Professor Derek Jeter being interviewed by Derek Hockaday on the 14th, I think it is 14th of February.
Well, Derek, you're a tremendous part of the medical school and that you've been involved with it for a long time.
So let's start at the beginning. You came up as an undergraduate to Japan.
Yes, 1959. Was that a Nuffield scholarship?
Uh, I was, uh, over next. Yes. Great.
And was that still with Percy O'Brien? Because, as you said, the use of that period of.
Perskie is an absolute wonderful tutor. Uh, because in those days.
It was very often the one to one choice. Sometimes there were two of us, um, we read essays.
Have they tended to shreds? Um, but my choice was always between six and seven.
And at seven o'clock, he would always produce a show for just before 7:00 so that he could get out of the senior home for dinner.
So he is, um. And he was very kind hearted, he was very supportive.
Um. And you just had to put up with his.
Sense of humour, um, which would now be regarded as testing, is pretty correct.
Uh. Um, he was very bright and, um.
He is one of these. People didn't do this in academic life.
OK, who was?
Have had a very destructive mind, but I found it quite difficult to be constructed in such a sense and therefore these publications were quite small.
Um, but, uh, yes, he was a lively character competition, it was.
Um, not always pleasant, the great,
she said they usually had your first three years of the beer and then you did one year of on a school of animal physiology.
Yes. Had they reformed it by that time? No. So what did you think of that?
Um, well, we knew the difference. That was how it was.
And we enjoyed a great year and.
Um. Just there is an enormous privilege you gave to to have people like.
Uh, within the parameters of professor physiology, um.
And David Matthews said there was a, uh, vaguely akin to, uh.
Sherrington. Um, and then also we had, um, uh, Dan Cunningham, um, Brian Boyd and respiratory physiology, uh, yeah.
It was a very, uh, stimulating environment to, uh, to study that, uh.
Most if you're not part of this group, you did two terms of, um, pathology and.
Uh, pharmacologic bacteriology and then most people in the April 12 to 15 technical and a few of the stay, I wanted to stay.
But I wanted to do. The adoption of this event would do, um.
If I think we did that first and four terms for schools, you could do I mean, I did that way back and I mean, I'm ten days days.
I did it. But you could do the part about it first and then do the full terms of schools.
And that's that's what I did find. Um, and I have to say that one of the major reasons for doing it was because, um.
The first several schools, the fall was, of course.
Yeah, I was very active on the river ride and a Secretary Gates at that work and.
Were you a Cox? I was. Yeah. And, um, uh, was also involved in a little bit of research in the respiratory physiology part.
So that was the reason for, uh, carrying that.
But pass back for us. And did your research lead to anything or was it just a bit of work?
I didn't it wasn't a degree registered thing. That's great.
Um, and the respiratory thing, they were quite metabolic in a way.
I was you was very breathing or was it to do with whatever it is?
Um. Um, I began to fall silent behind the Brandenburg's equations, which I found very difficult.
It's, uh, you know, and then what made you decide to do clinical in Oxford?
Um. I think really the total going to London didn't seem particularly attractive.
Um, and, uh, stay in Oxford.
Where that is, we have some groups having spent just three years here, um.
It's much more attractive, so. I think I recognise some of the, um, teachers in the technical school that.
Early stage as being the. Very, very stimulating and, um, you know, I just enjoyed it, and I think that Percy, uh,
brought a great interest in on the 12 and of course one actually came to the US, which were very much interested in other departments and.
And so I think there are a number of reasons that made you want to stay in some cases during your preclinical ahead,
Ullico been doing demonstrations of patients.
Um, he had, um, we had one,
a finical physiology or a chemical that's in the lecture quite often to tend
to kind of open to that kind of nasty or nasty as applied to clinical lesson.
And then we had people like Francis Caird. And cook.
Um. Those are the two I remember most did it's a chemical physiology.
So, uh. There you all will be exposed a little bit to some of the teachers,
thing I forgot to mention was what did you think of the entrance procedure to Pennbrook and to the university's, uh.
Uh. Well, in those days, if you wanted to apply to Oxford and Cambridge, uh, you did A-levels again two years and then you stayed on for 36.
Um, uh, I was being encouraged at school to.
Talks which surrounded the thirty six so tried for.
Um, oxer, I think, largely because I lost my schoolmasters.
Um, were Oxford graduates from Cambridge? I remember a few from Cambridge, but once you had those two friends who were probably from Oxford.
Uh. The application form me has to, um.
This colleges, in order of preference, at least for about half a dozen.
Mm hmm. Uh, but I have no idea. You know, I was the first member of the family that even think about going to, um.
But, um, it was my history, my school, who, um, was very interested in, uh, and I got home very well and even in the sciences,
um, we often used to talk in the corridors until he graduated from Pembroke.
Mm hmm. Um, and the current master plan.
But I can tell you very well the kind of history he said, I will write on your behalf.
And so I came up for an interview. Um. They discussed, for example, issues.
What they don't see is, uh, came straight from school.
Living in the college for a week. Uh, which is very smart.
You have to cross to quadrangles in wins and wethers to get into the bars and the.
Um, and. Um, it is early December.
Yes, it was cold and wet. The examination schools don't seem to say the least.
Um. I think they did exams Thursday, Friday.
We have about until Sunday evening. When a list of top military.
To, um. Indicate who has being invited to stay for the practical examinations, um, on Monday and Tuesday.
Well, I my name is on the list, so you stayed on.
And did the fact that in some parts of. The is.
And the. Uh.
The Science Show is. 310 professors of colleges listed.
I for temporary less and was more constructive, is infuriating to ask you about the interview in a large.
So to ask you about the practical use of for.
Yes, but that's. Um, just came round during one of the past four days and asked me a few questions.
It didn't last very long. Um, no more than ten minutes.
And then, um, uh, John Walker is here.
You know, he came out and said, would I please, uh, come down to us for an interview at five in the was finished at five.
That was a terrible experience because it goes against the principles and is absolutely shocking, was read.
I had a raincoat, but it's quite a sad story to lose and I rain soaked in drag.
And just really awful that I had to have an interview in this state until the second sat down in this room,
there was a fire going and he said, just take off your raincoat.
Really, don't worry about being said he's opposed to share your life with one another in which you are clinically is not.
Sixty three to sixty six. Yeah. So I don't know who's the director of clinical studies and how did you enjoy those?
It was it was enormous fun. Uh.
Because like taking full turns for schools, I came in with the base more than 10 times in September.
There were. Five or six of us may be up to this team, Jones.
Uh, um. And I remember the the introductory course, Feiwel, which is four weeks at that time, I'm very much hands on.
And we were told we were being split in.
To the, um, on how often do, um, a surgical firm, the other half of this would do a medical and then we swap out,
but so they were just I think in the end they were four of us on the surgical front.
And so. They're just. And you were allowed to do far more now than what they do?
Uh, yes, because when you say that you had a smooth entry because of the setting, it wasn't that big the other half, was it?
Well, it was about. Um, usually mid 20s, yes, somewhere between 23 and 26, so, uh, we were the two best students in Germany, but.
Right. So there was quite a big difference. Mm hmm.
And by that time, Pickering had got going. And what was the sort of feeling of the Pickering Witt's relationship?
Um. It rapidly became obvious that they didn't speak to me, that I was never on.
Uh, the can we just oppressiveness.
So I really didn't know them very well in the course of the afternoon, technical meetings, which was called the Witches.
Yeah, that was uh, uh, that was because Professor Woods, um, sort of on occasion when he, uh, up here.
Still, there is usually, um, telling nature I take on the religious right.
There's no precedent. Yeah. And did you get into an V12, in fact?
Um. Yes. I mean, uh, I thoroughly enjoyed being has.
On the idea and then subsequently did the S.H.
And, um, particularly during the election year, if you not enough in politics and with sheer candour and,
um, and so had their own, that she was much higher than the rest of us because, um.
And the. Afternoons of thirty five, and very often,
if I had time go along that corridor up to the doctor and read the blood films and the battle lines, maybe to kill him.
And then she apparently would come along, um.
Show me what nonsense I so that was a very interesting time, not very much enjoyed that, but of course I also enjoyed the, um, the gastroenterology.
And so should the games, uh, the 12 interests.
And it was towards the end of that year, the next election that she attended and asked me if I'd like to be film.
And I said, yes, I'd love to. So she said, well, we need to find some money.
It was a week afterwards. The Sydney True called me down to his office and said what I like to do it, he said, yes, I would, but not in.
Ask you the same question, and I said yes. He said, I don't think she'll ever find you Cinefamily within a few weeks, uh, and I never had any more.
And so that's why I went to and told you, isn't it interesting what determines things and is happenstance.
Right? Was there a guy called Jeff? Yes.
And what was your view of him and his place? Jeff was, uh.
I mean, he was a scientist. And.
He was. He was quite gruff, but I just got off the phone with his, uh, uh, you know, when I did get going.
Will the city that that city was just adjacent to just this office and he acted as the administrator for,
um, for the laboratories year anyway, so, you know, basically like.
Yes, and I've always seen him as quite an important guy.
And that set up very much. Yes, entirely. Now, we've been talking about Pickering and what about Badenoch and True Love?
How did they get out of. I think they respected each other, but they were not particularly friendly.
No, they're different animals, aren't they? Yes.
And did was jumping off, as it were, going along a research line.
And then things changed and he took up the wider ambit of practise and.
When I was a technical student and then subsequently.
How soon, I said, sure. Uh, Baker wasn't doing any research right in any way.
Yeah, it was an excellent mission. Yes. Um, he director of clinical studies, but, um, there was no academic activity going on.
And I she really was following his paper on absorption and adults.
And Jack, I don't think he really published anything.
Mm hmm. That's all substantial, right? So you did your jobs then, did you do the you before the OSHA?
Uh. I did.
Last time I talked to Hammersmith for six months, I was a SAHM and, uh, came back, uh, for the one year S.H. job and then straight into research.
Yes. And the answer was that in the end again. Yeah.
Yeah. So you really sausen in those guys and that was still it, was it.
Uh, no. I came back, um, on tape.
Mm hmm. So that must be an interesting and good as well.
And which was good. I really, you know, some.
Um, yeah, they're supposedly, um.
He was often not present on the weekends, but when he was he was very stimulating.
Yes. Um, and he would do a movie at.
And then there was a coffee break and then six.
And as for some of what I saw, which is what I watch, um, uh, for the past and present support to students in cases, and he was paying off that.
And that was a terrifying experience because he was really a shock, um, as it was presenting cases which which I did many times.
Uh, he would always find when you came back from the Hammersmith,
what did you feel about Oxford compared to the heavens with the headmistress compared to Oxford?
Um. I think Oxford was a bit more gentlemanly.
Uh. It seems smaller than the Handsworth.
Uh. And it is the stuff that has left over the last line, right?
I never have, but, um, because they were.
They were electrifying experiences. Um.
The home of the department is gathered in quite large shifts this.
Along the front. Well, um, all the serious stuff.
Uh, Crispus was the president as as he was in the chair.
Um. In gastroenterology, you had heard Darwin and Thomas.
There in cardiology. That was, um, surgeon Michael Suda, hopefully for.
Um, we had, um, uh, chronologies.
Russell Fraser, Russell Fraser, um, and Joplin, yeah, um, solidness with the.
All of own, this was their correspondence with the.
It was it was Star-studded. And.
Were they prima donnas? There is extraordinary and and the fight to proceed discussion of the cases was just amazing and we didn't have that option.
It was much, much more gentle. And that wasn't to say people can make some very insightful comments.
But they did, and I swear this house, it animals, right?
And then you were convinced and. Oh yes. What did you feel about his arrival?
Well, you know, that was a very different. Um, way of doing things and, um, you.
On the move. Tell him about the past and he would then dictate to you what you have to record in the next and see your writing seriously unhappy.
You're not more in this group. Um, in the days after this, um.
Um, he was he was a very she. Um.
Very nice to push. But he found it very difficult to.
With a parasitic walk around, yeah, busy now, busy men.
Twelve patients in 24 hours, which, of course, is a joke.
Um, you should usually have about 20 to 30 in a 12 hour shift.
And. I learnt that one group that.
He wanted to learn something about the family history.
And in particular, I remember he wanted to know my grandmother died of and I did not know there.
And the message that was like, yes, you're in a secret.
Yeah. And the other said, OK, then you sort have to start eating them mind so off the wall that you're compensating for pieces of this.
And so it was. Um.
It's. I think that she will this whole here.
Says he wasn't used to dealing with 12 new patients and the medical problems were more than.
That is certainly shocking. Yes, so you do feel that clinically linked to you, pretty laboratory based?
Um, uh, it was mainly laboratory based, but it was, um.
Looking at a variety of logical, um, processes related to, uh, in fact,
she certainly had to collect samples, uh, from the critics and friends and get you to.
So I started looking at, um, um, uh, I teach AGP antibodies to three proteins because, like,
you were just just two or three years ago being put on the map and discovered by volunteers in Cambridge.
In fact, I spent a couple of weeks in approach, approach and the techniques.
Um, and that is proving to be a.
Disciplines you take to study. Uh, so, uh, in Montana, uh, was along the corridor.
Yes, and so. After that, 18 months on, IG Antiquities were proving to be still related, um.
Then I asked if I could study, uh, the president's contacts, his.
In the. In the city of.
Keep with mission that is much more productive and is now he was one of the two that came in on the peace and ticket, George Elberta McLennon.
Yes. And how did you see McClellan's sort of face working role working?
And he was he was very successful. He ran a, uh, very good.
Um, uh, um.
Now, is it very nice that, um,
it wasn't a surprise that after about five or six years and also that he took the chair and then all of a sudden she's had, um.
Now, after your feel, um, what did you do then, um, became senior registrar to, uh, from the age of letting a ride?
Um, and, uh, and then, uh, she just is as well as I can remember, you in the Hudson.
I was wondering just which busy was, but that I got it.
Yeah. And well that was a fact. There were some rockets my around in that firm.
The bench was absolutely. And how long did you do that?
Three years or I guess it's yes, um, I, I really had both shortened senior registrar time because, uh, um, I think it was in my second year.
Towards the end of the second year, I got to graduate for you, right?
And so after about two and a half years and I saw this kid off to Stanford for my year pool because in those days they were actually trying to shoot.
Um, get here and also touch the bus approach and the attachment that I think you were to to the high tech four times to.
Which is seen as a junior person. You didn't have to take out a.
They seriously was to intimidate me, but I did go in, I think, twice.
Um, um. And then the second year provided you with some money to go abroad.
And so I worked extensively with computers. What made you choose for and Keith Taylor and your circulation in Oxford?
You know, I think a lot of that, um, and he have.
Uh. I think it was about 90.
Seventy one, seventy two, so that's pretty, uh, it was, uh, and so I got to know him well they uh and uh, that is really why I say, uh.
So you're back on the B 12 from now. Yeah. Yeah. I was sort of, uh, I spent my year trying to isolate for five cents in the stomach.
And we did some very nice. Um.
They were trying to demonstrate the Massachusets.
He did.
The, uh, we made available, um, gas, food, and, um, incubated these products with it, wash it off and then, um, um, exposed it to actually tanks.
So, um, um, the first experiment and it's quite a big experiment because there were obviously lots of controls.
Um. Uh, maybe not positive.
But then, um, because the results were so good.
Um, Casebolt found some money for me to stay on instead of.
But I had to come back. So I've have my senior registrar had some notice.
Um, so the laboratory technician promised to keep these guys away.
Uh. And, uh, when I got back to the.
And various things happened, I think it was there for another three months.
Um, um, uh. Since just I think the Asians didn't come in time.
We got past the fact that it was never sufficient to publish it is about.
Four or five years later, the Los Angeles group.
Um, actually published a paper today showing that it was the gas prices, I mean,
that all sounds very unlike what we thought about American medicine in those days.
You said she hadn't done it. You mean that she had not attempted it or she'd attempted it and failed to do it?
No, I and it is just one project that she she had.
Yeah. Yeah, I understand. And so she just didn't and they couldn't get the reagents.
I can't remember which I think was Gap, the pure gastric.
Uh, um. Um. That the run actually has been rewarded and it's just happened and I think I, I really can't.
It's very interesting. Yeah, yeah.
Um, how much clinical did you do in America? Right.
I had taken my DCF energy, so I was is, um, I was given the title of associate professor at Stanford and.
When? Uh, Keith was there was a two week period where he was away when he was actually attending for gastroenterology,
that I think I was allowed to attend, um, for inpatient, but I didn't do the outpatient know that inpatient experience.
How did you enjoy that? Well, it was extraordinary because, um, you are not allowed to do anything without inviting half a dozen other.
Yeah, that's, uh. That's right. And we had.
A patient with undiagnosed coeliac disease. Well, the diagnosis was obvious, but they had died.
And so I said, well, how about this 2012?
And then you need to need a haematology consult, all frightfully cumbersome.
It was very thorough. Um, um, it was.
Good collaboration of different disciplines that we grew up in this system were moved as you did it all yourself, and if you stop, then compromise.
So it was, uh, I thought it was rather cumbersome.
Every time anybody gave a concert, there were about three or four pages in the names of the writing.
They just, uh, just seemed to be a bit dense. And so you were glad to get back to parties.
So how much more did you do as an aside, before you got a consultant from us?
Three months. But I suppose I was myself in more than, um, coming up to three years.
And I mean, was that because sitting at a time that no one ever knew?
Um, I came back. I went to Stanford in April 17th.
Three, um. In January of 74.
Then there was a job advertised at Middlesex Hospital because I knew I was coming back, um, city so that I should apply for it.
So I came back for an interview. And his testimony did not get the job and.
Who did it? Peter Costello, a distinguished pathologist.
OK, right, OK. Yes. And I mean, he is not just the world IACP.
All right. So these are the states officially retired.
Um. But at the final interview, the London University representative on this was an NHS post last year, Sherlock and.
It was a short time afterwards. I got cancelled at about 8:00 in the morning.
And the phone is ringing and it was Sydney. And.
He said, I've had she [INAUDIBLE] up on the floor wondering why you haven't applied for that job.
And so I said, well, I didn't know that was a job. And I was a senior lecturer post.
So she advertised for and she clearly identified.
During this interview, Little says the first person to be appointed.
Yeah, um, and so I finish my job.
He just returned to Stanford for just a few more weeks, um, came back, got married and started a free range.
And how long were you then there? From 1974 to 1980, right.
In the 1980s. And what was your speciality at the military?
I just had to look after to do that. Right. Um, and any time I showed an interest in and I was warned off in no uncertain terms.
Um, so, uh, um. And she have the policy of having a senior lecturer who was promoted to do that.
And so my predecessors were Tony Dawson, who was I know.
And then, um, in that chair.
Yes. Went off to. It it reaches, uh, and.
Uh, Grayson, Rand had just said there was no space at the new hospital and announced it was being built.
All this built up, so I arrived roughly in August 1974, and in October, I was the first person to occupy any space in the new hospital in the house.
Very good. Yeah, and that was just laboratory space of.
So, I mean, there was no inflammatory bowel disease care so that you started it and, you know.
Came into a thriving G.I. Joe, G.I., um, kind and service by, uh, um, that's on my desk.
And were you an honorary consultant there? So what made you move back to Oxford?
I was it a better job in Oxford? Well. The attraction coming back was it was really the big check, the Sydney man.
And the. The ability to network with immunology and, um, uh, yeah, it was a very attractive.
So which immunologists rather should be, um, what it was really, um, links with the South possible.
Yeah. No, I guess put them in the Willingdon school. And who was it really.
Um, well we soon started collaborating with SonicWALL but.
Yeah. Great. And you're glad you made that move, I would guess.
But before we go on to what you did, as it were, tell me about sitting in his place in the Oxford school and inflammatory bowel disease.
Um, yes. Uh.
Well, Cindy had a very interesting career because.
As a. Young consultants, already senior registrar, has increased his medical school was King's,
um, he went into the RNC and, um, was in Italy, um, towards the end of the.
And his first paper was on what was then called his fascist titles, which was, of course, at it's hard to say, um, um,
on on the epidemiology of this in the troops and his paper that's really largely focussed on the book,
but actually preceded anything else and had something to say for a long time.
Um, and, uh, then he came back as a consultant physician in Norwich.
And I don't know why this is what's.
Knew about him and asked him to kind of.
To Oxford, and if you remember, the Oxford technology was and first assistant professor to see the Canada, um, and Sydney.
So Sydney arrived in Oxford, um, I think 1948 or somewhere there in the late forties.
Um. Perhaps slightly late.
Yeah, I think it is about that 48 49. Uh, and then, uh, um, corticosteroids were had been introduced and, um, for future disorders.
And I don't know whose idea it was.
The thought about studying the use of steroids in their classes.
I didn't know that the severe weather was nasty ones, but I think it was Sydney, um, that really got the Austin colitis interest.
Um. And of course, he's paid for all the, uh, uh, coaches and reducing the mortality rate in severe colitis from,
uh, something like 30 percent down to about 10 percent.
Um, was dramatic, and that picture was the most widely quoted and was that animal, so that was, um.
I think or no, I mean, um, but the animal studies followed, uh,
because Cindy knew by then the technologies for using topical steroids, uh, XMA classlessness of.
Masterclasses is just like eczema, the skin so chocolatey.
That's the reason for the yellow. And then, of course, his other landmark paper, apart from the course was, uh, uh,
the two packages going to be a check on the natural history and lasted for this year.
Yes. Now, he was a remarkable man because he had a very important paper on pulmonary embolism to be he.
Yes. And his habit to work there. Well, it's, um.
Well, so the whole time I knew him from, uh, 1959 onwards,
they did not get involved and always said that he used to live here about thirty 12 in the morning and gave him about seven.
So he came about 11 who didn't start working,
and he usually got in in time just to shuffle through a few pages on his desk post in
the morning and sign that investors and then handed off to the canteen for lunch.
Um, usually with Islamised in the red. Yes.
He's worked closely with, um, and, uh, he worked at that time one of the major textbook in gastroenterology, um, uh,
called diseases of that type digestive system, which he did with, um,
one of the lecturers in the department, Peter Renda, who became a consultant in Bradford.
So I so the first edition was published, um, late 1950s and uh, Blackwells, he published it once.
It's a second edition. So she asked me if I would help, but that was a very interesting experience because, uh,
we would have a somewhat unpleasant summer in the county, about seven to seven thirty in the evening.
We then walk over to the actual science library and using the index medicus because PubMed and such electronic search engines are not available.
Uh, we looked up the latest work in whatever chapter we've been working on, the oesophagus, on Pattakos.
So, uh, we may some those, um, important papers and the reference and then the library closed at 10 o'clock in the evening,
we went to his house, the Tiger Woods store. Right. Um, where I'm have had coffee ready.
Uh, and we then added that chapter bringing us up to date until about 3:00 in the morning.
Uh, sometimes Sidney would run out of cigarettes. So it was about talk.
Talk.
That one says, um, we had to take a breath of air, which meant walking up to the roundabout, to the garage to buy cigarettes and came back again.
And, uh, then two thirty three o'clock, uh, he was decided he decided it was time for a glass of whisky.
So I used to get hold of that for a bit.
And this was uh, sort of May, June, July, August time.
So and it was already getting late, but I was getting ahead and I was in the in the requisite seven by eight to
eight thirty in the morning because you were doing general medicine as well.
But carrying on with my research. Yes. Uh, often in the clinics but in the afternoons.
So there was no clinical work in the morning, although I would often get called in to see, um, somebody on the ward with Kagi.
So I sort of acted as a senior registrar and gastroenterology for that for that time and for Peter.
And now he left. But obviously, you know. I understand. And jumping way back, was he an assistant to it?
So was he always. And it just because I thought he became an adjacent to physics.
Yes. I think he, uh, he he did have a full time academic post initially, but that became NHS.
I think that must have been four of them at one time, but they probably shuffled a bit.
But it doesn't matter. Um, and he was a remarkable man, as I say, because he had lots of hobbies.
I believe he had old cars. Yes, he had pottery.
Yes. And heaven knows whether there's a God. Right. Right.
Yes.
And was he a great runner, too, in his youth where he did run, but he got half billion for boxing from Cambridge because I'd heard he got the flu.
Gosh, he grew up in, uh, um, a small village just outside Cambridge.
Um, and, uh, got a scholarship to.
Trinity Hall and foxing now as a fugitive.
And did you find it difficult talking to him? He's very slow speech or did he talk fast or one to one?
I was very nervous because he slept, but it didn't bother me.
Hmm. And then he returned much more so some of the very bright academics in the university that went off like a train, that train.
So then he retired. Yes. And you came back from the Royal Free to take up the clinic, as it were.
And you would be single handed then, as it were. Yes.
As a consultant. And how do you see things from then on it?
Sort of two comments. The subject itself and the way the NHS evolved when I was in Sydney, of course, was a long time university.
Yes. And by the time he retired there, Weatherill had been in place for, um.
A couple of years, maybe three, um, and had a large enough department interest quite considerably, and so when Sidney retired,
um, David said that he really did division and that's so gastroenterology became a full time NHS post.
Um, and I was always did not apply for the job because, um, with the amount of general medicine that went with it being a generalist.
But I mean in times of uh oh. Laboratories.
Yeah. Uh, but then David said we just moved out to the Raptors February as a piece of laboratory space available to that.
Hmm. And uh. Uh, Robert Turner yourself, people are still down here and he said you can use the administrative procedure, the TED.
Yes, it is, um, of purchasing stuff and keeping the party running.
And, um, so that's why I continue to have an interest.
And I don't mind me being here just a short time, just a few months from when I called for Senator Sessions, which made a big difference,
because up to then, had you been working in a laboratory setting, you set up a laboratory straight away, did you?
Yes. Yes. And then the full of the months you got proper allowance for.
Yes. That's great. And did you have to fundraise? Yes.
I don't know. I was getting no money. Yeah. And how easy was that?
The, uh. The feeling. Yeah. How easy was the fundraising?
Where did you get it from? Well, it's never easy.
Fact. Uh, I got it from wherever you could. Yeah. But I mean, was it the most serious.
Well, Cassie, welcome.
Um, we were ready without a clinical trial and the fellowship from the L.L.C. love and um and then from the charitable organisations,
there was this thing called the National Association of Trans Colitis.
And a few grants from that is, um, uh, what is now called coeliac.
Uh, it's got money from, um, uh, the pharmaceutical industry sometimes provided the grants all the time.
So I would be involved in clinical trials and all the money, uh, patients that you had went into the research team.
So, I mean, it was, um, it was just wherever he is from industry and, uh, from the pharmaceutical industry, but not on a regular basis.
Um, but I mean, you couldn't run, um, I think the maximum number of research facilities we ever had was ten, which was a bit too many years.
Um, you needed a full time research secretary to about all that, and I had to pay her from wherever.
I saw a few patients in the in the John Radcliffe, um, not very many, and all of that went into the kitty to the,
uh, the research side is now in that subject, the interaction with the surgeon surgeons must be very important.
Yes. And Sidney with a built up, I think it this built up a very, very strong link.
Uh, and of course, when he retired, the key GI surgeons were like, OK, well, I had to manually write.
I have no it was very, very, um, keen that I should come back from London.
And, uh, we worked together very well. So it was a great idea on the face of it, um, when I first came back.
Yes. I wasn't one of them. That trial was cut off the liver disease.
So I didn't have to do it here until he did the liver surgery.
Um, so the legal team was ready.
Myself and the two surgeons had done that for radiology.
And we had lost the very distinguished guy dislodges to Australia.
And that was, uh, Dick Whitehead. But, uh, was John.
So I brought on and I was the Whiteheads procedure, and they both went off to do it right.
So for theology, um, think we had a senior registrar denoted.
Yes. Um, to look after us. Who wrote it?
Well, it had never intended to be, um, the senior registrar coming up to the end of his time, that thoughts were in passing the NRC past.
Mm hmm. Uh, and of course, as soon as I got that exam, it was an exit exam.
So as soon as they said they were applying for jobs, so it turned out that they had rabbit is um and obviously they were trained in general pathology.
But most of the time I knew more about what we were looking at as a little piece of gastrointestinal mucosa than they did.
So we trained them a bit. But that actually to them can really very competent and very useful later on.
Did you get a focussed. Well, a pathologist finally we got Brian Burke, who, of course, um, sadly just died a year ago.
Yeah. Um, but I mean, he was one of the leading inflammatory bowel disease GI soldiers in the world that
the enormous difference you said earlier about the neighbour due to network.
So who in the sense was that with, um, did you travel all of a sudden travel?
Um, most of the network was just down the road.
Um, and as I said with, um, uh, the Dinescu, um, um,
Philipa is now a professor of gastroenterology who's just come back from California to join Peter Morris.
Right. And it has some collaborative work on the um.
And um, uh. She do any collaborative work with Richard Boyd that Richard is always a good sounding personality,
but, um, doing projects in coeliac disease and the small intestine, uh, that's nice.
This guy was an anatomy that is really gosh, I didn't realise that's not what I asked Richard.
And I know quite well right now, he's a good guy. Um, and then the subject was developing all the time.
And do you feel that they've, uh, can you confidently say what is the pathogenesis of ulcerative colitis, Tom?
Crohn's disease. Um, what we can tell you what we think.
Well, pathogenesis. And how confident are you? Well, we know, um, that genes play a major role.
Um, they may they almost certainly provide susceptibility, which underlies this familial instance of diseases.
And, uh, I think there is absolutely no doubt they, um, do influence the natural history that the disease,
um, which patients are going to get extra intestinal manifestations, which patients can run a severe course?
Um, and, uh, I think in terms of polygenic disease, because the way, uh, you know,
one hundred sixty three um um, genetic associations, um um that says is shared between U.S. and French disease.
Um, the. That this disease specific, so that begins to make sense,
but the fact that sometimes the diseases are so severe and yet classically said different, um, we know the environment plays a major role.
There's a wonderful study, um, two years ago from Denmark showing quite unequivocally, um, that in the first two years of life,
if you have multiple courses on antibiotics, you have something like a 12 fold increase in risk of developing the disease during their lifetime.
If you have just a single, um.
Exposure to an antibiotic, many of the sort of penicillin, uh, flu toxin and cephalosporin group, not the nature of the days, I was, um.
Then again, you've got a five, six fold increase, so eventually my.
It's the hygiene hypothesis that's been around in Crohn's disease for a long time, um, and if you grow up in a very clean environment,
um, then you're much more likely to develop the disease than if you grow up in the in the gutters.
So I think trying to get into the system early in life.
By these environmental factors, it's very important. You've got the genetic soil.
Um, so that's against and then there are bacteria and, um,
is becoming the microbiome in relation to you, synchronises is the growing area of research.
Yes, yes. Because I was thinking that the disease must affect the flora, but the flora early on may or may not affect the disease here.
Yeah, yeah. It's a chicken and egg situation.
And, uh. And how much is treatment? Improved treatment has, uh, um, change has little recognition.
I mean, I grew up as a young researcher and gastroenterology.
We had steroids and we had SASE selective high.
Um. Service housing is another, um, is a service like link to yourself,
security has a lot of side effects and it is certainly true that here was a young Bangladeshi research fellow called Azad Carr.
Um, that showed that it was a celestial light that was causing the benefit and not so,
um, and so the whole pharmaceutical industry got busy trying to.
Get the five of money, salicylic acid, um, down into the kettle without proper absorption.
Uh, and so there are lots of tricks to link to this page linking the the salicylate
molecule to itself or to the mind of acid and all of these been attempted.
So that's, um. Changed very considerably because the fundamental salicylic acid drugs used in Saluzzi.
Um. Are relatively non-toxic. You can get big doses and really for love, just colitis and even more interesting,
certainly in the states, um, Chitose, Wisconsin is not first First-line treatment yet.
So that's changed a lot. Um, in the.
Mid 60s as a friend had come in again, mainly for Ducos and, um, but there were a few cases reported of hostage crisis,
responsive customers, very small studies from the states and Sydney instituted a big trial of basis upon which I ran for, um.
Induction information and then maintenance on it was quite clear it didn't do very much in the first three months,
I mean, I know that it takes three months to start to work.
Um, but it was effective in the long term. So.
In the latest clinical trials, the latest drug test, you will find the.
Says he 40 50 percent of patients have been on the premises of a widely used truck,
and then, of course, the other big change is being the biologics, the ATF agents.
Um, and they made an enormous difference. Uh.
Intent on the. Passions have long term benefits, so and there are lots of new compounds in them, has all this reduced the amount of surgery?
Yes, good. Um, now it has reduced the amount, I think it would be fair to say, the last three years.
Right. Um, in terms of the. Yeah.
Uh, um. Uh.
You know, using these powerful vacations we learnt to take because cheating is really the goal of therapy,
because that is associated with longer periods of repression than if you use.
Centonze. You mentioned the hundred and thirty genes.
No, I'm sure you know where they are, but do you know what they do, what they code for?
Um, not a lot of, um, we know that name.
And, um, and you've always got this.
Even with the latest, um, genome wide association studies, you still have a problem of whether the gene that you've,
um, identified is the gene of interest or whether it's an individual with a very close neighbour.
Yeah. Um, but the genes of these hundred and sixty three, um, genetic mutations,
they fall into some very aggressive cancers like adaptive immunity, the HLA.
Um, James, innate ability and, um, various function potentially for free, you see, um, um, autophagy, uh, and immune regulation.
Uh, great. So, you know, there are some, um, things it's a very much story building up.
Yeah. No, don't be modest about this. We're with Oxford, Sydney and the rest of the World Centre for Inflammatory Bowel Disease.
Um, well, certainly in Sydney's day, it was an internationally recognised centre.
Um, um, and it's not for me to say, but I think we maintained.
Yes. On the surface where the other big centres, really big centres.
Um. In the U.K., um.
And this time there were no really big sense. So Marks, for example, in London, Leeds is, um, mainly surgical, but the medical as well, um, and.
Perhaps, but, um. Well, that was mainly coeliac disease and malabsorption.
Rather than I yes, the big IPD clinic, um, um, uh, Cheryl Cook was was Professor Gates and his main interest was in Malabsorption, uh, his project.
But that was the same age as me that we grew up together.
But we had a big identity and and, um, and then of course Guy I did the surgery, um, and then I was also very big.
Um, um, so these were the key senses, maybe Edinborough.
But the states of Australia and the UK declined to, um, Fanfan Panopto, so which which is, um, Edinburgh is still strong.
Box is. A shadow of its former self who's still has a big IBT presence, um, in the States,
there's concern and New York, um, Chicago, um, the Cleveland Clinic,
um, and, uh, North Carolina, Chapel Hill, um, big centres in Canada, like Toronto, um, and then mean that Europe has been really in the forefront.
The friendship is very strong, mainly in Paris, but they have a wonderful, um, I pronounce it in French,
but the initials of Jeté G.T. and, um, and it's a group for the study of, um.
In fact, she addressed the soldiers and they that's wonderful for clinical trials, um, the Germans have become really very strong.
So, yeah, uh, it's it's it's really centres around the world.
Did you ever feel you'd like to do a sabbatical period with one of those?
Yes. It's a big image as they it.
Yeah. Because you would have had a lot going on here all the time. I realise that.
But it would have been fun. Yes. But I did have so many sabbaticals.
Um, this thing in Australia, um, called Bushra Lectureship, um which I was giving them, that meant we were in Australia for about six weeks.
Um and then I did a visiting professor at the Alfred Hospital in Melbourne and another four weeks, a different time in Adelaide.
And you know, that was four weeks without any fixed clinical comment is gave it time to be catching up, um, beating up,
going through manuscripts, um, through the latest thesis written by somebody in the unit who could speak English.
And so this was a very nice reading. Is it because you were doing general medicine to take.
Yes. When did you stop other than that. Um, two thousand years.
And what made you stop? Um. It was about what I think it was nineteen ninety nine,
I became vice president of the Society of Gastroenterology and then going on to a presidential year two years later.
Um, I'd like to go to the, uh, I was also at the same time chairing the.
So. Section of an enquiry which the MRC is set up, um, and that meant frequent trips to London.
What was that? And so that's why. That's fine.
That's fine. Yeah.
And everybody was very happy for me to give up, but they ended up near the embassy enquiry and, um, uh, was all about autism and the MMR vaccine.
All right.
Uh, and the Department of Health had got very worried about the drop off in these vaccination, he said, and told us he ACLC to set up an enquiry.
Yes. And I was asked to chair the subgroup on, um, um, the gut because there was a story that, um, the measles vaccine caused.
The kid is. Information that's a up in this case is all about, um, uh, it's, uh,
the person involved and bothered to go back and see what the earliest I can get healthy.
Other kids, which has more information, is, um.
Nordhausen. Afterwards, it was a real tragedy.
Yes. Yes. And then, uh, now you mentioned the textbook way back.
Did that continue? No, it finished with the second edition.
Um. And I think largely because a very, very big American text came out in two volumes, um.
And then there was another tax bill coming out, I think, that was decided in Sydney, which they didn't want to get into.
So you were probably but, um, I published a book with How Thomas.
On immunology, the GI tract, and, uh, during the three days we did produce that as a as a second addition I had.
Um, and then we did another book, um.
Um. We did it with a man.
I'm like, OK, well. Uh. Uh, how to do what was called but entrance into the second edition, so, you know, there were there were books around.
I was very pleased not to be taking a general tax because it had to change to multiverses.
But you would have contributed to the Oxford Dictionary. Yeah.
What did you do that the encounter about the horror of the guys and the coeliac chapter and the U.S. trade.
And then I think I did that for. Um, for Ed. Yeah, and then.
The first one. I decided that I should reduce it to somebody else, and they they asked me to do the U.S. chapter.
Yes. Um, but I'm not doing anything awful. Uh, and you would have had your name on all 300 papers, so.
Yes, there were 400, you know, that kind of thing.
Now, final, very difficult years ago.
I always remember Cindy coming back, um, from visiting as a unit as possible and then an see exercise, reviewing that unit's.
And he wrote in his report the most damning statement, he said.
I saw evidence of a lot of. Activity, I wasn't sure how much research has been done, and he was a very methodical man, I would guess.
Yes, yes, yes. He didn't like. Just chilling out of potboilers had to be some focus on the findings is now a
difficult question because we all know that things get worse as we get older.
But how do you feel the NHS trajectory has run since the 1970s?
Um. But I was always a nonpolitician.
I had too much to do. No, um. I didn't enjoy sitting on that hospital.
This is still a little bit, but I avoided it as much as possible.
Um. And. I'm going to sit.
Patient care, in many ways has been transformed. Because we've got so many new treatments, we're going to send a new diagnostic techniques,
um, which don't which become more rather than less pleasant.
Um, and. I think.
One doesn't like.
The Break-Up of the old firm structure and the ship's system changes according to the working time directive, and that really has been a disaster.
And I know for the last year or so in general, we do oppose.
Right. And sometimes, um, none of the genius attorneys seemed impassioned because the ones who come from office might have been a bit of a hand.
Uh. If he had 20 acute patients in overnight.
Perhaps more sometimes a new reaction focus on.
Yeah, you know, yeah, so.
That's his. That's been a big difference, um, and, you know, the responsibilities of consulting staff home now to keep them safe,
where it's really a consulting service, I think, uh.
Very demanding because. But I suppose this a specialist.
And you feel that you're sort of on top of the game within your speciality,
you then rapidly realise you're not on top of the game in the latest in cardiology or professional or whatever.
So I think the responsibility of the senior staff is actually increased monumentally under this shifting centre to me underneath the.
Um. Miss. So they still take on that responsibility.
Um. So I have a student teaching, I think this has.
Um, the students are still very bright and they adapt to the system that they've got,
so they still produce some very good PENNICOTT options, some very good academic.
Um. But that the lack of continuity in the first is not good for teaching.
And you were referring to the practical procedures. You did as alert as they were and they wouldn't be allowed to do that.
And of course, they do have all these simulated models. But, um, so they they practise the function of elitism, um, picking up chips and so on.
On all the multiples. Um, so maybe that's a good thing.
I was recalling. Um, just earlier this week of something somebody would say, I mean, really struggling with putting in, um, you Rachel Casitas.
I was a first year 10 student. Um.
I just shudder to think the discomfort of these poor chaps had, so I think this may be the same in some ways, but there are lots of students nowadays.
Um, their exposure to clinical medicine is not what we had.
Um, and they don't have the opportunity to practise the skills and so that they can of has uh uh,
it's, uh, it's a whole change in culture that it will get back.
Um, but but I think it's, um. They don't have the.
I don't think they have the teaching, that first hand experience that I had.
Did you have any experience of interference with your clinical practise from management administration?
Um, not much. I think because I was in the report, just got out and did it on.
Great, that's been a wonderful interview. Now, anything else you'd like to say yourself, throw into the pot?
I don't think so. I think.
But what I find very exciting is that, as I said, I said at the beginning, when I came back here in a senior capacity, I had to start a lot of fresh.
Um, which was down here on the west side, I think that that's what I think, that office adjacent to the.
Um. And then, of course, the actress and family finally exposed, and that was about the last person still still down here.
Um. And that was a very weird experience, because sometimes you'd have to go up to the front desk,
the infirmary, to collect something or deliver something, and you walk up and down that main corridor.
Even entirely by his side, and the extraordinary thing was a series of awards disappeared out of the church.
All the wars without his. And when there was no activity.
The silence in the main character was extraordinary, and you never realised how nice it was until all the world shut down.
Uh, and then when you were by yourself in this very long, um, quiet corridor, it was really quite spooky with the cockroach running around, you know.
So then what was going to happen to academic gastroenterology?
Um, but when I was retiring, I was about two years before I retired from the universe,
from the NHS, so, um, four years before retiring the university sessions.
I wrote a paper.
On the academic gastroenterology outlining what the city had achieved and what we have done, yes, um, and saying that they really ought to be.
A professor of gastroenterology to maintain. The academic interest is and that went about all sorts of university committees,
but it was finally agreed and good and, um, they tried hard to appoint.
And. She was appointed a coalition, which was not a.
But a first rate, because given mortgages in a five star on the international stage.
And, um. So that that was really exciting and, uh.
The name of our. Which is at the John Radcliffe instead of.
Right. That plus the offensive of the.
Biomedical research. Um, yeah, um, as that academic gastroenterology to.
Um, transform itself into a major of, um.
So CNN has two senior lecturers, one is a gastro.
Well, Alison is gastroenterologist does two sessions of clinical work week and then husband work is a paediatrician.
He does two sessions with the rest of their time.
It's in research, it's a very strong unit, and, um, so that's really very exciting to to, um.
Certainly see a Phoenix rise and you would have been succeeded by one of the two energise people.
Uh. The whole we've got lots of gastroenterologists now, but I mean,
Shannon Travis was here when I retired, um, they appointed, um, Sateesh Keshav, who was.
He said, South Africa, it is difficult to set, um.
And then they got. And that is a young Australian gastroenterologist, they just made an excellent appointment in James E,
who who is a sort of professional and person with an academic bent.
Um, um, and the and the Riverside Scurrah says that, um, you know, it's, uh.
And the. About some point, another to consult.
It's yes, and did you ever think of trying to work in the I am in the black box?
Um. I didn't see any minute and I just wondered, you know, how that fitted into the whole picture.
I mean, we did. We were often. Um, do you think that you had some very creative work on, um.
In collaboration with a chemist working with Adriene Hill, went to, um, Andrew and Michael, we lived next door to each other.
So so number of years, um, Kiki was wonderful and bouncing ideas or suggestions.
Yeah. It's just it's, um, uh, William Rose.
And that was a student of ours. And he worked, uh, many supervised by John Bell, if we had enough and you know, what was in the eye and a lot.
That it was very. In some ways, inconvenient, cutting that out of the main office down here with patients in the jail.
It actually was a godsend for research sessions.
I had I used to be full time down here on Monday and Wednesday.
And. Because she could have had to pass the jail on the way ahead.
Mm hmm. Yes, Ted, um, good stuff.
Good to see. Keep patients, Constance. But it meant for most of them, Monday, Wednesday, he will not travel back in time to stay for.
Yeah, yeah, um, that's what I'm waiting for other people.
So actually, it turned out that the geographical separations was actually beneficial.
You must be very proud of all that. And thank you very much for the interview.
You said what you want. Yes. A lovely many, many thanks.
Cheers. Still running the.
It's got a plan.