1
00:00:01,410 --> 00:00:09,970
This is Derek Hockaday interviewing Julian Britain, and it's the twenty third of January two one nine.

2
00:00:09,970 --> 00:00:15,630
Julian, what really made you come towards Oxford from Gwent?

3
00:00:15,630 --> 00:00:27,540
The reason I came here was because the department had a new professor and had the opportunities for a new start in surgical life.

4
00:00:27,540 --> 00:00:32,430
And the reason was because in many ways it's extremely surprising.

5
00:00:32,430 --> 00:00:38,370
I never came here because beforehand Oxford and Cambridge were one of the few places in this

6
00:00:38,370 --> 00:00:47,610
world that I didn't plan to work outside was known as a difficult place to work for surgeons,

7
00:00:47,610 --> 00:00:50,730
for surgeons, for all sorts of reasons.

8
00:00:50,730 --> 00:01:01,710
But a new professor and I fancied at the time being a professor, as it turned out, that would have been a terrible mistake.

9
00:01:01,710 --> 00:01:06,870
It didn't work out so. But that's what I thought. So I applied for the leadership.

10
00:01:06,870 --> 00:01:12,960
Right. And Peter Morris, I got an interview.

11
00:01:12,960 --> 00:01:18,150
Peter Morris, David Tibs. Joe Smith.

12
00:01:18,150 --> 00:01:22,170
James Gowans. Yes, Robert Duthie.

13
00:01:22,170 --> 00:01:34,560
And I think Jill Williams was the lady. And it was held in the Radcliffe Infirmary boardroom with all the names on the wall.

14
00:01:34,560 --> 00:01:43,220
And on a Saturday morning, four of us were interviewed.

15
00:01:43,220 --> 00:01:47,770
David Tweddle, Roger Greenbelts and Grant Gill.

16
00:01:47,770 --> 00:01:56,310
Uh, David eventually became a consultant in Manchester. Roger became a professor of surgery and, uh, turned course in London.

17
00:01:56,310 --> 00:02:00,340
And Grant went back to Australia. All right.

18
00:02:00,340 --> 00:02:11,300
I did, but I didn't think I'd get it. Particularly Greenhouse was clearly going to be a professor and had had had the qualifications.

19
00:02:11,300 --> 00:02:18,810
So I was a bit surprised when I was invited back to take the job.

20
00:02:18,810 --> 00:02:19,020
Well,

21
00:02:19,020 --> 00:02:31,440
they wouldn't they didn't say in the US and they wouldn't tell me that I get a consultant post if that was in the gift of the Medical Staff Council.

22
00:02:31,440 --> 00:02:38,220
So. Well, anyway, David Tips sensibly said what he felt confident that it would pass.

23
00:02:38,220 --> 00:02:49,410
So of course, yes, I accepted the job. Um, my father, who, as I mentioned, was an Oxford man, was absolutely thrilled.

24
00:02:49,410 --> 00:02:59,070
He was still alive at the time. And I think he said that we'd explored going to Oxford or Cambridge to do medicine.

25
00:02:59,070 --> 00:03:02,730
And he did all sorts of reasons. It didn't happen.

26
00:03:02,730 --> 00:03:10,050
And I went to Barnes instead. So he was very thrilled when I got the job and I'm pleased about that.

27
00:03:10,050 --> 00:03:23,760
And many of them. Yeah. Um, anyway, we were we were we were pleased to come when I left London to go to the Newport as a senior registrar.

28
00:03:23,760 --> 00:03:29,130
One of the persons that worked to a man called said Britain, dreadful.

29
00:03:29,130 --> 00:03:36,790
You'll never come back. Uh, so that was another reason for being pleased.

30
00:03:36,790 --> 00:03:45,630
All right. But, um, when I arrived, I like at Newport was a very good place to work.

31
00:03:45,630 --> 00:03:55,020
One of the reasons I went there was, um, certainly academic surgery was mostly seen as a destination of people who could think, but not.

32
00:03:55,020 --> 00:04:04,800
All right. And there were endless examples of my experience of people who have clever, pleasant, but they could not operate.

33
00:04:04,800 --> 00:04:12,000
I think it was it was sad. They'd gone in a way that chosen career.

34
00:04:12,000 --> 00:04:17,520
So when I mean, the reason I went to Newport was I was determined if I going to be an academic,

35
00:04:17,520 --> 00:04:24,250
I had to be able to write whatever the and it was very good.

36
00:04:24,250 --> 00:04:27,120
So I only worked in Cardiff for a very short time.

37
00:04:27,120 --> 00:04:35,130
And Cardiff was a very difficult place surgically and generally actually at that time was nice new hospital.

38
00:04:35,130 --> 00:04:40,410
But all the same it was a bit of a I never quite made it out really.

39
00:04:40,410 --> 00:04:53,510
And I wasn't there for very long before I came here. Um, arriving here now, it was quite an eye opener, um, all sorts of things.

40
00:04:53,510 --> 00:05:01,100
It was very intimidating. The interview was a bit intimidating, but particularly Duthie.

41
00:05:01,100 --> 00:05:04,640
Yes, I can imagine. But you didn't that was normal.

42
00:05:04,640 --> 00:05:15,050
I mean, you expected that in a way you wouldn't have been pleased to have got the job if you hadn't been a bit stretched.

43
00:05:15,050 --> 00:05:21,380
Um, but when I arrived in Oxford, I couldn't make it out.

44
00:05:21,380 --> 00:05:30,920
It was highly intimidating. And the first thing I realised, actually, it was obvious you couldn't miss it,

45
00:05:30,920 --> 00:05:37,400
was that the NDIS was extremely unpopular, right, amongst the other surgeons?

46
00:05:37,400 --> 00:05:44,620
Well, definitely amongst the other surgeons. But I could see that it was regarded as a bit of a dubious entity amongst everybody.

47
00:05:44,620 --> 00:05:49,040
Right. And that I realised after a while I was history.

48
00:05:49,040 --> 00:05:59,660
Yes. That I was thinking and nothing. Alison. Yes. And a nothing in a way to do with me or Peter, but it took a little while to realise that,

49
00:05:59,660 --> 00:06:07,160
um, and clearly you in the presence of some incredibly clever people,

50
00:06:07,160 --> 00:06:10,640
all the physicians, and there's nothing to do directly with yourself,

51
00:06:10,640 --> 00:06:17,840
with all the physicians were clearly very highly competent people, very well qualified, good clinicians.

52
00:06:17,840 --> 00:06:24,200
Um, the surgeons gain, but a slightly mixed bag.

53
00:06:24,200 --> 00:06:29,210
The senior one clearly didn't like the NDIS at all.

54
00:06:29,210 --> 00:06:42,060
And the. I know the history of it, but, you know, I was absolutely the enemy, the NDIS had its own words.

55
00:06:42,060 --> 00:06:51,730
It had its own operating theatre. It wasn't allowed in the town theatres until after five o'clock at night.

56
00:06:51,730 --> 00:06:56,140
And were two things stand out, really.

57
00:06:56,140 --> 00:07:03,760
And there was a New Zealand man called Malony who was basically was quite a nice man.

58
00:07:03,760 --> 00:07:10,720
I don't think he was a terribly technically good surgeon, but, well, not by the time I met him.

59
00:07:10,720 --> 00:07:16,720
But he he was a senior and he clearly had had endless difficulties with the NDIS over the years.

60
00:07:16,720 --> 00:07:21,880
And I can remember I used to be the eldest.

61
00:07:21,880 --> 00:07:27,310
It takes twice a week more than the other surgeons Peter had.

62
00:07:27,310 --> 00:07:37,180
Peter Morris, the professor, had instituted that. So we always had more emergency patients around on other people's wards.

63
00:07:37,180 --> 00:07:44,380
One morning I used to start the ward rounds at eight and one morning I went to Beaver's ward,

64
00:07:44,380 --> 00:07:51,100
which was below the neurosurgical theatres in the old Radcliffe Infirmary and wasn't an NDIS ward.

65
00:07:51,100 --> 00:07:55,510
So I think deliberately but not I can't prove that.

66
00:07:55,510 --> 00:08:01,510
But at about ten past eight, the doors of you may remember were too narrow.

67
00:08:01,510 --> 00:08:07,090
One small one person could get through one about ten to eight.

68
00:08:07,090 --> 00:08:11,950
I approach the door to Beaver's ward as I approached it.

69
00:08:11,950 --> 00:08:18,190
Mr Mellini right. Their usual retinue of students moaning.

70
00:08:18,190 --> 00:08:26,740
Britain. You'll get the patients out, won't you?

71
00:08:26,740 --> 00:08:36,190
As well as much as possible. And so I got the drift and he he allowed us to get look anyway.

72
00:08:36,190 --> 00:08:40,330
Well, move.

73
00:08:40,330 --> 00:08:49,660
A few months later, a year or so was on me and I had to operate in that town of theatres at about half past four.

74
00:08:49,660 --> 00:08:56,110
We weren't allowed in till five. Mr Maloney was operating.

75
00:08:56,110 --> 00:08:59,920
So I'm in scrubs and have seen.

76
00:08:59,920 --> 00:09:04,570
What are you doing here? Britten Well, fortunately.

77
00:09:04,570 --> 00:09:14,290
Well well, I'm clearing up one of my messages, Mr Maloney And that went down a treat of ever afterwards.

78
00:09:14,290 --> 00:09:21,310
It had all gone well. Um, and he was, he was perfectly OK.

79
00:09:21,310 --> 00:09:29,770
He retired soon afterwards anyway, but I don't know what it was, but he realised that it was just like anybody else had your complications.

80
00:09:29,770 --> 00:09:36,490
It was a dreadful mess. But we didn't do that. And the patient survived the pain.

81
00:09:36,490 --> 00:09:47,590
Peggy Frith is you'll remember. Yes, well, he was the patient was presented at the at the medical grand rounds by her.

82
00:09:47,590 --> 00:09:50,860
And she came with the notes, which were about six inches thick.

83
00:09:50,860 --> 00:09:57,640
And she started by saying the patient during the course of this erm has lost twenty five pounds in weight,

84
00:09:57,640 --> 00:10:10,780
which is about the same weight as his notes. Um, the other thing too that I suppose you'd say rather casual really,

85
00:10:10,780 --> 00:10:19,150
but there was a long corridor in the rack if in fact you used to have to walk up and down it to the X-ray department amongst other things.

86
00:10:19,150 --> 00:10:22,810
And one of the nice things when I first started was that they did speak to you in the corridor.

87
00:10:22,810 --> 00:10:29,680
They they were. You were. But they just all posture, you know, consult their colleagues and they go, you know, all of them,

88
00:10:29,680 --> 00:10:35,890
but some of them and I found that a bit odd is sort of quite the way I would normally.

89
00:10:35,890 --> 00:10:45,550
But anyway, I got over that quite early on, actually, because I worked out the simple way to get over that was always to say hello.

90
00:10:45,550 --> 00:10:50,590
Yes. And the more reticent they were, the louder you said hello.

91
00:10:50,590 --> 00:10:54,490
So there was no way, as I'm avoiding the fact that you were recognising them.

92
00:10:54,490 --> 00:10:58,810
And actually, you know, it it it all went by the time we went to the job market.

93
00:10:58,810 --> 00:11:02,310
I had now that was a new place then.

94
00:11:02,310 --> 00:11:04,210
It was no long corridor.

95
00:11:04,210 --> 00:11:12,640
And by that time, the Indesit sort of Peter illness is an excellent surgeon, a it was an excellent condition, obviously a very good scientist.

96
00:11:12,640 --> 00:11:21,460
And, you know, the Indians had good surgical staff, all of them out there, Robyn Smith, those sort of people, they could all operate.

97
00:11:21,460 --> 00:11:25,930
And it was perfectly OK and they came to be recognised as such.

98
00:11:25,930 --> 00:11:31,770
So what did you stand in this right through? No, I thought no, this.

99
00:11:31,770 --> 00:11:38,850
Um, well, um, again, I came thinking, I want to be a professor,

100
00:11:38,850 --> 00:11:47,100
so eventually Chang came out and I applied and I can remember being mildly shocked that I didn't get on the short list.

101
00:11:47,100 --> 00:12:20,840
In retrospect, it was obvious. But at the time, you get and, um, about the same time a man called Charles Webster is one of the NHS surgeons.

102
00:12:20,840 --> 00:12:27,350
And so he's just applied for it and I thought about that, too, wasn't so, and I got it.

103
00:12:27,350 --> 00:12:34,250
So I changed in 1980 as the job market opened right to the NHS.

104
00:12:34,250 --> 00:12:41,990
What research would you, Dan Rather, in the end is now before I came?

105
00:12:41,990 --> 00:12:48,620
I've done quite a lot of work in the past about the way blood clots during surgery

106
00:12:48,620 --> 00:12:54,710
and the influence of the sympathetic nervous system on that particularly adrenaline.

107
00:12:54,710 --> 00:12:59,900
And that was tied in really with the introduction of beta blockers because they

108
00:12:59,900 --> 00:13:06,200
understood the understanding of the sympathetic system was quite compelling. It was becoming quite, you know,

109
00:13:06,200 --> 00:13:15,260
the differentiation of the alpha beta receptors in a subdivision of the beta receptors and the drugs that actually blocked individual bits.

110
00:13:15,260 --> 00:13:22,850
And so I'd done quite a bit of that and I did a little bit of research on some money in Cardiff on the same lines.

111
00:13:22,850 --> 00:13:29,720
And there was a very good haematology department in Cardiff and the Royal of Rate and all those sorts of things.

112
00:13:29,720 --> 00:13:38,240
And I continued that in the end. Yes, but actually I it was came obvious to me that I really wasn't a scientific research.

113
00:13:38,240 --> 00:13:44,540
I didn't have that skill. So I'd done a bit, but not much.

114
00:13:44,540 --> 00:13:53,730
And it clearly was clearly it became obvious I wasn't I didn't have that sort of technical, skilful ability to become a professor.

115
00:13:53,730 --> 00:13:58,130
You just said know. And then, um.

116
00:13:58,130 --> 00:14:01,940
And so the move to the NHS was a wise one from that point of view,

117
00:14:01,940 --> 00:14:07,790
because Charles Webb served in surgical Chuter thing and presumably they got rid of that job that they were.

118
00:14:07,790 --> 00:14:12,800
Then there is going on. Robin Smith got it. But that was as a senior registrar.

119
00:14:12,800 --> 00:14:16,610
Yes. A consultant was I think Charles was perhaps a consultant. He was.

120
00:14:16,610 --> 00:14:28,310
Yes, yes. Yes. No, I Peter was a very strong scientist and had a big department, and he was less interested in the teaching side of it.

121
00:14:28,310 --> 00:14:33,120
So I was more interested in the teaching of it. So that's what I developed.

122
00:14:33,120 --> 00:14:40,190
Really? Yes. There wasn't a surgical ground round when we started, so we created one.

123
00:14:40,190 --> 00:14:47,090
Yes. Certainly never as successful as the medical grand round.

124
00:14:47,090 --> 00:14:55,970
Too early in the morning. Yes, yes. And surgeons like to operate is so that took a while to get going.

125
00:14:55,970 --> 00:15:04,080
And of course, to begin with, of course. No, no, NHS surgeons can't come to this meeting.

126
00:15:04,080 --> 00:15:15,740
So that's a bit of an exaggeration. Yeah. And, well, I overcame that quite simply because, um, I we had grand rounds and they got to be known.

127
00:15:15,740 --> 00:15:19,940
And I just asked each individual surgical firm to put on the ground round.

128
00:15:19,940 --> 00:15:31,010
Yeah, yeah. And you know, they take whatever they thought they couldn't refuse, so they incorporated everybody else eventually.

129
00:15:31,010 --> 00:15:40,790
When you came from Reoccurred roughly, what was your impression of the nursing anaesthetics laboratories?

130
00:15:40,790 --> 00:15:46,670
The overpowering impression when I came to the Radcliffe was that it was a bit Dickensian.

131
00:15:46,670 --> 00:15:51,470
They've met the medical wards down the hearts.

132
00:15:51,470 --> 00:15:54,980
I can't really quite believe that the er at the end.

133
00:15:54,980 --> 00:16:00,680
Yes. Wards where conventional Nightingale type wards and they were fine.

134
00:16:00,680 --> 00:16:06,110
Um, but overall I thought gosh, for a place of this quality to have these facilities,

135
00:16:06,110 --> 00:16:13,340
however, that John Radcliffe was in prospect, the nursing was just as I expected.

136
00:16:13,340 --> 00:16:24,840
And um, we had a very good ward sisters on both our wards and actually on the other side of wards to, um, anaesthetics immediately.

137
00:16:24,840 --> 00:16:32,000
It was absolutely top class. You could tell that you're in safe hands.

138
00:16:32,000 --> 00:16:43,730
Radiology, uh, eventually twigged that that was all due to that terrible row that they had when they all argued with each other.

139
00:16:43,730 --> 00:16:49,940
Um, only one of the what both parties and something was there for a month or something when I first came or something like that.

140
00:16:49,940 --> 00:16:58,490
I think I'd only just left. And the other participant in the main row was at the Churchill.

141
00:16:58,490 --> 00:17:11,090
And I at that time didn't go there. Um, but you could eat you didn't know what to make of it.

142
00:17:11,090 --> 00:17:21,050
You can't say more than that, really, and the pathology laboratory services, again, a variable one thing I couldn't understand.

143
00:17:21,050 --> 00:17:30,410
I've been quite used always. If that patient died and had a post-mortem and I always went home and I found.

144
00:17:30,410 --> 00:17:34,740
But not here. Not in Oxford. And I found that very odd.

145
00:17:34,740 --> 00:17:43,130
And also you weren't wanted. Now, I can understand that if there was some issues that it hadn't been managed.

146
00:17:43,130 --> 00:17:50,690
Right. Well, there actually that's important to find out. So I found that a bit tricky.

147
00:17:50,690 --> 00:17:59,510
One of the stroppy letters I wrote, I didn't I only read one or two in a career, actually, but I wrote one to one of the pathologists.

148
00:17:59,510 --> 00:18:07,910
One of the patients had died. And there was some question of whether the operation had been done quite right by me, not to anybody else.

149
00:18:07,910 --> 00:18:12,560
But you wanted to know. Yeah, cause I wanted to go and see what it what it was.

150
00:18:12,560 --> 00:18:19,860
It happened. Yeah. Yeah, of course. But they never told us when the I made made arrangements to go.

151
00:18:19,860 --> 00:18:29,480
Yeah. No it was all done. Yeah. Which I know and but I did make sure that you get over it.

152
00:18:29,480 --> 00:18:34,400
Oh yes. Yes. But they had not um.

153
00:18:34,400 --> 00:18:42,510
Yes. I imagine the sort of seeing how much trouble seemed to me he was a nice man and perfectly but I don't know what he thought really.

154
00:18:42,510 --> 00:18:48,600
Anyway. Whatever. So I found that a bit odd. Um otherwise no.

155
00:18:48,600 --> 00:18:53,480
Uh, the results that you needed seemed to come back in reasonable time.

156
00:18:53,480 --> 00:19:02,320
There was not the comments that I mean, to be fair, the actually the reports that you've got were perfectly satisfactory, but it didn't.

157
00:19:02,320 --> 00:19:09,200
And, you know, at some stage you became director of clinical studies.

158
00:19:09,200 --> 00:19:15,230
Yes. And was that roughly eighty three? Right. So you did three years as well.

159
00:19:15,230 --> 00:19:19,880
And then also for six years. Yes. And three years up the hill.

160
00:19:19,880 --> 00:19:25,590
Yes. And how did you fit that in with everything else. Well, I wanted it, yeah.

161
00:19:25,590 --> 00:19:29,090
I, I've had an interest in it.

162
00:19:29,090 --> 00:19:35,990
There's a family background in education teaching and um so I did want it.

163
00:19:35,990 --> 00:19:40,850
And so I suppose I'm not going around saying that, but I think people pick it up.

164
00:19:40,850 --> 00:19:53,570
Well it was up um who had given up on it I think from the first test and John Ledingham and uh and it

165
00:19:53,570 --> 00:20:04,190
was up and I think well I'd obviously let it be known without saying say that I was interested and um,

166
00:20:04,190 --> 00:20:17,180
they gave it to Chris Paine and Joe Smith told me at the church one day that I was going to get it, which was fine.

167
00:20:17,180 --> 00:20:20,810
And he saw me the next day and he said, how was I? So I said, what?

168
00:20:20,810 --> 00:20:29,630
I done that and describing that sort of an upside down, you, you know, a bit depressed and it's recover anyway.

169
00:20:29,630 --> 00:20:33,770
Chris was excellent. And very soon after he took it on,

170
00:20:33,770 --> 00:20:41,570
he came to me at the church erm again in the thirties when he was doing some radiotherapy procedure and said would I like to be his deputy.

171
00:20:41,570 --> 00:20:51,200
But of course I jumped out there and he made it plain, as in others, that, you know, I'd get it when he finished his term.

172
00:20:51,200 --> 00:20:54,720
So that's how it started. And I enjoyed that.

173
00:20:54,720 --> 00:21:07,380
And um, um, it's again, a I have the first first week I was in charge after Chris retired first week Tuesday.

174
00:21:07,380 --> 00:21:17,390
Uh, young medical students representing please, may I have time off to climb Everest, uh, you know, is now not symbologist.

175
00:21:17,390 --> 00:21:26,180
I think. I think that's right. Anyway, Friday, same week, Friday, another young man comes in.

176
00:21:26,180 --> 00:21:31,160
Please, may I have time off to go and play cricket for Middlesex County in the West Indies?

177
00:21:31,160 --> 00:21:37,820
Well, I've, uh, uh, come across this before.

178
00:21:37,820 --> 00:21:46,790
Well, of course, you said yesterday without hesitation, so you suddenly realise you're in a slightly different league to any other medical students.

179
00:21:46,790 --> 00:21:56,630
I've met because I taught medical students in Cardiff and some ways I thought and think the Cardiff was a better medical school.

180
00:21:56,630 --> 00:22:04,550
The not so in the sense that Oxford takes on the cleverest able youngsters, they're always going to do well.

181
00:22:04,550 --> 00:22:10,190
The highly motivated by clever people. Cardiff took on this the.

182
00:22:10,190 --> 00:22:17,810
Medical students at the other end of that spectrum capable reasonably can, but not that clever.

183
00:22:17,810 --> 00:22:26,750
And it brought them up to a very good standard. So in other words, what I'm saying is that kind of made the most of the young people it had.

184
00:22:26,750 --> 00:22:31,680
I'm not saying I didn't do that, but it didn't need to very low to achieve it.

185
00:22:31,680 --> 00:22:39,980
Well, um, but, you know, climbing Everest and getting to play cricket for me is in a different league.

186
00:22:39,980 --> 00:22:46,910
And there are a lot of sort of personal relationship troubles or not in respect of the students.

187
00:22:46,910 --> 00:22:53,720
Is there with the students? Um, no, not really good.

188
00:22:53,720 --> 00:23:05,330
Um, no. And there was a bit, I think, in in as the House inevitably a little bit of tension between them or because they it's quite competitive,

189
00:23:05,330 --> 00:23:17,180
but it never really impinged in the medical school office. I sort of heard about it, um, and knew about it but never needed to do anything about it.

190
00:23:17,180 --> 00:23:22,070
Um, odd things. Uh, one time.

191
00:23:22,070 --> 00:23:27,590
Clever boy, not karate film.

192
00:23:27,590 --> 00:23:38,010
The first of course. I didn't get a house job on the selection system.

193
00:23:38,010 --> 00:23:49,140
It was in my office immediately after the news and was very shirty and he wasn't rude thing,

194
00:23:49,140 --> 00:23:55,950
but he was clear and he said I I have a right to have a job.

195
00:23:55,950 --> 00:24:00,510
Well, I have a right to have any room.

196
00:24:00,510 --> 00:24:06,570
You have to compete. And of course, he was clever, but he didn't quite have the clinical touch.

197
00:24:06,570 --> 00:24:15,350
Nothing wrong with that. There's plenty of medicine in that. But that's why he hadn't, you know, been selected because he didn't quite have that.

198
00:24:15,350 --> 00:24:25,290
Anyway, I spent a lot of time. I kept a large packet of tissues in my office and he was in tears about it and I couldn't stand.

199
00:24:25,290 --> 00:24:31,140
But it had to be expected that, you know, there's more to medicine than just being very clever with the DFL because he told me all this.

200
00:24:31,140 --> 00:24:38,130
Of course, I got it first. And then actually I realised it was the first time in his life it failed.

201
00:24:38,130 --> 00:24:45,840
Yes. I was thinking about this ever. Yeah. And it is you were aware of it in others, but not quite so severe,

202
00:24:45,840 --> 00:24:55,680
but no top of the school best day levels and top of the class in the university first class honours degree.

203
00:24:55,680 --> 00:25:01,800
Good. They fell and passed all the exams in the clinical school.

204
00:25:01,800 --> 00:25:06,810
No problem at all. Then bang. You know what happened to him.

205
00:25:06,810 --> 00:25:10,440
Yes I do. Yes. I don't know what he is now.

206
00:25:10,440 --> 00:25:17,490
No, I met him. He was charming and he came to me deliberately some years later when I left the

207
00:25:17,490 --> 00:25:21,990
medical school about three years later and said how grateful he was to talking to me.

208
00:25:21,990 --> 00:25:28,560
Oh, that's nice. Yes, it was very nice because I went away, you know, feeling because I had to be put out with him.

209
00:25:28,560 --> 00:25:32,400
Yes. Show. And how do you made his way as a clinician?

210
00:25:32,400 --> 00:25:37,130
So I think he drove them to the research side of things, which was his his knees.

211
00:25:37,130 --> 00:25:42,330
Yes. But yes, he did. And I was rather relieved when he did.

212
00:25:42,330 --> 00:25:47,460
And because you sort of you and I had to be hard to him.

213
00:25:47,460 --> 00:25:54,210
You have to understand that that's life is that's competitive and it isn't all about the brains.

214
00:25:54,210 --> 00:26:00,750
There's other things, particularly in medicine. Absolutely is. And so yes.

215
00:26:00,750 --> 00:26:11,790
No, then you became very interesting there, a pioneer in the keyhole surgery when with everybody and I was very lucky in my life, actually.

216
00:26:11,790 --> 00:26:19,080
Very lucky indeed, because as with all things and when you first started as a surgeon,

217
00:26:19,080 --> 00:26:29,730
you were dead keen to take an appendix out any appendicectomy on the firm you'd be there to by the time you'd done that for five years.

218
00:26:29,730 --> 00:26:37,920
And it's the same. So when I became a consultant in the NHS in nineteen eighty, I took over Charles Webster's practise,

219
00:26:37,920 --> 00:26:43,680
which was basically he was interested in gall bladder disease. He got a big series.

220
00:26:43,680 --> 00:26:48,480
He'd done about a thousand to his career, I think he said, um,

221
00:26:48,480 --> 00:26:53,730
and I took that over because the others were particularly interested and the liver was

222
00:26:53,730 --> 00:27:00,930
starting to become a surgical opportunity and the pancreas was known to be a problem.

223
00:27:00,930 --> 00:27:12,300
So I gradually acquired that practise. Now, at the same time, endoscopy was coming into medicine and surgery, um,

224
00:27:12,300 --> 00:27:25,110
and in particular endoscopy as the biliary tract and known as IACP endoscopic retrograde KALLANGUR pancreatic graphy for the historians.

225
00:27:25,110 --> 00:27:34,920
And it's basically a scientific endoscope. And you cannulate the bio that or the pancreatic duct and obtain an X-ray image of it.

226
00:27:34,920 --> 00:27:37,440
But it wasn't only taking the image which was an advantage,

227
00:27:37,440 --> 00:27:44,820
but you could actually do procedures down there and open up the opening and take stones out.

228
00:27:44,820 --> 00:27:51,960
And this was just starting. It was actually in this country pioneered at the Middlesex Hospital in London.

229
00:27:51,960 --> 00:27:56,640
And Malcolm Gough, who at the time was the senior surgeon, I think,

230
00:27:56,640 --> 00:28:09,930
and Peter Morris recognised and I was involved and they arranged day in range for me to go to Peter Cullen at the Middlesex for a month for training.

231
00:28:09,930 --> 00:28:18,540
And they also encouraged me to go. I went off to Europe to a couple of places in Holland and Germany where they were known to be good.

232
00:28:18,540 --> 00:28:25,980
And along with Roger Chapman, who was a gastroenterologist and we developed and he LCP service.

233
00:28:25,980 --> 00:28:32,190
And that came quite serious. You know, I did all day Friday's Roger did choose Tuesdays, I think.

234
00:28:32,190 --> 00:28:37,640
And he'd sometimes had another list during the week as well, because the demand for the.

235
00:28:37,640 --> 00:28:45,340
comScore stands for search for common problem. The demand is there, so that was one thing.

236
00:28:45,340 --> 00:28:51,200
And then in the early 1980s, and as you quite rightly say, then Kiho came.

237
00:28:51,200 --> 00:28:58,420
Now, that's a spin off of technology, as so much of surgery is or has been.

238
00:28:58,420 --> 00:29:05,800
Small television cameras making pictures available to everybody at the end escapes.

239
00:29:05,800 --> 00:29:09,980
First of all, it was just fibre optics. You had to look down. No one else can see.

240
00:29:09,980 --> 00:29:14,950
You just had to do it. Then they put a television camera on the end of the skit.

241
00:29:14,950 --> 00:29:22,210
Then they put a television camera at the end of the year and you add the image quality was fantastic.

242
00:29:22,210 --> 00:29:30,460
And of course, you could transmit these images electronically anywhere in the world with the NAACP.

243
00:29:30,460 --> 00:29:39,940
So used to say I used to have used to watch two television screens, one with I guess has been kind of going way.

244
00:29:39,940 --> 00:29:47,860
You did have had the image of the popular avatar in educating them on one screen and the x ray on the other.

245
00:29:47,860 --> 00:29:52,450
And, um, but anyway, with the keyhole, it's the same story.

246
00:29:52,450 --> 00:29:58,180
The endoscopes, the Bridgit and Escape's television cameras on.

247
00:29:58,180 --> 00:30:07,960
Then they had television cameras at the end and they produced a two dimensional colour image of the highest quality.

248
00:30:07,960 --> 00:30:15,740
And Syreeta and laparoscopic operations have been done by gynaecologist's for sterilisations for quite a long time.

249
00:30:15,740 --> 00:30:20,680
And a lot of the tools that you needed were adapted for them.

250
00:30:20,680 --> 00:30:32,660
But then whether when laparoscopic cystectomy came in, which for us was on February the 12th, nineteen ninety one church or hospital, um,

251
00:30:32,660 --> 00:30:41,770
added to that day previous that we'd spent quite a few nights and days in the

252
00:30:41,770 --> 00:30:48,670
surgeon's room at the Churchill dissecting tangerines inside a cardboard box,

253
00:30:48,670 --> 00:30:55,930
and that reproduced this. We arranged the dimensions so that reproduced the abdomen roughly.

254
00:30:55,930 --> 00:31:02,740
And then when the tangerines survived, we moved onto the patients.

255
00:31:02,740 --> 00:31:11,500
Um, and that was a big thing. I found that it the style suited my abilities.

256
00:31:11,500 --> 00:31:12,820
I quite liked doing it.

257
00:31:12,820 --> 00:31:22,360
And it's odd, of course, because it's upside down and back to front because, you know, you've got that lever effect of the abdominal wall.

258
00:31:22,360 --> 00:31:26,680
And when you move the instrument up, it doesn't move. It moves down.

259
00:31:26,680 --> 00:31:31,360
And, um, so that took a little while. But the brain is amazingly adaptable.

260
00:31:31,360 --> 00:31:36,400
And, you know, the the the the cross, the cross, the cortex.

261
00:31:36,400 --> 00:31:46,990
And once you've got it, it's like riding a bike. Actually the depth was a problem of depth of field because it's two dimensional.

262
00:31:46,990 --> 00:31:50,920
So you have to use parallax and that takes a little while.

263
00:31:50,920 --> 00:31:58,540
And it's it's potentially slightly dangerous in in anatomy, you know, because the relationships get a bit confused.

264
00:31:58,540 --> 00:32:03,070
But once you've worked it out and by and large,

265
00:32:03,070 --> 00:32:10,060
many of the surgeons sort of have a three dimensional image of it, you're operating on their brain anyway.

266
00:32:10,060 --> 00:32:20,380
So after a while. Yeah, so it was but that was that was so that was 10 years apart and lasted me till I returned.

267
00:32:20,380 --> 00:32:26,950
Really. When did your research 2004 where you said liver surgery was opening up.

268
00:32:26,950 --> 00:32:36,730
In what way? Well, it's a very bloody organ and for most of its life it was regarded as an area that

269
00:32:36,730 --> 00:32:43,780
not to go to because it bled like fury and was extremely hard to stop bleed his,

270
00:32:43,780 --> 00:32:49,000
um, but tend to gain technology started to come to the fore.

271
00:32:49,000 --> 00:32:57,980
There were methods of coagulating liver tissue with infra red red light which were developed, which enabled you to stop the haemorrhaging.

272
00:32:57,980 --> 00:33:07,060
Also, the anatomy of the liver started to come to the fore because most people think of the liver as just one great chunk right lobe,

273
00:33:07,060 --> 00:33:13,240
and then maybe they know and the caudate lobe, but the French not surprising.

274
00:33:13,240 --> 00:33:17,680
The French knew a lot about liver anatomy. Why do they back?

275
00:33:17,680 --> 00:33:22,120
And it was known to be absolutely segmental eight seconds.

276
00:33:22,120 --> 00:33:28,420
And the actual anatomy of the segments, although you couldn't see them from the surface, were quite well defined.

277
00:33:28,420 --> 00:33:33,430
And once you gain, if you could develop a three dimensional image of what it was supposed to be like,

278
00:33:33,430 --> 00:33:37,940
you could actually do segment activities of the liver, the.

279
00:33:37,940 --> 00:33:42,830
Given that you could that you could then control the main blood vessels in

280
00:33:42,830 --> 00:33:48,580
and out and the Biomet and you could stop that oozing from the liver surface,

281
00:33:48,580 --> 00:33:56,210
it became feasible. And, um, but it was several aspects to that.

282
00:33:56,210 --> 00:34:04,010
One was personal. You mentioned earlier that it was safe, Graham Smith, because he was a great expert on cussedness syndrome.

283
00:34:04,010 --> 00:34:13,310
And it was it's a funny Chuma carcinoid because it's metastasised the liver and it gives this carcinoid syndrome once you've got them metastases.

284
00:34:13,310 --> 00:34:19,610
And David had had a big quite a big practise, relet three digits in it.

285
00:34:19,610 --> 00:34:26,780
And it was known that if you could once you you could take the secondaries out of the liver in a rather crude way.

286
00:34:26,780 --> 00:34:30,870
But again, you could eliminate the carcinoid syndrome if you took them all out.

287
00:34:30,870 --> 00:34:39,530
Yeah. And so I you know, David sent me quite a few patients to do that for sometimes more than once.

288
00:34:39,530 --> 00:34:47,330
Yes. And even if you didn't remove all that, the whole bag completely, we couldn't remove all the tumour.

289
00:34:47,330 --> 00:34:50,990
You could still reduce the dose of drugs that they needed to control.

290
00:34:50,990 --> 00:34:56,640
The rest is quite a lot. And sometimes we got away with removing it completely.

291
00:34:56,640 --> 00:35:01,070
Um, and then the drugs didn't need to be given at all.

292
00:35:01,070 --> 00:35:12,680
And so that started a bit. Then it became discovered carcinoma, the colon, which metastasises to the liver commonly and is a common disease.

293
00:35:12,680 --> 00:35:24,020
It was starting to be shown that you could do the same with metastases from colonic cancer so that, you know, increased the need all along.

294
00:35:24,020 --> 00:35:30,380
There's always patients who traumatise the liver one way or another, car crashes,

295
00:35:30,380 --> 00:35:38,900
obviously horse kicks, these sorts of things, any sort of trauma to that part of the abdomen.

296
00:35:38,900 --> 00:35:42,860
And they had a very bad reputation. You know, they died on the table.

297
00:35:42,860 --> 00:35:47,690
Mary exsanguinated, and it was almost impossible to stop them.

298
00:35:47,690 --> 00:36:00,620
But as the anatomy became understood and how you could stop the using, you started to save some of those sort of people.

299
00:36:00,620 --> 00:36:06,860
So specialisation came. Somebody got a nasty liver injury.

300
00:36:06,860 --> 00:36:10,970
They were usually on the phone team to come and help sort it out.

301
00:36:10,970 --> 00:36:15,230
Segmentation. Did that go back to then and then? Yes, it did.

302
00:36:15,230 --> 00:36:27,290
Yes, he is a great man. And this game, you know, the French rather, but the British have had about as well when it started to come.

303
00:36:27,290 --> 00:36:32,570
You know, we're operating on the liver. So I started to look at the research and particularly the anatomy.

304
00:36:32,570 --> 00:36:41,780
And I rapides the course that the main papers were all in French, which involved in the French.

305
00:36:41,780 --> 00:36:49,310
And I can remember having had having a professor of French as a patient or French Dom.

306
00:36:49,310 --> 00:36:59,300
And I could well, I could make an effort at reading them, but I took one to him to translate it for him to actually terribly pleased.

307
00:36:59,300 --> 00:37:04,250
He thought I should know, I think. But yes, it was.

308
00:37:04,250 --> 00:37:09,400
And you know, it's clearly been known for 100 years. Actually, these papers were the 1890.

309
00:37:09,400 --> 00:37:13,400
Yeah. And the doctors don't make a difference.

310
00:37:13,400 --> 00:37:22,500
Yes. Huge. Definitely. Well, you remember the days patient turned up jaundiced.

311
00:37:22,500 --> 00:37:29,570
And as endless hundreds of. We spent all night listening.

312
00:37:29,570 --> 00:37:33,740
Between us, and you could never tell if there was an obstruction.

313
00:37:33,740 --> 00:37:41,300
Well, that's a bit of an exaggeration, but it was very hard to distinguish obstructive jaundice from, you know, hepatic jaundice.

314
00:37:41,300 --> 00:37:54,390
Ultrasound transwoman that didn't like. Yes, because it was I mean, of course, the radiologist did it to begin with, but.

315
00:37:54,390 --> 00:37:59,820
It's you know, if the dots weren't dilated and they weren't dilated after a week of jaundice,

316
00:37:59,820 --> 00:38:04,200
it was down to the physicians, there was something in the in the liver itself.

317
00:38:04,200 --> 00:38:09,050
If it's if they were dilated, there had to be a cause and it was either stains or tumour.

318
00:38:09,050 --> 00:38:15,480
And so, yes, there was a time when if what if Fletcher reported on the ultrasound?

319
00:38:15,480 --> 00:38:24,270
I believe that if anybody else did think the opposite. Yes, I know exactly what you mean.

320
00:38:24,270 --> 00:38:33,580
Well, there was quite instructive time about that, actually, because ultrasound was wasn't very well developed.

321
00:38:33,580 --> 00:38:38,910
And as you rightly say, it was a bit hard to know what to believe or otherwise.

322
00:38:38,910 --> 00:38:46,170
Well, then the out of the X-ray department was starting to sort of get better from their eyebrows.

323
00:38:46,170 --> 00:38:53,340
And they knew they needed ultrasound because it was all over the place and they didn't have it, really.

324
00:38:53,340 --> 00:39:03,540
So they want be a new consultant. And I was on the board and it was I was very Genea and really wasn't expecting to say very much.

325
00:39:03,540 --> 00:39:14,330
But I mean, and they advertised and it said ultrasound and they had a good shortlist.

326
00:39:14,330 --> 00:39:19,890
Wasn't to my eyes, it wasn't initially and over inspiring shortlist,

327
00:39:19,890 --> 00:39:26,580
and there was no one on there who really could claim a lot of experience knew about it.

328
00:39:26,580 --> 00:39:34,260
But anyway, one of them was sharp and said, well, no, I've done a bit of that.

329
00:39:34,260 --> 00:39:40,410
But if that's what you want, I'll not come for six months and I'll go and let it right.

330
00:39:40,410 --> 00:39:50,670
He got the job, of course. Yes. I voted for him immediately and David Lynch his ears wherever he was good.

331
00:39:50,670 --> 00:39:55,470
And he came and he was fantastic. He was a natural.

332
00:39:55,470 --> 00:40:00,870
Any report he wrote you believe? Absolutely. And he transformed it.

333
00:40:00,870 --> 00:40:04,800
And I think it was doing a good many of them. Yes.

334
00:40:04,800 --> 00:40:08,590
All right. That's fair. But what he really became a vascularity. Yes, he did.

335
00:40:08,590 --> 00:40:16,350
That's quite right. And for me, I would say, David, and certainly what he was sort of a little bit senior.

336
00:40:16,350 --> 00:40:20,140
Yes. And your generation rather than mine. And you're quite right.

337
00:40:20,140 --> 00:40:24,630
What is reports of all the things that he dealt with were utterly reliable.

338
00:40:24,630 --> 00:40:31,020
But but I would say for me also, I got so you know,

339
00:40:31,020 --> 00:40:37,260
I was quite often in the same department with David because sometimes you you

340
00:40:37,260 --> 00:40:42,060
needed to sort of talk with him about what the and he could get the image.

341
00:40:42,060 --> 00:40:47,700
You sometimes could help him interpret what it was that he was seeing, because it was always that,

342
00:40:47,700 --> 00:40:52,620
you know, for me it was always whether it's a tumour or stem effectively.

343
00:40:52,620 --> 00:40:55,830
And I know there's lots of other causes, but that was really what it came down to.

344
00:40:55,830 --> 00:41:00,720
And there's a bit of a difference in those two conditions.

345
00:41:00,720 --> 00:41:04,230
So for me, yes, and it was quite a quite revelation.

346
00:41:04,230 --> 00:41:11,700
He he's sharp enough to see that, you know, he didn't have quite the skills, but he thought the boy was the right choice.

347
00:41:11,700 --> 00:41:19,500
Very good being there during your time. There would be an administrative, managerial and nursing changes.

348
00:41:19,500 --> 00:41:23,470
And the organisations. Would you say anything about either of those?

349
00:41:23,470 --> 00:41:30,890
Let's do the nurses immersed in the salon report, which really produced it,

350
00:41:30,890 --> 00:41:36,360
produced a huge dilemma for the nurses because the seminar was a management change.

351
00:41:36,360 --> 00:41:45,540
And essentially, as a nurse, if you wanted to progress in the profession, you had to become a nurse manager.

352
00:41:45,540 --> 00:41:52,860
I simplified, but that was essential and it produced a dilemma for all those excellent board sisters,

353
00:41:52,860 --> 00:41:59,400
senior people, very experienced on the board, very sound. You rely on the name as a surgeon particularly.

354
00:41:59,400 --> 00:42:03,990
But I mean every all the consultant staff rely on their nursing staff.

355
00:42:03,990 --> 00:42:09,270
Um, and the seniors, they couldn't go any further.

356
00:42:09,270 --> 00:42:14,670
If they wanted to go any further, they had to leave the ward, leave nursing and become a manager.

357
00:42:14,670 --> 00:42:20,790
And, well, that's still the case. I don't think it's ever been resolved, really.

358
00:42:20,790 --> 00:42:37,290
Um, the administrators, I think, um, well, I had lots they changed endlessly and they mostly looked terribly stressed.

359
00:42:37,290 --> 00:42:42,450
Some are better than others. Chris was good, in my opinion.

360
00:42:42,450 --> 00:42:49,740
And of course, he went on to, you know, he's Lord Crisp and became the head of the NHS, which is no surprise.

361
00:42:49,740 --> 00:42:58,010
Um, I felt sorry for them in a way I can remember being it I don't think was crisp.

362
00:42:58,010 --> 00:43:04,620
It was one of the others. Doesn't matter. Chris had it to they had a fax machine in their office.

363
00:43:04,620 --> 00:43:08,280
And I can remember being in the office with some meeting.

364
00:43:08,280 --> 00:43:16,290
Not I wasn't the only one that knows, but the fax machine was going and I think it spewed out ten letters or some small number.

365
00:43:16,290 --> 00:43:21,090
But nevertheless, then and all of them were from the Department of Health,

366
00:43:21,090 --> 00:43:29,340
all in the name of the minister and all concerning patients in the job market who'd been admitted in the previous 24 hours and had been,

367
00:43:29,340 --> 00:43:33,720
on the contrary to law or some other version of that story.

368
00:43:33,720 --> 00:43:40,380
They were required to reply to each one by midday. Right?

369
00:43:40,380 --> 00:43:44,850
Well, you know, that's no way to work at that level.

370
00:43:44,850 --> 00:43:51,660
Yeah. I mean, you you'd have somebody delegated to deal with them and answer it.

371
00:43:51,660 --> 00:43:55,410
But I think, you know, several of them felt their jobs were on the line.

372
00:43:55,410 --> 00:44:04,530
In fact, they were if they didn't reply with a satisfactory explanation and they all these replies often came through region as well.

373
00:44:04,530 --> 00:44:10,290
And the region was never terribly fond of the Jauhari that was moved there.

374
00:44:10,290 --> 00:44:13,890
And then so I did. I felt.

375
00:44:13,890 --> 00:44:20,590
Terribly sorry for them, actually, one man who I quite liked and I thought was quite good, I saw him on Friday morning.

376
00:44:20,590 --> 00:44:27,230
I said, how are you this morning in the corridor? I said, fine, fine, fine. He was sacked at lunchtime and he knew it.

377
00:44:27,230 --> 00:44:37,260
And so I felt I felt because the doctors are very sniffy about administrative administrators, you know,

378
00:44:37,260 --> 00:44:43,440
I think we're all better, which is rubbish because administration quite skilful and it needs to be done.

379
00:44:43,440 --> 00:44:51,750
You can't run a hospital administration, have to be cleaners, have to be people who put the syringes where you can use them.

380
00:44:51,750 --> 00:45:01,650
And that means organising. And so I know it needed good people and it wasn't this constant.

381
00:45:01,650 --> 00:45:09,010
It's a constant threat to your job was not a way to encourage people to wear no good thing.

382
00:45:09,010 --> 00:45:18,810
A very good point, because, I mean, when we started more or less, we were advising the administrators what to do.

383
00:45:18,810 --> 00:45:25,110
And by the end, did you feel they were telling or advising you or to do telling you what to do?

384
00:45:25,110 --> 00:45:30,930
Yes. How did that come about? It was a gradual takeover.

385
00:45:30,930 --> 00:45:38,040
And for me it was when I started, you saw patients, our patients needing operation.

386
00:45:38,040 --> 00:45:42,930
You put them on your waiting list. You had that waiting list in your office.

387
00:45:42,930 --> 00:45:49,950
It was cots. And you could and you chose the names off that list to come in for care.

388
00:45:49,950 --> 00:45:57,000
And you were fair. But there are some people who need new needs to come through all sorts of reasons.

389
00:45:57,000 --> 00:46:08,160
And my cancer, obviously, they clearly but it could be somebody with a hernia whose job was at risk if you knew that you was you.

390
00:46:08,160 --> 00:46:19,860
Yeah, I expected to know it or to be told it one way or another. Um, waiting this times came in as a political directive.

391
00:46:19,860 --> 00:46:26,040
If these people weren't treated in that period of time, then there was difficulty.

392
00:46:26,040 --> 00:46:36,330
So the administrators started to get involved in admissions because they were under pressure to make sure people didn't wait a certain length of time.

393
00:46:36,330 --> 00:46:41,550
So they gradually started to dictate who was admitted.

394
00:46:41,550 --> 00:46:52,560
Um, it came to a point if I was doing the admissions and somebody slipped through, who should have been admitted but wasn't and I was doing it.

395
00:46:52,560 --> 00:46:54,720
It was my fault.

396
00:46:54,720 --> 00:47:06,390
And I was responsible for sorting it out and writing the letter of apology or explanation to the patient and his relatives or relatives.

397
00:47:06,390 --> 00:47:14,700
Once the administrator started to admit the patients, I said to a very nice lady, Mrs. Kennedy, it was excellent.

398
00:47:14,700 --> 00:47:24,780
Listen, you're admitting these people, if they aren't admitted, you must write the letters to the relatives and say X, Y, they have come in.

399
00:47:24,780 --> 00:47:32,040
It's not my responsibility anymore. So that's a she was fired about that and she did it.

400
00:47:32,040 --> 00:47:44,970
And that's the way it sort of changed. That came out of our hands. And then they were there were contractual changes, concerns when you started.

401
00:47:44,970 --> 00:47:50,970
I mean, you just had a contract to be a consultant.

402
00:47:50,970 --> 00:47:57,900
Um, then they sort of produced sessions, I think, if I remember rightly, eleven sessions in a week.

403
00:47:57,900 --> 00:48:01,950
And if you work full time, you've got eleven sessions.

404
00:48:01,950 --> 00:48:07,230
But if you a maximum part time, which allowed you to do private practise, you were I think it was nine sessions.

405
00:48:07,230 --> 00:48:14,430
I think I come back and I did private practise, so I actually became nine eleven.

406
00:48:14,430 --> 00:48:22,110
Um, you were expected to turn out for your clinics to your list, but there wasn't a well, you know,

407
00:48:22,110 --> 00:48:30,270
if you went there for some reason, there weren't wasn't somebody hanging over there then they produced pays.

408
00:48:30,270 --> 00:48:36,840
What was instead what was the. There was some that was a shortened the acronym from what it stood for.

409
00:48:36,840 --> 00:48:44,670
Anyway, we might remember before the end they introduced that and where the sessions really.

410
00:48:44,670 --> 00:48:47,160
But there were a bit more specific.

411
00:48:47,160 --> 00:49:00,570
You were actually nominated to do an operating list on the Wednesday and those morning after afternoon two to please you were on duty once a week.

412
00:49:00,570 --> 00:49:04,980
Your operating sessions must always have been the case with the anaesthetists or not.

413
00:49:04,980 --> 00:49:10,140
Yes, no. Yeah, but, um, yes.

414
00:49:10,140 --> 00:49:13,640
But as a surgeon, you had to do.

415
00:49:13,640 --> 00:49:20,510
Ontake, Yes, and you got, I think, years for doing it, take something, something like that,

416
00:49:20,510 --> 00:49:29,540
but then that starts to get a bit strict if you were on a pay to be in outpatients on that day.

417
00:49:29,540 --> 00:49:38,960
That was the deal. You were to be there and not in no Timbuctoo or in private practise, whatever.

418
00:49:38,960 --> 00:49:46,160
And indeed, I believe they did actually wrote just about the time they returned to the to the staff and say,

419
00:49:46,160 --> 00:49:51,860
you know, if you've got to pay, you'll be there. Not particularly.

420
00:49:51,860 --> 00:49:57,710
Not in the private hospital, which is fair enough if that's the deal.

421
00:49:57,710 --> 00:50:06,290
Yes. You know, you can't possibly complain. Supposing you were on a committee in London, could you ask permission to give you a yes.

422
00:50:06,290 --> 00:50:13,190
But you have to do that before when the system started, you just went to make sure that whatever it was was covered.

423
00:50:13,190 --> 00:50:20,920
Yes. But then you had and that I believe not to me, but I believe people were refused sometimes permission to go.

424
00:50:20,920 --> 00:50:34,040
I'm not wise, but, you know, I can understand is now I mean, they know so much by not trusting the system and pushing her out, right?

425
00:50:34,040 --> 00:50:38,270
Yes, that's true. Because like everybody else, there were exceptions.

426
00:50:38,270 --> 00:50:49,010
But by and large, most concerns, my acquaintance, were far more than they were ever at large and they couldn't understand that.

427
00:50:49,010 --> 00:50:53,990
And of course, there are always stories of people on the Gulf Coast or something, but they were mostly stories.

428
00:50:53,990 --> 00:51:00,050
Well, there was a reason or they were entitled to be on the golf course and.

429
00:51:00,050 --> 00:51:07,400
Yes, and, well, I.

430
00:51:07,400 --> 00:51:13,130
I think if it was clear what you were supposed to do, I didn't really mind too much, but it was a different way of working.

431
00:51:13,130 --> 00:51:20,300
Yeah, and the fact that you didn't control your own waiting list and sort of introduced slight difference with the patient since.

432
00:51:20,300 --> 00:51:23,930
Well, you know, you felt as if you saw patients. I need an operation.

433
00:51:23,930 --> 00:51:31,820
You felt a you know, that's one medicines about you feel a responsibility to achieve that for that patient.

434
00:51:31,820 --> 00:51:37,580
If you're just there to do this with someone else is completely different.

435
00:51:37,580 --> 00:51:44,750
It's a very different way. And of course, it does occasionally introduce difficulties because someone else has said an operation is appropriate.

436
00:51:44,750 --> 00:51:49,610
But you said you think it isn't the other way around and you know that.

437
00:51:49,610 --> 00:52:03,920
Can't that. Well, it's also it's not a very that's a I have heard that and the patient begged me to do the operation, actually I did do it.

438
00:52:03,920 --> 00:52:10,020
We got away with it. But, you know, those words are quite we got away with it.

439
00:52:10,020 --> 00:52:16,780
But if we hadn't got away with it, you know, I felt pretty, pretty bad about it because I didn't think it should be done there.

440
00:52:16,780 --> 00:52:22,390
And with the managers have come to see that. Oh, yes, that's terrible.

441
00:52:22,390 --> 00:52:28,900
I know. Where did you get your private practise? Yacktman days and right at the end of the manor.

442
00:52:28,900 --> 00:52:36,130
Yes. Oh, yes. Um, well I.

443
00:52:36,130 --> 00:52:42,640
I like that I did I because you get your people will say, oh he just like isn't money.

444
00:52:42,640 --> 00:52:47,950
It's not that. No the money isn't out and you can't deny that is ridiculous.

445
00:52:47,950 --> 00:52:54,070
But it's not that. No. Because private practise Bettmann it's really down to you.

446
00:52:54,070 --> 00:52:58,630
If you don't provide a service, do it well. You don't get the private practise.

447
00:52:58,630 --> 00:53:04,690
GP's won't referral them. So and also, if something goes wrong, there's only one person to blame.

448
00:53:04,690 --> 00:53:14,320
That's if you me it you know, you can't blame anybody else and say you get instant feedback of the success or otherwise of what you've done.

449
00:53:14,320 --> 00:53:24,730
Mm. And um well so you get to know the patients have been better and they give you very good histories to usually they we've taken time you know,

450
00:53:24,730 --> 00:53:28,660
with exceptions, but they obviously articulate people by and large.

451
00:53:28,660 --> 00:53:32,470
Well I always thought if you listened enough to a patient they told you what was wrong with.

452
00:53:32,470 --> 00:53:39,100
Right. Again, that's obviously an exaggeration here. But and the art was to get them to talk to tell you.

453
00:53:39,100 --> 00:53:45,880
Yes. And I mean, I can't speak for physicians, but I got very different.

454
00:53:45,880 --> 00:53:51,280
But if you have the time and just let them tell you, usually you can make it.

455
00:53:51,280 --> 00:53:57,220
And but, you know, and if you if you have to cut corners, all of that, that's a bit hard.

456
00:53:57,220 --> 00:54:01,790
But if you have to take a short time, you don't have that opportunity sometimes.

457
00:54:01,790 --> 00:54:13,570
Um, so, yes, I did like private practise. Um, I hope I never, ever let it impinge on my NHS practise because frankly, I think that is the problem.

458
00:54:13,570 --> 00:54:18,490
Yeah. The, the, the cream is now.

459
00:54:18,490 --> 00:54:20,860
There you are. And chest surgeon.

460
00:54:20,860 --> 00:54:30,480
Sometimes I've caught little indications that the O was not entirely sunny between then this and the NHS people that had gone by the.

461
00:54:30,480 --> 00:54:36,910
Yeah. Gone by the time we went to the John back. Yes. Completely I would say I never felt it after that.

462
00:54:36,910 --> 00:54:44,230
Never. Mm. Um so that's yours.

463
00:54:44,230 --> 00:54:52,470
Do you want to answer it. Yeah. Um no I never felt it and I don't think anybody else did.

464
00:54:52,470 --> 00:54:57,370
Peter Peter Morris, the professor of surgery, he was very inclusive.

465
00:54:57,370 --> 00:55:04,540
He was clearly a bit of the leader of the team, although there are colleagues who might not quite agree with that.

466
00:55:04,540 --> 00:55:12,430
But, um, no, he was. And from my point of view, I'd say it was a very happy set up,

467
00:55:12,430 --> 00:55:17,260
quite a contrast to what it was like when I first started the rapid and very clearly was not.

468
00:55:17,260 --> 00:55:22,000
No. Um, so, yes, I would say it was.

469
00:55:22,000 --> 00:55:28,690
And also we all had our specialities that came about. Peter was a vascular surgeon.

470
00:55:28,690 --> 00:55:32,860
Malcolm Gough and Nick Dudley had was paediatric as well as General.

471
00:55:32,860 --> 00:55:37,720
Mike Cantwell was a colorectal surgeon. I did the habitability stuff Nick does.

472
00:55:37,720 --> 00:55:40,000
He did the endurance stuff.

473
00:55:40,000 --> 00:55:51,250
And again, we all had enough to do I guess, you know, lots of central departments get very aggressive because they're competitive.

474
00:55:51,250 --> 00:55:56,100
And I mean, as an excellent example to serve.

475
00:55:56,100 --> 00:56:05,560
I never knew before they for my time, but neither would ever leave Newport for fear that the other one pinch their patients.

476
00:56:05,560 --> 00:56:12,250
Um, I never experienced that here because and that's true in private, too.

477
00:56:12,250 --> 00:56:15,910
There was quite now we were lucky in the way there's quite a wealthy area.

478
00:56:15,910 --> 00:56:21,610
There was enough private practise to go round for people to know to to do what they wanted to do.

479
00:56:21,610 --> 00:56:27,250
And not everybody wanted to do it from the cardiac surgeons got into trouble.

480
00:56:27,250 --> 00:56:31,510
I mean, there are too many surgeons for the number of operating sessions. Really?

481
00:56:31,510 --> 00:56:37,870
Yes. Yes. Well, you brought them up.

482
00:56:37,870 --> 00:56:42,490
I never realised before I became a consultant. How important was that?

483
00:56:42,490 --> 00:56:44,800
People got on with each other.

484
00:56:44,800 --> 00:56:51,400
And of course, the radiology department when I arrived was a prime example of where a big row had ruined the department.

485
00:56:51,400 --> 00:57:02,560
Twenty five years to recover. Really, in my opinion, and then the cardiac department, it was,

486
00:57:02,560 --> 00:57:10,120
I don't want to say it was terribly sad and ridiculous, two very talented people, they just obviously didn't get on.

487
00:57:10,120 --> 00:57:13,840
What happens if you probably have made it their business to get on?

488
00:57:13,840 --> 00:57:19,960
You can't get on with everybody, but professionally, I think it's a responsibility.

489
00:57:19,960 --> 00:57:29,320
You know, you don't allow personal antagonisms to impact on professional patient care if you can avoid it.

490
00:57:29,320 --> 00:57:36,880
And there has to be times with it. That's not possible because they were both good as WB and I.

491
00:57:36,880 --> 00:57:47,110
I believe that it's something serious. And WB is a very outgoing character and a bit of a know.

492
00:57:47,110 --> 00:57:52,840
It would be fair to say a bit of a difficult person to relate to be very, very good surgeon.

493
00:57:52,840 --> 00:57:59,980
I once went to see him doing a bypass and I was mesmerised and I couldn't leave him over there.

494
00:57:59,980 --> 00:58:05,920
Yes, it was yes, yes and no. For all his faults, I thought overall it was good.

495
00:58:05,920 --> 00:58:11,920
But he destroyed the department. Now, who is actually doing the thoracic surgery?

496
00:58:11,920 --> 00:58:16,690
Did they do that? Well, it was a problem. Really? Yes.

497
00:58:16,690 --> 00:58:25,660
Um, well, Westerby didn't review, I think occasionally did a human act to me or something, but it seemed rather on sufferance.

498
00:58:25,660 --> 00:58:33,840
I was never really involved because it is last names came from the respiratory physicians, so it didn't really come my way.

499
00:58:33,840 --> 00:58:44,380
Um, and again, you could never quite work out what the evidence was that surgery really was important for Cazenave and or Namjoo.

500
00:58:44,380 --> 00:58:51,070
You know, I never really didn't have a feel for it, really. Um, so I never quite knew.

501
00:58:51,070 --> 00:58:56,830
And now the oesophagus is carcinoma principly.

502
00:58:56,830 --> 00:59:02,800
Well, they didn't do that. And in fact, my Kettlewell did quite a bit.

503
00:59:02,800 --> 00:59:12,130
But then we appointed Nick Maynard, who was a specialist in oesophageal, said he came from guys having trained with it there.

504
00:59:12,130 --> 00:59:22,180
And so he took it on and transformed it in a way because it's a nasty cancer.

505
00:59:22,180 --> 00:59:28,360
But there's definitely a place for surgery in it. Without any question, there might be some doubt about cost over the lung.

506
00:59:28,360 --> 00:59:33,430
Not always, but, um, some doubt about it. But for customers, there's definitely a place for it.

507
00:59:33,430 --> 00:59:38,020
Yeah. And he took it on and did it and opened the chest up.

508
00:59:38,020 --> 00:59:41,290
I mean, it doesn't even open in the chest.

509
00:59:41,290 --> 00:59:47,820
Not isn't that we've got to be careful because the codecs and all clammy around the ER but it's not that difficult.

510
00:59:47,820 --> 00:59:52,420
It's once you know the principles and you know perfectly how to close it up with drains and things.

511
00:59:52,420 --> 00:59:57,580
I mean, and as long as you've got the nurses to look after the drains and know what to do with them,

512
00:59:57,580 --> 01:00:04,000
if they go wrong, then you know, it's not that tricky.

513
01:00:04,000 --> 01:00:08,560
But there are quite a lot of qualifications that relies on a team of people.

514
01:00:08,560 --> 01:00:18,370
And that's one of the things that came to be that, you know, surgeons were very egotistical, you know, that it took a while for them to realise.

515
01:00:18,370 --> 01:00:25,630
Actually, it's absolutely no lots of people taking these oesophageal things.

516
01:00:25,630 --> 01:00:30,590
You need a whole anaesthetist. And that's the person who does the nutrition.

517
01:00:30,590 --> 01:00:39,010
Yes, the ICU. When it you know, afterwards you need a really good intensivists to.

518
01:00:39,010 --> 01:00:45,970
And that applies to quite a lot. You know, if you start doing liver surgery and big time, you need quite a range of people to manage this.

519
01:00:45,970 --> 01:00:52,270
And, um, yes. Well, I, I would agree it's fair.

520
01:00:52,270 --> 01:00:59,380
Well, I do. When I was a little suppose you had a natural arrogance disease, but I was by the time you got to be a cancer, you realise that.

521
01:00:59,380 --> 01:01:02,960
No. The anaesthetist matter. Yeah. I was very lucky.

522
01:01:02,960 --> 01:01:10,930
I've had yeah. Yeah, yeah. Neil Schofield and these time for many years at the end and he was just fantastic.

523
01:01:10,930 --> 01:01:19,570
And I you can at one of the things if you, you could operate it did not have to worry about the anaesthetic.

524
01:01:19,570 --> 01:01:25,590
You just did the operation and you could actually trust Neil to deal with.

525
01:01:25,590 --> 01:01:29,230
And if he made a mess which happened. Yeah.

526
01:01:29,230 --> 01:01:34,210
He was, he wasn't blaming you just got on and sorted it out.

527
01:01:34,210 --> 01:01:39,670
And that's a really advantageous way to operate. Actually, he was fantastic.

528
01:01:39,670 --> 01:01:52,930
And did you publish papers on it? No, occasionally I did a few chapters in books is, um, five in the Oxford textbook of surgery, which Peter did.

529
01:01:52,930 --> 01:02:04,120
Um, gallbladders, those sort of things, laparoscopic work, the first one I was I was removed for the second one because it was it and moved on.

530
01:02:04,120 --> 01:02:11,050
Yeah, yeah. Other people knew better. So yes and yes, I did quite a bit.

531
01:02:11,050 --> 01:02:16,930
No, I would say, to be fair, my research was it wasn't my strong point.

532
01:02:16,930 --> 01:02:20,610
And when I was teaching, yes, I did do that.

533
01:02:20,610 --> 01:02:26,920
I always never won the golden stethoscope and never sat at the bedside or was at a lecture.

534
01:02:26,920 --> 01:02:33,260
Both Yes. Yes. And and, you know, survivors and health seminars and things.

535
01:02:33,260 --> 01:02:41,740
Yes. But very much at the bedside. Yes. Um, well, I was brought up with that.

536
01:02:41,740 --> 01:02:49,860
You had an intriguing title in the medical director about hernia, so.

537
01:02:49,860 --> 01:02:53,530
Oh, yes. Haemorrhoid activism. Yes, yes.

538
01:02:53,530 --> 01:03:03,940
Yes. I did write about that in Oxford. Yes. We went me Peter Morris, when he came, he I heckled me at first of it.

539
01:03:03,940 --> 01:03:10,360
But, you know, that's the usual problem, getting hernias in to repair them. And so he had a technique for doing it.

540
01:03:10,360 --> 01:03:13,870
And the local he'd read about it somewhere and we did between us.

541
01:03:13,870 --> 01:03:17,620
I was as much involved as he was, in fact, probably more because I did it.

542
01:03:17,620 --> 01:03:22,300
We got a technique for doing hernias under local anaesthetic as their cases.

543
01:03:22,300 --> 01:03:28,600
Right. And we published a little bit about it in Kitsune.

544
01:03:28,600 --> 01:03:36,850
And I made a film about it, um, which we showed and won a prise.

545
01:03:36,850 --> 01:03:48,640
And Peter Slight, the professor of Cardiology, Cardiology, he'd won a bigger prise for a film about hypertension, I think.

546
01:03:48,640 --> 01:03:54,400
And we showed them both in the John Radcliffe Lecture Theatre one day to anybody who, you know, advertised.

547
01:03:54,400 --> 01:04:00,190
It was quite a big turnout and mine was on about hernias under black anaesthetic.

548
01:04:00,190 --> 01:04:10,680
So we showed the patient in outpatients beforehand and we took the patient's blood pressure, which produced a huge laugh.

549
01:04:10,680 --> 01:04:19,720
Uh, so, yes, I did do things like that, actually, um, that sort of thing.

550
01:04:19,720 --> 01:04:20,110
Yes.

551
01:04:20,110 --> 01:04:29,320
And I did I did an article for the, um, for one of the big surgical American surgical sort of journals about doing hernias under local anaesthetic,

552
01:04:29,320 --> 01:04:34,930
whether the results were any good or not, and analysed the literature sort of thing.

553
01:04:34,930 --> 01:04:40,360
Yes, I did. And I made a little bit of thing about hernias.

554
01:04:40,360 --> 01:04:44,410
And of course, laparoscopic repair came in at the end.

555
01:04:44,410 --> 01:04:49,060
Um, that was tricky. And, um,

556
01:04:49,060 --> 01:04:58,780
you had to get the hernia repair in the early days was always adorned with nylon or some material for the

557
01:04:58,780 --> 01:05:08,830
strengthening the back wall of the abdominal cavity and on the back wall of the of the little canal.

558
01:05:08,830 --> 01:05:15,610
But then it was discovered that Meche plastic mesh was a very successful technique for doing it.

559
01:05:15,610 --> 01:05:21,760
And to begin with, it was done at an open operation and it was much the problem with Doney.

560
01:05:21,760 --> 01:05:25,970
It was this tension on the tissues. And that's known not to be a good idea. With Mesh,

561
01:05:25,970 --> 01:05:30,760
you didn't have any tension and it was very quickly realised that you could put the

562
01:05:30,760 --> 01:05:36,730
mesh in laparoscopically tricky and just a bit awkward getting the orientation.

563
01:05:36,730 --> 01:05:44,800
But if you got it right, it was very successful. But if you didn't get it right, the hernia recurred or didn't go away, that wasn't good.

564
01:05:44,800 --> 01:05:50,920
You never had any trouble with the actual measures and reactions. I never did know.

565
01:05:50,920 --> 01:05:56,530
Inevitably, infection was described with a foreign body.

566
01:05:56,530 --> 01:06:00,970
And if it happened, you had to take it out, which I, I never had to do.

567
01:06:00,970 --> 01:06:12,310
Um, no. It's very inert material and I'm sure someone said, yeah, but not commonly because the gynae people have had trouble with that sort of topic.

568
01:06:12,310 --> 01:06:22,150
Yes, we have. And well, yes. And they shift it moves around in the body, even if you separate it out, sometimes doesn't stay where you put it.

569
01:06:22,150 --> 01:06:28,300
Um, I used it quite a lot because the pancreatitis patients often, though,

570
01:06:28,300 --> 01:06:35,030
she had to operate under huge abdominal hernia and the mesh was pretty good for that.

571
01:06:35,030 --> 01:06:40,530
These large sheets. Do you think you had long enough Holliday's.

572
01:06:40,530 --> 01:06:54,900
Uh, yes, um, uh, I just I used have to take three weeks a week to recover from that thing, a week to have a holiday week to get back into, uh.

573
01:06:54,900 --> 01:07:01,460
So you did that twice a year? Yes. Well, I usually took three weeks and some months in the summer and the weekend.

574
01:07:01,460 --> 01:07:06,240
Yeah, the times. I always took the holiday. Good. Um, yes.

575
01:07:06,240 --> 01:07:10,590
And I had a hobby. I was fishing. Yeah.

576
01:07:10,590 --> 01:07:16,590
And, um, I didn't make any secret about it with anybody, anybody but particularly the juniors.

577
01:07:16,590 --> 01:07:21,960
In fact I rather made it plain that I thought that was quite important because I had a

578
01:07:21,960 --> 01:07:28,230
road on Thursday and I didn't have a timetable to commitment on a Thursday afternoon.

579
01:07:28,230 --> 01:07:33,810
And I used to go usually not always in the season is um.

580
01:07:33,810 --> 01:07:42,090
And I would tell people and I didn't have a bleep, I couldn't, you know, um and, you know, my colleagues knew that's what it was.

581
01:07:42,090 --> 01:07:46,050
And I worked with excellent people. So you could rule out some problem.

582
01:07:46,050 --> 01:07:52,950
They'd handle it. And yes, I personally I thought that was quite important in my professional life.

583
01:07:52,950 --> 01:08:00,600
What it is. Golf's popular, isn't it? Um, but I think I did think that.

584
01:08:00,600 --> 01:08:14,880
And, um, you know, one of the tricks with the fisherman was to say they're going to the bank because I said, um, but no, I didn't.

585
01:08:14,880 --> 01:08:21,660
I didn't. I would tell them I was going. And I think, you know, it's difficult to have a Hobby Lobby as a junior doctor.

586
01:08:21,660 --> 01:08:27,030
It's impossible. But once you become a consultant, you do have some freedom.

587
01:08:27,030 --> 01:08:35,190
Even now, I'm sure this and I always thought it's remarkable how surgeons stand up to the sheer physical

588
01:08:35,190 --> 01:08:41,640
demand of operating in tropical conditions and and and how did you feel towards the end?

589
01:08:41,640 --> 01:08:45,660
You sort of turned on. Yes, yes. Yes.

590
01:08:45,660 --> 01:08:52,080
Um, well, it pancreatic to me for cost out of the pancreas took about five hours.

591
01:08:52,080 --> 01:08:58,260
And that's not the longest operation, but it's quite a long time. Yeah. And I could do that.

592
01:08:58,260 --> 01:09:02,400
Yes. But by the end. Yeah. No, I knew.

593
01:09:02,400 --> 01:09:09,900
Um, yes. And I've realised since being retired as I'm sure you have to retire at just over sixty three.

594
01:09:09,900 --> 01:09:15,990
Right. I could easily have worked for another ten years but not doing pancreatitis.

595
01:09:15,990 --> 01:09:25,080
They'd have had to have found no Perlis for example, but one of the one of the less demanding operations you got.

596
01:09:25,080 --> 01:09:35,250
You know, because we worked where we do, we always had experience a staff, usually a senior registrar, and of course they had to know.

597
01:09:35,250 --> 01:09:40,780
And so there were bits of that operation that they could do.

598
01:09:40,780 --> 01:09:47,430
It's quite a lot of intestinal anastomosis. Well, senior staff, they do doing it without you being there to do it.

599
01:09:47,430 --> 01:09:56,550
And so you could split it up a bit like that. And, you know, you then can have a coffee or something and have a bit of a rest.

600
01:09:56,550 --> 01:09:59,700
Um, and that was one of the ways.

601
01:09:59,700 --> 01:10:12,000
But I know by the game to begin with, you want to do the appendicectomy after you sort of got that most of the mistakes,

602
01:10:12,000 --> 01:10:18,090
then the greatest pleasure is in getting a young person to do it safely.

603
01:10:18,090 --> 01:10:22,470
And that was the pleasure. And the same apply to the more complicated operations.

604
01:10:22,470 --> 01:10:27,480
You know, at the time, I dunno, it was quite a few times part of the pleasure was in making, you know,

605
01:10:27,480 --> 01:10:34,920
the younger person who's going to follow you, get them to to to do it and help them to to do it.

606
01:10:34,920 --> 01:10:38,430
And that's particularly also applied to the laparoscopic stuff, um,

607
01:10:38,430 --> 01:10:46,640
because not everybody was comfortable with the two dimensional image and the odd behaviour of the hands wasn't.

608
01:10:46,640 --> 01:10:56,790
They show an endoscopy. You could tell instantly if people had the facility or didn't they often do themselves, but they certainly applied to that.

609
01:10:56,790 --> 01:11:06,600
And, you know, I can remember helping youngsters, the younger people to get the hang of the keyhole stuff.

610
01:11:06,600 --> 01:11:13,650
What happened? I asked you about that. I said the green temperature is do tell me.

611
01:11:13,650 --> 01:11:22,170
Well, one of the when I became when it came to Oxford, I was an academic and I had a poster which is entitled to a fellowship.

612
01:11:22,170 --> 01:11:32,340
The broadly speaking, the other colleges in Oxford, the old fashioned ones, didn't much want lots more doctors on the staff.

613
01:11:32,340 --> 01:11:40,380
So I didn't have a scholarship. Well, that was, as you know, part of the background to Richardo if developing Green College and.

614
01:11:40,380 --> 01:11:46,990
When he did get it off the ground starts to get off the ground, I clearly was one of the people who was entitled to a.

615
01:11:46,990 --> 01:11:51,340
So my name was on that list. And I took an interest in it because it was teaching.

616
01:11:51,340 --> 01:12:02,010
And I was interested, um, and I actually was a junior boy on the Radcliffe committee of the University Committee that set it up.

617
01:12:02,010 --> 01:12:07,110
And that was quite an experience. Yeah, Vice-Chancellor himself chaired it.

618
01:12:07,110 --> 01:12:20,910
Of course, there was the master's son, Katharine's at the time and Bulloch notebook and Harris and Jack Harrison was the architect.

619
01:12:20,910 --> 01:12:29,400
And Richard had recruited Lord Pennock, who was the head of ICI at the time, and arrived in his role as chauffeur driven.

620
01:12:29,400 --> 01:12:40,230
And Vernae, I think it was from who was a landowner out in North Oxfordshire, Compton, Vernae and Hunter Valley.

621
01:12:40,230 --> 01:12:51,090
Yeah. So all these you know, I was just Genea well, that was I, Bullock and Harrison,

622
01:12:51,090 --> 01:12:58,140
but I had a discussion, shall we call it Harrison and design the new buildings for the college.

623
01:12:58,140 --> 01:13:04,110
And they were good. Ah, but they weren't the proper Georgeann proportion.

624
01:13:04,110 --> 01:13:12,030
Uh, so Bullock was on at him about the exact dimensions of the window and the slope of the roof.

625
01:13:12,030 --> 01:13:24,720
And there was a third thing I forgot they didn't teach you about Georgian windows and bars and well,

626
01:13:24,720 --> 01:13:34,080
you just listened and Harrison knew what the answers were. I mean, he had to I think he'd had the interaction with before as he knew the answers.

627
01:13:34,080 --> 01:13:39,000
And it was but it was I mean, just very impressive.

628
01:13:39,000 --> 01:13:43,110
But it wasn't a Nazi attack. But he showed you and he did know.

629
01:13:43,110 --> 01:13:47,320
He knew he wasn't you know, he'd been involved in Katharine's.

630
01:13:47,320 --> 01:14:00,940
So you knew from that. Yeah. Um, anyway, I was on the you know, the the the preliminary fellowship committee and so of election.

631
01:14:00,940 --> 01:14:04,350
Um, well, though he was clever at all.

632
01:14:04,350 --> 01:14:09,690
Yes. It would be fair to say devious. Yes.

633
01:14:09,690 --> 01:14:13,800
But devious in a way of getting things done.

634
01:14:13,800 --> 01:14:20,870
Um, and I guess I sort of come to realise that, you know, the only way to get things done is to be a bit devious.

635
01:14:20,870 --> 01:14:24,750
So, um, anyway, very effective.

636
01:14:24,750 --> 01:14:28,320
You know, he raised the money, got green involved.

637
01:14:28,320 --> 01:14:33,850
And now that was an example of the deviousness a little bit because it was Radcliffe College before.

638
01:14:33,850 --> 01:14:48,390
Yes. Dole he got hold of green through a man called William Gibson in Vancouver and Green and Cecil and I'd degree came for the weekend.

639
01:14:48,390 --> 01:14:52,290
After the weekend, it was going to be green.

640
01:14:52,290 --> 01:15:02,370
Um, and, you know, there's typical Oxford mutterings, you know, Radclyffe Green there a slightly different names, a green.

641
01:15:02,370 --> 01:15:09,080
But I say anyway, because it was never revealed how this was arranged.

642
01:15:09,080 --> 01:15:19,830
Well, you can bet you can guess how it was arranged, but it was never exactly explained what he had said.

643
01:15:19,830 --> 01:15:25,290
Um, but I was involved green throughout my time in Oxford.

644
01:15:25,290 --> 01:15:29,790
Really? Absolutely. Just after I came, it was starting and I retired.

645
01:15:29,790 --> 01:15:39,900
When I retired, I became an emeritus fellow and I was the first senior tutor and I was there for a period for the vice warden.

646
01:15:39,900 --> 01:15:44,520
So senior tutor, you'd be looking out for a lot of Gnomedex as well.

647
01:15:44,520 --> 01:15:49,710
There were I I was the first in said and I think there were eleven students the first year.

648
01:15:49,710 --> 01:15:55,130
So it was a highly dangerous job. Uh, and I think seven of them were medicks.

649
01:15:55,130 --> 01:15:59,100
But then you became the guys who later on. I did, yes.

650
01:15:59,100 --> 01:16:05,340
And it was a bit it was a bigger entity then I think probably a hundred students, something like that, perhaps a few more.

651
01:16:05,340 --> 01:16:13,200
And it was spread around or most of them were medicks still. But there was some social scientists and one or two others as well.

652
01:16:13,200 --> 01:16:20,610
And that was a different job, really was sort of keeping everybody on the side, as you might say.

653
01:16:20,610 --> 01:16:29,310
And that can be tricky because, well, it looks at people that they've got ideas and they don't hesitate to express them.

654
01:16:29,310 --> 01:16:35,970
That's the essence of the university where it's quite right to. But it can be difficult to manage sometimes.

655
01:16:35,970 --> 01:16:40,390
So would you be chairing fellows committees? I did a bit.

656
01:16:40,390 --> 01:16:44,980
Tough. Yes, I did a bit I wasn't chairman, you know the warden.

657
01:16:44,980 --> 01:16:48,760
Yes, he was there when you advised him. Yes, I did a bit. Yes.

658
01:16:48,760 --> 01:16:52,540
And getting the views of things and I mentioned that, you know,

659
01:16:52,540 --> 01:16:58,480
that we had a little bit of difficulty when times had to go and see the registrar because that people can be dissatisfied.

660
01:16:58,480 --> 01:16:59,740
He was very helpful.

661
01:16:59,740 --> 01:17:10,120
And but, you know, we resolved it without too much of a problem effectively, and because it was just a different way of working in the ward.

662
01:17:10,120 --> 01:17:17,470
And we had you know, I didn't really want to get too involved in the management of the college, whereas the fellows rather thought that was his job.

663
01:17:17,470 --> 01:17:22,750
And, you know, that's a difficult dichotomy to resolve. But he did resolve it effectively.

664
01:17:22,750 --> 01:17:28,240
We did. We got over it. But difficult time.

665
01:17:28,240 --> 01:17:39,280
And also, at one point in time, I had three portraits of the previous warden on my hands.

666
01:17:39,280 --> 01:17:45,340
Right. As you know, tradition and Oxford College to have a portrait of the warden.

667
01:17:45,340 --> 01:17:53,350
So the that John Walton, this was the fellows commissioned the portrait while the fellow if did it,

668
01:17:53,350 --> 01:17:58,210
worked in the Ashmolean and he was one of his mates to do it.

669
01:17:58,210 --> 01:18:25,610
And a portrait was produced. It was a I think it was a it was a chalk on paper.

670
01:18:25,610 --> 01:18:38,840
Then how is a patient with John Radcliffe? He lived in Aberdeen and he was a professional portraitist, not well known and sort of on the amateur side,

671
01:18:38,840 --> 01:18:46,910
but nevertheless, he'd been well treated in the John Radcliffe, not by John Walsh, but he wanted to pay the hospital back.

672
01:18:46,910 --> 01:18:52,970
So he off his own bat, Diana portrayed in oils of alter ego.

673
01:18:52,970 --> 01:18:59,720
Yes, it was perfectly acceptable, but of course, it wasn't what the fellow said, commissioner.

674
01:18:59,720 --> 01:19:07,650
And Watson, I think, quite reasonably thought, particularly as it commissioned something that was just awful to be done.

675
01:19:07,650 --> 01:19:11,330
So it was landed on my plate. What was to be done?

676
01:19:11,330 --> 01:19:17,570
Well, it was straightforward, actually, because I, I just simply went to John Bolton and said, who do you want to do it?

677
01:19:17,570 --> 01:19:21,560
And he said, Leonard Bowden straight off the line.

678
01:19:21,560 --> 01:19:27,110
I it. But that meant I had to find out.

679
01:19:27,110 --> 01:19:30,530
And he was a he he was a portrait.

680
01:19:30,530 --> 01:19:38,210
He had been the president of the Royal Society of Australia and he'd done all the presidents of the Royal Society of Medicine.

681
01:19:38,210 --> 01:19:46,400
If you go there, there's endless chalk drawings, you know, and he'd done John with John Morton.

682
01:19:46,400 --> 01:19:54,980
So I found him. He he used to live he used to work in Kensington and he then lived in North London.

683
01:19:54,980 --> 01:20:03,320
So I went there and explained the situation and arranged for him to do a portrait of autumn,

684
01:20:03,320 --> 01:20:09,740
which is in the college, and was perfectly acceptable and very good, actually.

685
01:20:09,740 --> 01:20:12,230
It was a spin off because when I went,

686
01:20:12,230 --> 01:20:23,870
I discovered that his wife was also a very good portrait artist and she'd been the president of the Society of Women's Artists.

687
01:20:23,870 --> 01:20:30,540
And I didn't even know that existed. I didn't even know the portrait painters existed.

688
01:20:30,540 --> 01:20:37,280
Um, anyway, um, well, the spin off was I asked her to to do our two children.

689
01:20:37,280 --> 01:20:45,730
All right. Lovely. And. And that was interesting because I asked her and I said, well, could you do them on the same page paper?

690
01:20:45,730 --> 01:20:52,010
Oh no. Mm. I don't know. But she did do it because I cos I was commissioning it.

691
01:20:52,010 --> 01:20:56,120
So I suppose if you know, if you're the commissioner you do what the client wants.

692
01:20:56,120 --> 01:21:01,940
But she wasn't very keen. And the reason of course was that, you know, it's,

693
01:21:01,940 --> 01:21:09,710
it's very easy to get accurate well accurate portrait images and the risk of that one being wrong and one being right is very great.

694
01:21:09,710 --> 01:21:15,830
So they usually do them on the same day. And in fact, she did do them on the same paper.

695
01:21:15,830 --> 01:21:20,130
It's very easily and deliberately divided down the middle.

696
01:21:20,130 --> 01:21:26,930
She also said, you know, what are you going to do when you die? What you're going to do anyway?

697
01:21:26,930 --> 01:21:30,620
So how do they represent. No, no, no, no, no.

698
01:21:30,620 --> 01:21:36,470
They were, um, Rachel was at university in Manchester, so she ran towards the end.

699
01:21:36,470 --> 01:21:45,290
So she should not twenty twenty two. And Jonathan was at university in London and I didn't tell Mona because I'd done it.

700
01:21:45,290 --> 01:21:49,560
And um, well it's not really relevant to the medical school. It.

701
01:21:49,560 --> 01:21:51,290
Well, well no.

702
01:21:51,290 --> 01:22:04,010
So I um I on Substitutive going to collect John Walton's portrait and we went to the house and they had a studio right in the roof in the attic.

703
01:22:04,010 --> 01:22:08,750
And so we went up to look at John Bolton's painting.

704
01:22:08,750 --> 01:22:19,370
But as we went through the door, up the stairs to the door straight ahead, it was her two children that were Dylan.

705
01:22:19,370 --> 01:22:23,420
What else and what else did I put on my paper?

706
01:22:23,420 --> 01:22:27,930
And you expect to see I made some notes because you asked me.

707
01:22:27,930 --> 01:22:32,720
So, yes, I think you owe the medical school office report to me.

708
01:22:32,720 --> 01:22:44,780
Yes. A little bit. And we did touch on it before. But one thing I didn't say and school I did science A-levels, arts rubbish.

709
01:22:44,780 --> 01:22:49,220
What do you want to do? Arts for Nagy's when I'm ridiculous.

710
01:22:49,220 --> 01:22:56,390
But that's what you thought. No, you were a scientist. Everything else.

711
01:22:56,390 --> 01:23:00,620
And I learnt in the medical school just how wrong and rubbish that was.

712
01:23:00,620 --> 01:23:04,700
And the reason was because the secretary, the medical school these days was Peter James.

713
01:23:04,700 --> 01:23:11,090
I know. Yeah, he was. He read grades and got a first degree.

714
01:23:11,090 --> 01:23:17,720
Yes. And clearly very academic, erudite man.

715
01:23:17,720 --> 01:23:25,640
And I realised then just what a ridiculous, uh, opinion I'd had of the arts previously.

716
01:23:25,640 --> 01:23:40,790
And there were two things that came to ABC. Firstly, he had a vocabulary streaks ahead of mine where he went ahead and his ability to write sentences,

717
01:23:40,790 --> 01:23:46,160
minutes in particular, was just you could see why grades mattered.

718
01:23:46,160 --> 01:23:51,890
Mm hmm. He had the ability to put words together and the vocabulary.

719
01:23:51,890 --> 01:23:56,660
So that exactly mirrored what the sense of a meeting was.

720
01:23:56,660 --> 01:24:00,170
I could never have done it. You know, I just didn't.

721
01:24:00,170 --> 01:24:06,410
And you suddenly realised that these subjects really did matter.

722
01:24:06,410 --> 01:24:10,430
They actually have a place because minutes, you know, two very important.

723
01:24:10,430 --> 01:24:18,780
They are they right? They run. People say there's a slight aside.

724
01:24:18,780 --> 01:24:22,580
I told him later, you know, how much I admired them.

725
01:24:22,580 --> 01:24:26,630
It it's true of other people. It's not only Peter, but it really brought it up.

726
01:24:26,630 --> 01:24:30,950
He brought it to me. He said to me once, he said, well, yes.

727
01:24:30,950 --> 01:24:37,550
He said them actually down to writing minutes, anxious to make sure you write down what they should have decided, not what they did.

728
01:24:37,550 --> 01:24:44,750
And I think he was joking, but I did it.

729
01:24:44,750 --> 01:24:49,070
Did I also have a daughter who's a musician?

730
01:24:49,070 --> 01:24:50,420
And of course, that brought her to me.

731
01:24:50,420 --> 01:25:00,950
You know, this is that sort of attitude is typical of my generation, the post-war grammar school and the clear you know,

732
01:25:00,950 --> 01:25:08,510
the fact that you live in science or in arts and you didn't mix you didn't do one of each or anything can do that.

733
01:25:08,510 --> 01:25:12,740
No, you can. You couldn't do it in Scotland as well at the time with hired.

734
01:25:12,740 --> 01:25:21,170
Uh, but not then. And so, yes, of course, we that crowd and you you did realise and of course, languages obviously have a place.

735
01:25:21,170 --> 01:25:36,920
I mean, that's obvious, but you did wonder what that meant. But I do now have anything else on the list of is them.

736
01:25:36,920 --> 01:25:47,330
I don't think so, we can write down some things like, oh, you asked me about national committees didn't just mention that.

737
01:25:47,330 --> 01:25:56,260
Yes, we haven't touched on that. And local committees I once did the BMA Academic Stuff Committee headquarters, as I understand it.

738
01:25:56,260 --> 01:25:59,660
Yes. What was that? No, I wrote down.

739
01:25:59,660 --> 01:26:05,660
Oh, dear. Yes, I think that's all you can say, really.

740
01:26:05,660 --> 01:26:11,540
I did my share of committees here. You know, the I did the chairman's surgery.

741
01:26:11,540 --> 01:26:14,890
So that was on the hospital board. Yes.

742
01:26:14,890 --> 01:26:23,630
Um, and a man who you remember, Alex Gazzara, as I remember, who was medical officer of health, district medical officer.

743
01:26:23,630 --> 01:26:27,920
He was very good. He was very kind. I liked him a lot.

744
01:26:27,920 --> 01:26:36,560
I thought he was very good as well. I had quite a bit of interaction with him when I was the chairman of the medical staff committee.

745
01:26:36,560 --> 01:26:42,470
And I thought he you know, there's always troublesome consultants or difficulty with them or whatever.

746
01:26:42,470 --> 01:26:55,930
I thought he handled that excellently. Very. I suppose you might say in this modern era of transparency, not very transparent, but effectively, yes,

747
01:26:55,930 --> 01:27:08,760
and without getting the getting the right end result, without causing a great deal of aggravation and upset to all the parties involved.

748
01:27:08,760 --> 01:27:17,530
And I admired him and he was very kind to me. He said you're very effective at speaking in committees, which I never thought.

749
01:27:17,530 --> 01:27:22,210
But he said, you always wait till the end. Do you listen to everybody else and then speak.

750
01:27:22,210 --> 01:28:00,140
And I appreciate. I never realised it until he said and I.

751
01:28:00,140 --> 01:28:07,640
OK, but I mean, it's very difficult in Oxford because should the professor be running one enterprise,

752
01:28:07,640 --> 01:28:12,880
you know, which actually they should, I think in the end about the right people.

753
01:28:12,880 --> 01:28:17,390
I think that's the key thing, isn't it? Is the right path. And we had to right people.

754
01:28:17,390 --> 01:28:21,440
And we did observe Morrison and they were very upset.

755
01:28:21,440 --> 01:28:25,160
And, you know, they're widely respected, is very good.

756
01:28:25,160 --> 01:28:29,720
Both of them very sound clinicians is you'd have either of them look after you.

757
01:28:29,720 --> 01:28:35,060
Yes. And they're both excellent, fantastic scientists.

758
01:28:35,060 --> 01:28:43,400
And yes, we were lucky like that. That's a very unusual I would say in my experience and the unusual combination, we were lucky and.

759
01:28:43,400 --> 01:28:51,350
Yeah. So they deserve to lead it. Yes. Yes. Um, so I liked Alex and I did that.

760
01:28:51,350 --> 01:28:56,150
Um, the faculty board in gowns, of course, Saturday morning.

761
01:28:56,150 --> 01:29:07,640
Is Potter and Daniel sitting opposite chairman so they could always control things that Potter always in, you know,

762
01:29:07,640 --> 01:29:14,960
subtask and the propaganda on and things, um, that the main memory I have about that relates to the region.

763
01:29:14,960 --> 01:29:22,930
They were invited. Yes. But they weren't ever allowed very much tables.

764
01:29:22,930 --> 01:29:27,530
You know, the four for Van Hooten, the four tables around the summit.

765
01:29:27,530 --> 01:29:40,730
And Morrison, the chairman that had have is there and well, they were allowed sort of in a corner the by the door.

766
01:29:40,730 --> 01:29:45,140
And there were always Rosemary Ruu. There was actually also a very impressive.

767
01:29:45,140 --> 01:29:53,270
Yeah, absolutely. Um, she was allowed to speak as long as she was giving them something.

768
01:29:53,270 --> 01:29:57,020
And I felt quite a bit at times. But she was up to that.

769
01:29:57,020 --> 01:30:08,390
Yes. I remember the Professor Jennings then faculty board, Grimley Evans.

770
01:30:08,390 --> 01:30:12,380
He turns up one day, waits for any other business as you do.

771
01:30:12,380 --> 01:30:22,010
Then he passes around photocopied sheets, which are from the Oxford English Dictionary.

772
01:30:22,010 --> 01:30:26,860
Professor of geriatrics, I don't like that name very much.

773
01:30:26,860 --> 01:30:36,090
He reads out the city. I can't remember it. And I think there's gerontology and gerontologists.

774
01:30:36,090 --> 01:30:40,240
And so he goes on about this and, you know, this is any other business.

775
01:30:40,240 --> 01:30:46,220
Everybody wants to go for coffee and this. And no one had the slightest clue anyway.

776
01:30:46,220 --> 01:30:51,380
You got to change to gerontology, I think was something that was a classic.

777
01:30:51,380 --> 01:31:01,140
What a triumph. Oh, yes. So those sorts of things, I'd never had much do with religion.

778
01:31:01,140 --> 01:32:46,380
Occasionally I went there. I once went to see.

779
01:32:46,380 --> 01:32:53,310
Did you have to build up in those Cabaser in Noton games or, you know, they did that by themselves?

780
01:32:53,310 --> 01:32:56,640
Yes. They never really did.

781
01:32:56,640 --> 01:33:05,280
LCP think we got them? Redding did, because they had good gastroenterologists and they were interested.

782
01:33:05,280 --> 01:33:13,440
But no, they'd send them over to us to do and we either to keep them a bit good, but they would be doing keyhole surgery.

783
01:33:13,440 --> 01:33:21,960
Oh, yes, they do that. Yes. Um, we start after us, um, and, um.

784
01:33:21,960 --> 01:33:26,520
But yes, they did. Everybody did because it was so I mean, it was dramatic.

785
01:33:26,520 --> 01:33:32,550
We did a ground on the ground round about these various endoscopic laparoscopic operations.

786
01:33:32,550 --> 01:33:41,700
And I think. Was it a surgical grinder? No, it was a I think I was I think I was well, I got we got organised with the EMT.

787
01:33:41,700 --> 01:33:45,900
People were doing the church operations up through the nose.

788
01:33:45,900 --> 01:33:51,000
And I was going to get somebody to do an arthroscopy of the knee, but they let us down.

789
01:33:51,000 --> 01:33:57,600
And I did a lap, Koelie, when I didn't do it, I was in the lecture theatre and I got my senior registrar to do it, but we had it on the screen.

790
01:33:57,600 --> 01:34:04,200
Life going on and go, Patison Yes, I've got what it was in.

791
01:34:04,200 --> 01:34:13,680
Was it? No, no. He was a plastic surgeon. Well, Michael Kettlewell had taken his gallbladder out on Wednesday morning,

792
01:34:13,680 --> 01:34:21,780
and I had him in the lecture theatre on Thursday afternoon for the ground round and advertise it to everybody.

793
01:34:21,780 --> 01:34:30,810
Yeah. So we shared this. We shared the bank doing the pituitary, which was fantastic images, because you never saw that.

794
01:34:30,810 --> 01:34:36,270
And you could see where the pituitary was playing the Xbox and up the nose.

795
01:34:36,270 --> 01:34:40,980
And I got Houbara to do that, Cobian, because that's quite you know,

796
01:34:40,980 --> 01:34:46,440
it's quite even if you're a physician, it's quite interesting to see you get lots of it.

797
01:34:46,440 --> 01:34:54,540
That means it's quite colourful. Anyway, at the end, I got Patterson to use it.

798
01:34:54,540 --> 01:34:57,900
He was dressed and in that thing he was at home anyway.

799
01:34:57,900 --> 01:35:09,120
So I got you down to the front and sat him in front and I asked him about his symptoms and things and, you know, sometimes gall bladder, etc, etc.

800
01:35:09,120 --> 01:35:13,990
And the last question before we left, I said, Oh, I'm terribly sorry.

801
01:35:13,990 --> 01:35:24,300
I forgot to ask you when you had this operation done yesterday morning, uh, and there was an intake of breath in the hole.

802
01:35:24,300 --> 01:35:28,920
Yeah. And we all went away. Lovely. It was a good, good time.

803
01:35:28,920 --> 01:35:32,590
Well, yeah. Well, deliberately, no. Yeah.

804
01:35:32,590 --> 01:35:43,350
Well we may as well because well now everybody in the room knew the code that as we kept in five days a week, uh and had a big scar of.

805
01:35:43,350 --> 01:35:46,890
That's a lovely note to end on the right. Perfectly well.

806
01:35:46,890 --> 01:35:51,014
Thank you very much. It's a lovely interview. Lovely to see you.