateful to him when I had the opportunity of going to Australia because he was from that from the antipodes, 69 00:08:10,000 --> 00:08:13,330 he was full of enthusiasm and gave me all the support he could. 70 00:08:13,330 --> 00:08:19,540 Who funded the scholarship that was funded by the University of Melbourne right around. 71 00:08:19,540 --> 00:08:24,820 So I applied for so, um, uh, and I suppose my credentials, 72 00:08:24,820 --> 00:08:31,720 having been a great organ street with people that they knew of at the Royal Children's Hospital in Melbourne. 73 00:08:31,720 --> 00:08:37,090 You talk to big operations now gurning like big operations. 74 00:08:37,090 --> 00:08:44,230 Yes. Oh, and did you think he was a bit of a guy? 75 00:08:44,230 --> 00:08:49,840 Yeah, he was O'Gara. And in a cardiac and cardiothoracic surgery. 76 00:08:49,840 --> 00:09:00,700 And when I reflect on it, you know, I had a huge mortality, um, and I was accepted and Älskling could cope with that. 77 00:09:00,700 --> 00:09:06,970 I mean, I would have been devastated if, you know, every third patient I had operated on at succumb. 78 00:09:06,970 --> 00:09:10,580 But Alf could cope with that. But he was a good surgeon. Yes. 79 00:09:10,580 --> 00:09:15,280 Oh, yes. Yeah. Uh, David Davis came to do the vascular work, is that right? 80 00:09:15,280 --> 00:09:21,930 That's correct, yes. And that must have been a sort of change because then he specialised in that. 81 00:09:21,930 --> 00:09:27,130 And, um, when did you begin to get a whiff of research? 82 00:09:27,130 --> 00:09:32,080 Not in Oxford, perhaps not till now, but no. Um, oh, no, no. 83 00:09:32,080 --> 00:09:36,520 My attachment in Melbourne was specifically to go and do research before that. 84 00:09:36,520 --> 00:09:40,660 Had you done in the end of year and what did you do in Melbourne then? 85 00:09:40,660 --> 00:09:51,040 Um, I developed a new operation for oesophageal atresia, so I did a lot of work in, uh, in conjunction with the Melbourne Veterinary School. 86 00:09:51,040 --> 00:09:59,710 That's where I could actually go. And that I did quite a lot of research on motility, studies in children with oesophageal atresia. 87 00:09:59,710 --> 00:10:04,870 A lot of them postoperatively had swallowing problems and actually identifying 88 00:10:04,870 --> 00:10:07,990 it and seeing if there were drugs that would actually help their motility. 89 00:10:07,990 --> 00:10:16,210 And so that's why I spent my year doing and I was I was very much that was very much, um, 90 00:10:16,210 --> 00:10:21,910 to further my prospects of getting on a teaching hospital because I always enjoyed teaching. 91 00:10:21,910 --> 00:10:25,120 And I you know, I was hoping that I would get on. 92 00:10:25,120 --> 00:10:30,970 I didn't expect to get on in Oxford, but I was in my aim was ultimately to be in a teaching hospital. 93 00:10:30,970 --> 00:10:35,080 So you enjoyed the undergraduates through the clinical students? Oh, enormously. 94 00:10:35,080 --> 00:10:43,750 Enormously. And it's one of the great sadnesses now that they're so relatively to contact with the students, with the consultants. 95 00:10:43,750 --> 00:10:51,520 And that is a real for the destruction of the firm system because they're always irritating, mean they're all rotating. 96 00:10:51,520 --> 00:11:01,550 And but they you know, when you had as you had in medicine, you had students on the firm for three months was now three months. 97 00:11:01,550 --> 00:11:06,310 You've got to let the students really well. Now, the the firm system's gone. 98 00:11:06,310 --> 00:11:10,030 And so the students don't really identify with consultants. 99 00:11:10,030 --> 00:11:15,340 And, you know, we as consultants, you can be you can be good role models and bad role models. 100 00:11:15,340 --> 00:11:20,110 But whether if you're a bad role model, that's actually quite educating. You know, they say, what? 101 00:11:20,110 --> 00:11:24,940 Yeah, I'm never going to be like that. And this is exactly like that. 102 00:11:24,940 --> 00:11:32,960 Yes. And I mean, did you feel the hours were excessive in those days? 103 00:11:32,960 --> 00:11:39,640 Well, straight answer is yes, because they were absolutely horrendous. 104 00:11:39,640 --> 00:11:45,460 And in fact, for the whole of my working life, the hours were pretty, pretty incredible. 105 00:11:45,460 --> 00:11:49,930 No paediatric surgeon in Malcolm Gough had incredible. Yeah, well. 106 00:11:49,930 --> 00:11:54,010 And when did you pair with him? Sort of split it. Yeah. Yes. 107 00:11:54,010 --> 00:12:04,300 And you were still pretty busy. We were. Well, I suppose, you know, as the years went by, there were more things that you could do a bit. 108 00:12:04,300 --> 00:12:13,000 I reflect now that that they're called index cases and in paediatric surgery say things like a soft you know, 109 00:12:13,000 --> 00:12:21,430 trees are in the same diaphragmatic hernia spine different than the cool index cases. 110 00:12:21,430 --> 00:12:26,860 Now, Oxford was in Malcolm on Monday. We're doing about 120 of those a year now. 111 00:12:26,860 --> 00:12:36,320 There are not a whole lot more. Index cases that come in from the region, right, but there are five full time paediatric surgeons now, you would. 112 00:12:36,320 --> 00:12:42,730 I was I was I succeeded by, um, uh, Timoteo, which is Intercrime practise. 113 00:12:42,730 --> 00:12:48,660 Yes. And you did the thyroids and the right and the adrenals. 114 00:12:48,660 --> 00:12:55,740 Uh, there are now three full time Intercrime surgeons. 115 00:12:55,740 --> 00:13:00,450 Having said that, there is more that there is there is definitely more endocrine surgery coming in, 116 00:13:00,450 --> 00:13:07,980 because, as you know, um, there's a government policy that major cases should be centralised in places. 117 00:13:07,980 --> 00:13:16,290 So and it's had an incredible impact on hospitals like Northampton, which was in the Oxford region. 118 00:13:16,290 --> 00:13:27,330 And I've got a close friend in in Northampton whose morale is absolutely hit the deck because they've lost their vascular surgeon. 119 00:13:27,330 --> 00:13:32,310 They left oesophageal surgery. They've lost no major colorectal surgery. 120 00:13:32,310 --> 00:13:37,380 So they're doing just basic, very basic routine, simple operations. 121 00:13:37,380 --> 00:13:39,840 And interested that you did find them before, 122 00:13:39,840 --> 00:13:50,250 because I thought it all went to Sheffield and there was a guy the window there was a physician in Sheffield and there was a surgeon up there. 123 00:13:50,250 --> 00:13:55,020 And at one time they were doing an immense amount. They were you're quite right then. 124 00:13:55,020 --> 00:13:58,620 But it was widespread, in fact. Oh, yes, yes, yes. 125 00:13:58,620 --> 00:14:10,740 Um, you see, now the paediatric surgeons do know the before the, um, the general paediatric surgeons on the staff. 126 00:14:10,740 --> 00:14:20,310 Right. It's all done by paediatric neurology neurosurgeons who I and you may have seen him on television recently, got a very big nose, I think. 127 00:14:20,310 --> 00:14:24,570 Well, I think that it is. But he he does. 128 00:14:24,570 --> 00:14:28,230 I don't I don't think he single-handed I think there are two of them who do it all. 129 00:14:28,230 --> 00:14:39,210 But Malcolm and I did all the spine of evidence. Yes. And the putting the bit talked about what the hydrocephalus story is so and so. 130 00:14:39,210 --> 00:14:46,950 I mean, that's been that's been the big change that we were multitasking is when I started. 131 00:14:46,950 --> 00:14:51,090 I mean, obviously, as the years went by, parts of my practise fell off. 132 00:14:51,090 --> 00:14:57,660 I mean, like I did a lot of breast surgery is now there are maybe two. 133 00:14:57,660 --> 00:15:04,980 There are two, maybe three surgeons or nothing else but breast surgery and don't get involved with General Take or anything like that. 134 00:15:04,980 --> 00:15:10,680 So and I suppose it's the same happened in medicine. Yes, I think it is, yeah. 135 00:15:10,680 --> 00:15:16,530 So how did you enjoy all the thyroid work? Because they're interesting patients. 136 00:15:16,530 --> 00:15:21,630 I had a lot of fun doing that. And it's again, it's a bit like paediatric surgery. 137 00:15:21,630 --> 00:15:33,270 There's a there's a precision about it. Um, uh, it brought me into contact with, um, Alister Lang at the church, 138 00:15:33,270 --> 00:15:41,670 who was the specialist radiologist giving radioiodine for those patients where that was more suitable than surgery. 139 00:15:41,670 --> 00:15:51,360 Um, and Chris Burke, who was a bit quirky character, um, and then he was succeeded by John Ross, 140 00:15:51,360 --> 00:15:55,740 but we used to do a joint thyroid clinic, um, once a month. 141 00:15:55,740 --> 00:16:01,140 Well, complicated, um, thyroid problems would be discussed. 142 00:16:01,140 --> 00:16:04,620 And I really enjoyed that. Yes. Chris was a very bright guy. 143 00:16:04,620 --> 00:16:08,460 Oh, he was. Yes. He was just a quirky character. 144 00:16:08,460 --> 00:16:18,240 Um, I mean, sometimes, you know, he'd come into this clinic and he would be, uh, effusive and overpack. 145 00:16:18,240 --> 00:16:21,890 And then another time he'd come in and sit in the corner and just a grump. 146 00:16:21,890 --> 00:16:26,010 Yeah. So he was very sort of labour emotionally. 147 00:16:26,010 --> 00:16:32,890 Um, but it was I really enjoyed that and I thought John was lastly, I really clicked with him. 148 00:16:32,890 --> 00:16:37,950 Now you're FLC is would you get that as a registrar or senior registrar? 149 00:16:37,950 --> 00:16:41,730 I we sat down in those days. You set your reference. 150 00:16:41,730 --> 00:16:49,030 Yes. There's a registrar, right? Yeah. And then was it your Australian work for a doctorate in. 151 00:16:49,030 --> 00:16:56,640 Well, that was the idea is that was the plan. Um, I was preparing to play together names. 152 00:16:56,640 --> 00:17:04,140 Um, so I did all the years research acquired all the data. 153 00:17:04,140 --> 00:17:15,030 Um, I really enjoyed my time in Australia. Um, you know, four young children grow at their early years there. 154 00:17:15,030 --> 00:17:19,110 And at the end of my time in the Royal Children's Hospital, they offered me a job. 155 00:17:19,110 --> 00:17:29,550 Um, and I was I was really tempted because, you know, we were very it was the three day working week in England and. 156 00:17:29,550 --> 00:17:37,430 I just thought, you know, the future for our children, that you took any profession, there were openings and we're coming back to England. 157 00:17:37,430 --> 00:17:42,410 We knew it was going to be tougher for them. But anyway, I came back because I had to work out my contract. 158 00:17:42,410 --> 00:17:48,860 Yes. And in the three three months that I came back from Australia, my job came up. 159 00:17:48,860 --> 00:17:51,350 The job that I got came up. 160 00:17:51,350 --> 00:17:57,890 And I've never been so relaxed in all my life going into an interview because I thought if you didn't want me, I'd go back to Australia. 161 00:17:57,890 --> 00:18:02,810 But the bottom line of that was that I immediately into consulting practise, 162 00:18:02,810 --> 00:18:08,660 I didn't have time to do my my and which I had regrets about because I've got all all the data. 163 00:18:08,660 --> 00:18:13,910 I've published a lot of papers, but I hadn't got the time to sit down and do a thesis. 164 00:18:13,910 --> 00:18:18,140 So it was in a register. You you'd be in training up registrars? 165 00:18:18,140 --> 00:18:22,920 No, the US had two or three. Well, one at a time, yes. 166 00:18:22,920 --> 00:18:31,860 Yeah, yeah, and then what was really the difference, looking back between being a senior registrar and being a consultant? 167 00:18:31,860 --> 00:18:37,920 Well, of course, the buck stops with you as a consultant. And that's that that's the, um. 168 00:18:37,920 --> 00:18:44,520 Where does the buck stop on the ward round or in that patient's. 169 00:18:44,520 --> 00:18:52,470 Well, yes, you've got to you as the senior registrar, you take a lot of decisions on your own band, 170 00:18:52,470 --> 00:19:00,590 but if if you're at any any doubt at all about what would be the right thing to do, you can you you defer to the consultant. 171 00:19:00,590 --> 00:19:09,900 So that's the major difference between as a senior as to how often roughly would you ring up or, 172 00:19:09,900 --> 00:19:14,290 you know, get in touch with the consultant twice a week? Oh, no, no. 173 00:19:14,290 --> 00:19:25,530 I thought know very, very. That's right. But you see, we were getting a huge amount of experience, which they don't get nowadays. 174 00:19:25,530 --> 00:19:32,820 And the more I won't name who, but I mean more the ones I would ring up the consultancy to. 175 00:19:32,820 --> 00:19:38,640 I trust you. I'm sure you'll make the right decision rather than get out of bed and come into the hospital. 176 00:19:38,640 --> 00:19:43,610 So you did bring them up at night and just occasionally. Occasionally I did. 177 00:19:43,610 --> 00:19:50,200 But overall, we were you know, by the time you got on the staff, on the staff is the senior registrar, 178 00:19:50,200 --> 00:19:54,970 you actually had quite a background, a bit of knowledge and an experience. 179 00:19:54,970 --> 00:20:04,170 Um. And then did you carry on your research at all when you were a consultant? 180 00:20:04,170 --> 00:20:11,490 Oh, yes. So what did you. Oh, I did a huge amount of, um, you know, across all the specialities. 181 00:20:11,490 --> 00:20:21,960 I, um, I didn't focus on, I would say I didn't focus in on any one thing in particular, although I did a lot of I did a lot of, 182 00:20:21,960 --> 00:20:36,540 um, uh, research in rectal anomalies, um, measuring the continents and how we could improve their continents. 183 00:20:36,540 --> 00:20:46,740 And, uh, so that was that was probably I probably publish more papers than that in the paediatric surgery, but then endocrine surgery. 184 00:20:46,740 --> 00:20:51,480 I was very motivated to find ways of identifying parathyroid. 185 00:20:51,480 --> 00:20:55,650 Yes. Um, which are really difficult to spot. 186 00:20:55,650 --> 00:21:00,540 And, uh, I developed in Oxford a method of of, uh, 187 00:21:00,540 --> 00:21:08,620 an intravenous drip with a dye that would actually show up the with the the and then you'd see them colour that operation, 188 00:21:08,620 --> 00:21:13,500 that operation when you open doors and see them in the um. And that worked. 189 00:21:13,500 --> 00:21:19,180 Yeah. Yeah. I mean it was slightly irritates me because it's actually still not still done. 190 00:21:19,180 --> 00:21:28,500 Right. And they've developed something much more expensive and then now they're now picked up with the radiologist which cost a lot of money, 191 00:21:28,500 --> 00:21:33,840 whereas actually methylene blue, which is what we developed. And that was a just a chance finding. 192 00:21:33,840 --> 00:21:37,770 Um, and it's safe and it's pretty safe. 193 00:21:37,770 --> 00:21:46,320 Um, but yeah, I know I had I had a number of research projects, you know, rectal stuff, Joe it Joe Smith was interested in that was, 194 00:21:46,320 --> 00:21:53,490 you know, not because he worked I mean, on the bladder side, I suppose, but very much the cloaca, you know. 195 00:21:53,490 --> 00:21:57,180 But with the pharmacologists, you did smooth muscle. Yes. 196 00:21:57,180 --> 00:22:08,130 And did you work with her at all? No, I didn't. You know that I don't it wasn't quite the same type as Joe's research, with which smooth muscle. 197 00:22:08,130 --> 00:22:18,950 Yes. You know, this was much more, uh, pelvic musculature and then how you could reroute the recommended for an erection anomalies, right? 198 00:22:18,950 --> 00:22:23,120 Um, no, it wasn't, because there was a remarkable business, wasn't there, 199 00:22:23,120 --> 00:22:28,860 that if you kept stimulating some of the pelvic smooth muscle, they became voluntary. 200 00:22:28,860 --> 00:22:33,990 That's why it is absolutely incredible. Yeah, but that yours is more routine there. 201 00:22:33,990 --> 00:22:45,580 Yes, I get it. And, um, when did you begin first to get an interest in, as it were, abroad, Ethiopia, Palestine, whatever. 202 00:22:45,580 --> 00:22:54,380 Um. Well, Ethiopia is just one of the many places that I've been to with my surgical travelling 12 years. 203 00:22:54,380 --> 00:22:58,220 We have a home meeting once a year and an abroad meeting. 204 00:22:58,220 --> 00:23:02,870 So while you were still working. Yes, yes. Yeah. 205 00:23:02,870 --> 00:23:13,750 I think surgical travelling clubs are losing their appeal, which I think is rather sad, um, because, again, it was a very good network. 206 00:23:13,750 --> 00:23:18,650 Uh, you only had one member from any one centre. 207 00:23:18,650 --> 00:23:26,240 Um, now I've been travelling with my group, uh, for the last 30 odd years and um, 208 00:23:26,240 --> 00:23:33,470 and at a time when concerns had much more say about where their registrars and senior registrar went to know, 209 00:23:33,470 --> 00:23:43,550 I could pick up the phone and I talk to somebody in Cardiff or in Colchester and say, we've got a really good guy who's looking for a place to, uh. 210 00:23:43,550 --> 00:23:47,780 So it was very good networking. Yes. 211 00:23:47,780 --> 00:23:53,360 Um, but that seems to be a lot of the surgical travelling clubs are struggling. 212 00:23:53,360 --> 00:24:01,520 Uh, the format of the meetings always is. We have, um, we if we go abroad, we always have a contact. 213 00:24:01,520 --> 00:24:06,950 Um, I don't know if you've read that book about the and the fistula hospital in Addis Ababa. 214 00:24:06,950 --> 00:24:13,370 Have you heard about it now? Uh, Absi fascinate girls in Ethiopia, Mary. 215 00:24:13,370 --> 00:24:19,670 Um, when they about 12 or 13 years and then they get pregnant, 216 00:24:19,670 --> 00:24:27,290 get into obstructed labour for days on end and they the baby's head causes scheme 217 00:24:27,290 --> 00:24:32,810 and they then get a fistula and we're back to somewhere they a fistula and, 218 00:24:32,810 --> 00:24:37,760 uh, and a hugely prevalent in Ethiopia. 219 00:24:37,760 --> 00:24:48,260 And two Australians, um, uh, went out and devised an operation to change these girls lives because once they became incontinent, 220 00:24:48,260 --> 00:24:50,720 they were ostracised, you know, 221 00:24:50,720 --> 00:24:59,690 they were shunned by society and some of them would walk hundreds of miles to get to this hospital in Addis Ababa, which is still going and doing it. 222 00:24:59,690 --> 00:25:09,380 I visited it when we were there, but we've been all over the world with the and went to Cuba to, you know, you name it, we've gone. 223 00:25:09,380 --> 00:25:14,880 So when you went somewhere like Undeservingly, how long would you spend in Ethiopia? 224 00:25:14,880 --> 00:25:21,680 The club we spent, um, I think less than three weeks. 225 00:25:21,680 --> 00:25:27,380 The format is always and that's unusual that unusually long because we were very keen to see the southern part of the country. 226 00:25:27,380 --> 00:25:33,890 So some of the some of the team who were still in active practise couldn't afford to spend too much time away from work, 227 00:25:33,890 --> 00:25:39,290 but knew I was a retired layabout so we could we could go to we could go down to the south and see more of the country, 228 00:25:39,290 --> 00:25:47,660 which was absolutely fascinating. But the format has always been three days with the local medicks who we have a contact with. 229 00:25:47,660 --> 00:25:53,000 And then we see a bit of the country and you'd be operating? 230 00:25:53,000 --> 00:25:59,060 No, it was always lecturing. The only exception was when we went to Ghana and we did. 231 00:25:59,060 --> 00:26:11,970 And the basic what we did, I did the first laparoscopic cholecystectomy in in Ghana took all the all the gear from Oxford. 232 00:26:11,970 --> 00:26:17,120 And, uh, we were on television. It was a big, big thing. 233 00:26:17,120 --> 00:26:22,160 And you only went to Israel after you retired. Did you Palestinians just say yes? 234 00:26:22,160 --> 00:26:30,830 Yeah. Um, I don't know if the College of Physicians does this, but, uh, I don't know if they're still doing it. 235 00:26:30,830 --> 00:26:41,270 But when I just retired, the college had a symposium for people recently retired who wanted to do VSOE. 236 00:26:41,270 --> 00:26:45,560 And I went to this meeting. And this won't surprise you. This will make you chuckle. 237 00:26:45,560 --> 00:26:53,630 Derek, um, there was a succession of talks by surgeons during the day who were all on ego trips, 238 00:26:53,630 --> 00:26:57,860 and they all said, oh, I think you should go to Tanzania. 239 00:26:57,860 --> 00:27:07,100 I went and I take a team every year and we carve up 200 natives in doing such and such a procedure. 240 00:27:07,100 --> 00:27:13,010 And then they come home. And I thought, you know, anything that goes wrong, they're off. 241 00:27:13,010 --> 00:27:21,260 They're off the planet. Yeah. Um, and so at the end of the afternoon, the man sitting next to me said, what do you think of that? 242 00:27:21,260 --> 00:27:25,280 And then I said, well, actually, I'm very disillusioned. You know, I said, just what I've said. 243 00:27:25,280 --> 00:27:33,530 Just, uh, I think, you know, if anything goes wrong after you've left, you haven't you're not there to pick up the pieces. 244 00:27:33,530 --> 00:27:37,400 You haven't taught the locals anything. 245 00:27:37,400 --> 00:27:42,800 You know, what I had in mind was going to actually show people how to do things themselves and stand over them and watch them. 246 00:27:42,800 --> 00:27:48,150 And, you know, you've then left a legacy and they said, well, I. 247 00:27:48,150 --> 00:27:57,340 On the island, I'm professor of research surgery at UCLA, and I've got a very close link with Al Quds University in Jerusalem, 248 00:27:57,340 --> 00:28:01,550 would you like to go there and teach anatomy, which I did? 249 00:28:01,550 --> 00:28:05,150 I well, um, I usually two or three weeks. 250 00:28:05,150 --> 00:28:17,620 Yes. Um, and, uh, the following year they said we would really like some surgical, uh, guidance at our hospitals in the West Bank. 251 00:28:17,620 --> 00:28:23,420 Um, do you think you could recruit some people and then it snowballed and I've been doing it every year since. 252 00:28:23,420 --> 00:28:32,290 And last November 12 of us went from Oxford, from Oxford is predominantly Oxford based. 253 00:28:32,290 --> 00:28:34,030 Some of them are people like you remember Tom. 254 00:28:34,030 --> 00:28:47,170 They do some Tom work got on at Redding, the royal, uh, you know, so people with close Oxford links, um, so we took it expanded. 255 00:28:47,170 --> 00:28:53,170 We now take three paediatricians, three surgeons and three physicians. 256 00:28:53,170 --> 00:29:03,910 I've been trying to talk David Warren into it, but Chris Caldwell in this column, Tim Littlewood, like Peggy Fritz, Peggy Fritz, come regularly. 257 00:29:03,910 --> 00:29:07,840 Yeah, um, and I think it's hugely appreciated. 258 00:29:07,840 --> 00:29:11,410 Yeah, I bet it was like, what is new? Is it? 259 00:29:11,410 --> 00:29:22,660 And this last year for the first time we I had been before, uh, but just to see rather than teach this last trip was to garner to Gaza. 260 00:29:22,660 --> 00:29:28,090 Right. Where the leader of the need is even greater in the West Bank. 261 00:29:28,090 --> 00:29:32,140 In Gaza is basically a ghetto. Yeah. It must be terrible. 262 00:29:32,140 --> 00:29:38,200 It's surrounded by a security wall. The locals have great difficulty getting out. 263 00:29:38,200 --> 00:29:44,290 And if they do get out, they're not allowed to get back in again. Um, so they feel very isolated. 264 00:29:44,290 --> 00:29:49,060 They're hugely appreciative of what's going on. But getting there is quite difficult. 265 00:29:49,060 --> 00:29:55,630 Getting the visas to go is a long process. And so that's how I got caught up in the night trip. 266 00:29:55,630 --> 00:29:59,410 So you did your preclinical in London? Yeah, yeah, yeah. 267 00:29:59,410 --> 00:30:04,360 Now, I know this is very difficult question and time is changing all the time. 268 00:30:04,360 --> 00:30:08,720 Do you think there's any marriage in the Oxford Preclinical School? 269 00:30:08,720 --> 00:30:19,690 Absolutely. My great regret is that I didn't go to Cambridge and do my preclinical because I was offered a place 270 00:30:19,690 --> 00:30:27,130 that Alan Keyes the year after I left school and in those days having a gap year was it was unusual. 271 00:30:27,130 --> 00:30:33,430 It was very unusual. I didn't come from a particularly wealthy family. They put me through public school and boarding and everything. 272 00:30:33,430 --> 00:30:38,290 And I had a real conscience about it being a burden to them for any longer. 273 00:30:38,290 --> 00:30:45,160 So I was offered a place at Cambridge the year after I left school to what is fifty eight or something. 274 00:30:45,160 --> 00:30:53,590 Yeah. And would be about that is um mind you, if I had gone to Cambridge, I was a very keen horseman, 275 00:30:53,590 --> 00:30:59,680 I probably wouldn't have qualified and I'd probably found a way to spend my time on the river. 276 00:30:59,680 --> 00:31:04,480 On the river. Really. That right. Yes. That was my number one sport at school. 277 00:31:04,480 --> 00:31:09,370 I did a lot of rugby as well, but I was rowing was my major stroke. 278 00:31:09,370 --> 00:31:12,940 I was well, I wasn't big enough to be, you know, middle of the boat. 279 00:31:12,940 --> 00:31:23,290 But I stroked the, um, when I stroke my school crew and then I stroked the butts first date and went to England. 280 00:31:23,290 --> 00:31:33,160 But now you're answering your question. Um, I think if I had my time over again, I would do my preclinical at Cambridge, 281 00:31:33,160 --> 00:31:38,200 because I think probably it has slightly the edge for basic science is on Oxford. 282 00:31:38,200 --> 00:31:45,790 On that I'd come to Oxford to do my clinical. Yes, because I think I think Oxford for Clinical is as good as anywhere I've seen. 283 00:31:45,790 --> 00:31:51,460 And I talk to I say all these members of my surgical travelling club who came to Oxford and saw what was going on, 284 00:31:51,460 --> 00:31:56,290 they all said, this is this is one of the best places in the country in our estimation. 285 00:31:56,290 --> 00:32:06,580 The, um. So then how did you link up with the district hospitals in Wallingford and, uh, Whitney and didn't didn't you. 286 00:32:06,580 --> 00:32:18,130 I did. Oh, very much so now. Well, I don't know if it's still going on, but, uh, there was a vogue for doing peripheral clinics. 287 00:32:18,130 --> 00:32:24,550 And I did a peripheral clinic in Didcot and I did another one in time, which both had a little cottage hospital. 288 00:32:24,550 --> 00:32:28,630 And then I think they did cover and it's now quite expanded. Um, 289 00:32:28,630 --> 00:32:34,180 but actually I quite know quite like I very much like having contact with the local GP's 290 00:32:34,180 --> 00:32:39,070 who are referring patients to me rather than just to an anonymous name on a letter. 291 00:32:39,070 --> 00:32:48,550 And if you actually went they quite often sat in all my clinics or they'd bring a patient is um and I really like that because the Markus's routine, 292 00:32:48,550 --> 00:32:52,240 they were I never knew them very well, Andrew said sadly, no longer alive. 293 00:32:52,240 --> 00:33:03,880 But, uh, Pat, I still see when she comes to any medication, um, um, just trying to remember the name of the guy that I had a very difficult course. 294 00:33:03,880 --> 00:33:15,610 No, Bill, Bill Colson was called some years, whose wife was at the, um, cancer centre in terms of OK, well, she knows. 295 00:33:15,610 --> 00:33:21,730 And then she ran it. She was so said she had nothing to say about it. 296 00:33:21,730 --> 00:33:29,920 But Bill was a very good GP. And you've got the you know, you've got the vibes about people if you actually saw them in their own environment. 297 00:33:29,920 --> 00:33:39,520 Um, so, yes, we had a and then I became ultimately I became regional advisor for the College of Surgeons. 298 00:33:39,520 --> 00:33:48,820 So and we had to go and assess hospitals. So I visited all the hospitals in the region, um, to see how they were running things. 299 00:33:48,820 --> 00:33:53,650 And if it was it was up to standard. Was there. Advisor for training to visit. 300 00:33:53,650 --> 00:33:58,870 Yeah, yeah, both. And what did you think? Did you think people were being well trained? 301 00:33:58,870 --> 00:34:06,730 It was quite variable. Um, and I was just mentioning a while ago about North Hampton. 302 00:34:06,730 --> 00:34:11,440 I mean, I was hugely impressed with Hampton in the United States is really good in that area. 303 00:34:11,440 --> 00:34:17,470 You remember Brian Dowling, who was he went from Oxford to become a consultant there. 304 00:34:17,470 --> 00:34:24,220 And then two of my senior registrars went to to North Hampton. And that was that was doing a fantastic job. 305 00:34:24,220 --> 00:34:28,570 Um, reading Roebuck's and reading. 306 00:34:28,570 --> 00:34:35,710 There was a lot of personality clashes there. So that went through a bad phase, but then had a better phase. 307 00:34:35,710 --> 00:34:43,450 Um, Milton Keynes again hospital, where a number of my registrars and registrars went on to become consultants. 308 00:34:43,450 --> 00:34:50,320 Um, so yes, I got to know all the peripheral hospitals very well, but mainly through being the college representative. 309 00:34:50,320 --> 00:34:54,580 And would you be getting up to London to committee meetings, so. Yes. 310 00:34:54,580 --> 00:34:59,050 Yes. But I was chairman of the Court of Examiners for the Fellowship. 311 00:34:59,050 --> 00:35:03,430 Wow. Um, so that brought me into contact with a lot of people. 312 00:35:03,430 --> 00:35:06,070 Did that mean travelling around the country as well or not? 313 00:35:06,070 --> 00:35:13,480 Laughter It did when I first started all the bit like the membership, because I think membership was exclusively held in it, wasn't it? 314 00:35:13,480 --> 00:35:18,220 And I don't know if that goes out and about it does now. Yeah. No change in the eighties. 315 00:35:18,220 --> 00:35:26,950 Yeah. Yeah, that was right when I when I was chairman of the Board of Examiners up until that point has always been that in Lincoln's infields. 316 00:35:26,950 --> 00:35:35,080 And then I remember the first, uh, the first, um, exterior examination for the fellowship was in Liverpool. 317 00:35:35,080 --> 00:35:39,460 And I can remember going there and then Manchester and um. 318 00:35:39,460 --> 00:35:44,110 So yeah. Yeah. And private practise. How much do you deem. 319 00:35:44,110 --> 00:35:48,220 Um, enough is enough. What's that come down to. 320 00:35:48,220 --> 00:35:54,430 And we do have several six operations a week or three or was very variable. 321 00:35:54,430 --> 00:36:00,340 And then the er if it's a big enough operation it needs to be doing what it's going to take that I needed. 322 00:36:00,340 --> 00:36:06,500 I consulted one morning a week, which is on Saturday morning, um, 323 00:36:06,500 --> 00:36:14,320 because the rest of my week was very busy and I did one afternoon's operating at then I didn't want, 324 00:36:14,320 --> 00:36:18,400 I didn't want private practise to completely take over my, my life. 325 00:36:18,400 --> 00:36:26,770 And, you know, because I was very dedicated, dedicated, I mean, I was very driven to to do a good job with my NHS patients, which I had a lot of. 326 00:36:26,770 --> 00:36:36,700 Um, but I, I, I wouldn't have missed private practise because it brought me into contact with, with people in the city that, 327 00:36:36,700 --> 00:36:42,760 you know, most of the downs, for example, including the very left wing door, they had private practise. 328 00:36:42,760 --> 00:36:50,770 Um, I didn't know that, uh, so I had some very interesting patients who I wouldn't have otherwise had contact with. 329 00:36:50,770 --> 00:36:56,470 Um, and, you know, in those days, all the private practise was done out of the åkerlund in the Banbury Road. 330 00:36:56,470 --> 00:37:01,250 And that was very that was very easy. Um, you know, geographically, 331 00:37:01,250 --> 00:37:05,920 it was very easy to just hop across the road and who look after those patients sort 332 00:37:05,920 --> 00:37:13,330 of post office with your registrar or husband to talk to you almost exclusively. 333 00:37:13,330 --> 00:37:17,650 Yes, myself. But actually, there was resident staff. Yes. 334 00:37:17,650 --> 00:37:24,590 In the act. Yes. I don't know if that's still true at the at the manor, but, uh, 335 00:37:24,590 --> 00:37:32,650 a lot of the demonstrators in anatomy is had rooms in the åkerlund and were on call at night. 336 00:37:32,650 --> 00:37:35,140 So if somebody is blocked or something, 337 00:37:35,140 --> 00:37:40,570 there was something you didn't have to get the consultant come in to put up another drip or something like that. 338 00:37:40,570 --> 00:37:47,210 But no, most of the day to day care was very much in your in your hands. 339 00:37:47,210 --> 00:37:57,190 And you were publishing, as you said, were they, as it were, trials of therapy or development of new operations or both? 340 00:37:57,190 --> 00:38:05,500 It's both. Uh, what therapies did you try? Gosh, I better go get my file. 341 00:38:05,500 --> 00:38:09,620 Right. I mean, I'm only one day I published it, but I think I published one. 342 00:38:09,620 --> 00:38:14,380 I think I know I published about seventy papers, but about a whole range of things. 343 00:38:14,380 --> 00:38:19,150 Yes. And then I was I got very involved with the Oxford textbook on surgery. 344 00:38:19,150 --> 00:38:23,110 Right. Uh, who was editing that. I needed to know. 345 00:38:23,110 --> 00:38:28,960 I mean that was Malcolm, that was um uh Peter. 346 00:38:28,960 --> 00:38:32,620 I had um Prof. 347 00:38:32,620 --> 00:38:37,420 And I'm just trying to remember who he is and his co editor was. 348 00:38:37,420 --> 00:38:42,220 And then I also got involved with the Oxford textbook he medicine to write the bit on, uh, 349 00:38:42,220 --> 00:38:51,960 Thornwood um, surgery of treatment, which I liaise with, uh, thing that was written, John was. 350 00:38:51,960 --> 00:39:00,210 Um, and then his own book on the chronology. Yes, he wrote me into the Adreno chapter for that. 351 00:39:00,210 --> 00:39:06,840 So yeah, I did quite a lot of writing and in the surgery book, Take Obstetrics with Surgery. 352 00:39:06,840 --> 00:39:14,930 What did you write about in that? That wasn't quite serious. Yeah, I think I did the thyroid chapter and the adrenal gland and the paediatric, 353 00:39:14,930 --> 00:39:24,980 you know, that was done entirely by Paul Tan and been my mind got my hands for it. 354 00:39:24,980 --> 00:39:32,190 Yeah. Yeah. What difference did Peter Moritz's coming make? 355 00:39:32,190 --> 00:39:36,480 Um, oh, Peter was pretty inspirational actually. 356 00:39:36,480 --> 00:39:46,060 Um, he was very much better with the general surgeons than his predecessor, Philip Anderson, who was pretty remote. 357 00:39:46,060 --> 00:39:50,650 Yeah. And if you remember him, he was he drifted off. He was a very remote character. 358 00:39:50,650 --> 00:39:58,230 He didn't, um, whereas Peter really did make a big effort to, uh, to integrate with, 359 00:39:58,230 --> 00:40:03,510 um, you establish one of the things which I was I thought was fantastic. 360 00:40:03,510 --> 00:40:08,970 And, uh, I'm still in contact with with the people that it generated. 361 00:40:08,970 --> 00:40:15,960 But Peter established a link with Johns Hopkins Hospital in Baltimore and their chief 362 00:40:15,960 --> 00:40:23,430 resident came over to work with our one of our surgical firms by rotation every six months. 363 00:40:23,430 --> 00:40:32,370 And I'm still in touch and that my surgical training at this year is going to Boston and Harvard just down the road. 364 00:40:32,370 --> 00:40:40,980 And my my the guy that came from Baltimore to me got fired up to do endocrine surgery. 365 00:40:40,980 --> 00:40:45,300 And he's now chief of surgery at Harvard. And we're going to meet up with him in the autumn. 366 00:40:45,300 --> 00:40:50,560 So, uh, that was a that brought into contact with North America. 367 00:40:50,560 --> 00:40:54,450 And Peter was responsible for that, which I thought was really, really good. 368 00:40:54,450 --> 00:41:00,180 Yeah, very good link. It's gone now. Sadly, I don't know why they let it lapse, but, uh. 369 00:41:00,180 --> 00:41:06,120 And did he, um, change the sort of research culture in any way, did you feel. 370 00:41:06,120 --> 00:41:08,430 Yes, you did. Oh, yes, definitely. 371 00:41:08,430 --> 00:41:21,660 Uh, um, there were at any one time there would be always two or three of our registrars seconded into the department to do to do their research. 372 00:41:21,660 --> 00:41:26,460 Um, but that aside, that he had a lot of people come from Australia. 373 00:41:26,460 --> 00:41:30,900 Right. And was the research mostly immunology of everything. 374 00:41:30,900 --> 00:41:41,470 So, um, I was very much related to his two major specialities, uh, transplant transplantation and, um, and vascular. 375 00:41:41,470 --> 00:41:48,930 Yes. Um, but yes, I think it was a lot to do with, uh, immunosuppression. 376 00:41:48,930 --> 00:41:52,890 And it was, uh, he did a good job. 377 00:41:52,890 --> 00:41:57,570 Yes. And then cardiac surgery was developing quite separately. 378 00:41:57,570 --> 00:42:02,540 Yes. Wasn't that was sort of split off and. Yeah. And had its troubles. 379 00:42:02,540 --> 00:42:08,130 Uh, yes. Yeah. And that's a better personality thing. 380 00:42:08,130 --> 00:42:13,170 That's what I was thinking there. Tell me about anaesthetists. How important are they for surgeons? 381 00:42:13,170 --> 00:42:19,770 Oh, no, they're absolutely pivotal. So would you have sort of one or two fixed ones or. 382 00:42:19,770 --> 00:42:23,680 Yes, yes. Yes, I think they still do. I think people have. 383 00:42:23,680 --> 00:42:28,500 You know, it's rather nice if you have a good relationship with a guy at the top of the table. 384 00:42:28,500 --> 00:42:39,040 And and I was very fortunate, Dick, for him. And I, um, and he also did for the cardiac surgeons and he was really on the ball for them. 385 00:42:39,040 --> 00:42:45,390 But if I had a really, really premature baby that was needing operating, there was nobody better than him. 386 00:42:45,390 --> 00:42:55,410 And he would quite I would if I got a really, really challenging baby came in that needed emergency surgery and it wasn't his night on. 387 00:42:55,410 --> 00:43:04,710 I would I would contact him and he would always come. He was, uh, but I did have some other very good colleagues, uh, John Stevens and Thea Schofield. 388 00:43:04,710 --> 00:43:10,780 Uh, Schofield is here. I am a GP or there is one. 389 00:43:10,780 --> 00:43:14,760 There is another. Schofield is quite right. But, um. 390 00:43:14,760 --> 00:43:18,390 No, it's not. It's so it's a different Schofield but it's not Schofield. 391 00:43:18,390 --> 00:43:27,090 You're quite right. Uh Schofield um was mainly work with Malcolm but occasionally Ontake he would uh I would work with him. 392 00:43:27,090 --> 00:43:36,900 But the two ones maybe I mainly work with, with Dick them and and they are having a good, a good again it's a team approach. 393 00:43:36,900 --> 00:43:42,390 If you know, if you have people that you work with regularly, they know how you operate and that you know how they operate. 394 00:43:42,390 --> 00:43:52,100 And so this is this is really important. Likewise, it's like, wow, how many would be I having to that you'd work with or more than that. 395 00:43:52,100 --> 00:43:56,420 Well, I I think it's still I think it's still the case, uh, 396 00:43:56,420 --> 00:44:08,810 all the emergency surgery is done at the John Radcliffe and each theatre has a sister and, uh, who had started if it's changed now. 397 00:44:08,810 --> 00:44:14,450 But, you know, whenever I was on take, it was pretty nearly always the same during the daytime. 398 00:44:14,450 --> 00:44:22,820 It was nearly always the same sister and the church were likewise. So I'm I'm still in touch with my theatre sisters. 399 00:44:22,820 --> 00:44:31,550 The, um, how much difference that I make to you is there you are the church for quite a bit of the time. 400 00:44:31,550 --> 00:44:35,490 Right. And what I mean, I started off my career at the Radcliffe Infirmary. 401 00:44:35,490 --> 00:44:39,860 So, uh, which was everybody, as you remember. And that was so cosy. 402 00:44:39,860 --> 00:44:48,590 And you knew you knew everybody who we all met for lunch in the piccalilli, uh, uh, at the top table with all consultants and all the juniors below. 403 00:44:48,590 --> 00:44:56,120 And, you know, uh, if you got a referral, you could just get up from the table and wander over and say, 404 00:44:56,120 --> 00:45:01,220 Derek, would you come and see if this patient on my ward was very cohesive? 405 00:45:01,220 --> 00:45:13,040 Um, moving to the John Radcliffe, um, I was I was very concerned that we should remain cohesive. 406 00:45:13,040 --> 00:45:17,030 And I fought tooth and nail that we should have a common room, which never was. 407 00:45:17,030 --> 00:45:21,360 Not in the original plan. No. Yeah. You know, there was was a. 408 00:45:21,360 --> 00:45:25,760 Elitism that consultants shouldn't have they should be eating with everybody else. 409 00:45:25,760 --> 00:45:32,870 But I mean, again, I thought that was really good, that we would be able to, over the lunch table, be able to talk to each other. 410 00:45:32,870 --> 00:45:40,420 Um, uh, so that was a real struggle to get to get that, uh, get that set up. 411 00:45:40,420 --> 00:45:49,310 Um, and a lot of people started having bring in a lunch box and having their lunch up, not in their office and not meeting anybody else, which I saw. 412 00:45:49,310 --> 00:45:56,400 I found that much less personal. And, um, what about actual physical conditions? 413 00:45:56,400 --> 00:46:01,430 Had the church been getting grafted? Yes. Bottom line, yes, it was. 414 00:46:01,430 --> 00:46:09,860 But you remember I mean I mean, two of the wards I worked out of Nissen huts, um, nothing wrong with that, except, you know, they were modern. 415 00:46:09,860 --> 00:46:18,810 They weren't modern facilities. Uh, now when I go to the to the church of that new block, have you been in the new block is the concept of cancer. 416 00:46:18,810 --> 00:46:29,520 That's absolutely amazing. That it is absolutely fantastic. Um, but no, it's the it was it was a field hospital, American field hospital. 417 00:46:29,520 --> 00:46:41,150 That was, um but again, it had a very good atmosphere. Um, and, uh, it worked well, um, and it was right for doing elective surgery. 418 00:46:41,150 --> 00:46:44,960 It was no backup intensive care unit or anything like that. 419 00:46:44,960 --> 00:46:53,540 You know, if you had a patient who really went off when they got into serious trouble, you had to transfer them to the job after. 420 00:46:53,540 --> 00:47:02,060 Um, how does the development of imaging in various ways affected your work? 421 00:47:02,060 --> 00:47:07,010 Because the imaging is made huge. Oh, yeah. Oh, yes. 422 00:47:07,010 --> 00:47:14,120 Dramatically. So dramatically. So do you think that affected your diagnostic approach? 423 00:47:14,120 --> 00:47:22,370 Well, I tried to not make it in as much that I think the old traditional skills, uh, are very important. 424 00:47:22,370 --> 00:47:30,980 And it's very, very interesting. When I got to Palestine, uh, they can't just click their fingers and have an MRI scan or CT scan. 425 00:47:30,980 --> 00:47:39,840 They've got to be able to examine the kidney or liver and the basic the basic skills, which I think is still very important. 426 00:47:39,840 --> 00:47:44,120 Um, uh, so all this imaging. 427 00:47:44,120 --> 00:47:48,200 Yes, it has improved accuracy of diagnosis, no question about it. 428 00:47:48,200 --> 00:47:53,090 But I think it's a bit overused, probably. Why is it expensive. 429 00:47:53,090 --> 00:48:04,430 Yes. Yeah. Yeah. Oh yeah. Um, you know, I think people can become very overdependent on imaging and say in the news that lose their basic skills. 430 00:48:04,430 --> 00:48:12,890 Um, I can lose. I was remember years ago when I went out, I got I got two scholarships, I got one to go to Australia, 431 00:48:12,890 --> 00:48:18,950 but I had another one from the regional authority to visit surgical clinics of North America. 432 00:48:18,950 --> 00:48:22,680 Uh, when I when I was a senior registrar. Yes. When I. 433 00:48:22,680 --> 00:48:26,750 Right. Um, for how long? Six months. Six weeks. 434 00:48:26,750 --> 00:48:32,120 Six weeks. Yeah. And, uh, and I went to the Mayo Clinic. I went to Philadelphia Hospital. 435 00:48:32,120 --> 00:48:37,610 I went to I went to Chicago. 436 00:48:37,610 --> 00:48:48,110 Um, but I, I do remember going to Boston to the Mass General Hospital in Boston and patients would go there, 437 00:48:48,110 --> 00:48:51,240 uh, through the front door of outpatients, which was a complete. 438 00:48:51,240 --> 00:49:02,540 A separate block away from the main hospital that had been sent up by they don't have GPS, but you know that their primary physician, um, 439 00:49:02,540 --> 00:49:12,080 and they would their first calling station was haematology and then have blood drawn and every investigation under the sun would be done on them. 440 00:49:12,080 --> 00:49:17,000 And then the next court of call would be radiology and then have a chest X-ray, 441 00:49:17,000 --> 00:49:24,570 then have this test and the other scan and then they'd finally see a consultant with all these results. 442 00:49:24,570 --> 00:49:35,120 So, you know, so that's one of the one of the disadvantages of over investigation, 443 00:49:35,120 --> 00:49:42,560 all these these things that are now available that people are not thinking, you know, that's appropriate to do or that's appropriate to do. 444 00:49:42,560 --> 00:49:52,090 Probably means a lot of people have much more radiation that is good for them. But what was that about America that impressed you? 445 00:49:52,090 --> 00:50:12,020 Um. For example, going to mass general they were doing at that time, 446 00:50:12,020 --> 00:50:21,260 I think something like a hundred title tank protectiveness a year, so, you know, way ahead of us, they were centralising things. 447 00:50:21,260 --> 00:50:28,670 Um, and, of course, the degree of expertise that you get if you do that volume I've talked to May not. 448 00:50:28,670 --> 00:50:34,640 The other day when I was doing oesophageal surgery with Outgunning, 449 00:50:34,640 --> 00:50:48,110 we had about a 40 percent in hospital mortality for for surgery on the oesophagus because we were doing perhaps five. 450 00:50:48,110 --> 00:50:52,010 Here now is part of government policy. 451 00:50:52,010 --> 00:51:02,670 All the cases are centralised. So Nick Maynard and his team at the John Radcliffe are now doing something like one a week. 452 00:51:02,670 --> 00:51:07,520 Wow. Yeah. And their mortality is two percent less so. 453 00:51:07,520 --> 00:51:15,170 And that's where I think where America was ahead of us. They have these big centres, lots of centralisation. 454 00:51:15,170 --> 00:51:21,620 And, you know, it would be the same in your speciality in medicine. 455 00:51:21,620 --> 00:51:27,230 There would be people who would just be seeing droves of patients with Addison's disease and they'd get very, 456 00:51:27,230 --> 00:51:33,450 very good at dealing with Alyson's, for example. Yeah. And you would have had to do with it. 457 00:51:33,450 --> 00:51:39,440 You paged paediatricians neonatal. You had a lot to do with that Peters out and. 458 00:51:39,440 --> 00:51:44,060 Right. He was there. Yeah. Yes. And then who succeeded in him? 459 00:51:44,060 --> 00:51:52,460 Really good question. The next professor was Moxham as a was, but he wouldn't have been. 460 00:51:52,460 --> 00:51:56,630 But he did. So then actually it you didn't have a professor. 461 00:51:56,630 --> 00:52:00,620 I mean that was his speciality, but he was also head of the department. 462 00:52:00,620 --> 00:52:05,880 So he would he would be chairing meetings about general paediatric care. 463 00:52:05,880 --> 00:52:19,400 Uh, Moxham, who succeeded him, um, had virtually no neonatal experience at all, um, very rarely went on the wards. 464 00:52:19,400 --> 00:52:24,440 So he was, you know, really research professor. Good case actually is to have two professors. 465 00:52:24,440 --> 00:52:31,870 Actually, that's true in medicine and surgery, where you have a research professor and you have somebody who is hands on clinician. 466 00:52:31,870 --> 00:52:41,360 I quite agree. Absolutely. Um, because Wilkinson came through it and it was that in your time. 467 00:52:41,360 --> 00:52:46,070 Yes. Yeah. He would have been he on a chair in the end. We did. Yes, indeed. 468 00:52:46,070 --> 00:52:49,760 You know, he was the lead after after Tizard died. 469 00:52:49,760 --> 00:52:57,860 He was in between or not. Um, I don't think it was that during the time of tenure. 470 00:52:57,860 --> 00:53:03,440 And then, I mean, tragically, as you remember, we got the chair in Bristol and before he could take up the chair, 471 00:53:03,440 --> 00:53:08,510 he was a helicopter crash and was a bicycle ride. He was doing a charity bicycle ride. 472 00:53:08,510 --> 00:53:14,600 I'm pretty sure it was not a cardiac surgeon who got knocked off his bike in the Banbury Road. 473 00:53:14,600 --> 00:53:18,620 There was one indeed. But you think, David? I do. 474 00:53:18,620 --> 00:53:25,340 That's the only thing that I thought he was on a helicopter trip to the Isles. 475 00:53:25,340 --> 00:53:30,290 It's possible maybe one of his brothers. I mean, I'm not sure. 476 00:53:30,290 --> 00:53:35,780 I mean, he's got a famous brother. Yeah. Still alive. Yeah. But he had a lot of brothers that did it. 477 00:53:35,780 --> 00:53:40,580 But Michael is actually looked after one of our very close friends with breast cancer. 478 00:53:40,580 --> 00:53:47,870 And he was one of the first people to blow the whistle about, um, about the inefficiency of breast screening. 479 00:53:47,870 --> 00:53:54,800 Really good for him. Yeah. Uh, because I gather I was very keen on that. 480 00:53:54,800 --> 00:53:58,100 Um, the breast screening, promoting it. Promoting it. 481 00:53:58,100 --> 00:54:06,170 Oh, yes. Well, it was it was very much government driven. And I was seen as I don't know if you would agree with me, but I got the feeling that, 482 00:54:06,170 --> 00:54:12,260 you know, this was, you know, look what we're doing to save women from this dreadful disease. 483 00:54:12,260 --> 00:54:17,120 But actually and I was picking up a lot of cancers. We didn't need radical treatment. 484 00:54:17,120 --> 00:54:25,520 Right. What was your feeling about the administrators and their involvement? 485 00:54:25,520 --> 00:54:31,490 Well, again, you know, I was aware of that generation. We were we saw seismic change. 486 00:54:31,490 --> 00:54:40,490 Um, the old Radcliffe Infirmary. We had the medical staff council who called the shots. 487 00:54:40,490 --> 00:54:53,390 We we set the priorities. Uh, now the administrators call the shots and they, by all accounts, didn't have a great deal of input from clinicians. 488 00:54:53,390 --> 00:54:59,090 So that's a completely seismic change. And that was that was happening latterly where we were being. 489 00:54:59,090 --> 00:55:03,530 Holds what to do rather than we were saying these are the priority. This is what we should be doing. 490 00:55:03,530 --> 00:55:15,880 How did that come about when you make. How did that come about? 491 00:55:15,880 --> 00:55:19,150 I don't know is the honest answer. I don't know really. 492 00:55:19,150 --> 00:55:34,170 And were you ever told you said they were calling the shots, so anybody administered to tell you what to do and you felt it was wrong? 493 00:55:34,170 --> 00:55:44,250 Um, I'm struggling to remember specific examples, but there were, um, I just there were there were things that cropped up where I thought, 494 00:55:44,250 --> 00:55:51,660 gosh, in the past we would have discussed that amongst our colleagues and decided that actually that was the priority. 495 00:55:51,660 --> 00:56:00,140 But in Lashley, it was the administration saying we'd actually decided that we're going to do so-and-so without any reference to us. 496 00:56:00,140 --> 00:56:04,740 No, but when you heard that, did you go along with it? 497 00:56:04,740 --> 00:56:08,260 No, I didn't. No, no. Because what do we do? 498 00:56:08,260 --> 00:56:12,160 So you just do something else and keep quiet. No, no, no. 499 00:56:12,160 --> 00:56:18,720 I remonstrated like crazy with, um, Ralph Johnson, who was just postgraduate. 500 00:56:18,720 --> 00:56:51,490 Lived in the village here. Yeah. But no, I had I enquired. 501 00:56:51,490 --> 00:57:00,250 I said it was it was very sort of civilised, you know, our disagreements with Ralph Johnson, 502 00:57:00,250 --> 00:57:05,110 for example, he was just one of them, you know, about the European Working Directive. 503 00:57:05,110 --> 00:57:12,250 And I said, you know, this is this is absolutely devastating for the phone system and it will be bad for continuity of patient care. 504 00:57:12,250 --> 00:57:17,200 But he was you know, he was under the government's remit and pushed it like crazy. 505 00:57:17,200 --> 00:57:22,120 But I and I was I was senior enough to stand up to him. 506 00:57:22,120 --> 00:57:27,700 But junior colleagues would have never dreamt of standing up to him to, you know, 507 00:57:27,700 --> 00:57:34,480 all that sort of thing, because he was a very influential figure for them. And I got my marriage award and I was going to say, this is wrong. 508 00:57:34,480 --> 00:57:40,730 So I think it was quite pleased to me off of a thing that was very much been on the training side. 509 00:57:40,730 --> 00:57:45,790 That was you were talking about the management and the management side. 510 00:57:45,790 --> 00:57:59,920 Um, yes. You are talking about on a personal level, you know, I can only think of examples where I was personally involved, 511 00:57:59,920 --> 00:58:08,090 but there was a there was a move which was successful to completely take out general surgery from the church. 512 00:58:08,090 --> 00:58:14,890 All right. And take it all into the job market. And that was driven by the administrators. 513 00:58:14,890 --> 00:58:21,100 And was that a good thing? No, it was. And what's and what's very interesting, in the fullness of time, 514 00:58:21,100 --> 00:58:29,140 they completely reversed the policy because I knew that if we took all the elective surgery out of the church and into the John Radcliffe, 515 00:58:29,140 --> 00:58:34,190 if we had a very heavy take with emergencies, then all the elective patients would get cancelled. 516 00:58:34,190 --> 00:58:40,300 Yes. So the church was a protected environment in the fullness of time. 517 00:58:40,300 --> 00:58:45,520 That and the population rising and were becoming more of a referral centre. 518 00:58:45,520 --> 00:58:50,170 That's exactly what happened. And more and more patients were elective procedures were being cancelled. 519 00:58:50,170 --> 00:58:57,760 And so now all the elective surgeries go back to the church. But it's it's taken a new block to do it. 520 00:58:57,760 --> 00:59:05,890 And what happened last year about that, I should add, because you're getting some bits of paper. 521 00:59:05,890 --> 00:59:12,160 This was just to remind myself of names. You may have thought, you know, who what sort of people influenced me when I first arrived. 522 00:59:12,160 --> 00:59:19,990 And there were certain and I mentioned Eric Pete because, you know, he operated in an adjacent theatre to me, Sir John Stallworth. 523 00:59:19,990 --> 00:59:23,500 He also had an operating theatre next to me. 524 00:59:23,500 --> 00:59:31,090 And I got to know him quite well. And how did he influence you, as you said, John Stewart? 525 00:59:31,090 --> 00:59:36,700 When he was just doing interesting things? I mean, I think surgeons are only quite stickybeak and they like to see what other people do. 526 00:59:36,700 --> 00:59:46,360 And that sometimes gives you ideas about where to do things. You know, particularly when endoscopic surgery came in. 527 00:59:46,360 --> 00:59:51,580 I did a list on a on a on a Wednesday morning, as I said, at the Occlude. 528 00:59:51,580 --> 01:00:06,570 Yes. Um, what's the name of the Neimann? Chris, I think, anyway, he was doing endoscopically, um, arthroscope, arthroscope, 529 01:00:06,570 --> 01:00:12,890 but he was also actually putting a new cruciate ligament and I was absolutely fascinated. 530 01:00:12,890 --> 01:00:15,160 I was looking at the instruments that he was using, 531 01:00:15,160 --> 01:00:22,210 but I was at that stage doing some of the very first laparoscopic gallbladders and he was actually fascinated what I was up to. 532 01:00:22,210 --> 01:00:28,120 So there was a cross-fertilisation which was very good. Now, Germany in Britain has always thought I was a pioneer. 533 01:00:28,120 --> 01:00:31,540 Yes, you were sort of together. We were actually together. Yes. 534 01:00:31,540 --> 01:00:40,780 Julian and I went to the very first demonstration at the College of Surgeons and we came back to Oxford and said, 535 01:00:40,780 --> 01:00:45,070 this is this is something we've got to develop. 536 01:00:45,070 --> 01:00:53,080 And I can remember we got hold of of a camera and the ports, you know, and in a cardboard box. 537 01:00:53,080 --> 01:00:59,110 And we used to buy chicken legs from and from a test case. 538 01:00:59,110 --> 01:01:03,220 And we would dissect them because, you know, you're no longer looking at your hands. 539 01:01:03,220 --> 01:01:16,810 You're looking at a screen. Um, and, um, Julian did a lot of RPG surgery, uh, but I was very, very motivated to do it for deals that I did. 540 01:01:16,810 --> 01:01:24,550 The first one in the country. Right. In Oxford. Vitrines, I don't know from back is no Transcom transmission. 541 01:01:24,550 --> 01:01:30,350 And that that actually revolutionised adrenal ectomy, which actually was a very difficult operation to open. 542 01:01:30,350 --> 01:01:34,890 It could only get to the adrenal by opening the chest and abdomen, which was very traumatic. 543 01:01:34,890 --> 01:01:43,090 And, uh, um, and I was invited over to I had a great chairman, Leo. 544 01:01:43,090 --> 01:01:51,250 He was the president of the French Association of Endocrine Stage and not as president as the English and the British Association and Gruntled. 545 01:01:51,250 --> 01:02:01,360 And we used to meet up at conferences and he he got the first man in the world to do a general ectomy laparoscopically to Leo. 546 01:02:01,360 --> 01:02:06,700 And I was invited to go and watch this man and then came back to Oxford. 547 01:02:06,700 --> 01:02:16,540 And I said, we did the first one in the country. Um, then and our Greg Sadler, my successor, is doing more than anybody else in the UK. 548 01:02:16,540 --> 01:02:22,930 And we're peeling oranges and deservingly because I remember Julian saying had the best we do. 549 01:02:22,930 --> 01:02:26,020 Well, we did all sorts of things the same way when we were practising our stitching. 550 01:02:26,020 --> 01:02:35,390 It was to put the skin back on the leg of a leg of chicken and we were peeling oranges and it was just getting our skills, um, organised. 551 01:02:35,390 --> 01:02:47,390 You know, when you say you went over to Lille now, did you in any way feel I can't go to LA because I've got to do my NHS work? 552 01:02:47,390 --> 01:02:54,790 I mean, what was your sort of feeling about that? It's obviously vital that you go to the you you know, the insurance. 553 01:02:54,790 --> 01:03:00,510 And how did that sort of fit in? You could be happy to leave your senior registrar today. 554 01:03:00,510 --> 01:03:07,570 Do is again, we're talking about the invasiveness of administration now. 555 01:03:07,570 --> 01:03:11,980 Um, I mean, this team that I take to to Palestine, uh, 556 01:03:11,980 --> 01:03:23,080 is a really tough call because they they all have to negotiate with the administrators to have their rotor's covid or um, 557 01:03:23,080 --> 01:03:28,130 whereas, um, you know, nobody ever challenged you in the past. 558 01:03:28,130 --> 01:03:35,050 So they just knew that you were you were the rest of the year you were pulling your weight like nobody's business. 559 01:03:35,050 --> 01:03:42,140 And that that was beneficial actually to go to to meetings in Paris or in there. 560 01:03:42,140 --> 01:03:47,080 And so it's got much more difficult to get to. 561 01:03:47,080 --> 01:03:50,740 Uh, but I think one of the reasons I just mentioned about the surgical travelling, 562 01:03:50,740 --> 01:03:55,000 perhaps that, you know, people that don't have the time or that they're being bred, 563 01:03:55,000 --> 01:04:04,720 that they're being sort of marginal much more closely, you were saying that the the terraces, the structure structures more or less going on. 564 01:04:04,720 --> 01:04:10,880 What about the the sisters and how do you think the nursing home those. 565 01:04:10,880 --> 01:04:22,920 They got worse, got worse. Yeah, really sad is I see it a little bit through relatives and uh, and I'm not just talking about the John Radcliffe now. 566 01:04:22,920 --> 01:04:28,730 I'm talking about Countrywide. Yeah. I think if you'd agree with me. 567 01:04:28,730 --> 01:04:34,610 But I think, you know, the moment they started saying, you know, if you're going to be a decent, you're going to have a degree, 568 01:04:34,610 --> 01:04:48,260 you actually started recruiting people whose whose heart wasn't quite in the caring, caring side of it was not so such a high priority. 569 01:04:48,260 --> 01:04:53,930 Um, and the number of nurses came came on to the wall type thing, 570 01:04:53,930 --> 01:04:59,000 particularly in paediatrics, you know, the paediatric wards, which I was involved with. 571 01:04:59,000 --> 01:05:05,990 And they would come back having got their degree and then their ambition was actually to be a nursing administrator. 572 01:05:05,990 --> 01:05:09,860 They didn't want to be on call or actually be on the mend, you know, 573 01:05:09,860 --> 01:05:15,410 having to wipe somebody Baltimorean on the wall that it was and that was let them learn. 574 01:05:15,410 --> 01:05:19,460 So the culture, I think, is quite changed in nursing is. Yeah. 575 01:05:19,460 --> 01:05:28,730 And they never made enough use, it seemed to me, of the state qualified nurses or whatever they were called, the ones who weren't state registered. 576 01:05:28,730 --> 01:05:32,630 Right. But the sort of second guess the next the next year. Well, 577 01:05:32,630 --> 01:05:41,070 I think they're much more dependent on them than the ones who don't have the degree that they have at the scrubbers and rubbers or anything else, 578 01:05:41,070 --> 01:05:44,270 Nick, because I think we're getting to the right. 579 01:05:44,270 --> 01:05:51,690 Um, this I said and I quote, I knew when you said you were coming up, I wonder what he's going to talk about. 580 01:05:51,690 --> 01:06:01,670 That is one, if there's anything else that really would that. Oh, you know, just there are a few things that just that struck me. 581 01:06:01,670 --> 01:06:07,100 I'm just what it would do to me. Um, I've just jotted down here. 582 01:06:07,100 --> 01:06:13,520 I mean, one of the things when I very first arrived at the Radcliffe Infirmary was Cronshaw. 583 01:06:13,520 --> 01:06:17,330 What do you remember Cronshaw Ward off the main on the main corridor? 584 01:06:17,330 --> 01:06:18,800 Yes, I do. 585 01:06:18,800 --> 01:06:27,310 Before you got to the main theatre on the right, the main theatre was on was just beyond the is when I Cronshaw Ward was where all the patients went, 586 01:06:27,310 --> 01:06:32,690 had broken their hips, the old ladies who'd broken their hips and they were all put. 587 01:06:32,690 --> 01:06:37,790 This is before beginning of hips. Yeah. They were all put in traction. 588 01:06:37,790 --> 01:06:47,990 Um and the mortality from bronchial pneumonia immobilised was astronomical, you know. 589 01:06:47,990 --> 01:06:55,150 Now you think that they sort of really aggressive orthopaedic surgeon, they will come in and have, 590 01:06:55,150 --> 01:07:01,520 you know, with a fractured hip, there'll be pain and they're out in 48 hours. But in those days, what war was the kiss of death? 591 01:07:01,520 --> 01:07:06,890 If you've got admitted that because you say you put in traction, you know, most of them were elderly people, 592 01:07:06,890 --> 01:07:14,480 70s and 80s with a broken hip put into traction and not moving, probably not getting particularly aggressive physiotherapy. 593 01:07:14,480 --> 01:07:22,370 And they all that long. Yes. Um, was there anything else that just goes to show there is? 594 01:07:22,370 --> 01:07:34,670 Because that's a really good point. Well, you know, that was just one of the things which really hit me when I was thinking about it. 595 01:07:34,670 --> 01:07:37,220 Ten anaesthetise and the staff, yes. 596 01:07:37,220 --> 01:07:49,460 How many there are now, but sixtyish cents, all the orthopod who wrote the book used to come and do a week at a time of any. 597 01:07:49,460 --> 01:07:54,770 There were never any specialists, they wrote. 598 01:07:54,770 --> 01:07:59,630 And then there is the huge battle of the three or amongst the neurosurgeons. 599 01:07:59,630 --> 01:08:07,250 Yes, service. Yes. Joe Pennypacker is I've just jotted down a few name people who made a big impression when when I first arrived, 600 01:08:07,250 --> 01:08:13,700 because, I mean, these were these were jobs. Yes. I mean, how close to did you get? 601 01:08:13,700 --> 01:08:19,880 Oh, not at all. No, no, not at all. I mean, it wasn't there wasn't there wasn't a speciality I was aspiring to. 602 01:08:19,880 --> 01:08:28,700 But, you know, he again, you know, one of the things which has changed with its grand rounds, um, 603 01:08:28,700 --> 01:08:36,980 I don't know what it's like in medicine now, but I'm talking to my colleagues, my contemporary and contemporary colleagues. 604 01:08:36,980 --> 01:08:48,810 Uh, they they say that grand rounds have completely lost their their sort of all-embracing audience. 605 01:08:48,810 --> 01:08:52,670 They used to have I mean, everybody used to get your Friday morning grand round. 606 01:08:52,670 --> 01:08:57,290 Now, at the colorectal surgeons don't go at all. 607 01:08:57,290 --> 01:09:01,760 They have their own mini grand round. 608 01:09:01,760 --> 01:09:09,230 So you're not interacting with people so much, which I think is so what I which is something I enjoy because I'm a people person. 609 01:09:09,230 --> 01:09:12,420 I like interacting with people. And you learn things. 610 01:09:12,420 --> 01:09:22,660 I mean, one of the things I go to this medical club hearing from Rabbi Pelli or somebody about what they're doing now and so grand rounds in surgery. 611 01:09:22,660 --> 01:09:27,290 And I don't know what it's like in medicine, but it's, um, is not well attended. 612 01:09:27,290 --> 01:09:37,010 Right. Did Addison have grand rounds? Well, he his he he would be he'd be allotted a space to do grand rounds. 613 01:09:37,010 --> 01:09:40,670 That'd be what, a surgical round round and Edison's time. 614 01:09:40,670 --> 01:09:45,050 Yeah, we were we had great crowds in those days but I mean the way it was and I think it's still, 615 01:09:45,050 --> 01:09:50,120 still probably goes on is that one week it would be the urologists who would be, 616 01:09:50,120 --> 01:09:54,380 you know, who would be George Smith and great fellows would be doing the ground round. 617 01:09:54,380 --> 01:09:57,620 And then the next week it would be David Temp's doing a vascular grand round. 618 01:09:57,620 --> 01:10:04,520 And then it would be me doing endocrine, um, because I had imagine and Peter Morris's term that he would run. 619 01:10:04,520 --> 01:10:09,020 It wasn't that Peter had a very strong hand in it. You're quite right. 620 01:10:09,020 --> 01:10:16,820 He did. And he was always there in the front row asking awkward questions, which is good, you know, stimulating. 621 01:10:16,820 --> 01:10:42,140 Absolutely. And he supported it very strongly. But did you have anything by the take positions, we had a meeting that wasn't in any way. 622 01:10:42,140 --> 01:10:46,050 Granted, it was an administrative meeting. Yeah, we did, yes. 623 01:10:46,050 --> 01:10:52,380 How often roughly? I think that was held a sentiment that was held once a month. 624 01:10:52,380 --> 01:11:01,500 Yes. And was that useful? Oh, tremendously. Now that we get you over things that, um, you know, administrative matters, 625 01:11:01,500 --> 01:11:08,850 which was and it would be a collective decision, um, Peter was pretty forceful. 626 01:11:08,850 --> 01:11:16,230 You know, he would Peter Morris when he would because he I think he I think he always chaired it. 627 01:11:16,230 --> 01:11:27,720 I tried it for quite a long time. Um, but that was a good interaction and I'm not sure that happens anymore. 628 01:11:27,720 --> 01:12:01,530 Anything else on your list? Have a look at. 629 01:12:01,530 --> 01:12:08,430 Well, I think we've covered pretty much everything that. Jotted down here. 630 01:12:08,430 --> 01:12:10,830 I was very lucky with my career that, you know, 631 01:12:10,830 --> 01:12:17,850 I'm looking at things that I did abroad and I did a lot of it because I was on the court of examiners at the college. 632 01:12:17,850 --> 01:12:27,450 I went out to Rijad, Hong Kong, Kuala Lumpur, lecturing, examining the fellowship. 633 01:12:27,450 --> 01:12:33,090 Right. Um, I was also on on the Court of Examiners of the Edinburgh College. 634 01:12:33,090 --> 01:12:40,020 So I did know I went to board with them. Um. 635 01:12:40,020 --> 01:12:52,890 I went as a visiting professor to North Shore Hospital in Sydney, a visiting professor to, um. 636 01:12:52,890 --> 01:13:05,250 Beijing lieutenant, um, I think I did a month I did a month in, um, you know, in, uh, 637 01:13:05,250 --> 01:13:14,760 in and out in Sydney and I did a month in Hong Kong and a month in in um, in Beijing, which was absolutely fascinating. 638 01:13:14,760 --> 01:13:19,890 Absolutely fascinating. You know, you you know, you saw different cultures. 639 01:13:19,890 --> 01:14:10,550 And I mean, take for example, um, um, Nephi blastoma now, you know, we would put I would put a lot of effort into those children. 640 01:14:10,550 --> 01:14:22,310 A very different world, a completely different world out there that the Iraqis will be putting out all the stops for a child with that, 641 01:14:22,310 --> 01:14:28,490 uh, that they would assess the child. Thought if that's the problem, if the prognosis is not good, 642 01:14:28,490 --> 01:14:35,840 just in the back of the country and this is the 80s or 90s or that must have been in the 90s. 643 01:14:35,840 --> 01:14:41,480 Yes, it was toward the end of my career when those sort of things actually. That was the end of your career. 644 01:14:41,480 --> 01:14:48,010 Would you have these invitations to go to these places? And, um, and we do operate in China. 645 01:14:48,010 --> 01:14:53,510 No, we are purely went there to lecture. And how about Australia? 646 01:14:53,510 --> 01:14:59,990 Um, again, I've been I've been back to the Children's Hospital in Melbourne on several occasions. 647 01:14:59,990 --> 01:15:12,860 And two years ago, I went to a fantastic meeting in Tasmania for Oxford alumni, um, uh, Cradle Mountain Lodge up in the air, which is fantastic. 648 01:15:12,860 --> 01:15:16,880 And there were a number of people there but that I had remembered working in 649 01:15:16,880 --> 01:15:21,820 Oxford because Roger Bradley would have organised that absolutely spot on. 650 01:15:21,820 --> 01:15:27,830 Yeah. He's he had a I don't know how, you know, but he's got a joint or had a joint base. 651 01:15:27,830 --> 01:15:33,400 I think he still has a joint post in Stoke Mandeville and in Tasmania. 652 01:15:33,400 --> 01:15:42,350 OK, so I think that six months in each of them. Right. But there was another guy with his name who you would remember was on the NDA. 653 01:15:42,350 --> 01:15:47,420 Um, there was Tim Davis, who was a dermatologist. Oh, he was there. 654 01:15:47,420 --> 01:15:53,330 But I don't know. I just remember this guy's name if I mentioned it. 655 01:15:53,330 --> 01:16:00,920 Yeah. You'd know exactly who was talking about. I mean, he would have been I think he was senior lecturer to, uh, Pickering or something like that. 656 01:16:00,920 --> 01:16:04,790 Right. Oh, Laurie Bailey. That's the man. 657 01:16:04,790 --> 01:16:09,170 He was there. And I hadn't seen Lawrie Bailey for ages. 658 01:16:09,170 --> 01:16:12,860 That's right. Um, I, I see. I mean, I was in good form. 659 01:16:12,860 --> 01:16:20,060 Very good form. Yeah. Uh, there were a number of people who had worked with Peter Morris and not surprisingly because they'd come out from Melbourne, 660 01:16:20,060 --> 01:16:23,990 worked and then and then the NDIS and then had gone back to Australia. No. 661 01:16:23,990 --> 01:16:32,400 Then he'd actually groom some very prominent people there, a number of professors at the various universities in Australia. 662 01:16:32,400 --> 01:16:41,210 So that was a lot of fun. Yeah. Um, but yes, no, I've, uh, I've kept up my Australian contacts, uh, very closely. 663 01:16:41,210 --> 01:16:50,390 So, you know, when I was still working and I they invited me back and, um, I like Australia and I said, Yeah, that right down to it. 664 01:16:50,390 --> 01:16:54,870 Yeah. So, OK, Nicole, thank you very much. 665 01:16:54,870 --> 01:16:59,833 Is that me to take the box for you? Absolutely. OK, thanks a lot.