Dr David Zuck: Full Transcript

I:             Right this is Michael Ward at the Association of Anaesthetists, Bedford Square on the 24th April 2012, interviewing David Zuck and I will ask you David to start off by telling me your full name.

P:           That’s it <laughs>.

I:             Oh nice and easy. I’d like to start at the very beginning. Tell me a little bit, if you don’t mind, about where you born and a little bit about your family background.

P:           Well I was born in Birmingham. Family background was that both sets of grandparents came over to this country in the early 1900s from what was, well the Russian occupied part of Poland and they settled here. My father served in the British Army during the First World War and automatically got British Nationalisation. It was an introduced marriage, my father was living in Leeds, my mother in Birmingham and they had a mutual friend who thought they were two nice people who would <laughs> suit each other, really. I’m the oldest of three brothers; the middle one also did medicine; youngest – dentistry, all at Birmingham.

I:             Was your father a medic?

P:           My father had a couple of shops and some drapery, outfitting clothing and that sort of thing. My maternal grandfather actually was extremely profound, he was a scholar, which didn’t earn him any money so <chuckles> they ran a grocery business, which I think was the only one in Birmingham – Jewish.

I:             And was the family’s name Zuck then?

P:           No, my father’s name was Zucoffsky and then they decided in the early ‘30s to rather stupidly anglicise it. My father wanted to change it altogether but my mother had some sort of sentimental attachment to part of it so that’s what I ended up with.

I:             And where were you at school?

P:           I started off in ordinary elementary school I suppose it was called, and I won a scholarship to what I think was the second best grammar school in Birmingham at the time, which was called Five Ways. From there I went into medical school which was in 1940.

I:             You were the eldest?

P:           I was the eldest.

I:             Had you always wanted to study medicine?

P:           No, actually I think it was much more my father’s urging because he wanted … things were very dodgy and certainly towards the end of the 1930s he wanted us to have, what he called, a portable career, occupation, which in fact wouldn’t have been that portable <chuckles> because anyone trying to get into, let’s say the States, would have found great difficulty in practising medicine without having to be qualified. But anyway, that was it. I think I was always on the science side.

I:             So it wasn’t too much of a hardship for you to decide to do medicine?

P:           No, I was rotten at maths, so again it was <laughs> in those days it was what you did if you were no good at maths and physics.

I:             What made you choose Birmingham Medical School?

P:           Well in those days, again, everyone went to the local medical school, you didn’t leave home. I think what’s happening today when everyone whizzes off as far as they can from their homes is a post-war phenomenon, which I think has made life probably more difficult for a lot of people. So you just went to your local medical school unless you were, you’d done your pre-clinicals at  Oxford or Cambridge where there wasn’t sufficient backup on the clinical side, so we had one or two people who had been at one or other of those who came to Birmingham for their clinicals.

I:             Did you enjoy medical school?

P:           On the whole yes. I learnt later on that it was unusual in being very cliquey, there were groups of people who’d been at the same sort of prep school or whatever it was and they tended to stick together. Now my brother, his year was completely different, everyone mingled and knew everyone else and so on. I think we gradually got to know each other because one of our functions was fire watching and when we had our 50th anniversary reunion in ’95 it would have been … that was the thing that people talked about, not about the lecturers <laughs> of anything else but just that experience. I can remember being on the roof of the medical school and seeing a great combustion going on which was actually Coventry burning, and that was about 30-odd miles away. So we were up there with our buckets of sand and stirrup pumps. Later on when we were into to the clinical year we manned… there was an emergency hospital in the basement of an old brewery in Aston, which was built on the side of a hill, and the basement had about 120 beds and a temporary operating theatre, a sort of make-do thing. And you went in at the top of the hill and you went down something like six floors to the bottom and that was where we were. There was a small little kitchen in one corner where we could make ourselves a bit of supper or breakfast, and there was a door and <chuckles> one day somebody decided to open this door and found themselves in the street <laughs> and in fact we were right down at the bottom corner of this hill and if a bomb had come down there the whole place would’ve gone up, you know we were not being protected by six floors at all <laughs>.

I:             It must’ve been a very exciting time.

P:           Well fortunately we never had to do anything but there was one occasion when we did, we acted as stretcher bearers in ’41 I think it must’ve been, there was a big bad raid on Birmingham and they had an emergency operating setup in one of the departmental stores in the centre of town and we were drafted in there to just move patients around. I think they had about six tables going.

I:             By the end of your course….. you graduated in, what year was it?

P:           ’45, June ’45 yes.

I:             OK. As you left medical school had you given any thoughts to what branch of medicine you were going to go into? I know what happened later but…

P:           No, I was thinking of becoming a physician, so I got a house physician’s job at Selly Oak Hospital, largely because I was fed up with the academic part of the …  you know the [7:33 IA] and the General. And also because this job paid £4 a week and I think you got a so-called honorarium of 50 quid at the end of your time if you worked in the teaching hospitals. And I’d learnt more in that six months at Selly Oak than I learned certainly practical stuff than I’d learnt in the previous <chuckles> five years, but you were really thrown in straight head first.

I:             Before we talk too much about your first medical job, I’m going to take you a couple of years back to your student days: did you have other interests outside of the medicine, were you involved with sport or drama, music?

P:           No, I think my interests would have been purely reading and literature, history, listening to music.

I:             So you already interested in history.

P:           Oh yes.

I:             Always?

P:           Yeah we had a very inspiring history master at school, I think it dates from that.

I:             Well we’ll come back to history perhaps later as we go on.

P:           Yeah

I:             So you qualified in 1945 and you got your house physician job in Selly Oak?

P:           Selly Oak yes. Now Selly Oak in those days, there was an acute part and an infirmary part which was a hangover from the old workhouse infirmary which had about 500 beds. And my chief was a sort of long-term locum, real time locum for the chappy who’d been called up and the other two physicians had dumped all the infirmary beds onto him, so I had something like you were supposed to see every patient once a day so I had all this to… well you just sort of whizzed round, ‘Everything alright?’ sort of business. But it was an incredible treasure house of chronic conditions, multiple sclerosis’ and all those sort of chronic neurological states, much of which I’ve forgotten already for which there was no treatment at all, and very bad contractures, a lot of them. And then on top of that there was an official called the Relieving Officer – he had the authority to sign a Relieving Officer’s Order and the relatives would take that along to the hospital and the patient had to be admitted, no argument about it at all you see, so if old grandma or whatever, was getting beyond their care they would go along, get this order with no trouble at all and then you had to take these people in. So they all had to be seen on the admission wards and then … yeah and they were coming in in fairly regular stream.

I:             And this of course was before the NHS came in?

P:           Oh yes.

I:             And so was there anything to pay on the part of the patients?

P:           No, no, no.

I:             Nothing, it was a charity?

P:           No, you see Selly Oak was a municipal hospital so it was all free.

I:             So anything else about that first house job, there was one story…

P:           Well apart from the fact that  dumped into anaesthesia.

I:             Well tell me that story.

P:           OK. There were three surgeons, each with a house officer, three physicians similarly, that was it, that was the total medical staff for virtually a thousand-bedded hospital <chuckles>. There were two married lady anaesthetists who came in once a week each and did an afternoon list of about two hours, routine hernias and things, but they had to be away so that they could collect their kids from school at three-thirty. All the emergencies were anaesthetised by the house physician, who also were on casualty duty for 24 hours every third day, in addition to having to do all their… it was a completely different life and we loved it on the whole. The only thing was we had a very … dragon of a casualty sister who would say, ‘Go off and have your lunch’ so at one o’clock you went off, any patients who came in they, ‘Ooh doctor’s gone,’ blah blah blah. So you were looked after by the nursing staff.

On the first Friday morning, I was having breakfast about half-past-eight and the phone rang and I was going to the phone and the voice said, ‘Where are you?’ And I said ‘Oh well I’m…’ and she said, ‘Mr Reading is waiting.’ And I said, ‘Well, you know…’ and she said <chuckles>, ‘Oh you poor soul,’ I can remember the words exactly, ‘Has no one told you that Dr Schnider’s health physician anaesthetises Mr Reading’s tonsil list on the Friday morning?’ I said, ‘No they don’t,’ she said, ‘Well you better get along here because he’s waiting,’ So I had to abandon my breakfast. When I got there actually he’d started without me and he had anaesthetised the kid himself, he had a catheter in the nose and the plunger of the ether bottle was down to the bottom and it was bubbling wildly through there and the sister was helping with a couple of pairs of Cheatle’s forceps. And I have a pair at home because they’re marvellous for taking teaspoons out of the waste disposer . They were designed by a Dr Cheatle  and they were long-handled and long-shanked forceps and they were kept in a long cylindrical container of some sort of antiseptic, so the bottom end was always supposed to be sterile and the nurse could pass things to scrubbed up surgeons and so on.

So she was handing him things off the instrument trolley, he was getting <laughs> on with it … <laughs> and I kind of pulled … the first thing I did was I pulled the plunger off the ether bottle, she sort of drifted round and pushed it down again with her elbow <laughs> and when she’d gone back to the trolley I pulled it back up again so she sort of shrugged and about two minutes later the kid started coughing so of course I…

I:             Pushed it down again.

P:           … put it down. So that was a good lesson. After he’d done the first case he said, ‘How much anaesthetics have you done?’ I said, ‘Well I did the obligatory 20 under supervision’ which we had to do in those days. He said, ‘Well if I’ve got you for six months I’d better started teaching you something.’ And it turned out that he was, as a secondary interest, he was very interested in anaesthesia and he was a very skilled, for those days, in inhalation inductions and so on. So he taught me quite a lot there then he showed me how to use the laryngoscope. I once went into Charles King’s shop and tried to buy a cuffed endotracheal tube  and there were no such thing on the market, I mean they were in the books. The only thing I could get was a sort of free-floating cuff which is sort of slid onto the tube which was jolly dangerous because when you pulled the tube out you could easily leave the cuff behind . So cuffed tubes, they were just not there but you would pass them, if there was any danger of blood say getting back down into it, you’d put it in a saline pack. So he taught me that.

Virtually at that moment I was fully trained because those were the techniques that one needed.

The youngest of the three surgeons was also a very friendly bloke and I hung around with him a little bit, he did all his work under spinals, all his emergencies, and one day he said, ‘Would you like me to show you?’ I said, ‘Yes please’ he said ‘It will be very good because once you are able to do it I can go and scrub up while you put the spinal in .’ So I learnt all about anaesthetics because of a certain amount of self-interest. Well Phillip Reading actually, shortly afterwards he got on the staff at Guy’s and my own chief was a chap called Charles Baker, he came back for, I think he was probably back for about six months and then he also got on to Guy’s. In the anaesthetics bit, he’d turned up, he’d had a six cylinder Rolls in storage for the whole of the war and the first thing he did was go and get it out you know petrol was rationed – I think it did about two-miles-to-the-gallon, something like this. So anyway one day this whacking great Rolls turned up and was parked outside the doctors’ room . Somebody else who was demobbed, two or three days after there was an eight-cylinder Rolls parked next to it. And my chief was rather narked, and then somebody’s got a bigger car.

I:             Those were the days when the consultants’ car park had Rolls Royces in it. Yes indeed.

So you were taught your anaesthetics primarily by a surgeon, or two surgeons.

P:           Yes

I:             How fascinating.

P:           Now my chief actually, we used to do ECGs on Thursday mornings, once a week, in a dark, blacked-out basement, using a machine … well it was one of these which they were … well I suppose it was sensitised cardboard or something, but it went across on the little engines of the thing and had to be developed afterwards, and I think if we did three cases a week that was a lot. So the amount of ECGs recorded  then was  very little.

I:             And what sort of monitoring would you have been using in those ENT cases?

P:           Pulse I suppose, and watching the breathing.

I:             That’s it?

P:           Yeah. I gave my first anaesthetic at the age I suppose of 19 – virtually 70 years ago, in the casualty department of Birmingham General Hospital, using an apparatus which must have been at least 50 years old. It was a cylinder on the floor, a big capnography bag I think they called it, and a face mask, and a little valve which allowed you to either divert … a patient could either breathe air or he could breathe from the bag and out to the atmosphere or he could breathe back into the bag.

I:             And the cylinder was nitrous oxide?

P:           The cylinder was nitrous oxide and it was on the floor and you worked it with your foot on the pedal sort of thing and I was just starting my clinical studies. I was taught by the chap who’d learnt it the week before.

I:             Oh my god!

P:           Yes, I know! <Laughs> And the instructions were ‘Give him pure nitrous oxide till his ears look blue. Then you give two breaths of air and then you go onto a three to one’ or whatever. So it was one of air, two or three of nitrous oxide. ‘If he starts jerking, give him a bit more air.’ No oxygen, air. And I eventually got quite good at this.

<Laughter>

And I noticed that, quite a useful slide, if the ears started looking a little bit reticulated, you knew that he was unconscious because you were just getting … you could see the blue blood going through the capillaries.

I:             And that was used in the A&E department? Casualty?

P:           This was in the casualty department, opening abscesses. Sepsis was very, very common then. There were no antibiotics, although there were sulphonamides which didn’t work against staphs.    So we got lots of carbuncles and whitlows, that sort of thing. And you might be doing … anything up to 10 cases in one session.

I:             And no morbidity?

P:           Oh gosh, nobody ever knew.

I:             Not that you know.

P:           I mean they were all our patients, I can remember they were jolly glad to …

I:             But they walked out again, that’s the important thing.

P:           Well they went out some way!

<Laughter>

I:             OK.  So was there anything else you would like to tell me before we move on beyond your first house job?

P:           Yes. Because we did see quite a bit of anaesthetics given in the main theatres, almost invariably they were inhalational inductions, the Senior Resident was a chap called Murtheh. He’d did intravenous inductions. Thiopentone then was 5%. It was reduced to 2.5% by the manufacturers in the early fifties I think, largely because of local extravasation.

I:             Really

P:           Yes. The technique was that you gave the thiopentone till the patient was unconscious. Then you gave the same dose again straight off, which stopped them breathing of course. You then put them onto gas, oxygen and ether and you just hoped that when they started breathing they didn’t go into laryngeal spasms! Quite often they did. And also I did wonder, although I knew nothing about anaesthetics, it seemed to me a slightly crackers sort of way to go about things. But everybody else did inhalation inductions and there was an old … I say old, I guess he was probably in the 50s, a chap called Dr Hassle, and he would start off with ethyl chloride and open ether always on a Schimmelbusch type mask put his hand in his pocket and he’d pull out a little bottle of chloroform and he’d look around and say, ‘Don’t tell anybody you’ve seen this.’ So he was giving a sort of combined ether/chloroform type of anaesthetic. And seemed to go alright. He was very … much trusted by the surgeons. They said he never flapped and he was a good steady pair of hands.

I:             And how much of that was open ether, rather than from a Boyles machine or equivalent?

P:           I think his was … it seemed to vary with the person. His was always open. Murtheh would always be in a Boyles machine. The hospital was equipped … opened in about ’38 and all the machines were bobbin flow meters. I don’t know why. Rotameters were available then but … that was it.

And again it was just gas, oxygen and ether in most places; Trilene  hadn’t really come in properly I think at that time.

I:             Was anybody using closed circuit?

P:           Yes, we had closed circuit. I can’t remember what … There was a separate outfit, there was an American neurosurgeon who had his own unit in one of the wards in the Queen Elizabeth, and he had a woman called Marion Green who did all the neurosurgical anaesthesia, so we didn’t really get very far into that so I don’t know what sort of techniques she was using. But I do remember the Coxeter-Mushin absorber coming out with the fluorescent knobs so you could see it in the dark if the light failed! <Laughs>

I:             So those experiences with Mertheh and Hassle, that was when you were a student?

P:           Mm. you had to get signed off for 20 anaesthetics. Generally you were supervised by registrars but we didn’t do any intravenous inductions at all.

I:             Did people at the end of their medical school say, ‘I want to be an anaesthetist’?

P:           No, never.

I:             Never?

P:           Never! <Laughs> I have vivid memories of watching some chap sitting at the end of the table half asleep and thinking to myself, ‘Who would want to spend the rest of their life doing that?’ Having gone through the whole of medical training. <Laughs>

I:             But in fact when you found yourself doing it, during your house job, you did enjoy it.

P:           No, I enjoyed it then, once I’d got the grasp of the techniques. You felt that you were doing something useful that maybe other people weren’t and you were in a way part of a team.

I:             So that takes us up to the end of your first house job really.

P:           Yes, can I go back a little bit?

I:             Yes, please do.

P:           Some things were incredibly primitive. I remember the first blood transfusion I ever saw was a large funnel-shaped glass container, open at the top, red rubber tube connected to the bottom of it which went into … in those days nearly all the drips were what were called cut-downs, you cut down onto the vein, you put in the cannula, could be either glass or metal and tied it in; and as the level of BP got lowered somebody tipped a bottle of blood in … and it was covered with a bit of gauze … Well after that, we gradually we got red rubber proper giving sets with rubber tubing. The received wisdom was that you couldn’t keep those sterile, you couldn’t keep the system sterile for more than say 24-36 hours because patients invariably developed phlebitis. And so one was encouraged to change the site, perhaps every day or whatever. And then when the plastic giving sets came in they discovered that the patients didn’t get phlebitis once! And what was happening was that the plasticiser or something was being leached out of the red rubber tubing, which was causing …

I:             Sulphur probably, yeah.

P:           Yeah, incredible! One other thing I learned was that all the worthwhile advances or developments were all due to the initiative of the commercial companies. One occasion where the Minister of Health got involved, they designed a giving set which was not a continuous sort of thing but … I think it was by people called Cup & Heaton, and it plugged in together so that as in those days when you wanted to pressurise it a bit and increase the flow, you would actually be pumping air into the bottle and this thing used to blow apart, and there was so much ridicule was poured onto these that the Department just decided it was never going to get itself involved in producing anything else again. So all the big advances are due to common sense.

I:             I think that’s still largely true now.

P:           I think that’s true as well. Yeah. You see, the other big difference was that nothing was disposable. Needles were used time and time again. They were sharpened, quite often you might get a needle that was caked with blood on the inside. It really was ghastly <laughs> and when the companies started trying to push disposable things, which our reaction to start with of course was, ‘You can’t throw that away! You can’t just use it once!’ And they went into a lot of trouble to work out the contrasting financial … they said, ‘Well you’re employing staff to do this, that and the other. It’s costing so much.’ And the comparison was always of course on their side, plus the tremendous advantage in not having to worry about infecting people with somebody else’s stored blood!

I:             I think, when I started medical school in the late sixties, they were still using glass syringes for taking blood. We had disposable needles at the end of them, so it really didn’t go over completely until probably in the early seventies or very late sixties. It’s remarkable how quickly it then happened once it started.

P:           Yes. I think the present system, which is brilliant, came in just as I was retiring. It would have been in the mid to late eighties I think. And having been the subject of <laughs> fairly frequently since then, it really is a great, great advance.

I:             When you started giving anaesthetics then, in the mid-40s, a patient, did they ever ask how risky the anaesthetic was?

P:           No.

I:             They just … didn’t think about it, or …

P:           It was accepted by the general public that some people couldn’t take the anaesthetic. If you had a death that was the accepted reason, excuse, ‘couldn’t take the anaesthetic.’ Nobody questioned it.

I:             I don’t know the figures for the morbidity of anaesthesia over the ages. One imagines it was much higher than it is now, but …

P:           Mm.

I:             Anyhow, was there anything else you wanted to say about the very early days?

P:           No, not until I went into the … I was called up.

I:             Well that’s where I wanted to go now. When you finished your first house job, a six month house job was it?

P:           Yes.

I:             House Physician, that’s when you got called up?

P:           Mm.

I:             And you went straight into the RAMC?

P:           I think I had about a two-month wait and I got a temporary job doing anaesthetics in a dental clinic, which was run by the Birmingham Corporation, for which I received the fantastic sum of £12 per session, which really was a lot of money in those days. The dentist was ex-Royal Army Dental Core I suppose; we were supposed to do something like a dozen patients in a three-hour session. We were invariably finished within an hour and a quarter. I mean his technique, as soon as I said right, He’d go “pull, pull, pull, pull, done”. And these were all pregnant women.  Whether they were susceptible to more conservative … treatment I just don’t know, but we were doing … well simple clearing, not doing molars, but things that came out were just quick pull. And then they were taken out and sat down in a waiting room and given a swab to hold to stop the bleed. That was a very primitive …

I:             And was most of that anaesthesia also gas and air?

P:           It was all gas and oxygen in those days. We had a Walton Mk 2, which I think was the best model they produced actually.

I:             That had a foot pedal as well, didn’t it?

P:           Yes, it had a big handle at the top which you could work with your elbow, so both your hands were free.

I:             I think I’ve used that – in a dental clinic, yeah.

<Laughter>

OK, and then you were called up.

P:           Then I was called up.

I:             So tell us about your military experiences.

P:           Well we had a sort of six-week induction period in the wretched Barrack near Aldershot.  We were sent of for about a week’s leave or something, and then you were … you crossed over to Calais, got on a train and I think we were driving through Holland, Belgium I suppose, till we got to the German border, and the difference as we crossed, there was absolutely … we were travelling through very pleasant countryside, small villages and that … and then all we saw was total devastation.

I:             Once you got over the German border?

P:           Once we got over there, yeah. And … hardly a building standing for miles and miles and miles and miles.

I:             So this was a year after the end of the war?

P:           About nine months after the end of the war I suppose by then. It was actually … I think we went over on 6 May, it would have been just about a year because they surrendered on 8 May, didn’t they, ’45.

I:             So what was your first posting then, which hospital were you sent to?

P:           I think I was posted to … I’m a bit hazy about this, I think it was a place called Isellohn which was slightly south of the Ruhr.

I:             How do you spelt that, do you remember?

P:           I-s-e-l-l-o-h-n. And the amazing thing was that there was quite a large Birmingham contingent there. There was a girl who had been a registrar at Queen Elizabeth, a girl called Eileen McShane, who used to infuriate the surgeons because she insisted on reading the patient’s notes and they were furious. What does she need to … she’s keeping us waiting! She was the anaesthetist, she had a DA so she was a Major automatically so she was the hospital anaesthetist. When I got there I was asked ‘What have you been doing?’ and  I said ‘House physician, done quite a bit of anaesthetics.’ ‘Oh right …’ So  I was given the option, they said, ‘You can either get yourself attached to her, or go and sit in the VD clinic this afternoon and see how you like it.’ And I hated it! It was really horrible! These poor chaps coming in and … having whacking great … I think they did it sadistically. They used the biggest possible needle they could, they were giving penicillin at that time. You see they were coming in and getting a shot in the bottom, and I thought this is not … Actually I was totally stupid of course, because those were the chaps who were making a fortune afterwards! Anyway, so that was it. And then I was posted to 25 British Military Hospital which was in Munster, and I was there from probably June to December, but in between I was being sent off to do leave locums with people being sent off, and after about four or five months I suppose somebody was looking at names ‘cause they said, ‘Who is this bloke who’s going around doing locums, he’s not on our list of anaesthetists?’ So I was sent off to Hamburg.

I:             For training?

P:           For training, by a chap called John Boxton, do you know him?

I:             I know the name.

P:           Ah, yeah. He was, I think he was in the Guy’s set, he eventually was working south London, very nice chap. I think that was where I saw my first case of malignant hypothermia, which we had no idea what it was. This was a poor chap who had come in for some sort of ENT procedure, seemed to develop some sort of fever. We thought well, they got the physicians to look at him afterwards.

I:             So you got him off the table, he didn’t die on the table?

P:           Yeah, yeah. They thought he’d had some sort of massive pulmonary something or other, and the poor chap died. Looking back on it, I’m pretty convinced that …

I:             And would have had nitrous oxide?

P:           He would have had nitrous oxide, oxygen and ether. Yeah.

I:             So how long were you trained?

P:           Four months. And then I was sent off on leave. That was a bitter winter, ’47. When I left in early April there was thick snow on the ground and I came back about ten days later and spring had suddenly arrived and it was gorgeous, and the trees were all in flower. One evening we had an emergency caesarean section and we came out at about 3 o’clock in the morning into this balmy sort of atmosphere, feeling great. And we said, ‘These administrators, they don’t know what it’s like to feel like this!’

I:             I’m interested – you mentioned an emergency caesarean section. How would you anaesthetise that in the mid-forties?

P:           Just gas, oxygen and ether. I think maybe cyclo….

I:             And did you tube the patients, ventilate them?

P:           No, no.

I:             So deep ether.

P:           Yeah, yeah.

I:             And did you have any cases of … regurgitation, inhalation?

P:           No, no. <Laughs>

I:             Very interesting.

P:           And then after that I was a fully-fledged graduate anaesthetist and I was sent off to a place called Wuppertal. And that was made up of two towns called Barmen and Elberfeld, and they’d been combined together round about 1930. I think it was the home town of either Himmler or one of those. And it was on the River Wupper  and it was connected by a monorail thing to Düsseldorf. So this was a very nice, modern, had been built as a civilian hospital I suppose, up on hill.   Proper operating theatre suite and so on. By that time there were families coming out and staying, so we had a maternity unit. A gynaecologist, a chap called Stanley Clayton.

I:             I knew Stanley Clayton at King’s. He became Professor Clayton.

P:           That’s right. And then eventually he was President of the Royal College of Obstetricians.

I:             And the Queen’s gynaecologist.

P:           Yeah. And he was writing a little book at that time, and he was very resentful of the fact that he’d been called up, because he reckoned he’d done his bit for the war! <Laughs> So anyway, he laid down the law. He said I mustn’t use intravenous induction, and I mustn’t use cyclopropane because it depressed the pressure; so gas, oxygen and ether. Couldn’t argue with him. In any case he was a major and I was only a captain! I became interested in … we called them relaxants in those days. They weren’t … you couldn’t get them, they were not on the official … list of drugs. So I wrote off, sent 30 bob to Duncan Flockhart and they sent me back a little box of six ampules of Tuberine. We had a case of a poor chap who had what was called a dish fracture.

I:             A face fracture?

P:           That’s right. When they brought him in, I think he’d been driving a three-tonner or something. They just kept his face covered with a towel because nobody could bear to look at him. Rather stupid – we should have evacuated him straight away, except that there were no helicopters in those days. He decided he was going to pull it out and he was going to put a wire suture through the chap’s pallet and … a one of my job was to keep the blood bank of two bottles of blood. Unfortunately if the local unit was off doing exercises somewhere, you couldn’t get them, so I think we may have had a couple of bottles in the fridge, I don’t know. Anyway, we started and I thought, ‘I’ve got to get a tube down this bloke, that’s the first thing I’ve got to do,’ so I started off with cyclo and then gave him some tuberine, and he relaxed nicely and I got the tube in, that was OK, but he was bleeding a bit, and I big gauze pack in the back of the throat and then I relaxed … and that was OK … and then he started putting his wire suture through the pallet and as soon as he did that it was pouring with blood and to cut a long story short, the chap bled to death.  As it happened, when the PM was done I think he was probably irrecoverable, well certainly by us because I think his oesophagus was ruptured…. he had all sorts of other things, he had a haematoma going down the thorax, pretty horrid. I mean today he’d probably have been saveable, but not with the conditions we were working in. That was the first one … well, what the sequel of that was that every six months the surgical brigadiers, one was surgical, the other was medical, and they used to go round and round the BAOR checking up on the hospitals, seeing what they were doing, so this Brigadier, he came along and he was going through our book and saying, ‘What’s this stuff, Tuberine?’ So I explained, ‘Well, it relaxes the muscles’ and I explained why I used it. He actually was right, he said, ‘What does it do to the blood pressure? Does it relax the smooth muscles in the blood vessels?’ I couldn’t tell him. Next thing that happened was that a directive came out that this stuff is not to be used in BAOR. Now the funny thing about … I was telling this story to Jimmy Payne about forty years later and he said, ‘Oh, that’s why it came round!’ And he was in the RAF and he was stationed in the RAF hospital somewhere or other and they couldn’t understand why this directive, because none of them … you know.

I:             You wrote, when you sent me the information, you mentioned myanesin as another … ‘An edict banning the use of Tuberine …’ So you sent off for a box myanesin.

P:           Oh, that was dreadful stuff!

I:             Well it’s not a name I recognise, so what was that product?

P:           I can’t remember what the official name was, but I think it did nasty things to the kidneys. It tended to … did something horrible to haemoglobin as well!

I:             But you got round the ban on Tuberine by using it for a bit, did you?

P:           Well I hardly used it. We were doing very little in the way of intra-abdominal work. There was one other dreadful emergency which we had. It would have been in January ’47, ’48 maybe. The River Rhine was very, very high and we were asked to send a team across to the other side of the river where a poor chap had shot himself with a shotgun going over a wall. So then they said there were no bridges that we can drive over, but if you go as far as … wherever it was, may have been Cologne I don’t know. Anyway, they said, ‘There’s a footbridge you can go across and you can carry all your drums and stuff with you, and we’ll meet you at the other side with an ambulance.’ So that’s in fact what we did, and we got to this casualty clearing station type of place. You know, perhaps one doctor and a few medical orderlies, and this poor chap was obviously in a very bad way and I don’t think we even had any blood. So I think we got a drip up and then I at least got him anaesthetised, got a tube down and all the rest of it. I think his spleen was all shattered and the bases of his lungs… basically he just died on the table. Again I mean it was just the difference between … whether he’d have recovered in this country I just don’t know.  At least he might have been able to have a transfusion perhaps.

I:             So at this stage you were a captain, you’d had an increasing amount of experience of anaesthetics, but you had no formal qualifications in anaesthetics at all.

P:           No

I:             So how did you acquire any formal qualifications, or didn’t you bother?

P:           No, no, no! Come on! <Laughs> See in those days there were correspondence courses, if you look in the back … if you can find a Lancet or a BMJ which still has the old adverts in, there were several adverts for these things, so I signed up for a correspondence course and every … well it started off I got a set of questions, and I had to mark them out as an exam, mock exam, send them off to my designated tutor and he would send them back with annotations and a fresh set of questions. So I worked my way through this and I’m trying to remember … there were only two text books anyway.

I:             Churchill-Davidson, was that around then?

P:           Oh no, no, no. There was no what you might call consultant-level text book in this country between Blomfield in 1923 and Churchill-Davidson and Nunn and Gray in what, ‘59/’60? So what, forty years? Oh dear, my memory’s gone. It went up to six editions.

I:             There was Macintosh and Mushin, but that was probably already …

P:           But really that was entirely for dental. Synopsis first edition was in  ’47. There was Recent Advances which I used. Anyway, I was working for the DA and that was before I was ready to take it they changed it into a two-part DA! So I had to do all the primary stuff. So I came on leave in May 1948 and I’d applied to take both parts and I got through part I and failed part II, which was a great shame because if I’d gone back with that I’d have become a Major automatically you see. So anyway, at least I had the primary. And when I was demobbed in August, I came back to Birmingham and there was supposed to be a scheme then where help for demobilised doctors, so I went to see the chap who was the Dean and he said, ‘Well I’ve never been asked to help an anaesthetist before!’ So anyway, to cut a long story short, I got a job, in fact I was very happy to help the Birmingham Accident Hospital where there was a chap called Joe Wolfson. Did you know him?

I:             No.

P:           He was really, really good. And he taught me quite a lot.

I:             He was an anaesthetist?

P:           He was the anaesthetist … there were three actually but he was the chief. They were doing all sorts of innovative stuff there and there was a burns unit there where they were doing instant grafts and things, and fractures were being plated as soon as they got through the door, that sort of thing. So it really was a forward-looking … they had a mobile ambulance that had been given to them by Lord Austin. You’d get a call for the ambulance, a big bell would ring and drop everything and off we used to dash.. the surgeon and anaesthetist… and invariably we came back empty-handed because the local ambulance had taken whatever it was to the local hospital before we even got anywhere near! So that really was a waste of time. We did a lot of stuff under local. I learned quite a lot of local techniques, because we were getting people coming in on Saturday nights absolutely blind drunk with cut scalp pouring blood and stuff, so we used to put in a ring block round that. We did a lot of local block for Colles’ fractures,  haematoma block.  And quite a bit of brachial plexus blocks.

I:             And what local anaesthetic agent would you use for that?  Lignocaine?

P:           Yes, probably lignocaine. There was Desicaine I think was one of the things. Procaine was a bit too short but you might use Procaine with a spot of adrenaline. Thinking about Macintosh and Mushin’s little book about brachial plexus block, not a word about the complications. So that was something we had to learn the hard way! So anyway, that was … how I learnt.

I:             In Birmingham Accident.

P:           Yeah. Then I took the part II again and passed in October/November, which was nice.

I:             Well done.

P:           At the end of the time Joe Wolfson said, ‘Look, if you’re going to stay in anaesthetics you’ve got to get off to London and get a job in a teaching hospital because there’s nothing going on in Birmingham, which was true. It was still the same old gang, almost.

I:             Your family were still in Birmingham?

P:           Mm.

I:             How would they react to having you back from the war, or at least from Germany …

P:           Well I was resident in the hospital virtually all the time.

I:             So they didn’t see much of you.

P:           I mean I wasn’t a burden on them or anything. No.

I:             So you went to …

P:           Hammersmith.

I:             And what sort of grade would you have gone to the Hammersmith with your DA?

P:           Registrar.

I:             And that was in 1948?

P:           That would have been ’49, spring of ’49. I think I must have got the least happy hospital I’ve worked in. Everyone was trying to stab everybody else in the back. The competition was incredible. I mean Iain Aird was the Professor of Surgery, he was a very, very good teacher, rotten operant! And he was like a terrier. And a chap called Shakman who was the number two, the Reader I suppose, and then they had some visiting surgeons and … there was a chap … I can’t remember his name. He was a cardiothoracic surgeon, it will come back to me, but he did the first … I think it was the transection of a patent ductusdoctors. And John Beard, he was one of the visiting anaesthetists and I used to try and help him, attached myself to him.

I:             So you said it was an unhappy place, but did you learn a lot there – was it a good teaching environment?

P:           No, nobody taught you anything!

<Laughter>

There was a chap in charge of the juniors, he wasn’t a registrar and he wasn’t a senior registrar but he was in charge of the junior outfit, and I suggested to him that we ought to try and get up a system of tutorials or something. He said, ‘Well, go ahead if you like.’ So I tried to get something going and see if I could get the others to prepare something and just give a talk about the odd thing. All the others were visiting, a chap called Woodfield-Davies who was famous later on because he anaesthetised his wife and knocked her off.

I:             Oh gosh!

P:           In one of the Harley Street clinics or something like that.

I:             OK … we’d better move on!

<Laughter>

P:           No, the thing about Hammersmith is that they working then on the beginnings of organ transplant and heart/lung machines and that sort of thing, so a lot of activity. Unfortunately it slowed everything down. I mean they would be doing measurements on straightforward gastrectomy would take 7 or 8 hours because they wanted to take blood samples all the time and this, that and the other. Plus the fact that Shakman had been over to the States and that slowed him down.

I:             You’ve not worked in the States at all?

P:           No.

I:             So how long were you at the Hammersmith?

P:           Probably about a year and then I was suggested that I applied, there was a senior registrar job at Winchester, so they said, ‘Look, you ought to have a go at that’ and one of the Winchester surgeons used to come to Hammersmith once a week anyway, had a little bit of a connection there, so I got that job, which was a disaster. I was the only resident and I was a senior registrar, I was expected to be on call something like 28 days out of 30. There were a couple of GP anaesthetists, one of whom had got the DA, the other one was reputed to have come back from trying to take it and saying, ‘Ha, the exam is a farce! They failed me!’ So there was that. There was a nursing home opposite where they’d skedaddle off  and I’d be left to finish off on it. I remember going to take over a gastrectomy once and the GP anaesthetist said, ‘It’s alright, he’s got an airway in …’ So after six months I thought well this is no good. So I started looking elsewhere. Then I was called to an interview at Thomas’s by the surgeon who was the overlord sort of thing of that Southeast region, whatever it was, Southwest … and he said, ‘Who’s teaching what?’ And I was pretty frank. He said, ‘I thought it was like that.’ And of course the next thing that happened, there was a big culling of senior registrar jobs, they were producing far too many people for the number of consultant jobs coming up. So then I did some locums around North London, North Mid and so on. Then I got a phone-call from a chap called Otto Belam, who was the senior consultant at the Whittington, and I don’t know how he’d heard of me but he said, ‘Look, I’ve got a senior registrar job coming up. Would you like to come and do locum for the time being and I’ll do what I can?’ So that was fine.

That was how I became Senior Registrar at the Whittington. Then they said, ‘Look, it’s time for you to start applying for consultant jobs’ and there was a little group of us who used to meet at the regional headquarters every so often and gradually we depleted one by one and eventually a job came up in Chase Farm and that was the one I got. That was one of the places I had done a locum at when I was going round, and I thought it looked rather a nice place and it was very nice to get to, because you were driving through bits of open country and in spring it looked nice, gorgeous. So that was it.

I:             So you would have been in your early thirties by then?

P:           Yeah, I was 32 I think. I was too young, two years too young to … because the baseline was 34, so they said, ‘OK, we’ll appoint you but we’re not going to pay you full rate for two years!’ So OK, well I was just glad to get the job anyway! <Laughs> By that time I was married, I had a son, and … <laughs>

I:             So what stage did you get married?

P:           Between Hammersmith and Winchester sort of thing. So that would have been 1950, yeah, ’50.

I:             How did you have time to get married with all these jobs that you were doing and moving around?

P:           Again we had mutual friends who knew me, knew my future wife – I’ll tell you the story afterwards but I don’t think it’s …

I:             Not suitable for the …

P:           Well … it’s not relevant, but it’s quite funny!

I:             Oh, please do. And you had one child, was that a son?

P:           I had a son in ’51, and then my daughter was born in ’55, that was after I’d been at Chase Farm for a year.

I:             We’ll talk about them perhaps a little bit later on, if we may. And then you say you were at Chase Farm and you liked it?

P:           Yes, it offered opportunities in a way of development, because for one thing the hospital management was absolutely primitive and ignorant, I’d put it that way. They had had a hospital secretary, I don’t know whether you know about what happened in ’48 but the government appointed hospital management committees who were mostly people who’d been on local councils or perhaps only been on the committee of a local voluntary … we had an Enfield War Memorial Hospital, Cheshunt Cottage, so those sort of people were appointed. Very good, well-meaning people … we also had a representative from the Fire Brigade! You know, trade union and all that. The first thing they did, they had to appoint a group secretary, and the chap they appointed was the clerk to the urban district council of Cheshunt, who knew nothing whatever about hospitals, although there were two perfectly good (or maybe more) tried and tested hospital administrators. In fact a complaint was put in to the region, who queried it and they were assured that this was a very good chap, but it was a disaster. So anyway, that was the thing. We had a medical staff committee and being the new bloke I was fairly quickly elected to be secretary of that! And we had a relationship with the management committee and I managed to persuade them to let me turn up to the meetings just to keep an eye and perhaps help them with things that they wanted …

I:             Communications.

P:           Yeah. So gradually I got sucked into that side of things, and we persuaded them to put the, what you might call the medical running of the hospital into the hands of a staff committee, so that we were in charge of things like casualty department, appointment and staffing, that sort of thing. We managed to persuade them to provide us with an instrument technician and we had a very nice little workshop set up and that sort of thing as well.

And then in probably round about ’60 or thereabouts I was appointed to the management committee and there was a medical consultant member and my colleagues weren’t pushing …

I:             They were happy for you to …

P:           Yes! <Laughs> So I was on that and nobody else wanted to take it on, so I did that till the Keith Joseph disaster in 1974. At which time I thought well, I don’t want to get involved in this, so I just came off. But we carried on. I was meeting the hospital secretary and the matron, we had a get together once a week to talk about problems and that sort of thing. We tried to control the medical staff, the juniors, as far as we could, and keep things smooth. So …

I:             And, did it work?

P:           Yeah, on the whole. Now you see one of the things … fairly shortly after I came there was a case where they’d sent an elderly person home without checking up that there was anybody, which they never would have done anyway. So there were complaints and all that sort of thing, so we decided that we needed to draw up a book of rules, book of advice if you like, and I got all the departments to put in their bits, so the pathology people told us what sort of containers for the … all that sort of thing, any useful information that medical staff ought to have. And one of the very strict rules was that don’t discharge a patient until you’re sure, you must ascertain that there’s somebody at home to see them. Nobody was ever sent out at midnight … it was daft anyway because statistics were being manipulated the whole time. You would admit at say 5 or 6 o’clock at night but you didn’t discharge the patients who were ready to go out until the next morning, so you could work it so that you had about 150% bed occupancy, but the statistics were fantastic! <Laughs> There was a thing called the turnover interval, the time that the bed was empty between … well if you’re doing that your turnover interval was minus something! So it was really a lot of …

I:             How much of your time was being spent doing admin then?

P:           I sort of worked it in. People would come down to me.  Had a sort of anaesthetic office just off the theatre and I was always around.

I:             So what I’m dying to ask you is where you responsible for organising the teaching at Chase Farm at this time?

P:           Mm.

I:             How was that organised? What were you arranging?

P:           I managed to get Wednesday afternoons set apart, partly because the consultant surgeons had other interests as well, it was a matter of fighting off their juniors, which was not too difficult on the whole. So I had the use of the lecture room eventually in the Postgraduate Centre, once that was established, and we met there every Wednesday afternoon. Sometimes I would try and get one of the juniors to prepare a talk on something or other. Otherwise I would be doing something myself and usually it would be 1.5-2 hour session, and unless there was some emergency or other than all the juniors were expected to be there.

I:             And at that stage, and I think we’re talking about about 1970?

P:           Yeah.

I:             How large was the department, how many juniors would there be, and how many consultants would there be?

P:           Three consultants then … we got up to four eventually. I think they’d have had two registrars, four SHOs, something like that. So about half a dozen.

I:             And at that time, would there have been any recognition for you, having organised that sort of extra-curricular activity? The teaching. These days we would talk about clinical excellence. In those days …

P:           It was known in the region unofficially … Dick Atkinson, did you …

I:             Yes, I knew him.

P:           Well Dick was our first rotating senior registrar from Barts in about ’59 I think, or ‘58/’59, and then he went to Southend, so he knew what we were doing, and in fact once or twice expressed the wish that he could organise the same thing.

I:             I bet!

P:           But it was just a matter of really just fighting them off. I think once I’d gone, that was the first thing that disappeared

I:             I was thinking also of things like merit awards.

P:           I did get a C award, can’t remember when, I eventually ended up with the B, yeah.

I:             Not as generous as they could have been, I don’t think.

P:           Well … <Laughs>

I:             OK, so we’re in the seventies, you’ve got your teaching programme, quite a remarkable teaching programme in my opinion, and you were getting involved in regional medical advisory committees and things, and your children now were in their what, mid-teens I guess …

P:           My son would have been 20 in ’71, he was at Cambridge.

I:             He went to Cambridge, so a high achiever. And your daughter?

P:           Daughter ultimately went to Sussex. Rather funny story there – she went by choice, she didn’t want to go to one of the older universities, and her husband was at Oxford and her daughter, at the age of eight, turned on her once and said, ‘You were too unclever to go to Oxford so you went to Sussex’ which we thought was rather nice.

I:             Now Sussex was at Brighton I think, wasn’t it?

P:           Yes, Sussex actually was one of the new up-and-comings.

I:             A campus  university.

P:           Yeah.

I:             And I would think would be very attractive in the seventies.

P:           Well unfortunately the first year they were farmed out so she was in the most ghastly boarding house accommodation, but she made a very good friend there, and they’ve kept in touch right through, so it wasn’t so bad. I don’t think she was actually … she was in digs the whole time actually when I think about it, but she stayed with this girl and they managed to find decent places for themselves.

I:             And what did she study? Did she follow your …

P:           No, she did French, Italian …what they call Modern European Studies, which was literature, history I suppose and that sort of thing, but languages were the main.

I:             And your son at Cambridge, what was he studying?

P:           Son went with the intention of doing English, found himself after three days, got a surprise, switched to philosophy! I said, ‘My god, what came over …’ ‘Oh, you can do anything with Philosophy.’ But after two years of philosophy he realised that you can’t do anything at all with it, so he applied to go back to transfer to English, but the said, ‘If you want to do that, you’ve got to do a two-year’ which meant that he had to do a four-year course. After which he went to teacher training college, he would have been an extremely good teacher but unfortunately he was also … slightly messianic and he thought he could teach the kids of East Ham and he got a job in a pretty grotty school and after three months he was ready to give it up. I mean all these children knew if they were lucky they were going to work in Ford’s in Dagenham and if they were unlucky they weren’t going to work anywhere, so there was no motivation at all. But we persuaded him to stay, we said, ‘Look, do the year, you’ll at least get on the register so if you want to go back to teaching any time or whatever you decide, you’ve got something.’

I:             Sounds good advice.

P:           Yeah. So then he spent best part of four years working for voluntary organisations and elderly people and that sort of thing. Eventually he was representing people at employment tribunals for unfair dismissal and his girlfriend persuaded him if he was going to do that he ought to do it properly and do a law qualification, which he went to College of Law and became a solicitor. To cut a long story short, he’s now what’s called an Employment Judge.

I:             Oh he done good then!

P:           He did really well. He sits on the employment tribunal in Croydon now and has made one or two quite important decisions which have influenced public policy. So he’s been a good chap as you might say!

I:             Yes, fantastic.

P:           Yeah.

I:             Whilst they were doing these things in the seventies, you were developing your other interests, weren’t you?

P:           I decided, I think it must have been ’75, that I wanted to do something serious in medical history. I’d been going to Wellcome meetings on and off.  So I signed up for the Wellcome course for the Diploma in History of Medicine, and the exam was run by the Apothecaries and I did the Saturday morning, and then they did a week fulltime at the end to cover all the points that they hadn’t done, and then we sat an exam which was a two-day affair, and it was rather funny. We were all in the same sort of age-group and so on, and we all said afterwards that it was the exam that we worried most about throughout the whole of our careers, and it didn’t mean a thing really! The funny thing, of course, was there was a 100% pass rate and the reason for that, they said, was because ‘you are all self-motivated so you all did very high-quality work.’ During the viva they said, ‘Why are you taking this?’ And I said, ‘Well, I want to have some sort of qualification that shows that I’m seriously interested in medical history.’ Well, so …

I:             And you have, and you got it!

P:           Well, yes! <Chuckles>

I:             And did you have to do a special subject as well?

P:           You had to do a thesis of your own choice. They had to approve it, but mine was on Nooth who invented the soda water machine, the bottom part of which was used as an ether vaporiser for the first anaesthetics. I’d seen his name always as a footnote and no one had ether said who or what he was, so I thought well, this was an interesting one to have a go at, worked on it for the best part of a year but I found an awful lot of very interesting stuff about him. He became the senior medical officer of the British Forces during the American War of Independence.

I:             Nooth did?

P:           Nooth, yeah. And an awful lot of interesting little bits and pieces. If he addressed his dispatches back to England in a certain way, the recipient, who was the Director  General, he didn’t have to pay, but if he nobbled the address then he had to pay 40 bob which was a lot of money! And they always sent them in triplicate by three different ships, so if all three ships got through he really had a pretty big bill to pay! So all these little bits and bobs.

I:             So you got your DHMSA, Diploma of History of Medicine from the Society of Apothecaries, and then what did you decide to do? Having got your qualification?

P:           I was working one or two odd bits and pieces and I think I got interested … really I was trying to look up chaps who appeared as footnotes with nothing else about them, so that kept me going. I mean I was still obviously working and everything else. And then if we can jump to ’86, there was going to be an International History of Anaesthesia conference in England. The first one, I think, had been in Netherlands, in ’82, and then Adrian Padfield and Ian McLellan got on to Tom Boulton and said, ‘Look, we ought to have our own society as well, to sponsor this thing,’ so they called a meeting at Reading and I was only too keen to get along there, and they set up the History of Anaesthesia Society.

I:             So there must have been a group of people who were already communicating in some way with their mutual interest in anaesthesia history. So that was the nucleus, and so when you started, how many members were there?

P:           Oh, I think there were quite a lot. There must have been about 50 or 60 people at the Reading meeting, virtually all of them would have joined as founder members. And they made a constitution. Macintosh was there, and Barbara Duncum – you know, the established figures. Alfred Lee.

I:             And it was a society in its own right.

P:           Mm.

I:             Was it affiliated?

P:           No, no, entirely independent. They depended on virtually the good will of the hospital. Adrian probably managed to wangle some sort of secretarial help through the back door sort of thing. Not so much now, but it would have been a problem if a retired person became an officer, because now you’ve got your own computer and your word processor it’s so much easier. Anyway, that was that.

I:             And when it first started you were a member, but then you became elected to council, how long after that?

P:           I can’t remember now –  a couple of years maybe, something of that sort. And I think you were on the council for about three years and then … Aileen Adams phoned me one day, must have been in the early nineties, and said, ‘We’d like to nominate you for President.’ I was very flattered! So I did two years and it was incredible because … you see you were inheriting something from your predecessor that had all been organised, you were organising something for your successor, but you never actually organised something for yourself. <Laughs> You had a secretary who did a five-year stint, so he was the continuity bloke, and the other thing I realised, the moment the meeting started, we had a meeting in Glasgow for example, you were actually on a treadmill, you couldn’t stop. Every minute of the day …

I:             So it was two years of hard work?

P:           It was two years of very pleasant work! <Laughs> It was very enjoyable, yes it was. I mean I had jolly good chaps who were backing up.

I:             So at the end of those two years, you revert to be I suppose past president for a year or something and then a member again. I can’t see you sitting still. There must have been something else.

P:           No, no, I was … giving a talk at least once a year on the programme, and some of those took an awful lot of research. The other thing I was doing, I went to Spanish classes for about twelve years! <Laughs> I got fairly … I can read still. I got fairly good. I mean we were on holiday one year and I was able to go into the local bus station and find out where the bus went from and to and what time and this sort of thing, and I could cope.

I:             So you speak Spanish …

P:           Well … yes.

I:             English. What other languages do you speak?

P:           That’s it!

I:             Did you not pick up German in the time you were working in BAOR?

P:           They had what was called a non-fraternisation rule, you were really strongly discouraged from having any contact with the locals.

I:             I didn’t know that.

P:           It was quite a strict thing.

I:             Since then, what other offices have you held?

P:           I think it’s mainly been the history that’s kept me going, or more or less has kept me going.

I:             Now what does it say here, you’re a curator?

P:           Oh … yes. I think actually this was Anna-Maria Rollin, who said once, ‘Would you like to come and help to set up an exhibition?’ This was in Bedford Square, and I said yeah, so then I was asked whether I’d like to become the official whatever it was, curator, and at that time I was a bit worried about my health and I was getting what turned out to be a hiatus hernia but I thought of course that I was getting angina, so I thought well I’d better not take up anything! So I said, ‘Well I’ll do it as an ad hoc’ and this went on for about five years till Trish was appointed, and it was a very enjoyable period because mounting an exhibition you’d be preparing perhaps for three or four months before you actually got into the museum at all, and then it was four weeks would be the rush period when you were getting everything, we were doing all our own labels and all the scripts and everything else. And so it was quite a hectic period, but I had Neil Adams and Jeff Hall Davis and we worked as a team.

I:             And what do you think about the Heritage Centre here now at Portland Place?

P:           Well it’s great.

I:             Can’t really say anything else, can you?

P:           No! <Laughs>

I:             Tell me a little bit about your book.

P:           Ah – this is John Snow, yeah, that kept me going for six years at least. I’d forgotten all about that. I got this email from Peter Vinten-Johansen, asking if I was the bloke they’d been looking for for the last month! And … if I was, could they quote from this paper that I’d written about John Snow’s uncle, Charles Empson. And I wrote back and said, ‘I’m very interested in anyone who’s interested in John Snow, tell me more about it,’ and he said, ‘Well we’re a group of five, we call ourselves the Snowflakes and four of us are medical,’ one is an epidemiologist and one is a general practice sort of thing and a couple of the others I can’t remember, I think one was a paediatrician, and he was a Professor of History, all at Michigan, and I said, ‘Have you got an anaesthetist?’ He said, ‘No’. ‘Well would you like one’ sort of thing. And they totally fell over themselves but they were very pleased, particularly to have somebody over here who could go and look up stuff for them! They kept me best part of six years. Eventually when they got round to writing the chapters, this was before broadband and I’d get something that was coming through hour after hour – about fifty pages.

I:             On the fax machine?

P:           No, it was on the computer, but … they would also send me a whacking-great envelope of 100 pages of text and I used to go through all this and turn all the Americanisms into English! <Laughs> And they used to go through it and turn them all back again. Eventually they explained although the publisher was Oxford University Press, it was the American OUP which is quite independent of the English one, and they said, ‘Look, you’re writing for an American readership on the whole. We are going to market it in Great Britain as well, but your main target is the youngsters here.’ So after that I thought well … I’ll just correct anything that needs. But there were some things that they just didn’t get at all. I mean the difference of status of say physicians and surgeons in the 18th/early 19th century and the way the colleges worked, all that sort of thing, apothecaries, the exams that John Snow took and so on, so I was able to put them right on that. We had a tremendous discussion about they wanted to talk about diapers and I said, ‘Well the English reader won’t know what the heck you’re talking about. We would say napkins or …’ Oh no, Americans wouldn’t … this sort of thing. There were certain expressions which were apparently colloquial over there which we don’t use, and which I had to learn so that I didn’t interfere with them! <Laughs>

I:             But it was a happy relationship?

P:           Oh it was great, it was lovely.

I:             And published when?

P:           2003 I think, yeah. In fact Peter and … I don’t want to disparage what the others were doing but he eventually ended up virtually writing the book himself, because the others were losing a bit of interest. I mean they’d done a certain amount of preparation and stuff, but it all fell onto him.

I:             And has it sold well?

P:           I think so. It won the Wood Library prize for the best History of Anaesthesia book It might be  that there wasn’t much competition because there aren’t too many anaesthetic histories about! I think so, I think it’s recognised as the standard biography.

I:             And what are you working on at the moment?

P:           Just at the moment I’m working on chloroform before Simpson. I was slightly, marked I suppose is the word … we were up in Edinburgh last June, they had the great Simpson bicentenary of his birth jamboree going on, and there were placards all over the place, ‘Simpson – discoverer of chloroform’ or ‘inventor of chloroform’, over the top, and I thought well I’d better not say anything this year, because I want to get home again … <laughs> so I thought maybe next year, so I’ve been preparing a talk for the … we have a summer meeting at end of June, not very far from you actually, in Wallingford I think. It would have been Reading I think, but … this was the nicest and nearest venue, nice hotel. So I’m putting this together.

I:             Keep me informed please.

P:           Yeah. Are you a member?

I:             No, I’m afraid I’m not.

P:           Oh! <tut> It’s probably the best value, certainly of any society I know!

I:             I’m not a member but I have been to a couple of the meetings in-house here, the history of anaesthesia meetings.

P:           Oh no, those wouldn’t have been … they were the Association …

I:             Oh yes, they were Association meetings.

P:           Alastair McKenzie’s meetings.

I:             Yes. So yours are better?

P:           I would … yeah, I think so! The thing I’ve noticed about them here is that you seem to have two speakers that do all the work, yeah! And one of the good things about it is that we are getting a lot of input now from juniors, and it’s been encouraged, there’s a prize and if they sign in they don’t have to pay for anything and they get a free membership for a year, that sort of thing. And some of the talks have been very, very good, excellent.

I:             Keep me informed please, and I will find out!

A couple of general questions then, I think this is a good one; looking back on your career, and I’m sure there’s more to come, but what’s been your proudest moment so far?

P:           I don’t know. I suppose probably getting either the Pask or the honorary membership I suppose. Hmm.

I:             The Pask is an important one, very important – not saying that honorary membership isn’t, but I think there are less Pask awards …

P:           I had a very nice Presidential Commendation, which is still waiting to be hung up on the wall! That was for …

I:             From the College?

P:           From the College. That’s for the … do you read the As We Were?

I:             I do.

P:           Ah, well that was for that. I think I’d just completed about ten years of it. No, it was great fun actually. I loved doing that! Takes me into all sorts of … one thing about the history of anaesthesia, that you just don’t know where you’re going to finish up. I started working on Hooper, who produced the very early ether vaporisers, and Hooper became interested in vulcanised rubber, which was just coming in in the early 1840s, and the use of vulcanised rubber in medical equipment, and then he got into the use of rubber to insulate wires, electrical wires and cables and he ended up putting in subterranean telegraph cables between Hong Kong and Japan. So when you follow this track and then eventually you’re reading all this stuff about things that I never had the slightest knowledge or interest in. And as I say, history of anaesthesia takes you all over the place.

I:             Very interesting. Is there anything that you’d like to add that I haven’t specifically asked you, anything or period of your career so far that’s missing?

P:           I think apart from odd bits of detail, I think we’ve covered all of it.

I:             You’ve had a fascinating life. I mean, clearly you have enjoyed what you’ve done and I congratulate you.

P:           Looking back, yes.

I:             Oh yes – you don’t always enjoy it at the time!

P:           No!

I:             It’s been very enjoyable to sit and chat to you for an hour and a half.

P:           Thank you. I’ve enjoyed it.

I:             Thank you very, very much.

<Interview ends>

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