12 minute read

Meet our Medics

It has been a hard year for healthcare workers. Nonetheless, Old Perseans who are studying, practising and teaching medicine continue to thrive from the challenges and fulfilment that their careers bring.

I THINK I ALWAYS wanted to be a doctor, and when I look at my life, family, job role and career trajectory it is difficult, I think, to see a more rewarding balance. I am a Consultant Trauma and Orthopaedic Surgeon in the UK, and my specialty interest is soft tissue knee surgery.

What does this mean? Half of my time I am fixing broken bones and mopping up the injured; the other half is keyhole multiligament knee surgery, leg realignment and eventually knee replacement. I operate on those aged 10 to 100. In my quietest hour, and don’t let this get out, I would admit that I would happily disconnect my job from its salary! Does my wife read this?

I left The Perse in 1993 to study at Nottingham Medical School, and five years later emerged as a qualified doctor. The standard pattern then, and it’s changed quite a bit now, was 90-hour weeks, with a subsequent focus of your specialty interest according to what took your fancy, and what you were successful at applying for. Over the years the hours decreased a little. Get ready to give up your time! Learn to sleep anywhere, in any position, on any surface (which is also useful when kids arrive later). Orthopaedic surgery quickly became my focus. I’m hands on, I make things better, I am the carpenter for geeks. The role has tough hours and involves many patients, amazing camaraderie, never-ending exams, and multiple interviews. Nobody makes you apply for surgery. There are much shorter career pathways in medicine. I worked it out later: my first exam was aged eight to apply for entry to the Prep, then exams every three to four years until age 33. I stopped exams and bought myself an expensive Swiss watch as a reward/cliché.

Then, frighteningly, aged 34 I emerged the other end as Consultant Surgeon – essentially a solo ship’s captaincy, and nobody at your side to help. Although of course, a modern hospital has lots of colleagues to ring for help. A retiring professor friend of my father sat me down on day minus five and said “Rule one: ask for help. Rule two: when things go wrong, go immediately to the patient, apologise and tell them everything.” There is no more sage advice.

Mostly I fix adults, but I treat children with busted knees. I do meniscal transplant, whereby we put in a piece of tissue from a deceased donor to salvage someone else’s knee. This is cutting-edge. We do paediatric Anterior Cruciate Ligament (ACL) reconstruction in the pre-teens and even ten years ago when I started, this was experimental. I performed an ACL reconstruction on a patient in his twenties, who years before had needed a heart transplant. His heart had stopped on the pitch aged seventeen, requiring transplant. He really wanted to get back to football. I recently treated a young man, a farmer, with a full knee dislocation, three out of four ligaments torn and nerve injured, floppy foot. This is a life-changing injury. He told me his parents were looking to sell the family farm (his inheritance) if he didn’t recover. He and I have had a lot of success and hard work, and he is back farming now. There are failures, and I have failures just like any other surgeon. There is death. You have to learn to accept it, learn and move on. There is nothing with more gravitas than looking a patient or relative in the eyes and admitting that it has gone wrong, and I am solely responsible.

I am part of the steering group for the National Ligament Registry; we collect patient and operative data on surgery. Prospective research on knee surgery is aimed at refining outcomes and working out what surgical techniques work best. I fund this through soft grants from industry and we are working on getting the government to fund it. The UK is part of the leading group of world surgical registries, and I want to give back, whilst using data accurately.

There are infinite challenges and new directions in the NHS. Pioneers invent new treatments and then steer the research and development to deliver proven clinical practice. Anyone can be that pioneer.

Covid-19 has ricocheted through orthopaedic surgery massively. We obviously stopped all nonemergency surgery initially, but resumed slowly from about September 2020. The fracture surgery continued throughout. In the worst times, I went back to a junior doctor role on the wards to cover doctor absences, back to what I did in 1999 as a 23-year-old. Nobody was specialist, everyone was just a doctor.

I am very happy with my success in the NHS, which started with the amazing springboard The Perse gave me into a scientific pathway. Doctoring is challenging and rewarding. Other people make more money, but it’s a people job and the ability to make people better is compelling.

Maddie Baron (2016)

I JOINED THE PERSE in Year 9 and I left in 2016 after finishing A Levels. I loved my time at the School, particularly biology and art. I went straight from The Perse to the University of Bristol, where I studied medicine. I studied for five years, graduating this summer.

I am now about to start my first job as a doctor at the Princess Alexandra Hospital in Essex. I applied to this hospital as it offered a programme for aspiring paediatricians. Throughout school and university, I always loved working with children and since 2014 I have worked at a playgroup for children with Special Educational Needs and Disabilities in Bishop’s Stortford. I plan on spending my free Saturdays volunteering there, as I cannot face saying goodbye just yet! During my fourth-year placement in paediatrics I learnt a lot about the role of a paediatrician, and I have wanted to do it ever since.

At the end of medical school there is an elective period where students usually travel all over the world to experience different health care systems, but sadly Covid-19 stopped me from doing this. Instead, my placement was in the Children’s Hospital in Bristol, which is one of the leading paediatric centres in the country. I worked in Accident and Emergency (A&E) and loved every minute. In A&E there is a vast range of children coming through the door every day, and usually we are able to address their needs and send them home that same day. The best thing about paediatrics is that children’s bodies have such amazing resilience, and usually bounce back to full health after minimal treatment.

After graduating from medical school, junior doctors spend two years rotating around six different specialties. My first job is in geriatrics, and my second job will be in paediatrics. After these two years we are then able to specialise. In paediatrics it then takes a further seven or eight years to become a consultant (although most people will take longer as they spend a year working abroad, teaching medical students, or studying for a master’s or PhD).

I cannot wait to get started, although I am nervous. It will be lovely to feel like a useful team member within the National Health Service (NHS) and it will be great to start getting paid!

It was at The Perse that I first thought of becoming a doctor. After deciding this was the career for me, I was given a lot of support and guidance from the School. This included work experience, volunteering and in my application to university. I am very grateful for this as it has got me to where I am today. I would highly recommend studying medicine, and hope many more students from The Perse continue to go on to do so.

IT WAS AT THE PERSE THAT I FIRST THOUGHT OF BECOMING A DOCTOR. AFTER DECIDING THIS WAS THE CAREER FOR ME, I WAS GIVEN A LOT OF SUPPORT AND GUIDANCE FROM THE SCHOOL. THIS INCLUDED WORK EXPERIENCE, VOLUNTEERING AND IN MY APPLICATION TO UNIVERSITY. I AM VERY GRATEFUL FOR THIS AS IT HAS GOT ME TO WHERE I AM TODAY.

I LEFT THE UPPER SIXTH at The Perse in 1998. My brother, Jonathan, left in 1996 and my mother, Penny, was the founding Head of the Pelican.

I went straight to UCL to study medicine. In 2001, I took an intercalated Bachelor’s degree in Pharmacology and spent the summer at Rockefeller University in New York City. The head of the lab, Paul Greengard, had won the Nobel Prize for Medicine that year and I came back a few days before 9/11.

I qualified as a doctor in 2004 and eventually specialised in nephrology (the branch of medicine dealing with the kidneys), transplantation, and general internal medicine. Along the way, I completed a PhD using whole genome sequencing technologies to try and work out why some people are affected by kidney disease. This gave me skills in data science and coding, which I now use to train and test machine learning models that might predict patients at risk of kidney failure.

I was appointed as a Consultant in nephrology and general internal medicine at the Royal London Hospital (RLH) in 2017. I look after patients with a range of kidney diseases, those whose kidneys have failed and are on haemodialysis, and many who have had kidney transplants. Kidney disease is closely linked to deprivation and East London has one of the highest rates in Europe, so we are kept busy!

Covid-19 has affected us all at RLH. East London was hit very hard. You may have seen Clive Myrie’s reports on the BBC from our hospital during the peak; these really captured what a disastrous period in UK history the winter of 2020–21 was. As a General Physician, I have seen many incredibly sick patients with Covid-19. It has also been very challenging for our vulnerable patients who are on dialysis, and immunosuppressed.

Medicine genuinely gives you opportunities to apply new and evolving science, treatments, and technologies to improve people’s lives. However, you are unlikely to be rich. In terms of advice for aspiring medics, I would advise that you never forget that each patient is an individual who thinks about things in their own way. Find out what is important to them about the decision you are making with them, and your job will be much more rewarding. Emails cost nothing. If you are interested in something someone has done – write to them and ask about it. You never know where it might lead...

I think I learnt two major things at The Perse which I still use to this day. Firstly, if you’re surrounded by talented people, you get more done if you work together than if you try to compete with each other. Secondly, achievements you have in life should always act as the motivation to start looking for the next challenge. Oh, and I still love Shakespeare thanks to mummery English lessons!

I LOOK AFTER PATIENTS WITH A RANGE OF KIDNEY DISEASES, THOSE WHOSE KIDNEYS HAVE FAILED AND ARE ON HAEMODIALYSIS, AND MANY WHO HAVE HAD KIDNEY TRANSPLANTS. KIDNEY DISEASE IS CLOSELY LINKED TO DEPRIVATION AND EAST LONDON HAS ONE OF THE HIGHEST RATES IN EUROPE, SO WE ARE KEPT BUSY! I STILL LOVE SHAKESPEARE THANKS TO MUMMERY ENGLISH LESSONS!

Sofia Baldelli (2018)

I CHOSE TO STUDY medicine because I love human interaction and science. During my pre-clinical years (the first three years at Oxford) I was able to develop my understanding of the science underlying medicine. This furthered a passion for developmental medicine that had begun with my Rouse project whilst at school, looking at twin-to-twin transfusion syndrome (of particular interest to me as I am a twin myself). I was also able to complete a research project in vascular biology in the Department of Pharmacology as part of my third year, which was an amazing experience.

One of the slightly strange things about Oxford is the limited clinical exposure you get in the first few years. However, during the Covid-19 pandemic I was thrust into the clinical world by working as a health care assistant in a neurological specific palliative care home in Peterborough. A memory I will never forget is the simple task of feeding a man with Covid-19 a yoghurt and then coming in the next morning to find that he had died overnight. This was the reality of the Covid-19 pandemic and will never leave me.

Having now returned to medical school and started my clinical years, I am struck by how much I have learnt in three years, and also how much more I have to learn. I am also very aware of how much has changed due to Covid-19. One of the key things I noticed on my recent GP placement in Reading was the huge decrease in face-to-face consultations compared to my work experience in 2017. The increase in efficiency was obvious but I personally was saddened at the decrease in human interaction. Many of my feelings were shared by the GPs and obviously many patients, but with the overwhelming numbers that GP practices are now dealing with it seems near impossible to go back to a system of only face-to-face consultations.

Extra-curricularly, I have been able to get involved with several societies, including the Paediatrics Society and Oxford University Friends of MSF (Médecins Sans Frontières). I’ve also been involved in non-medical societies, including being President of Oxford University Hockey Club and Atalanta Society (Oxford’s Society for Women in Sport). I was the goalkeeper for the Oxford University Women’s Hockey Team for the past three years, continuing the passion I developed at The Perse. This is important for me as it shows that although you might be studying one of the most intense degrees, there is still time to do other things that you love.

Studying medicine is a blessing and I’m so excited for the next three years I have at Oxford and my career ahead!

DURING MY PRE-CLINICAL YEARS... I WAS ABLE TO DEVELOP MY UNDERSTANDING OF THE SCIENCE UNDERLYING MEDICINE. THIS FURTHERED A PASSION FOR DEVELOPMENTAL MEDICINE THAT HAD BEGUN WITH MY ROUSE PROJECT WHILST AT SCHOOL... I WAS THE GOALKEEPER FOR THE OXFORD UNIVERSITY WOMEN’S HOCKEY TEAM FOR THE PAST THREE YEARS, CONTINUING THE PASSION I DEVELOPED AT THE PERSE. THIS IS IMPORTANT FOR ME AS IT SHOWS THAT ALTHOUGH YOU MIGHT BE STUDYING ONE OF THE MOST INTENSE DEGREES, THERE IS STILL TIME TO DO OTHER THINGS THAT YOU LOVE.