BLC BARTS and the LONDON CHRONICLE
Autumn / Winter 2009
The magazine for the alumni community of Barts and The London School of Medicine and Dentistry
In this issue... Microvascular research Interview with Professor Tim Oliver Geoffrey Bourne remembered Studying at Barts 70 years ago Electives you have supported Your reunions and news
Barts and The London Alumni Association (BATLAA) Barts and The London Alumni Association was formed in 2000, joining together Barts Alumni Association, The London Hospital Dental Club and The London Hospital Medical Club. Barts and The London Alumni Association aims to foster a mutually beneficial lifelong relationship between Barts and The London School of Medicine and Dentistry and its alumni.
Your benefits and services As a member of BATLAA you can receive: • Barts and The London Chronicle • twice-termly Queen Mary Alumni e-Newsletter • invitations to medical and dental clinical meetings for which PGEA/CPD approval is usually granted • invitations to regular social events and reunions at the School and College • help with promotion and support of special interest, regional and overseas groups, including The London Hospital Dental Club • help with finding lost friends, former classmates and tutors • the Queen Mary Alumni card for reference access to the College Library, both at Whitechapel and Mile End, and a Lifelong email Address for recent graduates • discounts on access to Qmotion, the new health and fitness centre on our Mile End campus • opportunities to support our current medical and dental students through bursaries and elective and hardship grants.
ALUMNI RELATIONS AND EVENTS OFFICE incorporating BARTS AND THE LONDON ALUMNI ASSOCIATION Head of Alumni Relations and Events and Editor of BLC Susan Nettle Alumni Relations Manager Anila Memon Alumni Relations and Events Office Queen Mary, University of London Mile End Road London E1 4NS UK Tel: +44 (0)20 7882 5392 Fax: +44 (0)20 7882 3706 Email: batlaa@qmul.ac.uk Website: www.batlaa.org
If you would like to contribute to future issues of BLC please get in touch. We welcome your articles, comments and ideas.
Barts and The London Chronicle is edited and produced by the Alumni Relations and Events Office, Queen Mary, University of London. No part of this publication may be produced without the prior permission of the publisher. Whilst every care has been taken to ensure the accuracy, no responsibility can be taken for any errors or omissions. The views expressed are not necessarily those of Queen Mary, University of London or Barts and The London Alumni Association. All rights reserved. © Queen Mary 2009. ISSN 1470 – 2282 Design www.rfportfolio.com
This magazine has been printed on environmentally friendly materials from sustainable sources.
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A Welcome from the President of BATLAA Welcome to the Autumn/Winter 2009 issue of Barts and The London Chronicle. Thank you to all our alumni for your continued support for Barts and The London Alumni Association. Your generosity and involvement is of enormous value to Barts and The London School of Medicine and Dentistry. The Queen Mary, University of London Foundation has been able to distribute a number of awards over the past year, which have helped a great number of potential doctors and dentists. I would like to take this opportunity to thank you all most sincerely for your ongoing contributions to this worthy cause and ask for your continuing support in the future. In this issue of Barts and The London Chronicle you can enjoy reading many interesting articles and re-live some of the recent reunions. Photographs from the BATLAA Dinner and Dance, held in November 2008, are included; images from tours of St Bartholomew’s Hospital; and the Golden Jubilee dinner of the Dionysian Society are also pictured. Featured interviews include Professor of Microvascular Pharmacology at the School, Sussan Nourshargh, and retired Consultant Oncologist and charity founder, Professor Tim Oliver. We find out what it was like to have studied at Barts 70 years ago, and how the late Dr John Dale MBE founded a health-centre in the Gambia, while Dr Laurence Wand sets the record straight about medical care at Belsen after the war had ended. There are also many interesting reports from our students who have recently returned from their electives overseas. Finally, please complete the enclosed readership survey and give us your feedback on the BLC. Thank you all for your valuable support and involvement. Keep in touch! With best wishes
Professor Brian Colvin President of Barts and The London Alumni Association q The London, 1969 Professor Brian Colvin shakes hands with Professor Sir Nicholas Wright, Warden of Barts and The London School of Medicine and Dentistry, on the occasion of the former’s retirement as Dean of Student Affairs
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BATLAA news
Contents
School news
Supporting Barts and The London
4
Reunions
6
Centre of the Cell opens
9
Reflections on RAE Success 10 Microvascular research – Professor Sussan Nourshargh
12
Principal thoughts – Professor Simon Gaskell
14
New Chairman of College Council – Sir Nicholas Montagu
15
An unquenchable thirst – Professor Tim Oliver
16
A Teacher Remembered
19
A student at Barts 70 years ago
20
Freshers from the Fens
24
Electives
26
A Doctor’s Life
32
Medical students at Belsen 34 Book reviews
36
Readers’ letters
38
Alumni news
39
Obituaries
42
Events
48
Become involved in the activities of BATLAA. Come to events; keep updated on developments at the School and College; write for BLC; become a Committee member for BATLAA or LHDC; organise a reunion for your year and encourage your contemporaries to join BATLAA. To find out more, contact the Alumni Relations Office at batlaa@qmul.ac.uk or +44(0)20 7882 3732. www.batlaa.org
Recent academic appointments The School of Medicine and Dentistry is continuing to pursue its ambitious plans to recruit new senior researchers. In the last year alone, more than a dozen new professors were appointed. Blizard Institute of Cell and Molecular Biology • Karin Brohi, Professor of Trauma Sciences, completed his medical training at University College Hospital and The Royal London. He has also worked in trauma in southern Africa and North America. • Non Clinical Lecturer, Dr David Bulmer’s research interests lie in the processing of sensory information from the gastrointestinal tract and the development of novel drugs for the treatment of IBS. • Visiting Professor Susan Lim is widely known in Asia for being the first surgeon to perform a successful liver transplant in 1990. She practices general surgery in Singapore, including advanced laparoscopic surgery, transplantation and robotic surgery. • Stuart McDonald (q PhD, Barts and The London, 2002), Professor of Digestive Diseases, has been working on stem cell biology within the human gastrointestinal tract with Professor Sir Nicholas Wright (ICMS and Cancer Research UK) and Professor Janusz Jankowski (ICMS and Leicester University Hospital) since 2004. • Gareth Sanger, Professor of Neuropharmacology, has a background in academic and industrial research with GlaxoSmithKline. The latter led to his proposal that a novel receptor mediated the ability of 5-HT to increase gastrointestinal motility, later named by others as the 5-HT4 receptor. • Professor of Gastrointestinal Physiology, Daniel Sifrim’s research focuses on the physiology and pathophysiology of esophageal motility and gastro-esophageal reflux disease.
School of Dentistry • Robert Hill, Professor of Physical Sciences in Relation to Dentistry, researches materials for restoring hard tissues. He is currently working on new biodegradable cements for use as bone glue. Institute of Health Sciences Education • Robert Walton joined the IHSE as Professor of Primary Medical Care. He is currently researching ‘personalised medicine’ with an initial focus on treating tobacco dependence. William Harvey Research Institute • Carol Shoulders, Professor of Lipidology, graduated from the OU in 1981 whilst working at the Medical Research Council’s Laboratory of Molecular Biology in Cambridge and was awarded a DPhil by the University of Oxford in 1984 for cloning the human apolipoprotein A1 gene. In 2009, she joined the Institute to continue studies into the highly atherogenic, disorder Familial Combined Hyperlipidemia (FCHL) and to diversify into other areas of lipid biology. Wolfson Institute for Preventive Medicine • Amrita Ahluwalia (q PhD Pharmacology, Barts, 1993), Professor of Vascular Pharmacology, is interested in the mechanisms of vascular homeostasis in inflammation, in particular the role of the endothelium. • Attila Lorincz, Professor of Molecular Epidemiology, is recognised for his research in human diagnostics and the natural history of human papillomavirus infections. He invented and disseminated the Hybrid Capture (HC) series of HPV tests which are generally recognised as the gold standard in routine HPV screening worldwide, with more that 10 million tests conducted annually.
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BATLAA news
Supporting Barts and The London Alumni Gifts Thank you to everyone who has made a contribution towards supporting our medical and dental students in the past year. Some 800 individual gifts have been received. Over 45 medical and dental students during 2009 have benefited from alumni gifts, which have enabled them to study at hospitals and medical or dental provision centres in more than 10 developing countries. You can read some of their stories on pages 26-31 and on our website at www.qmul.ac.uk/alumni.
A Gift in your Will The Queen Mary, University of London Foundation has produced a brochure for alumni who are interested in leaving a gift to Barts and The London School of Medicine and Dentistry in their Will. If you are considering writing or updating your Will, a gift to the School might be an area you wish to consider after you have made provision for your family and those closest to you. Recent legacy gifts have supported students and cancer research. If you wish
In addition, six medical students were supported during their intercalating year. Two achieved First Class Honours in their chosen subjects; with 2:1 degrees being awarded to the others. We hope that after reading this magazine as well as the enclosed How you can Help brochure, which highlights some of the stories of the young students who have benefited from previous gifts, that you will be encouraged to make a gift towards supporting current students.
to be sent a copy of the brochure, or to be put in touch with someone in the academic area that you are thinking of supporting, please contact Susan Nettle in the Alumni Relations Office on +44 (0)20 7882 7423. or email s.nettle@qmul.ac.uk. We are planning a Legacy Day in 2010. This will be an opportunity for potential legators to visit the College and see in-depth some of the research work that is currently a priority. If you wish to receive an invitation, please contact Susan Nettle as above.
BATLAA supports Sailing Club Mark Lewis, Captain of Barts and The London Sailing Club (BLSC) writes: “On behalf of all the members of BLSC, from professional yacht crew to first time dinghy sailors, I would like to thank BATLAA for its support through an extremely generous recent donation of £2,000. The gift has been put towards the purchase of a much needed new dinghy, a topper omega which we have christened Delirium Tremens. It has already been used extensively and is proving to be a great asset to the club; we have been able to double the number of people out on the water at any one time and it’s also a sound base for teaching beginners. This year we aim to get as many BLSC
members as possible trained to a RYA standard, and to encourage all our members to give racing a try, whether it be on dinghies or as part of our yacht crew. Our new topper will be our primary training boat, allowing us to make this happen. With more experienced sailors we would then like to build a race team so that we are able to enter both Burnham and student regattas. We hope to hold a dinner and drinks evening at the Royal Burnham Yacht Club for all members of the Sailing Club past and present on Saturday 27 February, to which you all are warmly invited. Please email blsailingclub@googlemail.com if you are interested in joining us. Once again many thanks for your support, it really is appreciated.”
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BATLAA news
New research centre for paediatric endocrinology Paediatric endocrinology at Barts and The London has an international reputation following 25 years of clinical excellence in which it has made major clinical and research contributions in all aspects of growth and development, diabetes, pituitary and adrenal disease. Its strengths stem from a combination of expertise in clinical paediatric endocrinology together with state-of-the-art molecular genetics research and a close interaction with world-renowned adult endocrinology services, thereby allowing a continuation of patient care from childhood through the transition into adulthood. Such a combination of outstanding expertise in each of these fields is unparalleled in the UK. High quality paediatric endocrinology services are presently more important than ever before, especially in view of: 1. The increasing incidence of childhood obesity and consequent diabetes. This brings long-term health care challenges and costs, and prevention and early management of these disorders is paramount. 2. The recognition of the long-term consequences of early life growth failure on later adult cardiovascular, metabolic and bone disease.
Paediatric endocrinology at Barts and The London hospitals Adrian Clark, Professor of Medicine and Centre Lead in Endocrinology at the William Harvey Research Institute, says: “A key component in this success story has been the roles played by our colleagues in setting new standards for treating childhood growth disorders. For example, pioneering the treatment of growth hormone insensitivity using human recombinant IGF-I. Ground breaking research continues, particularly in the molecular mechanisms of endocrine diseases. We were the first to describe the human IGF-I gene defect, and we lead the world in research on the causes of ACTH insensitivity. We are fortunate to have a unique environment within the world famous William Harvey Research Institute with its strong basic science research ethos and the School of Medicine Genome Centre. Today the most pressing problems we face are the rising levels of childhood obesity and diabetes. These conditions are the main cause of increased referrals to our clinics, particularly for children of Asian descent. New research is urgently needed to increase our understanding of these serious health problems as, if they are not treated early, they can cause even greater difficulties in later life. Childhood obesity and diabetes are likely to lead to heart disease, or other complications such as blindness and kidney disease, before patients reach 40 years of age.”
A new Child Health Research Centre An eight year old child with Cushing’s syndrome before treatment…and 12 months after being cured
The reason for this very special appeal is our need to establish a new academic Child Health Research Centre, to be sited in the
Donations to universities receive government matched funding In 2008, the UK government launched an initiative to encourage alumni and friends of the higher education sector to make philanthropic gifts to their chosen university. Any truly philanthropic gift could be supported, within a fundraising target set by each university. Therefore, all philanthropic donations to the Queen Mary, University of London Foundation from now until 31 July 2011,
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will ensure that the College receives matched funding at 50 per cent of the total value of the gift. This additional support will be used to ensure that our students’ experience and research will all benefit in the coming years. The matched funding can be applied to gifts from alumni around the world: this is not limited to those who live in the UK.
William Harvey Research Institute at Barts and The London School of Medicine and Dentistry and within the Barts and The London NHS Trust. We want to build upon our current strengths and develop new research directions in paediatric endocrinology. This will translate into better care for sick children and improvements in their long term health. With £1.88 million of the necessary £2.4 million already raised to fund the research into this vital area, Chairman of the fundraising committee, Christopher Hobden, says: “This is a difficult time to raise money but I believe this research is a priority as it has the potential not only to save and transform childrens lives but also to save the human and financial costs of caring for blighted young lives when cures can be found. Raising the £1.88 million has been achieved by building the “Case for Support” and maximising the contributions available to us from the NHS and from Charities. With more than 70 per cent of the target reached, please help us to finish the job and open this new centre of excellence in 2010.” If you wish to make a donation to this appeal, please use the Gift Form in the enclosed How you can Help brochure, marking your gift for the ‘CHRCA’, and return it to the Alumni Relations Office.
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BATLAA news
Reunions Proposed reunions Reunion for Old Londoners who qualified in Autumn 1960 Robert Dawkins (q The London, 1960) would like to host a 40-year reunion for Old Londoners who qualified in autumn 1960. The reunion will be held in autumn 2010 and the venue will be central London based. Do get in touch to register your interest.
Reunion for Old Londoners who started in 1987 Emma Sedgwick (née Price) (q The London 1993) would like to encourage contemporaries to get in touch for a catch-up reunion in 2012. Please get in touch if you would like to keep in the loop. For further information about the above proposed reunions, please contact batlaa@qmul.ac.uk or telephone +44 (0)20 7882 3732. Do visit our website at www.batlaa.org for an up-to-date list and information.
Reunion of The London Hospital Medical College Entrants of 1958 This event marked the 50th anniversary of our first gathering and was very well supported with over 40 of the original complement in attendance, many accompanied by their spouses. It took place over two days from 18–19 September 2008; many got together on the first evening at the Southwark Rose Hotel for an informal dinner. It was good to have so many members from overseas with John Seary, Peter Joules, Garry and Anna Cornel and Geoffrey Dunn from Canada; Sola Okuwobi from Nigeria; Ben Williams and John Hetherington from Australia, and Bill Peskett from New Zealand. Later Cyrus Kumana from Hong Kong joined the party. The following day we met in Whitechapel starting with a light lunch
in The Good Samaritan, after which we split into two groups for tours hosted by BATLAA President, Professor Brian Colvin. We had a nostalgic look at the old College and an eye-opening inspection of the new academic buildings, as well as the hospital. The tour ended in the Royal London Museum. That evening we had a formal dinner in the historic surroundings of Apothecaries Hall. The Beadle gave a very informative talk before the dinner at which John Anderson proposed the toast to absent friends and John Angel thanked the organisers. Peter O’Connor, Sola Okuwobi, Malcolm Harris and Anthea Kaan also spoke. John Anderson q The London, 1963
Topping-out at Barts At their luncheon on 18 October 2008, members of the St Bartholomew’s Hospital Decennial Clubs were delighted to be given the opportunity to view the roofed-off new Barts Hospital. This made the long and arduous campaign to save Barts all so worthwhile. 2009’s luncheon was held on 17 October in the Great Hall at Barts and included a talk on oncology. We were greatly honoured to have as guest speaker, Professor Martin Evans FRS DSC who received the Nobel Prize for Medicine in 2007 for his stem cell research. For more information about the Decennial Clubs, contact batlaa@qmul.ac.uk.
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BATLAA news
Reunion for Barts Alumni 1972–74
BATLAA Dinner and Dance 2008 BATLAA Patron Sir Michael Palliser and BATLAA President, Professor Brian Colvin welcomed alumni, their guests, staff and students of Barts and The London School of Medicine and Dentistry to the biennial BATLAA Dinner and Dance. Held at the Draper’s Hall, London on 21 November
2008, the evening was a great opportunity for alumni and their guests to celebrate milestone years since qualifying. Alumni from The London who qualified in 1958, 1968, 1978 and 1983 and from Barts who qualified in 1968 and 1988 were among the 150 attendees.
The evening of 29 November 2008 proved a popular time for the reunion of Barts graduates from 1972–74 vintage. There was a total gathering of 88 people, including spouses, many of whom were familiar with the surroundings of the Great Hall as they had spent several years in nursing attire there in the 1970s. A buffet dinner was served and guests were seated with past and present friends. This year we invited a guest speaker and contemporary, Dr Jon Fuller, who spoke of the developments in the selection and training of current medical undergraduates at Queen Mary, interspersed with humour and colourful illustrations. We all agreed that we had been very lucky in our timing entry to Barts when three Es were the expected grades at A Level! Good company and plenty of lively chatter kept us all engaged until “last orders” at 11.30pm. It will be all important to keep email addresses up-to-date with the Alumni Relations Office to give the organiser/s in 2013 a flying chance of contacting everyone in good time. Thanks to all who came to make the evening worthwhile. Richard Wells q Barts, 1973
Reunion of 1978 Barts Leavers Alumni who qualified from Barts in 1978 attended a reunion dinner on Saturday 11 October 2008 at Barts’ Great Hall. The evening, organised by Liz Cox (née Miller), was a great success and was attended by 107 alumni and their partners.
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BATLAA news
Alumni Reunion Weekend 2009
Photo by David Alder (q Barts, 1960)
Photo by David Wise (q The London, 1966) and Elizabeth Wise (q The London, 1968)
Barts and The London alumni joined those from Queen Mary and Westfield for events and reminiscences across the College’s three campuses at West Smithfield, Whitechapel and Mile End in early October. This was the first time that BATLAA and QMandWA members had come together in mutual
The 2012 Olympic stadium at Stratford – a work in progress
friendship. With guests spanning eight decades since graduating and representing every year since 1933 (when Queen Mary was known as East London College), there was much to celebrate and absorb. Guests could choose to partake in a number of activities across the weekend, including a visit to the Olympic site taking shape in Stratford, the new Heart Centre being constructed in Charterhouse Square, which ushers in greater collaboration with Barts Hospital cardiac patients, and the new Student Village at Mile End, where many first year doctors and dentists have the opportunity Alumni enjoy a three-course lunch in the to live when they first come up. Grade II listed Octagon at Mile End
London Hospital 1969 and 1970 Reunion A 40 year Reunion Dinner for medical alumni who qualified from The London in 1969 and 1970 was held at the RAF Club in Piccadilly on Saturday 14 November. Members of the 1964 start group, who did a BSc – and who therefore qualified in 1970 – were included this time and the occasion was lively and greatly enjoyed by all. Some long journeys were made to the venue – in particular, by Peter and Heather Loveridge who came over from Nova Scotia for the weekend! Brian Colvin, President of the Barts and
The London Alumni Association, and also a 1969 Old Londoner, gave an entertaining reminiscence of The London in the 1960s and an update on present developments at the School of Medicine and Dentistry. Most members of the year are now in contact by email and the plan is to hold a repeat reunion in two years time, ie 2011. Please contact the Alumni Office if you are not already on the list and are interested in keeping in touch. Judy Brown q The London, 1969
Dionysian Society Golden Jubilee Dinner The founder members of the Dionysian Society, men like the late Bill Russell, David Darby et al, would surely have been staggered to see 240 surviving past and present members of the Society descend into The Brewery in Chiswell Street to celebrate its 50th year on 7 November 2008. Members came from all over the UK, former colonies and dominions to celebrate the occasion and re-forge old friendships. Andrew Marsden (q The London, 1973) and Adam Harper (q The London, 1996) arrived from the antipodes, and Mike Ramsay (q The London, 1968) came over from Dallas for his first Society event in over 30 years. The assembled company dined well, and consumed the usual vast quantities of wine and bitter – 16 barrels of Fuller’s London Pride being downed before the early closure of the bar. The after-dinner speakers included the Student Society President, Ed Davis, Oggie Daniell (q BDS, The London 1974), Malcolm Jenkins (q BDS, The London, 1956), Peter Golding (q The London, 1962) and Mark Jackson (q The London, 1966), when toasts were drunk to absent Dionysians, the Society and to the Old London. The formal part of the dinner was brought to a close by the surprise presentation by Drs Nick Huddy (q The London, 1980), Simon Ellis (QMC, Genetics 1980) and Damien Hanbury (q The London, 1980) of two engraved tankards – one for use, the other for display – to Oggie Daniell for his work on behalf of the Society over the past 30 years.
Organising a reunion? If you are organising a reunion for your contemporaries, or if you would like help getting started, we would be happy to offer you our assistance. Contact batlaa@qmul.ac.uk or telephone +44 (0)20 7882 3732 to discuss your plans.
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L-R: Chris Emery, Barry Russell, David Hoare and Frank McFarlane
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School of Medicine and Dentistry news
Centre of the Cell opens The Centre of the Cell, Queen Mary’s unique children’s bioscience education centre, officially opened its doors for the first time on Thursday 3 September. Blue Peter presenter Helen Skelton opened the Centre which will provide young people, aged from 9 to 16 years, with the chance to learn about science through interactive games and videos Based at the Whitechapel campus of Barts and The London School of Medicine and Dentistry, the Centre of the Cell is the first in the world to be built within a working medical school research laboratory. This gives young people an opportunity to meet researchers based at the Medical School and ask questions about how their work influences real life situations. Lord Drayson, Minister of Science, also attended the launch day. Professor Fran Balkwill OBE, Director of the Centre explains: “Our approach to inspiring the next generation of scientists and healthcare professionals has been to build a science centre for young people in the middle of one of our research buildings. The Centre of the Cell was integral to the design of the Blizard Institute of Cell and Molecular Science in Whitechapel; indeed the original idea of building an education space at the heart of the laboratories came from the Blizard Director, Professor Mike Curtis. Following the opening we expect
over 30,000 young people a year will be able to visit our futuristic orange cell-shaped ‘Pod’ suspended above the laboratories. There are a number of advantages to bringing young people to the scientists – it saves time, ensures that good resources are always available and breaks down stereotypes. The Centre of the Cell gives us a custom-made, interactive environment in which junior and senior researchers and clinicians can discuss and debate their work with young people – and most of them will only have to climb a short flight of stairs to do so. Our postgraduate students have been trained by Centre of the Cell staff and STEMNET (Science, Technology, Engineering and Mathematics Network) to act as volunteer ‘explainers’ during the Centre of the Cell experience. Each will spend one or two (or possibly more!) days a year in the ‘Pod.’ In addition to meeting scientists in the ‘Pod’, visitors will actually look down onto other scientists at work before they learn about the research going
on beneath them via film shows, state-ofthe-art interactive games and top-of-therange microscopes. Visitors grow virtual cells to enable experiments in HIV research; grow virtual stem cells for research into burns treatments; explore real body parts and diagnose cancerous tissues using microscopes. The interactive games lead into discussions of how the procedures and results of research can raise ethical questions – ethical questions that our audience will be increasingly called on to consider in the future. Visitors also follow Patient Journeys which highlight the variety of careers in science, medicine and healthcare. This combination of digital technologies and real-world science creates a science education experience not available in the classroom or anywhere else in the world. We can reach so many more young people by bringing them to us. And equally important to all of the above, we have found that putting the science centre at the heart of a research building is generating an ethos of enthusiastic communication that permeates throughout our Medical School and University. With help from the Centre of the Cell team, over 80 of our scientists and clinicians have provided expert content; 150 pages of which is already available (alongside some 15 interactive games, teachers’ resources and much more) on our popular website www.centreofthecell.org. The Centre of the Cell team has also evaluated every step of the project in our local schools – so far they have involved over 8,000 pupils – and they are training our scientists and undergraduates in best practice in science communication. Time will tell if our model for science education and public engagement with research is successful but we dream that one day you will find Centre of the Cell ‘clones’ in biomedical research buildings around the world.” • To book a free session at the Centre of the Cell, log on to our website at www.centreofthecell.org or contact Kat Sandford, Learning and Access Manager, at kat.sandford@qmul.ac.uk. Blue Peter presenter Helen Skelton with local school children from the Petchey Academy in the Centre of the Cell
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School of Medicine and Dentistry news
Reflections on Research Assessment Exercise Success Professor Tom MacDonald, Dean for Research, looks forward following the RAE success Since I became Dean for Research back in 2005, I’ve thought of nothing else but the Research Assessment Exercise (RAE) as the means to boost the reputation of Barts and The London. The School has come a long way from 23rd place back in 2001 to top in London for quality medical research, and equal first in the UK for dentistry. Since that time, over 25 new professors have joined us and they have brought with them both funding and talented people in their teams. We have also employed an equivalent number of young researchers at lecturer and senior lecturer level. Much of this recruitment was due to the foresight shown by Queen Mary to invest heavily in the School in the run-up to the RAE. At the same time, our programme of building improvement and the opening of the stunning Blizard laboratories and refurbishment of the John Vane Science Centre have made this a School where the most talented academics want to work. But bringing the best people in isn’t enough. We have to keep them here and keep them at their best, and that is why we now have a robust system of performance management. Our academics know what is expected of them because they are scored on grant income and the number and quality of the papers they publish. At the same time they are incentivised for exceptional performance. The RAE results prove that this mechanism is making a difference. In the build-up to the RAE, nothing was left to chance. We carried out repeated dry-runs using eminent external referees to judge and give feedback on our publications. In the end we entered around 80 per cent of our researchers, in line with most other medical schools. The three and four-star ratings signifying high international quality research achieved in the 2008 RAE speak for themselves; the Wolfson Institute came second in the UK in epidemiology and public health; in cancer we were ranked third; the William Harvey Research Institute came third in preclinical and human biological sciences,
and we were joint 4th in primary care. It was a stunning performance, a great tribute to the leadership of the Warden, Directors of Institutes, Centre Leads, and an acknowledgement of the efforts made
by staff. We are now firmly among the top five research active medical and dental schools in the UK. Queen Mary is part of the 1994 group of smaller research-led universities,
Barts and The London School of Medicine and Dentistry has shown the largest increase in research funding in the last five years in the UK £60m £50m £40m £30m £20m £10m 0 2005-06
2006-07
2007-08
2008-09
The 2008-09 financial year was an outstanding success for the SMD with more than £50m in new research awards
RAE 2008 Biomedical Units of Assessment Ranking
University
%4* & %3*
GPA
1
University of Cambridge
82.1
3.157
2
University of Oxford
73.3
2.994
3
University of Edinburgh
72.5
2.900
4
Queen Mary, University of London
70.0
2.857
5
Imperial College London
69.2
2.883
6
University of Southampton
67.5
2.750
7
University of Manchester
66.9
2.806
8
University College London
64.4
2.750
9
University of Aberdeen
63.8
2.663
10
University of Bristol
61.3
2.725
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School of Medicine and Dentistry news
Staff Honours for Barts and the London
but when we compare the performance of the School of Medicine and Dentistry at Queen Mary with the 20 large medical schools in the elite Russell group, we came 10th in terms of total research spend, outperformed all but three in quality in the 2008 RAE, and, based on research spend per FTE, we rank third in the UK. But this is just the beginning. Even in the months since we made our submission, the School has continued to grow and we have ambitious plans for the future in our existing areas of expertise. We have made the strategic decision to continue to focus our research on our strengths. We will keep on expanding in these subjects while continuing to address the needs of the local community by building on our relationship with Barts and The London NHS Trust and our partner Trusts in north-east London. As a result of the RAE, the School will gain another £4.5m per year in direct funding. We need to make sure we maintain and increase this level of income by performing equally well in the next RAE (now called the REF – Research Excellence Framework) in 2012. A policy of investment in the School means that we will be able to increase our competitive edge by recruiting new researchers; increasing our annual income from competitively won research funding; as well as continuing to improve the quality of our educational programmes. Unfortunately size is important in higher education and we had one of the smallest number of staff submitted in the 2008 RAE, so we lost out in volume indicators. The only way to remedy this is to get bigger. We have recently purchased the last available property at Whitechapel, the ARC Building, which we are refurbishing for the researchers in the Centre for Health Sciences. We now have to work with Queen Mary to expand beyond our present boundaries at Charterhouse Square and Whitechapel to accommodate the numbers of staff we need to become the same size as the major metropolitan universities. •
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Professor Nick Lemoine (q Barts, 1983), Director of the Institute of Cancer has been awarded the 2009 Yellow River Friendship Prize. The prize is the highest honour bestowed on a foreigner by the Chinese Government. Professor Lemoine received the award in recognition of his ‘outstanding contribution to the wealth and social well-being of the people of Henan Province’. The award comes as a result of Professor Lemoine’s work for the SinoBritish Centre for Molecular Oncology, founded through a collaboration between Queen Mary and Zhengzhou University in Henan Province. Professor Mark Caulfield (q The London, 1984), Director of the William Harvey Research Institute and an expert in the genetic causes of high blood pressure, has been elected President of the British Hypertension Society. Professor Caulfield said: “It’s a great honour to be elected president for the British Hypertension Society. The Society plays a key role in research into the causes of high blood pressure and improving treatment and prevention of heart disease and stroke. The Society is making great leaps forward and it is an exciting time to take on this role.” Professor Andrew Lister (q Barts, 1969) has been recognised for his outstanding achievements by The European Society for Medical Oncology. Professor Lister, who is Centre Lead for Medical Oncology at the School, has been given this year’s Hamilton-Fairley Award. The award commemorates one of the founding fathers of medical oncology in Europe and is an international recognition for a lifetime’s achievements in science and clinical research.
Professor Fran Balkwill OBE has been awarded a prestigious British Science Association Fellowship in recognition for her dedication to communicating science. Professor Balkwill leads the Centre for Cancer and Inflammation in the Institute of Cancer and is Director of the recently opened Centre of the Cell. She said: “I am very excited about the recognition of all our work at the Centre of the Cell – it’s not just me but a fantastic team – and it was awesome to get the Fellowship at the same time as Bill Bryson was given one.” Professor Tom MacDonald, Dean for Research, and a world-expert on gut immunology and inflammation, has been elected President of the Society for Mucosal Immunology and organised the 14th International Conference on this topic in Boston last summer. He said: “It is really important that staff at the School take every opportunity to participate in international societies, and accept invitations to speak at international meetings. We are ambassadors for the School and by giving quality talks we enhance the reputation of Barts and The London.” Liz Davenport (PhD Dentistry, The London, 1992), Professor of Dental Education, has been appointed to the newly created Council of the General Dental Council. Professor Davenport is one of 12 dental registrants who will sit on the Council, which took-up office on 1 October 2009. Members are made up of dentists, dental care professionals and 12 lay people, who have been appointed for a four year term and can serve a maximum of eight in 20 years.
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School of Medicine and Dentistry news
Pioneering Microvascular Research
Professor Sussan Nourshargh, Head of the Centre for Microvascular Research within the William Harvey Research Institute talks to BLC about her work Professor Sussan Nourshargh and her team, at the Centre for Microvascular Research in the William Harvey Research Institute, at Barts and The London School of Medicine and Dentistry, are conducting pioneering research into the molecular and cellular events within the microcirculation, the network of small blood vessels in tissues. “Our overall objective is to understand the microcirculation, why it goes wrong, how we can restore its functions and the implications of a dis-functional microcirculation to the development of inflammatory disease states,” explains Professor Nourshargh. The centre, established in 2007, is currently composed of six post-doctoral research associates, three PhD students, an honorary Reader, a laboratory manager and Sussan herself. “We are a relatively small team but are growing. I don’t believe that big is always good. A focused team of say 10 people can achieve an awful lot.” “The microcirculation is critical to tissue perfusion and so maintaining healthy organs through delivery of oxygen and nutrients. It is also the primary site where white cells, leukocytes, migrate into tissues in response to injury, trauma or infection. Members of
my team are working on different projects around this theme. Some are specifically interested in the structure and morphology of microvessels and how this is regulated in inflammatory conditions. Some are interested in novel concepts related to regulation of microvessel responses by sensory nerves and some people are focusing on the white cells themselves. Specifically we have much interest in how leukocytes are activated, how they are switched off, and how the
“Inflammatory diseases such as rheumatoid arthritis, psoriasis, liver cirrhosis and multiple sclerosis are increasing. A common theme is that they are all caused by white cells moving from the blood into the tissues. Professor Nourshargh and her team are at the forefront of understanding the mechanisms involved and have produced arguably the most striking images of this phenomenon made so far. Professor Nourshargh’s work is applicable to many different diseases. It will have a very broad impact on human health. As part of the revitalised and ascendant School of Medicine and Dentistry, it is an independent marker of esteem that we are able to attract a scientist as talented as Professor
“ Supervising PhD students is one of the greatest satisfactions I get. They arrive a little hesitant and leave as independent skilled scientists, who are recruited to positions in great institutions all around the world” molecules on their cell surface enable them to migrate through blood vessel walls and into inflammatory sites. All of these issues are investigated using cutting edge imaging technologies, such as the 4-dimensional confocal microscopy.” Dean for Research at Barts and The London School of Medicine and Dentistry, Professor Tom MacDonald, explains:
Nourshargh to Barts and The London.” Sussan, who relocated to Barts and The London from Imperial College, is adamant that part of her team’s success is due to staying focused. “We analyse a small but very important area; absolutely fundamental to immunity and to understanding the cause of inflammatory disorders.” This approach has established a strong niche and presence
L-R: Interaction of leukocytes (stained with an antibody directed against a neutrophil protein, MRP14; shown in white) with endothelial cells (stained with an antibody directed against a specific endothelial cell junctional molecule, PECAM-1; shown in red); leukocyte responses in a venule within an inflamed tissue as viewed by real-time imaging using brightfield microscopy; interaction of leukocytes (white) with the venular basement membrane (stained with an antibody directed against collagen IV; shown in blue); interaction of leukocytes (white) with pericytes (stained with an antibody directed against SMA; shown in red).
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School of Medicine and Dentistry news
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Image courtesy of Peter Mills
for Sussan and her team within the scientific community and group members frequently contribute to national and international conferences. “When somebody is required to talk about migration of leukocytes through blood vessel walls, we are probably one of three or four groups in the world who are approached.” Indeed, Sussan has been asked to become a Programme Committee member of the prestigious American Society of Investigative Pathology (ASIP). “I will be involved in planning the scientific meetings of the Society; in particular I will be responsible for symposia related to inflammation and vascular biology. It is quite an achievement to have a non-American on a Committee like this.” In her characteristically generous spirit, Sussan says, “I hope through this position I will be able to nominate lots of colleagues and collaborators within Barts and The London, and the British scientific community, as future conference speakers of the Society.” Sussan is adamant about some of the challenges that she and her team face. “Staying in touch with the developments in the field can be quite a challenge. With all the great technical and information technology advancements made in the last two decades, science is growing at a very fast pace. It is critical for us to stay in touch with the progress of other groups, we can learn from them to advance our own projects, often through highly fruitful collaborations. A good way of achieving this is to participate at conferences. You hear unpublished data and have out-of-session discussions with peers. Another important challenge of my role is to make sure that our work is novel and innovative; we’re always aiming to push the frontiers and to stay one step ahead of our competitors.” “I enjoy my work tremendously and a number of aspects of the job are really satisfying. For example, recruiting promising, young people, who are at an early stage in their career; lacking confidence and seeing them grow is a fantastic part of the job. Supervising PhD students is one of the greatest satisfactions I get. They arrive a little hesitant about what they are doing and leave as independent scientists, who are recruited to positions in great institutions all around the world. I am in touch with most of my past PhD students and know that they are doing very well. I am very proud of that.” The research productivity of Sussan’s team also plays an important part in her job
satisfaction. “Generating results and work that are acknowledged and respected by peers, especially at an international level, is very satisfying. I always try to take as many of my younger team members as I can with me when I go to conferences. Being praised for their work by international experts makes them realise how well they are doing and that our work is making a real contribution to advancing the field of inflammation. I am confident that our work will continue to contribute to the development of novel therapies.” The team comprises a diverse, international group of scientists. “That’s another thing I am very proud of. To have seven nationalities represented within a team of 10 scientists adds another layer of fun to the whole thing. They get on very well as they share many common interests and issues. It creates an extra bond, which filters down to how they help each other in the laboratory. My role is to guide and advise them, make sure they don’t go off track and to ensure they are not standing still. I am very proud of the strong team ethos of the group.” “I have had a fantastic time since joining Barts and The London. It is a great place
to work. It is so open, people are very friendly and it is very easy to initiate collaborations.” Sussan continues: “The leadership is absolutely fantastic: so accessible and supportive. It’s also very inspirational to see that heads of the Medical School are themselves so research active.” From an overall perspective Sussan believes that the Medical School’s investment in people is once again making Barts and The London one of the best medical schools in the country but also recognised at an international level. “The international community is really noting the fact that there are lots of fantastic scientists concentrated at Barts and The London. This is reflected well in the quality of our new recruits. We are now able to attract bright, promising, young people from the best academic establishments in the world. For example, I have recruited a new member of staff from the Max Planck Institute in Munich, one of the elite European centres. I know she had other offers of jobs in London and she chose us. It is a great credit to Barts and The London, the William Harvey Research Institute, and our group. I know my whole team are really happy to be here and feel part of a strong institution.” •
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Queen Mary news
Principal Thoughts Interview with Professor Simon Gaskell, new Principal of Queen Mary, University of London In his first few weeks as Principal of Queen Mary, Simon Gaskell is very clear about his ambitions for the College: within the next five years, he wants to see it in the very top group of research-focused higher education institutions; and he wants that achievement to be measured against clear quantitative criteria. “In the future, universities will be subjected to much more scrutiny than hitherto,” he says. “It will be less easy to get away with bland assertions about being ‘world-class’: here at Queen Mary, we need to decide what we mean by that in an objectively verifiable way that reflects our character as an institution.” Professor Gaskell arrives at Queen Mary following a varied career spanning periods working in senior roles in the United States as well as the UK; and in medical schools as well as science departments. His experience as Vice-President for Research at the University of Manchester gave him further opportunities to work with colleagues across all academic fields, including the humanities and social sciences. Indeed, one of the aspects of Queen Mary that attracted him was that “its success has been broad-based, its excellence in research and teaching representing real breadth, as well as depth across a wide range of subjects.” He intends to build on this in the coming
years, seeing cross-fertilisation between disciplines as key and for all areas of the College to learn from those that are “stunningly good.” “We need to exploit links between such areas as digital technologies and the physical sciences and the arts; social science and medicine; and explore the full potential of the quantitative underpinning of the life sciences.” Professor Gaskell sees other strengths at Queen Mary as foundations for the future: “The College has developed dramatically over the past 10 years and has managed to achieve a strong balance of academic excellence and an extremely friendly environment that makes some of the best people want to work here so their work can flourish.” However, he also feels that Queen Mary now needs to develop more of a distinctive niche, “to compete in a smart way” to face the challenges of the future and to “be more confident,” but above all to be clear about what is required to bring all parts of the College up to the standard of the best. He believes that it is essential to have a clear strategic vision to tackle the challenges of an increasingly competitive – not least financially demanding – environment and will be communicating the principles of the College’s new strategic plan over the coming weeks. “While I will be setting out a firm framework of principles for the plan,
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I also intend to communicate with staff and students directly as we develop it.” He wants to adopt a “visible and open” style and encourages colleagues to contact him directly. Reflecting on his career, Gaskell says two aspects have satisfied him most. “As a research chemist I have always enjoyed challenging boundaries,” he says, and believes important scientific discoveries depend on this. “Intellectual discomfort is an academic responsibility.” He is also very proud of the role he played in the merger between UMIST and the University of Manchester, co-chairing a group that eventually brought together their institutional cultures. “I was very pleased that at the end of the process, the governing bodies of the two institutions both voted almost unanimously for the merger, a big shift in attitude.” It showed, he believes, that far-reaching change can be made by “setting out a clear vision and agenda” while showing that “you are receptive to people’s views.” He intends to draw on his experience at Manchester in implementing the next phase of Queen Mary’s development. Simon Gaskell is enjoying the benefits of London during his first few weeks in his new role, “access to powerbrokers and journalists that just isn’t possible in Manchester,” while recognising the complexity and competitiveness that comes with the London environment. He is also enjoying exploring the capital’s arts and cultural attractions with his wife Deirdre, a Senior Child and Educational Psychologist. Their two adult children, both busy professionals, also live in London. He believes that one distinctive characteristic of the College that it could build upon further is another balance: between international excellence in research and teaching and a real commitment to Queen Mary’s east London environment, in which he sees no contradiction. “We should see this as an advantage, especially in relation to the School of Medicine and Dentistry, but also in respect of many other areas. Our new strategic plan will make this clearer.” Although he was involved in developing the link between Manchester’s civic responsibilities and its academic mission “the London environment is more complex, rewarding and challenging.” •
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Queen Mary news
New Chairman of College Council In January 2009, the College announced the appointment of Sir Nicholas Montagu to succeed Dr Colette Bowe as the new Chairman of College Council. He took over from Dr Bowe in August, and talked to BLC about the job For Nick Montagu, Queen Mary is a return to his academic roots. After reading classics, ancient history and philosophy at New College, Oxford, he taught philosophy at Reading University for seven years. By his own account he wasn’t a true academic – “too lazy to get on with my research” – and left Reading for the Civil Service in 1974. Over 30 years Nick worked, under both Conservative and Labour administrations, on some of the most prominent issues of the day: pensions, rail privatisation and public service reform. He was in the Cabinet Office for both the change from Labour to Conservative in 1979 and the change back to New Labour in 1997. In July 1997, Nick became Chairman of the Board of the Inland Revenue, leading the Department through the greatest changes in its 200-year history, transforming it into a Department that treated taxpayers like customers and taking over responsibility for what had previously been social security benefits. He is quick to point out that he isn’t a tax person – “I went there knowing nothing about tax, and I left knowing nothing about tax: running the place was a full-time job.”
Retiring in 2004, Nick has since then built up a portfolio of paid and unpaid work, with Queen Mary taking up by far the greatest part of his tome. His enthusiasm for the College is infectious: he describes it and its achievements as “fantastic”; “stunning”; and a “community with the right values.” Asked why he decided to accept the offer to become the new Chairman, he says: “It is just such an exciting time to be at Queen Mary. It is a tremendous place that has gone far and has the potential to go further: taking over from Colette at the same time as the arrival of an outstanding new Principal gives me the chance to be part of that progress. It is an irresistible challenge!” But he adds a cautionary note, “I think they undersold just what the time commitment would be.” Nick Montagu has tried to visit as many departments as possible in the College, meeting academics, students and support staff, learning about their roles and aspirations, as well as their frustrations. He describes his style as “open and participative, with no hidden agendas.” He likes to “create groups that work together” but that will also “put a stake in the ground.” There are
challenges and engagements at every level: a key one is supporting Simon Gaskell in “reinforcing the College’s stellar performance in the RAE.” On his visits to Barts and The London School of Medicine and Dentistry, Nick saw “terrific things going on there, as well as big issues on its development and future direction, which will have to be on our agenda.” He recognises, for example, the opportunities offered by working with the Barts and The London NHS Trust and the Olympic Delivery Authority on the Olympic legacy. Nick was also at pains to stress his commitment to our alumni and keeping them in touch with what is going on at Queen Mary. He hopes to meet many of them at the College events he will be attending in the future.
Peter Morris new Trust Chief Executive In October, Barts and The London NHS Trust announced the appointment of Peter Morris as Chief Executive Peter joined the Trust as interim Chief Executive in March this year, replacing Julian Nettel. He has now been appointed substantively to the role. Peter, who was awarded an OBE in 2008 for services to healthcare, joined the NHS in 1979. Before coming to Barts and The London, he was Chief Executive of University Hospitals South Manchester NHS Foundation Trust (UHSM) from 2002. Following his appointment, Peter said: “I am absolutely delighted about my appointment.
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This organisation has a long history and an international reputation for clinical excellence, innovation and research, and has tremendous potential for building on this strong platform.” “With our £1 billion new hospitals’ programme taking shape, and our world-class Cancer Centre at Barts Hospital opening in Spring 2010, this is an exciting time to be at the helm.” He added: “I look forward to working closely with my colleagues at Barts and The London and our academic and healthcare partners so we can continue to build on our reputation.”
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An interview with Professor Tim Oliver
An unquenchable thirst Professor Tim Oliver spoke to BLC about his career, his family, dysgraphia and taking too much on “I have often been accused of being a dilettante,” says Tim Oliver, Emeritus Professor in Medical Oncology at Barts and The London, retired consultant oncologist and alumnus of The London. “I have a wide range of interests and since I retired from my NHS work, they seem to be growing rather than shrinking.” He has numerous projects on the go, including developing a palm held handwriting machine for doctors; raising support for a British Olympian for 2012; conducting research to determine the link between exercise, Vitamin D and cancer; and campaigning for sustainable electricity-generation in East London using its water canals; not to mention continuing to treat many of his patients. Not surprisingly he is a busy man. Tim Oliver grew up in Norfolk. Both his father (Tom Oliver, who also qualified at The London in 1936) and his grandfather were general practitioners. “I never envisaged doing medicine; I always wanted to do something different from them.” So, when asked how he came to study medicine at Cambridge and The London, Tim modestly replies, “Carpe Diem and a series of chances.” “I was a mediocre student at school,” he explains. “I had atrocious, illegible handwriting and that was one of my biggest problems. But, at A-Level, we had a new chemistry teacher who had worked in industry and I suddenly woke up. He just made it so interesting and I became top of the class; it didn’t require any written work and I just understood it. At the time Cambridge couldn’t offer me a place to study chemical engineering but fewer people wanted to be a doctor. As I had a medical background they asked if I would do medicine. Having done work experience in a big pharma-chemical plant, I accepted
that medicine might be a way of expanding my interest and said yes.” Achieving what he describes as “nothing very startling” at St John’s, Tim was really only interested in anatomy. “I loved dissecting. I could spend hours working on little nerves and things.” Having completed his pre-clinical at Cambridge, Tim chose The London, following in his father’s footsteps, for his clinical training. It was not until then that something really clicked. “I just loved it there.” On qualifying in 1966 Tim became a house physician in general medicine and cardiology under Wallace Brigden, amongst others. His mentorship of Tim was clearly extremely valuable. After a year’s general practice, Tim began groundbreaking work with Hilliard Festenstein on renal transplantation as part of an MRC Junior Research Fellowship in the newly formed Transplantation Immunology Unit at The London, for which Brigden had recommended him. His “quirky” mind gave him a unique insight and understanding of the complex newly emerging area of HLA tissue grouping and the implications for renal graft rejection. For a period in the 1970s the team at The London led the field in matching kidneys for HLA in the UK and Europe. While working in this pioneering unit at The Royal London, Tim explains, “I became aware that kidney patients were developing cancer because of the drugs used to suppress the immune system. It was then that Tim developed his interest in cancer. “Barts had just reported the results of the first trial vaccinating leukaemia patients and were expanding their team. I became involved in laboratory and clinical work and eventually became a consultant.” Devastatingly Tim’s mentor and boss,
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Gordon Hamilton Fairley, was killed by an IRA bomb. This meant the end of Tim’s employment at Barts too. Forced to look elsewhere for work, Tim says, “Fortunately John Blandy, Jim Malpas and Harold Hope-Stone rescued me. New research suggested that chemotherapy might benefit urological cancers.” Working in this area was a perfect fit for Tim. “I fell on my feet again. It was all just by chance. We helped to establish Medical Oncology at the Institute of Urology in 1977.” Tim became the first person in the UK to specialise in the medical management of urological malignancy. He ran a major service for treatment of these tumours, while undertaking a programme of clinical research in testicular cancer. During that time testicular cancer had become curable. “I suppose I made some contribution to the progress; I learnt how to use the drugs quicker than most people and was able to simplify the treatment so more patients benefitted.” In 1984 the Institute of Urology moved to The London. Tim has travelled extensively throughout his career, attending conferences and sharing expertise with peers from his field. In 1986 he first presented controversial data on minimal chemotherapy treatment of seminoma to a conference in Jerusalem, which ultimately led to the replacement of radiotherapy for this tumour. After the conference Tim enjoyed a family holiday in the Sinai Desert. “We climbed throughout the night to avoid the heat, so as to arrive to see the sunrise from the top of Mount Sinai. To this day my fondest memory of this trip was finding an almond tree bearing fruit. We added them to our breakfast at the top.” Following the merger of Barts and The Royal London, the funding for research worsened during the recession of the 1990s. Tim’s work was severely affected. It was then that the charity Orchid, which aims to save the lives of men who have testicular, prostate and penile cancers
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An interview with Professor Tim Oliver
portrait by john blandy
Self-confessed dilettante, Tim Oliver has been working with school children in East London to begin to address the health benefits of exercise and sunshine
An interview with Professor Tim Oliver
through pioneering research and promoting awareness, was established. “It was founded by an amazing man, Colin Osborn, a patient who, hearing of my plight whilst extremely ill in intensive care, promised that if he was cured he would raise me some money. During the last 10 years he has raised about £10 million which has supported my work,” smiles Tim. Orchid continues to support three major research teams at Barts following Tim’s retirement in 2006. Since then Tim has still continued to treat many patients; many are men from the UK who have read about his work and sought his help; others come from further afield. Another cause that Tim is championing in his retirement is rapidly developing into a second career. “With the Olympics coming to East London, I am trying to get a wider recognition of the health benefits of exercise,” he explains. New data, which became available in the early 1990s and which has subsequently been verified, shows that a lifetime of regular exercise prevented more different types of cancer than screening. Tim has researched this more thoroughly and has discovered that this evidence is confounded by the presence of sunshine. “Most exercise is done outside and skin when exposed to sunshine, manufactures Vitamin D.” There is an increasing number of cancers that have been shown to be less frequent in those whose lifestyle results in exposure to higher than average amounts of sunshine. “So, the question is, is it exercise that is good for you, or sunshine, or do the two synergise? It’s the burning of the skin that causes cancer. That’s the stupidity of lying out in the sun all day. The latest data suggests that enough Vitamin D is produced after just 15 to 30 minutes sunshine on the hands and face.” Tim has been working with school children in East London to begin to address the health benefits of exercise and sunshine. “I have fitness data on about 1,200 kids from East London. We are testing their fitness in the winter and the summer to see if it changes. The challenge is then to relate the data to cancer at the age of 60 or 70.” The key finding from Tim’s work on prostate cancer is that the PSA test (prostate specific antigen) becomes raised some 40 years before the prostrate cancer which actually kills you becomes apparent.” Tim’s daughter Cleo, during her time as a medical student on her elective, collected data from young gold miners in South Africa.
This has given rise to the still controversial idea that prostate cancer could be due to inflammation that is set up in the prostate from early puberty. More recently Tim is trying to encourage staff and students of Queen Mary to support a sabbatical year for a promising athlete for London’s 2012 Olympics. “I got the idea from the film Chariots of Fire. I think we should have our own champion. I am in discussion with the student fundraising committee. The idea is to organise a mass fun run to raise the most money and to achieve the best performance. We will see who is the fittest! Funds raised will be used to sponsor a sabbatical year for Queen Mary’s best hope for 2012!”
A final hobby-horse that Tim continues to champion is the development of a keyboard to speed up writing on palm-top computers. “I hated writing at school. I have since learnt that it was due to a form of dyslexia, called dysgraphia, thought to be a genetic disability. He heard about the QUINKEY keyboard, a hand-held portable computer. It has five keys for the fingers and thumb of one hand. “You make a picture of each letter. It is twice as fast as handwriting and even faster with predictive text,” Tim explains. “Since 1982 I have been trying to get it into medical practice.” • For more information about the work of Orchid, the men’s cancer charity, visit www.orchid-cancer.org.uk.
Professor Tim Oliver has an unquenchable thirst for improving the lives of those around him, be they cancer patients; dyslexics; TB sufferers; athletes. His enthusiasm and exuberance for life is refreshing and energising. Being a dilettante is surely no bad thing.
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A Teacher Remembered
Geoffrey Bourne (1893 – 1970)
Professor James Malpas pays tribute to Barts’ physician Geoffrey Bourne
If the horseshoe wrapped itself round the pin it scored a ‘ringer.’ Bourne became a founder member of the ‘Horseshoe Club’ which brought physicians from the United States and Great Britain together. On his appointment at Barts he pioneered Geoffrey Bourne was appointed assistant electrocardiography. The leads for the ECG physician to Barts in 1930 and promoted were applied to the patient’s arms and feet, to physician in 1940. His interest in which were in bowls of water, and then cardiology was rewarded with his being passed down to the operator in the given charge of the newly created basement where they were plugged in Department of Cardiology but, as he to heavy immovable apparatus. Geoffrey’s remarked in his autobiography, that meant technician Joe Board would telephone down he was in charge of himself as there were to where Geoffrey waited in the basement by no other physicians in the Department. Geoffrey was a tall, elegant and courteous the apparatus, letting him know the patient was ready, the power was then switched on man. His modesty hid the fact that as a and a tracing would be made. When the student he had been awarded almost every prize that was open to him and he had been tracing was complete Board would take appointed a consultant physician to Shadwell the leads to another bed-ridden patient. I was Geoffrey’s house physician towards Children’s Hospital at the age of 27. the end of his career when, thank goodness, He must have been one of the earliest ECGs were much easier to take as the physicians at Barts to have obtained apparatus was on a trolley. His ward rounds a BTA or ‘Been to America.’ In 1926 were unhurried and conducted in near he was awarded a Rockefeller Travelling silence. He asked that all radios should be Scholarship, working with Paul White in turned off (it was well before televisions were Boston and Joseph Erlanger in St Louis. When he was in St Louis he was introduced allowed) and that the ward would be as quiet as possible. This was because he examined to a game in which smoothed horseshoes his patients’ hearts with meticulous care. He were thrown at an iron pin in the ground. had excellent hearing and could hear heart murmurs that I, for one, could not. One spring afternoon after listening to a patient’s heart he looked up and said “that must be a blackbird.” It startled me somewhat wondering where he had heard the sound; surely not in the patient’s chest! Then I listened and very faintly through the open ward window came the sound of the first spring blackbird Dr Geoffrey Bourne Medical Illustration Department, in the plane trees Barts and The London NHS Trust in the Square.
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Geoffrey was a good teacher. He liked teaching in small groups. One day Gordon Fairley and I were sitting in the little room that he used when he screened patients’ hearts. Sister brought in a fit looking young man. Geoffrey took a history and then the patient’s blood pressure, which was high. Suddenly to our surprise and the young man’s, Geoffrey leapt up and plunged his hand down the front of the young man’s trousers. “As I thought,” he said, “coarctation of the aorta; the femoral pulses are only just palpable.” We were most impressed. He wrote a very good small book entitled An Introduction to Cardiology. What the modern medical student would make of the description of the murmur of patent ductus arteriosus as “being reminiscent of the Scottish Express running downhill in the tunnel outside King’s Cross with the brakes off,” I don’t know, but we knew then what he meant. He had a good sense of humour. Each Christmas the House staff would put on a show. Inevitably members of the consulting staff were made fun of. I remember one of us was primed when Bourne’s name was mentioned to call out, “Is that the bourn from whom no traveller returns” – an oblique reference to Geoffrey’s private practice from overseas. We believe he took it in good part. Sadly Geoffrey’s first wife died of hypertension. His second wife was a charming hostess and I was privileged to go to their home which was then in Harley House. I was always impressed by the watercolour paintings in the drawing room and asked who they were by. He quietly said that he had painted them. Many of his contemporaries on reaching retirement indulged in highly emotional “last ward rounds.” Characteristically he avoided what he described as the “metaphorical funeral pyre” of his last round at Barts by letting nobody know he was leaving. He put on his raincoat at the end of the afternoon and walked down to the Square. While he was crossing it, his students, who had somehow got to know, stopped him and gave him a bouquet. He was delighted. • Professor James Malpas q Oxford/Barts, 1955
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BATLAA feature
A Student at Barts
Seventy years ago 20 | Barts and The London Chronicle | Autumn / Winter 2009
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BATLAA feature
The late Richard Harrison who qualified from Barts in 1944, described his medical training during the disjointed and heady days of the Second World War. This is an edited version, the full and illustrated text can be found at www.batlaa.org How many doctors can claim that the reading of a book during adolescence determined their future career path? At the tender age of 13, I read The Elephant Man and Other Reminiscences by Sir Frederick Treves. That a young schoolboy could understand the book, and be so impressed by it, says a great deal about how simply and dramatically it was written. In my view it remains the best volume of surgical memoirs ever published, and I renew my acquaintance with it every few years. I turned 17 in the summer of 1939, after poring over the brochures issued by London’s teaching hospitals with my father; we decided Barts would be entrusted with my training, mainly because my mother had been successfully treated there. Of the day I went up to be interviewed I remember just two things; being interviewed by Charles Harris, Dean of the Medical College and a huge poster, covering the wall of the building nearest to the Old Bailey, which proclaimed Barts was the “Mother Hospital of the Empire.” In the end it was four years before I was taught in the actual “Mother Hospital” itself. With the outbreak of war the pre-clinical departments at Barts moved to Cambridge. Anatomy, biochemistry and physiology shared the university’s facilities, while the biology, chemistry and physics departments were accommodated in The Leys School. The London Hospital Medical School was also evacuated to Cambridge, but the only teachers we shared were the professors of anatomy, Messrs. Hamilton and Boyd. The former, from Barts, was sometimes difficult to follow, having a dense, voluble Scots accent. Boyd, on the other hand, often evinced a gift for style and rhetoric his counterpart never matched. Cambridge in wartime was a sombre, not very sociable place. Barts was at the university, but not truly of it. Our military service was deferred for only as long as we continued to satisfy our examiners, so there was a purposeful air about us, and most of us studied hard. Certainly for me that “First Examination for Medical and Veterinary Degrees” was more daunting than any other I ever sat, more so even than the Final Fellowship.
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In part this was because, though I found biology and chemistry relatively easy, I had no aptitude for the mathematics which physics entailed. What also made the first year’s study less congenial than any which followed was that the syllabus had only a tangential bearing on medicine and surgery. From the week I arrived in Cambridge I began to haunt, however prematurely, the Pathology Museum in Tennis Court Road and even during my first term succeeded in gaining entry to Addenbrooke’s Hospital. There I ran errands, was allowed to hold bowls or instrument trays and, occasionally, even recalcitrant patients. Looking back what surprises me was the unfailing toleration of all the staff. Nobody was ever too busy to explain what he or she was doing, or to impart some useful information. Throughout my two and a half years at Cambridge I spent some part of each
weekend in the Casualty Department. There were not many air raid victims (I saw those later) but patients in plenty were provided by the live-ammunition exercises going on all over the area. The town was ringed by the airfields of Bomber Command, Waterbeach, Oakington, etc, which became familiar because our most gravely injured cases, still wearing Sidcot jackets and flying boots, arrived in RAF ambulances. What made the long apprenticeship tolerable was that as it went on it became steadily more interesting. Just when I felt I could not face another dogfish, or cope with any more Volumetric Analysis, success at the 1st MB promoted me to an altogether different realm – that of physiology, biochemistry, pharmacology and human anatomy. We were required to dissect, in considerable detail, the whole of the body. Medical students today pass almost seamlessly from learning about normal function and structure to being taught what happens when those are deranged. In my day once the “2nd MB” was over, we suddenly switched from an academic environment to the intensely practical world of the ward and operating theatre. During
Above: Professor AM Boyd with a male bed-patient on a ward round, 1936-39 Left: Bomb damage to the Medical Lecture Theatre, 1940
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BATLAA feature
JEA O’Connell and Harold Wilson in theatre clothing, 1936–39
the war that change was the more intense because it was accompanied by a move to the sector hospitals. First to Hill End, outside St Albans, then to Friern Barnet, and finally to Barts itself. During this time we were trained by the last of the great clinicians, the men who worked, as the word means, at the bedside. They depended on punctilious history taking, meticulous examination and their personal experience. The x-rays which assisted them were rudimentary by modern standards. They could not ask for a complete biochemical or haematological profile of a patient, because each and every laboratory investigation demanded much time and expertise. These were such physicians as Geoffrey Evans and Geoffrey Bourne, such surgeons as John Hosford and Professor (later Sir) John Paterson Ross. Nobody else impressed me as much as the neurosurgeon JEA O’Connell. It was he who, on our very first morning at Hill End, introduced us to case taking. He had chosen his patient with the care that characterised everything he said or did. She was a schoolgirl, an air raid casualty,
Dr George Graham and Dr Geoffrey Evans with others, 1936–39
with an incomplete spinal transaction. The methodical and thorough way in which he elicited her story and symptoms, before demonstrating her physical sign, was something I shall never forget. I realised instinctively that I was being shown the procedure by a master, and had been provided with an example I should always try to match. St Bartholomew’s has always had a reputation as a conservative hospital,
The only time I ever performed vaccinations in earnest was three years later, after encountering a case of smallpox – myself first, and then a thousand civilians and service personnel. We also went, whilst at Barts, once a week for a month, to the London Fever Hospital. There I saw children moribund with diphtheria, though most who contracted the disease were saved by antitoxin. As we walked down a ward filled with those convalescing from it, each child
Medical students today pass almost seamlessly from learning about normal function and structure to being taught what happens when those are deranged. In my day once the “2nd MB” was over we suddenly switched from an academic environment to the intensely practical world of the ward and operating theatre but it was just in an historical context that we were shown dry-cupping, and the jar of leeches kept in the dispensary. Mine must have been the last generation who were taught how to write a prescription in Latin. In our fifth year, after a few short lectures and practicing on each other, we were given certificates as Public Vaccinators.
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shouted “Plum pudding,” to prove he or she had no palatal paralysis. German measles was a topic reserved for our fourth and final day, for the very good reason that any of us who had not already had the disease would develop it three weeks later. I am sure that for the majority of us the most memorable part of our training was
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BATLAA feature
all photographs Courtesy of St Bartholomew’s Hospital Archives
Professor Sir James Paterson Ross at a bedside, 1936–39
that spent “on the district.” Women from the surrounding area coming to the Barts ante-natal clinic, and pregnant for the first time, were booked for delivery in the City of London Maternity Hospital at the Angel. Students lived there for as long as it took them to assist at half a dozen confinements. I was so fortunate as to be allowed to deliver what were thought to be twins. After the first had been born, I said “I think there’s another baby.” The reaction of all around was much like that portrayed in HM Bateman’s cartoon The Guardsman who Dropped his Rifle, and a midwife immediately took my place. But I was right, and next day it was I who signed the petition to Buckingham Palace, asking for the royal bounty. By the autumn of 1944 I had completed the minimum period of study required before one could sit the Final MBBS exam. I decided to attempt all three parts (Medicine, Surgery, Obstetrics and Gynaecology) together. My friends thought this over-ambitious and foolhardy. As regards medicine and surgery it was along conventional lines but, to ready myself for obstetrics, I bought a little paper-backed
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book of specimen questions and answers. I took this with me on the two nights each week when I slept at a First Aid Post. There, whilst I was leafing through it, a young Red Cross nurse asked whether it would help if she read out the questions to me. Accepting her offer meant I had to explain my answers and the terminology. We were amused at the mystification of the rest of the staff when, one morning over coffee, I casually asked her, “What would make you suspect a placenta praevia?” and she promptly told me. By the time my actual viva was due she would have been able to acquit herself at it quite creditably. Confronted by two real examiners, my principal difficulty was not thinking what to say, but remembering I was not saying it to Patricia. Not all the Finals were quite so easy. Once they were over, feeling I deserved a rest, I went with my fiancée, Joyce, to her parent’s home. A friend who reported the results from the Examination Office at South Kensington told me I had a Special Distinction in Obstetrics and Gynaecology. But my number did not appear in the Pass List for either Medicine or Surgery. He was
not surprised. Nor, truth to tell, was I. What he had not realised was that the numbers of the candidates who had been awarded an Honours degree were posted separately, on a different notice-board. I was a qualified doctor for a week before I knew it. By then the house appointments at Barts had been allocated, so my first job was not there, but at the Royal Cancer Hospital. • Richard Harrison went on to become a squadron medical officer in the RAF and, having been admitted a Fellow of the Royal College of Surgeons, a Senior Registrar at the Royal Free Hospital. From 1952 to 1965 he commanded a Parachute Surgical Team in the Territorial Army and, in 1963, was appointed a Consultant in Orthopaedic and Accident Surgery to the SW Cumbria Health Authority, a post he held for 25 years. During retirement he was engaged in medico-legal work.
Sadly Richard passed away on 6 December 2009. He leaves his wife Joyce and their two sons.
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BATLAA feature
Freshers from the Fens and the upper reaches of the River Thames Barts and The London Cambridge and Oxford Graduates’ Club is the successor in title of the Cambridge Graduates’ Club of St Bartholomew’s Hospital, a Club founded in 1876 for the express purpose of welcoming each new generation of medical ‘undergraduates’ (Bachelors of Arts in statu pupillari), arriving from the University of Cambridge. Professor Chris Hudson (q Cambridge/Barts, 1955) and Marcus Setchell (q Cambridge/ Barts, 1967) reveal the history of the Club The tradition of welcoming new students to Barts was time honoured, going back to the welcome organised by Wilkinson, a Cambridge graduate, for William Harvey. The inaugural session in 1876 was organised by James Shuter (of the eponymous entrance scholarship) to enable the Cambridge graduates in ‘residence’ (staff and students) to meet and welcome the new entry. This was a success and led to an annual event in the winter session held in sundry venues around London, commonly with post-prandial entertainment in the rooms of one of the Senior Staff, often Dr Morley Fletcher. This was usually musical with a piano, violin and songs. The doyen of the Club soon became Dr (later Sir) Norman Moore, who wrote a definitive two-volume history of the Hospital. It seems likely that he was the initiator of the ritual of The Hairy Rauchie (or Rowky), an extremely lengthy ballad. When the traditional West End after-dinner reception ceased, the ballad was recited at the dinner; only in the 1950s was the recital consigned to a small coterie after the close of the formal dinner. The Club remains very unusual in having no written constitution and no membership fee. At first, there was a Convenor and a President for the day; latterly a Senior and Junior Secretary (with eventually a Lady Secretary), and a different Chairman for each Annual Dinner.
The Secretaries include some famous names such as Russell Vick and RB Etherington Smith (Ethel), a very distinguished CUBC President who died in office of a nosocomial infection and in whose memory, a small ward was endowed at Barts for sick housemen. ‘Ethel’ won the Grand Challenge Cup at Henley as Captain of Leander; the magnificent cup being displayed at the subsequent Club dinner. (This double, CUBC Presidency and Grand Cup winner, was actually repeated by RG Nicholson as a clinical student in 1963). The Club’s activities were suspended during both world wars, and, after the Second World War, H Jackson Burrows was a long serving Senior Secretary, succeeded by his Junior Secretary RA (Reggie) Shooter, probably the longest holder of the office, and later Dean of the Medical School. Over the years, the Chairmen have included five Heads of Cambridge colleges, among whom A Hill (Downing) was also Vice-Chancellor, the most recent being Lord Adrian (Trinity). Two Regius Professors of Physics have also been Chairmen: Sir Humphrey Rolleson in 1926, and W Langdon Brown in 1933. Also, Sir Harold Gillies (a former rowing blue), Sir Geoffrey Keynes and, more recently, HB (Henry) Stallard of Chariots of Fire fame. Guests were allowed in 1894. The first recorded guest from ‘the other place’
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was the surgeon W Bruce Clarke. The “Bruiser,” as he was known, replied for the guests in 1902. Over the years, the numbers attending the dinner rose to some 120, with around 50 attending the 50th dinner held in the Mayfair Hotel in 1930. Later, one of the more prominent guests was Lord Horder, who so enjoyed the party he continued to attend uninvited thereafter every year, a de facto situation accepted by the Secretaries! In gratitude, he presented the Club with a Loving Cup (now in the Barts Archives together with the Club’s snuff box). The Second World War saw both the Barts and The London’s pre-clinical schools evacuated to Cambridge; an event commemorated by the establishment of the Rahere Studentship. The Club re-established itself in 1948 under the Chairmanship of Reginald Vick, largely due to the efforts of Rupert Corbett. At some time, membership was also opened to doctors who had qualified in Cambridge, and subsequently worked at Barts. The arrival of women medical students inevitably included a cohort from Cambridge. There was much soul searching and it was agreed that there should be a welcome cocktail party in the library for all students in the winter session, and that the “all male” dinner should continue on the Wednesday after View Day. This was fine until the Cambridge women began to qualify. Eventually, they were asked if they wished to become full members of the Club, there being no written constitution which might have prevented this. The women doctors replied that they would wish to be so, but would not exercise their right to attend the dinner until a specific invitation was issued. This must have left them on the moral high ground, but the open invitation did not materialise until 1971, when the occasion was marked by the presence of the Mistress of Girton College as Club guest.
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BATLAA feature
The Duke and Duchess of Gloucester with Mr and Mrs William Shand in 1992
Since then there have been two splendid occasions. The hundredth dinner was held on 11 July 1992. The Secretaries, recognising the historic significance of the Club’s survival for well over 100 years, were determined to make it a very special celebration and agreed that William Shand, the long serving Senior Secretary, should be Chairman. HRH The Duke of Goucester (as President of St Bartholomew’s Hospital and a Cambridge graduate from Magdelene College) was invited to be the Principal Guest with many other distinguished guests. The oldest member present, Dr Percy Hancock-Thompson had gone up to Cambridge 71 years earlier! A new Club silk tie with stripes of Cambridge Blue rather than silver, was designed. A commemorative bone china mug was also produced, many of which are still in use. Fine red velvet chairs were hired for the 240 guests, and the Great Hall was filled to capacity, with a Top Table for 42 guests. The Duke of Gloucester gave the Guest Speech, and was presented with a Club Tie; while the Duchess received a set of commemorative mugs. After this splendid occasion, there was rather a decline in attendance. However, an even grander celebration soon followed
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when Mr (later Sir) John Chalstrey was elected Lord Mayor of London, the first medical man to hold this position for more than two centuries. His occupancy of Mansion House enabled us to hold the Annual Dinner there in 1995. The Duke of Gloucester was invited to attend again. This somewhat complicated the planning because, in the City of London, the Lord Mayor has precedence over the Royal Family, necessitating dual approval of all the arrangements. However Mansion House welcomed almost 300 people. A number of recent complicating factors has jeopardised the Club. The opening of the Clinical School of Medicine at Addenbrooke’s Hospital reduced the intake coming to London for clinical experience, and for a time such students were obliged to get their medical qualification as a London degree, albeit with a BA (Cantab). The newly formed Barts Alumni Association then decided to hold an annual dinner on View Day, one week before the traditional date of the Cambridge Dinner. For this reason a move of the Cambridge Dinner to November was tried. The merger of Barts Medical College with The London introduced a further problem. Although the Royal London had for many
years had a similar intake of Cambridge students, it had no equivalent Club. The Secretaries decided wholeheartedly to embrace the change, re-name the Club as the Cambridge Graduates’ Club of Barts and The London, track down as many Cambridge/London graduates as possible and invite them to join this unique Club, and one, moreover, with no subscription! The secretaryship was expanded to have two London Honorary Secretaries, as well as the two from Barts. Soon after the creation of the new Club, a Dinner was held at the Royal London. However, more negative forces were at hand. The Alumni Associations of the two Medical Colleges had amalgamated to form BATLAA, with The London Hospital Dental Club. Their main event was to be a Dinner and Dance in the Drapers’ Hall in November, yet again squeezing the newly expanded Cambridge Club. In 1999, Marcus Setchell, who had been Secretary for 20 years became Chairman for the Dinner, but numbers attending were down to no more than 60. It was hoped that with the new secretaries there would be a resurgence of interest, but for a few years no dinners at all were held! The problem of sustaining numbers has also affected BATLAA and it has been decided that the Drapers’ Hall event will be held in alternate years, with an occasional regional event in the intervening years (Queens’ hosted the 60th anniversary of the pre-clinicals’ return in 2005). With the Barts Fountain Club establishing a View Day dinner in a City Livery Hall, this has led the Secretaries to decide that this Club’s dinner should likewise be in November in alternate years. The relationship with graduates of ‘the other place’ has, since the Bruiser’s day, always been cordial, with an open invitation. In recent years the reduced intake from ‘grey stone’, has encouraged a more formalised Oxonian participation. The really important thing is that the Club has gone back to its founding purpose with a regular welcome party for both Oxford and Cambridge “Freshers” in the Senior Staff Common Room, hosted by staff members from both universities, and attended also by current students. It is to be hoped that the new structure and timetable of events will ensure that the Club will flourish for at least another century. The present Secretaries are Dan Berney (Jesus), Pathology and Professor Kate Costeloe CBE (Girton), Homerton. •
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Dental Electives
Elective experiences – Dentistry students Students of Barts and The London School of Medicine and Dentistry are supported by funding from BATLAA to go on elective studies overseas During 2008-09, some 45 students were supported by BATLAA grants. Elective studies are undertaken by medical students in their fifth year and dental students in their fourth year. Electives offer an excellent opportunity
for students to gain experience, compare and contrast global healthcare systems and strengthen transcultural communication and understanding, an integral objective of the MBBS and the BDS courses.
Five Dental students visited the Tsurumi University Dental Hospital in Yokohama. Two student accounts are published.
a significant difference. The Japanese restorative approach is to preserve every part of sound tooth tissue, however small. Although British dentistry employs the same philosophy, the routine techniques used in Japan have rendered the conservative aspect of their restorative dental procedures far superior. From the perspective of preserving tooth tissue, amalgam is not such an ideal restorative material. Such restorations require cavity preparations such as undercuts, and occasionally slots and grooves to provide retention; sound tooth tissue must be sacrificed to prepare the cavity for the compound. To avoid this problem, the Japanese prefer to restore larger cavities with indirect cast restorations; for example inlays, onlays or crown restorations. To ensure complete caries removal whilst maximising preservation of healthy tooth tissue, cavities are checked with a caries-detecting dye. Rather than using gold cast restorations, the Japanese have created a cheaper alloy, a mixture of gold and other metals. Named Kimpara, the alloy is composed from gold (12 per cent), silver and palladium. It is believed to have very good properties for tooth restoration, even on a par with gold, but at a lower cost. A gold restoration would typically cost around US$300, whereas a Kimpara restoration is one tenth of the price. Japan is a country of incredible beauty and endless excitement. The scenery is enchanting and varied, with ancient Buddhist temples within a stone’s throw of some of the world’s tallest skyscrapers. However, the sheer hospitality of our hosts impressed me more than anything else during this elective. Visiting Tsurumi has definitely been one of my finest experiences during my time at university.”
Jack Kwong writes: “Having always found restorative dentistry to be the most rewarding part of our curriculum, I chose to attach myself to the Restorative Department of Tsurumi University of Dentistry. I have been fortunate to visit Japan with my parents on several occasions. In the last couple of years I have met dental students from Japan during their elective placements at Barts and The London and have established friendships where many of them offered me the opportunity to visit them in their home country. My aim was to compare the literature, dental theory and clinical aspects employed at Tsurumi University of Dentistry with those taught at Barts and The London.
Barts and The London Dental students join the locals in Yokohama, Japan
I was particularly keen to see alternative restoration materials than dental amalgam. Amalgam is the most popular restoration material used in the UK. I was therefore surprised to learn that Japan, a country which has performed so much research on dental materials, has a very different opinion of dental amalgam. During my two weeks in Japan I noticed
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Zain Shamoon also experienced the excitement of Japan: “During my two-week elective I mainly observed in the Oral Surgery Department. This experience has given me a different perspective on how Exodontia is practised in Japan compared to at Barts and The London. I was well looked after all the time by my supervisors Dr Nakagawa and Dr Asada, both of whom made me feel very welcome. Dentistry in Japan is a six-year degree programme and the students I met were in their fifth year. However, they were not allowed to carry out any treatment on patients and were observing just like me. This illustrated how much theory and phantom head work Japanese dental students are taught before actually treating real patients. Patients at the Dental Hospital also have to pay for their treatment just as they would if they were treated outside by a GDP. The differences in treatment I observed included the frequent use of the surgical extraction technique, where a flap and suture procedure was used for most extractions. I also noticed that they prefered to use black silk, rather than Vicryl suturing materials, and of a slightly thinner dimension. The needle used in suturing was also different, having an eye in its tail through which the thread was passed manually before passing through the tissues. Once through the tissues, the needle is released from the thread, placed aside and a knot is tied using both hands without any instruments. My wonderful experience in Japan will stay with me for the rest of my life. I would like to thank BATLAA for helping to fund my elective.”
Dr Nakagawa and Zain Shamoon at the Tsurami University of Dentistry, Japan
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Dental Electives
Several students took the opportunity to visit the University of San Paulo in Brazil during their dentistry electives Minesh Patel wrote: “The 2008 summer elective presented me with the opportunity to visit and explore Brazil and the diversities it has to offer. A two-week visit to the University of Sao Paulo allowed me to gain a deep insight into the similarities and differences in the undergraduate training of dentists in Brazil compared to that in the UK. The elective also provided us with the opportunity to visit some very popular destinations in Brazil, including the fabulous Iguassu Falls as well as the depths of the Amazon jungle in Manaus. Sao Paulo offered its fair share of sights, the towering skyscrapers and nightlife are worthy of note. The University of Sao Paulo (USP) had an air of professionalism and beauty; especially in the Endodontics Department. USP is known for its pioneering use of laser treatment incorporating all aspects of dentistry, especially endodontics. I myself am a keen endodontist; my elective project proposal being based on laser endo. Endodontics is a difficult discipline, requiring meticulous canal debridgement, shaping and cleansing to be effective. Techniques that can amplify the success of canal disinfection are an asset to dentistry and should be incorporated into general practice. USP uses both high- and lowpowered lasers for canal disinfection. Methyl blue is used as a medium to attach to bacteria and destroy it in the presence of red laser. This produces the desired effect of making canals bacteria free prior to obturation. This technique is highly effective resulting in the university’s long term success rates for root treatment. However, we were also able to observe and use lasers for both soft tissue cutting (fraenectomies) and hard tissue cutting (caries removal). I am thankful to the Trustees of the Barts and The London Alumni Association and also to the staff and students at USP for making my elective the most memorable part of my dental degree.”
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Craig Hughes also visited the University of San Paulo: Criag’s elective proposal sought to uncover the differences in cross-infection control policy between USP and Barts and The London. He observed: “I found that actual policies differed very little, in only a few minor details. It was interesting however, that USP tended to re-use their Endodontic files (after sterilising), as CJD is not such a big issue there as it is in the UK. Interestingly, patient goggles were not seen as a necessity in Brazil although in oral surgery the patients have to wear a cloth (bandana-like) around their eyes! The patients appreciated not being able to see the instruments. However, to onlookers this made the patients look quite sinister (especially when the cloths are partially covered in blood!). The role of lasers in oral surgery was most interesting! The use of lasers was a “speciality” of USP and showed how advanced dentistry in Brazil is. The low-intensity lasers (red light) were used post-operatively in the socket to increase the rate of the healing process. The KAVO K.E.Y LASER (ER:YAG 11-220V) was a high-intensity laser (infra-red) that is used to make incisions in soft tissues for minor oral surgery. We even had the opportunity to use the lasers to make cavities on extracted teeth and incisions on pieces of chicken meat, which was fun! Finally, we took the opportunity for some free laser tooth bleaching, which was the most painful yet highlighting experience because of the hypersensitivity experienced afterwards – the pain lingered on for several long hours every time we ate, spoke or breathed through our mouths. Having undergone such excruciating pain, it has definitely made me appreciate my patients at The Royal London who suffer from hypersensitivity! It’s a good job that the pharmacy around the corner in San Paulo sold high strength paracetamol!”
Nikesh Patel travelled to Taiwan “For my dental elective I spent some time at the specialised Endodontic Division in the Department of Dentistry at the National Taiwan University Hospital. It is the largest teaching hospital in Taiwan and located in the densely populated capital, Taipei. The department consisted of eight chairs; patients were treated by a student, postgraduate or a specialist depending on their degree of complexity. The dental course in Taiwan has a length of six years, with students starting to treat patients in their fifth year of study. Each year group is comprised of around 30 students, which is half the size of my current year group here at Barts and The London. They are rotated through the different specialties in turn and for endodontics their requirement is the successful treatment of 35 canals. While visiting the department I was mentored by Dr Po-Hsuan Lin and Dr Li-Chun Liu. We spent most of our time
L-R: Rahul Patel, Professor Chun-Pin Lin (Dean of Dentistry, The National Taiwan University), Rehan Janjua and Nikesh Patel
in the main clinic viewing routine RCTs. There were, however, a few occasions where I was offered the opportunity to observe apicectomies and perforation resurrections being carried out under magnification in the laser room. While in Taiwan I also learned that gutta-percha is a genus of tropical trees native to south-east Asia, from Taiwan south to Malaya. The inelastic natural latex produced from the sap of these trees is used in root canal obturation. I was amazed that the techniques practiced in Taiwan are virtually identical to the procedures that we are taught here at Barts and The London. I did however learn a great deal, as well as notice some subtle differences in notetaking and clinical practice which I now use to help treat patients under my care here at The London.”
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Medical Electives
Elective experiences – Medical students The Medical Trust Hospital in Cochin, India I wanted to spend my elective experiencing medicine within a developing country. In India there are both government and private hospitals. The Medical Trust is a privately run, multi-speciality and acute care hospital in Cochin, a busy industrial city in Kerala, southern India. The majority of my elective was spent with the general medical department focusing mostly on infectious diseases. Patients are admitted more commonly with diseases such as Hepatitis A or rare diseases such as leptospirosis and dengue fever.
Enjoying the backwaters of Kerala
BATLAA supported Laura Geddes who attended a conference in Bologna XIX Congress of the European Association for Cranio-MaxilloFacial Surgery I usually equate the length of the name of a congress with how prestigious it is and, thus, how selective it must be. Nonetheless, I submitted my abstracts and hoped for the best. It was during my final year at Barts and The Royal London when I had worked at the Homerton Hospital within the Oral and Maxillo-Facial department. Two abstracts were accepted for my presentations ‘Intrathyroid parathyroid carcinoma – an unusual presentation’
Cases of tuberculosis are common in Cochin and the threshold for clinical suspicion of tuberculosis is very low. Compared to the UK, there are far more cases of extra-pulmonary tuberculosis, ranging from renal tuberculosis and tuberculosis of the bone. The most surprising element of my elective within general medicine was the very high levels of diabetes, hypertension and hypercholesteraemia amongst young active people. Men and women as young as 25 were regularly presenting with symptoms of Type 2 diabetes and were often found to have many co-morbidities. My experience at the Medical Trust Hospital was overall enjoyable. The staff were very welcoming and I was invited to doctors’ homes for dinner, as well as attending the annual doctors’ party. Even though the country is developing, the health care system is very advanced and not that dissimilar from our own. However, as the hospital was privately run I found it extremely hard and sad to see the lower levels of care given to the poorer patients. Medical care is often withdrawn when the patient’s family run out of money even if the treatment is life saving; patients simply aren’t given life saving medication if they cannot afford it. It made me appreciate the levels of care offered to all by the NHS. Thank you to BATLAA for supporting me. Clare Conroy q Barts and The London, 2008
Elective in Cairo and Tanzania
and ‘Patient satisfaction after thyroid and parathyroid surgery – a local survey.’ The former is a case study on a fascinating, unusual and very rare condition of primary hyperparathyroidism caused by an intrathyroid parathyroid carcinoma, with only three reported in the literature. For the latter project, I tried to see how surgery to the glands in the neck affects the aesthetic outcome and functional effects of the voice. Patients’ perception and quality of life after surgery is a fundamental but undocumented aspect in patient care and has not been recorded in the literature so far. It demonstrates a high level patient satisfaction after thyroid and/or parathyroid surgery and more importantly, how we can tackle those who have reported problems in a unique clinic.
The congress was held in Bologna, a magnificent city in north-east Italy; it is rich in history and contains a wealth of important
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My elective began in Cairo, Egypt. I was based in the ‘old’ Kasr Al-Ainy Hospital, a government-run hospital which relies heavily on charitable donations. It is the main teaching hospital for Cairo University’s Faculty of Medicine. Its name, ‘palace’ in
Abrar testing the vision of a school girl in Kibaha as part of the screening programme
Arabic, reflects the sheer size of the hospital consisting of 42 units and 1,200 beds. I was attached to a general surgical team which specialises in re-constructive surgery. I saw a variety of cases including patients with facial haemangiomas, hairy naevi and schistosomiasis which is extremely prevalent in Egypt due to the use of canal water by villagers. I assisted in theatres and saw surgical reconstruction of ears, breasts, as well as the removal of thyroid and parotid lumps. The lack of resources meant that there was a heavy reliance on clinical examination for the diagnosis of patients
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Medical Electives
An elective experience in Tobago, West Indies
at which the doctors were extremely skilled. In theatres, however, the lack of disposable surgical gowns and surgical sheets and the restricted use of cannulae, etc contributed to high post-op infection rates. Despite this, the doctors worked six days a week to help those most in need, earning such minimal pay that many had taken second jobs to cover their expenses alone. The second part of my elective was based in the charity-funded Wali-ul Asr School in Kibaha, a small town outside Dar-es-Salaam in Tanzania. The school houses approximately 500 children, between the ages of four to 18 years. The children’s only access to healthcare was a yearly check-up at the medical health centre run by one resident doctor who was overwhelmed that so many of the students’ problems went undetected. My two colleagues and I set up a screening programme to check the students’ general health. We found that many of the resident younger children suffered from dermatological infections due to poor personal hygiene. Some of the children also suffered from previously undetected visual field disturbances which had affected their performance in class. We referred these children to the resident doctor for further management. My experience in these developing countries has not only shown me the impact of economic conditions on the practice of medicine, but also the strength of the medics who, despite the adversities, all strive for the same goal, the betterment of life. Abrar Ibrahim q Barts and The London, 2008
overwhelmed by the new environment in which I would be spending the next six weeks. The wards were basic, patients restrained to beds with bandages. Provisions were basic and I was initially somewhat shocked to hear that Tobago had no CT scanner, patient care wasn’t too compromised. Doctors were forced to base
diagnoses on their clinical judgement, supported by the basic investigations they had access to. During my placement I learnt that most patients were admitted as a result of hypertensive emergencies: strokes, seizures, HIV or alcohol abuse. It became apparent that the threshold for admission to hospital was far greater than that of the UK; the number of patients on the ward was few, but they were very sick. During my experience I noted the huge issue of patient compliance to medications, this seemed somewhat influenced by a lack of patient education, poor availability of drugs and finances, as well as alcohol being a co-morbidity in so many patients. These patients were often re-admitted as a result of failed discharges, and some suffered potentially preventable complications as a result of their poor compliance. Aside from the daily ward rounds, which were rich in teaching for myself and the other elective students, we attended weekly outpatient clinics. These were overflowing with patients and another great learning opportunity. When not working in the hospital I explored Tobago’s culture and idyllic scenery and beaches. Tobagonians are a friendly and proud people. It was an amazing elective experience which I would strongly recommend to anybody wishing to combine developing world medicine in a place which is, quite frankly, close to paradise. I would like to thank BATLAA for sponsoring my elective. Jade Piper-Smith q Barts and The London, 2008
Medieval, Renaissance, and Baroque artistic monuments and, being an architecture lover, there were many a church or portico to explore in the evenings. The congress itself was jam-packed with masterclasses, speeches, posters and presentations. My favourite was a session dedicated to Paul L Tessier, the father of craniofacial surgery. He revolutionised previously untreated craniofacial birth defects and devised many new innovative techniques
in the 1960s and 1970s that are now being used today; these have also found their place in neurosurgery, ophthalmology, maxillo-facial and plastic surgery. I was privileged to meet one of his successors, Dr Henry Kawamoto, Director of the UCLA Craniofacial Clinic, and Chief of Plastic Surgery in the USA. His touching story of the life of Paul Tessier, a great man, was definitely an eye-opener. There were thousands of people at the event, which made me a little edgy before my presentations. All went well and I received some useful feedback on these projects. I attended many other talks ranging from cleft surgery to more intense experimental research; to new techniques such as Cyberknife robotic radiosurgery, a non-invasive alternative to surgery,
which has excellent potential, with only one hospital in the UK using it. Craniofacial surgery is a speciality which to my knowledge is not on the foundation curriculum. Thus, junior doctors (especially those who are not dentally qualified) do not get much exposure in this field. Attending this congress and presenting has definitely opened my eyes to how fascinating this speciality is, and I would urge those who have a passion for a field not yet fully explored to do the same. I am very grateful to the Barts and The London Alumni Association for their generous funding without which my attendance at this prestigious meeting would have been extremely difficult. Laura Geddes q Barts and The London, 2008
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As I stepped off the plane in Tobago after the eight hour flight, the warm air hit me and the sun was blinding. I felt excited as I left the airport; my adventures were just beginning. I was spending my placement at the Tobago Regional Hospital in the island’s busy capital, Scarborough. As we drove to the accommodation the roadsides were cloaked in stalls piled high with mangoes, locals ‘liming’ on street corners and stray dogs everywhere. On my first day at the hospital I was warmly welcomed by Dr Okeke, the consultant in charge of the Male Medical Ward, and his team. I was somewhat
Tobago Regional Hospital, Scarborough
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Medical Electives
Trauma service in South Africa
Rural Medicine
For my elective I spent four weeks in Johannesburg, South Africa at the Chris Hani Baragwanath Hospital (‘Bara’) doing trauma. The trauma service at Bara was distinctly different from that of the UK in that it was completely separate from emergency medicine and was delivered in the trauma unit, or the ‘Surgical Pit’ as it is known by the team of trauma surgeons and trainees.
As I attended the cadets’ briefing day at Sandhurst in January 2008 I was in a slight quandary; having recently spent well in excess of a four-figure sum on plane tickets for my elective and the holiday to be enjoyed afterwards, the hospital in Nepal had calmly emailed to inform me that my elective plans had fallen through. It was for this reason that I did not enjoy lectures that day as much as I should have! However, a ray of light at the end of the tunnel appeared in the shape of Heather Duncombe. Briefly, she explained that the RAMC had been trying to organise medical electives in Nepal for some time, but the funding was not available. After the briefing day I explained that funding was not a problem, and that I would be extremely keen to spend some time with the British Army abroad. It only remained to get the ‘green light’ from above. This, it turns out, was easier said than done, as I had to wait for several nail-biting weeks before the elective was approved. But, approved it finally was and,
Bara is one of two trauma centres in Johannesburg. It is a Level 1 Trauma Centre but sees all levels of trauma. It is said to be the largest hospital in the world with almost 4,000 beds. It primarily serves the socio-economically deprived population of Soweto. Johannesburg is well known for its high crime rates and as such Bara is world-renowned for the amount of trauma that it sees; it is a very popular elective destination for medical students from all over the world. During my elective I was on-call several times. This entailed a 24-hour shift in the Surgical Pit receiving trauma patients, assessing them, resuscitating them and organising investigations. There were many opportunities for hands-on procedures which provided an excellent opportunity to learn new skills and put them into practice. When I was not on-call, I was in the trauma ward and the trauma ICU looking after patients who had been admitted. The majority of patients had suffered penetrating injuries, namely stabbings with knives, machetes and bottles. I also saw many cases of road traffic accidents, pedestrian vehicle accidents, gun shot injuries and burns. This elective was a great opportunity for me to experience a different healthcare system. It also helped me to gain confidence in my own abilities and gave me a great deal of clinical exposure. I would like to express my gratitude to BATLAA for sponsoring this elective. Yasser Madani q Barts and The London, 2008
I could blink. The Army really does take care of you! After half an hour of struggling through Kathmandu rush hour (which lasts about 24 hours), I was dropped off at the British Gurkhas Kathmandu (BGK) where I was met by Colonel (retd) John Richardson, my tutor for the elective period. Following this, I was introduced to numerous people on the base, including Colonel G O’Keeffe RGR, Chief of Staff in Kathmandu. The following few days passed rapidly; having observed Colonel Richardson in clinic the day after I arrived, he handed the reins over to me the following day. To my relief, most of the patients I saw had injured themselves in a tug of war competition the previous weekend. Nothing too complicated! That Friday, I was lucky enough to be able to visit a local leprosy hospital. Having obviously learned about the disease at medical school, I was stunned at the level of disability inflicted upon the sufferers. Some patients I saw had lost complete limbs.
Andrew and Dr Dipak Malla examining a patient
having survived finals and the inevitable viscious hangover, on 16 March I found myself on a Jet Airways flight bound for New Delhi, having learned that I had passed my finals only hours before. As direct flights to Kathmandu tend to be rather expensive, my friend (who had organised a civilian elective in a local hospital) and I had opted to fly via India, a decision we later regretted as we spent eight and a half hours sitting on hard plastic chairs in the transit lounge waiting to connect to Nepal. Regardless, we connected to Kathmandu where I was met by a kind lady from the Movements Department who whisked me off in a spotless white Landrover before
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On my first weekend I was flown by the Army to Butwal, a town in Southern Nepal where one of the Gurkha Welfare Scheme’s (GWS) area welfare centre (AWC) is situated. Briefly, the GWS is a British Army affiliated organisation, primarily staffed by ex-Gurkha soldiers, which provides free healthcare for Gurkha pensioners. This provision of healthcare is achieved in several ways; the area welfare centres are essentially walk-in-clinics for all the Gurkhas (and their dependents) who live within a realistic distance. For those pensioners who do not, or who are infirm, regular visits to the surrounding villages are organised.
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Medical Electives
During the week in Butwal, I was fortunate enough to work with Dr Dipak Malla, one of three civilian Nepali doctors who are employed by the GWS to rotate between the numerous AWCs around the country. Within a few days, we saw in excess of 150 patients, all of whom attended the clinic in Butwal. In addition to these, we visited a few patients in the surrounding towns. By and large, the commonest diseases that we encountered were straightforward – a combination of diabetes, hypertension, vascular disease and gout. From my point of view, it was a privilege to see a side of Nepal that I guess very few westerners do. To be treated with such respect by so many different people, and to be invited into their homes to examine them is not something I will readily forget. Having finished a week in Butwal, and endured the very warm and humid conditions, it was a relief to be sent to the more mountainous and cool region of Tamghas, to another AWC. It is from here that Dr Malla and I, accompanied by two porters carrying a large supply of medicines, began a four day medical trek into the surrounding hills. After trekking for nearly 12 hours on the first day, we finally reached Hangsupur. Despite our fatigue and probable body odour from such a long trek, we set up an impromptu clinic on the steps of the local ‘hotel’ and invited the pensioners who lived in the village to attend. Again, a similar pattern of diseases to those already encountered were seen, cataracts and osteoarthritis were also evident. Once the clinic was over, there was a certain degree of competition amongst the villagers as to who would provide us with accommodation. We ended up staying in a tiny concrete bungalow, complete with candle and latrine outside the door; the redeeming feature was the breathtaking view from the window. The following two days passed quickly, plenty of pensioners requiring treatment and plenty of ‘daal baat’, (the local delicacy consisting of rice and lentils) for meal times. Before long it was time to leave, so we spent a further day trekking towards the valley floor, stopping at pensioners’ houses along the way. The medical trek now complete, we arrived back at the AWC tired and rather bedraggled, the porters’ rucksacks considerably lighter after dispensing so much medicine. From here, the Army yet again laid on transport to take me to Pokhara, the second largest town in Nepal. I stayed for several
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Andrew and Dr Malla on a patient’s farm after examining them
The view from Annapurna base camp over lunch, surrounded by 8,000 metre peaks
days, first staying at the British Gurkhas Pokhara (BGP) and acquainting myself with the young officers and the night life that Pokhara had to offer. Due to an administration error on my part, I then found that I was unable to travel to the Langtang region to complete a trek with my civilian friend. On one of the young officer’s advice, I decided to complete the Annapurna Base Camp trek. This posed a couple of problems; I was going to have to attempt it solo, and I only had four days in which to do it before flying back to India. I was assured with old fashioned Army grit that I would prevail! Leaving at 5.30am on day one, I ended up trekking 10 hours between Phedi, on the valley floor, and Chomrong, a distance of over 30km and a vertical rise of over 1,500m. On day two, I trekked for a further nine hours, finishing the day at only 3.30pm at Jinu Danda, due to adverse weather conditions (I had to sleep in a lightning storm). By breakfast on day three I reached the base camp, at 4,130m above sea level, around five days ahead of schedule. The views were quite simply breathtaking; I enjoyed brunch surrounded by 8,000m peaks in cloudless conditions. To save even more time, I opted to trek from base camp back to Chomrong in the same day. By the time I had reached my destination I had been walking with a full rucksack for over 12 hours and was utterly exhausted. I summoned the energy to wolf down two omelettes and a double helping of the local whisky before collapsing into bed. Leaving at 6am the following morning, I reached BGP by lunchtime, completing the 80km trek in around a third of the time advertised in Lonely Planet. As my elective in Nepal neared completion, I was looking forward to flying back to the Mess in Kathmandu, enjoying a civilised meal with Colonel Richardson, before continuing my travels in New
Zealand. Things, however, would not be so simple. After a delay of over three hours in Pokhara airport, I discovered that the plane had not even left Kathmandu due to bad weather. The only solution available to me, to enable me to be back in time for my connecting flight in New Delhi the next morning, was to endure a five and a half hour taxi ride, along less than optimal roads, in a vehicle over 35 years old. A fact that the driver decided to share with me during the loneliest and darkest part of the journey! However, I arrived back in Kathmandu with enough time for three hours sleep before flying back to New Delhi, four weeks to the day since I arrived. On reflection, I had an enormously maturing and enjoyable experience, both with the British Army and with the GWS. I felt enormously privileged to be given such opportunities, especially as I understand I was the first medical student to be given a placement in Nepal since the 1980s. With regards to the medical aspect of my trip, it was fascinating to learn how medicine works in more deprived areas of the world, when imaging and laboratory requests are a six hour drive away. I would like to thank Colonel O’Keefe for welcoming me to the British camp in Kathmandu, Lt. Colonel Griffith, Head of the Gurkha Welfare Scheme, for making my visit possible and Captain Anderson, erstwhile movements clerk of the BGP, for coordinating the latter stages of my trip in Nepal. Finally, and most importantly, I would like to thank Colonel Richardson for his tireless efforts in ensuring the success and enjoyment of my trip. Lastly, to any RAMC cadets who read this article, I would strongly recommend this elective. Nepal is a fascinating and beautiful country; there is a huge amount to learn and enjoy. Lt Andrew Pelham q Barts and The London, 2008
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A Doctor’s life feature
Mathematics and Medicine Earlier this year, John W Dale described a career interwoven by two school-boy passions which ran in parallel for over 70 years From the age of five I wanted to become a doctor but since I was good at mathematics and physics whenever there was an option the school put me in the physical science set. In the sixth form I gained admission to Selwyn College, Cambridge, through its Open Scholarship Examination to study Natural Sciences. Before going to university I did my National Service in the Royal Air Force where I had a one year course in electronics. Once at Cambridge I realised that my ambition to study medicine remained unchanged. Donning my gown, I went to see my tutor, Dr Durrant. My interview with him was short and to the point. I said I wanted to study medicine; he asked if I liked doing mathematics. I blurted out that I loved doing mathematics; he advised me to do both and that was it. I have never regretted the decision since. I didn't know much about London Teaching Hospitals but secured a place at both The London and St Bartholomew’s Medical Schools. I thought that St Bartholomew-the-Less was beautiful and was treated so graciously at the interview that I chose Barts. I particularly remember Professor Scowen’s lectures on medicine and Professor Shooter’s lectures on bacteriology. Above all I remember the care that was shown to the individual patient. I joined in the Christmas reviews. I became Secretary of the Bart’s Alpine Club and
persuaded Matron to allow nurses to join the Club activities. We climbed in North Wales, in Derbyshire and in the Lakes. In 1961 I was invited to join the Cambridge Arctic Canada Expedition to Cumberland Peninsula, Baffin Island, as student medical officer. We made a number of first ascents in the Penny Icecap and attempted the awesome Mount Asgard. On Broughton Island I treated my first patient, an Eskimo child called Mosessi. He had osteomyelitis of a finger following a fish hook injury. We returned to Canada on a hospital ship, the C D Howe, where I saw, at first hand, medicine in a developing country. I did my pre-registration house jobs in Whipps Cross Hospital in 1962. This was the year of the great smog which led to so many deaths. At one stage it was impossible to see across the ward. In 1963 I went to Southmead Hospital, Bristol, to do Paediatrics and then Casualty. Here I met Margaret, a midwife. I knocked over her trolley in the middle of a Caesar operation and was told in no uncertain terms to leave the theatre till I could behave. I realised I had met my match and one year later we were married. The following year was spent as Senior House Officer in Bacteriology at Birmingham Children’s Hospital under Dr Keith Rogers. Keith came to work every morning at 6.30am to ensure laboratory results were available
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on the wards by 9am which he thought essential in a children’s hospital. He was an outstanding teacher. By now I had realised that much of medical science had not passed through the Renaissance, and that the management of health care was almost non-existent. Keith introduced me to Professor Squire; I was then asked to join the team developing the first computerised hospital information system. On Professor Squire's death I was transferred to the Department of Social Medicine as Lecturer, under Professor McKeown. Here almost every member of the department had a mathematics qualification. I gave the first course on computing in the Medical School. We began teaching mathematics and epidemiology as part of the undergraduate medical course. In 1969 I was asked to set up a Medical Research Unit for the newly formed Health Education Council. The University of Bristol provided a home and the Unit was attached to its Department of Public Health. On my appointment as Director I received a Millbank Fellowship to study health care in Colombia. This gave me my second glimpse of health care in a developing country with its problems of infant mortality and lack of resources. There were even funeral parlours specialising in infant funerals around the maternity hospital. The Research Unit achieved many firsts. We carried out the first major investigation into injury in the home; the first television campaigns against smoking; established
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A Doctor’s life feature
a computerised register for child health, vaccination and immunisation; and introduced improved contact tracing for sexually transmitted diseases. Yet, in the end the Unit was closed down despite a fierce campaign of support organised by Archie Cochrane. This culminated in a “World in Action” programme. However, we did succeed in encouraging the Government to establish surveillance of domestic injury. In 1976 I moved to the South East Thames Regional Health Authority, titled first as “Specialist in Information” and then “Consultant Epidemiologist.” We carried out a programme to introduce health information systems across the region, starting with St Thomas’ Hospital, King’s College Hospital and Guy’s Hospital. I also chaired the National Child Health Computer System Working Party on Vaccination and Immunisation. Though still an enthusiast for information on health care, without which both clinical medicine and administrative management is impossible, we need to watch that the collection of data does not prevent the quality of patient care we learnt at Barts. On retiring from the NHS, Margaret and I determined to work in a developing country. In 1995 I became Epidemiologist in the Department of Health in The Gambia, and Margaret, Clinical Tutor in the Midwifery School there. We were both employed by
the Department of State for Health and learnt just how poor such countries are. I managed epidemics of such diseases as cholera and meningococcal meningitis. In the latter case we treated over 1,400 cases in The Gambia; just a pinch compared to between 250,000 and 500,000 cases in West Africa. Again we found how important information is in managing disease and in controlling politicians. In 1993 we had been asked by Old Jeshwang, an urban village in The Gambia, to assist in building a health centre. Women were dying in childbirth unable to reach the only hospital, the Royal Victoria Hospital in Banjul, the capital. Margaret set out for Africa for the first time and met the village elders. She was impressed by their competence. Our small village in Sussex, Ardingly, and Old Jeshwang Village in The Gambia have built a fine health centre which we are using to demonstrate how to deliver good health care with minimal resources and how to develop preventative health care. You can see more at www.aoja.org. Death rates are appalling, one in 14 women die in childbirth, one in five children die before the age of five. We are developing a whole range of health care programmes in Old Jeshwang; infant welfare, vaccination and immunisation, antenatal care, normal deliveries, school health, HIV screening, dispensary, and health
Pictured from L-R: Mosessi, my first patient in Broughton Island, off the coast of Baffin Island; Disease control group for the meningitis epidemic; Medical student Sabrina assesses an infant at a welfare clinic; Margaret and her class of midwives; Medical student James carries out a nutrition survey
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education. These must be accompanied by administrative programmes; accounting, manpower and stock control. Resource limitations are extreme; we split dip sticks up the middle to cut the cost. Each year we take a party from Ardingly Village to Old Jeshwang Village, partly as tour guides, partly to work. Margaret and I attempt to visit every six months. The Centre is managed by a local management committee, which is learning the necessary skills. Young people need physical and intellectual adventures and I have always been involved in youth activities. Students from Birmingham, Leeds and Brighton and Sussex University Medical Schools have carried out the operational research in The Gambia which we otherwise cannot afford. We have twice won the Royal Society of Tropical Medicine prize for the best undergraduate projects in the UK. We would welcome students from Barts and The London. I continue as Honorary Epidemiologist in The Gambia, and as Honorary Senior Lecturer in the Brighton and Sussex University Medical School. Medicine and mathematics can lead to an exciting life. • John W Dale MBE q Cambridge/Barts, 1961
We recently received the sad news that Dr John W Dale suddenly passed away on 26 November 2009
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BATLAA feature
1945 – Medical students at Belsen Setting the record straight
Laurence Wand writes: “Having recently moved house, I was sorting out old journals and correspondence, when I came upon the BLC Spring 2005, Vol 7/1, which contained an edited reprint of the article ‘Belsen 1945’ by Thomas Gibson, together with his letter, ‘Belsen – A postscript’ The original article first appeared in The London Hospital Gazette in 1945, which I never saw. It may have elaborated events more fully and accurately than the edited version and excellent though the edited version undoubtedly is, there are certain inaccuracies needing correction and possibly elaboration. I base this statement both on my own clear memory of events (I was one of the Barts Team) and perhaps rather more credibly on retained records made at the time. Time is passing and soon it may be too late to correct detail on what was a most momentous happening and which ought to have a correct record. The number of students was 96, not 100. This number fitted neatly into the six Dakota aircraft which were to be used for our transport to Germany: 16 per aircraft, each aircraft having eight moulded seats intended for paratroops. We were transported by lorries on the early afternoon of 28 April from BRCS, HQ, Lowndes Square to Paddington Station, where nobody knew anything about us and we were told to go away and return about 6pm. Eventually we were taken by train to Cirencester, whence we were taken by army lorries to Rover transit camp arriving about 10.30pm. It was bitterly cold. The accommodation was unheated Nissen huts with icy, concrete floors and no beds. I am unable to recall such bleak and comfortless conditions during my subsequent Army National Service nor in my subsequent 25 years as a TA soldier. We slept on ‘biscuits’ on the concrete floor in our greatcoats such was the cold. Ablution
facilities were rudimentary. Following a pre-dawn reveille we were taken to RAF South Cerney near to the village of Down Ampney. The airfield was covered in snow and ice. We were loaded into the aircraft at dawn and we remained in the bitterly cold metal unheated fuselages until afternoon, when we were told that the weather made flying impossible, so we were unloaded and returned to Rover camp. The only mitigation to the discomfort was mid-morning when tea and buns were dispensed from a NAAFI van. Next day, 30 April, the exercise was repeated. Weather conditions were slightly better
“ Time is passing and soon it may be too late to correct detail on what was a most momentous happening” and two aircraft got away. One gave up, over southern England, due to weather and landed at Croydon. The other (on which I was a passenger) also had to give up due to bad weather over Eindhoven, returning to Brussels, where we were extremely well looked-after in Belgian Army barracks. Finally we were able to get away next day, 1 May. We landed at Celle and were transported to Hohne panzer barracks (Camp 2) where we were billeted, indoctrinated regarding our function and on typhus. Next day, 2 May, we commenced work in Camp 1. That evening, weather having cleared, we were joined in Camp 2
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by the remaining 80 students. 3 May saw the whole body of medical students start work. Camp 1 had its prisoners’ huts divided into areas, male and female. Memory suggests that the female area was the larger and that most of the students were allocated huts in that part of the camp. Some of the huts had two students allocated to them, others only one. Those students working in pairs were significantly more effective than the singletons. It was of considerable help that many of the students had been together at Cambridge in their pre-clinical years. There were the University of Cambridge students as such; in addition the Barts and The London Hospital pre-clinical students, since both hospitals had evacuated their preclinical schools to Cambridge for the duration of the war. As a result, many of the students knew each other irrespective of which of the hospital teams they belonged to. This made for easy working relationships. I was a singleton, being allocated Hut 219 with some 460 inmates. Forty died the first night. In addition, two or three Hungarian soldiers were allocated as labourers to each hut. They came from the Hungarian regiment which had been allowed to remain after the British had taken the camp over. Surprisingly, they had been allowed to retain their firearms. Belsen was in a 48 square kilometre truce area. The Chief of Staff, German First Parachute Army, had approached the Brigadier General Staff British 8 Corps asking that we take over Belsen, where typhus was raging and the prisoners were in a terrible state. The German Commander was unwilling to hazard his own troops in the typhus area and he feared that freed prisoners, unless controlled, could spread the typhus among the German civilian population as well as exacting revenge. A truce was agreed. Despite this, 11 Light Field Ambulance, which had set up as a medical unit on the edge of the camp, displaying a red cross, was attacked from the air and one of its members was killed.
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BATLAA feature
Belsen, 1945 – L-R (front): Andrew Dossetor, Leslie Clarke, Roger Dixey, David Bradford, Ian Jackson (back): Ian Proctor, Laurie Wand
Tommy Gibson mentions his first night being disturbed by small arms fire. This escapes my memory. However, on a night much later in May, this did happen when Russian POWs, who had been freed, were due to be inspected by General Zhukov and were issued with rifles for the parade. The General never came but the rifles remained in the possession of the ex-POWS and that night, there was certainly gunfire in the woods. Tommy Gibson was extremely lucky to have escaped louse infestation. Despite being liberally dusted with AL63 (not the DDT he mentions) each time I entered or left Camp 1, I found myself louse infested when on returning to Camp 2, I changed into clean clothes. Fortunately, most of the lice seemed to be dead. Regarding student illness, I am only aware of that affecting the Barts Team. Two of our eight members become casualties. One with a large central facial abscess, the other with typhus. Both recovered fully, but the student with typhus was extremely ill and had to be left in hospital when the rest of the team returned to the UK. My final correction is regarding the destruction of Camp 1. This was by fire. Explosives including dynamite were not used. It is worth noting that the ceremonial burning down of the last hut was done using two Bren gun carriers fitted with flame throwers. One of them suffered an ejaculatio praecox, however, the flames were extinguished so
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that the ceremony could take place. 113 Regiment LAA, RE is praised and rightly so. Equally worth of praise is 612 Field Squadron RE who were responsible for our having clean water, without which nothing effective could have happened. Also to be singled out for praise was the 11 Light Field Ambulance, formerly, a TA Unit based at Ipswich.
“ I was allocated Hut 219 with some four hundred and sixty inmates. Forty died the first night” I cannot conclude without comment on Tommy Gibson’s postscript. Of course we all knew the ethnicity of the majority of the inmates. How could we possibly avoid knowing? Certainly, not all were Jewish, but most were. Those who had survived the exodus from Auschwitz in the face of the Russian advance were readily identifiable by the Auschwitz serial numbers each had tattooed on the forearm. They knew only too well what Auschwitz had been all about and those able to communicate with us had no hesitation in doing so. They knew full well that they (and all those who were Jewish) had been incarcerated because of their religion. This was equally true of the more recently incarcerated Hungarians who had arrived in Belsen other than via Auschwitz.
The purpose of what I have written is to expand on and, in some minor ways, modify Tommy Gibson’s account for the sake of completeness and accuracy for generations to come who might be curious. I would point them also to the remarkably comprehensive and wide-ranging paper by Colonel Vella L/RAMC, which appeared in the Journal of the Royal Army Medical Corps, Vol 130/1 of February 1984. This paper generated a correspondence which appeared in the same journal of October 1984 (Vol 130/3). The letter over my name which appeared in that issue had incorrect dates. The correct dates are as given in this paper. Finally, there should be recorded, that which we were unaware of at the time, namely, the history of Belsen. Originally it was a POW camp, Stalag 311. It was transferred to the SS in April 1943 to establish a detention camp for several thousand Jews with Allied connections or with foreign entry visas. This German Foreign Office plan was sanctioned by Hitler and Himmler and the purpose was initially, so that those Jews could be exchanged for German Nationals interned abroad. Belsen was the so called Star Camp with some 15,000 prisoners of which about 10,000 were the so called “exchange” Jews (hostages). At this time, to be interned in Belsen was to be given a good chance of survival. In December 1944, Belsen became a concentration camp with a huge increase in numbers reaching 60,000 at the time of liberation in April 1945. It was not an extermination camp. There were no gas chambers. The crematoria were sufficient to meet the pre-December 1944 needs. Food stocks were available nearby. Starvation was not a deliberate act of extermination, but a consequence of indifference and incompetence coupled with the gross overcrowding resulting from the evacuation of Auschwitz and similar camps in the face of the Russian advance. At the time of liberation, it is believed that the death rate was 500 per day as a consequence of starvation and disease. Murder took place capriciously and not as part of an organised extermination. Camp 1 was not off the beaten track. A good metalled road ran beside the camp and it was clearly visible through a scattering of trees. It cannot have been unknown to the local population. Quite apart from what could be seen from the road, there was the smell, which was overwhelming, truly dreadful and all pervading. • Laurence Wand TD QHS q Cambridge/Barts, 1946
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Book reviews
Book Reviews Comprehensive Coronary Care (4th Edition, Bailliere Tindall, 2007) By Nigel Jowett (q Barts, 1976) and David Thompson Comprehensive Coronary Care is, and remains, a seminal text for those involved in the care and management of people with coronary heart disease. First published in 1989, the content has been updated on several occasions. In this edition extremely interesting data is presented in relation to the diminishing burden of disease in Western Europe, the USA and Australia while the obverse is the case in Eastern Europe and the Russian Federation. In my early years in intensive care, beginning in 1976, I remember upwards of 70 per cent of patients admitted to ICU had experienced an acute coronary event ranging from myocardial infarction to full blown cardiogenic shock.
CD Rom Breaking Barriers: management of cancer-related pain This CD ROM-based programme, developed by the Interactive Education Unit at the Institute of Cancer Research, in collaboration with The Royal Marsden NHS Foundation Trust, is aimed at healthcare professionals in both the hospital and community setting. It has clearly been produced primarily with the Anaesthetic Pain Management Service at The Marsden and has a focus on this model of care. This may frustrate some users of the programme who have less easy access to pain services for their patients. Specialist palliative care is acknowledged as another multiprofessional team offering expertise in pain control. The program is easy to use, clear and
At that time we could do little but give inotropes and insert intra-aortic balloon pumps. All intervention was supportive and none offered definitive treatment. The data from Eastern Europe reminds me how far we have come, and sadly how far others have yet to come, in all manifestations of cardiovascular disease, from prevention and pharmacological intervention, through to definitive treatment in terms of primary percutaneous coronary intervention and rehabilitation. All these aspects are addressed comprehensively, but concisely, within the text. They are the essential elements of care which must be understood if management of acute coronary syndromes is to be both effective and efficient. As has always been the case, this textbook deals with complex issues in an unpretentious manner, which is easy to comprehend. Much use is made of algorithms which clearly indicate not only the treatment required but also the level of evidence underpinning decisions which must be made. The clear intention of the authors is to enlighten and inform, rather than make understanding unnecessarily
complex, and in this they certainly succeed. The needs of the individual requiring admission to a coronary care unit or cardiac ward have also been given an appropriate emphasis. Whilst understanding of the disease process and effective management are of the utmost importance, these alone do not make a person feel cared for. Attention to fundamental aspects such as how good it feels to have a shower, have clean dentures, the balancing of rest and activity, together with the provision of small but frequent and nutritious meals are what can make all the difference to a person’s perception of their recovery. I have always recommended this text to students and those working in cardiac areas. This edition is no exception and I congratulate the authors for continuing to update and provide such a useful resource for those experienced in the specialty, but in need of an update, and for those at the beginning of their careers in the specialty. Carol Ball Consultant Nurse in Critical Care, Royal Free Hospital Senior Research Fellow, City University
well organised and gives a comprehensive overview of pain management for patients with cancer. Equal weight is given to the classification and pathophysiology of pain, psychological, social and spiritual factors influencing pain and barriers in effective pain management, as well as sections on pain assessment and clinical management. The benefits of a team approach to pain management are well described and backed up with a video gallery of professionals describing their roles. Features that are particularly good are the resources section which includes relaxation scripts and assessment tools. However the contact information for professionals is only for pain organisations and does not include palliative care equivalents. Overall the layout and options for accessing information within the programme work well. Additional detail such as the glossary, references or more
specific details come as ‘pop ups’ leaving the main screen uncluttered. Some aspects such as the section on NSAIDs including cox 2 inhibitors are now a little out of date. One topic that would have been useful to develop further is the use of parenteral analgesia. Routes of administration are included but indications for subcutaneous use and how to use a syringe driver for continuous infusion would complete the picture. However, despite a slight degree of disappointment in the over-emphasis on pain services, this is a very flexible teaching and learning tool which can be used by a wide range of healthcare professionals, from generalists to those undergoing specialist training. Clare Phillips Macmillan Consultant in Palliative Medicine The Macmillan Palliative Care Team
36 | Barts and The London Chronicle | Autumn / Winter 2009
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Book reviews
George Guthrie: Soldier and pioneer surgeon (2008, Royal Society of Medicine Press) By Raymond Hurt Foreword by Sir Barry Jackson Bernard Cornwell’s Sharpe novels and television series have given us a vivid picture of the Peninsular Campaign and Waterloo. We have wondered at the courage of the private soldiers who faced cannon and musket fire sustaining tremendous casualties. Then they faced the surgeons. Of these George Guthrie was the leading light on our side, despite being far less well-known than his opposite number, Baron Larrey. Guthrie has been neglected for far too long. Now Raymond Hurt, retired consultant cardiothoracic surgeon at Barts, has filled the gap. His fascinating tale begins when Guthrie was 13 and suffered a severe accident. He was treated by John Rush, the Inspector General of the Army Regimental Hospitals and this inspired the boy to emulate Rush and become an Army surgeon. After a brief apprenticeship to a surgeon in Pall Mall, Guthrie passed the new examination for membership of the College of Surgeons at
Crash Course: Physiology (2008, Elsevier) By Mohammad Shahid (q Barts and The London, 2004) and Ayesha Nunhuck (q Barts and The London, 2005) Mohammad Shahid and Ayesha Nunhuck are both recent alumni of Barts and The London School of Medicine and Dentistry. Written in their final year, this book forms a comprehensive yet succinct guide to the essentials of human physiology.
the age of 15 and was immediately appointed assistant surgeon to the 29th Regiment of Foot (then the Worcestershire Regiment, today part of the 2nd Battalion of the Mercian Regiment, recently home from Afghanistan). Within a year Guthrie became the sole medical officer to the 29th Regiment. It was then commanded by the 22 year old Lt Col Byng (later Lord Strafford). Despite their youth it was said that ‘no regiment was better commanded or better doctored.’ After six years in Canada the regiment was posted to the Peninsular in 1808. There Guthrie soon became renowned not only for his surgical skill but for capturing a gun – unusual for a Regimental Medical Officer. During this long campaign Sir Arthur Wellesley wrote that ‘the 29th is the best Regiment in the Army, has an admirable internal organisation and excellent non-commissioned officers’ and he personally congratulated George Guthrie. After Napoleon had been beaten, Guthrie retired to London to set up in practice. But when Napoleon escaped from Elba and once more confronted the Allies at Waterloo, Guthrie hurried back to help treat the survivors of the battle and was offered a knighthood as a reward for his services (which he declined). On his return he wrote a best-selling textbook on the management of gun-shot wounds in which hard-won experience had taught him to disagree with the teaching of John Hunter, especially in the matters of early amputation and ligature of both ends of an injured artery.
He went on to found the Westminster Ophthalmic Hospital and become surgeon to the Westminster Hospital, Fellow of the Royal Society, and three times President of the College of Surgeons. There he fought nepotism, became the scourge of the fuddy-duddies who then ran the College, and pushed through much needed reforms. His teaching covered a far wider field than battle-field surgery: he wrote on ophthalmology and even urology (he became my hero for his early advocacy of the procedure that was one day to become transurethral resection). He continually pressed for reform of the Army Medical Services, and his vision of a Royal Army Medical Corps was eventually realised in 1898. Fiery, brave and passionate – and no doubt thoroughly difficult – he kow-towed to no one: for him his wounded soldiers always came first. He must have been very intelligent: he was fluent in French and Spanish, and during his travels had become such a skilful navigator that he was able to prevent at least two shipwrecks. This is a splendid book. Mr Hurt has given us, for the first time, the story of a remarkable man and his remarkable times. Lavishly illustrated and replete with references, it is a jolly good read for anyone who would like to know what really would have happened to Richard Sharpe when he was wounded. Professor John Blandy q Oxford/The London, 1951
The book addresses the body system by system. Each chapter starts at a level accessible even to those approaching the topic for the first time, with listed objectives providing a first-line defence against the subject's potential to overwhelm. Knowledge is built steadily and clearly on this foundation until the whole picture is elucidated. Memorable diagrams and illustrations accompany the text to aid and clarify, and key concepts are highlighted for those skim-reading. The style of the text turns the workings of the human body into easy reading; understanding grows surreptitiously, with almost no conscious effort. The authors conclude by testing comprehension with a series of exam-style questions. Their recent personal experience
allows for tailoring of the format to perfectly prepare current students to face their exams. Appeal, however, is not limited to pre-clinical students of medicine and the medical sciences. Rather, the coverage of simple physiology and its clinical relevance makes it ideal both as an aid in passing exams, but also during the junior stages of a medical career, to refresh details of principles and pathways buried in the further reaches of the memory! Crash Course Physiology’s great advantage lies in the simplicity of its design despite the complexity of the topic, and in the authors’ underlying insider knowledge of the pressures faced by young medics. Charlotte Trainer q BA Oxford, 2009; third year Barts and The London
If you have recently had a book published and would like to promote it in the pages of BLC, please contact us and we will endeavour to list it in a future issue
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Autumn / Winter 2009 | Barts and The London Chronicle | 37
Readers’ letters
Letters Dear Editor Some readers perhaps remember that when I said goodbye just over two years ago to my friends at Queen Mary and in the School of Medicine and Dentistry, I was planning to spend more time in France – which I have been doing. Whilst there recently I noticed that Hugh Laurie in the guise of Dr House, has become a big hit there. Old Londoners may know that Laurie’s father [Dr William George Ranald Mundell Laurie (q Cambridge/The London)] was one of their number. Idly reading a magazine interview with “Dr House,” I came across the following (my translation, I don’t know what he actually said, assuming the interview was in English): Your father was a doctor. Does House take after him? My father was the exact opposite of House. Totally different. He was kind, attentive, considerate, generous, polite. He did all he could to make people feel better. He would have been horrified by House. But at the same time, I think he would have applauded his rationality, his logic and his scientific approach. Now, am I subconsciously under my father’s influence? Possibly. With all my best wishes to all my old friends Sue Boswell Former Editor, BLC
Practice makes perfect Bearer of my secrets, Knower of my body’s vulnerabilities, The weak places, the hidden shadows, Bringing their fragilities to light, Where are you when I need you, When the midnight hour strikes And fear creeps into my soul And my body will not be at ease with itself? Tired, tired physician Called from slumber and safety Out into the cold of the night, Fumbling with torch at unknown doors
Dear Editor I have been interested and amused by the two articles by Michael Partington in the last two copies of the BLC and, in particular, the ‘Obstetrical rotation in Dublin 1947.’ I did an “elective” at the Rotunda whilst a medical student at Barts in 1957-58. A very similar article of my experiences appeared in the Barts Journal in early 1958. I did my clinical work as a student for three years at Barts from 1955-58, having done my pre-clinical three years at St John’s College, Cambridge. Subsequently I too, after taking the MRCP and an MD research degree, went into psychiatry for most of my career. The experience at the Rotunda was fascinating, great fun and a great experience. We assisted and did lots of deliveries in the delivery room and later on in the district when I was paired with a dishy Glasgow student called Margaret Hanlon. We used chloroform as an anaesthetic, and dealt with retained placentas on a kitchen table. We got far more hands-on experience of reality childbirth than students ever do today and came out of it confident of our abilities. I also recall the fleas! I was under Mr Badenoch and Mr Corbett for my surgical clerking and Drs Black and Cullinan for medical. Dr Black introduced me to the Society of Apothecaries where in my time I served on the livery committee and was an examiner for the PLAB exam. Michael Haslam TD q Cambridge/Barts, 1958
And greeted with anxious looks And the panics of a pain-painted body, Where are your calming words, The reassurance of confident hands? You who practise medicine Be my healer in this hour of need. Let that practising be made perfect So that I may live. Roger Hurding q Barts, 1959
If you would like to comment on anything featured in BLC, write to the Editor Susan Nettle at: Alumni Relations and Events Office, Queen Mary, University of London, Mile End Road, London E1 4NS or email batlaa@qmul.ac.uk
38 | Barts and The London Chronicle | Autumn / Winter 2009
Dear Editor John Ross’s article, ‘Membership Memories’, BLC Autumn/Winter 2008, on the subject of the MRCP examination brought back vivid memories from the early 1960s of my involvement with the FRCS – I was senior registrar when my chief Mr Hermon Taylor (HT) was an examiner It was my job to find one long case and four short cases on four days of each week for three or four weeks at a time, twice a year, and to add to the difficulty all had to be able to get to Queen’s Square. The soft option was to recruit from the tried and trusted panel of my carefully nurtured out-patients with such conditions as Paget’s disease of the bone, odd scrotal swellings or those, reeking of stale tobacco, with a variety of missing lower limb pulses and dodgy looking feet. There were never enough of these, nor were they sufficiently challenging. The only other source of suitable patients was those admitted under the other surgical firms. They mostly came in on Sunday mornings so I had to check the admission lists for likely contenders, be in early to survey the field and make sure that the outdoor clothes of my selections stayed on the ward – an adamantine rule of Matron’s Office was that they couldn’t leave the hospital without these. The lucky five assembled each morning in the front hall of the hospital at 8.30am to be ferried on by taxi. For their ordeal the patients were remunerated with the princely sum of 7s.6d. (37.5p); an insult to those (the majority I like to think) whom I had convinced as to the enormous benefit they were contributing to the noble cause of surgical education, who would have done it for nothing, and nowhere near enough for those with a mercenary motive. For me it made a lot of extra and totally unrewarded work – not even a slap-up dinner at the end of it – but a slight consolation was the opportunity I had to exercise my diagnostic skills. For instance a case of ‘cervical adenopathy’ prompted a quick trip to the library (I could get the keys on Sunday) and became bilateral
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Alumni news
Alumni news carotid body tumours. This even resulted in a small addition to my CV*. And a ‘sebaceous cyst’ on the face, which after a few moments palpation transformed into an aneurysm of the superficial temporal artery (a cricket ball injury). I was gratified to learn from the patient on his return that none of the candidates had detected pulsation. But my real triumph was in the field of leprosy – not a common diagnosis in 1960s London. The first instance was when one of the housemen told me he had a patient with a perforating ulcer on the foot and a positive WR. I simply wrote tabes dorsalis on the card and indeed this was apparently the accepted diagnosis for most of the session. But at lunch time, an agitated HT rang me with the news that towards the end of the morning an Egyptian candidate had looked at the patient and, dropping the legendary bombshell, said, “This man has leprosy.” An examiner who had worked in the tropics was consulted and he confirmed that this was indeed so. And then, a year or so later, I found myself looking at what were supposed to be multiple lipomas of the legs (a Consultant diagnosis). They didn’t look like lipomas to me but as I stood thinking and looking at the patient’s face, it suddenly struck me. Although my earlier leprosy patient had been a Somalian and this man was a West Indian, they could have been brothers: both had the leonine facies of leprosy. Another trip to the library to make sure, and in a firm and confident hand on the back of the card – ‘nodular leprosy.’ Despite the (to me) distasteful task of persuading patients to do something most of them didn’t really want to do, the knowledge that I had made a small addition to the exotica among the hospital’s statistics and the pleasure of (twice) walking into Matron’s Office to tell them they had leprosy on the premises was at least some small consolation. Peter Higgins q The London, 1955 * Higgins PM, ‘Bilateral Carotid Body Tumour’ (1965) Proc. RSM 58, 173
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Please keep in touch and tell us your news. You can submit your update using the enclosed form or by email at batlaa@qmul.ac.uk 1941 Dr Peter Miller (Barts): “Staying on” – keeping well in three storey, 11 rooms (house-and-surgery) whence and where I was a single-handed NHS GP. GP Assistant here 4/12 before the NHS. Eight grandchildren, five greatgrandchildren. Family visit me frequently.
15 years. I underwent bilateral knee replacement surgery and a prostatectomy from which I am making a slow recovery. My wife Joan died about two and half years ago. My son, also Richard, is a Consultant Rheumatologist and Consultant Physician at Ipswich General Hospital and a Senior Lecturer at the University of East Anglia in Norwich.
1943 Dr Maurice Ernest (Barts): Retired Pathologist and Cytologist. I am alive in spite of my current age. One of my friends was Michael Thomas, deceased maybe 40 years ago (he liked beer). I still own a 34ft sail boat but maybe I should sell it.
1946 Dr Zakaria Asfoury (The London): I have done lots of research and want to continue doing so. You can look at my published book on the internet for the results of my research.
1947 1944 Mr Peter JW Monks (Barts): Moved from Dartmoor to Ipplepen, in the house next to the Old Vicarage, to be near our daughter. Still fairly active and near several old colleagues.
1945 Dr Cecil Jones (The London): 40 years as a GP in Llanelli, followed by 20 years locuming. Feel I did as much as anyone for the NHS. Now collecting abnormal physical signs of my own! Dr Richard Watts (Barts): Professional life at Barts 1945-70 – (House Physician, Medical Professorial Unit; House Surgeon, Neurosurgical Unit; Demonstrator and lecturer in Physiology, 1949-55; Medical Professorial Unit, 1956-70) including service in RAMC, 1947-49. Moved to the Medical Research Council Clinical Research Centre in Harrow (CRC) where I was Assistant Director (Clinical) and Consultant Physician. I set up and was Head of the Division of Inherited Metabolic Diseases, which was a multi-disciplinary team of physicians, paediatricians, biochemists and geneticists with particular interest in lysosomal storage diseases and developing treatments for inborn errors of metabolism. On retiring from the CRC in 1988 I continued clinical work with a private practice in Harley Street for about
Mr Kenneth Cleminson (The London): Returned to the UK in 2003 after 46 years in Queensland, Australia. Mr Peter Weston (Barts): Still fully occupied with large garden, family, fell-walking and kayaking.
1950 Dr Ion-Dan Edeleanu (The London): Our nine acre garden was opened to the public under the National Garden’s Scheme in June 2009.
1951 Dr Geoffrey Birch (Barts): Awarded an MA in Medical Humanities in 2007 from Swansea University at the age of 84, after three years part-time study. Now learning German with the Open University. Dr Walter Chisholm-Batten CB (The London): Still a locum GP in Swindon, have cut down to three days a week, but still very much enjoy my work. Dr Michael Essex-Lopestri (QMC/The London): I still lead guided walks and provide commentaries on all-day cruises on London’s canals. I lecture to film appreciation courses and also to historical and other groups interested in Britain’s waterways. I write regular articles in the Journal of Visual Communication in
Autumn / Winter 2009 | Barts and The London Chronicle | 39
Alumni news
Medicine. Recent papers published in the Lancet include the history of operating theatres and my memories of my association with the first Your Life in Their Hands to mark the 50th anniversary of the BBC series. I am secretary of the Enfield Local Involvement Network (LINk) which monitors local health and recommendations to Trusts and other health care providers which must respond within 20 working days saying what action it is taking.
1958 Professor Charles Joyce (QMC, The London): I’ve been retired since 1988 but this is (I think) the first ever contribution to BLC. After writing or editing over 200 papers and five books, I have now returned to my true vocation as a poet. Dr Marion Liss (The London): Enjoying my retirement; travel, visiting grandchildren and hobbies.
1960 Dr Douglas Smith (Barts): Retired as a GP 20 years ago. Still interested.
1953 Dr Brian Hick (Barts): We are both retired and keep in touch with our Barts colleagues. I with Mike Gompertz (q Barts, 1953), and my wife (a Barts nurse) with fellow nurse Annie King. Dr Barbara Vaudrey (née Lewis) (Barts): Working two sessions a week in a slimming clinic; almost agony aunt sessions. Dr Desmond Sharland (The London): Still teaching anatomy at UCL (part-time).
1954 Dr June Brady (Barts): Chairperson of the California chapter of American Academy of Paediatrics International Child Health Committee.
1955 Mr Bryan Hauldren (q BDS, The London): My wife Margaret died in February 2002. I have three grandsons.
1956 Dr John Davidson Parker (Barts): Still attending medical meetings and playing bridge (fairly well) and tennis (very badly). Do occasional life assurance work. Taking a family history, he asked the applicant, “Are your parents alive?” The applicant, replied: “No.” JDP: “What did they die of?” Applicant: “Nothing serious, Doctor.” A marvellous answer!
1957 Dr Campbell MacKenzie (Barts): ‘Mac’ retired as Director of the Renal Unit at Bristol to sail around the world in 1992. Now looking after the medical needs of offshore and ocean yachtsmen. He follows Liz, his wife, to museum conferences and other “arty” pursuits.
Dr Francis Wells (The London): Have published the fourth edition of Fraud and Misconduct in Biomedical Research (RSM Press, London), £45. Ed: Wells and Farthing. ISBN 978-1-85315-786-8.
1961 Dr Peter Johnson (The London): Fully retired from medical practice at the beginning of January 2009.
1962 Dr Cecil Pearce (q BDS, The London): Retired from practice and as Dental Advisor for Wiltshire Health Authority. Fantastic recovery from Guillain-Barré Syndrome. Most grateful to my 1962 colleagues who gave a great deal of support. Always welcome any contact.
1966 Dr Richard Cooper (Barts): Retired in 2008 after 13 years in private practice and after 20 years at the University of Western Australia, leaving as Associate Professor of Ophthalmology.
Mr Marcus Navin (Barts): Been in Australia for 35 years. Working as a specialist Occupational Physician in Practice and in the RAAF Reserves with the ranks of Squadron Leader. Dr Simon Williams (The London): Living in Perth, Western Australia and continuing to work as a GP in South Perth. His wife – Alison (née Walker-Arnott) (The London Hospital School of Physiotherapy, 1970) is a Senior Hand Physiotherapist at Sir Charles Gairdner Hospital and was formerly in the same position at Royal Perth Hospital. Sons, James and Mark, are a Tennis Coach and Equities Analyst respectively, and daughter, Fiona, is a Mechatronics Engineer. Simon is to be seen regularly on the fairways at Royal Perth Golf Club. He is a re-born hockey player, playing State Veterans Hockey and representing Western Australia since 2001. Recently achieved national selection to play for Australia’s Over 60’s team in a Test series against New Zealand. Ali was a finalist at the 2008 Australian Masters Squash Championships, and has recently retired after nine years as National Secretary of the Australian Masters Squash Association.
1971 Dr John Sorrell OStJ (Barts): Past Chair Association of Local Authority Medical Advisors and their webmaster. Awarded Fellowship from FOM this year. Now semi-retired and have down-sized (moved house).
1973 1968 Dr Stephen Gately (The London): Advertising soon for an Assistant with a view to a partnership in Dublin. This is for the GMS. I will need to work part-time. Dr Peter Harris (The London): Took a new position as Vice-President of Oncology and have been looking after a new R&D unit in Cambridge since the beginning of March.
Mr Henry Annan (Barts): President-Elect: Section of the Obsetrics and Gynaecology of the Royal Society of Medicine, 2009-10. Honorary Treasurer of RSM from 2006-09. Miss Melissa Dominy (q BDS, The London): I finished working in 1998 because of osteo-arthritis in my hands. Thoroughly enjoying retirement; travel extensively, including Greenland, Patagonia and smaller Caribbean Islands.
1970 Mr Stephen Copeland (Barts): Retired from the NHS five years ago. Now working as an orthopaedic surgeon, specialising in shoulder surgery as Director of Reading Shoulder Unit. Married to Jenny (née Almeyda) who is now a retired GP but back working half-time. Two children, Sara and Matthew, and now three grandchildren and one more on the way!
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Dr Alison House (née Burkitt) (Barts): I work as a GP in inner city Leeds. I am due to retire shortly. Dr Mary Sutton (The London): Now retired (previously Consultant Paediatrician Community Child Health). Enjoying a quiet life; painting, walking and reading with husband!
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Alumni news
1974
1988
1997
Professor Allan House (Barts): After a peripatetic training I ended up in Leeds in 1989, first as a consultant in Leeds General Infirmary and then as a Professor of Liaison Psychiatry. Since 2005 I have been Director of a multi-disciplinary research-led institute at the university. View our website at http://www.leeds.ac.uk/lihs.
Dr Fui Quek (Barts): Part-time GP in Sutton. Also Managing Director of SynerGem, an executive search company placing senior level physicians in the pharmaceutical industry. Also busy with two daughters (19 and 14 years) and one son (six years). This year, I celebrated my 25th wedding anniversary to Swee Lip whom I married in my first year at Medical School.
Dr Caroline Jenner (Barts and The London): Absolutely loving General Practice. Planning to emigrate to Australia in the next year or two. Let me know about any BATLAA reunions over there!
1975 Dr David Low (The London): National Clinical Head of Paediatrics and Child Health (Connecting for Health) since October 2008.
1989 Dr Rig Patel (The London): Became adjunct Associate Professor of Medicine at the University of North Carolina, USA in 2008.
1976 Cllr Dr Howard Bloom (Barts): Elected Mayor of Crawley, West Sussex for the year 2008-09; he was first elected to Crawley Borough Council in 1984. He is GP Tutor for Mid Sussex, Assistant Chief Commander of St John’s Ambulance and represents the South East Thames Faculty on the Council of the Royal College of General Practitioners. Dr John Moyle (Barts): Retired as a Consultant in Anaesthesia and Palliative Medicine in Milton Keynes at the end of November 2008. Now researching for a PhD in Victorian telegraphy.
1980 Dr Alun Bevan (Barts): Living in South Africa with my wife Anne, and working for the gold mining industry as Managing Director of AngloGold Ashanti Health. Son, James, is living in London and daughter, Blanche, is working as an architect in Johannesburg. Dr Caroline Shaw (Barts): Working as an Associate Specialist in A&E at Norfolk and Norwich Hospital. Dr Mark Smith (Barts): Ill health has caused early retirement. I have discovered medical students and teaching. Loving every minute; best bits still the holidays and riding the bike too fast.
Professor Andrew Pollard (Barts): Awarded title of Professor of Paediatric Infection and Immunity by the University of Oxford in 2008.
1993 Dr Tim Child (The London): Consultant Gynaecologist and Senior Fellow, University of Oxford, John Radcliffe Hospital since 2004. Ageing rocker; joined a pub band as guitarist/singer.
Dr Mehjabeen Paliwalla (Barts and The London): Married a vet and managed to produce three children in four years! Did MRCPCH then saw the light and am now an SpR in Radiology. Due to flexible training not due to become a consultant until 2013! Living the ‘good life’ in Bucks. Dr Mark Scoote (Barts and The London): Appointed Consultant Cardiologist at Colchester General Hospital and Essex Cardiothoracic Centre on 1 April. Still happily married to Radrie (née Cole) (q Barts and The London, 1998) with two young children.
2000 Mr Graham Adlard (q BDS, Barts and The London): Currently own an expanding modern practice in Plymouth.
1994 Mr Lee David (The London): Recently appointed as a locum consultant orthopaedic surgeon. Living in Tunbridge Wells with wife, Ruth (ITU sister at Royal Free) and children, Rosie, Luke and Gracie. Dr Richard Mason (Barts): Appointed as new Chief Executive Officer of 4-Antibody AG. He joined 4-Antibody from venture capital firm Advent Venture Partners, an investor in 4-Antibody, where he had been an Executive-in-Residence. Previously he was Senior Vice-President Business Development at Cambridge Antibody Technology plc (CAT). As head of CAT’s business development team, he was responsible for numerous transactions with major pharmaceutical and biotechnology companies, including leading the negotiation of the original antibody co-discovery and co-development agreement with AstraZeneca. This subsequently led to AstraZeneca’s acquisition of CAT for $1.3 billion.
Former staff news 1967-96 Mr Alan Lettin (Consultant Orthopaedic Surgeon, Barts, 1967-96) Honoured to have been made an Honorary Fellow of the British Orthopaedic Association of which I was President in 1994.
Please keep in touch and tell us your news. You can submit your update using the enclosed form or by email at batlaa@qmul.ac.uk
1983 Mr Christopher Long (q BDS, The London): Has purchased his own practice; specialising in periodontics and implants.
Mr Nick Steele (Barts): Consultant spinal surgeon in Taunton. Happily married to Patsy.
1995 1986 Lt Col Dr David Ross (Barts): Still in the Army Medical Services and selected for promotion to Colonel in 2009. Recently taken over as the clerk of Barts Fountain Club.
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Dr Claire Bailey (Barts and The London): Living in Cornwall – GP, with two children. Sailed around the world; dismasted just after Cape Horn. Rescued by the Argentinians. Now speak good Spanish!
Autumn / Winter 2009 | Barts and The London Chronicle | 41
Obituaries
Professor WR Keatinge (1931 – 2008) William Richard Keatinge (Bill) was born on 18 May 1931. He was educated at Rugby School and subsequently studied Medicine at Pembroke College, Cambridge and St Thomas’ Hospital in London. He completed his National Service with the Navy in Cambridge (1956-8) before taking up the post of Director of Studies in Medicine and Junior Fellow at Pembroke College Cambridge (1958-60). He subsequently spent several years in San Francisco as a Fulbright Scholar before returning to England to an MRC post and Fellowship at Pembroke College, Oxford (1961-68). Bill joined the Department of Physiology at The London Hospital Medical College (LHMC) as Reader in Physiology on 1 January 1969 and was promoted to a Personal Chair in Physiology in July 1970. Bill was appointed Head of the Department of Physiology in October 1981. Following the merger of the Basic Medical Sciences Departments from LHMC and St Bartholomew’s Hospital Medical College in 1990 with Queen Mary and Westfield College (QMW), Bill became Head of Physiology in the joint school. He held this post until his retirement in 1995 when he became an Emeritus Professor. Bill ran an active and successful research group, which was highly rated and supported by the MRC for many years with a series of Project and Programme grants. Among his many publications are important articles on survival in cold water and local mechanisms controlling blood vessels. He had many international collaborations, developed especially close links with Russia and led a large EU Eurowinter grant which co-ordinated research in eight European countries. Following the break-up of the Soviet Union it became possible for him to extend his Eurowinter project to Siberia. He made full use of the advantages of being part of a multi-faculty environment at Queen Mary, University of London by forging a link with the Russian Department and learning to speak the language well enough to be understood on his visits to the new Russia. He wrote many chapters in textbooks and journals of both Physiology and Medicine, principally on temperature regulation and the control of blood vessels. Bill served as Preclinical Dean at the
LHMC at a time of considerable change and uncertainty. The merger of the preclinical departments at the LHMC with those at Barts and the move to QMW eventually happened but only after discussions lasting over 20 years and many false dawns. A new building at QMW and a new curriculum were initiated at the time of the merger in 1990 and Bill had played a leading role in designing and implementing these changes. In the following year Bill was elected Dean of the Faculty of Basic Medical Sciences at QMW. He took on the reins of authority at yet another difficult time for the Faculty when student numbers were being rapidly increased and staff appointments reduced. In 1994 Bill’s term as Dean ended and he was content to leave administration behind to concentrate on his research, which was of paramount importance to him. He retired in 1995 but continued to attract grant funding and pursue his research interests. He retained an office and facilities at Queen Mary and concentrated on environmental problems such as global warming and the fact that cold caused far more deaths than heat; he was frequently the expert interviewed by the media at times of extreme cold and during heat-waves.
42 | Barts and The London Chronicle | Autumn / Winter 2009
Bill also made substantial contributions to the teaching of Human Physiology to undergraduates and postgraduates throughout his career. He organised the Whole Body and Nutrition Module in the Integrated Curriculum, introduced in 1990 at QMW for the large combined intake of medical students at the new Mile End site. Bill was first married to Annette Hegarty who predeceased him and with whom he had three children, Richard, Claire and Mary. He subsequently found happiness again with Lynette Nelson who became his second wife. His children and Lynette survive him. Although he became ill several years ago, he faced his illness with considerable courage and dignity. He continued to work until a few weeks before his death and completed the write-up of his final projects in a distinguished research career. He died on 11 April 2008 and will be greatly missed, not only by his family, but also by his many friends and colleagues. Professor Margaret Bird (QMC, Zoology, 1969) Professor of Anatomical Studies, Barts and The London School of Medicine and Dentistry
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Obituaries
Dr Roderick JK Brown FRCP FRCPCH (1918 – 2008) Like many others of this generation Roderick Brown was a clinical master of the then growing art and science of paediatrics. After war service and higher training in paediatrics with the late Professor Watkins in Cardiff (Llandough), Dr Brown became a consultant paediatrician to the Queen Elizabeth Hospital for Children, Hackney Road (the Queen’s closed in 1998), the Mother’s Maternity Hospital, the Hackney Hospital and the Middlesex Hospital in 1959. At the Queen’s, Dr Brown succeeded the late Dr Helen Mackay who was one of the first women to be FRCP, and a most formidable intellect and clinical leader. It was my privilege to be Dr Brown’s first registrar at Queen’s and I found him a most inspiring teacher in my postgraduate years. Learned, patient and gentle but quick and efficient were his characteristics. His branch of medicine was handicapped by the lack of technological tools which we now take for granted. How we wished we could measure blood gases and oxygen saturation, and assist ventilation in the newborn! Dr Brown was a pioneer in the study of congenital heart disease but contrast radiography was in its infancy. Paediatrics and particularly the laboratory at Queen’s were leading in the development of micro-biochemistry so sparing small children the fears of venipuncure, and also
the study of inborn errors of metabolism. A few months later it was my turn to put on the National Service khaki and pips of an RAMC medical officer. I was then able to draw on the strengths of his wisdom and effectiveness and the background of excellence at Queen’s. Very advanced paediatric intravenous fluid giving sets made for the Queen’s were flown to me for use in the families’ unit in the British Military Hospital in Germany. Also, through Dr Brown’s teaching, I was able to treat there successfully, by exchange transfusion, a low birth weight baby who was the most difficult case of haemolytic disease due to rhesus incompatibility I ever saw. What a mercy it is that giving anti-D has made that previously common and grievous disorder in the newborn now rare. In 1972 I joined Dr Brown as a consultant colleague at the Queen’s, a Professor of Child Health at Barts and The London Hospital Medical Colleges, then not merged but with facilities at the Queen’s. The most respected of senior colleagues, Dr Brown’s sagacity was so much valued by us all. In their turn, our students at Barts and The London, as well as postgraduates, had the immense benefit of his teaching and guidance for another 10 years before his retirement. Emeritus Professor Christopher BS Wood q Barts, 1957
Dr Patricia Jane Bateman (1943 – 2008) Patricia was born in Westbury-on-Trym. As a child of considerable talents, she progressed easily to Barts, winning the Eye Prize while a student, and, after qualification in 1966, specialising in ophthalmology. She married fellow student Tony Bateman in 1969 and they went to work in Kampala, Uganda for two years. She was known for her dedication and hard work there. Upon returning to England they settled in Cambridge, producing two children: Wigs, an international public health doctor, and
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Dave, an IT design engineer. Patricia held a locum consultant post at Doddington for 17 years, as well as a number of Assistant Specialist posts at Addenbrooke’s and Hinchinbrooke. Her wisdom, wit, modesty, gentleness and patience won over all who worked with her. She died of a stage 4 left thalamic glioma at home, surrounded by family. She showed immense courage and is much missed by family and friends. Anthony Bateman q Barts, 1966
Dr Michael Stewart Moss (1935 – 2008) Barts pre-clinical students of the late 1950s will be sad to learn of the death, on 26 November 2008, of Mike Moss, who died during the terrorist attack on the Oberoi Hotel, Mumbai while holidaying in India. At Charterhouse Square, Mike was one of those unforgettable characters who enlivened student life. A great teller of ‘tall’ stories, he was very much into the student scene and played rugby for the Extra A team in 1960-61. However, illness, and perhaps a tendency to enjoy himself rather too much, led him to fail 2nd MB and he almost abandoned medicine in favour of the Colonial Service. With encouragement and testimonials from staff at Barts he was accepted for clinical medicine in Dublin and never looked back. He enjoyed a varied and productive career mainly in Montreal, Canada, initially at the Queen Elizabeth Hospital, and later at the Richardson. Still working at 73, he was regarded by colleagues as the elder statesman, an old-style family doctor and British gentleman. He was known for his compassion, dry wit and ability as a raconteur. He married twice and leaves four children. Janna de Vere Green (née Frears) and John Harrison q Barts, 1965
Autumn / Winter 2009 | Barts and The London Chronicle | 43
Obituaries
Dr Sarah Mitchell (1966 –2008) Sarah Mitchell qualified at The London Hospital Medical College in 1991. She completed an intercalated BSc Hons in Psychology whilst a medical student and soon decided on a career in paediatrics. Most of her early paediatric training was in North London; she completed her CCST at the Whittington and Great Ormond Street Hospitals, quickly gaining MRCP and MRCPCH.
She developed a special interest in neonatology and transport medicine for sick neonates which eventually took her to Australia with her husband, Steve, allowing her to combine her career with her other passion, travel. Sarah and Steve fell in love with Australia and settled in Perth where she became Consultant Neonatologist at the Princess Margaret Hospital and Director
of the Western Australia Neonatal Retrieval Service. Sarah worked until two weeks before her tragic death from breast cancer, aged 42, in May 2008. She bravely fought the disease for six years. To her, cancer sometimes just seemed to be a mere inconvenience that interrupted her busy and fulfilling life. Sarah succeeded in everything she tried. Her energy, vitality
and enthusiasm for everything she did were an inspiration. She achieved many great things both personally and professionally. One of Sarah’s consultant paediatric colleagues at the Whittington Hospital described her great gift of talking to the parents of seriously ill children. It is a cruel irony that a talented professional who saved the lives of so many babies and children
We regret to report the death of the following alumni and former staff Obituaries printed in the BMJ can be read at www.bmj.com and in the BDJ at www.nature.com/bdj/journal/index.html
Mr Paul Abbey q The London, 1944 Consultant ENT Surgeon, Windsor d 10 09 08 BMJ 10 01 09 Douglas Leslie Albert q BDS, The London, late 1940s b 1927 BDJ 11 10 08
Mr Richard Simon Baumber q Barts, 1968 d 02 08 07
Dr John Alexander Burnett q Barts, 1938 d 2007
Dr Gerhard Behr q Barts, 1937 Consultant Pathologist, Burnley, Lancashire b 25 01 14, d 10 11 08 BMJ 06 06 09
Professor Yvonne Carter Director, Institute of Community Health Sciences (1996-2003), Barts and The London School of Medicine and Dentistry b 16 04 59, d 20 10 09 The Guardian 26 10 09
Dr Timothy Iuean Francis Arthur q Barts, 1955
Dr James Arscott Raleigh Bickford q Barts, 1941 Superintendent, De La Pole Hospital, Willerby, East Yorkshire b 25 06 17, d 15 01 09 BMJ 02 05 09
Dr David Bailey q The London, 1946 d 31 01 09, aged 88
Dr Paul Byrne Biddell q Barts, 1953 d 25 12 06
Dr David Baker q Barts, 1980
Dr David Black q Barts, 1955 b 27 03 28, d 03 01 08
Dr John Nathaniel Highmore Andrews q Barts, 1942 d 12 06
Dr William Harrison Jessop Baker q The London, 1938 Dr Philip Taylor Ballantyne q Barts, 1946 Dr Edmund Hugo Banister q Barts, 1943
Dr Eric Aylmer Burkitt q Barts, 1942 Senior Consultant Psychiatrist, Darlington Memorial Hospital b 18 12 16, d 11 11 07 BMJ 30 08 08
44 | Barts and The London Chronicle | Autumn / Winter 2009
Dr Michael John Dolman Cassidy q Barts, 1974 b 05 05 51, d 11 01 09 Dr Joseph Connolly q The London, 1956 b 06 05 30, d 25 09 08 Mr (Rainier) Campbell Connolly Consultant Neurosurgeon, Barts q Barts, 1941 b 15 07 19, d 15 08 09 Daily Telegraph 24 09 09 Dr John Stanley Cox q Barts, 1950 GP, Portsmouth b 1926, d 27 06 08 BMJ 13 09 08
Dr Robert Davies Cundall q Cambridge/The London, 1948 Missionary Surgeon, Nigeria (1953-59); GP, Harrogate, Yorkshire b 1924, d 25 05 09 BMJ 01 08 09 Dr John William Dale MBE q Cambridge/Barts, 1961 Honorary Consultant, Public Health and Epidemiology and Health Informatics, Department of State for Health, The Gambia; Honorary Senior Clinical Lecturer, Brighton and Sussex University Medical School; Chairman, Ardingly Old Jeshwang Association b 13 01 34, d 26 11 09 Dr John Richard Eccles Davies q Barts, 1954 GP, Barnet, Hertfordshire b 03 01 27, d 02 10 08 Dr Richard J Davies q The London, c. 1970s Chairman, Department of Surgery, Hackensack University Medical Centre, New Jersey; Professor of Surgery, New Jersey Medical School, USA d 05 02 09
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Obituaries
John Joseph Richard Pollak (1933 –2009) was prevented by illness from achieving her own dream of becoming a mother herself. Through her work, her family and her friendships, Sarah touched, and often changed, the lives of countless people. She leaves her husband, Steve. Helen Shaw (née Byrom) q The London, 1991 Contributions from family, friends and colleagues
John’s early family history was remarkable: the family arrived in England from Czechoslovakia two weeks before the outbreak of war in August 1939. The family were initially unable to live together because while John’s father found a job as chief chemist at Crittals in Braintree, he was unable to find a family house in the vicinity; John, his mother and sister stayed in London. When a house was eventually found at
Silver End in Essex, John went to the elementary school there and used to caddy for the headmaster’s wife, a keen golfer. The family moved back to London and, in 1952, John started his dental studies at The London Hospital Dental College. After qualification, he did his National Service in The Royal Army Dental Corps and, on leaving the army, practiced dentistry in the City of London. John was a
long time member of the Highgate Golf Club where he held the office of President, as well as Captain, and won many trophies. He was also a first class bridge player. John bravely endured multiple sclerosis for many years before passing away peacefully in hospital, in the early hours of 30 April 2009. He is survived by his sister Daisy, who lives in New York. Geoff Pears q BDS, The London, 1957
Dr John Alexander Dew MBE q The London, 1945 GP, Horsham, West Sussex. Kept wicket for Sussex County Cricket Club; received a Lifetime Achievement Award from the England and Wales Cricket Board b 12 05 20, d 07 09 08 The Times 25 09 08 BMJ 15 11 08
Professor David John Evans q Cambridge/The London, 1961 Professor of Histopathology, Imperial; Honorary Consultant, St Mary’s Hospital, London b 1937, d 23 11 08 BMJ 21 03 09
Dr Thomas Garrett q Cambridge/The London, 1942 GP, Keynsham b 1942, d 29 05 09 BMJ 18 07 09
Mr Ronald Taylor Heylings Senior Hospital Dental Officer, Barts b 15 11 17, d 28 01 09 BDJ 09 05 09
Mr Richard J Ginns q BDS, The London, 1968 d 07 08
Dr Harold Hope-Stone q Cambridge/The London, 1951 Consultant Radiotherapist and Oncologist, The Royal London Hospital b 20 08 26, d 02 09 08 BMJ 1 11 08
Dr Roger Patrick Doherty q Barts, 1956 Consultant Obstetrician and Gynaecologist, St Bernard’s Hospital, Gibraltar b 12 05 32, d 15 06 08 BMJ 13 09 08 Dr Peter McAllister Elder q Barts, 1938 GP, The Hadhams, Hertfordshire b 07 01 16, d 14 02 08 BMJ 07 02 09 Dr Claire Hazel Epstein q Barts and The London, 2000 Specialist Registrar, The Royal London Hospital b 10 11 77, d 12 02 09 BMJ 23 05 09
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Dr James Hamilton Fairley q Oxford/Barts, 1953 GP, Caversham, Berkshire b 1927, d 11 05 08 BMJ 11 10 08 Colonel Bill Fletcher Part-time Clinical Lecturer, Prosthetics Department, The Royal London Dental Hospital b 09 12 31, d 07 10 07 BDJ 23 08 08
Sir George Edward Godber q The London, 1936 Medical Officer, Ministry of Health (1939); Deputy Chief Medical Officer (1950-60); Chief Medical Officer, DHSS, DfES and Home Office (1960-73); Chairman, Health Education Council (1977-78) b 01 08 08, d 07 02 09 BMJ 21 02 09
Dr Ronald Howard Fox q Barts, 1946 Physiological researcher and GP b 1946, d 09 07 09 BMJ 10 10 09
Dr Alistair John Gordon GP, London q Cambridge/Barts, 1961 b 1936, d 29 11 08 BMJ 21 03 09
Mr Frederick Charles Francis GDP, Chichester and Havant (1946-80) q BDS, The London, 1939 b 23 11 15, d 09 02 09
Dr Stanley Hacking q Barts, 1950 d 20 10 07
Lt-Cdr Paul Winchester Houghton q Barts, 1935 Naval Surgeon (1938-45); General Surgeon, Shrewsbury and Worcester b 30 09 11, d 05 08 09 Daily Telegraph 22 10 09
Dr Richard Harrison q Barts, 1944 d 06 12 09
Mr Louis Arnold Ives q Barts, 1938 b 28 06 14, d 04 03 08
Dr John Anthony Guy Horton q Barts, 1940 Consultant Anaesthetist, Royal Victoria Infirmary, Newcastle upon Tyne b 07 01 18, d 27 07 08 BMJ 06 09 08
Autumn / Winter 2009 | Barts and The London Chronicle | 45
Obituaries
Dr Derek Conrad James q Barts, 1950 Consultant Radiologist, Leicester Royal Infirmary b 23 01 27, d 21 01 08 BMJ 19 07 08 Dr Norman Kaye q The London, 1951 Consultant Psychiatrist d 23 06 08 Dr Frederick Donald Wills Knight q Barts, 1937 d 2007 Dr David Askey Lammiman CB LVO q Barts, 1957 Former Deputy Surgeon General and Medical Director General, Royal Navy b 1932, d 29 01 09 Professor Patrick Joseph Lawther CBE q Barts, 1950 Expert on environmental medicine based at Barts: House Physician (1950-51); Associate Chief Assistant, Medical Professorial Unit (1952-62); appointed Honorary Consultant in Environmental Medicine (1962); appointed inaugural Professor of Environmental and Preventive Medicine (1976) b 09 03 21, d 06 06 08 The Times 25 06 08 Dr George E Lovatt q The London, 1954 b 23 06 22, d 08 02 09 Dr Bruce Peter Luxton q The London, 1955 d 10 06 Professor Iain MacIntyre d 17 09 08, aged 84 Dr Kenneth Alan McCluskey q Barts, 1948 Based in Canada: Former Chief of Staff, St Joseph’s Hospital; President of Sudbury District Medical Society; Founding Chief of the Orthopaedic Department, Laurentian Hospital d 12 10 09, aged 86
Dr Peter Dennis Meers q The London, 1952 d 10 07 08 Dr Kenneth Hugh Nickol q The London, 1946 Occupational Physician, Ford Motor Company, Dagenham and Warley, Brentwood, Essex; Honorary Clinical Assistant in Respiratory Medicine, The Royal London Hospital b 04 09 24, d 16 02 09 BMJ 02 05 09 Mr Donald Hayes Norman Part-time Tutor of Paediatric Dentistry, The Royal London Dental Hospital b 24 06 19, d 26 02 09 BDJ 23 05 09 Mr Hugh Osborne q BDS, The London, 1957 b 13 07 28, d 31 08 09 Dr Philip Paton-Philip q Cambridge/Barts, 1946 Senior Consultant Urologist, Epsom and St Helier Hospitals b 1922, d 02 03 09 BMJ 13 06 09 Dr James Frederick Pearce q Barts, 1954 b 02 07 26, d 28 12 08 Dr Bernard Woolf Perlow q The London, 1946 GP, Muswell Hill, London b 21 01 26, d 17 05 09 BMJ 05 09 09 Dr Edward Hamilton Dalrymple Phillips q Cambridge/Barts, 1936 GP, Worcester Park, Surrey b 1910, d 08 11 09 BMJ 01 08 09 Dr John Michael Roberts q Cambridge/Barts, 1944 GP, Twyford, Hampshire b 1919, d 06 05 08 BMJ 16 08 08
46 | Barts and The London Chronicle | Autumn / Winter 2009
Professor James R Robinson q The London, 1943 Emeritus Professor, Department of Physiology, University of Otago, New Zealand d 28 09 07
Dr Ruth Cameron Thomas q Barts, 1965 d 30 05 08
Dr Robert Gerald Rowe q 1953 Medical Officer, Dorset County Council b 21 01 26
Dr Bryan Eykyn Lomb Thompson MBE q Cambridge/Barts, 1949 Medical Superintendent, St Luke’s Hospital, Hiranpur, Bihar, India b 1925, d 02 06 08 BMJ 09 08 08
Dr George John Rushton q Barts, 1963 d 28 08 08
Dr Douglas Ellis Truscott q The London, 1945 d 13 11 08
Dr Ruth Seifert Consultant Psychiatrist, Barts (1980-98); Deputy Chairman of Barts Medical Council (1988-90) b 20 12 43, d 04 03 09 The Guardian, 16 03 09
Mr John Watson Consultant Plastic Surgeon, The Royal London Hospital b 1914, d 15 01 09 BMJ 16 05 09
Dr Jeremy Robert Sides q The London, 1973 GP, Norwich b 1949, d 23 06 09 BMJ 26 09 09 Dr Anthony John Smith q The London, 1959 Former editor of The London Hospital Gazette; Deputy Editor of the BMJ (1965-2000) b 04 12 34, d c. 05 06 08 BMJ 14 03 09 Dr Peter Arthur Forbes Smith q Barts, 1973 d 2008 Dr Peter George Smith q The London, 1956 Consultant Histopathologist, Queen’s Medical Centre, Nottingham b 1933, d 09 05 08 BMJ 30 08 08 Dr Robert James Stout q The London, 1940 b 19 04 17 Dr Robert Miles Swinburne q The London, 1959 GP, Rayleigh, Essex b 04 07 36, d 06 03 09 BMJ 19 09 09
Mr Anthony Reynold Lucius Weekes Honorary Consultant Gynae-oncologist, Barts and The London NHS Trust b 1941, d 15 02 08 BMJ 12 07 08 Dr Brian Ralph Whittard q Barts, 1953 b 13 01 28, d 08 06 08 Dr John Richard Burton Williams q Barts, 1946 Consultant Haematologist, Lister Hospital, Stevenage b 1923, d 03 06 09 BMJ 25 07 09 Dr Robert Sidney Winwood q The London, 1957 Consultant Physician, Whipps Cross Hospital, London b 1932; d 10 12 08 BMJ 31 01 09 Dr Philip Henry Nicholls Wood q Barts, 1955 Director, Arthritis Research Campaign Epidemiology Unit, University of Manchester b 1928, d 16 06 08 BMJ 18 07 09
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Postgraduate Diploma in Clinical Dermatology – UK and Overseas The Postgraduate Diploma in Clinical Dermatology is a one year part-time distance learning course designed for practitioners who wish to further their knowledge base of clinical dermatology and improve their diagnostic and clinical management skills. The British Association of Dermatologists and Primary Care Dermatological Society recommend that GPs wishing to practise as a GPwSI in the UK are in possession of a Postgraduate Diploma in Dermatology as part of the requirements to practise (http://www.pcc.nhs.uk/uploads/pwsis/gpwsis_dermatology.pdf). There are two courses: the UK course for students who are UK residents, and the Overseas course which is designed for clinicians practising overseas who do not hold UK residency. The course is delivered via the Department of Dermatology, Barts and The London NHS Trust, affiliated hospitals and the Centre for Cutaneous Research at Barts and The London School of Medicine and Dentistry, which has an international reputation for teaching and research in Dermatology. The course starts in September and comprises three academic terms of 10 weeks duration. It offers a blended learning package delivered via an e-learning platform using Web-CT via the internet. Group on-line tutorials with the Course Director occur each term. The course covers the core dermatological curriculum with an Pub3871 BLC Advert 09 v1.qxd 17/12/08 14:40 Page 1
emphasis on the practical aspects of dermatology and management of patients as they present to the primary care practitioner. In addition to the core curriculum, the course covers dermatological surgery with reference to the NICE guidelines, basic cosmetic dermatology and non-invasive treatments, essential histopathology and wound healing. Assessment is via weekly multiple choice questions (MCQ) using the e-learning platform, submission of a 5-10,000 word dissertation on a topic selected from a prescribed list or based on patient cases from clinical practice and a two-part Clinical Examination at the end of the course. Successful completion of all three parts will result in the award of Diploma in Clinical Dermatology (University of London).
For further information about the course, including entry requirements, please contact: Ms Sam Matthew (UK students) Ms Penny Stavrinou (Overseas students) Course Administrators Centre for Cutaneous Research Blizard Institute of Cell and Molecular Science Tel: +44 (0)20 7882 7173 Fax: +44 (0)20 7882 7171 Email: s.matthew@qmul.ac.uk p.stavrinou@qmul.ac.uk
Barts and The London School of Medicine and Dentistry Barts and The London School of Medicine and Dentistry, part of Queen Mary, University of London, has invested £100 million on state-of-the-art facilities, providing a world class environment for your postgraduate study. Taught Course Subject areas • Aesthetic Surgery • Analytical Toxicology • Cancer Therapeutics • Clinical Dermatology • Forensic Medical Sciences • Gastroenterology • Clinical Microbiology • Molecular Pathology and Genomics • Public Health • Primary Care
• Sports and Exercise Medicine • Clinical Drug Development • Healthcare Research Methods • Surgical Skills and Sciences • Transcultural Mental Healthcare • Vascular and Cellular Inflammation
• Dental Public Health • Experimental Oral Pathology • Orthodontics • Paediatric Dentistry • Periodontology • Prosthodontics • Dental Clinical Sciences • Dental Technology • Endodontics
www.smd.qmul.ac.uk www.batlaa.org
Autumn / Winter 2009 | Barts and The London Chronicle | 47
Forthcoming Events
Events Below is a selection of College events taking place over the coming months. To attend or find out more about any of these events please contact events@qmul.ac.uk, unless otherwise stated. More up-to-date information can be found on our website at www.qmul.ac.uk/events
2010
2010 Inaugural Lectures
Barts and The London Sailing Club: Dinner and Drinks Saturday 27 February Past and present members of the Barts and The London Sailing Club are warmly invited to a dinner and drinks evening at the Royal Burnham Yacht Club in Burnham-on-Crouch, Essex. Club accommodation available. Price: tbc. Please email blsailingclub@googlemail.com for more information.
Newly appointed Professors are invited to give an inaugural lecture, which is their first public lecture. Please note that the information below is correct at the time of going to press, please visit www.qmul.ac.uk/events for up-to-date information.
London Hospital Dental Club Annual Clinical Meeting Friday 5 – Saturday 6 March This year’s eclectic programme has been curated by Dr Bill Meeson (q LDS, The London, 1981). For a full programme and booking information, email batlaa@qmul.ac.uk or telephone +44 (0)20 7882 7790.
Wednesday 3 March Ken Suzuki, Professor of Translational Cardiovascular Therapeutics, WHRI Willoughby Lecture Theatre
Alumni Reunion Weekend Friday 1 – Saturday 2 October Incorporating alumni of Barts, The London Hospital Medical and Dental colleges, Queen Mary and Westfield, this two-day event will be based on and around Queen Mary’s campuses at West Smithfield, Whitechapel and Mile End. To register your interest, email batlaa@qmul.ac.uk or telephone +44 (0)20 7882 3732. William Harvey Day Tuesday 26 October
Monday 1 March Sandra Eldridge, Professor of Biostatistics and Joint Centre Lead, and Clive Seale, Professor of Medical Sociology, IHSE Perrin Lecture Theatre
Monday 15 March Constantino Pitzalis, Professor of Experimental Rheumatology, Centre for Experimental Medicine and Rheumatology, WHRI Rotblatt Lecture Theatre Wednesday 17 March Andrew Silver, Professor of Cancer Genetics, BICMS Perrin Lecture Theatre Thursday 15 April Daniel Sifrim, Professor of Gastrointestinal Physiology, BICMS Perrin Lecture Theatre
Monday 19 April Patricia Munroe, Professor of Molecular Medicine, Centre for Clinical Pharmacology, WHRI Willoughby Lecture Theatre Tuesday 27 April Gareth Sanger, Professor of Neuropharmacology, BICMS Perrin Lecture Theatre Thursday 16 September Janusz Jankowski, Honorary Sir James Black Professor of Gastrointestinal Biology and Trials, BICMS Perrin Lecture Theatre Wednesday 13 October Joan Morris, Professor of Medical Statistics, WIPM Wolfson Lecture Theatre Tuesday 30 November Kairbaan Hodivala-Dilke, Principal Investigator Angiogenesis Laboratory, Centre for Tumour Biology, IoC Willoughby Lecture Theatre
Recent inaugural lectures
BATLAA Annual General Meeting Tuesday 26 October BATLAA Dinner and Dance Friday 19 November Drapers’ Hall, Throgmorton Avenue, EC2N 2DQ To register your interest, email batlaa@qmul.ac.uk or telephone +44 (0)20 7882 3732.
48 | Barts and The London Chronicle | Autumn / Winter 2009
Monday 23 November 2009 Professor Amrita Ahluwalia: Sex and drugs – my rock ‘n’ roll L-R: Professor Sir Nicholas Wright, Warden; Amrita Ahulwalia, Professor of Vascular Pharmacology, Centre for Clinical Pharmacology, and Professor Mark Caulfield, Director and Centre Lead, William Harvey Research Institute
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