This is Derek Hockaday interviewing Julian Britain, and it's the twenty third of January two one nine.
Julian, what really made you come towards Oxford from Gwent?
The reason I came here was because the department had a new professor and had the opportunities for a new start in surgical life.
And the reason was because in many ways it's extremely surprising.
I never came here because beforehand Oxford and Cambridge were one of the few places in this
world that I didn't plan to work outside was known as a difficult place to work for surgeons,
for surgeons, for all sorts of reasons.
But a new professor and I fancied at the time being a professor, as it turned out, that would have been a terrible mistake.
It didn't work out so. But that's what I thought. So I applied for the leadership.
Right. And Peter Morris, I got an interview.
Peter Morris, David Tibs. Joe Smith.
James Gowans. Yes, Robert Duthie.
And I think Jill Williams was the lady. And it was held in the Radcliffe Infirmary boardroom with all the names on the wall.
And on a Saturday morning, four of us were interviewed.
David Tweddle, Roger Greenbelts and Grant Gill.
Uh, David eventually became a consultant in Manchester. Roger became a professor of surgery and, uh, turned course in London.
And Grant went back to Australia. All right.
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.
So I was a bit surprised when I was invited back to take the job.
Well,
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.
So. Well, anyway, David Tips sensibly said what he felt confident that it would pass.
So of course, yes, I accepted the job. Um, my father, who, as I mentioned, was an Oxford man, was absolutely thrilled.
He was still alive at the time. And I think he said that we'd explored going to Oxford or Cambridge to do medicine.
And he did all sorts of reasons. It didn't happen.
And I went to Barnes instead. So he was very thrilled when I got the job and I'm pleased about that.
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.
One of the persons that worked to a man called said Britain, dreadful.
You'll never come back. Uh, so that was another reason for being pleased.
All right. But, um, when I arrived, I like at Newport was a very good place to work.
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.
All right. And there were endless examples of my experience of people who have clever, pleasant, but they could not operate.
I think it was it was sad. They'd gone in a way that chosen career.
So when I mean, the reason I went to Newport was I was determined if I going to be an academic,
I had to be able to write whatever the and it was very good.
So I only worked in Cardiff for a very short time.
And Cardiff was a very difficult place surgically and generally actually at that time was nice new hospital.
But all the same it was a bit of a I never quite made it out really.
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.
It was very intimidating. The interview was a bit intimidating, but particularly Duthie.
Yes, I can imagine. But you didn't that was normal.
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.
Um, but when I arrived in Oxford, I couldn't make it out.
It was highly intimidating. And the first thing I realised, actually, it was obvious you couldn't miss it,
was that the NDIS was extremely unpopular, right, amongst the other surgeons?
Well, definitely amongst the other surgeons. But I could see that it was regarded as a bit of a dubious entity amongst everybody.
Right. And that I realised after a while I was history.
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,
um, and clearly you in the presence of some incredibly clever people,
all the physicians, and there's nothing to do directly with yourself,
with all the physicians were clearly very highly competent people, very well qualified, good clinicians.
Um, the surgeons gain, but a slightly mixed bag.
The senior one clearly didn't like the NDIS at all.
And the. I know the history of it, but, you know, I was absolutely the enemy, the NDIS had its own words.
It had its own operating theatre. It wasn't allowed in the town theatres until after five o'clock at night.
And were two things stand out, really.
And there was a New Zealand man called Malony who was basically was quite a nice man.
I don't think he was a terribly technically good surgeon, but, well, not by the time I met him.
But he he was a senior and he clearly had had endless difficulties with the NDIS over the years.
And I can remember I used to be the eldest.
It takes twice a week more than the other surgeons Peter had.
Peter Morris, the professor, had instituted that. So we always had more emergency patients around on other people's wards.
One morning I used to start the ward rounds at eight and one morning I went to Beaver's ward,
which was below the neurosurgical theatres in the old Radcliffe Infirmary and wasn't an NDIS ward.
So I think deliberately but not I can't prove that.
But at about ten past eight, the doors of you may remember were too narrow.
One small one person could get through one about ten to eight.
I approach the door to Beaver's ward as I approached it.
Mr Mellini right. Their usual retinue of students moaning.
Britain. You'll get the patients out, won't you?
As well as much as possible. And so I got the drift and he he allowed us to get look anyway.
Well, move.
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.
We weren't allowed in till five. Mr Maloney was operating.
So I'm in scrubs and have seen.
What are you doing here? Britten Well, fortunately.
Well well, I'm clearing up one of my messages, Mr Maloney And that went down a treat of ever afterwards.
It had all gone well. Um, and he was, he was perfectly OK.
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.
It was a dreadful mess. But we didn't do that. And the patient survived the pain.
Peggy Frith is you'll remember. Yes, well, he was the patient was presented at the at the medical grand rounds by her.
And she came with the notes, which were about six inches thick.
And she started by saying the patient during the course of this erm has lost twenty five pounds in weight,
which is about the same weight as his notes. Um, the other thing too that I suppose you'd say rather casual really,
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.
And one of the nice things when I first started was that they did speak to you in the corridor.
They they were. You were. But they just all posture, you know, consult their colleagues and they go, you know, all of them,
but some of them and I found that a bit odd is sort of quite the way I would normally.
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.
Yes. And the more reticent they were, the louder you said hello.
So there was no way, as I'm avoiding the fact that you were recognising them.
And actually, you know, it it it all went by the time we went to the job market.
I had now that was a new place then.
It was no long corridor.
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.
And, you know, the Indians had good surgical staff, all of them out there, Robyn Smith, those sort of people, they could all operate.
And it was perfectly OK and they came to be recognised as such.
So what did you stand in this right through? No, I thought no, this.
Um, well, um, again, I came thinking, I want to be a professor,
so eventually Chang came out and I applied and I can remember being mildly shocked that I didn't get on the short list.
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.
And so he's just applied for it and I thought about that, too, wasn't so, and I got it.
So I changed in 1980 as the job market opened right to the NHS.
What research would you, Dan Rather, in the end is now before I came?
I've done quite a lot of work in the past about the way blood clots during surgery
and the influence of the sympathetic nervous system on that particularly adrenaline.
And that was tied in really with the introduction of beta blockers because they
understood the understanding of the sympathetic system was quite compelling. It was becoming quite, you know,
the differentiation of the alpha beta receptors in a subdivision of the beta receptors and the drugs that actually blocked individual bits.
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.
And there was a very good haematology department in Cardiff and the Royal of Rate and all those sorts of things.
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.
I didn't have that skill. So I'd done a bit, but not much.
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.
You just said know. And then, um.
And so the move to the NHS was a wise one from that point of view,
because Charles Webb served in surgical Chuter thing and presumably they got rid of that job that they were.
Then there is going on. Robin Smith got it. But that was as a senior registrar.
Yes. A consultant was I think Charles was perhaps a consultant. He was.
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.
So I was more interested in the teaching of it. So that's what I developed.
Really? Yes. There wasn't a surgical ground round when we started, so we created one.
Yes. Certainly never as successful as the medical grand round.
Too early in the morning. Yes, yes. And surgeons like to operate is so that took a while to get going.
And of course, to begin with, of course. No, no, NHS surgeons can't come to this meeting.
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.
And I just asked each individual surgical firm to put on the ground round.
Yeah, yeah. And you know, they take whatever they thought they couldn't refuse, so they incorporated everybody else eventually.
When you came from Reoccurred roughly, what was your impression of the nursing anaesthetics laboratories?
The overpowering impression when I came to the Radcliffe was that it was a bit Dickensian.
They've met the medical wards down the hearts.
I can't really quite believe that the er at the end.
Yes. Wards where conventional Nightingale type wards and they were fine.
Um, but overall I thought gosh, for a place of this quality to have these facilities,
however, that John Radcliffe was in prospect, the nursing was just as I expected.
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.
It was absolutely top class. You could tell that you're in safe hands.
Radiology, uh, eventually twigged that that was all due to that terrible row that they had when they all argued with each other.
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.
I think I'd only just left. And the other participant in the main row was at the Churchill.
And I at that time didn't go there. Um, but you could eat you didn't know what to make of it.
You can't say more than that, really, and the pathology laboratory services, again, a variable one thing I couldn't understand.
I've been quite used always. If that patient died and had a post-mortem and I always went home and I found.
But not here. Not in Oxford. And I found that very odd.
And also you weren't wanted. Now, I can understand that if there was some issues that it hadn't been managed.
Right. Well, there actually that's important to find out. So I found that a bit tricky.
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.
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.
But you wanted to know. Yeah, cause I wanted to go and see what it what it was.
It happened. Yeah. Yeah, of course. But they never told us when the I made made arrangements to go.
Yeah. No it was all done. Yeah. Which I know and but I did make sure that you get over it.
Oh yes. Yes. But they had not um.
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.
Anyway. Whatever. So I found that a bit odd. Um otherwise no.
Uh, the results that you needed seemed to come back in reasonable time.
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.
And, you know, at some stage you became director of clinical studies.
Yes. And was that roughly eighty three? Right. So you did three years as well.
And then also for six years. Yes. And three years up the hill.
Yes. And how did you fit that in with everything else. Well, I wanted it, yeah.
I, I've had an interest in it.
There's a family background in education teaching and um so I did want it.
And so I suppose I'm not going around saying that, but I think people pick it up.
Well it was up um who had given up on it I think from the first test and John Ledingham and uh and it
was up and I think well I'd obviously let it be known without saying say that I was interested and um,
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.
And he saw me the next day and he said, how was I? So I said, what?
I done that and describing that sort of an upside down, you, you know, a bit depressed and it's recover anyway.
Chris was excellent. And very soon after he took it on,
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.
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.
So that's how it started. And I enjoyed that.
And um, um, it's again, a I have the first first week I was in charge after Chris retired first week Tuesday.
Uh, young medical students representing please, may I have time off to climb Everest, uh, you know, is now not symbologist.
I think. I think that's right. Anyway, Friday, same week, Friday, another young man comes in.
Please, may I have time off to go and play cricket for Middlesex County in the West Indies?
Well, I've, uh, uh, come across this before.
Well, of course, you said yesterday without hesitation, so you suddenly realise you're in a slightly different league to any other medical students.
I've met because I taught medical students in Cardiff and some ways I thought and think the Cardiff was a better medical school.
The not so in the sense that Oxford takes on the cleverest able youngsters, they're always going to do well.
The highly motivated by clever people. Cardiff took on this the.
Medical students at the other end of that spectrum capable reasonably can, but not that clever.
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.
I'm not saying I didn't do that, but it didn't need to very low to achieve it.
Well, um, but, you know, climbing Everest and getting to play cricket for me is in a different league.
And there are a lot of sort of personal relationship troubles or not in respect of the students.
Is there with the students? Um, no, not really good.
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,
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.
Um, odd things. Uh, one time.
Clever boy, not karate film.
The first of course. I didn't get a house job on the selection system.
It was in my office immediately after the news and was very shirty and he wasn't rude thing,
but he was clear and he said I I have a right to have a job.
Well, I have a right to have any room.
You have to compete. And of course, he was clever, but he didn't quite have the clinical touch.
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.
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.
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.
Of course, I got it first. And then actually I realised it was the first time in his life it failed.
Yes. I was thinking about this ever. Yeah. And it is you were aware of it in others, but not quite so severe,
but no top of the school best day levels and top of the class in the university first class honours degree.
Good. They fell and passed all the exams in the clinical school.
No problem at all. Then bang. You know what happened to him.
Yes I do. Yes. I don't know what he is now.
No, I met him. He was charming and he came to me deliberately some years later when I left the
medical school about three years later and said how grateful he was to talking to me.
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.
Yes. Show. And how do you made his way as a clinician?
So I think he drove them to the research side of things, which was his his knees.
Yes. But yes, he did. And I was rather relieved when he did.
And because you sort of you and I had to be hard to him.
You have to understand that that's life is that's competitive and it isn't all about the brains.
There's other things, particularly in medicine. Absolutely is. And so yes.
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.
Very lucky indeed, because as with all things and when you first started as a surgeon,
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.
And it's the same. So when I became a consultant in the NHS in nineteen eighty, I took over Charles Webster's practise,
which was basically he was interested in gall bladder disease. He got a big series.
He'd done about a thousand to his career, I think he said, um,
and I took that over because the others were particularly interested and the liver was
starting to become a surgical opportunity and the pancreas was known to be a problem.
So I gradually acquired that practise. Now, at the same time, endoscopy was coming into medicine and surgery, um,
and in particular endoscopy as the biliary tract and known as IACP endoscopic retrograde KALLANGUR pancreatic graphy for the historians.
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.
But it wasn't only taking the image which was an advantage,
but you could actually do procedures down there and open up the opening and take stones out.
And this was just starting. It was actually in this country pioneered at the Middlesex Hospital in London.
And Malcolm Gough, who at the time was the senior surgeon, I think,
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.
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.
And along with Roger Chapman, who was a gastroenterologist and we developed and he LCP service.
And that came quite serious. You know, I did all day Friday's Roger did choose Tuesdays, I think.
And he'd sometimes had another list during the week as well, because the demand for the.
comScore stands for search for common problem. The demand is there, so that was one thing.
And then in the early 1980s, and as you quite rightly say, then Kiho came.
Now, that's a spin off of technology, as so much of surgery is or has been.
Small television cameras making pictures available to everybody at the end escapes.
First of all, it was just fibre optics. You had to look down. No one else can see.
You just had to do it. Then they put a television camera on the end of the skit.
Then they put a television camera at the end of the year and you add the image quality was fantastic.
And of course, you could transmit these images electronically anywhere in the world with the NAACP.
So used to say I used to have used to watch two television screens, one with I guess has been kind of going way.
You did have had the image of the popular avatar in educating them on one screen and the x ray on the other.
And, um, but anyway, with the keyhole, it's the same story.
The endoscopes, the Bridgit and Escape's television cameras on.
Then they had television cameras at the end and they produced a two dimensional colour image of the highest quality.
And Syreeta and laparoscopic operations have been done by gynaecologist's for sterilisations for quite a long time.
And a lot of the tools that you needed were adapted for them.
But then whether when laparoscopic cystectomy came in, which for us was on February the 12th, nineteen ninety one church or hospital, um,
added to that day previous that we'd spent quite a few nights and days in the
surgeon's room at the Churchill dissecting tangerines inside a cardboard box,
and that reproduced this. We arranged the dimensions so that reproduced the abdomen roughly.
And then when the tangerines survived, we moved onto the patients.
Um, and that was a big thing. I found that it the style suited my abilities.
I quite liked doing it.
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.
And when you move the instrument up, it doesn't move. It moves down.
And, um, so that took a little while. But the brain is amazingly adaptable.
And, you know, the the the the cross, the cross, the cortex.
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.
So you have to use parallax and that takes a little while.
And it's it's potentially slightly dangerous in in anatomy, you know, because the relationships get a bit confused.
But once you've worked it out and by and large,
many of the surgeons sort of have a three dimensional image of it, you're operating on their brain anyway.
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.
Really. When did your research 2004 where you said liver surgery was opening up.
In what way? Well, it's a very bloody organ and for most of its life it was regarded as an area that
not to go to because it bled like fury and was extremely hard to stop bleed his,
um, but tend to gain technology started to come to the fore.
There were methods of coagulating liver tissue with infra red red light which were developed, which enabled you to stop the haemorrhaging.
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,
and then maybe they know and the caudate lobe, but the French not surprising.
The French knew a lot about liver anatomy. Why do they back?
And it was known to be absolutely segmental eight seconds.
And the actual anatomy of the segments, although you couldn't see them from the surface, were quite well defined.
And once you gain, if you could develop a three dimensional image of what it was supposed to be like,
you could actually do segment activities of the liver, the.
Given that you could that you could then control the main blood vessels in
and out and the Biomet and you could stop that oozing from the liver surface,
it became feasible. And, um, but it was several aspects to that.
One was personal. You mentioned earlier that it was safe, Graham Smith, because he was a great expert on cussedness syndrome.
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.
And David had had a big quite a big practise, relet three digits in it.
And it was known that if you could once you you could take the secondaries out of the liver in a rather crude way.
But again, you could eliminate the carcinoid syndrome if you took them all out.
Yeah. And so I you know, David sent me quite a few patients to do that for sometimes more than once.
Yes. And even if you didn't remove all that, the whole bag completely, we couldn't remove all the tumour.
You could still reduce the dose of drugs that they needed to control.
The rest is quite a lot. And sometimes we got away with removing it completely.
Um, and then the drugs didn't need to be given at all.
And so that started a bit. Then it became discovered carcinoma, the colon, which metastasises to the liver commonly and is a common disease.
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.
There's always patients who traumatise the liver one way or another, car crashes,
obviously horse kicks, these sorts of things, any sort of trauma to that part of the abdomen.
And they had a very bad reputation. You know, they died on the table.
Mary exsanguinated, and it was almost impossible to stop them.
But as the anatomy became understood and how you could stop the using, you started to save some of those sort of people.
So specialisation came. Somebody got a nasty liver injury.
They were usually on the phone team to come and help sort it out.
Segmentation. Did that go back to then and then? Yes, it did.
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.
You know, we're operating on the liver. So I started to look at the research and particularly the anatomy.
And I rapides the course that the main papers were all in French, which involved in the French.
And I can remember having had having a professor of French as a patient or French Dom.
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.
He thought I should know, I think. But yes, it was.
And you know, it's clearly been known for 100 years. Actually, these papers were the 1890.
Yeah. And the doctors don't make a difference.
Yes. Huge. Definitely. Well, you remember the days patient turned up jaundiced.
And as endless hundreds of. We spent all night listening.
Between us, and you could never tell if there was an obstruction.
Well, that's a bit of an exaggeration, but it was very hard to distinguish obstructive jaundice from, you know, hepatic jaundice.
Ultrasound transwoman that didn't like. Yes, because it was I mean, of course, the radiologist did it to begin with, but.
It's you know, if the dots weren't dilated and they weren't dilated after a week of jaundice,
it was down to the physicians, there was something in the in the liver itself.
If it's if they were dilated, there had to be a cause and it was either stains or tumour.
And so, yes, there was a time when if what if Fletcher reported on the ultrasound?
I believe that if anybody else did think the opposite. Yes, I know exactly what you mean.
Well, there was quite instructive time about that, actually, because ultrasound was wasn't very well developed.
And as you rightly say, it was a bit hard to know what to believe or otherwise.
Well, then the out of the X-ray department was starting to sort of get better from their eyebrows.
And they knew they needed ultrasound because it was all over the place and they didn't have it, really.
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.
But I mean, and they advertised and it said ultrasound and they had a good shortlist.
Wasn't to my eyes, it wasn't initially and over inspiring shortlist,
and there was no one on there who really could claim a lot of experience knew about it.
But anyway, one of them was sharp and said, well, no, I've done a bit of that.
But if that's what you want, I'll not come for six months and I'll go and let it right.
He got the job, of course. Yes. I voted for him immediately and David Lynch his ears wherever he was good.
And he came and he was fantastic. He was a natural.
Any report he wrote you believe? Absolutely. And he transformed it.
And I think it was doing a good many of them. Yes.
All right. That's fair. But what he really became a vascularity. Yes, he did.
That's quite right. And for me, I would say, David, and certainly what he was sort of a little bit senior.
Yes. And your generation rather than mine. And you're quite right.
What is reports of all the things that he dealt with were utterly reliable.
But but I would say for me also, I got so you know,
I was quite often in the same department with David because sometimes you you
needed to sort of talk with him about what the and he could get the image.
You sometimes could help him interpret what it was that he was seeing, because it was always that,
you know, for me it was always whether it's a tumour or stem effectively.
And I know there's lots of other causes, but that was really what it came down to.
And there's a bit of a difference in those two conditions.
So for me, yes, and it was quite a quite revelation.
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.
Very good being there during your time. There would be an administrative, managerial and nursing changes.
And the organisations. Would you say anything about either of those?
Let's do the nurses immersed in the salon report, which really produced it,
produced a huge dilemma for the nurses because the seminar was a management change.
And essentially, as a nurse, if you wanted to progress in the profession, you had to become a nurse manager.
I simplified, but that was essential and it produced a dilemma for all those excellent board sisters,
senior people, very experienced on the board, very sound. You rely on the name as a surgeon particularly.
But I mean every all the consultant staff rely on their nursing staff.
Um, and the seniors, they couldn't go any further.
If they wanted to go any further, they had to leave the ward, leave nursing and become a manager.
And, well, that's still the case. I don't think it's ever been resolved, really.
Um, the administrators, I think, um, well, I had lots they changed endlessly and they mostly looked terribly stressed.
Some are better than others. Chris was good, in my opinion.
And of course, he went on to, you know, he's Lord Crisp and became the head of the NHS, which is no surprise.
Um, I felt sorry for them in a way I can remember being it I don't think was crisp.
It was one of the others. Doesn't matter. Chris had it to they had a fax machine in their office.
And I can remember being in the office with some meeting.
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.
But nevertheless, then and all of them were from the Department of Health,
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,
on the contrary to law or some other version of that story.
They were required to reply to each one by midday. Right?
Well, you know, that's no way to work at that level.
Yeah. I mean, you you'd have somebody delegated to deal with them and answer it.
But I think, you know, several of them felt their jobs were on the line.
In fact, they were if they didn't reply with a satisfactory explanation and they all these replies often came through region as well.
And the region was never terribly fond of the Jauhari that was moved there.
And then so I did. I felt.
Terribly sorry for them, actually, one man who I quite liked and I thought was quite good, I saw him on Friday morning.
I said, how are you this morning in the corridor? I said, fine, fine, fine. He was sacked at lunchtime and he knew it.
And so I felt I felt because the doctors are very sniffy about administrative administrators, you know,
I think we're all better, which is rubbish because administration quite skilful and it needs to be done.
You can't run a hospital administration, have to be cleaners, have to be people who put the syringes where you can use them.
And that means organising. And so I know it needed good people and it wasn't this constant.
It's a constant threat to your job was not a way to encourage people to wear no good thing.
A very good point, because, I mean, when we started more or less, we were advising the administrators what to do.
And by the end, did you feel they were telling or advising you or to do telling you what to do?
Yes. How did that come about? It was a gradual takeover.
And for me it was when I started, you saw patients, our patients needing operation.
You put them on your waiting list. You had that waiting list in your office.
It was cots. And you could and you chose the names off that list to come in for care.
And you were fair. But there are some people who need new needs to come through all sorts of reasons.
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.
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.
If these people weren't treated in that period of time, then there was difficulty.
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.
So they gradually started to dictate who was admitted.
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.
It was my fault.
And I was responsible for sorting it out and writing the letter of apology or explanation to the patient and his relatives or relatives.
Once the administrator started to admit the patients, I said to a very nice lady, Mrs. Kennedy, it was excellent.
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.
It's not my responsibility anymore. So that's a she was fired about that and she did it.
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.
I mean, you just had a contract to be a consultant.
Um, then they sort of produced sessions, I think, if I remember rightly, eleven sessions in a week.
And if you work full time, you've got eleven sessions.
But if you a maximum part time, which allowed you to do private practise, you were I think it was nine sessions.
I think I come back and I did private practise, so I actually became nine eleven.
Um, you were expected to turn out for your clinics to your list, but there wasn't a well, you know,
if you went there for some reason, there weren't wasn't somebody hanging over there then they produced pays.
What was instead what was the. There was some that was a shortened the acronym from what it stood for.
Anyway, we might remember before the end they introduced that and where the sessions really.
But there were a bit more specific.
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.
Your operating sessions must always have been the case with the anaesthetists or not.
Yes, no. Yeah, but, um, yes.
But as a surgeon, you had to do.
Ontake, Yes, and you got, I think, years for doing it, take something, something like that,
but then that starts to get a bit strict if you were on a pay to be in outpatients on that day.
That was the deal. You were to be there and not in no Timbuctoo or in private practise, whatever.
And indeed, I believe they did actually wrote just about the time they returned to the to the staff and say,
you know, if you've got to pay, you'll be there. Not particularly.
Not in the private hospital, which is fair enough if that's the deal.
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.
But you have to do that before when the system started, you just went to make sure that whatever it was was covered.
Yes. But then you had and that I believe not to me, but I believe people were refused sometimes permission to go.
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?
Yes, that's true. Because like everybody else, there were exceptions.
But by and large, most concerns, my acquaintance, were far more than they were ever at large and they couldn't understand that.
And of course, there are always stories of people on the Gulf Coast or something, but they were mostly stories.
Well, there was a reason or they were entitled to be on the golf course and.
Yes, and, well, I.
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.
Yeah, and the fact that you didn't control your own waiting list and sort of introduced slight difference with the patient since.
Well, you know, you felt as if you saw patients. I need an operation.
You felt a you know, that's one medicines about you feel a responsibility to achieve that for that patient.
If you're just there to do this with someone else is completely different.
It's a very different way. And of course, it does occasionally introduce difficulties because someone else has said an operation is appropriate.
But you said you think it isn't the other way around and you know that.
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.
We got away with it. But, you know, those words are quite we got away with it.
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.
And with the managers have come to see that. Oh, yes, that's terrible.
I know. Where did you get your private practise? Yacktman days and right at the end of the manor.
Yes. Oh, yes. Um, well I.
I like that I did I because you get your people will say, oh he just like isn't money.
It's not that. No the money isn't out and you can't deny that is ridiculous.
But it's not that. No. Because private practise Bettmann it's really down to you.
If you don't provide a service, do it well. You don't get the private practise.
GP's won't referral them. So and also, if something goes wrong, there's only one person to blame.
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.
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,
with exceptions, but they obviously articulate people by and large.
Well I always thought if you listened enough to a patient they told you what was wrong with.
Right. Again, that's obviously an exaggeration here. But and the art was to get them to talk to tell you.
Yes. And I mean, I can't speak for physicians, but I got very different.
But if you have the time and just let them tell you, usually you can make it.
And but, you know, and if you if you have to cut corners, all of that, that's a bit hard.
But if you have to take a short time, you don't have that opportunity sometimes.
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.
Yeah. The, the, the cream is now.
There you are. And chest surgeon.
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.
Yeah. Gone by the time we went to the John back. Yes. Completely I would say I never felt it after that.
Never. Mm. Um so that's yours.
Do you want to answer it. Yeah. Um no I never felt it and I don't think anybody else did.
Peter Peter Morris, the professor of surgery, he was very inclusive.
He was clearly a bit of the leader of the team, although there are colleagues who might not quite agree with that.
But, um, no, he was. And from my point of view, I'd say it was a very happy set up,
quite a contrast to what it was like when I first started the rapid and very clearly was not.
No. Um, so, yes, I would say it was.
And also we all had our specialities that came about. Peter was a vascular surgeon.
Malcolm Gough and Nick Dudley had was paediatric as well as General.
Mike Cantwell was a colorectal surgeon. I did the habitability stuff Nick does.
He did the endurance stuff.
And again, we all had enough to do I guess, you know, lots of central departments get very aggressive because they're competitive.
And I mean, as an excellent example to serve.
I never knew before they for my time, but neither would ever leave Newport for fear that the other one pinch their patients.
Um, I never experienced that here because and that's true in private, too.
There was quite now we were lucky in the way there's quite a wealthy area.
There was enough private practise to go round for people to know to to do what they wanted to do.
And not everybody wanted to do it from the cardiac surgeons got into trouble.
I mean, there are too many surgeons for the number of operating sessions. Really?
Yes. Yes. Well, you brought them up.
I never realised before I became a consultant. How important was that?
People got on with each other.
And of course, the radiology department when I arrived was a prime example of where a big row had ruined the department.
Twenty five years to recover. Really, in my opinion, and then the cardiac department, it was,
I don't want to say it was terribly sad and ridiculous, two very talented people, they just obviously didn't get on.
What happens if you probably have made it their business to get on?
You can't get on with everybody, but professionally, I think it's a responsibility.
You know, you don't allow personal antagonisms to impact on professional patient care if you can avoid it.
And there has to be times with it. That's not possible because they were both good as WB and I.
I believe that it's something serious. And WB is a very outgoing character and a bit of a know.
It would be fair to say a bit of a difficult person to relate to be very, very good surgeon.
I once went to see him doing a bypass and I was mesmerised and I couldn't leave him over there.
Yes, it was yes, yes and no. For all his faults, I thought overall it was good.
But he destroyed the department. Now, who is actually doing the thoracic surgery?
Did they do that? Well, it was a problem. Really? Yes.
Um, well, Westerby didn't review, I think occasionally did a human act to me or something, but it seemed rather on sufferance.
I was never really involved because it is last names came from the respiratory physicians, so it didn't really come my way.
Um, and again, you could never quite work out what the evidence was that surgery really was important for Cazenave and or Namjoo.
You know, I never really didn't have a feel for it, really. Um, so I never quite knew.
And now the oesophagus is carcinoma principly.
Well, they didn't do that. And in fact, my Kettlewell did quite a bit.
But then we appointed Nick Maynard, who was a specialist in oesophageal, said he came from guys having trained with it there.
And so he took it on and transformed it in a way because it's a nasty cancer.
But there's definitely a place for surgery in it. Without any question, there might be some doubt about cost over the lung.
Not always, but, um, some doubt about it. But for customers, there's definitely a place for it.
Yeah. And he took it on and did it and opened the chest up.
I mean, it doesn't even open in the chest.
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.
It's once you know the principles and you know perfectly how to close it up with drains and things.
I mean, and as long as you've got the nurses to look after the drains and know what to do with them,
if they go wrong, then you know, it's not that tricky.
But there are quite a lot of qualifications that relies on a team of people.
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.
Actually, it's absolutely no lots of people taking these oesophageal things.
You need a whole anaesthetist. And that's the person who does the nutrition.
Yes, the ICU. When it you know, afterwards you need a really good intensivists to.
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.
And, um, yes. Well, I, I would agree it's fair.
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.
No. The anaesthetist matter. Yeah. I was very lucky.
I've had yeah. Yeah, yeah. Neil Schofield and these time for many years at the end and he was just fantastic.
And I you can at one of the things if you, you could operate it did not have to worry about the anaesthetic.
You just did the operation and you could actually trust Neil to deal with.
And if he made a mess which happened. Yeah.
He was, he wasn't blaming you just got on and sorted it out.
And that's a really advantageous way to operate. Actually, he was fantastic.
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.
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.
Yeah, yeah. Other people knew better. So yes and yes, I did quite a bit.
No, I would say, to be fair, my research was it wasn't my strong point.
And when I was teaching, yes, I did do that.
I always never won the golden stethoscope and never sat at the bedside or was at a lecture.
Both Yes. Yes. And and, you know, survivors and health seminars and things.
Yes. But very much at the bedside. Yes. Um, well, I was brought up with that.
You had an intriguing title in the medical director about hernia, so.
Oh, yes. Haemorrhoid activism. Yes, yes.
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.
But, you know, that's the usual problem, getting hernias in to repair them. And so he had a technique for doing it.
And the local he'd read about it somewhere and we did between us.
I was as much involved as he was, in fact, probably more because I did it.
We got a technique for doing hernias under local anaesthetic as their cases.
Right. And we published a little bit about it in Kitsune.
And I made a film about it, um, which we showed and won a prise.
And Peter Slight, the professor of Cardiology, Cardiology, he'd won a bigger prise for a film about hypertension, I think.
And we showed them both in the John Radcliffe Lecture Theatre one day to anybody who, you know, advertised.
It was quite a big turnout and mine was on about hernias under black anaesthetic.
So we showed the patient in outpatients beforehand and we took the patient's blood pressure, which produced a huge laugh.
Uh, so, yes, I did do things like that, actually, um, that sort of thing.
Yes.
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,
whether the results were any good or not, and analysed the literature sort of thing.
Yes, I did. And I made a little bit of thing about hernias.
And of course, laparoscopic repair came in at the end.
Um, that was tricky. And, um,
you had to get the hernia repair in the early days was always adorned with nylon or some material for the
strengthening the back wall of the abdominal cavity and on the back wall of the of the little canal.
But then it was discovered that Meche plastic mesh was a very successful technique for doing it.
And to begin with, it was done at an open operation and it was much the problem with Doney.
It was this tension on the tissues. And that's known not to be a good idea. With Mesh,
you didn't have any tension and it was very quickly realised that you could put the
mesh in laparoscopically tricky and just a bit awkward getting the orientation.
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.
You never had any trouble with the actual measures and reactions. I never did know.
Inevitably, infection was described with a foreign body.
And if it happened, you had to take it out, which I, I never had to do.
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.
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.
Um, I used it quite a lot because the pancreatitis patients often, though,
she had to operate under huge abdominal hernia and the mesh was pretty good for that.
These large sheets. Do you think you had long enough Holliday's.
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.
So you did that twice a year? Yes. Well, I usually took three weeks and some months in the summer and the weekend.
Yeah, the times. I always took the holiday. Good. Um, yes.
And I had a hobby. I was fishing. Yeah.
And, um, I didn't make any secret about it with anybody, anybody but particularly the juniors.
In fact I rather made it plain that I thought that was quite important because I had a
road on Thursday and I didn't have a timetable to commitment on a Thursday afternoon.
And I used to go usually not always in the season is um.
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.
And I worked with excellent people. So you could rule out some problem.
They'd handle it. And yes, I personally I thought that was quite important in my professional life.
What it is. Golf's popular, isn't it? Um, but I think I did think that.
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.
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.
It's impossible. But once you become a consultant, you do have some freedom.
Even now, I'm sure this and I always thought it's remarkable how surgeons stand up to the sheer physical
demand of operating in tropical conditions and and and how did you feel towards the end?
You sort of turned on. Yes, yes. Yes.
Um, well, it pancreatic to me for cost out of the pancreas took about five hours.
And that's not the longest operation, but it's quite a long time. Yeah. And I could do that.
Yes. But by the end. Yeah. No, I knew.
Um, yes. And I've realised since being retired as I'm sure you have to retire at just over sixty three.
Right. I could easily have worked for another ten years but not doing pancreatitis.
They'd have had to have found no Perlis for example, but one of the one of the less demanding operations you got.
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.
And so there were bits of that operation that they could do.
It's quite a lot of intestinal anastomosis. Well, senior staff, they do doing it without you being there to do it.
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.
Um, and that was one of the ways.
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,
then the greatest pleasure is in getting a young person to do it safely.
And that was the pleasure. And the same apply to the more complicated operations.
You know, at the time, I dunno, it was quite a few times part of the pleasure was in making, you know,
the younger person who's going to follow you, get them to to to do it and help them to to do it.
And that's particularly also applied to the laparoscopic stuff, um,
because not everybody was comfortable with the two dimensional image and the odd behaviour of the hands wasn't.
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.
And, you know, I can remember helping youngsters, the younger people to get the hang of the keyhole stuff.
What happened? I asked you about that. I said the green temperature is do tell me.
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.
The broadly speaking, the other colleges in Oxford, the old fashioned ones, didn't much want lots more doctors on the staff.
So I didn't have a scholarship. Well, that was, as you know, part of the background to Richardo if developing Green College and.
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.
So my name was on that list. And I took an interest in it because it was teaching.
And I was interested, um, and I actually was a junior boy on the Radcliffe committee of the University Committee that set it up.
And that was quite an experience. Yeah, Vice-Chancellor himself chaired it.
Of course, there was the master's son, Katharine's at the time and Bulloch notebook and Harris and Jack Harrison was the architect.
And Richard had recruited Lord Pennock, who was the head of ICI at the time, and arrived in his role as chauffeur driven.
And Vernae, I think it was from who was a landowner out in North Oxfordshire, Compton, Vernae and Hunter Valley.
Yeah. So all these you know, I was just Genea well, that was I, Bullock and Harrison,
but I had a discussion, shall we call it Harrison and design the new buildings for the college.
And they were good. Ah, but they weren't the proper Georgeann proportion.
Uh, so Bullock was on at him about the exact dimensions of the window and the slope of the roof.
And there was a third thing I forgot they didn't teach you about Georgian windows and bars and well,
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.
And it was but it was I mean, just very impressive.
But it wasn't a Nazi attack. But he showed you and he did know.
He knew he wasn't you know, he'd been involved in Katharine's.
So you knew from that. Yeah. Um, anyway, I was on the you know, the the the preliminary fellowship committee and so of election.
Um, well, though he was clever at all.
Yes. It would be fair to say devious. Yes.
But devious in a way of getting things done.
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.
So, um, anyway, very effective.
You know, he raised the money, got green involved.
And now that was an example of the deviousness a little bit because it was Radcliffe College before.
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.
After the weekend, it was going to be green.
Um, and, you know, there's typical Oxford mutterings, you know, Radclyffe Green there a slightly different names, a green.
But I say anyway, because it was never revealed how this was arranged.
Well, you can bet you can guess how it was arranged, but it was never exactly explained what he had said.
Um, but I was involved green throughout my time in Oxford.
Really? Absolutely. Just after I came, it was starting and I retired.
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.
So senior tutor, you'd be looking out for a lot of Gnomedex as well.
There were I I was the first in said and I think there were eleven students the first year.
So it was a highly dangerous job. Uh, and I think seven of them were medicks.
But then you became the guys who later on. I did, yes.
And it was a bit it was a bigger entity then I think probably a hundred students, something like that, perhaps a few more.
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.
And that was a different job, really was sort of keeping everybody on the side, as you might say.
And that can be tricky because, well, it looks at people that they've got ideas and they don't hesitate to express them.
That's the essence of the university where it's quite right to. But it can be difficult to manage sometimes.
So would you be chairing fellows committees? I did a bit.
Tough. Yes, I did a bit I wasn't chairman, you know the warden.
Yes, he was there when you advised him. Yes, I did a bit. Yes.
And getting the views of things and I mentioned that, you know,
that we had a little bit of difficulty when times had to go and see the registrar because that people can be dissatisfied.
He was very helpful.
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.
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.
And, you know, that's a difficult dichotomy to resolve. But he did resolve it effectively.
We did. We got over it. But difficult time.
And also, at one point in time, I had three portraits of the previous warden on my hands.
Right. As you know, tradition and Oxford College to have a portrait of the warden.
So the that John Walton, this was the fellows commissioned the portrait while the fellow if did it,
worked in the Ashmolean and he was one of his mates to do it.
And a portrait was produced. It was a I think it was a it was a chalk on paper.
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,
but nevertheless, he'd been well treated in the John Radcliffe, not by John Walsh, but he wanted to pay the hospital back.
So he off his own bat, Diana portrayed in oils of alter ego.
Yes, it was perfectly acceptable, but of course, it wasn't what the fellow said, commissioner.
And Watson, I think, quite reasonably thought, particularly as it commissioned something that was just awful to be done.
So it was landed on my plate. What was to be done?
Well, it was straightforward, actually, because I, I just simply went to John Bolton and said, who do you want to do it?
And he said, Leonard Bowden straight off the line.
I it. But that meant I had to find out.
And he was a he he was a portrait.
He had been the president of the Royal Society of Australia and he'd done all the presidents of the Royal Society of Medicine.
If you go there, there's endless chalk drawings, you know, and he'd done John with John Morton.
So I found him. He he used to live he used to work in Kensington and he then lived in North London.
So I went there and explained the situation and arranged for him to do a portrait of autumn,
which is in the college, and was perfectly acceptable and very good, actually.
It was a spin off because when I went,
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.
And I didn't even know that existed. I didn't even know the portrait painters existed.
Um, anyway, um, well, the spin off was I asked her to to do our two children.
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?
Oh no. Mm. I don't know. But she did do it because I cos I was commissioning it.
So I suppose if you know, if you're the commissioner you do what the client wants.
But she wasn't very keen. And the reason of course was that, you know, it's,
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.
So they usually do them on the same day. And in fact, she did do them on the same paper.
It's very easily and deliberately divided down the middle.
She also said, you know, what are you going to do when you die? What you're going to do anyway?
So how do they represent. No, no, no, no, no.
They were, um, Rachel was at university in Manchester, so she ran towards the end.
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.
And um, well it's not really relevant to the medical school. It.
Well, well no.
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.
And so we went up to look at John Bolton's painting.
But as we went through the door, up the stairs to the door straight ahead, it was her two children that were Dylan.
What else and what else did I put on my paper?
And you expect to see I made some notes because you asked me.
So, yes, I think you owe the medical school office report to me.
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.
What do you want to do? Arts for Nagy's when I'm ridiculous.
But that's what you thought. No, you were a scientist. Everything else.
And I learnt in the medical school just how wrong and rubbish that was.
And the reason was because the secretary, the medical school these days was Peter James.
I know. Yeah, he was. He read grades and got a first degree.
Yes. And clearly very academic, erudite man.
And I realised then just what a ridiculous, uh, opinion I'd had of the arts previously.
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,
minutes in particular, was just you could see why grades mattered.
Mm hmm. He had the ability to put words together and the vocabulary.
So that exactly mirrored what the sense of a meeting was.
I could never have done it. You know, I just didn't.
And you suddenly realised that these subjects really did matter.
They actually have a place because minutes, you know, two very important.
They are they right? They run. People say there's a slight aside.
I told him later, you know, how much I admired them.
It it's true of other people. It's not only Peter, but it really brought it up.
He brought it to me. He said to me once, he said, well, yes.
He said them actually down to writing minutes, anxious to make sure you write down what they should have decided, not what they did.
And I think he was joking, but I did it.
Did I also have a daughter who's a musician?
And of course, that brought her to me.
You know, this is that sort of attitude is typical of my generation, the post-war grammar school and the clear you know,
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.
No, you can. You couldn't do it in Scotland as well at the time with hired.
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.
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.
I don't think so, we can write down some things like, oh, you asked me about national committees didn't just mention that.
Yes, we haven't touched on that. And local committees I once did the BMA Academic Stuff Committee headquarters, as I understand it.
Yes. What was that? No, I wrote down.
Oh, dear. Yes, I think that's all you can say, really.
I did my share of committees here. You know, the I did the chairman's surgery.
So that was on the hospital board. Yes.
Um, and a man who you remember, Alex Gazzara, as I remember, who was medical officer of health, district medical officer.
He was very good. He was very kind. I liked him a lot.
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.
And I thought he you know, there's always troublesome consultants or difficulty with them or whatever.
I thought he handled that excellently. Very. I suppose you might say in this modern era of transparency, not very transparent, but effectively, yes,
and without getting the getting the right end result, without causing a great deal of aggravation and upset to all the parties involved.
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.
But he said, you always wait till the end. Do you listen to everybody else and then speak.
And I appreciate. I never realised it until he said and I.
OK, but I mean, it's very difficult in Oxford because should the professor be running one enterprise,
you know, which actually they should, I think in the end about the right people.
I think that's the key thing, isn't it? Is the right path. And we had to right people.
And we did observe Morrison and they were very upset.
And, you know, they're widely respected, is very good.
Both of them very sound clinicians is you'd have either of them look after you.
Yes. And they're both excellent, fantastic scientists.
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.
Yeah. So they deserve to lead it. Yes. Yes. Um, so I liked Alex and I did that.
Um, the faculty board in gowns, of course, Saturday morning.
Is Potter and Daniel sitting opposite chairman so they could always control things that Potter always in, you know,
subtask and the propaganda on and things, um, that the main memory I have about that relates to the region.
They were invited. Yes. But they weren't ever allowed very much tables.
You know, the four for Van Hooten, the four tables around the summit.
And Morrison, the chairman that had have is there and well, they were allowed sort of in a corner the by the door.
And there were always Rosemary Ruu. There was actually also a very impressive.
Yeah, absolutely. Um, she was allowed to speak as long as she was giving them something.
And I felt quite a bit at times. But she was up to that.
Yes. I remember the Professor Jennings then faculty board, Grimley Evans.
He turns up one day, waits for any other business as you do.
Then he passes around photocopied sheets, which are from the Oxford English Dictionary.
Professor of geriatrics, I don't like that name very much.
He reads out the city. I can't remember it. And I think there's gerontology and gerontologists.
And so he goes on about this and, you know, this is any other business.
Everybody wants to go for coffee and this. And no one had the slightest clue anyway.
You got to change to gerontology, I think was something that was a classic.
What a triumph. Oh, yes. So those sorts of things, I'd never had much do with religion.
Occasionally I went there. I once went to see.
Did you have to build up in those Cabaser in Noton games or, you know, they did that by themselves?
Yes. They never really did.
LCP think we got them? Redding did, because they had good gastroenterologists and they were interested.
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.
Oh, yes, they do that. Yes. Um, we start after us, um, and, um.
But yes, they did. Everybody did because it was so I mean, it was dramatic.
We did a ground on the ground round about these various endoscopic laparoscopic operations.
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.
People were doing the church operations up through the nose.
And I was going to get somebody to do an arthroscopy of the knee, but they let us down.
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.
Life going on and go, Patison Yes, I've got what it was in.
Was it? No, no. He was a plastic surgeon. Well, Michael Kettlewell had taken his gallbladder out on Wednesday morning,
and I had him in the lecture theatre on Thursday afternoon for the ground round and advertise it to everybody.
Yeah. So we shared this. We shared the bank doing the pituitary, which was fantastic images, because you never saw that.
And you could see where the pituitary was playing the Xbox and up the nose.
And I got Houbara to do that, Cobian, because that's quite you know,
it's quite even if you're a physician, it's quite interesting to see you get lots of it.
That means it's quite colourful. Anyway, at the end, I got Patterson to use it.
He was dressed and in that thing he was at home anyway.
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.
And the last question before we left, I said, Oh, I'm terribly sorry.
I forgot to ask you when you had this operation done yesterday morning, uh, and there was an intake of breath in the hole.
Yeah. And we all went away. Lovely. It was a good, good time.
Well, yeah. Well, deliberately, no. Yeah.
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.
That's a lovely note to end on the right. Perfectly well.
Thank you very much. It's a lovely interview. Lovely to see you.