1 00:00:03,030 --> 00:00:11,670 This is the 11th of February to 015, whom Tchang being interviewed by Derek Hockaday, 2 00:00:11,670 --> 00:00:20,290 whom I guess that the first time you came to Oxford in connexion with opthamologist, be one of the conferences. 3 00:00:20,290 --> 00:00:34,950 That's right. Yes. Yes. We there to be roughly. Oh, I first came, I think, in nineteen sixty seven or eight to the Oxford Congress, 4 00:00:34,950 --> 00:00:41,790 which, as you know, is an annual international Congress held at that time in Balibo. 5 00:00:41,790 --> 00:00:49,290 And although it was started by Doyne, Robert Thorne, who is the founder of the hospital, 6 00:00:49,290 --> 00:00:57,390 the Oxford Hospital actually had very little to do with the Congress other than from from time to time. 7 00:00:57,390 --> 00:01:00,450 The people who work there participated. 8 00:01:00,450 --> 00:01:11,790 Um, but it was a very lively meeting because the location of it was so attractive in the summer for an international meeting. 9 00:01:11,790 --> 00:01:17,700 And we had people from the three continents for more. 10 00:01:17,700 --> 00:01:23,850 So I first got to came to Oxford for that reason. 11 00:01:23,850 --> 00:01:33,030 Who would be chairing the conference? Well, the conference has a master and this rotates every two years. 12 00:01:33,030 --> 00:01:45,900 Right? So usually somebody Eminem is elected into the Mastership and but there is a committee that runs the programme. 13 00:01:45,900 --> 00:01:53,980 And these are the, uh, the committee usually consists of both regional and academic representatives. 14 00:01:53,980 --> 00:02:02,570 So in other words, there would be people interested in the front of the on the back of the eye, people from Ireland, from Scotland, so and so. 15 00:02:02,570 --> 00:02:11,340 It's sort of fairly representative of a national body that is sort of a reputable representative. 16 00:02:11,340 --> 00:02:20,490 And it's very, very good. And of course, because if they at that time, it was limited to only senior registrars and consultants. 17 00:02:20,490 --> 00:02:31,800 It was much later on when we find a bigger venue that we we made it into an open meeting at that time. 18 00:02:31,800 --> 00:02:37,470 We met in the physiology school. But you see how small that is. 19 00:02:37,470 --> 00:02:44,940 Um, and I first came because I wanted to present a case that diabetic Mac Allopathy, 20 00:02:44,940 --> 00:02:53,250 which I treated by Zino, and I got the sense in the next few days to disappear. 21 00:02:53,250 --> 00:03:04,380 I mean, there was no comment on the seizure, but it just this caused and that was a step forward, so to speak. 22 00:03:04,380 --> 00:03:09,270 And that's my first acquaintanceship with Oxford. 23 00:03:09,270 --> 00:03:13,740 You were just telling me about Xenon. Yeah, yeah. 24 00:03:13,740 --> 00:03:19,720 Retinal Vertigo regulation. And it was the Hammersmith or More Fields, the first place to do it. 25 00:03:19,720 --> 00:03:23,040 And Morpheus was the first place to do it. 26 00:03:23,040 --> 00:03:40,320 And because Hammersmith had a big diabetic clinic and they were doing sort of innovative research to do with the treatment of science retinopathy, 27 00:03:40,320 --> 00:03:48,030 it was natural that morphine, which is aiming to introduce this treatment, should be pleased with that. 28 00:03:48,030 --> 00:03:53,370 And this is how I got involved, because I'm saying to you, I mean, as you know well, 29 00:03:53,370 --> 00:03:59,190 at that time, diabetic retinopathy was the commonest cause of blindness. 30 00:03:59,190 --> 00:04:13,770 So I was motivated to get involved with looking into that and see whether or not the regulation was what it came to be. 31 00:04:13,770 --> 00:04:27,090 A professor in Germany, Komachi Karaf, he was a retinal surgeon and he invented this treatment partly to try and, well, 32 00:04:27,090 --> 00:04:42,630 the retina back onto the collar, onto the underlying coat, because initially, before the retina becomes completely detached, you have a tear. 33 00:04:42,630 --> 00:04:53,220 And that was a time when you actually could put it back on before the fluid separated the retina from the core and then they wouldn't have any effect. 34 00:04:53,220 --> 00:05:01,470 And because this is a welding process, in other words, you produce heat, coagulate tissue. 35 00:05:01,470 --> 00:05:13,890 He also applied it to retinopathy, and he claimed in his little booklet about the use of light xenon after further 36 00:05:13,890 --> 00:05:21,840 calculation that this was also effective in the treatment of DABIC diabetic retinopathy. 37 00:05:21,840 --> 00:05:31,410 So up and down the country and in different parts of the world, people bought this gigantic machine, which is called a jumbo, 38 00:05:31,410 --> 00:05:42,330 because it had to house this mechanism to generate an intense xernona, which is then reflected by mirrors onto a Summerskill. 39 00:05:42,330 --> 00:05:53,710 Um, well, when we actually apply this treatment, it wasn't really that as successful as he implied in this book, 40 00:05:53,710 --> 00:06:04,590 but nevertheless, it had some I mean, like old treatment, which sometimes was effective and sometimes not. 41 00:06:04,590 --> 00:06:13,710 There was a lot of doubt. It was natural that it was a sort of prelude to a randomised controlled trial. 42 00:06:13,710 --> 00:06:22,770 And that was what was started in London, spearheaded by the group in London between Morpheus and the Hammersmith. 43 00:06:22,770 --> 00:06:32,880 To you and Niva. Yes, I was the one of the active members who went around the country trying to drum up interest. 44 00:06:32,880 --> 00:06:43,050 And I did some of the treatment in, Um Moorfield where I did most of the treatment of it, 45 00:06:43,050 --> 00:06:49,110 but it was actually very difficult to get people to really put their back into it. 46 00:06:49,110 --> 00:06:56,640 So essentially it became mostly Moorfield and with the simple patient in the hemispheres, 47 00:06:56,640 --> 00:07:03,060 a handful of cases from other places like Bristol, one or two from Ireland. 48 00:07:03,060 --> 00:07:08,400 But, um, and this accounted for the small numbers. 49 00:07:08,400 --> 00:07:12,790 So we are dealing with hundreds of patients as opposed to thousands. 50 00:07:12,790 --> 00:07:25,070 We hope to God. And that would have brought the trial to an earlier to brought some conclusive results earlier. 51 00:07:25,070 --> 00:07:30,150 Um, so when did it change, Joergen, to Argon? 52 00:07:30,150 --> 00:07:44,760 But that was really when the United States, um, I mean, Argan was introduced or early on, but by different people. 53 00:07:44,760 --> 00:07:51,520 And I've forgotten the name of the person who mostly initiated in the United States. 54 00:07:51,520 --> 00:07:59,530 It seemed a much more weird way. And also you could generate more power, so to speak. 55 00:07:59,530 --> 00:08:06,690 Uh, so the American, Marty, Multicenter randomised controlled trial was based on argon, 56 00:08:06,690 --> 00:08:17,790 whereas we started earlier and we had only the xenon, which was a sort of, uh, tool that most people possess in the UK. 57 00:08:17,790 --> 00:08:32,640 And so our our study was based on 094 for the regulation, whereas the American was based on argon laser vertical regulation. 58 00:08:32,640 --> 00:08:49,320 Um, and, um, I mean, as I say to you, these were exciting times because it seemed that this ravaging disease was, um, could be brought under control. 59 00:08:49,320 --> 00:08:56,280 And in fact, we published the first paper in the UK, as you know, 60 00:08:56,280 --> 00:09:02,250 I can't remember the day I think it was 76 in the ER in The Lancet when we published 61 00:09:02,250 --> 00:09:11,250 the results to say that it was effective in the treatment of meritocracy. 62 00:09:11,250 --> 00:09:20,460 Now, we didn't have quite enough cases to analyse subgroups in the way that Americans did, 63 00:09:20,460 --> 00:09:27,960 but overall there was a statistically significant difference in the treated and untreated groups. 64 00:09:27,960 --> 00:09:34,460 And is that provision of visual appearance of provision for this? 65 00:09:34,460 --> 00:09:46,510 This is obviously important because this is MacKillop. This is essentially to do with the macular and vision across the prime indicator of a function. 66 00:09:46,510 --> 00:09:57,130 Uh, a year later, the Americans published a bigger study and they show that it was also effective and delivered. 67 00:09:57,130 --> 00:10:01,810 It was opposite where we then publish in the paper a year later. 68 00:10:01,810 --> 00:10:13,170 Supporting it, but with smaller numbers, um, so, you know, I was very lucky to be involved in such a study and, 69 00:10:13,170 --> 00:10:21,660 you know, to reach positive results as it was the first generation Oxford before you came. 70 00:10:21,660 --> 00:10:33,480 Yes, 35 years. There was a jumbo, you know, um, but and as far as I could tell, some patients were treated, 71 00:10:33,480 --> 00:10:41,700 but there wasn't really, uh, organised effort to to tackle retinopathy. 72 00:10:41,700 --> 00:10:52,720 And when I came already, there was a portable xenon would be much easier to use, which we did. 73 00:10:52,720 --> 00:11:01,200 So we acquired that. And then, um, very shortly afterwards, the organ became available. 74 00:11:01,200 --> 00:11:05,910 And it was, um, then we use that. We converted to that. 75 00:11:05,910 --> 00:11:12,840 What made you decide to come to Oxford? I mean, there you were in London, notable black, you know, doing well. 76 00:11:12,840 --> 00:11:26,430 Well, I was attracted to London to to Oxford for a number of reasons because, um, um, I also had a very nice place and not a lot going on. 77 00:11:26,430 --> 00:11:42,810 And I to tell you, choose the person who's, um, my immediate boss didn't really want me as, um, on his unit as a whole, as a permanent colleague. 78 00:11:42,810 --> 00:11:46,860 So he didn't know if he had his eye on another fellow. 79 00:11:46,860 --> 00:11:52,590 So I really need to find another job. Now, did you were you a consultant in Tunbridge Wells? 80 00:11:52,590 --> 00:11:57,000 Yes. Yes. And while you were working at Moorfield? Yes. Yes, I. 81 00:11:57,000 --> 00:12:03,420 I had so I this is how I, I, I had to, you know, in case I did. 82 00:12:03,420 --> 00:12:09,510 So, as you know, when you become a senior registrar, there was sort of pressure for you to go. 83 00:12:09,510 --> 00:12:14,850 And I could have gone. I mean, I could have applied to the London if I did apply to the London. 84 00:12:14,850 --> 00:12:28,260 And I was hot favourite, according to one of the people who was on the board of selection, you know, but I didn't like the senior surgeon. 85 00:12:28,260 --> 00:12:34,290 Chappell Barry Jr. is dead now, and he was not a very nice person to be working with. 86 00:12:34,290 --> 00:12:44,010 And for me, thinking about it, you know, to spend my next 30 years, 35 years or twenty five years with him was unthinkable. 87 00:12:44,010 --> 00:12:53,170 And, of course, um, there's a very nice unit here headed by Tony Brown, who is very innovative and active. 88 00:12:53,170 --> 00:13:03,700 And so I would be very nice to collaborate with Tony Brown, particularly at a time when he actually had gone from the welcome, 89 00:13:03,700 --> 00:13:24,570 um, um, welcome trust to do to, um, see if they improve glucose control had a beneficial effect on, uh, retinopathy. 90 00:13:24,570 --> 00:13:33,830 Yes. Yeah. As you know, um, the methods for controlling diabetes wasn't refined and therefore you couldn't tell. 91 00:13:33,830 --> 00:13:40,050 Uh, so anyway. But we need but I contributed to that. 92 00:13:40,050 --> 00:13:50,340 And, um, and of course, the other thing is I was lucky in other respect that lends implantation was beginning. 93 00:13:50,340 --> 00:14:01,140 And I, um, um, did some early work, um, when I was in London, Tunbridge Wells, um, 94 00:14:01,140 --> 00:14:08,430 and I because of my work with the randomised controlled trial on diabetic retinopathy, 95 00:14:08,430 --> 00:14:16,200 the head of the NIH, I gave a paper in the United States and he hit one of his associates. 96 00:14:16,200 --> 00:14:24,510 I heard him say, look, why don't you do a randomised controlled trial on Lenzi implantation? 97 00:14:24,510 --> 00:14:28,230 And so I designed something to design that. 98 00:14:28,230 --> 00:14:34,620 And I said, well, if I could come to Oxford, I would be able to find collaborators. 99 00:14:34,620 --> 00:14:42,180 If I was, you know, elsewhere in a provincial hospital, I couldn't possibly attract young talent. 100 00:14:42,180 --> 00:14:49,350 You know, people could assist me in research. And indeed, I did get a big grant from the NIH to do this. 101 00:14:49,350 --> 00:14:53,520 And we published some some papers. 102 00:14:53,520 --> 00:15:01,660 How do they we had we had this grant for five, six years or longer. 103 00:15:01,660 --> 00:15:08,480 And so what I came that I introduce to implantation, 104 00:15:08,480 --> 00:15:20,570 which then subsequently took off in a big way because it was the natural way to go and not I didn't need a randomised controlled trial, 105 00:15:20,570 --> 00:15:23,180 but in the randomised controlled trial, 106 00:15:23,180 --> 00:15:36,410 did stir up some methodological formulae or ways in which they actually subsequently employ to do other studies, 107 00:15:36,410 --> 00:15:39,330 notably one in India where they're trying to. 108 00:15:39,330 --> 00:15:50,780 And I funded a big study in India trying to compare LENZEN implantation with other forms of treatment to see. 109 00:15:50,780 --> 00:15:58,730 But it was a save, but it was cost effective. So so it wasn't completely wasted and it was something that had to be done. 110 00:15:58,730 --> 00:16:07,040 A randomised randomised controlled trial. And then Tonin Institute had people working on the biochemistry of the lens. 111 00:16:07,040 --> 00:16:10,810 Yeah, that's right. Yes. Yeah. Did you get involved with that at all? 112 00:16:10,810 --> 00:16:18,540 Well, I didn't, um, other than as a um. 113 00:16:18,540 --> 00:16:22,250 There was one paper I didn't, I contributed to it. 114 00:16:22,250 --> 00:16:26,030 But you provided some lenses. Oh yes. Yes, yes. 115 00:16:26,030 --> 00:16:35,630 We uh. But the method of lens implantation, uh, 116 00:16:35,630 --> 00:16:48,830 evolved in such a way that they actually lost a lot of material because initially when you wanted cataract surgery, one removed the whole lens. 117 00:16:48,830 --> 00:16:57,710 And then we send the lens to the lab and they looked at the camp biochemistry, what we did about biophysics. 118 00:16:57,710 --> 00:17:13,400 But when we discovered the best way to retain the implant in the space where the lens should be was not to remove the holes, 119 00:17:13,400 --> 00:17:24,920 but to remove the contents of lens, but retained the capsule so that the artificial and goes into the capsule that they lost the materials. 120 00:17:24,920 --> 00:17:29,210 So but I mean, not altogether. There was there was still some there. 121 00:17:29,210 --> 00:17:42,710 So, um, and then later on, the cataract surgery improved the technical aspects and I introduced a fake ID, 122 00:17:42,710 --> 00:17:48,530 which is greatly simplify the way cataract was removed. 123 00:17:48,530 --> 00:17:54,830 So so I mean, this in a way runs up the way I was saying to you that I was involved. 124 00:17:54,830 --> 00:18:00,560 Lucky to be involved in a time of a lot of innovation, important innovation. 125 00:18:00,560 --> 00:18:10,100 And that was my ultrasound was yes. I think most education was instituted by a man called Kelmann, who's a charismatic figure, 126 00:18:10,100 --> 00:18:14,660 uh, who plays the saxophone in New York in a nightclub the night time. 127 00:18:14,660 --> 00:18:25,130 And they did some ophthalmology in the daytime, but he had the vision to persuade the engineer to do it to to make it, uh, ultrasonic probe, 128 00:18:25,130 --> 00:18:31,730 which you could then introduce into the lens space and fragment the lens and then 129 00:18:31,730 --> 00:18:38,960 evacuate the lenticular material as a liquid so that you could then preserve the. 130 00:18:38,960 --> 00:18:50,240 Mm hmm. I mean, obviously, like all innovative surgery, it didn't it had its problems initially, but then he became kind of an adopted method, 131 00:18:50,240 --> 00:19:00,440 which not only revolutionised cataract surgery, but, uh, and enable people to have cataract surgery much earlier on. 132 00:19:00,440 --> 00:19:02,900 So they weren't so desirable. 133 00:19:02,900 --> 00:19:13,570 But it made it a much faster operation, which meant that in a few minutes you could and the patient didn't have the rest for so long after, 134 00:19:13,570 --> 00:19:23,480 you know, did anybody work at all from your memories? How many people got, like, veins on both sides of parliament in but the cataract surgery? 135 00:19:23,480 --> 00:19:28,380 Well, in my time already, people were mobilised very well. 136 00:19:28,380 --> 00:19:40,040 OK, it was only in the very early days before I started ophthalmology that they put sandbags that were on both side of the head. 137 00:19:40,040 --> 00:19:46,350 And they, as you said, quite rightly, there was some other systemic complications. 138 00:19:46,350 --> 00:19:53,210 Yeah. And I mean, obviously, you were doing general upturn, logical practise and the Lansberg. 139 00:19:53,210 --> 00:20:01,000 Yeah, to me, actually, because I came to one day because you came to Oxford as a real diabetic Pontypool. 140 00:20:01,000 --> 00:20:07,300 What you have is that that you can I came in 77. Yes, you see seventy six. 141 00:20:07,300 --> 00:20:10,780 We just started a prospective Oxford study. Yes. 142 00:20:10,780 --> 00:20:21,220 Looking at control against tissue damage and linked up with Audry because before you came in, he was the guy most interested. 143 00:20:21,220 --> 00:20:25,780 And then, of course, a bit later, Rob turned over to his desk. 144 00:20:25,780 --> 00:20:29,140 Did you get involved with the UK? We did. I did get involved. 145 00:20:29,140 --> 00:20:43,180 I help the embassy, the fellow American fellow, although I never got acknowledged when I thought and I never realised that. 146 00:20:43,180 --> 00:20:51,250 On the other hand, I helped him. I gave him a lot of help. And and also I did some of the initial assessment for Robert Turner. 147 00:20:51,250 --> 00:21:02,590 Right. But you know how it is. It's it didn't matter to me in those days anymore because, I mean, other interests. 148 00:21:02,590 --> 00:21:06,160 You now have it. Williams was it Juliet? Her. 149 00:21:06,160 --> 00:21:10,630 William Yes. Is he she did a lot of work on average. 150 00:21:10,630 --> 00:21:21,170 No, there is only with Audrey. Yeah. But she didn't work with you and so you were to have your own little team and Philip would have his. 151 00:21:21,170 --> 00:21:22,690 That's right. Right. Yeah. Yeah. 152 00:21:22,690 --> 00:21:35,590 You know, Philip, um I, he continued to give the medical school a lecture on diabetic retinopathy, retinopathy to the medical students. 153 00:21:35,590 --> 00:21:46,640 Um, and and but I don't think he was involved with the research when Robert Turner had his study. 154 00:21:46,640 --> 00:21:53,950 When you got go initially and he sent all his patients with me to assess the annual I checked. 155 00:21:53,950 --> 00:21:59,650 But then as the study grew, I couldn't possibly accommodate in my room everywhere else. 156 00:21:59,650 --> 00:22:07,900 So so he had to appoint other people where he did it with either and probably several other people he did with other people. 157 00:22:07,900 --> 00:22:11,990 But I think the retinopathy was I can't remember. 158 00:22:11,990 --> 00:22:22,240 Well, I mean, because when the fellow was here, he did it right. But he either was the sort of national speaker, as you can imagine, in the UK. 159 00:22:22,240 --> 00:22:29,590 It is retinopathy. Yeah, but. And where did you eventually come to give the lecture? 160 00:22:29,590 --> 00:22:43,420 Well, as long as I did give lectures on on diabetic retinopathy and I was flattered that they got Professor Glassco whenever he wrote about breast. 161 00:22:43,420 --> 00:22:53,260 And obviously he was quoted the very first paper that I gave to do with the efficacy of treating macular, obviously. 162 00:22:53,260 --> 00:23:07,330 Um, but I mean, I tell you a story which which means you when you asked me to give the rest of the lecture to your cause, 163 00:23:07,330 --> 00:23:17,230 I you said, oh, we got double projection. And so stupidly on my part, I didn't check that you had double projections projection. 164 00:23:17,230 --> 00:23:21,550 We are used to it. So I got to carousels. 165 00:23:21,550 --> 00:23:25,060 I prepare the lecture two cars. 166 00:23:25,060 --> 00:23:34,690 I arrive at yourself only to find that you've got one projector and the other one you did by hand had some blanks. 167 00:23:34,690 --> 00:23:43,060 But because you were down there and I was up there, I, I couldn't communicate with you effectively, said, look, there are some blanks. 168 00:23:43,060 --> 00:23:51,220 So the whole thing was a fiasco because I was it to remember that side. 169 00:23:51,220 --> 00:23:55,300 But it was my fault. I should never have ever since I've checked. Yeah. 170 00:23:55,300 --> 00:24:00,040 Yeah. But you gave it again and I said, well I didn't like it. 171 00:24:00,040 --> 00:24:08,710 I'm sure I'm sure you're aware of that. And now when you came, I mean the hospital is a small place, small building. 172 00:24:08,710 --> 00:24:14,640 And there was the institute behind it. Yes. I mean, what changes did you see in the actual hospital where you were? 173 00:24:14,640 --> 00:24:31,990 You know? Well, huge changes, because when I first arrived, we had this operating theatre with a tiny space adjacent for the needs of anaesthetics. 174 00:24:31,990 --> 00:24:38,740 And from many points of view, from, you know, strictly hygiene point of view, 175 00:24:38,740 --> 00:24:49,840 it wasn't really the ideal solution that we continue to work there until we could move to the top floor. 176 00:24:49,840 --> 00:25:01,680 There's another funny story, which I will tell you, because when I first arrived, Tom Patterson, the plastic surgeon. 177 00:25:01,680 --> 00:25:06,300 And he said, oh, yes, I am, 178 00:25:06,300 --> 00:25:20,550 and I know the hospital because I used to work with Perthes who when I was operating with him one day I heard a pitter patter. 179 00:25:20,550 --> 00:25:27,720 I looked around. There was Matron bringing her little dog to see how we were getting on. 180 00:25:27,720 --> 00:25:31,020 Well, things had changed for that. 181 00:25:31,020 --> 00:25:46,410 And when we moved to the tower block and we did everything the same as the I can't remember what date it was, but we we did away. 182 00:25:46,410 --> 00:25:54,780 And then, of course, the other thing was we modify because numbers grew and we did many more things in the hospital. 183 00:25:54,780 --> 00:26:01,440 So we had to introduce more consulting space. 184 00:26:01,440 --> 00:26:11,340 And we obviously made use of the theatre, the part of the theatre which we converted into the casualty department and so on. 185 00:26:11,340 --> 00:26:16,920 And so things sort of gradually improved. 186 00:26:16,920 --> 00:26:22,440 They built a corridor to it. The linking you to a bit to the to the. 187 00:26:22,440 --> 00:26:24,630 Yes, to the main building. The main building. Yes. 188 00:26:24,630 --> 00:26:31,520 Because I can remember that arrived and it made it much easier to get outside to the aisles, particularly to the lecture theatre. 189 00:26:31,520 --> 00:26:36,510 Yes. Yeah, yeah. And so you were teaching. 190 00:26:36,510 --> 00:26:41,270 I was the clinical student. So you favour teaching teaching technical students? 191 00:26:41,270 --> 00:26:50,580 Well, the time that they were allowed, they were exposed to ophthalmology was very short. 192 00:26:50,580 --> 00:27:02,280 So they they used to come to my clinic and then I would show them cases so that the sort of hands on teaching methods of examination, 193 00:27:02,280 --> 00:27:12,200 some of the material they saw, um, and as far as I can tell, not all the students came. 194 00:27:12,200 --> 00:27:21,720 I mean, I think it was sort of, you know, far left to those who had an interest, those who had other things to do. 195 00:27:21,720 --> 00:27:31,300 So as a handful of them, um, rotated through the Cape because they nearly always hit somebody in the clinic. 196 00:27:31,300 --> 00:27:37,440 So this is how some of it was taught. And then you had house for the surgeons? 197 00:27:37,440 --> 00:27:47,490 We had how surgeons and the team expanded, uh, when, um, when I first came, 198 00:27:47,490 --> 00:27:56,100 there was just one senior registrar, uh, and but with the with the diabetic retinopathy work, 199 00:27:56,100 --> 00:28:04,830 um, we second man was appointed to work with me with a particular emphasis on emphasis 200 00:28:04,830 --> 00:28:11,670 on helping the local diabetic retinopathy and then also on the junior staff. 201 00:28:11,670 --> 00:28:26,550 We got more, um, S.H. out. And also we, um, um, had some technical assistance because one of the nice thing was that Rosebury rule, 202 00:28:26,550 --> 00:28:31,920 it introduced the party part time training scheme for married women. 203 00:28:31,920 --> 00:28:42,750 And we benefited by having, uh, these three in my time who went through the rotation and, uh, and others came. 204 00:28:42,750 --> 00:28:49,920 So we think that the team, the junior staff expanded a bit. 205 00:28:49,920 --> 00:29:03,300 And because of the sort of things that was going on in the lab, Tony's lab and also in the clinical field, we attracted some very good, 206 00:29:03,300 --> 00:29:18,390 um, uh, students from, uh, for for example, I quote the Julian Stevens, who was supposed to be the top, uh, top of the his year. 207 00:29:18,390 --> 00:29:31,110 He became an ophthalmologist. I had a chap, um, Keith Bates, who was a right, a scholar of Orio, I think. 208 00:29:31,110 --> 00:29:40,350 Or Copas, I can't remember. They all had, um, either first or extremely well qualified. 209 00:29:40,350 --> 00:29:44,100 So, um, I there were several of these people. 210 00:29:44,100 --> 00:29:48,660 So full time Oxford University. Can I have some. 211 00:29:48,660 --> 00:30:04,580 Excuse me. They about this, they we had some very good people who's been through and as a matter of fact, 212 00:30:04,580 --> 00:30:13,910 the president, Professor Robert MacLaren, he went through a very, very nice and he's extremely innovative. 213 00:30:13,910 --> 00:30:24,530 And you may have seen him on television and the first person to put a microchip behind the retina, but to simulate a sort of vision. 214 00:30:24,530 --> 00:30:29,660 Oh, yes, I've heard of that because he's blind and he's got other he's got lots of grants. 215 00:30:29,660 --> 00:30:34,010 And so that professorial unit is very active. 216 00:30:34,010 --> 00:30:37,650 So that's certainly broadens readership made in church. Yeah. 217 00:30:37,650 --> 00:30:44,600 Ten years is a person who chair the eye. 218 00:30:44,600 --> 00:30:49,160 As far as I can see that it is a personal chair. 219 00:30:49,160 --> 00:31:02,330 But I think he has the leadership and Margaret Ogleby readership, but he's working in the umbrella of neuroscience. 220 00:31:02,330 --> 00:31:08,640 The professor of the neuroscience department is Russell Foster. 221 00:31:08,640 --> 00:31:12,450 Yes, he is correct. 222 00:31:12,450 --> 00:31:13,370 Yes. 223 00:31:13,370 --> 00:31:38,110 Um, and, um, um, so Robert MacLaren has continued, um, to propagate the name of Oxford after Tony Braun said that the research part is alive and well. 224 00:31:38,110 --> 00:31:48,110 Yes. They got stem cells, gene therapy, all that sort of thing going on, which they move up the hill would be after your time after year after night. 225 00:31:48,110 --> 00:31:51,770 And has the laboratory gone up there as the institute? Yes. 226 00:31:51,770 --> 00:31:55,550 Yes, it was the engineering. Science neuroscience. 227 00:31:55,550 --> 00:32:12,140 Yes. Is, um, so, um, I don't know whether, um, um, the integration is I have to say, I haven't really looked into it closely. 228 00:32:12,140 --> 00:32:16,930 I did go to one of their seminars and I was very impressed by what was going on. 229 00:32:16,930 --> 00:32:20,440 Um, so it seemed to be working well. Yes. 230 00:32:20,440 --> 00:32:31,140 And, um, I mean, when you came, my guess is the facilities were all at least a bit more cramped than all fields when you went into the tower. 231 00:32:31,140 --> 00:32:41,750 Yeah. Was that everything you wanted or. Um, well, the tableau, um, the operating theatres were more modern. 232 00:32:41,750 --> 00:32:50,570 And, uh, as you know, I also worked with Mike Poole in the um, um, craniofacial. 233 00:32:50,570 --> 00:33:03,140 So it was much more, much more convenient. Uh, there were cases where I had operated with him and, uh, there were also cases where he came to us and, 234 00:33:03,140 --> 00:33:10,440 uh, that wouldn't have been possible if we didn't go into the towable. 235 00:33:10,440 --> 00:33:16,490 Um, but I have to say the changing room was left a lot to be desired. 236 00:33:16,490 --> 00:33:20,810 But I like, uh, but I hope things are better than they were. 237 00:33:20,810 --> 00:33:25,940 But so, you know, the hospital hadn't had anything to do with the design of it. 238 00:33:25,940 --> 00:33:30,140 No, that's right. Yeah. Yeah. 239 00:33:30,140 --> 00:33:47,900 Um, no, that was the craniofacial unit was also, um, something which was, um, um, a very interesting development in the right of infirmary. 240 00:33:47,900 --> 00:34:01,130 Uh, and, uh, the eye of the monastery was very glad to be involved because as you know, some of these gross deformities, iPads and Khuza'a, 241 00:34:01,130 --> 00:34:14,240 were attempting to try and correct, uh, to to some extent that deformity is is it accidents or was it a deformity, a congenital deformity? 242 00:34:14,240 --> 00:34:21,770 Uh, mostly congenital rivalries that the craniofacial, um. 243 00:34:21,770 --> 00:34:35,270 And. Oh. And Mike Pool was, um, the, um, uh, she, uh. 244 00:34:35,270 --> 00:34:41,450 Prime mover in that now, obviously, insurgent depends on a lot of people. 245 00:34:41,450 --> 00:34:47,600 How did you find the standard of nursing? Well, the standard of nursing was very good. 246 00:34:47,600 --> 00:35:03,650 I, I, uh, I must say, because they were very when I first came, there were some sisters who were elderly school. 247 00:35:03,650 --> 00:35:10,310 And I, I don't think if you were a nurse, you get away with being sloppy. 248 00:35:10,310 --> 00:35:16,070 So, um, they, uh, they said very good examples. 249 00:35:16,070 --> 00:35:27,290 And, um, they're also the outpatient sister was a big lady and there could be no nonsense with her. 250 00:35:27,290 --> 00:35:34,160 Now I think that was and alcohol, gradually things change, uh, sometimes for the worse. 251 00:35:34,160 --> 00:35:40,040 But I'm glad to see that that changed back to, for example, the discarded their uniforms. 252 00:35:40,040 --> 00:35:46,130 Yeah. And I thought that was a retrograde step because a patient didn't know who they were. 253 00:35:46,130 --> 00:35:52,660 And also, you wonder about, you know, um. 254 00:35:52,660 --> 00:35:59,030 From the on theoretical grounds, it can't be the Kennedy spot is questionable. 255 00:35:59,030 --> 00:36:08,680 So, so, so, um, so, um, I don't know what else, but when you first came, 256 00:36:08,680 --> 00:36:14,800 did you have a nominated number of bids or was it all fused, as are all the fossil fuels? 257 00:36:14,800 --> 00:36:25,420 Yes, it was Allseas. Um, and uh, but of course the hospital being separate the that were largely protected. 258 00:36:25,420 --> 00:36:33,710 Yes. So that's well, we didn't we weren't always looking over the shoulder to see where the medicine might pinch the fan. 259 00:36:33,710 --> 00:36:39,220 So but did you even have a word with, say, one other consultant or was it a complete job? 260 00:36:39,220 --> 00:36:44,550 It was I it was there were two was a male and a female. 261 00:36:44,550 --> 00:36:48,790 I was. And they were there was one one group. 262 00:36:48,790 --> 00:36:56,610 Um, so which was supposed the isolation is or isolation more private. 263 00:36:56,610 --> 00:37:09,940 Um so they felt like they were nearly always enough beds for the people who were on the waiting list, 264 00:37:09,940 --> 00:37:16,090 because more often than not we have some long cases I retinal detachment. 265 00:37:16,090 --> 00:37:20,830 So it's limited by the duration of the list. Mm hmm. 266 00:37:20,830 --> 00:37:25,990 So for the duration of the list, we nearly always had beds available. 267 00:37:25,990 --> 00:37:32,970 I mean, do you remember roughly how long would have been the waiting time for, say, cataract back then? 268 00:37:32,970 --> 00:37:46,090 Oh, um, there was a time when it was maybe I think I, I this is, uh, not something I can vouch for. 269 00:37:46,090 --> 00:37:50,940 No, no. But I think a year or is. 270 00:37:50,940 --> 00:37:55,270 Um, actually it is. So that was a very long wait. 271 00:37:55,270 --> 00:38:01,720 But I wouldn't have any other condition whether as long awaited as that. 272 00:38:01,720 --> 00:38:07,930 Oh well if you had talked you wouldn't have to wait long. 273 00:38:07,930 --> 00:38:17,920 If you had the attachment, you wouldn't have the way that these sorts of, uh, um, detectable more or less an emergency like, 274 00:38:17,920 --> 00:38:27,160 um, glaucoma would have priority because, you know, it wouldn't want wouldn't do so if you left it. 275 00:38:27,160 --> 00:38:33,040 So this is so cataract was because it's a known as an operation. 276 00:38:33,040 --> 00:38:42,760 And to check the progression of cataracts by not slow, uh, but the thing that, um, 277 00:38:42,760 --> 00:38:52,670 perhaps the group that was disadvantaged a little bit was the squinch children misdoings because of the waiting time. 278 00:38:52,670 --> 00:38:59,520 Uh, and I think the waiting time was largely limited by the time available, but also by the sessions, 279 00:38:59,520 --> 00:39:09,730 a number of sessions we have bit of them that you didn't have enough sessions so that you can actually have a much bigger time. 280 00:39:09,730 --> 00:39:18,940 Mm hmm. Um, I think that was my recollection to that sessions in the javadoc as opposed to our own surgery. 281 00:39:18,940 --> 00:39:21,820 You're right. Even even even before. Right before. 282 00:39:21,820 --> 00:39:32,410 Because it was sort of linked to the anaesthetic I this one room available for I say operating for three years for four consultants. 283 00:39:32,410 --> 00:39:36,730 Yeah. Yeah. So now is they're important. 284 00:39:36,730 --> 00:39:42,160 And how did you find that. And I suppose it became quite a lot of it became local. 285 00:39:42,160 --> 00:39:46,450 Yes. Yeah. Progressively. Um I operate all time. 286 00:39:46,450 --> 00:39:50,560 Exergy rely less on gentlemen. 287 00:39:50,560 --> 00:40:06,010 It's easier. Uh and this was became more or less universal I think that um long operations. 288 00:40:06,010 --> 00:40:10,870 Like a detective or complicated retinal detachment. 289 00:40:10,870 --> 00:40:24,580 Well, they they changed much later. But for nearly all the other surgery, apart from death row, just around next to me, uh, 290 00:40:24,580 --> 00:40:32,260 you change over the local, but then because of the age of the patient, we still needed. 291 00:40:32,260 --> 00:40:44,170 And in these cities, uh, so it although, um, a particular surgery, because many of the patients that, oh, 292 00:40:44,170 --> 00:40:55,680 we still needed anaesthetists to be available in case of any sort of emergency like, uh, respiratory distress or some heart problem. 293 00:40:55,680 --> 00:41:01,390 So and then the local anaesthetic, you know, dropping stuff into the air. 294 00:41:01,390 --> 00:41:06,130 And then there are things of injecting. Yeah. Now anaesthetists do that presumably. 295 00:41:06,130 --> 00:41:17,380 Do they did you. Well, in our time, um, we still use Rencher Balbir or Perivale them anaesthesia um and injected IV. 296 00:41:17,380 --> 00:41:23,320 So you inject we did that because on the whole we were more used to doing that. 297 00:41:23,320 --> 00:41:30,700 And the anaesthetist, although they're trained to give local anaesthetic, they're not trained, they'd be less expensive to administer. 298 00:41:30,700 --> 00:41:37,090 We prefer that we take the risk rather than to let you know unsentenced. 299 00:41:37,090 --> 00:41:46,160 But now cataract surgery has evolved so much that, um, more often than not, they only use topical anaesthesia. 300 00:41:46,160 --> 00:41:53,170 In other words, some cocaine and some short acting anaesthetic drops. 301 00:41:53,170 --> 00:41:57,820 And when you arrived, how did anaesthesiology compare with London? 302 00:41:57,820 --> 00:42:12,910 Um, I thought it was much the same. If anything, I think the, um, uh, the anaesthetist were more sort of. 303 00:42:12,910 --> 00:42:17,290 I mean, compared to morphemes, notably, we had, uh, 304 00:42:17,290 --> 00:42:30,560 quite senior people and it seem out of fashion compared to all sorts of sort of progressive of I mean, the school is famous from Lafayette. 305 00:42:30,560 --> 00:42:37,990 Yes. They had a son. And then how much do you work with pathologists and how important is that? 306 00:42:37,990 --> 00:42:46,590 Um, not so much because, uh, we didn't do so much to my work. 307 00:42:46,590 --> 00:42:53,320 I mean, melanoma's. What do you do them melanoma's, of course, local excision. 308 00:42:53,320 --> 00:43:00,250 Uh, but, um, um. And of basal cell carcinoma. 309 00:43:00,250 --> 00:43:09,110 But, um, I personally didn't get a lot of, uh, tumour what passed my way. 310 00:43:09,110 --> 00:43:23,820 Uh, and I think the tendency was, uh, referring to melanomas, to plastic surgery because it require bigger excision and also some reconstruction. 311 00:43:23,820 --> 00:43:27,580 Yeah. Quite often. And then bacteriologists you. 312 00:43:27,580 --> 00:43:39,970 I've been very much yes. Because the one disaster, the one complication with fear after cancer surgery or any intraocular surgery is an optimises. 313 00:43:39,970 --> 00:43:45,130 Yeah. I mean critically depend on working closely with them. 314 00:43:45,130 --> 00:43:50,170 Uh, but we have a case which I'm happy to say happened rarely. 315 00:43:50,170 --> 00:44:01,910 But when we did, it was very critical that we liaise with closely about type, uh, what sort of. 316 00:44:01,910 --> 00:44:10,540 The sensitivity, that type of bacteria and sensitivity, light sensitivity and so on, you know, 317 00:44:10,540 --> 00:44:20,490 when were you busiest in your professional career, would you say, as a consultant or previous fellow? 318 00:44:20,490 --> 00:44:28,090 I would say that as a consultant, because, as you know, 319 00:44:28,090 --> 00:44:40,450 one is given so many sessions and to try and write papers if it has to be done in your spare time. 320 00:44:40,450 --> 00:44:51,250 And it's a question of creating, um, I'm a sort of working myself up to the energy and then creating the time, 321 00:44:51,250 --> 00:44:56,500 you know, to to do things in order to write right up. 322 00:44:56,500 --> 00:45:07,000 So I would say that the middle period when I was particular, when I was travelling, going to report to the NIH, 323 00:45:07,000 --> 00:45:11,170 that was sort of the most demanding period because, you know, 324 00:45:11,170 --> 00:45:19,180 you go there because you're trying to get things ready and get the paper ready to to get to go. 325 00:45:19,180 --> 00:45:27,560 And you suffer from jet lag when you got there and you come back and you have a project and you try and catch up. 326 00:45:27,560 --> 00:45:32,800 Uh, so it wasn't, uh, easy, as it turns out. 327 00:45:32,800 --> 00:45:46,210 So, um, but it's actually salutary because, um, uh, I don't as I don't need to say to you, did you do outpatients outside Oxford? 328 00:45:46,210 --> 00:45:51,760 I did. Banbury, um, once a week arrived at once a week every Friday morning. 329 00:45:51,760 --> 00:46:03,220 And I was always a big rush. Uh, but, um, you know, it's a service fund which, uh, one had to deliver. 330 00:46:03,220 --> 00:46:10,140 And, uh, but it's always a rush trying to get back to the afternoon activity. 331 00:46:10,140 --> 00:46:16,550 So, uh, it was when I, I, I. 332 00:46:16,550 --> 00:46:27,200 I was so I had such a long waiting time for people to get to my clinic that I once said to the, 333 00:46:27,200 --> 00:46:35,300 um, I once wrote to my colleague Unfoldment, but I'm getting many referrals. 334 00:46:35,300 --> 00:46:42,380 And I discovered it from a clinical system that he's thinking of actually cutting down his genius. 335 00:46:42,380 --> 00:46:48,200 So I wrote to the Medical Council committee to say, look, for heaven's sake, 336 00:46:48,200 --> 00:46:53,330 don't let him because your wife is not asking to send me some of your patient, 337 00:46:53,330 --> 00:46:59,150 send more to him because, you know, the waiting time to get to my clinic is over long. 338 00:46:59,150 --> 00:47:04,490 And, you know, I you know, invariably it's five days is a day. 339 00:47:04,490 --> 00:47:10,130 I don't have any lunch because of the sort of the rush. 340 00:47:10,130 --> 00:47:20,210 So apparently this was a bit of a joke because Robert Bell is a paediatrician. 341 00:47:20,210 --> 00:47:24,980 He's all very, very sort of extrovert. 342 00:47:24,980 --> 00:47:29,390 Yeah, loquacious. He said, oh, I see. Yeah. 343 00:47:29,390 --> 00:47:40,740 The man who never has any lunch. But I know, but I mean, at Bamburgh were you just doing outpatient your operation. 344 00:47:40,740 --> 00:47:49,150 I wasn't there, but he was I well I mean he was. 345 00:47:49,150 --> 00:47:55,630 I would do it, but there wasn't a facility and the pressure of the clinic was too great. 346 00:47:55,630 --> 00:48:03,220 Too many patients you couldn't stop there to to operate, so they'd come to Oxford without having to answer it. 347 00:48:03,220 --> 00:48:14,440 And I think and of course, the other thing is that ophthalmic equipment, when it comes to things like lasers and so on, are so expensive. 348 00:48:14,440 --> 00:48:14,920 Yes. 349 00:48:14,920 --> 00:48:27,250 You couldn't really put them in all the outpatient places like Whitney Banbury Stupenda over there, the second to get thrown out, said Mandaville. 350 00:48:27,250 --> 00:48:31,480 Uh, I in the region, it was winzer. 351 00:48:31,480 --> 00:48:37,030 Right, that had a very active chap called Jack Kanaskie. 352 00:48:37,030 --> 00:48:44,410 And he he managed to to get a lot of equipment. 353 00:48:44,410 --> 00:48:48,210 And were you involved in, as it were, educating him or did he come? 354 00:48:48,210 --> 00:48:56,380 No, he was a contemporary of mine, Jack, and he was a year ahead of me in those years. 355 00:48:56,380 --> 00:49:07,390 Um, and, um, the people that we sort of trade up with, nearly all the consultants and Stoke Mandeville now. 356 00:49:07,390 --> 00:49:19,270 Mm hmm. Uh, and, um, but in those days, they weren't, um, they weren't, um, part of. 357 00:49:19,270 --> 00:49:25,750 Did you lecture much in the region. Yes. Regularly because we have, um, regional days. 358 00:49:25,750 --> 00:49:33,240 Right. And um. And well. 359 00:49:33,240 --> 00:49:38,170 He was part of my mission to try and get them to go organise their diabetic. 360 00:49:38,170 --> 00:49:40,500 Well, you remember Charles Fox? 361 00:49:40,500 --> 00:49:52,310 Yes, he was very active and he used to get me to talk to North Hampton is a lot, but not just North Hampton Roads and poverty. 362 00:49:52,310 --> 00:50:00,870 And how much private work really? Um, I was doing, um. 363 00:50:00,870 --> 00:50:04,560 Initially, I didn't do any right, um, 364 00:50:04,560 --> 00:50:19,450 and I might consult my accountant persuaded me to have a room in my house so I could claim that that was right there, 365 00:50:19,450 --> 00:50:23,730 but I didn't do anything for five years. 366 00:50:23,730 --> 00:50:29,110 So, um, but then gradually, the more demanding all the time they retire. 367 00:50:29,110 --> 00:50:34,950 No, no, no. It just doesn't suggest that there was just the demand increase. 368 00:50:34,950 --> 00:50:41,730 And so I didn't share rooms with Philip Audry and on Frieman. 369 00:50:41,730 --> 00:50:45,750 So I did I did two or three 1/2, two 1/2 days. 370 00:50:45,750 --> 00:50:51,810 I did two days. It was Saturday morning. 371 00:50:51,810 --> 00:50:56,100 And and and one of the other days. Yeah. 372 00:50:56,100 --> 00:51:00,460 And then the operations. I did them in the afternoon. Yes. 373 00:51:00,460 --> 00:51:05,760 Um, and that was all well kitted up. Well no they actually um. 374 00:51:05,760 --> 00:51:25,860 I mean I was very um at times uh very uh uh disenchanted with them because they didn't have, um, the sort of, uh, equipment that I need. 375 00:51:25,860 --> 00:51:36,450 I had to bring them from the aisles, but eventually I persuaded them when they saw that there is a potential for them to earn some money. 376 00:51:36,450 --> 00:51:42,210 And there were no nurses trained in. 377 00:51:42,210 --> 00:51:59,400 And I, uh, and one nurse who along with, uh, Hotan, uh, who's predecessor, um, he, um, was, um, um, 378 00:51:59,400 --> 00:52:11,190 she was very cross with me because I, I point out things that she had to do, which she wasn't doing. 379 00:52:11,190 --> 00:52:18,120 So, uh, that she is good enough for Mr. Holtan, but it's not good enough for you. 380 00:52:18,120 --> 00:52:25,710 That's progress. And, uh, and so they act better because, um, you know, as you know, um, 381 00:52:25,710 --> 00:52:35,600 as one stays in the place long enough, uh, people get to know you, they want to to come to you. 382 00:52:35,600 --> 00:52:48,030 And so, um, in a way, I mean, I say I'm not saying this, um, um, out of all the right words to choose, 383 00:52:48,030 --> 00:52:54,120 but I didn't want to make a virtue of it to some extent that the private practise. 384 00:52:54,120 --> 00:53:00,660 But what sort of push on to me, because the particular people in university, 385 00:53:00,660 --> 00:53:10,140 they came and either they had insurance, the colleges ensure that they they want the service. 386 00:53:10,140 --> 00:53:22,080 And I'm there as a clinician. I provided the service. And so to come back to their initial bid, the annual meetings. 387 00:53:22,080 --> 00:53:24,770 Yeah. Were you involved with this? You have to be. 388 00:53:24,770 --> 00:53:38,430 Yes, I was regional advisor for five years and I was college, the college representative of the for the region for for a long time. 389 00:53:38,430 --> 00:53:43,410 And so I was involved with the the regional meetings. 390 00:53:43,410 --> 00:53:47,770 Yes. I was really thinking of the national meetings. The Oxford. 391 00:53:47,770 --> 00:54:01,200 Oh yes. Yes, yes, yes. Oh yes, yes. I mean if I had a paper to give and because when I was doing this, uh, during the, uh, randomised control, 392 00:54:01,200 --> 00:54:10,200 uh, control, uh, study on diabetic retinopathy of almost every every meeting, uh, presented the paper. 393 00:54:10,200 --> 00:54:18,040 Good. Um, and also when I was doing the randomised controlled trial on cataract surgery, it was a lot to talk about. 394 00:54:18,040 --> 00:54:26,580 Yes. I said and also all the people asked me to. And so both the we had two national meeting. 395 00:54:26,580 --> 00:54:35,130 One is the college meeting. A lot of the you know, the O u k before the college to establish the ophthalmology society, the United Kingdom. 396 00:54:35,130 --> 00:54:41,090 Uh, so that was an animal that moved. And then in the summer, there's the Oxford Congress. 397 00:54:41,090 --> 00:54:48,300 Uh, and, um, I from time to time I gave papers. 398 00:54:48,300 --> 00:54:56,880 Were you the master of it? No, I was there. I was the deputy master, but well, there only chose masters from amongst counsel. 399 00:54:56,880 --> 00:55:07,250 Right. And Tony was already. The council member, so so, uh, I was deputy minister for one year, so. 400 00:55:07,250 --> 00:55:11,610 So when you were going to America, that was mostly on the retinopathy, was it? 401 00:55:11,610 --> 00:55:16,110 No, it was mostly on the lens. That lens implant. 402 00:55:16,110 --> 00:55:20,340 Oh, yes. Right. Yes, yes. For cataract. 403 00:55:20,340 --> 00:55:24,030 Cataract. Yeah. And did you keep that up? 404 00:55:24,030 --> 00:55:37,310 I mean. Well, I didn't, because when the lens implantation became mainstream, there wasn't. 405 00:55:37,310 --> 00:55:45,810 And it was largely overtaken by the Americans and then also eventually became commercialised. 406 00:55:45,810 --> 00:55:50,220 And so I didn't go. It was I also I was in Dubai then. 407 00:55:50,220 --> 00:56:06,480 I wasn't doing any innovative work. So I, I stopped there, uh, and, um, but it was a very interesting experience because in England, as you know, the, 408 00:56:06,480 --> 00:56:15,090 uh, the concept of internal implantation was started by a man who had originally in England, he was a Scientologist. 409 00:56:15,090 --> 00:56:28,290 And, um, uh, apparently a student said to him, so you move a lens from an eye to a cataract, so why don't you put one back in? 410 00:56:28,290 --> 00:56:34,080 And he thought about this and that and developed a lens which is very heavy. 411 00:56:34,080 --> 00:56:40,500 But by a great stroke of luck, the first two cases worked. 412 00:56:40,500 --> 00:56:45,780 But after that, there were all sorts of complications which he never really admitted to. 413 00:56:45,780 --> 00:56:50,310 And I said the whole thing went into sort of, uh, you know, 414 00:56:50,310 --> 00:57:04,890 became part and and also later attempts led to all sorts of complications and to a man in Holland, publish a whole series of cases, 415 00:57:04,890 --> 00:57:12,450 more or less honestly, which show that if you did it in a certain way, that the complications were, 416 00:57:12,450 --> 00:57:18,360 quote, acceptable, unquote, and then people took a great deal of interest. 417 00:57:18,360 --> 00:57:24,660 But, um, how original disciple was a tactical choice? 418 00:57:24,660 --> 00:57:30,570 Peter Toys, who was, uh, want a better word, man? 419 00:57:30,570 --> 00:57:34,470 Very economical with the truth. Yeah. 420 00:57:34,470 --> 00:57:46,200 And he and because of that mainstream surgeon, but had gone off as planned implantation and therefore it wasn't done for decades, 421 00:57:46,200 --> 00:57:52,890 really, really until there's been publishing the result in nineteen seventy six. 422 00:57:52,890 --> 00:58:02,850 But then you see Peter Choise went to America and persuaded the Americans because of the commercial angle, 423 00:58:02,850 --> 00:58:14,230 you know, he could do this and they should do it. And for four years the Americans were copying him and there was a whole load of disasters. 424 00:58:14,230 --> 00:58:24,310 And so this is this is what led up to the necessity to do a randomised controlled trial trial and also, you know, to studies, you know, 425 00:58:24,310 --> 00:58:37,930 have sort of, uh, sort of protocols and follow ups and, uh, but then, you know, like things in America, things evolve very quickly. 426 00:58:37,930 --> 00:58:48,130 And it's said that the commercial lobby took over and it became very commercialised. 427 00:58:48,130 --> 00:58:52,200 And we were writing papers up to retirement. 428 00:58:52,200 --> 00:59:01,050 Or did you stop for a bit? I stopped, I'm afraid went not because, um, basically I ran out of things to say and I did. 429 00:59:01,050 --> 00:59:09,840 And, um, but other things to do. But we were doing last paper being, which is magic as well. 430 00:59:09,840 --> 00:59:16,950 Uh, it was um I, I it, it had my name on it. 431 00:59:16,950 --> 00:59:28,440 I contributed to it. It was again a contract study in Southeast Asia and I helped a Norwegian, um, 432 00:59:28,440 --> 00:59:36,600 who got a big grant from the Foreign Office, Norwegian Foreign Office, and he was a Truesdell University. 433 00:59:36,600 --> 00:59:45,510 He did a thesis which is sort of a continuation of the work I was in. 434 00:59:45,510 --> 00:59:50,970 I took my protocol for the U.S. project and he modified it. 435 00:59:50,970 --> 00:59:55,020 And and then I, you know, got involved with his work. 436 00:59:55,020 --> 00:59:59,910 And I visited the places where he had, uh. 437 00:59:59,910 --> 01:00:07,010 To prevent blindness, blindness prevention studies in Nepal, Bangladesh and India. 438 01:00:07,010 --> 01:00:11,720 So I got I wasn't the prime mover, but, you know, I helped, you know. 439 01:00:11,720 --> 01:00:31,400 And so I think there was in the early 90s, I got I, I got to go to India or this is what I ran a workshop in Chittagong and also in Kathmandu. 440 01:00:31,400 --> 01:00:36,710 And so I used to go from time to time. 441 01:00:36,710 --> 01:00:43,670 But India was a I don't I don't know, you know, in India is a very taxing experience. 442 01:00:43,670 --> 01:00:49,370 Yes. And I needed to be tough. I always enjoyed it. 443 01:00:49,370 --> 01:00:55,500 But I. But I know what you mean by that. You mean are you glad you came to Oxford? 444 01:00:55,500 --> 01:01:05,690 Oh, hugely. Hugely. Because, um, people ask me, why don't you if you like France so much, why don't you go to live in France? 445 01:01:05,690 --> 01:01:11,740 I said, well, I like France a lot, but I also like Oxford better. 446 01:01:11,740 --> 01:01:16,610 I now is there something I should have asked you that I haven't? 447 01:01:16,610 --> 01:01:33,790 Well, we, I, I don't think so. I mean, um, we've gone over the um uh what I did was I was involved in the, uh. 448 01:01:33,790 --> 01:01:41,660 I hospital visit a number of changes, I don't I don't I don't think so unless you can do could think of it. 449 01:01:41,660 --> 01:01:45,650 No, I have no idea right now. Impossible to stop them. 450 01:01:45,650 --> 01:01:50,853 Yes. Yes. That was lovely. Thank you very much. That's terrific.