Richard, this is an interview between Professor Richard Knox and Paediatrics Professor and Derek Hockaday, 21st of July for 60.
Richard, just to plunge directly because we're dealing with your happenings with Oxford University.
When did you first feel you were going to come to Oxford? What made you want to come to Oxford?
It was a complete surprise.
I was in the United States at the Johns Hopkins University, in the Department of Paediatrics, where I was the chief of paediatric infectious diseases.
I had a very good research programme there and obviously an exciting job.
So a letter arrived from the University of Oxford, which strangely said at a recent meeting of the electors of the university,
your name came up as being interested in the chair of paediatrics.
And David Weatherall was the person who. Suggested this.
I was shocked. News to you is that's completely news to me.
So I actually called David Weatherall and he's sort of in his typical way, said, oh,
it's just this northern accent, which I would attempt to imitate, just typical Oxford politics.
The fact of the matter is that Henry Harris, who's the richest professor, knows John Littlefield,
who is your department chair, and John Littlefield, put your name forward as somebody who, um, might be interested.
So I said, well, it's the first I've heard of it. And at the same time, I had a sort of media style reaction.
And it's difficult for I've been in the States by that time, about 12 years.
I didn't really have any intention of returning to the U.K. And in the States, we are doing mostly research work on mostly clinical admixture.
It was a mixture of the two. Um, uh, I had probably at that time something in the order of 60 percent of my time was research,
40 percent was clinical, largely infectious diseases being a very specialised, uh, department, um, head.
I was head of the Division of Paediatric Infectious Diseases. So that involved me obviously also in a lot of training and teaching.
Did you have your own IQ with somebody? Really you know something the infectious diseases team, uh, consulted on in patients.
And also, of course, we had a, uh, extensive outpatient programme, but not a dedicated I.T. facility.
And sorry, you were saying about teaching. I mean, what was that ward rounds or lectures?
Yes. I mean, we had all the states medical school. We had a large number of extremely, by their own admission, extremely bright medical students.
But we also I had a, um, a fellowship programme for training in infectious diseases.
So we had a number of of what we call fellows who spent three years in the programme training in infectious and paediatric infectious diseases.
This was supported by the National Institutes of Health grant that belonged to the department.
Did you have to come to an interview in Oxford or had they killed off the other candidates?
No, it was very odd. Again, Wetherall said, well, you better come along and visit us.
Uh, so I did. Um, and I remember David met me in a pub in the evening that I arrived and he said, oh, by the way,
they'll probably want to talk with you tomorrow for formal the Oxford Quadrille, he called it, which again, was completely unanticipated.
I thought I was just coming to take a look and meet with people.
So actually, this was the electoral board meeting.
There were other candidates and, um, they as far as I know and recall.
There had been other people who had been approached and for one reason or another.
Discarded, I think, because they didn't fit.
To be honest, the real reason was that Harris and Wetherall were dreaming up the Institute of Molecular Medicine,
and it had become obvious that there was a big gap not only in Oxford but in the UK in infectious diseases research,
and which obviously I had been involved in and which was very strong in the United States, but comparatively weak in the UK.
And they wanted somebody for the Institute of Molecular.
If if the Institute of Molecular Medicine, which is a pipe dream at this point, was going to take off,
they've been given a pretty strong hint from Sydney Brenner and others at the MRC
that they ought to have at least one post senior post the professorial level,
obviously, in infection. And so I think that there was not much motivation to appoint people who did not have a molecular genetics background,
which happened because I was in the United States to be a good fit for them.
So when you came over, you got the job, came over.
What did you feel, say, after a fortnight about the Oxford Hospital as compared to the Johns Hopkins?
Do you think they were very different or. I was in a daze. It was so completely different.
But I you know, I, I knew that it was going to be I mean, I come from an institution where the Department of Paediatrics had 119 faculty members.
In the Department of Paediatrics and I had five faculty in infectious diseases, and they were all international figures.
I was coming to the UK in a setting where I was the only card carrying infectious diseases paediatric specialist.
And I was coming to, in a sense, a hospital that combined what one might call tertiary speciality,
um, clinical and research and teaching with a district hospital.
Um, so I was, in a sense, having to get used to the combination of the National Health Service and the university.
But there was a very small cast of characters on the university side in paediatrics.
I mean, we basically had a reader and a lecturer and both of those were destined to leave.
I went to Newcastle and David went to Bristol.
Um, so it was it was radically different, um, from the point of view of what I would call a structure of things.
And I was now obviously expected to be a consultant paediatrician on the NHS,
as well as taking responsibility in my university capacity for research and teaching.
Um, the lines between what a professor does and doesn't do with respect to the NHS has always been, shall we say, ambiguous.
I saw my role very clearly as having, shall we say, leadership vision, um,
rather than being hands on in the management and governance of my NHS position.
But it became very clear. That, as a professor of paediatrics in Oxford,
I had major responsibilities for child health at the national level and the European level, even the international level.
And I think that did coincide with what one might call vision leadership,
but in order to fulfil those, one had to be pretty involved in integrating one's,
um, activities with with all of my colleagues in the NHS, both within the Department of Paediatrics and elsewhere.
So it was a it was very challenging. You mentioned size and organisation, but what about actual clinical care?
Did you feel that the two institutions were roughly similar?
Did you think they were? You know, there was a very, very decisive difference.
I was used to being in the United States for all that time to specialities.
Paediatrics was no longer, you know, a general paediatrician with an interest in people, were oncologists or neurologists or nanotechnologies or.
Infectious diseases specialists, cardiology, etc. I came to Oxford, and in essence, although people had interests in research in the clinical arena,
there was a huge emphasis on being a general paediatrician, as I say, with an interest in.
I found this completely anachronistic and it was my immediate sense that my job,
my vision had to be to essentially put in place a firm basis for paediatrics, sub specialisation.
We didn't even have a centre for cancer in Oxford.
The only recognised subspecialty was neonatal medicine, which Professor Tizard, my paediatrician, my predecessor had built up.
And there I think there were some strengths. But again, it was largely on the back of the NHS with very little in the way of academic appointments.
So the whole structure of things was was extremely different, and I know that to begin with, I was viewed as.
How can I put it an extreme and aggressive head, because I felt no sympathy at all towards those who were harmed, shall we say?
I saw them as meddling around in areas where they didn't have any training, sort of amateurs.
Well, I mean, you know, I give you a very concrete example. I mean, you know, oncology.
Yeah. I mean, to me, it was unthinkable that people who would be looking after patients with solid as well as,
you know, blood malignancies would not be trained.
It was and it looked awful. And there wasn't really an adult centre for cancer.
No. I mean, all of this was to come. Yeah. Things in 1984 were still in I say more traditional.
Obviously, the Department of Medicine was much further ahead because it was so much bigger.
But even there, you know, many areas of expertise were, in a sense,
not covered by people who had been grounded, trained, immersed in their subspecialty.
Do you think. I wouldn't say one compares the nursing or the physiotherapy with Johns Hopkins.
Yeah, I mean, although there were differences in the the management.
The structure of things, because, of course, we didn't have the NHS in the United States, we had a hospital in which everything was integrated.
So in a sense, I did not in the UK, in the US, expect to, you know, attend the meetings of nurses, physiotherapists, whatever.
Yeah, one was much, much more adjacent. Now, in the interface with the NHS meant that one had to be visible and credible to staff such as nurses.
One of the first things that happened, I'd only been in post for a few weeks when suddenly the hospital management,
for financial reasons, decided to close one of the paediatric wards.
And I had to organise a petition signatures from Oxford citizens, but also involve the physiotherapists, people and pharmacy, the nurses,
respiratory technicians and so on and so forth,
so that they became aware that we had a role to play in championing child health because it was a district hospital.
There was no identity as such to paediatrics. We had a ward or several wards and the neonatal unit which were embedded within the district hospital.
But there was no sense of there being a children's hospital, as we now have in the West Wing.
There was no centralisation. Indeed, the hospital was designed in the 60s by people and overseen by people who were not paediatricians.
So none of the wards were ever designed to have children in them or to think about the fact that
parents would need to speak with their children if they were very ill and there were no facilities.
There wasn't even a place where you could take distressed parents and sit them down and talk to them in private.
All of these things became suddenly of huge, a huge dimension of what I could see to be a need for the future.
It was going to take many years. In fact, it took 20 years.
But eventually we did manage to succeed in making the case for and getting the children's hospital.
I'm getting the impression from your turn, really, that you felt that these deficiencies, shortcomings did impact on actual patient care.
Yes, without a doubt. I mean, you know, we had sick children with neurological conditions who were in the Radcliffe Infirmary.
And if they became. Over and above that neurological condition, it was something that needed, you know,
paediatric care, somebody had to go down there or they had to be whisked up to the job.
And people in the Radcliffe Infirmary, with all due respect, did not know how to look after children.
And that's the neurologists or the neurology department.
Yes. And you'd have a house officer supervised by a consultant in adult neurology who may have been on
the job for a few weeks looking after an extremely sick child and having to work out fluid balance.
So we had a number of absolutely awful situations in which kids came up in an ambulance from the R.I to the jail,
and we found that they got pulmonary oedema from being given too much fluid, especially since many of them had ADHD syndromes.
Right. Just for the time that to the teaching had to do find the clinical students compared with.
Wonderful. From the moment I came, one of the great joys was the terrific.
Characters and intelligence and. Depth and breadth of the Oxford medical students, they were ajoy from the word go.
Um, and I think they really liked paediatrics, um, and enjoyed their time on this six to eight weeks that they did.
Of course, it occurred to me very immediately that we had, again,
an incredible system in the UK where about 50 percent of our medical students would end up in general practise,
not necessarily deciding at that time to do that at the time when they were students,
but they would end up about 50 percent would end up in general practise.
And about one third of your practise is paediatrics and child care.
So how I asked myself, can you prepare people to go into general practise when they're going to do six to eight weeks of child health?
Mm hmm. This is clearly not sufficient.
Did you get to change it length and that still the same? Right.
And I still feel that this is a major problem with general practise is that they are unsure and and why wouldn't they be?
It's good that they're unsure about managing children, although the majority of children go to their GP are going to get better.
We know that. But for those who have difficult problems, whether they're acute or chronic,
it's asking an awful lot of general practitioners to have the knowledge to be able to make the right calls.
And as a result, it's my belief that, of course, they need their hand held.
They need to talk to somebody who's a paediatrician to be reassured that they're not doing the wrong thing.
And much of the time they're doing the right thing, but they need to be reassured.
And so, of course, they had to be referred to the hospital. They come to outpatients or they get sent up to the emergency room.
And this is a very inefficient way to carry out primary care in child health.
Did you redesign the courses of rotations of lectures etc for almost completely.
But I would say that I, I was very, very, hugely supported by NHS paediatricians as well as obviously,
um, my academic colleagues who had university appointments.
And the reshaping of the teaching of this eight week course was an evolutionary process that started when I came,
was enormously facilitated by the interest and input, as I say, at the NHS and and my colleagues.
And I think it took roughly five to 10 years before we felt that we had got something that was excellent.
And I believe that from about nineteen ninety four or five onwards, our evaluations,
whether they were formal and external or internal, were uniformly, um, placing paediatric teaching on the top level.
Yeah. Now in the States, have you been doing vaccine work.
Well, yes and no. Yes. In the sense that I was deeply conscious of the work that was going on in the field of Vaccinology.
Um, my own basic research was that not necessarily pragmatic.
And when I came to Oxford and realised that I had a role as a clinician scientist,
it was a no brainer that I needed to take the the interest that I had at the time.
It was my office influenzae type B continue to have a lab that was doing basic research, but I had to develop a clinical programme.
And actually this was a no brainer because the UK, believe it or not, had not caught up with the fact that there was fact.
Seeing that was not just in research and development, it had been implemented in the United States and actually in Finland.
But a curious thing happened, I was told by the head of clinical microbiology, Cellcom was his name.
He said, Why have you come to the UK? We don't have a problem with him.
Office influenzae type B? I said, Oh, that's interesting. Can you show me the the epidemiological data?
And she said, Well, I'm not sure I can point to it exactly, but I'm part of the group of,
you know, public health microbiology that have labs all over the country.
We talk, we meet regularly and we know what's going on.
So I said, so you don't actually have any figures? He said, well, no.
But I mean, you know, all of these labs are processing islands' of him office influenzae.
So we would know.
So at that point, I set up with the help of the US a five year prospective study to actually find out what the incidence of invasive HIB disease was.
And after five years, we found that the incidence was about the same as it had been in Baltimore,
Maryland, in the USA, and it took it took Cellcom completely by surprise.
But he was absolutely delighted that actually it had gone on in Oxford.
So he then gathered all the data, which was perfectly reasonable,
put it under his arm and went off to the meetings and neglected actually to attribute the findings to to the to the pathology,
which would have been such a surprise to the microbiologists who were, as, you know, quite a sort of regimented group.
And the idea I mean, it took people a very long time to come to terms with the fact that as a paediatrician,
I was also a microbiologist of a serious microbiologist.
So that was that was to come to your question, really was yes.
Yes. I needed to extend vaccines from the basic work I was doing in the lab to the epidemiology.
And we then went on to set up clinical trials because having decided that there was a high incidence,
the next step was to to actually do studies to show that the that the vaccine was well accepted and effective in children.
And first of all, Oxfordshire and then Countrywide is the Haemophilus.
This infection, virtually all respiratory tract to. No, no meningitis.
Right. So the biggest problem with meningitis, but there was also a terrible condition called epiglottitis,
which is an acute inflammation of the larynx and life threatening many.
It's a septicaemia disease. So you have conditions like septic arthritis.
You do get pneumonia. But the biggest issue with hip disease was meningitis.
I mean, we would see one or two and sometimes more cases every month at the John Radcliffe and life threatening disease.
So in your first year and then later, how many people did you have, as it were, a unit for?
So I was able to hire immediately on the day that I started a lecturer, David Isaacs.
Um, uh, and very quickly after that, I recruited Simon Kraul, who had been an Oxford student and who was very excited about doing research.
Um, I then was able through the system was very different from what it is now.
I was able to get a new blood investigator award, um, which brought me another, if you will,
position that I had a reader who was I mean, David Beckham's position became vacant rather quickly and so did our Alan Stewart.
Green left almost immediately, um, to go to Newcastle.
So really sort of had to lecturers a new blood and to establish posts.
But I had also asked for research assistance for my laboratory as part of my.
Package, which Henry has supported for three years.
Um, so it was a pretty small operation, but I was able to recruit registrars to doing research and then to generate funding.
Um, so and so I was able to to, in a sense, generate opportunities for people to do a one or two year stint.
When you have a registrar doing research, did he do some clinical.
Yes, often on call as part of their required green stamps that they needed for their career progression.
So they actually wanted to do it to keep their hand in. But in the end, they would do weekends and evenings.
Um, during the day they were doing research.
My guess is that the cut the colleges train of people who look after things, we're aiming to train general paediatricians at time.
Yes. I mean, to be honest with you, I had very little involvement with the Royal College of Paediatrics and Child Health.
Well before that it was actually the British Paediatric Association.
It had none of the characteristics that.
Suggested that I should use it as a I prioritise my time and I thought there are
other people who will go to the PPA and Andrew Wilkinson was a stalwart at that.
And I left nothing. They did look to me, it seemed to me, to be in line with the vision that I had for paediatrics, and I told them so.
But it didn't change and it still hasn't. So when you came and got into the epidemiology and all the other interests, did you continue benchmark?
Well, no, I think I did very well. Some some but more showing people techniques.
But no, I was, you know, in terms of concentrated time at the bench,
that was now impossible and in fact, was a very good reason why after seven years,
I applied to take a sabbatical because I was worried that not having been actively involved in any lab work at the bench myself,
I really had lost a lot of Know-How.
And techniques were exploding in molecular genetics at the time.
So I actually went off to Washington University in the States and Lewis for a year, which was restorative, um, absolutely fantastic.
Um, but those first seven years were, um, well, it was all pretty low, but I think the first seven years were particularly challenging.
You're never worked hard in your life. There's probably.
Yeah, I think that's right. In retrospect, um, it didn't seem like I was working hard.
It just seemed that there were so many things that needed to be done.
I don't think I ever really felt that I was working hard. I mean, in that sort of sounds curious.
I just had day in, day out, enormous sense of I think it was internal pressure that all these things needed, needed attention and needed to be done.
And I was actually when I came to Oxford, very concerned that I would fail.
The challenge seemed to me to be enormous.
It seemed to be wonderful and the promise of the Institute of Molecular Medicine, which didn't actually happen until nineteen eighty eight.
So that was four, five years after I'd arrived with a wonderful vision and idea.
And I embraced that with passion.
But again, it was going to be a huge amount of work and time.
Um so uh. My recollection is that most days I was up half,
five or six trying to get some quiet time before going in and that I very rarely got into bed before 1:00 or 2:00 in the morning.
Did you feel you got enough sleep? No, I was sleep deprived and I knew it.
Yes, sure. Um, but I had somebody who who never seemed to share it, and in fact, I couldn't believe it.
And, of course, you know, in my mind, David Weatherall was the with the model, um,
he not only was very supportive, but I looked to him for how did he do things?
And in fact, I realised that, you know, he was physiology was different.
I never, never have met anybody who was able to do so much of such high quality despite being, you know, largely without sleep.
I once stuck a note on his door and the old level seven, which said, Wetherall,
Wetherall, how do you do it all now before the I am where was the laboratories?
The military was on the fourth floor at a relatively small laboratory in that corridor.
Yeah, that's where I housed myself. And then there was another one a bit further down, which eventually became the laboratory for the reader,
Mark Gardner, who was working more on human genetics.
And, uh, yeah. Now, I don't understand.
In the States, you've been doing what you call basic work, as it were.
And then over here you had to generate a vaccine. Well, the vaccines, yes.
Yeah. The basic work was really that I was looking at the genetics of, um, capsule production,
the B capsule of the organism, which is a complicated macro molecule.
So there's obviously the synthesis, its transport, its assembly, its expression.
And so there was a large amount of DNA within the genome of the organism devoted to making this antigen and expressing it.
And this is the key virulence factor of the organism.
But it was also the target for antibodies that would be protective.
So the vaccine incorporated the antigen, the B antigen, the capsule polysaccharide with some modifications to make it more immunogenic.
That work was not part of what I had done.
I was doing so say the work on the genetics to try and find out much more and also to be
able to make mutants that would allow us to dissect the role of the antigen in the disease.
It was very unclear what role the type B antigen had in carige colonisation, transmission, invasion and so on and so forth.
Um, but because a vaccine formulation had been developed in the United States.
It was now a question of implementing that formulation, and that's why we needed the epidemiology of clinical trials,
and this led eventually to the formation of what is now the Oxford vaccine group.
Is there a genetic so human susceptibility? Yes, there is.
And we didn't work on that. Now, later, you came to have to generate your own vaccine, not to be that road.
You worked on another subject yet? Well, when the head was introduced in 1990, 92, we did a lot of work to see what happened.
But I began to realise that I wanted to move on to meningococcus, another cause of meningitis and septicaemia.
And the big problem there was that the model of conjugate vaccines which worked for him,
worked for many of the strains of meningococcus, was not going to work for the B strain of the meningococcus.
So a new approach was needed and in 1993,
for an era began to emerge that was going to revolutionise the whole of infectious diseases, indeed of biology.
And that was whole genome sequencing. I was deeply involved in that with my mentor from the United States and with Craig Venter.
Right. And so the Home Office influenzae was first completely sequenced living organism in ever.
So you setting and that set the phase for being able to do genome sequencing.
And around 97, I began with Craig Venter to explore how we could not only sequenced the complete genome of the meningococcus B,
but use that as a a directory of every antigen that might be included in the vaccine, of which there were about 600.
But crucially, that time a colleague, Tripoli from Italy, who was the chief scientific officer for current vaccines, was going the same direction.
And we formed a tree as a triad.
Oxford Tyga, the Institute for Genome Research in USA and Kairouan and CNR that started in 97.
The strain came from Stroud in the outbreak, the meningitis outbreak, which I sent to Craig Venter for sequencing.
And by 2000 we had assembled and had the complete sequence of a strain, the Stroud strain of the meningococcus,
which allowed us to interrogate the genome to find other potential antigens.
As I say, there were over 600 possibilities that had to be narrowed down and was narrowed down over the years,
the next few years, to the point where a vaccine formulation containing effectively four antigens was made.
Kairouan by now become Novartis. And it took until 2013 before all the clinical trials and testing and rigmarole that goes into producing
a vaccine satisfy the European Medicines Agency that we had a vaccine that they could licence.
And do you think all the rigmarole as a due and proper process so extensive?
It's a very, very good question. Safety of vaccines is so important that the public, I think, would say they want no stone,
no stone left unturned in the bureaucracy and the communications and the inevitable fallout from commercial companies
making vaccines and government supported institutions regulating them is a difficult is a very difficult recipe.
I am absolutely clear that the process is too long and it's not always efficient and it is very, very difficult to know how one can improve it.
Mm hmm. You hinted that quite a lot of data was derived, been obtained in the States.
How much data was obtained in Oxford? Well, you said, well, what was happening was we were getting just the sequence data from the United States.
All of the analysis was going on in Oxford and in Siena.
Right. And was Craig Venter doing an American strain when they doing this trial?
Oh, no. That was that was our strain.
And he was really just supervising the project, along with many other bacterial genomes, which they were sequencing.
And again, I don't think he knew at the time whether or not it would ever get to being a vaccine.
But it was obviously very delighted when it did. Now, you had your sabbatical and at the end of that, did you come back with a reformed structure?
I mean, were are you going to do things different? No, there was. I mean, the sabbatical was absolutely pivotal.
My lab changed dramatically at that point into.
We had stumbled across a genetic trick that a bacterium has for invading host immune responses,
and the technical details are not perhaps of interest, but we discovered repetitive DNA in bacterial genomes, which is a complete surprise.
And that was a really exciting discovery because the repetitive DNA actually
showed us how amorphous influenza and meningococcus and many other organisms,
it turned out, are able to shuffle their genes and create a variation on the surface of the bacterium to confuse the immune defences.
We call them contingency genes because bugs never know what environment they're going to be in and the host.
So as you go from one person to another, you go into a completely different ecological niche.
How do you adapt quickly?
And the repetitive DNA turned out to be one of the keys to understanding the behaviour of the organism and its successful encounters with the host.
And we spent many years working on that with a huge grant from both the MLSE and from the Wellcome Trust.
But I returned from the sabbatical. Had you decided to change your interactions with the NHS?
I suppose very gradually,
circumstances were making it easier for me to be less involved with the NHS because the structure of paediatrics and child
health had now become much more streamlined and huge numbers of appointments at the consultant level were made in paediatrics.
We went from, I think, about six or seven consultants in 84.
By the time I finished, there were more than 70 consultancies. And so what started off and I mean, that wasn't driven by me.
That was circumstances. I mean, people began to realise that child health paediatrics was so important and one thing led to another.
There was the money coming from the government for that, for the expansion of the consultants.
Know that was coming, you know, first of all, from the regional health authority and then the government on it.
Yes, it is. Yes, it's government money. But but obviously also going through the.
Yeah. So who was the regional chief medical officer paying and could well actually started off being.
What was her name. Oh Rosemary. Rosemary Roux. Yes.
Who's wonderful taste. Yeah. She was absolutely so supportive.
And um then Chris Paine was the sort of district officer and Alex Gatherer.
It was very important. I worked very closely with Alex and Chris, but not Chris Paine.
What pain I think it was they may have been.
Chris, thank you. Yes. I worked very closely with Alex Gather.
In fact, the other day I found my Talk Green College on the future of child health, which was in nineteen eighty eight.
Right, in which I laid out the dream of the Children's Hospital.
And um, it's quite interesting to read it now.
Yeah I know, but yes, I mean I had to work very closely, obviously,
not only with them but also with the succession of people who were the chief execs of the of the trust of which Nigel Crispen was the most fantastic.
He stood out like a sore thumb against a background of very droll and inefficient characters.
And I was very involved in trying to get the money through the regional health authority and the McGray for for a proper vaccine centre,
which is now, of course, the Centre for Clinical Vaccinology and Tropical Medicine.
We thought we had that money from R&D, but they removed all R&D funding in December of 2006.
And did you manage to close it? Yes, no. Well, I put in an application to Geoff, the Joint Infrastructure Fund,
and that's how we got the money for the Centre for Clinical Pathology, and that would be an NHS fund known.
And that was combined because the John Warren Ward was on that site.
We combined really a university based project with the NHS.
Now, when you say that side, that was the church, yes, it was that the first time you'd spread the church?
Yes, except that, of course, we did interface a lot with orthopaedics, for example.
And but, yes, that was the first time that I had to have an office on the church side.
Yeah. And now you must have been travelling quite a bit.
Yes. Huge amount. Yes.
I felt that we had to the part of my job was to be a PR agent for showing that we were a research department of international stature.
Plus, I enjoyed obviously the the contact and giving lectures and and.
Yeah. And you were writing articles on show, um, only 500 about seven years.
Well I suppose when I came to Oxford I had. Twenty eighteen, so more than 400 articles call because when did you start?
I'm still waiting. Oh, yeah, I don't remember from the 2008.
Yes. Yeah, that's when the university decided that my contract was null and void.
And when you did retire, what did you miss anything particular?
Well, yes, closing my lab was had me extremely, I would say, sad and depressed for several months.
But you I'm working in it. Well, you know, I faced a decision which I took with Marianne.
If I was going to continue my lab,
then I would have had to obviously have applied for funding and then I would have had to have gone to a different department.
I was adamant that it was the wrong thing to do to stay in my own department, especially when it's a relatively small one.
Yeah, but the imam would allow you to. Well, the imam is a hotel and that requires that you pay your dues.
So you've got to be part of a department to be in the imam. You've got to be affiliated to somebody.
It's a bit different now because there is a provision for various units within the imam.
But from my point of view, it was it was I would have to go to the Nuffield Department medicine or somewhere and say, what do you have me?
Hmm. And I thought to myself, you know, you're sixty seven.
Why would a head of department want to take you on in preference to somebody who's thirty eight and Brighton years ahead?
And how do you know you will get funded because you can't put in an application for funding without the backing of your head of department.
And I thought, do I really want to go this route, you know, down on my hands and knees to Peter Radcliffe to please take me on you a figure of speech?
And I thought, hang on a second.
What about, you know, you're so young at 67, why don't you reformulate you can do research with other people in other labs.
And then Reno came up and you said, well, for God's sake, you said it's a no brainer.
I'd like you to spend 50 days of the year in Siena.
Who wouldn't? And what you will do there is work with all the scientists who are on the early research programmes.
It'll be with the PhD students. You'll be holding lab meetings one on ones, providing advice, whatever.
And I thought, well, that's two months of the year. And I thought, well, your own counsel for Institut Pasteur,
that is four meetings a year and that takes up at least six weeks of time while then you're on the Advtech and I,
it is up and suddenly six months of the year were completely and utterly taken care of.
I would be working full time on those days, if not more.
And at that point I thought, right, I will give this a go.
If it doesn't work, I'll find another way.
But I don't have to have my own lab and go through this machination which and then I felt after 30, what would have been ative 74 was my first.
Seventy four, twenty six plus eight, thirty four years of getting funding, fighting,
fighting for it and being responsible for 10 to 15 people just in my lab, 70 people in the Oxford Vaccine Group.
And I certainly thought that's what keeps you awake at nights.
Wouldn't it be nice just to do that? So that's that's the answer.
But you asked me the question was yes.
I mean, not having my own lab was was very painful, but I soon rationalised and got used to it.
Let's go back to a particular question. You were saying how difficult oncology was when you arrived?
Well, it's just an example. Yeah, I know.
But when you left, um, say there was a sick child with a cousin, would they be in the church or would they be in the job market?
Well, the situation was that, uh.
The consultant oncologist's of which there were three by the time I finished, were really working hand in glove with adult colleagues,
using facilities on all of the sites, but also recognising where their limitations were,
which is one of them very important roles that oncology specialists must do.
You know, have we got what it takes here? Do I need to refer?
And if so, to who? So, um, the there was no oncology centre for children as such, but we did have the expertise now in being head of a department.
I've got the feeling that you're in the zone, as it were, modern school like David Wetherall, where you would take a topic.
And by and large that was where the research went.
Well, say Pickering, way back he believed in let a thousand flowers bloom, you know, here, there and everywhere.
And what are your thoughts about?
Well, I mean, you know, times change to compete successfully on the international scene for MRC, Wellcome Trust, European funding, whatever.
There's no way that you can say, well, I'll do a little bit of haematology and a little bit of oncology and the mandates here.
And, oh, yeah, infection could be interesting. So the eclectic approach of Pickering, I mean, I admire it, but it's it's absolutely it was impossible.
And we had to build a reputation for basic and applied research and infections.
And I chose to focus on the lab stuff on bacteria, meningitis, pathogens, the neonatal unit,
which was a very important area for clinical research, managing infections in the newborn nursery.
And then obviously the outreach, the clinical trials and all that goes with clinical trials,
including epidemiology, which was the Oxford Vaccine Group.
So that's the that was my decision as to how we would remain viable and that and unrealistic now really bright like David Dunga,
we are sorry to see him go. Yes, he was very bright, eccentric individual.
I had a great deal of time for David. He was very difficult to communicate with.
And he only came to see me when he wanted something and when I would talk to him out of genuine interest about what he was up to.
I always got the feeling that he thought I was asking him so that I could criticise.
He was quite defensive, defensive, but also had a very strange, um.
I don't think he understood me as a scientist.
I think he saw me as hierarchical.
And that makes sense because David Dunga was brought up and he was a survivor where the quality of what he did was never going
to be at the time that he was a senior registrar and a young consultant was never going to be the way you would get on.
Mm hmm. I think he was a very bright, creative individual.
And had he been in different circumstances, he was already pretty well known.
I mean, don't get me wrong, but had he been brought up in the kind of environment that I was lucky enough to be brought up and,
you know, at Johns Hopkins and Boston and so on, I think he would have been a completely different kind of individual.
Do you think he found that in Cambridge? I'm not sure.
I I sort of get the feeling that it was more of the same.
And by this time, David's personality and the way he did things and I don't know the difficulties he seemed to get himself into,
hung around him again.
I don't think he was any more successful in building bridges with colleagues, despite the fact that they were very warm in wanting to receive him.
I think he continued to have a sort of paranoid defensive close to his chest.
Don't let anybody know what you're up to. That's just my impression.
But I want to say that I thought very highly of him. Now, have I?
Is there something I should be asking you about or do you want to tell me?
Well, I would I would like to say that if I had some doubts when I came to Oxford initially and I did, I'm so glad I made that decision.
Of course, I've got no control as to what would have no control.
Experience would have happened if I had stayed in the States. I think I was incredibly fortunate.
I came at a time when it was all waiting to be done and all I needed to do was to apply oneself more than someone.
Yeah, OK. But that was easy for me.
What I couldn't have dealt with and there were only a very few such instances were insoluble problems.
I mean, if it can be done and but there are some that are insoluble.
You can have people problems, structural problems, work problems.
You know, I have incredibly good fortune.
I had only one person in the entire time and I was chairman with whom I could not get on and where it got to three wise men and all of that.
And it hurt me. I still.
Still worries me, you know, I mean, I hated the confrontation.
It was unavoidable and it was a nightmare.
But rest, I had such fantastic people around me, the students, the colleagues.
Why would I stay in Oxford? Very simple reason. People.
Oxford is just fantastic because of the people, maybe the university doesn't do everything,
but people are wonderful and that's the the abiding thing that I've had the fortune to have been a clinician scientist.
In a setting where it's been a joy to work with so many fantastic people and that without a doubt made it so,
so much easier to be able to get things done. I don't want to go into the particular details, but what did you think of the three wise men set up?
It provided a way to solve a problem that had become impossible, it was bureaucratic, it was.
Clumsily handled, but it did at least get to the point where the boil burst, right, and lines were drawn,
decisions were made by the individual in question very quickly left or look to leave and did leave.
One last thought, I want to just add one thing, and that is I have been so fortunate to because my home life has been wonderful,
wonderful kids and fantastically supportive wife, very happy marriage and good health.
And, you know, yeah, all of those things are easy to take for granted.
One, I thought you were saying that your chief in America, Johns Hopkins, had, as it were,
recommended you to Oxford, but now you'd known David Weatherall and Johns Hopkins.
There was really. No, never. Oh, I thought we did not overlap.
Well, they both had. Yeah, yeah. But at different times I had never heard of him.
Right. Right. And where did you get that stunning picture, Stella?
Because when I was doing a lecture for I was asked to give the Hattie Alexander Memorial Lecture at New York.
I wanted to trace the I knew by this time that Stella had been the technician for one of the
faculty members in the Department of Biochemistry in the School of Public Health at Johns Hopkins.
And so I asked her if she had any pictures of of, uh, of Harriet, Roger, Harriet and herself.
And she did not have anything else. But and what's been a marvellous interview.
Thank you very much, Richard. I hope it's been helpful. Yeah.