I think today is the 25th of June, July 2012, and I'm Peggie for it,
and I'm talking with Christopher Paine for Oxford Medicine about his time in Oxford, particularly as director of clinical studies.
And we hope to cover some members of the medical school in general and perhaps something about Frank Ellis and O'Malley Lee.
And we're in the eating room at New College on a nice sunny day.
And they won't ask you to run it, see whether it works or you think you have confidence in it.
It's very tricky to come out and go back and do the say, but I can see that the balls are going up.
And so I have every confidence that is.
And I will actually make the occasional note, just say, well, you know, if I could say in return, thank you very much for spending time with me.
It's a long time after the event as far as bigger studies, when it's a pleasure and it will be fun,
actually talking with directors I talk to generally and I talk to John of who have you and who to to, uh.
And Michael Dunn. Michael Dunn, who was interviewed by someone else, not by me, possibly by Derek.
But when he's driving I saw him last week and he goes to the Athenaeum and uses the library.
And I happen to think that's what did.
Were you when were you doing clinical studies in relation to Michael?
Oh, no, not a long time afterwards, I think. I know.
I'm quite sure. I mean, Jim has done it several times, hasn't they? John Lennon's done it twice.
I think Jim did a stint, uh, after Michael Dunnill because Michael Dunn interviewed me for a clinical place when I came in nineteen seventy one.
So he would have interviewed me in nineteen seventy. Right. But by the time I came in 71, Jim was director of clinical studies then.
So useful would have been perhaps John never going to be distinctive.
When you did a stint. Maybe that was the I think I came after John Ledingham.
Yes. But it was probably John's second stint was devoted quite a bit.
I can't remember the last of that.
I'm sure in the records I certainly followed, John, because, you know, he talked to me quite a bit before I took it on.
Yes. And I was very nervous about taking it on because at that time I was still doing radiotherapy,
um, full time at the church and also with him once a week.
And I thought that radiotherapy is difficult.
You can't you have to be there quite a lot because it's a matter of looking at plans and physics and all that.
And I just didn't think I'd have time. In the end. I was told by David Weatherall and John that I had time.
Well, so that's how it came about.
They obviously thought you were the bypass. Well, then they thought, well, I think they're quite right.
You know, what they were looking for, really.
But I think they quite wanted somebody outside the John Radcliffe or the Radcliffe Infirmary as it was then,
and looked around and and thought, oh, yes, they will do things.
I'm sure that it was because all about big and being someone who's interested in humans and human beings and a medical student.
But, you know, doctors are interested to know most of them are humans out there.
And so I don't know. But anyway, I very much enjoyed it and it was a great challenge, but it was a new world.
I knew nothing really about the university because although I was here as an undergraduate, I've never left the place really.
I didn't actually do anything at university at all. Once I was appointed at the church, it an NHS job.
And I was doing that really. And we had this large regional commitment, you know, Swindon, Wickham, Banbury.
And so one was rushing around the country quite a bit when I was a fairly junior and, uh,
didn't come very much and didn't go to the it very much, except that I did for a time do the neurosurgery and uh, neuro.
So things went backwards. So, um, so I knew them fairly well.
And what was it like to step into that world? Well, I think, um, it was a matter of feeling my way.
Uh, luckily a few of the students were new, so they were also feeling, as know, the students were very good.
I mean, I think in contrast with my colleagues who, as we all know, have very strong views and can be difficult and all the rest of it.
And the students on the Hill are pretty reasonable people.
And they do, uh, they try hard to do what they think is the right thing.
And, you know, at the same time, they've got very good new ideas.
And to take account of themselves like this, I mean, I think my first duty was admitting,
I suppose the first lot of students I was responsible for and we did have.
A bit of difficulty because John had always tried to keep the numbers slightly below one hundred,
um, how many do you have now but one hundred and sixty every year. But we kept them below hundred a year if we could or John did.
And he did it by simply, you know, everybody knew that we wanted to drop out and he made no effort.
And that was fine until about a couple of months before my lot were due to come on, we got a message from the University Grants Committee,
which controlled things in those days, which said that for every student, less than 100,
that to take on the university will be 10 percent to one percent of your grant.
So I immediately had a telephone call saying, you've got to whatever happens, you are to admit 100 students.
We don't mind if it's a hundred and two or three. But you are not to admit 99 because that is a substantial sum of money.
Yes. Um, and, uh, nobody quite expected that they had been saying, I think that we weren't quite a place you should anyway.
So the long and short of that was we then had to scrape around because we're only about ninety five or ninety eight students that we had.
And then there were two or three that were sort of, you know,
we would have certainly taken had them in places that I had hastily interview one or two of those,
including a charming girl whose name I can't remember now, although I have met her the last year at some rehabilitation run documents.
And I said, oh, she was interviewed, uh, during a whole show, um, in the middle of Exmoor.
And because I said to do something before the end, before the first of September,
and she had perfectly good credentials and was taken, but I don't think anybody else knew that.
And she remembered fondly if she came to you to take over the timekeeping.
Somebody was you know, I was sure she was tested and testing the security skills and she was obviously up that.
I'm delighted to hear that she's done very well in medicine now, so I'll give them a good deal older.
And, uh, consultant Summerset. So it was very nice, but said that was the first thing that made me realise that finance came into this job a bit.
And, uh, and then of course there were all these commissions which, uh, I never asked for that I knew about them vaguely.
I'm in the Planning and Development Committee and for several quite serious committees.
Um, mostly we didn't put on guns for that, but of course we did for the Clinical Medicine Board.
And in those days, Rex Richards, who was vice chancellor, was chairman of Clinical Medicine Board because the medicks weren't really entirely
trusted by Rex not to go off on some tremendous tangent and use a very good job,
the most charming man.
And of course, I knew him very well because he had, uh, a tremendous contribution towards magnetic resonance imaging, developing the science of it.
Really. He didn't you know, he had one of the people who did, um, and, uh, so we knew him very well.
I knew him afterwards, too, but he was chairman. And so we all put our guns on the board is held there on Saturday morning.
I don't know whether it is now. Uh, you probably don't know you you've it maybe.
No, I'm not a member. Tim Lankester probably is because he's director of clinical.
Yes. Yes. Um, it was your deputy and wave director before.
No, no, no, no. I would've taken whether I was interested. Yeah.
I wasn't able I felt to give up my political career so much more now.
Yes. Yeah. Um, that's what I thought for a time.
Yes. But, um, I mean, as far as work went, I mean, my colleagues, particularly Alistair Lang,
who's now retired of a long time, but he was my senior colleague by year two.
And he's always all these jobs that I did. He was extraordinarily good.
And I really would, uh, thank him again and again for that.
I mean, in those days, people took on extra work. They didn't expect to be paid or recompense or anything.
You know, he just did it out of the goodness of his heart.
And he thought that it would have been nice for me and that he was not a person who wished to deal with sort of local politics.
He was happy doing the the job and radiotherapy.
And had it not been for Alistair, I couldn't have done any of these things, starting with being a director of clinical studies, really.
I mean, I had several talks to him and he said, well, you know,
do it and I'll have the hold the fort when you can't do that and it'll be alright, that's for sure.
That was very, very helpful, essential regularly for all of us.
And so if you take one person away part part of the week when they're only four now, I think they have a dozen radiotherapists or something.
I, I know I was I was succeeded by. And that is marvellous, but, you know, everything is tough.
Yes, absolutely. So, yes, this is that was arranged in, you know, sort of the practical way, uh, with the cooperation of one's colleagues.
But, you know, some people didn't have easy colleagues and that wouldn't have been possible.
I do realise that. And, of course, having done one of these jobs and been away for a time from the base, then,
you know, it's not so difficult to do that because people have got used to not being there.
Probably rather glad that you do seem to find a level where it frees up time.
Yes, it's a matter of reorganising one's thoughts, isn't it?
And you do find time. And I mean, one was enormously good support in the medical school.
That was Peter Brown, who was the secretary then.
Um, uh, he didn't get on with everybody, partly because he'd been district commissioner, I think in Kenya or somewhere.
I mean, I'm sure of the country. But he very much was possessed of the fact that he was in charge.
Yes. Having been a district commissioner. And John, that and I got him on with him very well indeed.
But he could be he was with the same city for the ways of doing things.
We knew him as a true fibrillation because of his signature. I wanted you could ask because we said yes.
Yes. Because he said to everybody, um, but, uh, but also the director of the studies, of course, uh, was his boss in a certain way.
Um, and separate fact is that it was actually his boss, but we got on very well and he he fished you know, he was a man that liked the outside.
Yes. And very, very sadly died soon after he retired. And I gave a farewell speech.
It must have been the last year that I was director. I think that he retired and almost the next year then sadly died.
Um, but he was a very helpful, stable force.
And then a lady came along who was also a very good man. What was her name?
Can you remember that? I was probably there would be in the range.
Yes. Very nice lady.
And this was before David, Brian and I, as I think about it, it comes back to me because I remember watching her and the other Sunday night moon.
It'll come back then. Yes, exactly. I have that problem, right?
Yes. Yes. And then the other the one or two other stalwarts in the medical school at that time,
those that chapter, uh, David Messa, who was in charge of the set that aside,
because I went on for some years being treasurer of the Gazette after I finished being the and David was a sort of organiser of Gazette.
We got the new guy. I mean, he was very, very helpful and sort of the small finance side.
He ran with that. And so it was a good office and they were very keen to relieve the director of responsibilities he or she didn't have to do.
And that had it not been for that, it would have been much more difficult for a clinician, uh, you know, as I was to come along and do the job.
I think. So all those things were helpful. I don't know to what extent it's a nice thing to do.
I mean, it's a good office. But yes, um, I think I think there's a lot of committee work I do most to the pastoral care.
But Tim Lancaster, who's the president talks, does most of the academic side of things.
Yeah. It's getting to grips with the need to have T's crossed and I's dotted before the syllabus and the curriculum and developed that.
Yes.
What would you say the balance of work was in your time between what you might broadly call the university, but the academic base in the pastoral?
Um, let me tell you, it's difficult to know that.
I mean, I made an effort to meet all of the students every year, and they all used to come in.
And I used to see two or three, um, every every two or three days or something like that.
So I try and tried to find a way out of going like that.
But of course, there were crises. Yes. One or two rather bad crises.
And I suppose the other possible thing that I remember is that most of the students who went on this show,
especially the first time surgical firm, they all came back to me about how beastly the surgeons had been to them and their discipline.
And Peter was particularly victimised. No doubt mention it, but I think yes, he did.
Yes, but but I think, you know, Peter was a good teacher and he felt that students to toe the line and went around.
They made a difference. Swimmer's husband came from Oxford or or Brisbane.
They were all the same people.
But was it was a very gifted surgeon.
So I think that when students were genuinely interested in surgery, they would have realised that he had exceptional gifts as a surgeon, I'm told.
And he even made transplant operations look as if. As if they were relatively easy to do.
Yes. Yeah, you know, and these Academi and he's a very good scientist, you know, he by his drive and determination,
he got that transplant unit going, as I know, from wearing other hats later.
You know, he was a and students were all right.
I mean, they were part of one's life. And what. No one can go out one's way to please them in this case.
But I think he was good to them. He was fair. But they did come and learn.
Um, but otherwise, I mean, I think the students were pretty good, uh, psychologically, even though they didn't seem to have that number of problems.
We didn't lose very many leaving medicine all day. We had one or two very unsatisfactory appointments.
I mean. Because one or two mistakes like that, in the end,
he did go on someone and one chap and a different chap who was unfortunately a student during my time,
and he went off and became a bit of a criminal, really.
And. There were a few things like that, but the social side of things wasn't enormously burdensome,
you know, one that occasionally people I think they can't talk about their elective elected a lot.
Yes. And I tried to give them advice, and I expect they still do.
It's, uh, it's an important thing for them. A lot of them were trying to get through, not all of them, but quite a.
Well, 50 50 of them. And I got more. Yes.
And still a very popular part of the cause. Very, very quite often.
Now do us a combination of tech and track, because some of them want to keep their academic credentials.
So they go off to. Yes, Hopkins sounds like the yes. And then might go somewhere else and then go to Africa and work amongst the poor.
And that's all good stuff, isn't it? Yes. And you can understand those things.
Yes. So that's still very popular. But as to the I suppose the only other thing I did do, whether it's one,
whether it's just sort of the social side of things or the academic, I'm not sure I decided to have a questionnaire of all of the students.
I said the medicine where I think some of said I'm trying to cause trouble.
Somebody said that you were able to ask the students what they think has to be right for the students, what they think.
I told them that we could ask them, and so we asked all three hundred.
And in those days, everything is done, uh, in writing.
And we so we sent out a little questionnaire at all of them and asked them to read the thoughts and be quite uninhibited in what they said.
And so I then got three hundred replies concerning about seven or eight hundred different attachments and subjects.
And all I could do was put them around the dining room table with her and autopilots.
Yes, yes.
It did give one a feeling for some things that were difficult and some things that were not so good.
And they weren't always what you thought you were. There was nobody. There was there were other things.
And I think occasionally it's worth doing it. Somebody else said maybe later on you going to do it every year?
And I said, no, uh, you know, because of these things occasionally.
And, uh, but it was actually quite useful. And some of the comments made I mean, read it, uh, they couldn't make it couldn't possibly divulge that.
I know. But on the whole, my impression is that Oxford students, apart from a few rogues and a few students who have mental health problems.
Yes. Have actually been pretty much on track. I think so.
But they care about what it is we're asking them to do, whether that's different from any other batch of medical students.
The Peter Morris point to know about Brisbane, I wouldn't know, because, you know,
these are all coming from an intelligent, intelligent, um, boys and girls and so on and have gone up that route.
Um, and there are bound to be a few of them who do get depressed.
So you can't really cope with the clinical side of things because medicine, like everything else,
is very difficult to know what it is that you have a relative who's doing it until you actually start in this country.
And it can be difficult if I can. But on the whole, I think that's absolutely true.
It's nice to know that when students do go on elective to someone prestigious like Johns Hopkins in particular, they, um, several of them,
I won't say many of them,
but more than some of them come back with a glowing report from someone from the other kids say I'm not a student is wonderful.
Really nice to know. Now that also it is it's very good all the time that people who went off to some other place,
whether in the UK or whether abroad, actually came back with me.
No one is relieved. Yes.
I don't think I ever had the reverse when somebody came back with a really bad report.
You had that? No, no, no. Thank you. Thank goodness. No, but all thanks to the students.
Yes. And I thought maybe that's what a student would tend. Probably not to go that far.
Yes, that is the difficulty. They probably wouldn't. They be fairly selective?
Yes. Did you did you have any particularly helpful colleagues when you took over who were understanding in their particular field?
I know Jim found Jim, hoedt, when you took over, found that Tim Tebow was terribly helpful because he was very he was able to stay home.
And interestingly, also on the surgical side, of course. Yes. Yes.
I think that the gobbing surgeon or the academic surgeon and the medical student did not always a comfortable coming.
No, no to a Tim was coming to the end of his time.
When I was doing that, I was looking through one or two of the few papers I have got last night.
And in a moment, it was a wonderful letter from Gentil, which I haven't brought.
When I thought about when I was appointed consultant, uh, deficits, but, um, many congratulations on being made a consultant,
nobody tells me anything and I would not have known this had I not danced with your mother last night at the Hollywood Ball.
Um, I believe that says a lot about Tatum, about your mother and about.
Yes. Well, I mean, when he was an amazing man, as you know, and he retired,
he took over the health club and ran it for about ten years as district commissioner.
Uh, the thing that I once mentioned to Peter Brown, who simply, uh,
was horrified at the idea that anybody could be associated with the programme and called by the glorious name of district commissioner.
Yes, motivation, possibly.
Yes, but yes, he ran and used to take me and take the hands down to Exmoor quite a bit, and so we knew him for years.
Mm hmm. Um, and then the academic side,
I don't think we've made many changes when I say studies that the curriculum have been looked at several
times and fairly thoroughly by John before I took over and we didn't make anything other than minor change.
I can't remember what they were. I did think during that nothing that excited the board anyway.
They'd gone to the bridge course because this is some six months appearing out of nowhere.
Yes, I'd say something had to be put in to that. Yes. And I remember Jim saying something about that.
So there were no major. I remember all that stuff about the bridge schools, but I can't remember much about it.
And I think they'll be gone.
I think they have been I know there was a lot of, uh, interest and work on that in the previous time when I think John was still in charge.
Yes. And and the committee and university work, I found it rather boring.
You know, um, it was I was by then, I think.
Well, the last year of my time, I was, uh, on the, um, uh, anyway, I attended the thing.
They called it a. the area management team where, um,
the hospital was run by this and the director of clinical studies was invited, which was quite nice.
I mean, I always thought it was very important that the hospitals and the university
and the medical school should work together as far as they possibly could. Yes.
And those days, uh, there were two clinicians on, uh, area management team.
Malcolm Gough happened to be one and the other. I can't remember, um, those that psychiatrists and Ted Smith was on for time anyway.
And I used to get that. And the administrator of the hospitals was named John Spencer.
He was. And they do now. John Mitchell and I met him briefly or I have, but I have to.
But basically a historian, very interesting man, really. And he was, uh, a good administrator and quite a came to us from the Mastan.
And we've been running that you can't around this very well.
And then, of course, there are all these reorganisations. It all came to an end.
But he and Brian Hulce really ran the show. But it was decreed by the government of the day that there could be no chairman of the management team.
They must rotate every week. So every week we had a different chairman.
And one week at about age, I was chairman nine nothing whatever about it.
Um, but it seemed to work alright. But it was not a very sensible way to run the paper.
Yes. Yeah. And so, so the reams of paper from the university with the committees in the Medicine Board and all that always in shape.
And I mean the policy I adopted with the papers to these meetings when they became three quarters of an inch thick,
I used to drill through them with a drill and put a Treasury team through the lot.
So I well, the hospital ones that they were way even thicker than one drilled through them.
But then when they were, of course, all these things were very interlinked,
because if the university wants to do anything on the medical school, they nearly always did have an impact on the hospital.
We and, you know, on costs or something and all the things we talked about them all so talked about.
Now we have different names. Um, and, uh, so it was important, I think very important that the two should get together.
And I tried to ensure they did well, I understand with no disagreements. And then of course, I became general manager afterwards.
Soon after I'd finished being grateful that I had to give up, I think, to do that.
And as I was appointed and, um, David Wetherall wrote to me and said, Chris, disaster, uh,
Institute of Molecular Medicine actually overlaps the perimeter road four and a half feet.
Um, you know, are we for the executioner or will it cost a million?
And I said, David, I am the general manager and I can tell you that will make no difference whatsoever to your plans, that we will move the road.
And I was able to write back and say that the same day, because I do think of the trouble with these things is, you know,
you must and the one thing I tried to do when I was a general manager was to answer everything the same day and answer all the letters I got,
which was also innumerable in that job, because I didn't get very many letters straight.
Federal studies, you know, people wrote in, but nearly always there was not a lot of response or people on the phone.
Of course, you didn't get all the. Whereas in the health law, it was quite different, it was it was quite Eliot's documentary.
Well done. Everybody was pitching around.
And, you know, I used to get a telephone call in the morning from the Department of Health almost every day saying,
oh, you know, the Today programme has this has gone wrong and explored the John Radcliffe or the Churchill.
Uh, the minister's got to answer a question at two o'clock in the House of Commons.
Could you please let us have a suitable thought? And that's when the whole blessed morning run finally at it.
And in the end, of course. Well, if it's based on an early on in my time, nothing to be grateful for the studies.
And the renal unit at the Churchill had people press with long lenses,
taking photographs through the windows, and the sister and most of the staff left.
They couldn't stand the pressure and the whole thing was ghastly.
So I didn't have any pressures of that sort.
When you think sounds like a very interesting example of the sort of pressures that led to the current war,
he was used that that chaplain was had been quite an intelligent man.
He was. And I think it was an architect or something.
But his brain became affected after years of dialysis and he was eventually adopted by the Right to Life Association.
He had no, um, next of kin. And they it was they and the British Kidney Patients Association, not DARPA.
They they they worked everything out, worked the press up.
And it was all extremely difficult. Kenneth Clarke, who is actually health secretary then he was very helpful to me because he stood up and said this
is entirely a matter for the Oxford hospitals to decide and I'm not going to take any part in it.
And my view from what I've heard, that doing the right thing. And of course, he got no joy for that.
And in the end, sort of tipped the balance to the comment down simply by refusing to react.
But I'm not sure the president would know that, and that's very much so.
So I became rapidly aware of politics. Yes.
And I think the suddenness of that, which was, as I said, just out just the end of my time, is right from the start when I was just getting down,
made me rather sort of I should think for the last few months for Julian, who succeeded me, he, as Alastair had done, and radiotherapy as well.
And Julian really took over from me for the last three or four months because I couldn't do it.
It was impossible and. Really go.
So it was so that being dicks, was that actually.
Do you think that helped you to feel that the other jobs that you were getting increasingly interesting and intense?
It helped me because I think as you were you were steering the ship.
Yes. I think it particularly helped because when I was trying to do what I could for the opposite hospitals really around themselves.
But from time to time, things did develop and you did have to do something.
You could do something for a few years. You could I mean, it was before trusts.
Yes, I was the general manager. Caroline was the chairman.
We had all five acute hospitals, including Banbury and five psychiatric hospitals and our child and the community services,
everything except the general practise services. So we could we could do a few things.
And we did do I mean,
I went one time and one of those trips from Wantage rang me up and I was doing a clinic at High Wakamatsu doing a clinic on Friday,
even when I was general manager. Um, and he said, oh, Chris, um, you know, the roof leaking.
And I said something we've done about it. And I said, well, when I finished the clinic, I'll come and have a look.
In the meantime, put a bucket on average and see about seven or eight apply.
And there was still there. You know, there were no mobile phones that they knew that I was coming.
I mean, that, of course, has been another amazing change. All the electronics.
And it I mean, you know, I don't think we had any computers in the medical school when I was there.
We certainly didn't have radiotherapy. It's hard now, isn't it, to think back to when we didn't have them?
The students were aghast the other day when I said that I've done my neurology training as an next Joe.
Yes, before scanning because I remember ordering the first scan from yes, we could have spent Jane Bristol before that.
Right. And they thought I was out of the. OK, so how did you manage the one?
Did exactly did you think of it? Yes.
Um, I think that the diplomatic skills were actually, in a sense, even more important when there weren't those ready communications.
Yes. Turning up and being there. And so it looks all right or doing something or talking to the right person can sometimes cut the Gordian knot.
Yes, I think that's not very important to see people and and eyeball always.
And a lot of this trouble, a lot of the trouble with emails is that people may be tactless remarks, um, without really thinking about it.
And even worse, they copy them to others. Everyone always had that risk was always a risk that copies of letters might be sent to the wrong
person or the patients never go to the doctor or this kind of thing that happened to me once or twice.
But but but that is nothing compared with what can happen now.
And it really can cause most major events. Um, so I think there are upsides and downsides to this.
And I'm not sure. I mean, the upsides is something, I suppose.
But see, I'm doing my text this morning, took hours filling in that text form if, um,
and it would have been much quicker to have died in a paper form, no doubt to shove it in the post that someone always used to.
Um, so it is that now that I can do it this way and I suppose I have time, if I haven't got time, I'm sure that I would you know,
it's that you've got to think very carefully about whether the electronics really
move one further forward or simply waste time and how you prioritise things.
When I say when exactly do you feel on the whole that that you you you enjoy the decision that you made to to to continue with your clinical practise,
but also to do these various roles, which.
I know that you're very good at because you're very good at being clear with people and also this interpersonal bit of it,
I suppose in a way that's an extension of the doctor's role, I think.
So, I mean, I think I always enjoy it very well. I mean, I wanted to go on doing some medicine if I could.
I think in the end I gave up. Finally, when I became president of the college, because that wasn't possible once in London, when I was here,
the general manager, I did a little bit of medicine, but actually I realised I was getting out of touch.
Like you actually thought that it was very helpful and important and gave one in a way,
kind of standing amongst the sort of administrative staff and treasurers. They felt that you were something of a real doctor.
And they spread that thinking it was right because, you know, it was quite nice to do that and the privilege for me.
But in the end, I found that I wasn't really keeping up with what was, although nothing changed that much in radiotherapy.
A few things. Policies change about what you did.
Um, and there were great battles between the medical and radiation oncologist taking place at that time.
And I was slightly above that. But I thought that thing I was getting out of touch, but it was very, very helpful.
I wouldn't want it to be directly clinical studies unless I was firmly doing something here in medicine.
And I actually thought that would be a good idea for the future. Really, being chief executive, I'm not so sure whether it was helpful to me,
but I was helped simply because there were three hundred and fifty consultants and I knew all this.
It was I went to see him go at one time I did this.
You should come to see any more. After all, you are a manager and I was different.
That's not the slightest bit of nervousness I started to feel and they said, well don't worry.
Uh, it was it was very helpful to me to go to see because people said things there and they would get at me.
That's fine. But, you know, you could then answer, you know, why things were happening.
And so I always after that, John Cochrane actually was chairman of that.
I said that he said because under no circumstances are you not to come to see, um, uh, because, you know, we find it helpful.
And so, uh, so there were those things that you have to be a bit tactful.
And I did go out once or twice when they want to talk about things or really have a beef about the events in the winter or something.
I said, well, let me know what you think afterwards and I'll go out, um, and, um, but otherwise.
And I certainly think being Dean, the students like to have a doctor there or some sort of it has to be a doctor,
but they equally they wouldn't want somebody who a full time. I don't think they were full time.
I think that's absolutely right. I think there's something about this. There's two aspects to it.
One is one's strict credentials, which are based on how you actually are as a doctor and seeing clinical practise.
And they think, oh, this person does know the messages that we're going through.
That's right. And I think also the transferable skills of knowing that you can deal with difficult people.
Yes. And difficult decision. Yes. I'm thinking I'll stay in the saddle.
This isn't very comfortable, but I think the best thing to do is to. Yeah, they sit down and they say, I think it's right.
Yes. It's things they want to do in those days.
And it still happens over radiotherapy attachments. We used to have seven or eight students with us and not for very long a few days at a time.
But, you know, you could give them quite a feeling about cancer and they came towards them and did the ward round.
And if one was there to do that, I think the the the students quite liked the fact the director was involved in some way and in medicine.
Yes, I think so. I think they see you in a different light. Yes. Because they can see that you are a professional.
Yes. And not just as I call myself. You can't get into medical school.
Yes. Yeah. Well, that makes you say things get more and more difficult.
And I don't know about confidentiality and all that, but I think that's much worse than it was,
um, on the how much confidentiality was shared openly because it's that way.
Yes. Yeah, that's the thing. That's I. I want to thank you for all, because it's really the things I want to do.
Yes. You something else that you would be interested in this stuff if we didn't do this today.
I'll have you back on another occasion to defend.
Well, on that note, let's talk about Frank a bit, but I will send you his obituary, tells him his life.
It was a remarkable man and he started quite a number of techniques.
And radiotherapy is still used now, really in particular particularly was remarkable because he was a very he was an
individualist and he would never treat a patient and two patients with the same condition,
the same way twice. Which, of course, infuriated everybody who was wrong about him attractiveness.
And the registrar, he drove us all that mad that I think we're going to change.
Yes. Um, to a question, intuitive tendency.
But he he really he was, of course, been at the beginning of radiotherapy, wasn't quite the first generation was the generation before the first war.
But he came just after the first borns there in the nineteen twenties and thirties.
Um and he did make a major contribution.
And as far as I was concerned, I mean I wouldn't mind being taken over, not for him entirely.
I mean and it happened because I was husband and Auschwitz's.
Yeah. Um which was slightly odd. So I'd been passed and I wasn't a student here.
I was undergraduate here when I went to bars, as many people did.
And then I got sick of London and we wanted to come back here, uh, and I was married by then.
And so I went to see Professor, which I've been on this course for about.
And so and I've learnt a bit about leukaemia and so on.
And I went to see Woods and said, do you have any chance of a House job?
And he said it would be very nice letter back and said, you know,
we don't normally take people from outside Oxford because we have our own students, but sometimes they're vacancies.
And why don't you apply? But as luck would have it, the two people who thought they'd get that job luckily failed something very important.
And so I got the job and I thought that was a good job.
I was very lucky that, um. And so I did a surgical job and with him first and then kind of did my medical job here.
And then, uh, Frank came and did a wardrobe and he was always and Frank was always going around the wards collecting people.
You know, he was very much a person, uh, kind of doctor and came to see one of our people with something that required radiotherapy,
which there were quite a lot because we had families and all that. And I thought, well, there's some in this.
And I thought, well, the only way you can really do cancer, unless you're going to do only leukaemia, there was no real medical oncology then.
It didn't quite exist. It was just beginning, but might exist, I suppose.
Sheila Canada was the nearest to it. Um, but.
Everybody and these other people were not really just oncologist's, they were general physicians and very good ones.
And everybody I mean, he always used to turn up on the black tide,
but we always thought amongst the students that it was because the queen was just about to send for it,
you know, because opposition to the queen, you know, saves a lot more about the students.
But anyway, which took me on a came and I thought, well, if I'm going to do I want to be interested in cancer,
which was what I thought, um, I got to be a radiotherapists. And he told me that.
And so then I went to lie detectors more times for Robert Smith and Mike Duncan and so on.
And then I went to, um, the Hammersmith for a time and then came back here as Frankie's registrar.
And he he saw me through, as I said, so him so disappointed you.
And I think I think I think you should be an oncologist. I don't need to do.
No, you didn't say that. Particularly in the term of colleges who didn't exist then either it was radiotherapy or not.
Yes. Um, no, I said I would like to do it.
I think several letters from him going back that time. But he was very encouraging.
And but the problem was one had to go back and do a bit of physics again and that kind of thing.
But it wasn't enormously long since one had left school. It felt like a long time.
But looking back on it, it wasn't very long. So I suppose. But I remember.
And and. Pass more exams than the membership and so on.
Yes, but that's the life of the junior doctor. Is that still the same now?
Expect more or less. Yes, except you can't chop and change so much. Good, then that's been a great difference.
It's it's hard on this line of patronage, which was in many ways a very good thing.
In other ways, Dick wasn't always a good thing, but the line of patronage has now been cut, I think.
Yes, I think Oxford suffers from that to an extent, yes.
Because it means there's much more of a diaspora. People go out and they don't necessarily come back because they can't do it because they can't.
It's very difficult to to to continue the team between someone who's been spotted as a student, which is interested in you.
Yeah, actually, I think it's a junior level.
And then coming back as this registrar and it sounds as if the two were in parallel because of the interest.
And he obviously thought that you'd be a good person. And I regretted that it wasn't the most popular thing.
So there were more vacancies than, I mean, in general medicine that would have been quite different.
Um, but no, I'm sure you're writing a novel, upsides and Downsides to this kind of patriotism.
Well, yes, but I think that it's gone to a different model.
So it is it feels different in some ways.
But you must have been through a stage with him when you were working as his as his registrar, as a trusted member of his team at the junior level.
The developments must have been quite quick in some ways. Or were they?
No, I don't think so. I mean, Kerbel megamergers radiotherapy started after the war largely because of the work
on the atom bombs and the ability to make artificial radioisotopes in quantity.
That's what started Kerbel therapy. And then later Accelerator's came on quickly afterwards.
But after that, I mean,
there were a few devices that you could use with your megamergers therapy filters and listening to attenuate the beam and make it more accurate.
Um, and there were advances in implant therapy, originally radial needles.
I was brought up with radium needles. And, uh, that changed to really what and I was really concerned quite a lot with the change to a radium world,
to the much safer material to use emancipation removed.
I have been from that time flying out of the window on Ward seven.
Then we sort of Rustavi. I can't really find this really across several.
But, you know, I didn't I didn't think there were enormous developments, radiotherapy.
And then there have been big developments since I stopped,
partly because of further electronics and improvement in the attenuation of beams and all that,
and partly because of energy and because imaging has been absolutely transformed.
Um, since I was working know MRI didn't exist when I was working hard at cat scanning, Alfred right from his scanner was, you know,
that he was the first person to raise money and nobody else wanted to do it for a CAT scanner and also read a rather,
uh, despised in some ways radiologists at the Churchill.
Um, I was always saying things you shouldn't insulting people. Um, and he was the one who actually got us our first scanner in this town.
Uh, and it's worth remembering that. And now, of course, there are scanners everywhere.
And also there's an MRI, too, and every pet and everything.
Um, but but that has been an enormous change and pinpointing things with enormous accuracy and three dimensions,
Sandison and Phoebus, which is, you know, all that positrons.
And Frank, I, I remember that I did. And I made it out of being here.
So that's why I'm checking with you.
But but he devised the idea of introducing radioactive sources within the body and particularly in gynaecological cancer.
Yes. That wasn't his idea. It wasn't something that he developed.
And I became very keen on this. But now it's been entirely given up.
It's so funny that I knew, you know, I did my demo on this Sulston all I time,
but it's now they just I think it's partly the hazards of handling the materials.
And even with after loading, it's still quite hazardous and people simply aren't prepared to do it.
Um, but I love doing implants, you know, all these accessible cancers of the oral cavity of the tongue and not so much the fact,
but certainly the tongue, lips and all that kind of thing. And gynaecological cancers and bladder cancer.
That's where we implanted this morning or not. Andrew Smith was very keen on we all, uh, there was a good, um, trade in that.
But it's now more it's entirely ceased. Um, and I think I don't know really whether the results were any better or other than the advanced.
Which was that you want to help preserve the architecture of the mosque if you operate on people, especially then when, uh, I mean,
that's another thing that's changed, is the microvascular anastomosis in surgery has, of course, gone ahead by leaps and bounds.
And you can do wonderful reconstructions now, which were very much more difficult in the days of flaps and things like that.
Um, so I think, you know, partly surgery has remove the need and partly improvements in surgery,
partly imaging has helped to define better things that you can then treat with the external beam.
So much of the things that Frank really was very keen on, uh, now people would see a lesser need, I'm afraid.
But then that's the way is the way things move forward. I mean, it said to me that we might have build something like radiotherapy.
I think you'll find the drugs in five years. He wasn't riding, sold me out.
But it is it is probably in the end going to happen.
But then once again, thank goodness, because it's not very pleasant having radiotherapy and really,
if you can find some other way, a better way to do it. So much better, right?
Mm hmm. But Frank. Well, I send you the obituary because it I do.
Thank you. That would be very to tell you a few things. I think it will have to come as a copy of some sort.
I haven't got any electronic. I don't think I have it. That would be fine.
Good. And and, uh, pleased to compete in that town.
But he was one of the one of one of the great figures of to medicine for quite a long time.
Yes. I never really appreciated because he was a difficult man. Yes.
And upset everybody. Yes. And very definite views areas.
And here Macbeth. And they used to fight like cats.
I bet that was enjoying the empty clinic. Yeah.
We will go down there and they've been at it and they're trying to talk to the third patient in some serious disagreements in public with the patient.
Oh, so that was a Scott, you know, I mean, you you might but this is so this is the radiotherapists to sit in and the other one stalwartly,
who, again, was a very strong willed man and actually gave me a reference to when I was a consultant.
But he has had the most tremendous up and downs and strength to over individual patients.
Well, we basically go to the middle. Yes.
No, I don't remember being terrified. I was called in. I think I'd just been made registrar and something happened at the weekend.
Somebody was bleeding from the cast of the corpus, I think.
And so is it. We will operate on her this afternoon, get Alice and and we'll put in some radio or something that is was never to be found.
And I was there and I had to sit down once before on the Tuesday.
But this was set. So I took I said, why are you saying that like that?
I said, I think it would be better if it's done as well, Doctor.
It is. Oh well if it is so, yes. Alright, we'll get on with it and then waste of time reading about the birds with their drums.
So I do because he was, I think he was in his last term of of professor observation.
Yes. I was a student not long after the centre opened.
So all it otherwise the whole, the whole field of combat was that.
Yes. As it was in the field to be honest. Yeah. Yes.
And that's where. Yeah. So. Parenthood says people should now control the patient, really?
I mean, it is disgraceful. Uh, and some really just didn't care if others cared and they were reminded about it.
But it is because a cultural norm is more the surgeons and the physicians will, you know, classify all these people.
Uh, dermatologists do one thing. Orthopaedic surgeons. You know, I think there's a grain of truth in some of them.
They they did a formal survey to see whether or not in the Christmas BMJ to see
whether orthopaedic surgeons indeed did swear more than ordinary surgeons.
Right. They do. Yes, they've done. They've done that. They've done recordings with the surgeons knowledge.
Yes. But I don't have any doubt at all. I mean, I had my lead on a year or two ago.
Justin Cobb did it. And I mean, his father was the captain of the Dreadnought, a battleship or something.
And I mean, he's exactly like that. And you don't get a physician or a psychiatrist like that to request special debriefing about money,
because you gave me a copy of the character of it.
Yes. But he used to have the same character in particular, I think, didn't he?
He didn't sing in committee. He quite often. Well, he he did a joint clinic in breast cancer, uh, mainly with Keith done sometimes with me.
And I got to know him a bit better.
Sadly, Keith was diagnosed, um, he, uh, he was a very, very thinking surgeon and, uh, you know, not at all bombastic,
uh, the other end of the spectrum from from that sort of very nice man, uh, and very knowledgeable.
Uh, as I say, he wrote this amazing book about the, uh, South African War.
It's. And suddenly died of asthma. Did you see what I'm saying in London this year?
Yes, needn't have done so had one realised, you know, that. But anyway, you did.
He did. Were you aware that he done portraits of other people on the committee?
Did you sort of used to do the work? We all knew he was doing.
Yeah, that one. Yes.
Yes. But they used to be, but they're still up there.
And they were he mounted a series of of pictures that were to do with historic figures in medicine.
But I have lost sight. I think his caricatures, maybe mostly within the Department of Surgery.
Now, somebody may have claimed. Yes, but I can find out because I would be interested to, um, to see who he has made.
But what might be the country outside the medical school office?
Well, they were these series of framed picture where the neck.
The necklace. Yeah. Yeah. Sort of historic figures in the history.
They've recently gone, but they are in store somewhere. You've this somewhere there's some discussion about where they should go.
And I pointed out because they had a little little plaque saying that they that
Mandela had given the funds as well as the vets just to frame them and mount them.
So I'm sure they will go somewhere and be, um, as long as people can sort of understand that they exist.
That's only half the trouble in history, is people didn't know things exist to them.
But if there are some more cartoon characters, I would be very interested in those because they are part of.
Well, I think most people are aware that would be I mean,
the subject would be the only person now who would and he must have done the people who were doing things at that time.
And then on those particular committees, I mean, what about the other surgeons?
Would they let you do my in Britain? Um, um, I'm not sure because this this would have been done in 1982.
Yes, probably some. Yes.
Most of those of Malcolm might. Yes.
Yes. I mean, he's still about two of my men.
Um. Jail, possibly, yes. Oh, yes.
I'll ask both of. If they know of anyone else who was portrayed and where they might be, they were together, yes,
they would be insurgents and any of the surgeons or some of the physicians who were physicians,
that they would have been people sitting around the tables at that time when there is and
we do have some of Rachel Armstrong's wonderful colour caricatures of David Wetherall,
John Ledingham, Battleship, St. Peter Morris, there are those house are that quite big?
Yes. Yes. You just. Uh, and, uh, she she came back to a little island.
I do. Because we invited her back, um, and that was very interesting to make a connexion between her and the people she portrayed.
Yes. It's the people of the moment. Yes. Yeah.
Gosh, so my impression is that your stint as director of technical studies, which came at a relatively early stage of your career,
actually did lead on to all sorts of other things that when you try to combine, they were sort of short of the things.
I mean, I did I did for years something like that.
Um, um. And then I was general manager again for four years, and the president of the college for about three, some overlapped.
And then the and then all those things were really stints. Once I became president, the college I was I resigned when I was 16.
I was 16 because I thought that was appropriate.
And then of course, I, I got asked by Gordon Robison to take on the marriage awards, and that was another chapter.
Must be very interesting. Yes, it was interesting and an extremely interesting one.
Had 5000 easier to read and spent most of the time on British Rail going around the country to these committed.
And the important thing with that was always know. I mean, I had a lecture, um, because the, um, my predecessor, Gordon Robison,
who was an elitist, uh, was replaced by two by me as medical director and a LHR initially,
Bill Dautry, who was the chairman of Northwest Regional Health Authority,
and then William Reid, who was, uh, a civil servant, is completely different.
Different, but wonderful chairman, charming people. But they didn't know much about medicine.
So I had all the balls read and I always had to try and make sure as far as I could that I knew more about the people on that.
That's coming up before a committee than any of the members of the committee knew.
And very often one caught them out and they hadn't read the papers. And so so I did have to do a little reading papers.
Is it? And that that might be a theme running through a lot of what you've done,
which is bringing together the sort of inspiration and perspiration that you can have an intuitive feel for people.
But knowing what what's in some of the paperwork?
Well, you do have to read the papers. I remember Henry Harris say to me right at the beginning of my time, I said, you know, please remember this.
If you don't have a clerk who was then vice chancellor for a brief time, chairman of the health authority majority,
absolutely hated and gave up after the whole health authority was occupied by a lot of screaming babies,
uh, when we proposed to close the Abbington maternity, which don't have it but couldn't cope with that, we gave up.
But he said, you won't remember this if I don't have a card.
He's vice chancellor. And all those papers that go to all the committees, most committees of which he attends.
And so he's read them all, even the subscripts. And, uh, you have to do that read.
If you're going to be chairman of something, you've got to know the detail, because if you don't,
uh, you can, you know, read things in a very, really unsatisfactory direction.
Yes. It becomes somewhat haphazard. So it's knowing that.
The information is there and that you can use it.
As the whole thing plays out at the time, but also knowing the people who are involved as it is, they're not hiding when you know everything.
When I was general manager, I knew almost everything of what was going on in the hospital.
I knew what mental handicap were doing charitable work.
And one had one had a real, uh, privileged knowledge of most of the the big things and many of the smaller things that were going on.
You knew who didn't get on with whom and all this kind of thing. And all that's very important in management at the moment.
People don't know that kind of thing. They're not going to be very good.
And I think one of the problems with the NHS has always been in these recent years, too many changes and nobody really is at the helm.
I don't know how these two people are doing very well because she was chairman psychiatrist when I was a prison psychiatrist.
When I was a radiologist, she had said we were friends and I don't know.
I've met Jonathan Meakins once or twice. Jonathan was saying, what was his name?
Jonathan Michael. Michael, that's right. Once or twice. And he seemed a reasonable chap, but and there have been there for a reasonable time.
So I don't know how they're getting on. But it's a good thing that the doctors are saying yes.
Do they have a good time, do people think? I haven't seen the two of them together enough because I retired from clinical work three years ago.
Yeah, I haven't I haven't been party to that. I sense that it was good that we had to talk to unusual, I think.
Yes. And that they were both seasoned warriors in their lives.
They had always. Yeah. Yeah. Um, but I think the whole climate with the health reforms is very problematic.
And you see all these trusts, seven or six trusts or something set up in Oxford, uh, in the acute hospital system, you knock not their own ridiculous,
really, because then the orthopaedic surgeons start to divide with the neurosurgeons about who did banks and all this kind of thing.
We were able to suppress all that when Caroline and I were, so to speak, there.
And we had a manager in each hospital, Johns by the not David Wilson at the Radcliffe and so on, the good Jafo.
So and, uh, that worked quite well.
But the members, they became independent of an independent board of governors papers.
It all thought it was no good. And now, of course, it's been realising that all of them have been amalgamated again.
So I don't think that was a good period. Read it.
You know, yes. I think I think I think that things tended not to hang together.
Well, there are some I mean, they never did hang very well together with the NSC.
I mean, they were always they were always considered themselves different. Um, but, you know, it was better the way it was.
I thought in management terms, more sensible to have it going that way.
Then my boss was read through and, you know, that was quite good.
She was very pro Oxford and very helpful to us. It was helpful to read in the other places, too.
She had a good reputation and all is. And she was another of the great characters of Oxford, but did you learn a lot?
Yes, I knew that because she set up the flexible training.
Yes, she did. Yes. And it is very interesting to talk to her about why she did it and how she did it.
Very clear strategies that I found very much and very with a doctor's intuition, but also that they're quite astute about how to negotiate things.
Yes, she put a lot of money into the bureau.
She made appointments here and in liaison with David Wetherall and his predecessors and did an awful lot good for us.
And I think I was very sad to see the region,
although Rosemary and I didn't always get on and we were fighting for more money and she was trying to give it to charity and we thought so.
But nevertheless, I thought it was probably not going to be good for Oxford when that structure
was dismantled and we became in Portsmouth or some of Southampton or somewhere.
And that was that didn't last long either. No, I don't. It's the lack of continuity.
Yes. And you needed the ministers needed some intermediate care between themselves
and the department and the hospitals in the regions and provided that quite,
quite efficiently. Well, yes. And things would change at a micro level.
Yes. With some continuity in the. Yes. Immediately.
But Rosemary had a very good feel. She was, again, a decent person for detail and she knew exactly what was going on much down.
But she jolly well knew. And you couldn't pull the wool over her eyes and say, oh well thank you, but it gives recording someone speaking.
It's a very much more vivid impression. I think it's quite different from writing.
Yes. Yes, I think it is. And I think I'm very grateful that you've given us the time and also that you've been candid.