1
00:00:00,090 --> 00:00:04,390
Press this and it will start to record and what, the twenty third debate.

2
00:00:04,390 --> 00:00:08,790
Yes. And it's Professor John Natyam and Gracie Fitzherbert Jones and Peggy Fritz.

3
00:00:08,790 --> 00:00:18,850
And we are putting Norm Gardens in Oxford. So I stick with my family is going to start it becomes a reality.

4
00:00:18,850 --> 00:00:33,660
We will turn it off. We have got five questions that I noticed, like drastic about the growth of medical school,

5
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the fact that they also medical school is currently very successful. One of the elements that the old timers DCX.

6
00:00:39,220 --> 00:00:43,600
And then what about women in medicine? And then what makes a good doctor?

7
00:00:43,600 --> 00:00:51,030
Oh, that's right. We may or may not have be warning about it, Benevento.

8
00:00:51,030 --> 00:00:55,800
Absolutely. But over several decades, you saw the medical school at Oxford grow.

9
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Yes. And we wondered if you could tell us something about the main drivers for this growth, because it started off very small and grew a huge debate.

10
00:01:04,930 --> 00:01:09,580
Floristry from very, very small origins.

11
00:01:09,580 --> 00:01:18,180
All right. Because I came to Oxford October of 1966.

12
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I think I should do the checking. The total repeat for most of us then was about.

13
00:01:24,850 --> 00:01:38,210
Thirty three years, not happiness. And I cast my mind back to when I left in 1954 to go to London with the concept with great respect.

14
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Tried to stay. It was in my head. On the whole, you didn't come here.

15
00:01:43,220 --> 00:01:50,230
I missed you. A bit of your youth married someone that want to stay in Oxford or frankly,

16
00:01:50,230 --> 00:01:54,900
even if you could get into a London medical school that she wanted Gafoor ask about.

17
00:01:54,900 --> 00:01:59,860
But this was very much not what you did and your future advanced.

18
00:01:59,860 --> 00:02:11,140
You've got to do it. And I'd say it was interesting to me that when I came, it was still supposedly something is introduced.

19
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But I think my first medical fir included Margaret Zeray.

20
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Oh, but is seen with black. Just let me see if I could get them all but there full of Basil Shipstead.

21
00:02:25,650 --> 00:02:31,500
They were tenanted, actually. And the housetop, pretty talented. Thank you.

22
00:02:31,500 --> 00:02:38,820
Who was it that ran in the end? The pregnancy, hypertensive squishier presented here.

23
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His bedroom was my house position took root yet and I was shaken up when I got here

24
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that I thought perhaps I'd come to Sleepy or Augusta from that give our number.

25
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And the absolute reverse was the case. I remember the first day I came on, take Brian Crouch, who's my senior raised.

26
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Right. I said it's customary here to do a take around. The patients who come in.

27
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Never heard of. Nothing like that ever happened. None consulted.

28
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Never appeared to see people who had been hit and students were put on the more of an.

29
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And after. We did it. He told me to take one.

30
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Was it four? And could I please. He wanted particular advice or maybe would never think I'd been doing research for two years.

31
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Capable, measured. I realised that I wasn't going to be advising people to advise on liver failure.

32
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I remember saying that I'm in the boss and I'll be half an hour. Give me a little time to do some work for me.

33
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So they won't consider where the New and the Great came and there were the grand rounds.

34
00:03:51,800 --> 00:03:56,120
I suddenly realised when I arrived that when you went on the ground runs, they went to there.

35
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Were you any good? So you were a target. So there you were, the new physician.

36
00:04:00,980 --> 00:04:08,780
Your opinion was often employed by Tony Mitchell and George Pickering. And they weren't sure they would be your calibre within a month or two.

37
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They all tell a joke. I think you would consider it.

38
00:04:10,610 --> 00:04:17,780
Now, Concettina were Wednesday afternoons, I think, which was an hour of telling people about your research.

39
00:04:17,780 --> 00:04:23,570
And they took place every week and they were dead. But I felt like this is an intellectual hothouse.

40
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It was quite shaking, a little section of Western society. Why not?

41
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In contrast it on totally a contrast to Lobban, which is a sleepy old place.

42
00:04:33,560 --> 00:04:44,260
But coming back to the students was what you wanted to know was I could quite see why they ought to come and.

43
00:04:44,260 --> 00:04:49,600
George Pickering I talk to you about before. I think he was the architect of it all.

44
00:04:49,600 --> 00:04:59,620
I'm firmly of that view because he felt passionately about putting those clinical school on the map.

45
00:04:59,620 --> 00:05:09,460
And the first thing he did, which is perhaps almost relevant to, was he looked at these new physicians and surgeons.

46
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Six of us were having a dinner celebrating in a week's time of Malcolm Gough Smith, Robert Duffy criticising me and Derek Carr.

47
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And we all arrived. And, of course, we were appointed for nine sessions by the NHS in two sessions.

48
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We could do what we liked. And the assumption was that we'd do private practise and GWP took a shorter dinner and said, look,

49
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I have a passion on this medical school that there should be no difference between NHS physicians and surgeons and the academic people.

50
00:05:56,770 --> 00:06:02,230
Thanks. Began to civilities as is raising. And John.

51
00:06:02,230 --> 00:06:05,530
No, thanks. And I'm wrong. I'll give you some more.

52
00:06:05,530 --> 00:06:08,290
No, it be lovely. Thanks.

53
00:06:08,290 --> 00:06:19,270
So Pickering was passionate about finding together the NHS staff and the university sophon that been a good deal of friction.

54
00:06:19,270 --> 00:06:25,420
If you look at it before, which I'm sure you know, I know what he said to me and to all the others.

55
00:06:25,420 --> 00:06:32,530
I don't want to this second half term. What he said was, look to John.

56
00:06:32,530 --> 00:06:39,220
He said, you can do a private practise if you like, and I showed you a good witch, but I have an offer to make to you.

57
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If you do not do private practise, I will offer you, Campbell, to research sessions.

58
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I will make you a lecturer in medicine in the university.

59
00:06:49,790 --> 00:06:58,030
Could you sing? I'd like to be. And I will give you laboratory space from five hundred pounds a year expenses to start researching.

60
00:06:58,030 --> 00:07:02,020
And all six of us and all five of us give Robert Duffy was professional.

61
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Any. All five of us had what was then called A plus B appointment.

62
00:07:07,150 --> 00:07:11,380
So that's just an it didn't. It caused us to decided.

63
00:07:11,380 --> 00:07:19,250
And Derek and I were impressed me until I think Derek was forever and the other two of us translated into investee anyway.

64
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The surgeons, of course, with much more money to make. Oh, you dog much more quickly.

65
00:07:24,790 --> 00:07:32,410
Yes. That's fascinating because it's always bringing together. I've been talking with John Chambers and Owsla.

66
00:07:32,410 --> 00:07:36,520
Yeah. And that was a way of bringing together Flexner with the academic side of things.

67
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And I was that with the ethical presence and the ability to.

68
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Because if you had good people and ameliorate them, then they wouldn't want to say you, professor.

69
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So that was it. And we did.

70
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And we suddenly felt that it with a sort of sense of invigoration that we were there was Tony Mitchell is absolutely marvellous.

71
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First assistant to Pickering.

72
00:08:01,780 --> 00:08:09,850
And of course, Ralph Wright and various other people with whom and so on suddenly realised that this place actually could explode.

73
00:08:09,850 --> 00:08:15,270
And we all thought we were in an exploding group. I think, in fact, we were.

74
00:08:15,270 --> 00:08:20,590
And in terms of it and then get away, the reputation grew.

75
00:08:20,590 --> 00:08:27,190
I think the influx of a young that it that sounds arrogant, includes me, didn't do something.

76
00:08:27,190 --> 00:08:40,150
But again, Pickering started liaising with his old university, Cambridge, and started to say, well, why don't you come and jump in a bit?

77
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This had ended when I was who studies first, but whenever it was, I used to go.

78
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God, remember it every winter around Christmas.

79
00:08:52,820 --> 00:09:02,810
I drove to Cambridge and drove back and dined with them and went to Cambridge University Medical Society.

80
00:09:02,810 --> 00:09:10,710
Well, one or two London Deans. And here, Chalmers, you might know in Middlesex who was running Cambridge at that time, too.

81
00:09:10,710 --> 00:09:17,650
In fact, the new Cambridge School. And tell me why they should come here.

82
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And I did that for five years. I think they came in flats.

83
00:09:21,530 --> 00:09:27,560
Of course, I can remember at the height of it all. When you could.

84
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I'm sure I'm not wrong in saying that you could you turn down 50 percent of the people who wanted to come here.

85
00:09:39,290 --> 00:09:43,940
You looked I mean, Cambridge flooded, really flooded.

86
00:09:43,940 --> 00:09:52,970
Oxford, flooded London medical schools, Andrews, particularly in Scotland.

87
00:09:52,970 --> 00:09:56,360
Those who had an integrated B or C could come.

88
00:09:56,360 --> 00:10:09,180
And you sat in a settlement committee and suddenly realised that you were taking top class people and turning down one and two.

89
00:10:09,180 --> 00:10:13,220
And you were one of them. I think it was a refugee Camp David.

90
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What do you want of the anti refugees? I think became a flood, actually.

91
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And he and I could remember the regions of Cambridge.

92
00:10:23,500 --> 00:10:28,610
And Theo Chalmers is that Keith Peters and me are charming. You invited me here.

93
00:10:28,610 --> 00:10:34,150
I say they were fed up with the black orthodoxy of the past, all their best graduates.

94
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They're the only ones that stayed with them were the ones who couldn't get a visa.

95
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That was that's actually true in. And so it was Pickering who put the kettle on.

96
00:10:48,310 --> 00:10:52,440
It was Pickering who started it as Pickering who said, you got an opportunity.

97
00:10:52,440 --> 00:10:58,580
And Pickering who said, I want to NHS consultant's to do research and teach as much as the university.

98
00:10:58,580 --> 00:11:01,640
And I want the university to do as much teaching as pinnacle work.

99
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And I don't want it to be I don't want this medical school quite different from anywhere else.

100
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He achieved it in my view, and he was supported by Paul Beeston very much.

101
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But I do think and people attribute attributes of victory to Richard.

102
00:11:19,810 --> 00:11:24,020
I wouldn't. I think it's all it all happened before he came.

103
00:11:24,020 --> 00:11:27,290
And what was the role of Nuffield spending faction? Because that was.

104
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Must have been an extraordinary moment when Nuffield puts a lot of money in to people, in particular the professors.

105
00:11:34,490 --> 00:11:39,280
You mean the nineteenth? Was it forty six or Newton that are the creation of.

106
00:11:39,280 --> 00:11:44,340
That's something I don't know terribly much about. I'm an idiot. I know the legends and I'm sure you do.

107
00:11:44,340 --> 00:11:51,560
No you didn't. Professor of Anaesthetics. Then we, we had the gas man and all.

108
00:11:51,560 --> 00:11:58,190
And yes, there's a there's a big history which I'm sure you can get hold of of of the

109
00:11:58,190 --> 00:12:02,670
argument the university had it didn't want to it didn't want a clinical score.

110
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And as it ran it itself, it didn't want any NHS input.

111
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And if it if if we're going to have a university medical school within all the appointees must be university.

112
00:12:12,370 --> 00:12:22,200
We can't have fifty x ray people from the NHS. Lots of arrogance from preclinical logic because they were very arrogant.

113
00:12:22,200 --> 00:12:31,160
I'm diverging a little bit because that's I mean, it seems to me the argument once it had taken off, people started flooding in.

114
00:12:31,160 --> 00:12:37,970
I mean, if I suppose the Advent Wetherall course made a huge difference in 1974 when Peter

115
00:12:37,970 --> 00:12:42,620
Morris a year later and put some dents because everybody wanted to come here,

116
00:12:42,620 --> 00:12:47,500
then I don't think David Weatherill would have come here as it was two years before.

117
00:12:47,500 --> 00:12:54,280
And I'm sure he wouldn't even ask him, but I think he wouldn't.

118
00:12:54,280 --> 00:13:03,680
So, you know, it's some it then took off and of course, because one had this extraordinary group of students.

119
00:13:03,680 --> 00:13:59,800
I mean, if you want, it goes I think when I was DCX, it was 50 a year.

120
00:13:59,800 --> 00:14:05,930
Thus ensuring that medical school remains small. Because the one thing that we all saw wasn't Pickering.

121
00:14:05,930 --> 00:14:11,370
So what if this place is good to survive as something really unique?

122
00:14:11,370 --> 00:14:17,110
It's got to stay small. It has to be a personal relationship between the teachers and the students.

123
00:14:17,110 --> 00:14:22,460
That has to be a tutorial systems and this and once it got bigger, it wasn't.

124
00:14:22,460 --> 00:14:27,330
And it had lost. It had lost. And details that were written by John Potter.

125
00:14:27,330 --> 00:14:31,850
Yes. All right. You're agreeing with what I'm saying.

126
00:14:31,850 --> 00:14:39,490
Yes. To my second point, which is that the Oxford Medical School, as you know, is currently ranked first in the U.K.,

127
00:14:39,490 --> 00:14:48,870
both in terms of its research income as a bio sciences unit and also more directly by its students graduates.

128
00:14:48,870 --> 00:14:55,550
They have a questionnaire. The key elements in its success, as you mentioned, this is, in your view, its size.

129
00:14:55,550 --> 00:15:00,810
And I would agree with that, of course. What do you think of the other key elements? Is it.

130
00:15:00,810 --> 00:15:09,000
I suppose this is this process of having very good people who also have a mixture of self generation X and yourself generate.

131
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If you get people will look at them.

132
00:15:12,810 --> 00:15:20,580
You look at the Adrian Hills and the John Mills. Well, I can't list of all, but just wherever you go.

133
00:15:20,580 --> 00:15:31,060
Yes. You'll find that Oxford graduates from this clinical school were populating the rest of the university and read the rest of the country.

134
00:15:31,060 --> 00:15:37,480
Students and going on onto the president's world class. I mean, if you look at it, I haven't got chapter and verse.

135
00:15:37,480 --> 00:15:44,190
I mean, there's almost nobody who left. I didn't go with distinction and make their mark outside.

136
00:15:44,190 --> 00:15:48,210
Once that happens, because that's where people want to go.

137
00:15:48,210 --> 00:15:55,930
Usually when I feel passionately diverging a bit about the need to support in the House and the and all the other stuff that goes on,

138
00:15:55,930 --> 00:16:02,250
that I hope passionately that the university might be turning to make a mistake,

139
00:16:02,250 --> 00:16:07,770
putting all its eggs in the research basket because it's got a lot of eggs is research.

140
00:16:07,770 --> 00:16:17,350
Bacik is huge and well-respected. But I sort of had a sort of feeling that it might be at the expense of the teaching just beginning to be.

141
00:16:17,350 --> 00:16:25,980
And this would be a great mistake because New Zealand phrase, your clinical students are the seed corn of of of the people to come.

142
00:16:25,980 --> 00:16:28,810
Therefore, you want the best students in the country.

143
00:16:28,810 --> 00:16:33,840
If you don't have the best students in the country, you will ultimately have the best clinical school.

144
00:16:33,840 --> 00:16:42,300
And I have an example for that. If you look back in the 1930s, there were three or four fellows of the Royal Society at University College London,

145
00:16:42,300 --> 00:16:49,260
and you was on the place that people went to intellectually and frankly, what do they call it?

146
00:16:49,260 --> 00:16:55,300
By about the 1970s? It was a dump. It had no intellectual.

147
00:16:55,300 --> 00:17:00,390
They did is professor of medicine was a disaster area. It's got productivity was no good.

148
00:17:00,390 --> 00:17:06,530
It started I don't know, it just went on to call it Manchester United when the football championships.

149
00:17:06,530 --> 00:17:12,030
Bloody difficult to stay there. Yeah. And also, maybe no one is going to have to struggle hard to stay there.

150
00:17:12,030 --> 00:17:21,030
Absolutely. I suppose also say UCL being a large I don't know how it is comparatively without other London medical schools in terms of size,

151
00:17:21,030 --> 00:17:24,570
but all along as well, I should say big. I'm not no one person can.

152
00:17:24,570 --> 00:17:27,900
No, I'm not in any way. And frankly, I think it's too big here.

153
00:17:27,900 --> 00:17:34,320
But I'm glad to say so. I said yes.

154
00:17:34,320 --> 00:17:38,550
Other key elements in the success say that would be the key people coming.

155
00:17:38,550 --> 00:17:43,940
The people interchange between Oxford, Cambridge, which you've mentioned, and the way I tell you what,

156
00:17:43,940 --> 00:17:49,410
I think the essential thing was something very different, perhaps not in London.

157
00:17:49,410 --> 00:17:51,570
When I came here,

158
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I found it very refreshing that any student was allowed to have an opinion equal to my own that do worship of the consultant was absolutely absent.

159
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It was then in London. You didn't argue with the boss, even if you knew you'd be.

160
00:18:06,590 --> 00:18:12,030
He was hopeless. You didn't know here from the first moment.

161
00:18:12,030 --> 00:18:19,100
Consultants, I think, did treat students as their intellectual equals and wanted their opinion and gave it.

162
00:18:19,100 --> 00:18:23,280
I mean, that sort of thing that I would do and I'm sure others did with somebody asked me,

163
00:18:23,280 --> 00:18:29,380
I didn't something I didn't know I wouldn't bluff a way out of it, which might have happened.

164
00:18:29,380 --> 00:18:32,250
You'd say to the student, well, that's a damned if I can question.

165
00:18:32,250 --> 00:18:38,370
I have no idea what the answer is, but perhaps you could look it up and tell me when we next make it.

166
00:18:38,370 --> 00:18:48,330
In other words, the students were treated as as part of the team looking after the patient and whose opinion was equal.

167
00:18:48,330 --> 00:18:50,470
And you ended with the boss because.

168
00:18:50,470 --> 00:18:57,990
So what, you were the boss and you and what your way, provided you have persuaded your team that this was the right thing to do.

169
00:18:57,990 --> 00:19:06,060
That was very refreshing. I mean, it may be cover pleasure, but then if it is, I think the idea that that seniors earn the respect of the students,

170
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particularly if the students are particularly high calibre. Probably still is something that's particularly prominent at Oxford.

171
00:19:12,720 --> 00:19:18,270
I count how prominent it is at Cambridge because I've never done thing where I don't have it.

172
00:19:18,270 --> 00:19:21,150
That's very interesting that the whole thing was a team effort.

173
00:19:21,150 --> 00:19:32,770
It must have been quite a strain to keep together the top clinical practise and also to move forwards in research area and to have research students.

174
00:19:32,770 --> 00:19:37,200
So is how did you juggle that one? Because that's quite a difficult.

175
00:19:37,200 --> 00:19:50,010
I mean, how do one keep up with clinical medicine? Well, I yes, I think that this is actually slightly diverting self a different subject, but.

176
00:19:50,010 --> 00:20:02,890
If you if you wish to be a consultant, physician or surgeon in a teaching hospital in the U.K., in my time, you had to have a research record.

177
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You had to have a track record of publication. You had to show some.

178
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Some activity in the research field, and though I think many of us were not ready but suited to that.

179
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And I remember as a young chap wondering there was so much to learn in clinical medicine and applied.

180
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What did I really want to do? It's spend two years in the lab doing work that I really wasn't as good as as as people who primarily did it.

181
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And I thought you ought to do research if you wanted or were interested in it rather than the compulsory thing.

182
00:20:39,590 --> 00:20:47,120
And all of our time you had before you got here to do your BDA, been to America.

183
00:20:47,120 --> 00:20:52,790
If you had not been to America, the state of the English medical schools research, you couldn't do any research.

184
00:20:52,790 --> 00:20:56,690
I mean, I couldn't do anything that he use Middlesex, even the John Novara.

185
00:20:56,690 --> 00:21:03,680
So I went and spent a year at Columbia. We've done our own research in Reading and Angiotensin and hypotension.

186
00:21:03,680 --> 00:21:13,010
I don't regret it. It was good. But I sometimes look back and think, well, I could have spent those two years being a bit of a day to day physician.

187
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And would I have been any less good at teaching students? I simply don't know.

188
00:21:18,680 --> 00:21:24,110
But the gospel of the Great Professors, Pickering particularly,

189
00:21:24,110 --> 00:21:30,140
was that there was a thing called the Medical Research Society, which did exist century when I was ultimately chairman of it.

190
00:21:30,140 --> 00:21:37,130
But it made every month, I think, in London where the young gave a paper for ten minutes.

191
00:21:37,130 --> 00:21:46,790
Papers should be spoken and not read in the front row of the audience for all the professors of medicine in the U.K. looking out for.

192
00:21:46,790 --> 00:21:52,760
I'll have him. So it was a cattle market. Is Egypt a fishing trip?

193
00:21:52,760 --> 00:21:59,310
Well, you when you went there and hoped that you know how you could if you went out and enjoyed your paper, my boy.

194
00:21:59,310 --> 00:22:03,790
I want. What are you thinking of going. Want to go. And.

195
00:22:03,790 --> 00:22:08,090
And that was it. So we all had my generation.

196
00:22:08,090 --> 00:22:13,940
I mean, if you look at a slight well, you'll find out when you're talking. We had all come back to the United States.

197
00:22:13,940 --> 00:22:21,650
In fact, I got appointed here when I was still in New York and then came back six months after the others had finished.

198
00:22:21,650 --> 00:22:28,940
And no sooner I've been, as I say, oh, your interesting work in New York to talk about it on the Concilio.

199
00:22:28,940 --> 00:22:37,400
And then you've got no plus B in your lab. Suddenly you've got people wanting to you were driven piggy by the.

200
00:22:37,400 --> 00:22:44,280
By the people who wanted to do deals with you. My first was Perry Leary, who later became professor of medicine in South Africa.

201
00:22:44,280 --> 00:22:49,050
My second was Martin Gregory. Whose story is it? It was David Warren.

202
00:22:49,050 --> 00:22:57,670
There was Gwinn Thomas in it. And suddenly you had always two or three DeSales students attached to you.

203
00:22:57,670 --> 00:22:58,730
And they were very bright.

204
00:22:58,730 --> 00:23:10,370
Say I'm the first in the first century that if my published work, a lot of the engineers, a lot of the technical talent came from the chapel.

205
00:23:10,370 --> 00:23:19,580
I suppose it is. If you look at Peter Radcliffe now, if our Essene professor, he was in that group,

206
00:23:19,580 --> 00:23:25,010
I had a wonderful time when I had he and Jonathan Turley reign as a career.

207
00:23:25,010 --> 00:23:29,750
And when you look at them, as you can see, well, it was a powerhouse and you could say, well, how did I keep up?

208
00:23:29,750 --> 00:23:37,290
I don't know. And I know they were all but equal. But Peter Radcliffe started.

209
00:23:37,290 --> 00:23:43,820
With me, for instance, saying what I do. I've gone to a Cambridge and the.

210
00:23:43,820 --> 00:23:55,150
I'd like it to be Renald vaguely, and I'd got interested in that kind of I said Peter Hamby thought, why God put a little cohesion on the kidney.

211
00:23:55,150 --> 00:24:01,790
Well, like I said, national, you know, there are ways of looking at oxygen levels in the kidney and the different.

212
00:24:01,790 --> 00:24:08,850
We get interested in that well within a year. He left me well behind and was going into the molecular biology of ocean.

213
00:24:08,850 --> 00:24:15,030
Sensing in general is now a world authority on it. But he did start with that.

214
00:24:15,030 --> 00:24:19,740
Mr. Very often. My job was to simply what of the question?

215
00:24:19,740 --> 00:24:24,150
Light the blue touch paper and then then the talent of the other subset.

216
00:24:24,150 --> 00:24:27,600
And I did not do that again. Did you did also have to look after them?

217
00:24:27,600 --> 00:24:33,000
In a sense, I would imagine. Oh, that's it. That you had to have that sort of getting them stale.

218
00:24:33,000 --> 00:24:34,790
Yes. Well, they all felt they weren't adequate.

219
00:24:34,790 --> 00:24:45,810
Well, Dr. Peter, particularly you wanted to apply for a job in geriatric mentioned in Chelmsford Wednesday,

220
00:24:45,810 --> 00:24:49,320
which leads me onto your times as director of clinical studies. You did.

221
00:24:49,320 --> 00:24:53,810
You decided to start institute. I read No. Two loops above.

222
00:24:53,810 --> 00:24:59,330
And they were very influential because I think that you took this idea.

223
00:24:59,330 --> 00:25:05,330
There's this this this passion of yours for being individually known to students.

224
00:25:05,330 --> 00:25:09,450
Yes. And you built that even maybe to that to the clinical school.

225
00:25:09,450 --> 00:25:12,850
But what are your key memories at those times as directly paid for?

226
00:25:12,850 --> 00:25:19,210
That is what what is it what are the things that will stay in your mind? Well, and I knew when it was in the womb.

227
00:25:19,210 --> 00:25:25,320
And I suppose you have to say what is director of Cadenzas Studies, therefore?

228
00:25:25,320 --> 00:25:36,870
And people would have different views. My feeling very much about it was to to try to get the best clinical students you could,

229
00:25:36,870 --> 00:25:44,950
but mostly to be there to represent them against the university, if you like.

230
00:25:44,950 --> 00:25:52,080
Oh, yes. Now there are directors of clinical studies who are disciplinarians or who are people

231
00:25:52,080 --> 00:26:02,540
who will select the curriculum or want to see the student who failed to turn up.

232
00:26:02,540 --> 00:26:09,030
That's something I never took that I had to do that bit on the whole in a way that was far too benign,

233
00:26:09,030 --> 00:26:14,460
I'm afraid, and let murder take place occasionally.

234
00:26:14,460 --> 00:26:20,850
But but on the whole, I regarded myself as this in the position of the students trend in both times.

235
00:26:20,850 --> 00:26:29,790
I did it and I don't regret that. And I don't know. Compared with the other people who've done it, whether whether it was the same or different,

236
00:26:29,790 --> 00:26:35,260
how their property took it a little bit to an extent, I certainly felt that I wanted to know them all.

237
00:26:35,260 --> 00:26:38,050
And as you probably know, I mean,

238
00:26:38,050 --> 00:26:45,580
I used to get into the medical school at about a quarter to eight and and have a cup of coffee and between eight and nine.

239
00:26:45,580 --> 00:26:53,560
Any student could drop in. But of course, between October and Christmas, I managed to see them all and kept in touch.

240
00:26:53,560 --> 00:26:59,870
Course, maybe people will call this dinner unnecessary, but I.

241
00:26:59,870 --> 00:27:05,530
Because with the school's small school, it was very good. But the other thing was, was to find out what was happening to them.

242
00:27:05,530 --> 00:27:17,500
And on that aspect of being D.c.'s that I remember being influential in, if I dare I say it, is that people would come to me saying, where do I go?

243
00:27:17,500 --> 00:27:21,370
What career am I going to take? Which medical school am I going to?

244
00:27:21,370 --> 00:27:26,930
What's going to be my what's going to be my aim and object?

245
00:27:26,930 --> 00:27:36,880
And that I found very interesting. But I said I then built up an enormous he Azel with people all over the country.

246
00:27:36,880 --> 00:27:41,830
I had only to tell Georgia about it in Newcastle that I had a student who

247
00:27:41,830 --> 00:27:49,840
better take him on the house and did the same for the golden the golden root.

248
00:27:49,840 --> 00:27:57,390
That left us with the top students. I would simply ring up the Brompton ICU at St.

249
00:27:57,390 --> 00:28:05,900
Thomas is the renal unit at guys. People really want to get their feet wet in in in clinical medicine.

250
00:28:05,900 --> 00:28:09,890
Stoke-On-Trent, believe it or not, clinical school would form. We want to.

251
00:28:09,890 --> 00:28:13,990
So Newcastle and various other schools.

252
00:28:13,990 --> 00:28:25,210
But those were the main ones in which I simply got on the telephone and rang up and said, well, your next your next house physician is X.

253
00:28:25,210 --> 00:28:29,590
And they were. Yes. Such was that. Such was the calibre of the people we sent them.

254
00:28:29,590 --> 00:28:35,310
They didn't even bother. I didn't bother with interviewing or query none.

255
00:28:35,310 --> 00:28:44,590
They said, well, great. And for many years, students went through the branch and two guys who Thomases.

256
00:28:44,590 --> 00:28:49,380
And and it was a steady stream of them. You'll find if you look at the distinguished ones now, you find that subtract.

257
00:28:49,380 --> 00:28:59,350
They took the Senate. But that was a personal thing. Yes, I was cut now and I was able to ring people up and say, I've got somebody exceptional here.

258
00:28:59,350 --> 00:29:03,190
You also had, of course, the ones who would are going to be in difficulty.

259
00:29:03,190 --> 00:29:16,870
I can remember the girl committed suicide. I won't name her, but and others who weren't getting through who you had to somehow got into other things.

260
00:29:16,870 --> 00:32:36,560
So I never got bothered what was in the curriculum.

261
00:32:36,560 --> 00:32:44,840
There's an illustration of what the D.c.'s could do to my tribe and how I saw the job to be it.

262
00:32:44,840 --> 00:32:52,070
And that sort of creativity on behalf of the students is giving them permission to do those like evil off,

263
00:32:52,070 --> 00:32:56,000
off, off the wall, things that it doesn't have to do.

264
00:32:56,000 --> 00:33:02,860
Another example, it doesn't matter. They had a chat with a young musician of the year and he wanted to go from his French horn.

265
00:33:02,860 --> 00:33:08,810
Yeah. And he made a deal that he would come back and finish the clinical course, even if he decided that he would become a professional player.

266
00:33:08,810 --> 00:33:12,580
And he came back saying, I've had a wonderful year, but I'm going to be a doctor. I'm not.

267
00:33:12,580 --> 00:33:17,360
Well, that's right. And I wonder how many universities, how many middle schools or even an Oxford now.

268
00:33:17,360 --> 00:33:18,900
Well, that would happen. You can tell me.

269
00:33:18,900 --> 00:33:28,640
But just one other example was Emily Harris, MP, Evan Harris MP arrived and said that could take three months of thought,

270
00:33:28,640 --> 00:33:34,970
not to general practise at all because he wanted to stand as a liberal concert, the city of Oxford.

271
00:33:34,970 --> 00:33:40,760
He had political future. And he was only doing mentioned with a view to qualifying, knowing something about it,

272
00:33:40,760 --> 00:33:47,090
that joining the Liberal Party and at last having somebody in the House of Commons who knew something about mentioned.

273
00:33:47,090 --> 00:33:59,380
I gave him three months. Well, yes.

274
00:33:59,380 --> 00:36:33,730
And so fighting the corner of of the students with the university in terms of funding froze the House into.

275
00:36:33,730 --> 00:36:36,880
I know, but there was that there was the bird club.

276
00:36:36,880 --> 00:36:45,430
Yes, there was the time that the Bird Club joined and the university said, by all means come because there were no bloody good.

277
00:36:45,430 --> 00:36:52,630
And gradually, John Bell and other people found them to be good. And suddenly, as they were coming head of the river before he knew where it was.

278
00:36:52,630 --> 00:37:02,430
And then there was a meeting that our UBC went head to boat to all the colleges and Oxford and announced it as the house was unfair.

279
00:37:02,430 --> 00:37:07,300
It would be syndicated from a well because it got all sorts of places in them, all of them.

280
00:37:07,300 --> 00:37:15,330
And things said they must be thrown off the river. They had to fight that one went over to Vincent's and talked to people.

281
00:37:15,330 --> 00:37:19,360
And we won that one to do with Tom CANDU.

282
00:37:19,360 --> 00:37:23,360
Hudson was extremely helpful in that matter. Absolutely.

283
00:37:23,360 --> 00:38:23,010
You know, if you read. Yes. Yes.

284
00:38:23,010 --> 00:38:31,030
So there were no that was one thought and then my first era these years, most of which I think were valid.

285
00:38:31,030 --> 00:38:32,940
So that's another illustration that I saw.

286
00:38:32,940 --> 00:38:40,890
The DEA says the bloke who who made sure that this that this was a place that people wanted to dump to be students, you know.

287
00:38:40,890 --> 00:38:45,170
Excellent. So tell us your views on women in medicine.

288
00:38:45,170 --> 00:38:52,500
You were always. I remember in my time there were either two Indian housemen, one of whom always, always was a woman.

289
00:38:52,500 --> 00:39:00,360
And then for Indian housemen, the reason we were women was one time the entire junior staff on the Indian women.

290
00:39:00,360 --> 00:39:04,530
Beatrice Sommer's was the senior registrar there on the beach.

291
00:39:04,530 --> 00:39:09,510
She was in Cambridge. Yes. Well, she went. Yes. I mean, we had a time when it was really quite a joke.

292
00:39:09,510 --> 00:39:13,950
But I don't think it had anything to do with anything other than talent, actually.

293
00:39:13,950 --> 00:39:18,710
You may have said that whether all letting him have a soft dye for the girls. So this must be true.

294
00:39:18,710 --> 00:39:21,510
Do you think they were good doctors do? I do.

295
00:39:21,510 --> 00:39:29,020
I mean, I think going right back, Peggy, and you'll notice that when you're picking medical students at new college at the age of 18,

296
00:39:29,020 --> 00:39:39,870
the young woman with a bit of Polish and a bit of charm and the pimply, acne ridden, almost unable to speak, shy, try tarring chap.

297
00:39:39,870 --> 00:39:43,110
What did you do? I mean, you used to say to a beat, it said, look,

298
00:39:43,110 --> 00:39:51,930
we're going to have to give the chaps 50 percent more and the girls happy percent and it would never elect another man.

299
00:39:51,930 --> 00:39:55,950
So I don't know. I mean, it's done. My view about women in medicine starts, of course, with that.

300
00:39:55,950 --> 00:40:01,110
My mother was a physician. My wife is a physician, my daughter's physician.

301
00:40:01,110 --> 00:40:05,790
So I have no prejudice against women in medicine to them.

302
00:40:05,790 --> 00:40:15,300
But I think if you look at the day they are girls at school should do attend lessons and work champs,

303
00:40:15,300 --> 00:40:20,580
go and play rugby and and come to their come to their peak later.

304
00:40:20,580 --> 00:40:30,720
Yes. If so, I'm not surprised that the girls get on it and they shine and everything else.

305
00:40:30,720 --> 00:40:41,160
People ask me why they aren't all not any medicine, why they aren't on governing bodies of city companies,

306
00:40:41,160 --> 00:40:48,840
why they aren't all in politics where they aren't. Or Professor of medicine. Am I also this is twofold.

307
00:40:48,840 --> 00:40:54,660
I think one is I think they do peak earlier than men and the men really don't get down to it, too.

308
00:40:54,660 --> 00:41:03,460
We have to do a bit later. But I think the other thing is the same old story of what a woman wants to do.

309
00:41:03,460 --> 00:41:12,990
Yes. And you remember Peggy being one of the things so much when he was saying, well,

310
00:41:12,990 --> 00:41:21,610
I'm coming back to being DC s now because it's somewhere about March of each year, students would come in saying, what am I going to do?

311
00:41:21,610 --> 00:41:25,910
Which has structure at Blackall and what sort of medicine do I want to do?

312
00:41:25,910 --> 00:41:36,780
And it's simple sort of a characterisation, but a surprising number of people who had a double first at Cambridge and a little of this,

313
00:41:36,780 --> 00:41:41,670
every other president of the union female who would come and say the following to me.

314
00:41:41,670 --> 00:41:47,070
They'd say I was I was bright at school in Science City, pushed me to science.

315
00:41:47,070 --> 00:41:54,030
And then there's a initial private side. You better do medicine. And when I was found to be really quite good at that, they said, well,

316
00:41:54,030 --> 00:41:59,450
if you really want to do medicine the top place, you go to Cambridge and the preclinical school.

317
00:41:59,450 --> 00:42:05,220
And then they told me at Cambridge that if I was ready, very bright, the right place to do clinical mentioned was Oxford.

318
00:42:05,220 --> 00:42:10,830
And here I am. You can think of all the people I'm talking about. And I loved it.

319
00:42:10,830 --> 00:42:19,770
It's a hobby. It's something I'm used to. But actually, I want to marry and have children.

320
00:42:19,770 --> 00:42:26,820
And I do not wish to be a professor of medicine at Hammersmith.

321
00:42:26,820 --> 00:42:34,560
I know I could be, but I want to be. And can you advise me? I remember my own daughter saying, shall I do haematology or rheumatology?

322
00:42:34,560 --> 00:42:42,270
Because it seemed to be the ones that I am least likely to be born out of bed at night when I can about you and people.

323
00:42:42,270 --> 00:42:48,040
I mean the concept that women actually want to run things.

324
00:42:48,040 --> 00:42:54,470
Yes, there are odd ones that Sheila showed up, for God's sake, get.

325
00:42:54,470 --> 00:43:05,940
Yeah. So it's a particular sort of so I might wish that there is a small proportion who really want to be a Margaret Thatcher.

326
00:43:05,940 --> 00:43:12,660
But the vast majority that they want to do a good job, they look them broadly educated.

327
00:43:12,660 --> 00:43:20,580
They're fascinated by medicine as an intellectual pursuit. But they're not ambitious to have a better department than somebody else.

328
00:43:20,580 --> 00:43:25,460
The show is today the rose, and that debt is very obvious.

329
00:43:25,460 --> 00:43:32,590
Two sessions that it made, maybe 10 years is. And the mother who.

330
00:43:32,590 --> 00:43:39,990
Did medicine between diet consultant between 1929 and 1947 without any payment at all?

331
00:43:39,990 --> 00:43:43,060
You did. I mean, before the days of the health service,

332
00:43:43,060 --> 00:43:50,140
you were known we didn't say mom did five five sessions a week at the world free at five sessions

333
00:43:50,140 --> 00:43:58,070
a week looking after children and no money at all that I would put up with that as a background.

334
00:43:58,070 --> 00:44:02,560
And I still think it's true. I think people who try to push it any other way are pushing against a motor

335
00:44:02,560 --> 00:44:07,060
that won't move and maybe making women guilty if they're guessing to do that.

336
00:44:07,060 --> 00:44:08,840
Oh, absolutely. Yeah.

337
00:44:08,840 --> 00:44:17,050
Yeah, I you know, I only I went to that come to the same point of view as well, that it may be that women don't choose to go into those roles.

338
00:44:17,050 --> 00:44:21,220
And I think they will be given increasingly superhuman that some of those.

339
00:44:21,220 --> 00:44:27,670
I think we're asking too much of people who lead huge enterprises.

340
00:44:27,670 --> 00:44:35,490
Medical research. I think your point that the ones who who don't want to push it start feeling guilty.

341
00:44:35,490 --> 00:44:45,840
It's also true that. But also, passengers are terror by having a wife who isn't mentioned in my time.

342
00:44:45,840 --> 00:44:50,860
The concept, when do medicos married?

343
00:44:50,860 --> 00:44:55,000
The wife had an equal career. It wasn't to be thought of.

344
00:44:55,000 --> 00:45:01,630
I mean, Elaine and I got married when she didn't SAHM and said Crick's want to be an obstetrician within a year.

345
00:45:01,630 --> 00:45:05,710
We got a child and she was doing part time general practise with Jillian.

346
00:45:05,710 --> 00:45:10,150
Slight. I meant what Jillian did.

347
00:45:10,150 --> 00:45:20,090
I think it was sort of my keeping even, you know, pregnancy advisory service or law school or medical office or something when you could look.

348
00:45:20,090 --> 00:45:25,690
Did Hockaday, on the other hand, did pursue a career. But got held back?

349
00:45:25,690 --> 00:45:25,960
I mean,

350
00:45:25,960 --> 00:45:35,230
one of the cities at Oxford had was to find that there were wives who could be made use of and one get to leave because their husband for them.

351
00:45:35,230 --> 00:45:40,780
So they didn't promote them and didn't give them the recognition they needed.

352
00:45:40,780 --> 00:45:44,290
So that said, what did he want to say? Ask about women in general.

353
00:45:44,290 --> 00:45:51,790
I think God, women and men to know their. I think they are.

354
00:45:51,790 --> 00:45:54,420
I don't know whether they do provide more.

355
00:45:54,420 --> 00:46:02,840
I mean, my chief worry about medicine now is my shorthand and what I think the NHS does, which is they treat disease, not people.

356
00:46:02,840 --> 00:46:06,520
That is my shorthand. Yes. And I believe people should be taught.

357
00:46:06,520 --> 00:46:12,480
And I think women are more likely to treat people who are less fascinated by the Meccano set of their

358
00:46:12,480 --> 00:46:21,160
latest gadgets that we have of the women who are still wanting to sit the other side of a patient.

359
00:46:21,160 --> 00:46:26,310
And it is, I think, well, who still value that as an element in the profession.

360
00:46:26,310 --> 00:46:32,880
Yes, I have. That brings me on to my last question, which is that you have a long career as a distinguished clinician.

361
00:46:32,880 --> 00:46:41,330
So what do you think makes a good doctor? Well, I think it's very difficult.

362
00:46:41,330 --> 00:46:54,530
There are lots of things you can write down. A good doctor has to have had a very, very, very broad and intense experience, which he no longer has.

363
00:46:54,530 --> 00:47:04,940
I believe that the code to which we grew up was into many people's minds at this dreadful era.

364
00:47:04,940 --> 00:47:10,460
But by the time I was consultant, I had seen almost anything it was possible to see.

365
00:47:10,460 --> 00:47:19,040
And I would see some difficulty and I'd say, I've seen that before with something else.

366
00:47:19,040 --> 00:47:24,310
I can remember that case that I saw with. I turned him on.

367
00:47:24,310 --> 00:47:31,040
I remember that case that I saw with Dick Bayliss, know where it was.

368
00:47:31,040 --> 00:47:39,260
And so there nothing that primary need is real deep in depth, out of bed at night.

369
00:47:39,260 --> 00:47:48,140
Follow it right through this clinical experience. That he's a cynic known and the current business of working hours.

370
00:47:48,140 --> 00:47:53,180
And this is, I think, nothing short of a disaster, in my view.

371
00:47:53,180 --> 00:47:57,090
It comes piecemeal rather than joined up. Well, yeah, you can't.

372
00:47:57,090 --> 00:48:02,080
It's the piece that that's one aspect. Peggy, the other is the total lack of experience.

373
00:48:02,080 --> 00:48:15,360
If. If, if. When I was on the House and Middlesex, I had six hours out of the hospital in the first year, there was a barber in the hospital.

374
00:48:15,360 --> 00:48:23,190
There was a bank in the hospital. If your patient was ill, they might have been up three nights in the way it was you who got cold again.

375
00:48:23,190 --> 00:48:28,430
Now, people say that was dangerous and you killed them. I don't believe we did, actually.

376
00:48:28,430 --> 00:48:33,360
But there's nothing you learnt doing it that way.

377
00:48:33,360 --> 00:48:37,260
You learn not only clinical medicine, the outcome and recognition of things,

378
00:48:37,260 --> 00:48:41,070
but you also learn how to talk to people and how to be personal with people.

379
00:48:41,070 --> 00:48:45,600
All this rubbish, the way he put it to of communication skills, you do that.

380
00:48:45,600 --> 00:48:51,480
It will need that. You learnt it the hard way by sitting and communicating endlessly.

381
00:48:51,480 --> 00:49:01,500
I have a vivid recollection of my first sales job, a 26 year old girl with lactating cosson and with a breast.

382
00:49:01,500 --> 00:49:05,850
It was going to go like a forest for her and be did. She wasn't sent home.

383
00:49:05,850 --> 00:49:15,000
She wasn't sent to save our house. She remained was the responsibility of the team to look after it to their dying day.

384
00:49:15,000 --> 00:49:20,280
And I would go and spend half or three quarters of an hour with her every morning and every evening.

385
00:49:20,280 --> 00:49:26,020
Now, what did I learn about how to handle people who were dying?

386
00:49:26,020 --> 00:49:31,330
Much better than having an actor. A list of things, how you hold hands and how you make eye contact, all that rubbish.

387
00:49:31,330 --> 00:49:36,640
I mean, put it that way. I feel actually passionate about this.

388
00:49:36,640 --> 00:49:38,050
You can't put the clock back.

389
00:49:38,050 --> 00:49:47,920
But I think what made great commissions, the first thing you need is experience and personal responsibility and not handing it over to somebody else.

390
00:49:47,920 --> 00:49:52,060
And spending every hour of the day seeing people.

391
00:49:52,060 --> 00:50:00,310
But even when you do that, there were some people who had what I think is a clinical gift of what it is.

392
00:50:00,310 --> 00:50:07,410
There was an obituary of a chap the other day who had this. Some people just have an instinct.

393
00:50:07,410 --> 00:50:09,970
Of course, in my time,

394
00:50:09,970 --> 00:50:19,230
you had to make decisions on totally inadequate evidence a lot of the time these days with MRI scanners and C.T. scanners and doohickeys of diagnosis.

395
00:50:19,230 --> 00:50:24,520
The technical skills, of course, are disappearing and probably unnecessary.

396
00:50:24,520 --> 00:50:30,760
But some people had I don't know what it what it was a kind of feeling of which way to jump it.

397
00:50:30,760 --> 00:50:33,250
Like a musician with musical ability. Yes.

398
00:50:33,250 --> 00:50:45,600
And you could find other people who I can think of my kid, many of my contemporaries who read the journals and knew every bit of research.

399
00:50:45,600 --> 00:50:51,630
And we're not top class conditions, they hadn't they hadn't got this ability to act.

400
00:50:51,630 --> 00:50:57,420
They would have perhaps Piggy, who shall we? I can never take a case.

401
00:50:57,420 --> 00:51:05,910
A girl comes in with a big pulmonary embolism. Should she have a pulmonary embolism to me or should you hold tight?

402
00:51:05,910 --> 00:51:10,440
She might be killed by the bambrick to me. She might die.

403
00:51:10,440 --> 00:51:14,180
The good condition somehow instinctively makes the right decision.

404
00:51:14,180 --> 00:51:23,040
The chap or lady who knows just as much medicine or more haber's doesn't make a decision.

405
00:51:23,040 --> 00:51:26,490
We know of colleagues who were indecisive at the bedside.

406
00:51:26,490 --> 00:51:31,920
You can't be pleased you couldn't be there. It might be something to do with this strategy.

407
00:51:31,920 --> 00:51:38,970
Knowing what worst case scenario is, how it might pan through in terms of experience, either entirely just funny instinct.

408
00:51:38,970 --> 00:51:43,250
And I don't know where that comes from. There are people who could build on conditions.

409
00:51:43,250 --> 00:51:50,110
I can't tell you what that is. But the other thing I think, though, that makes a great condition.

410
00:51:50,110 --> 00:51:55,890
I'm telling you that the future is awful because it doesn't. All the things I liked don't exist anymore.

411
00:51:55,890 --> 00:52:05,940
When I was ascending the medical thing, you didn't decide you wanted to pursue a career in cardiology or something else.

412
00:52:05,940 --> 00:52:16,680
What you did was. You worked for X, you worked for a man with a reputation and a charisma and his special, you may be different from one.

413
00:52:16,680 --> 00:52:23,940
By the time you're qualified. I mean, I spent so it would be said much about me, but I'm not alone in my era.

414
00:52:23,940 --> 00:52:29,290
I got emotionally entranced by my second house job in neurology with Michael Kremer.

415
00:52:29,290 --> 00:52:33,300
Valentine. Hello. The son of The King's Speech. Logue.

416
00:52:33,300 --> 00:52:46,680
Yes. And. You know, these people inspired me, so I ended up doing two years in Iraq, McCain, and then I got to see.

417
00:52:46,680 --> 00:52:53,750
An adviser, he as well. Well, before you go to Queen's Square as a house officer, you better do a bit more, general.

418
00:52:53,750 --> 00:52:58,910
So you end up as a registrar to don there. Our own topic is endocrinology, metabolic diseases.

419
00:52:58,910 --> 00:53:04,160
He says, John Nephrologist, he offered people you better than to do it. Remote object.

420
00:53:04,160 --> 00:53:06,590
And then I've just done my dick a bit research with him,

421
00:53:06,590 --> 00:53:13,730
and I find the senior registrar with the various queen's position, the X D of Hammersmith is available.

422
00:53:13,730 --> 00:53:19,420
He's clearly in the best condition under my bed. Got went for him.

423
00:53:19,420 --> 00:53:30,080
So that if I was any good physical medicine, I base it on being followed in the footsteps of Michael Cremer, John Novarro and Dick Bennett.

424
00:53:30,080 --> 00:53:35,240
To that sort of role model. Take all away, actually, real role [INAUDIBLE] doesn't exist anymore.

425
00:53:35,240 --> 00:53:46,070
You don't have farms. And I think Rosie was essential because you learn from them how to behave, how to think, how food by osmosis.

426
00:53:46,070 --> 00:53:52,130
And again, the musical analogy that if you haven't if you're if you're with somebody who has the ability,

427
00:53:52,130 --> 00:53:58,310
but also the technique, I think you if you have innate ability, then you learn that, as it were,

428
00:53:58,310 --> 00:54:05,240
the technique of how a very broad range, not just the technical things, but also the people, things like that,

429
00:54:05,240 --> 00:54:12,590
you you pick those up and unbuild on them, whereas without them, you have to build the whole thing yourself from scratch.

430
00:54:12,590 --> 00:54:16,040
And I suppose that students do rotate too much more quickly now.

431
00:54:16,040 --> 00:54:19,550
So they don't and they don't get the ability to work with a particular person.

432
00:54:19,550 --> 00:54:24,390
So I know they're allocated much more than that, I suppose. Well, I think it is inevitable, but an ending.

433
00:54:24,390 --> 00:54:26,990
The cop turned the cop magnet, Nancy, off.

434
00:54:26,990 --> 00:54:36,450
So what I'm saying also, of course, you have to learn what not to do from people whose behaviour as your chief you don't like.

435
00:54:36,450 --> 00:54:42,470
And there is an illustration that the great athlete as the Evan Bedford Library in the commission positions,

436
00:54:42,470 --> 00:54:47,720
great cardiologist, was on his firm as a medical student.

437
00:54:47,720 --> 00:54:56,240
And we used to when he'd done a walk round, the student had to go round and prepare the weeping patients who he'd handled that badly.

438
00:54:56,240 --> 00:55:03,870
And I could recall when you went to Bedfords Outpatient Clinic, the new patient to come in, he didn't make eye contact, didn't look up.

439
00:55:03,870 --> 00:55:09,900
He was cute to write the letters and he would say rather Russia. Well, what brought you here then?

440
00:55:09,900 --> 00:55:15,190
Or something go in that room and get undressed.

441
00:55:15,190 --> 00:55:20,830
Come back, cheque. Come back. On occasion, they had the temerity to say, go to Bedford.

442
00:55:20,830 --> 00:55:24,910
Can you tell me if there's anything wrong? And he had two answers.

443
00:55:24,910 --> 00:55:33,620
One is a busy man. All right. Your doctor. The other was you wasted my time or suffering from your particular health.

444
00:55:33,620 --> 00:55:39,400
And I sort of as a clinical student, I thought at least I have not had. I mean, that was an extreme.

445
00:55:39,400 --> 00:55:47,170
How not to behave. But there were people who treated patients abominably.

446
00:55:47,170 --> 00:55:55,190
And you're right from that, too, I think. And if those you worked with, would you single out one or two who were particularly inspirational?

447
00:55:55,190 --> 00:55:59,620
The Michael Cremer, funnily enough, then you would have lost his job.

448
00:55:59,620 --> 00:56:04,730
Yes. My Premal. He had an ability.

449
00:56:04,730 --> 00:56:11,450
Oh, of course. He's a marvellous condition. And knowledgeable. He tell you why you would want to work with him?

450
00:56:11,450 --> 00:56:16,830
N.K. decided that his house physician was the person around whom.

451
00:56:16,830 --> 00:56:20,710
But he revolved his registrars and his senior registrars and research fellows.

452
00:56:20,710 --> 00:56:24,550
On what grounds remain quiet? Yes.

453
00:56:24,550 --> 00:56:32,420
He asked my opinion. He said, well, now the his thing. Just tell us about this patient and tell us what you think.

454
00:56:32,420 --> 00:56:41,530
And I could remember Patty Fullerton. You wouldn't know. Patty became professor of neurology and later might be good office to grab your attention.

455
00:56:41,530 --> 00:56:47,720
And Patty went to a make or two. And I overlapped with her with Grima.

456
00:56:47,720 --> 00:56:56,230
She was his house physician first. And she made an absolute pig's ear of telling what the physical signs were of a patient.

457
00:56:56,230 --> 00:57:01,420
She had either forgotten or she'd been unable appropriately. I postnatal.

458
00:57:01,420 --> 00:57:08,560
Kremer then initiated the physical signs that she said were there by cooking them.

459
00:57:08,560 --> 00:57:19,240
And then it's like a Tea Party. Never do that to me again. Well, if you work for a condition like that, it will also force.

460
00:57:19,240 --> 00:57:22,750
Well, here I can remember and legends about my Klima.

461
00:57:22,750 --> 00:57:32,110
There was an BBC Radio three chat with Avenal was GSF and Funny or Orangy, and nobody could come and he'd look back and she said,

462
00:57:32,110 --> 00:57:40,150
John, at four o'clock, Sir Francis Walsh, abuse age is going to come and see this patient to give his opinion.

463
00:57:40,150 --> 00:57:46,880
And at six o'clock, Sir Charles Simons is going to come and we should be both at both attendance and

464
00:57:46,880 --> 00:57:53,530
then ring me up and tell me which is the better neurologist not to do what for,

465
00:57:53,530 --> 00:57:56,950
man? That is you. And you watch him clinical skills.

466
00:57:56,950 --> 00:58:07,660
You watch him handling people and ethnic gore, this practise of hysterical illness, people with hysterical and word headache, hysterical.

467
00:58:07,660 --> 00:58:13,120
I can't move my limbs. I've got a problem. I'm dizzy, Doctor.

468
00:58:13,120 --> 00:58:17,170
I know. And he. I can't go into any.

469
00:58:17,170 --> 00:58:22,120
But he actually handle these people in a way that I read.

470
00:58:22,120 --> 00:58:30,450
I said is a dimension of medicine. So be far beyond science that there is a strategy for managing that just as much as managing pain.

471
00:58:30,450 --> 00:58:35,600
Yeah, but I put this Sydney in the Gazette, but I medicine.

472
00:58:35,600 --> 00:58:47,250
But my father, who was an Aberdonian. Medical graduate saying to me when I went to university, he said,

473
00:58:47,250 --> 00:58:52,430
you you're going to be another these people who get all the work done by somebody else and travel

474
00:58:52,430 --> 00:58:58,580
around the world giving papers on what your unions have done and not getting up at night.

475
00:58:58,580 --> 00:59:03,290
They are losing. I wish you hadn't done it, my boy.

476
00:59:03,290 --> 00:59:16,640
But when you reach my age, which is 70 plus, he said, you will realise that to have found a new disease found a new gene for something.

477
00:59:16,640 --> 00:59:26,750
A. Even discovered the structure of DNA didn't say that or have made a diagnosis jeopardies, Mr.

478
00:59:26,750 --> 00:59:38,040
Vanity, all is vanity. When you reach my age, you will realise that if you go and see a patient who is either undiagnosed or untreatable.

479
00:59:38,040 --> 00:59:42,180
And sit with them for half an hour. Get back there better. That's for my mind.

480
00:59:42,180 --> 00:59:52,590
What venture about? It still is for me. And I regret that it's I think gone probably will be interesting to reflect on that.

481
00:59:52,590 --> 00:59:56,640
I mean, it hasn't been on this weather to date in it better than anybody.

482
00:59:56,640 --> 01:00:01,710
We've always said that Silwad. Mm hmm.

483
01:00:01,710 --> 01:00:09,210
But there are others I can think of a word. Thank you.

484
01:00:09,210 --> 01:00:13,500
It's great that there is a micro sense. Easy and my like to act now.

485
01:00:13,500 --> 01:00:20,880
And I've got to tell you on spring break, it's it's a it's a pretty personal philosophy,

486
01:00:20,880 --> 01:00:27,730
but that's all part and parcel, I think, of the home for all the guests over a very long period of time.

487
01:00:27,730 --> 01:00:32,220
I think it all. I think it all streams. It all rubs yourself. Yes.

488
01:00:32,220 --> 01:00:41,460
Have you gotten this memorable patient? Oh, absolutely.

489
01:00:41,460 --> 01:00:54,980
Yes. Do I know you may see what it was. It was a mutt Mesmer.

490
01:00:54,980 --> 01:01:01,040
With high fever, rapid pulse rate, intractable diarrhoea.

491
01:01:01,040 --> 01:01:13,970
A tremor. And video. And here's what I think about medicine is as it was, and they couldn't sorted out who she was.

492
01:01:13,970 --> 01:01:18,680
She was thought to have some metabolic disturbance. Sarcosuchus just came up.

493
01:01:18,680 --> 01:01:26,090
It wasn't right. And there was a strange condition in which you some mitochondrial disease or something or another.

494
01:01:26,090 --> 01:01:33,610
Anyway, we went to the small print and nobody knew and she put it out her ear and eventually

495
01:01:33,610 --> 01:01:42,440
it got to his old friend at Hammersmith and sent the lady over to Hammersmith,

496
01:01:42,440 --> 01:01:51,970
where by chance they did him. I don't know why they did a better balance, but they did give what she made and what came out.

497
01:01:51,970 --> 01:02:02,540
I found a lot of magnesium in her stool and she did come back and the ward sister found that her bath salts rose

498
01:02:02,540 --> 01:02:10,280
something or other bath salts continued sodium magnesium sulphate with which she had been poisoning herself.

499
01:02:10,280 --> 01:02:18,650
I can think of those sorts of patients. Never mind that the patient of Sheila Canada that I shared with her here,

500
01:02:18,650 --> 01:02:26,680
who had an anaemia, persistent depression, positive alchol, blood's in the stool.

501
01:02:26,680 --> 01:02:34,250
Never did do it until she stopped being a good condition, devised a method putting into a sideboard and finding it with a syringe and needle.

502
01:02:34,250 --> 01:02:38,510
She could take out having 50 vials of blood and swallow it.

503
01:02:38,510 --> 01:02:44,470
These are often these are sort of cases that live in my mind because they are beyond see.

504
01:02:44,470 --> 01:02:51,830
He's getting an MRI and molecular biology. They are actually letting deciding what?

505
01:02:51,830 --> 01:02:55,040
What people do, and I think in some way this is sort of genetic.

506
01:02:55,040 --> 01:03:03,590
I'm being very you know, when I look at the silver plate that my mother was given on Rapscallion for the World Free.

507
01:03:03,590 --> 01:03:16,880
It has some words which I wish they'd written about me, which was to a great teacher of medicine and a teacher of the ways of human beings.

508
01:03:16,880 --> 01:03:23,190
So I did. Of course, there are other uses in Moscow. What Susie's saying, oh, she's in the bath salts.

509
01:03:23,190 --> 01:03:27,540
I've heard that before. Well, no, you weren't. I think she probably unique.

510
01:03:27,540 --> 01:03:35,800
Yeah. But selfies on people, people who who who were epileptic, you would say another one.

511
01:03:35,800 --> 01:03:43,070
Do I remember that they all the ones I read or remember are in this category with the girl that came in when I was a registrar.

512
01:03:43,070 --> 01:03:49,550
Middlesex. Who announced that she had a very severe headache?

513
01:03:49,550 --> 01:03:56,710
The tape of the last week, she couldn't see things to the right, to the left, and that she suddenly become terribly thirsty.

514
01:03:56,710 --> 01:04:03,350
And gave a chemical history. Of course, a pituitary tumour of some size and grey.

515
01:04:03,350 --> 01:04:08,250
And so you ring the boss and say, I've got her. And he says, you better do a caracara garrotted.

516
01:04:08,250 --> 01:04:18,330
And she goes, Oh, you did then. And then the radiologist said, this woman's got holes in her head from previous neurology at that moment.

517
01:04:18,330 --> 01:04:22,970
Kreamer brings me back and says, John, I've been thinking I know it's 3:00 in the morning.

518
01:04:22,970 --> 01:04:29,250
Has she got red hair and is she around? I said, yes. She said, we have heard the National Assembly last week.

519
01:04:29,250 --> 01:04:33,800
She's a classical Munchhausen and she likes having garrotted edges.

520
01:04:33,800 --> 01:04:38,430
And I remember going to see her and say, well, we were in Queen's Square last week with Dr. Kreamer.

521
01:04:38,430 --> 01:04:44,340
Funny. Oh, Doctor. She said, I'll go.

522
01:04:44,340 --> 01:04:51,980
Say these have vivid memory or something together with that sort of great triumphs of first drops from done in this country in Oxford,

523
01:04:51,980 --> 01:04:58,340
which is all it was unwell. It was me and Tom Patterson and Joe Smith.

524
01:04:58,340 --> 01:05:07,680
Yeah. Yeah. I do. Yeah, but you see, that reflects that I'm not caring about terribly clever science.

525
01:05:07,680 --> 01:05:12,120
It's human nature. I I'm a little bit leading to a conundrum.

526
01:05:12,120 --> 01:05:17,810
I think that detective story side of medicine is Cassity. When a detective story about Baylis and I'm getting off now.

527
01:05:17,810 --> 01:05:22,380
But when I had to write Bates's victory, I had to look into him.

528
01:05:22,380 --> 01:05:27,450
I thought for what made him a great clinician. And he was in India.

529
01:05:27,450 --> 01:05:36,240
In the war, there's an outbreak of diarrhoea and vomiting off of infective nature that nobody could track down.

530
01:05:36,240 --> 01:05:41,460
And he, Captain Baylis, was sent out to do this by the brigadier.

531
01:05:41,460 --> 01:05:50,430
And he observed after a little bit that it didn't affect the how the ranks or the Sarge Smiths.

532
01:05:50,430 --> 01:05:57,600
It was confined to the officer. And it was confined to the end, to the nursing officer's mess.

533
01:05:57,600 --> 01:06:08,470
And then what else? And they'd be a good tradition, went round and asked them what they had to drink before dinner.

534
01:06:08,470 --> 01:06:16,070
And some are happier. Some had escaped. And some had to.

535
01:06:16,070 --> 01:06:23,030
Gin, gin and tonic. And they found that the gin and tonic ones were the ones.

536
01:06:23,030 --> 01:06:25,800
Then find out whether gin and tonic was made.

537
01:06:25,800 --> 01:06:39,680
Later, Lake in India found that only a picture of the gin and tonic factory was a source of water in which of a couple of dead cats.

538
01:06:39,680 --> 01:06:44,780
That's clinical medicine, man.

539
01:06:44,780 --> 01:06:55,150
They wanted to test as I studied medicine and so on.

540
01:06:55,150 --> 01:07:01,910
And when do you decide to study medicine? Really?

541
01:07:01,910 --> 01:07:08,270
I fought very hard against it as men found having not only two parents, father and mother in medicine,

542
01:07:08,270 --> 01:07:17,090
but an uncle, an obstetrician, another uncle in general practise, and a great aunt who had been a midwife.

543
01:07:17,090 --> 01:07:22,280
On the other hand, my mother's family were distinguished journalistic family.

544
01:07:22,280 --> 01:07:30,680
Her father be in Egypt, The Observer, her step brother was deputy editor of the Times.

545
01:07:30,680 --> 01:07:35,300
My two aunts had been up, but somebody were reading English one and both.

546
01:07:35,300 --> 01:07:44,210
One was the literary editor of The Observer and the other the other the literary editor of The Telegraph.

547
01:07:44,210 --> 01:07:50,270
So I was surrounded by people and I thought, I want to be and I want to edit dimentia to God.

548
01:07:50,270 --> 01:07:55,340
And I thought, hmm, I find no talent actually in imagination or writing.

549
01:07:55,340 --> 01:08:02,130
So I don't know. I decided within the Army in Hong Kong that I want to do medicine because suddenly the decision was there.

550
01:08:02,130 --> 01:08:06,230
You can have to do something with your life. And did I really want to do Latin?

551
01:08:06,230 --> 01:08:12,860
Greek? The rest of it an indefinite schoolmaster to say in Paris.

552
01:08:12,860 --> 01:08:18,820
And I thought probably I didn't learn very much. My second string from medicine would have been teaching holiday.

553
01:08:18,820 --> 01:08:20,870
Yeah. Yeah, no question.

554
01:08:20,870 --> 01:08:29,990
So then I decided in the Army and I'm living in a tent in Hong Kong with a little to do because the Chinese were not coming over the borders.

555
01:08:29,990 --> 01:08:39,560
He thought they would. I remember buying. Grove, a news biology steads, electricity and magnetism.

556
01:08:39,560 --> 01:08:44,610
And reading these textbooks and attend land on the census.

557
01:08:44,610 --> 01:08:48,420
Then arrived at Oxford. I had to do prelims in the first year.

558
01:08:48,420 --> 01:08:52,620
I went to a cram school behind Victoria Station for a bit.

559
01:08:52,620 --> 01:09:02,310
And did that attitude botany and then all sorts of zombies for you as an undergraduate at New College, not three, and didn't qualify for this.

560
01:09:02,310 --> 01:09:07,700
And you do your cooking for the Middlesex Anderson.

561
01:09:07,700 --> 01:09:15,180
Yes. Yes. I didn't consider it if I went to the middle states, which actually was great.

562
01:09:15,180 --> 01:09:24,690
Very strong, surgically offset the military. But, you know, I, I remember doing final in schools here, going back to Oxford.

563
01:09:24,690 --> 01:09:30,990
I actually had enough of this sort of, dare I say it, intellectual arrogance of the preety,

564
01:09:30,990 --> 01:09:37,900
the professors of the era when, you know, slightly felt to.

565
01:09:37,900 --> 01:09:40,900
They slightly felt that you.

566
01:09:40,900 --> 01:09:48,910
When selling us intellectual sailed on the river of information, you rarely were any respectable with few remaining physiology.

567
01:09:48,910 --> 01:09:56,260
And I guess what? I don't want to hear anything more about symmetry conduction or the squid axon.

568
01:09:56,260 --> 01:10:05,060
I wish to see the sick. Yeah. So at once arrival, little Middlesex and I had a medical firm that quite extraordinary was still alive.

569
01:10:05,060 --> 01:10:13,570
Had dinner with them. There were three of us from Oxford in a total of two from Cambridge, three from Oxford and one from London.

570
01:10:13,570 --> 01:10:20,380
Our first medical firm. And of the three.

571
01:10:20,380 --> 01:10:26,020
I am one that Jeffrey Redden became professor of endocrinology at Middlesex.

572
01:10:26,020 --> 01:10:33,100
And Ross McCarty, professor of medicine at Edinburgh.

573
01:10:33,100 --> 01:10:40,770
Christian was who payment paediatrician Vic Aldan speak to. They were good partnership advantage, yes.

574
01:10:40,770 --> 01:10:44,470
Well, we had fun. So I enjoyed the Middlesex Great.

575
01:10:44,470 --> 01:10:49,090
Yeah. And then, of course, London, you know.

576
01:10:49,090 --> 01:10:53,190
You I mean, you said what Gregory wanted to be a neurologist.

577
01:10:53,190 --> 01:10:57,460
Wanted to be an endocrinologist. Answer them. I just want you to look it up.

578
01:10:57,460 --> 01:11:09,910
But I think the advert in the BMJ for Hockaday site and I was wanted general physicians with an interest in cardiology.

579
01:11:09,910 --> 01:11:21,640
The one, the dairy crocodile in office. General medicine, diabetes, endocrinology and metabolic disease and nephrology.

580
01:11:21,640 --> 01:11:29,760
We have a pretty general. Yes. That I was here.

581
01:11:29,760 --> 01:13:40,320
Europe and the other question did an. Oh, tell me anything about the house and how they get funding for the Reforge servicemen.

582
01:13:40,320 --> 01:13:45,300
Can I do for you? What can I do for the medical school so there's no wind, Tapley Romanos,

583
01:13:45,300 --> 01:13:51,180
the house given by him that will win Tetley scholarships for a good 10 years where three out of

584
01:13:51,180 --> 01:13:58,650
students went to Hong Kong and three outcomes students gain to a new thing all through winter.

585
01:13:58,650 --> 01:16:58,710
And I suppose also music with Ms. Threat opening a study and making, as is he had the whole of the upper floor of Greven House to say goodbye to and.

586
01:16:58,710 --> 01:17:02,740
Revising now. Yes, indeed. Yes.

587
01:17:02,740 --> 01:17:07,570
Is then anyone that that is alive or either of hers or something?

588
01:17:07,570 --> 01:17:12,660
When I got connected, I think I was about. And did you see? Because, Alistair, if I have to say I mean,

589
01:17:12,660 --> 01:17:20,800
Alastair was that Lachlan was the chap who when Green College was coming up and where the students are going to go there or not,

590
01:17:20,800 --> 01:17:30,870
as the House had a meeting with its lecture theatre, which doll was invited to arrive to discuss what the new daughter arrived a bit early.

591
01:17:30,870 --> 01:17:35,770
Well, the business was going on and you wouldn't be surprised how Buchardt behaved.

592
01:17:35,770 --> 01:17:46,570
He said, Regis, I'm afraid we're busy. Would you please leave me and change my marriage?

593
01:17:46,570 --> 01:17:50,770
He, of course, is now headed to the house. Yeah.

594
01:17:50,770 --> 01:17:56,560
So that's why that happened. Yes. Interesting. You were saying racist in the rally is.

595
01:17:56,560 --> 01:18:05,290
No, I never. I suppose I know you want to have a chap who had a hockey blue and regarded oarsmen.

596
01:18:05,290 --> 01:18:12,310
It is beyond the pale, actually. I thought when I arrived at Veoh college, they had just gone head of the river.

597
01:18:12,310 --> 01:18:18,670
They also won the ladies play to Penny and they had six members of the Oxford Blue Boat.

598
01:18:18,670 --> 01:18:23,080
You call yourselves and they lounged about the common room either with pink

599
01:18:23,080 --> 01:18:29,900
socks from Leander or with M.J. Hawks written across a bloody great red sweater.

600
01:18:29,900 --> 01:18:38,660
And they ate separately. And I thought they were paying. And I was delighted with the Oxford crew sack.

601
01:18:38,660 --> 01:18:49,370
I was sort, you know, people who are real athletes did something with a bowl of people who rode boats were just people who are sick of.

602
01:18:49,370 --> 01:18:54,340
Come on, let's go. Now, I said they got some.

603
01:18:54,340 --> 01:18:59,920
I mean, you know, we should be going. And, you know.

604
01:18:59,920 --> 01:19:05,140
But you wonder about rowing. Of course, there's the high school, you know, rowing, and everybody wants him and everybody read it.

605
01:19:05,140 --> 01:19:11,040
So that was. And I've never been to the river. I've never I've never watched each week.

606
01:19:11,040 --> 01:19:16,330
No, not even once. No, no, not even once. I like to watch the Olympic rowing.

607
01:19:16,330 --> 01:19:20,200
But if you wanted to know about the distinguished people who are around,

608
01:19:20,200 --> 01:19:26,630
when I used to see people look back at what is now the warden's lodgings of greed gone and used to be my officers.

609
01:19:26,630 --> 01:19:36,210
Yes, sir. And they came in and one day came in this Canadian road scholar with head on to here looking like a pop star,

610
01:19:36,210 --> 01:19:42,040
then a reverse belt baseball cap on his head who turned out to be a bell.

611
01:19:42,040 --> 01:19:48,000
And he came in with the following. Director, he said.

612
01:19:48,000 --> 01:19:55,820
I don't wanna waste your time. Bell. I'm OK, you said, but I have something to tell you.

613
01:19:55,820 --> 01:19:59,960
Oser could go head of the river if you get the right guy.

614
01:19:59,960 --> 01:20:04,810
There's a bloke at Keibel who stroke the Canadian Olympic crew.

615
01:20:04,810 --> 01:20:09,640
Want to come to the house, but he's sick. He fails exams.

616
01:20:09,640 --> 01:20:17,560
Dull and ever have an. It's up to you to answer my question, and it's about Ron.

617
01:20:17,560 --> 01:20:22,780
John Bell, who first time I met him.

618
01:20:22,780 --> 01:20:26,650
No, I think good. Also, I think they are.

619
01:20:26,650 --> 01:20:35,040
Peggy would know this, that and I do. But I can remember when you had applications for new college or.

620
01:20:35,040 --> 01:20:40,460
No application of the clinical school in a pile done in my head.

621
01:20:40,460 --> 01:22:10,650
And I. He asked a reverse.

622
01:22:10,650 --> 01:22:16,950
Can't say it enough. No, but he might be helpful. I'm here to respect Sanchez.

623
01:22:16,950 --> 01:22:20,094
Well, not a bit. Whether or not he is in charge.