1
00:00:01,350 --> 00:00:10,170
John, talking about the Oxford Medical School now, as I remember, you must have done Latin and Greek in the entrance exam.

2
00:00:10,170 --> 00:00:21,420
I did, yeah. Well, I did Latin and Greek till I was 18 at Rampy and into the new college or the new college entry.

3
00:00:21,420 --> 00:00:27,750
As an aspiring classicist, I don't remember that I had any particular hurdle.

4
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I sat in the hall and wrote a series of essays and met the warden or general English.

5
00:00:34,860 --> 00:00:40,940
As I said, I didn't have a severe examination of Latin, Greek at all.

6
00:00:40,940 --> 00:00:47,760
But the place was offered. Yes. Did you? Right. Yeah. So then you confronted them with your ways to do medicine?

7
00:00:47,760 --> 00:01:00,960
I did. I, I was fortunate enough to to go to Hong Kong for my national service as a second lieutenant for months.

8
00:01:00,960 --> 00:01:06,420
And as I lay in a tent in the new territories, there was really nothing to do.

9
00:01:06,420 --> 00:01:11,580
You know, you you drilled the men in the morning and you'd come back for breakfast and

10
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there really wasn't much else to do except to organise sports in the afternoon.

11
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So you lay in your tent and wondered what you want to do in life at 18 and gradually wandered really with it.

12
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You wouldn't want to do medicine after all. So then I. I bought textbooks.

13
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I can remember steads electricity and magnetism and somebody else's biology revenue.

14
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Yes. You remember, as I do in a bookshop in Hong Kong.

15
00:01:35,640 --> 00:01:48,030
Good though. Right. And I started reading this and then went back to new college in the April of 1950.

16
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I went up to see the warden in April 1950, and he allowed me to change the medicine, believe it or not.

17
00:01:54,810 --> 00:02:05,970
And I remember him saying that I'd have to pass the preliminary examination of the natural sciences by March of 51, and that that was quite a thing.

18
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And he recommended me to go and see Dr. Creedon staircase, one who would offer me advice about a cram school in Eccleston Square,

19
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which is where I went for people who couldn't do high school, sat for six days a week right through to October, then grade with a manual tutor.

20
00:02:27,810 --> 00:02:34,440
He was, what, for all three years? Absolutely. And then and the old fashioned way, he was my duty for everything.

21
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And that's. No, that's true of I did my biochemistry at Queen's right.

22
00:02:38,580 --> 00:02:44,140
And they were both very old fashioned about it and told me what to read very wisely.

23
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I don't know what Creed really did any very useful work in context of how you employ people, but he's a very good tutor in terms of guiding you.

24
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He's my moral tutor as well. And did you have to rely on him?

25
00:02:59,560 --> 00:03:06,480
No, no. He just gave me the sort of advice that doesn't exist now and probably is beyond the pale.

26
00:03:06,480 --> 00:03:08,640
And I hope this is not irrelevant.

27
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But Crede, when I first started, said Oxford is an experience that you want for the rest of your life, and medicine is hard taskmaster.

28
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And it takes time. But there are so many other things to do in Oxford.

29
00:03:22,290 --> 00:03:31,410
But you must do it can be spoilt. It could be Artec to be debating what's been going on a bicycle ride, but don't chain yourself to work.

30
00:03:31,410 --> 00:03:41,310
And I remember him saying, you know, nobody can do useful academic work for more than four or conceivably five hours a day at the outside.

31
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So if you get up early in the morning, there's never any reason to work after lunch.

32
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And he has a glass of Sherry Rehman and tutorials was absolutely it was.

33
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And actually right at the beginning of the tutorials.

34
00:03:55,080 --> 00:04:02,520
And he obviously was an educated chap broadly because he'd say, do you mind if we do physiology for the first three quarters of the church?

35
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And then what? You like Olvido or Levere? I think it was for the last quarter an hour.

36
00:04:07,160 --> 00:04:10,710
All right. And what about Surakarta?

37
00:04:10,710 --> 00:04:19,960
Because he was pretty dry as he was very dry, as far as I can see him now in what I think my right to Donegal Tweed suit to the West Coast.

38
00:04:19,960 --> 00:04:33,360
Yes, I had the pipe. Yes. Sitting in the corner. And my vivid memory of him was in my last year when I was doing doing my biochemistry Jutes.

39
00:04:33,360 --> 00:04:37,170
He said, letting because you didn't use John in Nottingham.

40
00:04:37,170 --> 00:04:40,650
He said, how is the hockey going?

41
00:04:40,650 --> 00:04:44,070
Are you going to get your blue? And I said, Well, I don't know, but I hope so.

42
00:04:44,070 --> 00:04:51,780
He said, Well, it's more important than your degree, so no need to write an essay if you don't want to write.

43
00:04:51,780 --> 00:04:56,160
So I went against that of him.

44
00:04:56,160 --> 00:05:00,240
Now, your first two years, then your schools. Yeah. How did you read?

45
00:05:00,240 --> 00:05:07,410
They enjoy those, too. I enjoyed it, I think you should enjoy anatomy, was I alone in that?

46
00:05:07,410 --> 00:05:15,480
Yes, and and I loved physiology. And in my final year, I tell you, there were bits I didn't like.

47
00:05:15,480 --> 00:05:24,170
I did not like the squid taxon and I didn't like what I regard still with the overemphasis on neurophysiology.

48
00:05:24,170 --> 00:05:26,820
I thought there were other aspects of physiology you want to know.

49
00:05:26,820 --> 00:05:37,290
And I was very lucky with Crete because I had read a book called Homer Smith on Comparative Physiology of the Kidney.

50
00:05:37,290 --> 00:05:38,700
And that entranced me.

51
00:05:38,700 --> 00:05:49,020
And I said to him, you know, all this stuff on your own, I will be right that two of our papers were one year old and one anyway.

52
00:05:49,020 --> 00:05:55,560
There was one pioneering and but I was allowed to sort of neglect neurophysiology

53
00:05:55,560 --> 00:05:59,490
a little bit to the the advancement of spending a lot of time on kidney.

54
00:05:59,490 --> 00:06:03,870
Right. Which served me and great purpose later in life, which is.

55
00:06:03,870 --> 00:06:09,810
And who are the lecturers you enjoyed or who appreciated those?

56
00:06:09,810 --> 00:06:13,650
Did you think of those? Uh, yes.

57
00:06:13,650 --> 00:06:19,060
Impressive. Yeah. Frightening in a sort of way. Yes. Yes.

58
00:06:19,060 --> 00:06:22,830
Who else was you know, you've got me on this. You got me on the spot there.

59
00:06:22,830 --> 00:06:34,590
No, I don't remember anybody very vividly. Remember in physiology, Dan Cunningham, of course, um, with the respiratory physiology.

60
00:06:34,590 --> 00:06:39,310
Was it Victor Cochrane who did with the kidney? I think he was Carson's.

61
00:06:39,310 --> 00:06:43,320
Carson's of. Oh possibly. Oh well. Passenger worshipped or I guess anyway.

62
00:06:43,320 --> 00:06:50,550
Yes, yeah. Absolutely. No, you got them. You know, you're reminding me people who did and was it little who is a professor.

63
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He was. And who gave those awful dry lectures on a Saturday morning.

64
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Yes. Yes. And actually and looking back and I remember wishing that Florida was a better lecturer to say, what did you make of those two terms?

65
00:07:05,320 --> 00:07:12,030
Oh, I enjoyed the I enjoyed the what was it called path and back path and back.

66
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And I got one thing which might be good for the reminiscence.

67
00:07:14,940 --> 00:07:23,730
And what really turned me on in Oxford from start to finish compared with school was the emphasis on you thinking

68
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for yourself and not believing dogma and not not taking facts as well as anything that we're at all sound.

69
00:07:32,460 --> 00:07:41,430
And one of the things that really inspired me was Rob Smith in the path and back course, who had a morning on blood coagulation.

70
00:07:41,430 --> 00:07:47,820
And I remember it very well because he started at the beginning and said the first part of the morning,

71
00:07:47,820 --> 00:08:00,750
we're going to teach you about the dogma of blood coagulation, how you would act as a clinician and how you would answer exam questions.

72
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And then we'll have coffee. And then for the second half, I get to tell you what's likely all of that is wrong.

73
00:08:08,670 --> 00:08:12,780
And I thought this is teaching of the sublime is the great.

74
00:08:12,780 --> 00:08:21,000
And one of the things I thought about Oxford was that it really did it treated it as well.

75
00:08:21,000 --> 00:08:26,400
You know, this is what they say. But in your tutorial, just try and poke a hole in it.

76
00:08:26,400 --> 00:08:31,290
Yes. Then the scores. What did you think of all the practicals?

77
00:08:31,290 --> 00:08:39,540
Because erm there's, there's a lot of practical as well as chemistry, practical all day help.

78
00:08:39,540 --> 00:08:45,270
And the cat we did cat experiments, the inside ganglion cats and things.

79
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I enjoyed that and enjoy the squid. I can't remember why though I did.

80
00:08:51,930 --> 00:08:53,620
I enjoyed it all very much actually.

81
00:08:53,620 --> 00:09:03,600
I had left school I think rather rather flat and uninteresting and very lucky to have gone to Oxford at the age of 21

82
00:09:03,600 --> 00:09:15,330
because I was a bit older and it just turned me on actually it of salvation from a kind of medical mental nemesis,

83
00:09:15,330 --> 00:09:20,730
which I'd had as a schoolboy. Yes. Then we went up to the Middlesex to do your clinical.

84
00:09:20,730 --> 00:09:27,090
Yeah, we went strictly to talk about that. I know you enjoyed it hugely, but did you ever.

85
00:09:27,090 --> 00:09:35,100
And probably not. But looking back, comparing Oxford people with London people, did you feel you were better educated?

86
00:09:35,100 --> 00:09:41,970
Yes, I shouldn't say so. Well, with a mother who taught in London and had a wife who was educated.

87
00:09:41,970 --> 00:09:45,930
And and I go further actually, and not for publication in Cambridge.

88
00:09:45,930 --> 00:09:57,030
I think it was better than Cambridge. I had a sort of a view that the old anecdote that I was brought up on that in medicine in Oxford,

89
00:09:57,030 --> 00:10:00,270
they ask you what you think and in Cambridge about, you know.

90
00:10:00,270 --> 00:10:09,930
And in London, what you don't know, and even further than that in in the Scottish Medical School, what does the professor say?

91
00:10:09,930 --> 00:10:11,850
I think there was a bit of concern.

92
00:10:11,850 --> 00:10:23,430
And I find I find that highly talented graduates from Cambridge in my year at Middlesex were much more inclined to take the dogma without criticism.

93
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And they also knew much more. And I remember when Morgan Campbell was teaching us in the preliminary exam, had to examine the abdomen,

94
00:10:34,140 --> 00:10:43,910
making very rude remarks about Oxford and saying, oh, Oxford, think you know it all and don't know anything.

95
00:10:43,910 --> 00:10:48,270
Least the Cambridge chaps know something.

96
00:10:48,270 --> 00:10:54,690
And I remember he said, I don't suppose you even know, since we're examining abdomen, which side of the abdomen the spleen is on.

97
00:10:54,690 --> 00:11:00,240
So we would have missed that area and replied, You must.

98
00:11:00,240 --> 00:11:02,050
I went out to do it.

99
00:11:02,050 --> 00:11:09,880
Geoffrey O'Riordan, later, professor of technology at the Middlesex, saying, My dear Campbell, isn't that what you're here to take?

100
00:11:09,880 --> 00:11:14,790
Is there a certain arrogance about arrogance of graduates which Elaine would tell you?

101
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It's my wife as a as a as a London girl looking at Oxford and Cambridge echoes my view, actually, that the Oxford plot were much more enquiring.

102
00:11:24,750 --> 00:11:29,190
All right. But she did say where they were.

103
00:11:29,190 --> 00:11:33,750
You have words unspeakably arrogant.

104
00:11:33,750 --> 00:11:42,660
Then you went on with the various clinical levels in London for quite a time and then got an award through America.

105
00:11:42,660 --> 00:11:49,140
Yes. A lot of travelling scholarship. Yes, British. I think it was British Medical Federation or something like that.

106
00:11:49,140 --> 00:11:55,500
Yeah. And you were in New York. In New York at College of P.A. Columbia.

107
00:11:55,500 --> 00:12:06,340
And that's Presbyterian Hospital with a man called John Alara. And they are HGH, who is a very leading light in the in the hypertension world.

108
00:12:06,340 --> 00:12:09,550
How much clinical did you do then? I know quite a lot.

109
00:12:09,550 --> 00:12:15,540
I did a clinic once a week and I did what's the equivalent of one take with the American medical students?

110
00:12:15,540 --> 00:12:20,820
And that was horrendous, I find, because I don't know what you had the similar experience in Boston,

111
00:12:20,820 --> 00:12:33,270
but I found that the students would have clocked the case that they were lost later, going to be brought on by me.

112
00:12:33,270 --> 00:12:37,710
And I spent two hours in the library reading about it before I got there.

113
00:12:37,710 --> 00:12:43,890
And I found that the American medical student was much more competitive and

114
00:12:43,890 --> 00:12:48,740
hardworking than the laid back British who'd like a pint of beer and a game of rugby.

115
00:12:48,740 --> 00:12:52,050
And I find it very testing during that.

116
00:12:52,050 --> 00:12:55,980
Yes. So you go, yeah, that's fine.

117
00:12:55,980 --> 00:13:03,210
I mean, so I didn't do any more work other than teaching on people that came in, but I did do our patients once a week.

118
00:13:03,210 --> 00:13:07,090
So when you came to Oxford and we'll go back into that a bit more,

119
00:13:07,090 --> 00:13:18,090
how did you feel the functioning of the racket compared with Presbyterian, Columbia Presbyterian or compared with London's schools?

120
00:13:18,090 --> 00:13:20,810
Well, actually, I thought the Radclyffe was an eye opener.

121
00:13:20,810 --> 00:13:30,720
I mean, if you take the London schools, first of all, I think you had quite a busy day if you had a couple of emergencies a day or a bit more.

122
00:13:30,720 --> 00:13:38,580
And when they were admitted, my memory was that they were admitted by the high staff and the registrar and the consultant

123
00:13:38,580 --> 00:13:45,030
really didn't need to know that they'd come in and would find out later about it.

124
00:13:45,030 --> 00:13:48,600
And the same was true. No.

125
00:13:48,600 --> 00:13:55,800
Well, Columbia Presbyterian, the senior resident, was the dominant figure, of course.

126
00:13:55,800 --> 00:14:06,330
And and they had tremendously good sessions in the morning when you had to present the case overnight that you may remember.

127
00:14:06,330 --> 00:14:14,760
Well, they call that it had a name to it or something. But when I came to Oxford, the thing that shattered me about it didn't show to me.

128
00:14:14,760 --> 00:14:24,690
What surprised me was the immediate involvement of the consultant as a teaching weapon right from the first moment.

129
00:14:24,690 --> 00:14:32,970
So it was that something you and other people then originated or had it been happening in Oxford, have been happening in Oxford before?

130
00:14:32,970 --> 00:14:47,520
I think because my memory was that when I arrived and was Elaine was selling a house in London and I was in in oh,

131
00:14:47,520 --> 00:14:50,850
a room somewhere across the road near the pub.

132
00:14:50,850 --> 00:14:59,960
Anyway, the phone rang and Ron Prout, who was the senior registrar of the day, rang me and said, Did I realise that?

133
00:14:59,960 --> 00:15:09,860
Expected to do what he called a take rod, which I'd never heard of, and that he was particularly worried about a patient with hepatic coma.

134
00:15:09,860 --> 00:15:19,010
I remember that. And I had spent the last year and a half trying to assess angiotensin rats with smoke

135
00:15:19,010 --> 00:15:24,260
drums and had a certain feeling that I didn't remember much about hepatic failure.

136
00:15:24,260 --> 00:15:29,720
And then after that, I was in the bath would be another half an hour so I could look things up if I could.

137
00:15:29,720 --> 00:15:33,440
I found myself tested enormously when I came to Oxford.

138
00:15:33,440 --> 00:15:38,790
I thought this is a place where they really want to know whether you're any good and you.

139
00:15:38,790 --> 00:15:43,190
I felt exposed and actually quite anxious to begin with.

140
00:15:43,190 --> 00:15:49,420
But do you think Pat Malam did take grounds and then. I wouldn't know.

141
00:15:49,420 --> 00:15:58,610
I mean, I think my own guess now is that the professorial firms figuring out with probably were right and maybe some of the others were,

142
00:15:58,610 --> 00:16:03,860
but I don't think it was and it cooked well. He's the one I'm not sure about.

143
00:16:03,860 --> 00:16:08,900
I don't think Teddy bothered with it. But, you know, well, that's very interesting because they were more like the London patent.

144
00:16:08,900 --> 00:16:13,790
But as soon as I got into the tech runs, you really were all right.

145
00:16:13,790 --> 00:16:20,930
You're the consultant. You're the public, but you were much less protected out of your senior registrar than you ever were in London.

146
00:16:20,930 --> 00:16:27,800
But now what about the standard sort of nursing care? What did you think of that in comparison?

147
00:16:27,800 --> 00:16:33,920
Oh, well, of course, Middlesex Nursing Care was fantastic. Yes. I think I've never seen anything quite like it.

148
00:16:33,920 --> 00:16:39,470
Was that different from the Westminster? No, Westminster was equally good, I would say.

149
00:16:39,470 --> 00:16:46,260
And it was also very good. Pianists were actually mostly I was working on the metabolic ward.

150
00:16:46,260 --> 00:16:55,970
So, you know, it was all very quiet. I think the nursing was pretty good also when we had our own wards, Rodney and Alex, in my case,

151
00:16:55,970 --> 00:17:02,270
and yours too, with their particular nursing staff and I can't remember the name of Mr Harris.

152
00:17:02,270 --> 00:17:06,650
Thank you. Yes. No, they were extremely good.

153
00:17:06,650 --> 00:17:12,530
You know, I think the nursing then was as good as it was anywhere else.

154
00:17:12,530 --> 00:17:20,840
Tell me about your appointment in Oxford, because it ended up with that amazing two days in which they made the three appointments.

155
00:17:20,840 --> 00:17:26,720
And you've been called over to the Middlesex, I think. Oh, yes, I had.

156
00:17:26,720 --> 00:17:34,130
It's a very long story and not pertinent to this. But I had been I didn't particularly want to go to the Middlesex,

157
00:17:34,130 --> 00:17:44,000
but I was told I should go to an interview for a job in technology chronology that really Slater eventually took.

158
00:17:44,000 --> 00:17:48,510
And I went on to I think it was a Friday and a Monday.

159
00:17:48,510 --> 00:17:54,260
There were two interviews at the Middlesex and that gave me a week long a man, a nice man called Buckley,

160
00:17:54,260 --> 00:18:05,390
who'd I mentioned before I left the Westminster saying that if he could keep his eye on what was happening,

161
00:18:05,390 --> 00:18:15,230
Alan and I would I'd pay the money to come back for jobs in I think I said Oxford, Edinburgh and Bristol or something.

162
00:18:15,230 --> 00:18:19,040
And I didn't want to be in London. And there I was in London.

163
00:18:19,040 --> 00:18:25,790
Anyway, he basically told me by luck, you know what, there's a job advertised in Oxford.

164
00:18:25,790 --> 00:18:31,610
Why don't you go up there on the Saturday, which I did, and found George Pickering in,

165
00:18:31,610 --> 00:18:36,800
can you imagine on a Saturday morning and had a very good session with him.

166
00:18:36,800 --> 00:18:45,350
And of course, I was very lucky because I hadn't realised I mean, I knew he was a hypertensive king and that was my principal research at the time.

167
00:18:45,350 --> 00:18:54,890
I didn't realise he thought the brightest light in the hypertension world was that my then boss in in in the States.

168
00:18:54,890 --> 00:19:00,230
That was a great bit of luck. And you hit it off with Baker very well.

169
00:19:00,230 --> 00:19:08,270
Yes. Yes, yeah. And then when you go again, because you would have been appointed as an endocrinologist.

170
00:19:08,270 --> 00:19:14,090
Now let's you and I had the same I think we ought to look it up.

171
00:19:14,090 --> 00:19:26,780
But I think it said once you a general physician with an interest outside endocrinology, metabolic medicine, diabetes, nephrology.

172
00:19:26,780 --> 00:19:32,180
Right. And possibly something else, I don't think it even mentioned the probability you.

173
00:19:32,180 --> 00:19:37,220
I don't think it did. But then what did you feel about being shunted into nephrology?

174
00:19:37,220 --> 00:19:42,470
You were delighted. Oh, well, I had been sort of mythologically orientated.

175
00:19:42,470 --> 00:19:51,500
I got tremendously interested in salt and water balance in the kidney and handling of salt and water when actually when surgical thermoplasty, McCain,

176
00:19:51,500 --> 00:19:59,760
who wrote a remarkable monograph on fluid balance postoperatively and the metabolic response to injury and things, and I got interested in that.

177
00:19:59,760 --> 00:20:06,090
I've been interested in the kidney in front of the schools, and when nephrology began,

178
00:20:06,090 --> 00:20:14,370
people began to do kidney biopsies and rather and think that was when I was with John Nabarro at the Middlesex when he said,

179
00:20:14,370 --> 00:20:20,040
well, you'd better do the nephrology, John. Right. And you better learn to do renal biopsy.

180
00:20:20,040 --> 00:20:27,300
And I learnt how to do renal failure. Michael Dukakis at the Merrison Hammersmith.

181
00:20:27,300 --> 00:20:37,020
Yes. And then I had carried on because when I was with Dick Bellison at Westminster,

182
00:20:37,020 --> 00:20:42,870
I also did sessions in nephrology with Living in Africa and Malcolm Milne.

183
00:20:42,870 --> 00:20:49,380
So I was, you know, orientated towards the kidney. And so it was certainly nice when that came up.

184
00:20:49,380 --> 00:20:57,600
And I remember Paul Vision saying we're going to be given the renal unit because the government are going to do this everywhere,

185
00:20:57,600 --> 00:21:03,030
1966, and that's going to be dialysis and mechanics.

186
00:21:03,030 --> 00:21:09,360
And I remember what you said. You don't want to be bothered with all that, do you?

187
00:21:09,360 --> 00:21:12,210
Why don't you find someone who would like to do that?

188
00:21:12,210 --> 00:21:20,850
And then you couldn't get on with the wider aspects of anthropology and not too bogged down with connecting people to machines.

189
00:21:20,850 --> 00:21:24,900
And so that's what I did. And that's why that's all I ever took on the record.

190
00:21:24,900 --> 00:21:28,390
Yeah, because he'd been in Pickering's unit. Yes.

191
00:21:28,390 --> 00:21:33,060
And again, he was a stalwart, but not really a typical peccary.

192
00:21:33,060 --> 00:21:38,940
I know he was a very sound chap who wasn't interested in anything at all.

193
00:21:38,940 --> 00:21:46,470
Floury. He was he was immensely interested in what was practically has to be done today, which he did supremely well.

194
00:21:46,470 --> 00:21:52,590
And you were out with the Churchill doing that. Yes. In Ward one. And you find that difficult moving between the two.

195
00:21:52,590 --> 00:21:56,280
You know, now, you know, the traffic wasn't bad, was it?

196
00:21:56,280 --> 00:22:02,340
And we had that extraordinary session on Ward one where all the consultants had beds.

197
00:22:02,340 --> 00:22:10,290
You, I think to but that's the renal unit sort of started infiltrating that and ultimately took it over.

198
00:22:10,290 --> 00:22:19,170
Yes. Yes. And it had it when it began to just desert me and two nurses, I think was quite extraordinary.

199
00:22:19,170 --> 00:22:23,130
Yes. Because I can remember one or two dialysis.

200
00:22:23,130 --> 00:22:30,580
PAPANTONIOU That is done in the RADCLYFFE. Yes. The people, they were waiting, as it were, for the real set up there.

201
00:22:30,580 --> 00:22:36,450
Oh, yes. I mean, if you're really thinking back to medicine then and now,

202
00:22:36,450 --> 00:22:51,210
I've got a vivid recollection of Christmas Day and a child with haemolytic uraemic syndrome under the age of one in Liow one or whatever it was.

203
00:22:51,210 --> 00:22:57,270
Ward, I think that's what it was. And I can remember going in where the consultant staff was Christmas morning.

204
00:22:57,270 --> 00:23:05,340
So everybody's dressed up and there was this child and we thought we'd better try and do some peritoneal dialysis.

205
00:23:05,340 --> 00:23:11,610
And when Williams was then my senior registrar and we set up a Heath Robinson effect,

206
00:23:11,610 --> 00:23:19,140
we found an oesophageal tube which we could put into the abdomen, and that was connected to a bit of plastic.

207
00:23:19,140 --> 00:23:24,390
We could find that which round in circles we put that into a basin of hot water.

208
00:23:24,390 --> 00:23:29,270
And we we had a bag from water.

209
00:23:29,270 --> 00:23:36,800
It wasn't as bad as we're having and we just did it and the child survived.

210
00:23:36,800 --> 00:23:38,150
I forgotten it, actually.

211
00:23:38,150 --> 00:23:48,030
And it's astonishing when you think back to how primitive things were then and then you went down to your old Christmas lunch, did you?

212
00:23:48,030 --> 00:23:54,960
Yes. Oh, yes, absolutely. Because I couldn't have that well, carving the turkey, but and it didn't come off along, did one,

213
00:23:54,960 --> 00:23:58,710
because it then came from a central kitchen and came all you did, but you still were there.

214
00:23:58,710 --> 00:24:02,820
And your children with you have now I have patience, time and have patience.

215
00:24:02,820 --> 00:24:08,730
Would you be doing a week to. Yes. And how did you enjoy that very much.

216
00:24:08,730 --> 00:24:15,600
It's rather sad to find that my daughter, now a physician, says, oh my God, I want to do our patients, all those complaining people.

217
00:24:15,600 --> 00:24:19,920
I look forward to it. I thought it was the highlight of the week in a way,

218
00:24:19,920 --> 00:24:26,310
because you never knew what was going to become what you get referrals when we were wrong

219
00:24:26,310 --> 00:24:33,620
and it really was general medicine you didn't know know anything from anorexia nervosa to,

220
00:24:33,620 --> 00:24:38,820
I don't know, acuteness. I remember acute tetanus actually one morning.

221
00:24:38,820 --> 00:24:42,630
Right. And then you were going out doing a centre is not too many.

222
00:24:42,630 --> 00:24:48,270
But initially, I think when one was first there, I think the GP's wanted to know whether you were going to actually ah,

223
00:24:48,270 --> 00:24:52,200
since you mentioned Ballymun cocain, perhaps not relevant.

224
00:24:52,200 --> 00:25:00,170
I remember one of the GP's saying to me, well, thank God it was the people at Abingdon where you drank beer before you went to see the patient.

225
00:25:00,170 --> 00:25:07,460
And they sat down, had a beer, I said, well, thank God you seem to be somebody we can refer to because we really thought the end had come because,

226
00:25:07,460 --> 00:25:14,660
you know, we wouldn't dream of sending anything to the academics because we don't think they're medically sound.

227
00:25:14,660 --> 00:25:23,160
And a cook was arrogant. And the only physician whom we thought was any good was malem and now he's gone.

228
00:25:23,160 --> 00:25:28,220
Well, that's a lesson that and then you do a teaching round to the students.

229
00:25:28,220 --> 00:25:32,840
Yes. And they go on your clinical programmes. Yes, we did.

230
00:25:32,840 --> 00:25:37,440
You're doing also sort of on one case with them on how to do.

231
00:25:37,440 --> 00:25:42,830
You know, I think we just went round. I had a reputation for going on too long.

232
00:25:42,830 --> 00:25:52,520
I think you did too much and you just went until it was finished and now you kept me going round and round me to obey.

233
00:25:52,520 --> 00:25:58,730
Well, no, I went around by myself. Actually, that was a tiresome thing with all great respect for Brian.

234
00:25:58,730 --> 00:26:02,370
He had a view that he used this word sit here all the time.

235
00:26:02,370 --> 00:26:09,050
He may remember and he thought we should have a sensitive or firm, which I went round with all his patients.

236
00:26:09,050 --> 00:26:15,980
He went or I was always I found that impossible and said, look, I can't I'm sorry,

237
00:26:15,980 --> 00:26:23,660
but we can't have argument about what we do or competition at the end of the bed, which is very much what I'm afraid he did.

238
00:26:23,660 --> 00:26:31,880
And it was it was slightly difficult eight years that I had with him.

239
00:26:31,880 --> 00:26:37,010
And what happened after that? You went into the into the pub?

240
00:26:37,010 --> 00:26:43,430
Yes, the May readership came up. And I don't know whether it should be something.

241
00:26:43,430 --> 00:26:44,120
I was right.

242
00:26:44,120 --> 00:26:52,940
I was very dubious about that because I rarely saw myself in the primaries and the nature physician and clinician and thought that if I ever

243
00:26:52,940 --> 00:27:04,040
had a really weak spot because in in fundamental basic research and therefore to take a university appointment was stretching it a little.

244
00:27:04,040 --> 00:27:07,430
But I was persuaded by David Wetherall. Very interesting thing.

245
00:27:07,430 --> 00:27:11,900
That ought to be that I, I can't it the letter precisely.

246
00:27:11,900 --> 00:27:22,880
But when he invited me to take the May readership, he wrote a letter and said, I have a vision of how to run the Nuffield Department of Medicine,

247
00:27:22,880 --> 00:27:31,970
which is firstly that it should be the department which had the highest reputation for clinical skills.

248
00:27:31,970 --> 00:27:41,690
Secondly, that it was had the highest reputation in the hospital for teaching and only then when I consider the needs of research.

249
00:27:41,690 --> 00:27:49,160
And he went on to say, I am a humble laboratory haematologist who knows little general medicine in my room.

250
00:27:49,160 --> 00:27:59,210
The rumour has it is you're a computer technician and I hope you would join me to do the other side, which actually effectively we did.

251
00:27:59,210 --> 00:28:02,780
Except, of course, he was a better clinician than I was when he was at one time,

252
00:28:02,780 --> 00:28:08,960
but he was a very good patient, is extremely good with a very modest man show.

253
00:28:08,960 --> 00:28:18,560
But he had this vision actually, though, that that developed later that academic departments could have a twin, the head,

254
00:28:18,560 --> 00:28:26,670
which the orientation was teaching clinical medicine versus research, both doing both, but one really dominating the other.

255
00:28:26,670 --> 00:28:34,980
Then I say it myself. I think it worked very well. But in the first years, you can be appointments.

256
00:28:34,980 --> 00:28:39,680
Yes, we're doing a bit of university research. Oh, yes. So you're sitting on.

257
00:28:39,680 --> 00:28:51,200
Oh, I was working on the on the kidney and hypertension, angiotensin aldosterone know reading in particular,

258
00:28:51,200 --> 00:28:57,680
who was a whole field of the origin of hypertension and the kidney and renin, which was a big field in those days.

259
00:28:57,680 --> 00:29:04,760
I think it's probably all gone now. And I had, of course, luckily enough, ended up with a whole series of difficult students,

260
00:29:04,760 --> 00:29:09,210
all of whom were highly, highly talented, to whom I was nominally supervised.

261
00:29:09,210 --> 00:29:15,620
You know, I was supervising, which, you know, people like Martyn Gregory or Gwen Thomas or Wayne Williams or whatever.

262
00:29:15,620 --> 00:29:20,240
Let's think about it before that. I mean, was this based in Pickering?

263
00:29:20,240 --> 00:29:26,210
Yes. Now, Pickering gave me and you had a South African up there, very leery Apkarian area.

264
00:29:26,210 --> 00:29:34,130
And then what about Mike Lee was him and Mike Lee was no was one of George espec was in the same field.

265
00:29:34,130 --> 00:29:40,520
So there was a lot of hypertension interest in that time. Mike Lee also on renin.

266
00:29:40,520 --> 00:29:48,860
And I think that, yes, Perry Leary was the first film student who looked at actually interestingly about the rather than the rate of formation,

267
00:29:48,860 --> 00:29:51,980
the rate of destruction of angiotensin by various organs.

268
00:29:51,980 --> 00:29:58,430
And he used Brian Ross exactly to produce kidney, which a lot of us used that for a long time.

269
00:29:58,430 --> 00:29:59,710
So there wasn't. Yeah.

270
00:29:59,710 --> 00:30:09,080
A good deal of lab work going on, very much animal work, although we did some research at Holwell on the distribution of blood pressure and,

271
00:30:09,080 --> 00:30:16,640
you know, how many patients might have primary austerities or whatever it was going to almost hit, a lot of that would already be nice.

272
00:30:16,640 --> 00:30:23,210
Yes, we know. We know. God, I wish it would be. No was the old with the old ganglion block rat.

273
00:30:23,210 --> 00:30:27,170
All right. Well, another virus, not a virus. A ground.

274
00:30:27,170 --> 00:30:37,250
You think it was out at town? Oh, wouldn't know that. How was how was where we got the patients that we were measuring reading in a normal population.

275
00:30:37,250 --> 00:30:43,910
So cool and so and went out there and got sort of 300 or so they were.

276
00:30:43,910 --> 00:30:47,780
And yes, they were a very, very bright lot of people.

277
00:30:47,780 --> 00:30:55,340
Martyn Gregory, perhaps the brightest in the room. Yes. And it was certainly a great privilege to be given them, actually.

278
00:30:55,340 --> 00:31:00,410
Funnily enough, George Pickering, when I'd been there for a long time,

279
00:31:00,410 --> 00:31:08,150
said those young back young chap back from from America who I think ought to do a deal and he ought to do it.

280
00:31:08,150 --> 00:31:17,930
You ought to interest him in hypertension. His name's George Oberti and George George appeared in my room and I said,

281
00:31:17,930 --> 00:31:25,730
I'm beginning to think this story of attention and reading and aldosterone, they've gone off almost as far as they're going to go.

282
00:31:25,730 --> 00:31:32,810
And I don't think the gold dust. And he said he'd been measuring insulin and things.

283
00:31:32,810 --> 00:31:36,860
And I said, well, I think why don't you go and see Derek Hockaday, do you remember?

284
00:31:36,860 --> 00:31:45,020
Well, I do remember coming to see me. I didn't know that bit there because I thought, well, I.

285
00:31:45,020 --> 00:31:49,310
I wasn't too sure, actually. I hadn't started in the field I was in anyway.

286
00:31:49,310 --> 00:31:53,720
And the E.M.S. revenge attention was pretty difficult at that time.

287
00:31:53,720 --> 00:31:58,520
And the essay you were using in the racket, was that the same one as the last.

288
00:31:58,520 --> 00:32:02,270
Yes. Oh yes. I took it really last. I took it back from there.

289
00:32:02,270 --> 00:32:11,950
Yes. Great. And copied down the mayor as he shunted the Edinburgh Group off or even went for the rest of army.

290
00:32:11,950 --> 00:32:15,980
And I said, yeah, well, he was the first chap to discover that.

291
00:32:15,980 --> 00:32:20,940
Was it the structure of education that he got for it. And then he had Brown, Beaver and Robertson,

292
00:32:20,940 --> 00:32:31,980
the great what we call lever brothers who actually quarrel with with with with quarrel but wanted freedom from Stand Pat and went to the MRC.

293
00:32:31,980 --> 00:32:37,420
And I think that was fundamentally they wanted to stick with the virus and he wanted the rate of interest.

294
00:32:37,420 --> 00:32:40,790
That's why I didn't want to spend time on it. That's right.

295
00:32:40,790 --> 00:32:46,130
Now, John, when did you begin to have to go to London for various committees and colleges and things?

296
00:32:46,130 --> 00:32:51,840
Oh, well, I suppose one became a membership examiner quite early on.

297
00:32:51,840 --> 00:32:59,210
Um, did you spend much time in London or not?

298
00:32:59,210 --> 00:33:03,240
No, not initially, but I would later. I mean, much later.

299
00:33:03,240 --> 00:33:08,390
I was a sense at the college in the early 80s with when Bill Hofburg was running it.

300
00:33:08,390 --> 00:33:14,820
And that was an interesting experience. But I know I didn't go to London terribly much.

301
00:33:14,820 --> 00:33:20,560
And, you know, and I when I went to I went to erm if if they were the most am I talking.

302
00:33:20,560 --> 00:33:23,240
Of course I did. I went to the Medical Research Society. Yes.

303
00:33:23,240 --> 00:33:30,260
Endlessly where you were looking for young to hide you about when it was when it was in London and.

304
00:33:30,260 --> 00:33:37,860
Yes. So we went for that and contributed quite a lot of stuff to clinical science which was a paper that in general,

305
00:33:37,860 --> 00:33:47,030
that sort of thought was quite frightful. Did say, oh, yes, he thought it was, you know, people what he called it,

306
00:33:47,030 --> 00:33:52,650
crawling over the frontiers of science because he relied on the quarterly Journal of Medicine.

307
00:33:52,650 --> 00:33:59,130
Yes. He thought political science was sort of people doing stupid research on animals with no practical use.

308
00:33:59,130 --> 00:34:05,600
But how much interaction did you have with Alec? Well, you know, social.

309
00:34:05,600 --> 00:34:11,060
Yes, very, very strongly social. He'd actually examined me in membership.

310
00:34:11,060 --> 00:34:15,200
He'd remembered that time and he'd known my family.

311
00:34:15,200 --> 00:34:20,240
So, you know, we know him very well. And I looked after his wife when she was unwell.

312
00:34:20,240 --> 00:34:23,750
Things for their kids. When did you start publishing things?

313
00:34:23,750 --> 00:34:31,910
Papers? Oh, well, I'd published a little bit before I came. And then I suppose there was a trickle.

314
00:34:31,910 --> 00:34:45,860
Funnily enough, having said, I had a lousy research note, but there are something like 140 in my career, published papers in decent journals.

315
00:34:45,860 --> 00:34:55,790
I do think an awful lot of them. No, um, I would not have done on my own without very talented young people with me.

316
00:34:55,790 --> 00:34:59,470
But I think it's one of the things that I look back on and said.

317
00:34:59,470 --> 00:35:08,370
George Pickering, when he was looking on that task of an academic and.

318
00:35:08,370 --> 00:35:18,360
I think if I were to contrast George Pickering with Hans, for instance, if you look back at what George achieved research wise,

319
00:35:18,360 --> 00:35:24,240
actually there's a marvellous book on high blood pressure, which was, well,

320
00:35:24,240 --> 00:35:28,980
juiced, but it was a book and it reviewed other people's work as well as his own.

321
00:35:28,980 --> 00:35:34,380
If you said what were the what were the startling features of his work?

322
00:35:34,380 --> 00:35:43,770
Actually, it doesn't add up to all that much compared with Nobel laureate people that we're now familiar with in Oxford.

323
00:35:43,770 --> 00:35:55,350
And yet, if you if you were to look at what George did for Oxford as Regius professor versus Crib's as professor back in history,

324
00:35:55,350 --> 00:36:04,110
the one was a great research man of his own. The other was a nutritionist of of the young.

325
00:36:04,110 --> 00:36:10,860
And I think that's a real one can play in research even if you're not the most gifted bloke.

326
00:36:10,860 --> 00:36:15,150
Yes. And John, I know. Did you come across all the time?

327
00:36:15,150 --> 00:36:21,000
All the time. Every day, right? Oh, yeah. When I was when I said yes.

328
00:36:21,000 --> 00:36:25,310
But something was going on in the. What did you do have every day.

329
00:36:25,310 --> 00:36:36,090
Yes. No, no, I did because it was in the lab. But, you know, it was up there and the the deep field chap would be doing his stuff.

330
00:36:36,090 --> 00:36:42,870
And John, all that would be wouldn't be providing the kids or telling me that he hasn't watched the bench properly at all.

331
00:36:42,870 --> 00:36:45,030
You wanted to actually interesting with John,

332
00:36:45,030 --> 00:36:51,660
you wanted a bit of apparatus that could do something to get into the vein of the of the rat or something,

333
00:36:51,660 --> 00:36:55,320
and he would be delighted and make it for you, remember?

334
00:36:55,320 --> 00:36:58,530
Yes, I do. So we had a very tiring job.

335
00:36:58,530 --> 00:37:12,000
I mean, very Leary was my first film student who had these awful vision, isolated perfused rat kidney was actually quite a set up of, you know,

336
00:37:12,000 --> 00:37:15,810
getting the catheter into the vein and the operator collecting all the stuff and

337
00:37:15,810 --> 00:37:20,250
making it produce urine and seeing what happens when you put renin angiotensin.

338
00:37:20,250 --> 00:37:26,040
That required an awful lot of technical apparatus and set up, which John also just was.

339
00:37:26,040 --> 00:37:30,940
Yes. You know, terrific, because using ground rules for that had really come out of the cribs.

340
00:37:30,940 --> 00:37:35,880
Yes. Yes. I do think they were using everything. Yes, absolutely.

341
00:37:35,880 --> 00:37:39,630
As isolated organs. Yes. And then the clinical field.

342
00:37:39,630 --> 00:37:44,480
Now, when you got to the end, erm you'd had just the two of you as consultants, correct.

343
00:37:44,480 --> 00:37:49,530
I had it already know. Shadow Sheila Canada. Yes.

344
00:37:49,530 --> 00:37:55,260
But the other people had gone, Sydney Truelove and John Badenoch disseminated elsewhere.

345
00:37:55,260 --> 00:38:05,910
Yes. So it was David and me. When you were selling the NHS, had you been joined by more before you went up to India or was it just and.

346
00:38:05,910 --> 00:38:07,230
Oh, just me and Grant.

347
00:38:07,230 --> 00:38:13,920
Yes, because there was the time when it all blossomed out was when there were always grants different students in my business, you know.

348
00:38:13,920 --> 00:38:17,080
I mean, the consultants on offer. Oh, no, they were just the two of us.

349
00:38:17,080 --> 00:38:22,230
Yeah. Because the work came the time when we went up to three and then I had up to four and we were just two.

350
00:38:22,230 --> 00:38:30,060
And do you think that made a change, that sort of closing out because you had be been and then the arm with yourself and David,

351
00:38:30,060 --> 00:38:36,420
whether or the calendar and more not for a bit until David Graham Smith appeared right.

352
00:38:36,420 --> 00:38:44,610
When David thought, well, we must give David's family space when I was difficult, actually, I said, well, look, you know, I enjoy my work.

353
00:38:44,610 --> 00:38:47,040
I got my half. I like my team.

354
00:38:47,040 --> 00:39:01,170
I don't like this idea of that and had of rotating people ONTAKE and running things so that you had four months when you weren't on the boards,

355
00:39:01,170 --> 00:39:04,680
very American set up. I disliked it greatly.

356
00:39:04,680 --> 00:39:09,240
I thought I was there to do clinical medicine and I didn't. I thought so.

357
00:39:09,240 --> 00:39:15,660
David Gravies, clinical pharmacology that will do clinical pharmacology,

358
00:39:15,660 --> 00:39:22,650
but reluctantly, I, I well actually what happened is David Wetherall such a nice man.

359
00:39:22,650 --> 00:39:27,240
David started sharing with with David Graham Smith.

360
00:39:27,240 --> 00:39:32,670
And I kept my health actually. But now David Smith went after our firm after a bit.

361
00:39:32,670 --> 00:39:40,110
Yes. Was that of any reason? I don't think there was any bad that we got on extremely well.

362
00:39:40,110 --> 00:39:40,770
They were very well.

363
00:39:40,770 --> 00:39:50,280
I think it was just a feeling that David Weatherill had that we ought to have a greater distribution of the so-called academic services,

364
00:39:50,280 --> 00:39:53,640
the so-called non-academic. Yes, of course.

365
00:39:53,640 --> 00:39:56,730
You know, I know there was very little difference. Yes.

366
00:39:56,730 --> 00:40:05,520
I remember Peter Slight when you and I and he started doing A plus B appointments, and I think he wanted money.

367
00:40:05,520 --> 00:40:09,910
Remember what we weren't allowed to. Weren't allowed to keep any money for private practise.

368
00:40:09,910 --> 00:40:19,810
Remember, we had that dinner with Picaridin and I think in which Peter said, well, if you think by doing private practise, we'll neglect our research.

369
00:40:19,810 --> 00:40:31,870
And I just point out to you that Hockaday, Ledingham and Slight have published in the last year rather more than the full time academics.

370
00:40:31,870 --> 00:40:49,120
Yes. Said we were competitive. Yes. Yes. And so later on, Amanda, did you see the ending or maybe just the war faction changing up your retirement?

371
00:40:49,120 --> 00:40:59,200
No, not fundamentally. We still actually the thing that I like most of the SDM, actually, funnily enough, I had started Begi Grantly,

372
00:40:59,200 --> 00:41:08,280
and I thought we ought to have a session once a week with the students in which we discussed cases in detail.

373
00:41:08,280 --> 00:41:13,810
That was Thursday morning at 8:00 till 10:00. And you had your visiting?

374
00:41:13,810 --> 00:41:23,410
We had John Spaulding coming from and we had a lecture in psychiatry who went on to be a professor of psychiatry at Glasgow,

375
00:41:23,410 --> 00:41:28,000
who his name has just forgotten, just escaped me. So he had a psychiatrist.

376
00:41:28,000 --> 00:41:38,290
We had Alan Sharp doing haematology and Joe Smith the bugs right there.

377
00:41:38,290 --> 00:41:40,790
Yes, we all came on the ward run together.

378
00:41:40,790 --> 00:41:49,270
But on Thursday morning, we had two cases that would be presented by the students and then discussed with all of us having a good go now.

379
00:41:49,270 --> 00:41:57,310
I thought this was great. And we carried that on with David in the Indian and I gather it still exists.

380
00:41:57,310 --> 00:42:01,630
Peter Radcliffe does it. And it was an admirable session.

381
00:42:01,630 --> 00:42:05,470
No, we only had one on one case. I absolutely agree.

382
00:42:05,470 --> 00:42:09,490
It was a very important part of the week. Oh, yeah. Did you have a pathologist, Bill?

383
00:42:09,490 --> 00:42:12,850
It said Michael Dunning. Yeah. Well, yes.

384
00:42:12,850 --> 00:42:18,460
Now, he was very important in the renal. Yes, he was bit you know, that's well, that's an old story.

385
00:42:18,460 --> 00:42:28,180
But when I arrived in Oxford to do renal stuff, I went to Rob Smith's running back and said, who is going to do the renal histology?

386
00:42:28,180 --> 00:42:33,310
Because it's a very expert area in which people don't agree and people got proper equipment.

387
00:42:33,310 --> 00:42:37,670
And he said it would be the frozen section registrar of the week.

388
00:42:37,670 --> 00:42:43,450
And I thought, oh, God. And then very enquiry.

389
00:42:43,450 --> 00:42:50,400
And somebody told me that there was a man called Daniel who was one of the world's greatest pathologists of the lung,

390
00:42:50,400 --> 00:42:55,300
and that he indicated that he was tired and wanted to do something else.

391
00:42:55,300 --> 00:43:00,190
And if I took him out to lunch and gave him a decent claret, he might be right.

392
00:43:00,190 --> 00:43:07,390
We could within two years. Michael have written a very good book about renal histology here is very quantitative.

393
00:43:07,390 --> 00:43:15,910
And there he was. He was obsessional. And so quite I mean, if you're doing a real biopsy for Michael Cunningham,

394
00:43:15,910 --> 00:43:22,910
you had to remap say you were doing it and he would appear in the theatre and he would make sure that he would be a bit came his way.

395
00:43:22,910 --> 00:43:26,890
He wouldn't send anybody else. Then he'd ring you up and say, come and look at it.

396
00:43:26,890 --> 00:43:30,580
Oh, boy, I would get and look at it with him. It was great fun.

397
00:43:30,580 --> 00:43:35,650
Yes. But now you rather glad the nursing, etc. went on the same.

398
00:43:35,650 --> 00:43:39,640
But gradually the takes became more and more. Yeah, no, no.

399
00:43:39,640 --> 00:43:45,730
It became more. And by the time I retired, I really wanted to retire from general medicine.

400
00:43:45,730 --> 00:43:49,690
I think one of the things that happened was we all did it and enjoyed it.

401
00:43:49,690 --> 00:43:57,700
And as it got tougher, there was an increasing tendency which you and I didn't do, but others did, to say, I don't want to do this.

402
00:43:57,700 --> 00:44:01,150
I'm going to be a young man or a kidney man or a heart man.

403
00:44:01,150 --> 00:44:05,920
And I won't do Ontake to the detriment, I think.

404
00:44:05,920 --> 00:44:10,870
But they were driven to it because Ontake, when we started, was enormous fun,

405
00:44:10,870 --> 00:44:18,340
because you never knew what was going to come and find out if I had the enormous privilege

406
00:44:18,340 --> 00:44:25,180
of of getting all the haematology and quite a lot of the oncology of when I started,

407
00:44:25,180 --> 00:44:35,020
because they probably know this. There was a great Routt original and haematologists is whether they were allowed to look after patients.

408
00:44:35,020 --> 00:44:39,280
Alan Sharp and poor, he never said, were not allowed to look after patients.

409
00:44:39,280 --> 00:44:44,590
And Alan came to me one day and said, look, I'm getting all these bloods and I know how to handle them.

410
00:44:44,590 --> 00:44:50,680
And because I'm not allowed to because I have to send them all to Sheila Calendar and I perfectly well can we

411
00:44:50,680 --> 00:44:58,120
have an arrangement that they're admitted under you and you're looking after them and I'll tell you what to do.

412
00:44:58,120 --> 00:45:07,110
So we had that for four or five years. So my general medicine was incredibly generous in the old Radcliffe because I had our own and Pauline was.

413
00:45:07,110 --> 00:45:11,460
Patients as well, and the lymphomas unit. Yes.

414
00:45:11,460 --> 00:45:18,780
So I suppose somebody would say now you must have been very dangerous because it was so widely spread, but I don't know about that.

415
00:45:18,780 --> 00:45:29,790
If you if you had a small team of people and if there wasn't if somebody come in with septicaemia or meningitis,

416
00:45:29,790 --> 00:45:33,780
Joe, the bug space would come on the wall, run with you, you know.

417
00:45:33,780 --> 00:45:38,910
So in a sense, how did you keep up to date? And I was there at National Regional Society.

418
00:45:38,910 --> 00:45:47,310
Yes, it was. Yes. Yes, there was the renal association, which I was officer of for a long time, used to meet every two months.

419
00:45:47,310 --> 00:45:53,250
Really? Yes. And that would move around the country?

420
00:45:53,250 --> 00:45:58,650
No, it was in London largely. But people came down from Newcastle and places David Carr and people like that.

421
00:45:58,650 --> 00:46:03,930
So this was sort of the beginning of nephrology, really in the 60s and 70s.

422
00:46:03,930 --> 00:46:08,400
A lot of young people. No, that's right. You did keep up, I suppose.

423
00:46:08,400 --> 00:46:11,380
What about journals? I read. What did I read?

424
00:46:11,380 --> 00:46:26,490
Well, I read The Lancet, The New England Journal, a kidney thing called Nephron, which you won't have read watch and the quarterly journal, I suppose.

425
00:46:26,490 --> 00:46:37,230
But I always thought The New England Journal was really the thing you had to read and your suspicions were, oh, no, that's interesting.

426
00:46:37,230 --> 00:46:42,680
There were. He wasn't attending.

427
00:46:42,680 --> 00:46:52,520
Well, I think he's great virtue was to give people their ahead and encourage them and not act as the Lord high panjandrums,

428
00:46:52,520 --> 00:47:01,010
but assume that his colleagues knew as much medicine as he did, would listen to the House officer's opinion,

429
00:47:01,010 --> 00:47:05,180
would certainly listen to one's opinion or even ask one's opinion.

430
00:47:05,180 --> 00:47:12,650
You I admired him enormously for his quiet knowledge when you asked him to see somebody that trouble

431
00:47:12,650 --> 00:47:20,270
he took and the care with which he and the way he talked to people patients was it was an example,

432
00:47:20,270 --> 00:47:27,410
of course, I had actually, as you know, because I also had to cover his life for the Dictionary of National Biography.

433
00:47:27,410 --> 00:47:35,660
And when I look back at his origins, it is interesting the reasons that he came to Oxford, which he said which choice?

434
00:47:35,660 --> 00:47:42,170
Right. He came to Oxford in order to escape the trends that were going on in America, which he thought were deleterious,

435
00:47:42,170 --> 00:47:51,470
namely increasing specialisation and increasing administration and increasing emphasis on research to the detriment of clinical medicine.

436
00:47:51,470 --> 00:47:55,460
So that he came for those views. And of course, he held them and and pervade them.

437
00:47:55,460 --> 00:48:06,680
So I think he was quite different leading figure from Pickering and I think probably did slightly less but than George,

438
00:48:06,680 --> 00:48:12,710
because I think George was just he was a man who was determined that Oxford was going to be on the map.

439
00:48:12,710 --> 00:48:25,220
And, you know, anything I didn't like about, about and was the feeling that the junior very American, the junior staff could do that.

440
00:48:25,220 --> 00:48:29,370
They couldn't come for advice if it was wanted, but otherwise leave it to them.

441
00:48:29,370 --> 00:48:40,010
Um, and the other was that, you know, the way he ran Badenoch and Truelove and other sorts of people, was that this rotating on the walls or.

442
00:48:40,010 --> 00:48:46,040
Ralph, I did better any any anybody in his department could do it.

443
00:48:46,040 --> 00:48:55,640
And I think there were a few no names, no pack drill of people who took on consultant work in the admin business time,

444
00:48:55,640 --> 00:49:00,170
who were inexperienced clinicians who read on the backs of their senior registrars.

445
00:49:00,170 --> 00:49:03,860
Frankly, I you probably know whom I mean. I've got to guess.

446
00:49:03,860 --> 00:49:09,110
Yes. Yes. And the Ontake physicians group that was useful.

447
00:49:09,110 --> 00:49:13,820
I did. It was a mafia, I suppose. I mean, where was it?

448
00:49:13,820 --> 00:49:18,050
Once a month we mentioned something to discuss.

449
00:49:18,050 --> 00:49:25,940
Well, it did bring us all together. And in a way that I I sensed that before I came.

450
00:49:25,940 --> 00:49:35,660
And you were there before that there was some kind of enmity between or not rivalry between the academic departments and the NHS ones,

451
00:49:35,660 --> 00:49:43,100
which really was completely when we did really treat the whole thing as one what George Becquerels creation was.

452
00:49:43,100 --> 00:49:52,160
Yes. So that you don't take positions included always poor and always Tony Mitchell or somebody erm George apartment.

453
00:49:52,160 --> 00:49:56,570
And of course the agenda was an interesting one because what to do about geriatrics remember.

454
00:49:56,570 --> 00:50:07,560
Yes. If you know all geriatricians really physicians, are we going to allow them to do amazing back around the text.

455
00:50:07,560 --> 00:50:12,680
I know, absolutely. And what was your feeling about surgery and the Oxford hospitals.

456
00:50:12,680 --> 00:50:17,510
Oh well no, I didn't think it was as good as medicine, frankly.

457
00:50:17,510 --> 00:50:26,900
I think when you know that the NDIS was well, it wasn't good.

458
00:50:26,900 --> 00:50:32,690
I think our funding was terrific. But Intesa morale was a funny go.

459
00:50:32,690 --> 00:50:38,870
But on the whole, that wasn't good. And then I think there were other people, Tim, too.

460
00:50:38,870 --> 00:50:48,200
It was marvellous. But I thought the surgical side, well, it needed the injection injection of Joe Smith and Malcolm.

461
00:50:48,200 --> 00:50:53,910
They did a good job. And then Peter Morris was the changes were, well, tremendously.

462
00:50:53,910 --> 00:51:04,100
Of course. I remember when that chair was up there was there I sat on the advisory committee of description for the Nuffield

463
00:51:04,100 --> 00:51:10,370
professor of surgery because it was going to be transplantation and they actually offered the job first,

464
00:51:10,370 --> 00:51:16,510
a chap called Meiburg from America, from us, from South Africa,

465
00:51:16,510 --> 00:51:22,250
who had been a Rhodes Scholar at Oxford before and a very formidable transplant figure.

466
00:51:22,250 --> 00:51:30,650
And Meiburg insisted that he had to have a primate lab to do his research and he needed monkeys and that the rest of it.

467
00:51:30,650 --> 00:51:35,780
And so the university said, we're not going to do that. Right. And so in a sense, he doesn't know it.

468
00:51:35,780 --> 00:51:39,590
Peter Morici was a second choice, but.

469
00:51:39,590 --> 00:51:43,400
They are in the desert, Larry Moffett's. Yes, exactly.

470
00:51:43,400 --> 00:51:50,240
I mean, gosh, what a what a what an injection. And here would have affected you through getting transplantation.

471
00:51:50,240 --> 00:51:57,200
Oh, yes. And that's actually in the light of what you hear about medicine, about looking at central performance.

472
00:51:57,200 --> 00:52:02,480
I remember Peter coming when there's Oliver with me a little bit in the background,

473
00:52:02,480 --> 00:52:09,620
had established one of the best dialysis units in the country, I think, in hospital.

474
00:52:09,620 --> 00:52:18,380
So home, home, dialysis, peritoneal dialysis, three days a week on the machine, whereas with an enormous number of people,

475
00:52:18,380 --> 00:52:24,800
beds occupied eight hours by somebody, anaesthetised by somebody and everybody surviving.

476
00:52:24,800 --> 00:52:32,750
But because we hadn't transplantation in those early years, sometimes there was a need to offload.

477
00:52:32,750 --> 00:52:38,890
Desmond's view was we would offload people who really were not doing well on dialysis.

478
00:52:38,890 --> 00:52:46,640
That actually meant people who were irresponsible and, you know, at things they shouldn't get in, came in potassium was off the map and things.

479
00:52:46,640 --> 00:52:51,110
And the term came out amongst the patients that Dr. Ornish was going to offer as a punitive

480
00:52:51,110 --> 00:53:00,860
transplant because we sent them to Cambridge and to and to Bristol and then never came back.

481
00:53:00,860 --> 00:53:06,950
I don't know whether when you came from another place, it didn't sit well with other icons.

482
00:53:06,950 --> 00:53:10,160
You it wasn't doing all that well.

483
00:53:10,160 --> 00:53:15,950
But when Peter Morris arrived, there was a very strong view amongst the patients that were frightened of transplantation.

484
00:53:15,950 --> 00:53:20,600
We think it'll kill us. We're very happy with dialysis. Thank you, Desmond Oliver.

485
00:53:20,600 --> 00:53:25,190
Officers say if they had told me that my quality of life is going to be a lot better on a transplant,

486
00:53:25,190 --> 00:53:30,440
but we know of X and Y and Z who went here and they're not here.

487
00:53:30,440 --> 00:53:36,200
So Peter entered into this field and said, well, look, I can't afford to lose anybody.

488
00:53:36,200 --> 00:53:45,630
So I'm only going to transplant people with a young fit with an absolutely perfect tissue match.

489
00:53:45,630 --> 00:53:50,900
And in context of you, I don't remember whether you were involved.

490
00:53:50,900 --> 00:54:01,550
A girl who late 20s, diabetes, kidney, went right off the map in the course of an ill advised pregnancy,

491
00:54:01,550 --> 00:54:13,170
ended up in the post natal period requiring dialysis, not given dialysis by Peter Bye Bye Des Oliver,

492
00:54:13,170 --> 00:54:18,500
on grounds that diabetics didn't survive the scandal and refuse to transplantation

493
00:54:18,500 --> 00:54:25,160
by Morris for the same reason and given sedation and died because that is.

494
00:54:25,160 --> 00:54:31,880
When did you change your view about diabetes, diabetics, or was that from the 2000s?

495
00:54:31,880 --> 00:54:38,630
I am sorry to say I had the view that the risks and diabetes were ever overrated.

496
00:54:38,630 --> 00:54:43,910
I spent I have battled against both, however, and but I got nowhere.

497
00:54:43,910 --> 00:54:50,000
And until, as you say, Victor Parsons, it king started showing that he could be done.

498
00:54:50,000 --> 00:54:55,700
Um, no. I always thought that was a there was a certain rigidity about both those chips,

499
00:54:55,700 --> 00:55:01,700
whether it was cause of Australia, New Zealand and not Oxbridge upbringing.

500
00:55:01,700 --> 00:55:06,830
But there was a there was a very black and white view about how you manage people with Alzheimer's.

501
00:55:06,830 --> 00:55:11,420
And what about the hypertension? Because a lot of these people must have been hypertensive.

502
00:55:11,420 --> 00:55:17,030
Oh, yes. And how easy it to look after was that? Oh, very difficult.

503
00:55:17,030 --> 00:55:23,660
I mean, the renal hypertension was really a very big problem.

504
00:55:23,660 --> 00:55:29,570
And that's one of the things I got really quite interested in hypertension and chronic renal failure.

505
00:55:29,570 --> 00:55:39,170
Um, and sometimes you did abide by nephrectomy to cure hypertension occasionally.

506
00:55:39,170 --> 00:55:44,270
And then you would then you then you could control blood pressure better when

507
00:55:44,270 --> 00:55:49,010
the kidneys were out and I was wanting to know what the [INAUDIBLE] it was, whether it was rated and then never still don't know.

508
00:55:49,010 --> 00:55:53,990
I don't think so. No. There was an enormous field for hypertension.

509
00:55:53,990 --> 00:56:01,070
And of course, I ran when George left, there was a hypertension clinic that was run by him in New Orleans.

510
00:56:01,070 --> 00:56:10,700
And then me and I then put aside it a bit and then really for the rest of my time, I had a hypertension clinic twice at once a week as well.

511
00:56:10,700 --> 00:56:14,810
What was the evolution of drugs to treat hypertension in your time?

512
00:56:14,810 --> 00:56:18,500
I don't know. What you see is the mileposts. Oh, well.

513
00:56:18,500 --> 00:56:23,810
Started, didn't we, with with adding and things like this.

514
00:56:23,810 --> 00:56:31,220
I think the advent of the. Beta blockers?

515
00:56:31,220 --> 00:56:37,190
Well, beta blockers, yes, missile dopa, yes, not really very effective.

516
00:56:37,190 --> 00:56:47,640
And until you can get the converting enzyme inhibitors right end, it was very difficult to control some people that you really simply couldn't do it.

517
00:56:47,640 --> 00:56:56,930
And but the advent of of Captopril and those drugs have been enormous difference.

518
00:56:56,930 --> 00:57:00,590
And with the receptor blockers a real advance, or is that really the same?

519
00:57:00,590 --> 00:57:08,730
No, same thing. I think very little difference, funnily enough, because of the of the hypertension, like hypertension interest.

520
00:57:08,730 --> 00:57:17,270
So I did serve on the Cardiovascular Advisory Committee for Squibb and Merck in America, which was quite fun, basically,

521
00:57:17,270 --> 00:57:26,150
because I remember being invited to Squibb saying we have we about to develop a drug which would inhibit the angiotensin voting enzyme, we think.

522
00:57:26,150 --> 00:57:29,030
Do you think there's any future in it?

523
00:57:29,030 --> 00:57:38,020
And remember that the two British representatives, Bob Robertson from Glasgow and me and and actually Barry Blumberg.

524
00:57:38,020 --> 00:57:42,500
Mm. Yeah. I was on that committee and we said, go ahead and do it.

525
00:57:42,500 --> 00:57:49,460
And there and we were of course persona grassa with, with the pharmaceutical industry there, which you know,

526
00:57:49,460 --> 00:57:54,410
nothing was too much until about five years later they invited me along to say that

527
00:57:54,410 --> 00:58:01,640
they thought they had a new agent that would inhibit the synthesis of cholesterol.

528
00:58:01,640 --> 00:58:05,390
What did we think about those meetings of standing up to a man?

529
00:58:05,390 --> 00:58:12,290
All six of us said don't. It's an essential part of cell membranes.

530
00:58:12,290 --> 00:58:16,520
We've had one that made dogs go blind. If I were you, I wouldn't do it.

531
00:58:16,520 --> 00:58:26,870
But it wasn't long that I wasn't getting any more. I started to focus on the renal failure, but as these people live, it became quieter.

532
00:58:26,870 --> 00:58:39,260
Oh, yes, I did. Yes, Barry Jim Barry McGrath did an entire day filled with me on lipids and, um, and hypertension in the stage.

533
00:58:39,260 --> 00:58:45,440
Yeah, I was involved in that. So, no, I knew about Jim and Barry would talk to him.

534
00:58:45,440 --> 00:58:50,870
And Barry probably don't remember Barry McGrath, who I had a series of Australian detailers with.

535
00:58:50,870 --> 00:58:56,780
Barry was now a professor of medicine at Flinders.

536
00:58:56,780 --> 00:59:00,890
Was was doing that. Yeah, we didn't.

537
00:59:00,890 --> 00:59:05,570
But we didn't have statins that we had an absolute no no John.

538
00:59:05,570 --> 00:59:09,740
Interaction or the new college. How much to that bulk up?

539
00:59:09,740 --> 00:59:21,110
Well, I of course, nuclear should be where I've been undergraduates. And I have to say that one of the reasons I want to call whatever it is the

540
00:59:21,110 --> 00:59:24,470
May got interested in my readership is carried a fellowship at new college,

541
00:59:24,470 --> 00:59:35,720
and that seemed to me a great privilege. And then I did find that when I was director of clinical studies or before I was there,

542
00:59:35,720 --> 00:59:44,990
when I was read studies first we were beginning to get people to come from Cambridge and George Picaridin.

543
00:59:44,990 --> 00:59:48,830
And I went over once a year in December.

544
00:59:48,830 --> 00:59:53,780
Usually, I think, well, that was not December at the end of that Michaelmas term to Cambridge,

545
00:59:53,780 --> 00:59:59,090
to the Cambridge University Medical Society to tell them to come to Oxford.

546
00:59:59,090 --> 01:00:07,820
And I then liaised with all the clinical preclinical tutors in Cambridge, including your brother in law.

547
01:00:07,820 --> 01:00:11,240
And I used to be invited to dine with one college after another.

548
01:00:11,240 --> 01:00:12,650
And it was very nice.

549
01:00:12,650 --> 01:00:22,640
And we started persuading Cambridge people and with Arthur Cork as the warden of New College, we started trying to pinch the best ones right there.

550
01:00:22,640 --> 01:00:29,750
And I think, in fact, we did become the most popular college for Cambridge graduates to come to.

551
01:00:29,750 --> 01:00:34,250
Yes. Whether that's still so, I think Peggy Fritz is still doing that now.

552
01:00:34,250 --> 01:00:40,850
I think they do pretty well. Sir, when you went Denver, how long would you have to talk at the medical centre?

553
01:00:40,850 --> 01:00:47,700
Oh, I'd have to give a lecture. Lecture on the kidney lecture on why come to Oxford.

554
01:00:47,700 --> 01:00:52,250
Gosh. And now. Yes. Followed by dinner. No. And then I would drive home.

555
01:00:52,250 --> 01:00:55,820
Yeah. I mean a long, long time. Oh yes. But it wasn't.

556
01:00:55,820 --> 01:01:03,560
Yes. No there was an aha. Sorry. There was an hour between Theo Chalmers who was trying to persuade them to stay in Cambridge,

557
01:01:03,560 --> 01:01:09,140
has really tried to persuade them to come in also and an assorted London did occasionally.

558
01:01:09,140 --> 01:01:16,220
But the London boys thought they were so impregnable they didn't bother to come to their own detriment.

559
01:01:16,220 --> 01:01:19,460
What were the things you really said for Oxford?

560
01:01:19,460 --> 01:01:29,090
I said it was small, that it was personal, that you would have on the grounds that you would be involved, that you would be your opinion would be one.

561
01:01:29,090 --> 01:01:35,610
And to be honest, tonight, with all the things I went to and said, you know, Cambridge hasn't yet,

562
01:01:35,610 --> 01:01:43,240
we've just started that school and they can't keep anybody out and they have to farm them all out all over the place.

563
01:01:43,240 --> 01:01:47,110
We don't do that in Oxford, I said, because we're small enough.

564
01:01:47,110 --> 01:01:53,140
And that means you're going to get tutored by people like Wetherall or Maurice or whatever it might be.

565
01:01:53,140 --> 01:02:02,180
And so I thought it was very important, actually. What did your family and friends of the emergency service was in London?

566
01:02:02,180 --> 01:02:06,250
Well, if you want to put up a prime example of that, it was awful.

567
01:02:06,250 --> 01:02:14,110
The emergency bed service prevented well, it stopped the students being rather than that much run of the Mill Med.

568
01:02:14,110 --> 01:02:18,460
I got a very good example of that straight up your street, because I don't think you were that.

569
01:02:18,460 --> 01:02:29,170
But I once admitted to my cardio informed as as deputy premier at the middle at the Middlesex was admitted into evidence,

570
01:02:29,170 --> 01:02:34,000
was a 23 year old with a myocardial infarction.

571
01:02:34,000 --> 01:02:41,260
And I got a phone call from Bedford, which remember Ledingham, you put a myocardial infarction patient in my bed.

572
01:02:41,260 --> 01:02:49,300
I don't have patients like you have till tomorrow to move in.

573
01:02:49,300 --> 01:02:58,000
And I moved him to the academic unit with Hepcat Quick, who I think John Dickens was preferred to take him on.

574
01:02:58,000 --> 01:03:00,140
So there was this view that, you know,

575
01:03:00,140 --> 01:03:07,940
eradicate congenital heart disease or murmurs some other things that I'm not interested in and in this case, make heart disease.

576
01:03:07,940 --> 01:03:13,600
I have a cardiologist. I was here, D'Ovidio hyperlipidaemia.

577
01:03:13,600 --> 01:03:17,740
I had an abnormal coronary arteries, right? Yes.

578
01:03:17,740 --> 01:03:27,310
Yes. No. So and of course, I knew about the obvious because Angus Robson and I, their, uh, regulated admissions show.

579
01:03:27,310 --> 01:03:30,140
So if it sounded interesting, you said, yes, we've gone a bed.

580
01:03:30,140 --> 01:03:37,150
And if it didn't sound interesting, I said terribly sorry was so incredible, that would be done with Dinosaurus.

581
01:03:37,150 --> 01:03:43,210
And what would you like to talk about? We haven't I haven't danced. Oh, I don't know really.

582
01:03:43,210 --> 01:03:48,490
I think when have we I talked to Peggy Frith about George Pickering and the A plus B,

583
01:03:48,490 --> 01:03:56,710
but I think I would like to say that that my abiding memory of the development of

584
01:03:56,710 --> 01:04:04,480
Oxford from 66 to was the unification of everybody and George Pickering's vision that

585
01:04:04,480 --> 01:04:10,510
there was no difference between the academics and the and the and that with all the

586
01:04:10,510 --> 01:04:14,860
research that we do do some teaching and that we'd be paid by different paymasters,

587
01:04:14,860 --> 01:04:18,370
but mostly we'd be a team. Yes.

588
01:04:18,370 --> 01:04:21,940
And I think that's exactly what happened. Yes.

589
01:04:21,940 --> 01:04:30,490
And of course, he has ascended in a most extraordinary way and wouldn't have if George hadn't got asked to do that.

590
01:04:30,490 --> 01:04:38,980
Would the reputation have been coming? Would we have got whether or we have got Morris, we have got whoever it was.

591
01:04:38,980 --> 01:04:44,530
I forgot. Alec Turnbull, Michael Gallagher, a series of extraordinary stars.

592
01:04:44,530 --> 01:04:56,020
Is this lifted the place? Yes. How important do you think it is to have a clinical Regitze and keep in the hospital?

593
01:04:56,020 --> 01:05:01,480
Well, I think we have an example of of how difficult that was.

594
01:05:01,480 --> 01:05:08,260
And that really was. I think that when David Weatherall became Regius,

595
01:05:08,260 --> 01:05:14,680
he didn't want to really he wanted to stay in clinical medicine and he didn't want the administration

596
01:05:14,680 --> 01:05:19,420
side and the interaction between the university and raising funds and all the rest of it.

597
01:05:19,420 --> 01:05:27,040
He wants to be on the wards or in the lab. And it was for that reluctance, I think, he took to the Regents professorship.

598
01:05:27,040 --> 01:05:30,460
And quite honestly, I don't think he enjoyed it and I'm not sure he did it terribly well.

599
01:05:30,460 --> 01:05:35,740
He wasn't a politician. And you need a bit of politics for the region's job.

600
01:05:35,740 --> 01:05:43,510
Equally, I think when David went to be Regius, we had John Beller's and I feel that was my view, a disaster.

601
01:05:43,510 --> 01:05:52,060
It was young. Mel wasn't interested in either teaching or and nor did he know any clinical medicine and he was in the wrong job.

602
01:05:52,060 --> 01:05:58,510
He's now absolutely in the right job. Yeah, he's a supreme medical politician and he's in the right job.

603
01:05:58,510 --> 01:06:05,800
So I think the Regius does need to be a medical politician and I think the clinical side can be looked after by the Nuffield profession is frankly,

604
01:06:05,800 --> 01:06:11,710
what I haven't asked is what about the administrators, your interactions with the administrators as well?

605
01:06:11,710 --> 01:06:18,730
John Barrow with John Barrow. We go back to Robyn Engineering.

606
01:06:18,730 --> 01:06:23,380
They were good, Robyn. Engineering was a bit of a lawyer, but, you know, good in a few.

607
01:06:23,380 --> 01:06:28,910
And they were there. No, it was the evolution of Imit administer.

608
01:06:28,910 --> 01:06:35,810
What can I do to help you to I'm a chief executive officer. How can I spike your guns?

609
01:06:35,810 --> 01:06:37,970
When do you think that occurred?

610
01:06:37,970 --> 01:06:45,140
Well, I think funnily enough, not till after we had gone really in any big way, because when I left and when you left,

611
01:06:45,140 --> 01:06:51,770
Nigel Crisp, who's running the place later, Lord Crisp, now at the House of Lords, running the whole of the NHS.

612
01:06:51,770 --> 01:07:01,640
And I remember Nigel Crisp coming to talk to me about some problem about what actually was on Take the Money.

613
01:07:01,640 --> 01:07:05,690
People had said we don't want physicians or surgeons in any way.

614
01:07:05,690 --> 01:07:09,200
We can do it all and we will send them what they like.

615
01:07:09,200 --> 01:07:16,340
But we don't want Hockaday already coming. And I said, well, I think this is thoroughly dangerous.

616
01:07:16,340 --> 01:07:19,850
But Chris did come and ask what we thought we should do.

617
01:07:19,850 --> 01:07:28,790
And we did run a programme of trying it to see what was wrong with it. But no and more importantly, Chris said, look, you're a busy man.

618
01:07:28,790 --> 01:07:36,410
Can I come and see you when it's convenient? And I have a daughter now who tells me the chief executive officer summons

619
01:07:36,410 --> 01:07:41,420
her and tells her what she has to do is a completely different relationship.

620
01:07:41,420 --> 01:07:45,530
And Chris had a relationship of serving still in 1995.

621
01:07:45,530 --> 01:07:49,130
Yes. And I think that's gone now. I don't know that.

622
01:07:49,130 --> 01:07:55,730
And what about the public officers of health or whatever they were called?

623
01:07:55,730 --> 01:07:59,900
Well, I gather I don't know. But I tell you, the Rosemary Roug of Davis,

624
01:07:59,900 --> 01:08:08,180
people in the regional health authority enormously helpful and promoting women in medicine and really trying to help.

625
01:08:08,180 --> 01:08:15,290
No antagonism. Just all of us working very well together. I think it got really good.

626
01:08:15,290 --> 01:08:19,650
It got because I never quite understood Alex's role.

627
01:08:19,650 --> 01:08:24,780
Now, how would you define the job description? Well, I don't know either.

628
01:08:24,780 --> 01:08:30,110
And there were theorists like Muir Grey who thought, you know, we'll tell you how to run the health service.

629
01:08:30,110 --> 01:08:34,580
Dare I say it, without any real knowledge of what's going on.

630
01:08:34,580 --> 01:08:44,570
So I think one of the things that happened is that the people more and more divorced, divorced from the frontline people instead of sitting down.

631
01:08:44,570 --> 01:08:53,960
And you and I used to be invited to strategic planning committees or Coquille or how do we involve doctors in the administration.

632
01:08:53,960 --> 01:09:01,640
And it also kind of emerged. And then I think it became a them and us, because for two years you would have been on that committee.

633
01:09:01,640 --> 01:09:08,080
Yes. And the place. Yes. Representing the sector in medicine. Yes, I was well, I was chairman of staff council.

634
01:09:08,080 --> 01:09:15,560
Yes, I was. And we had a chair. But that was when McKinsey knew how to run the hospital as a maxford.

635
01:09:15,560 --> 01:09:20,720
Yes. Whose son is now Regius at Cambridge. He said he thought Maxwell.

636
01:09:20,720 --> 01:09:28,130
Yes. Oh, yes. Yes, it is also went through the regional unit here isn't any of that.

637
01:09:28,130 --> 01:09:36,410
Yeah, no. They shadowed Gwen Williams as a senior registrar for a year or two.

638
01:09:36,410 --> 01:09:42,290
And then we had this executive committee, which they said, well, the only way to run the hospital is a small committee.

639
01:09:42,290 --> 01:09:46,170
Any committee over eight or ten can't decide anything.

640
01:09:46,170 --> 01:09:51,440
You've got the Medical Advisory Council of 50. That's disastrous. Everybody planning their own thing.

641
01:09:51,440 --> 01:09:55,630
You want to have people like members of parliament representing other groups.

642
01:09:55,630 --> 01:10:02,600
So if you're representing medicine, for instance, and you're representing endocrinology or cardiology or anything else,

643
01:10:02,600 --> 01:10:06,590
and you want and we've got to decide which one you're going to balance.

644
01:10:06,590 --> 01:10:21,080
And you had surgery and medicine and labs and the chairman and you had then the treasurer and John Boehner and the president and Tara and the matron.

645
01:10:21,080 --> 01:10:27,570
And, you know, of course, there's the days when Tyler would find that there was a world class that was difficult.

646
01:10:27,570 --> 01:10:34,070
He would say, get me the minister when teaching hospitals had privileged dollar here.

647
01:10:34,070 --> 01:10:38,990
We've got a problem. You know, straight to the minister is amazing.

648
01:10:38,990 --> 01:10:45,950
Yes. Oh, that thing was they had you for two years when you were just beginning to know the ropes.

649
01:10:45,950 --> 01:10:47,820
Well, that's true.

650
01:10:47,820 --> 01:10:58,620
One of the things that was interesting that McKinsey had was that nobody should serve on the executive committee over the age of 45 right now,

651
01:10:58,620 --> 01:11:05,270
that you must make decisions which you live with is the view they had.

652
01:11:05,270 --> 01:11:10,400
And if you made decisions when you were under and you don't have to live with them when you have no stuck so high.

653
01:11:10,400 --> 01:11:16,580
And so that's why you have chairman and staff counsel the first to, if you dislike me, hardly out of the egg.

654
01:11:16,580 --> 01:11:24,530
I mean, I know that you were short trousers and tried to handle people like Stalwartly or George Pickering,

655
01:11:24,530 --> 01:11:28,650
for instance, as supposedly Jablin Stopcock.

656
01:11:28,650 --> 01:11:33,180
When you were in their 40s and a miserable NHS physician.

657
01:11:33,180 --> 01:11:38,380
Yeah, okay, John. Well, that's a wonderful. Well, thank you very much.

658
01:11:38,380 --> 01:11:42,160
I bet you think. You hope. I hope. Yes. Yeah.

659
01:11:42,160 --> 01:11:47,186
OK, all the best. And thank you for, you know, organising it because you.