Prof David Hatch: Full Transcript

I:             This tape recorded on the 13th of March. It is 11:20 and we’re at Portland Place, Association of Anaesthetists and I’m interviewing David John Hatch. So David, I think it’s logical to start right from the very beginning, so a little bit, if you don’t mind, about your parents and your early education.

P:           Yes, well I was born on the 11th of April 1937. My father was a research engineer for Marconi, the wireless and telegraph people, so he was in a reserved occupation in the war. He was involved in the design of direction-finding equipment for aircraft. My mother was a pharmacist, a hospital pharmacist, and I had two younger sisters. The interest in medicine I suppose started with her influence, because I remember going to Tilbury Hospital during the war, where she was the pharmacist, and helping dish out medicines through the little hole in the window, and I suppose I was always quite interested in that, and she was encouraging really about going into medicine, but she thought it would be better to do medicine rather than do pharmacy, because it was only a year or so longer training and the opportunities were much greater, so she was quite wise about that. I had a happy childhood, definitely.

I:             Right, very similar background that I have. My father was a pharmacist and the house, there was always medicines and things lying around our house. We lived over the shop for a while. My father was clearly a frustrated doctor. Was your mother a frustrated doctor, do you think?

P:           No, I don’t think so. I think in those days women were quite pleased to be working at all. I mean she was in among the pioneers of people who got a full-time job really. And because it was a hospital pharmacist appointment, we didn’t have drugs around the place that I can recall.

I:             So this would have been pre-NHS days?

P:           Yes, it must have been of course, because the NHS didn’t come in till 1948.

I:             And you say you had two sisters?

P:           Yes, both sadly died now. They were younger than me, but … I was four years older than my older sister and then she was four years older than the younger one, so we were never really all that close, and especially as I went to boarding school, so I didn’t get to know them very well.

I:             Was your primary education also a boarding school?

P:         No. I was born in Hutton, near Shenfield in Essex, went to St Mary’s Primary School in Shenfield. I was all set up to go to Brentwood School, to take the 11+ as it used to be, the scholarship, and my father, who was very much influenced by the minister of the local congregational church, we were quite heavily involved in the church, suggested that I might take the entrance exam for Caterham in Surrey as a sort of back-up in case I didn’t get into Brentwood, and then in fact I got them both so I then had the choice, which I think is a bit unfair on an 11-year-old but I went to Caterham in the holidays and it was absolutely beautiful, lovely countryside in Surrey and nobody else around, and I thought it was a wonderful place to go to school, whereas when I sat the entrance for Brentwood it was in term time and I was hustled and jostled in the playground by lots of older kids <laughs> and I think that’s probably one of the factors that influenced me, which is a bit stupid!

I:           But in the mid-forties Brentwood would have still been in the countryside. It wasn’t a huge, built up …

P:         No, it was on the expanding edge of suburbia, but we had a lot of countryside round about the house that we lived in, which was only a small, detached house. It was overlooking a farmyard, and I can remember the chink of the bridle of the farmer’s horses as they came up and ploughed it, came up to the bottom of our garden and turned round.

I:           Oh wonderful!

P:         All built up now of course.

I:           And they encouraged you in your aspirations to do medicine?

P:         Yes, certainly. My mother particularly, and my father was always very easy-going and he didn’t pressurise me to do what he’d done or anything like that. No, they were very good parents actually, very supportive.

I:           And what made you choose London University?

P:         Well, I thought I’d get in wherever I could really, and I took ‘A’ levels at school and was actually unsuccessful in biology because unfortunately the University of London first MB exemption decided not to recognise London ‘A’ level exams, or whatever they’re called now, because the frog had been taken out of the syllabus, would you believe. And so <laughs> half-way through the sixth form we had to suddenly change. There were only two of us doing ‘A’ level biology and we had to change to do botany and zoology and the teacher didn’t really cover the syllabus because we knew as soon as we opened the paper that we were going to fail because half the questions we hadn’t covered. And so I went up to do first MB, I had the opportunity either of staying at school and resitting the ‘A’ levels, which I thought was a bit of a disgrace, or go to UCL and do first MB. I had been accepted by UCL. I was turned down by the London Hospital because I remember the interview there was really largely encouraging me to tell them what my father did, and I of course made his career look much more interesting than it was, and then of course the follow-up question was, ‘Why don’t you do that?’ <Laughs> And I got turned down by the Middlesex, so I was pleased to get into the UCL.

I:           All the best people get turned down by the Middlesex!

P:         <Laughs> I was quite pleased to be at UC because I think it had all the other faculties as well and I polished off the first MB biology in the autumn and then I had to wait two terms before I could start second MB, so I was allowed to go to other faculties. In fact I couldn’t go to the Slade School of Art, but I could go to any other faculty, so I did a course in English Legal System, and English Literature.

I:           How interesting.

P:         And particularly the chap who was my tutor for the English Legal System, he wrote a special syllabus for me and there were two of us doing it I think, and we used to go down to the divorce courts, they were the days when the maid had to give evidence that she’d served tea in bed to this couple, you know … evidence for divorce. <Laughs>

I:           Were you living at home still?

P:         I was living at home initially and then I went to live with my uncle, who was in Highgate in the old family house in Highgate that had been divided up into flats, and he was a teacher, had been in the Bomb Disposal Unit in the war, very brave man, and then we got a little flat in Robert Street, another student and I, a chap called Bernard Woolford, in a really grotty street off the Hampstead Road above a Cypriot nightclub, and it became quite famous for student parties and things! <Laughs>

I:           Good for you!

P:         And it had a wonderful landlord who lived in the basement, who answered the door when we first went to look at the place, and he was a Russian Orthodox priest, he had a huge Makarios-type hat and a big beard with most of his breakfast in it, and I won’t digress too much but he had a fascinating history because he had trained, done theology at Cambridge and then gone to Russia because he didn’t think much of the Church of England, he thought he’d spend a few years in Russia, teaching English, and he ended up being the personal tutor in the royal household before the Russian Revolution, met Anastasia and tutored the Tsarevich, the boy with haemophilia, and he was actually present in the household when the massacre occurred, and he had fantastic stories to tell.

I:           Had he ever met Rasputin?

P:         Yes, he’d met Rasputin.

I:           How fascinating! I’ve now met a man who met a man who met Rasputin!

P:         <Laughs> There is a museum I think, Father Nicholas Gibbes, his name was, and there is a museum in Greenwich where I understand that some of his memorabilia are, because eventually he came back and he was the Head of the Russian Orthodox Church in Oxford for a long time. He became an Archimandrite, but he was living in this grotty little basement! <Laughs>

I:           Gosh! And you’ve already mentioned that you’d come from a devout Christian family. Going to the godless place in Gower Street wasn’t an issue for them?

P:         No, I don’t think I was particularly holy. I don’t think I’ve ever been particularly holy but certainly in my student days … the godless College seemed quite attractive to me!

<Laughter>

I:           Let’s move on to your clinical days – did you enjoy your clinical time?

P:         I did. I enjoyed it very much. The undergraduate preclinical at UCL on one side of the road and then doing the dissections, I liked anatomy, I liked physiology, I wasn’t very good at pharmacology, but then crossing over to the old Crucifix building the other side of Gower Street and going on the wards for the first time, I think we all can remember the excitement of taking your stethoscope out for the first time. I loved it! We had a very good group of student friends and I played hockey quite a lot, I played for the hospital, so I had a good time there, and I was treading the boards a bit, because one of the other reasons why I failed the ‘A’ levels at school was because I played Hotspur in the Henry IV Part I <laughs> but there was an undergraduate medical show called Fallopians, typical medical student humour! In the year following Jonathan Miller, he’d been there beforehand, so he was a big act to follow, but we ended up, four of us, forming a cabaret team and we used to go round and the do the debs’ balls and things, and in fact I got engaged at the Dorchester because my girlfriend, Rita, who I’d met just before I went up to university, and I, decided we’d get engaged, so I actually got married in my final year, because the idea of getting married and then being a houseman wasn’t terribly attractive, knowing that you were virtually on call all the time in those days.

I:           Indeed. When did you get attracted to anaesthetics? Was it as an undergraduate?

P:         Not really, although I gave one anaesthetic as an undergraduate. I wasn’t particularly interested … there was an optional four-week period that you could do in anaesthetics but everybody knew there were no exams in it or anything, no questions in the exam, so I didn’t take that very seriously, but when I was doing my obstetric elective, where I went to Nottingham, I got called out one evening to go on the flying squad, because you remember that a lot of women had their babies at home and they had this flying squad in case they got into trouble, and there was a woman with a retained placenta, and I found myself in this ambulance with a lady obstetric registrar, a nurse and myself. And on the way the obstetric registrar said, ‘Oh, you’ll give the anaesthetic, by the way, and I’ll tell you what to do’ and that was my training!

When we got to this lady’s house, the anaesthetic was chloroform on a Schimmelbusch mask, the one and only time I gave chloroform, and the training was that I poured it on from a dropper bottle and she told me when to stop.

I:           She being the registrar, not the patient.

<Laughter>

P:         No, the registrar! And it was very successful, I thought it was terrific.

I:           Were you hooked?

P:         Not really, no. But I think the thing that next influenced me was that I did, first of all I did a house job at St Pancras Hospital, an HP job for Lord Amulree, a geriatrician. Then I had the luck to get a surgical house job for a UCH surgeon, Mr DR Davis, down at Harrow Hospital, which has closed now but used to be a general hospital, and I suddenly found out to my horror at the end of the HP job that the house surgeons at Harrow had to give the anaesthetics at casualty in nights and weekends, my experience having been an n of 1. So fortunately I had a month between the two house jobs, so I collared a chap called John Bland who was an anaesthetic registrar a couple of years ahead of me, who I’d been playing hockey with. He was in goal and I was left back so when we were winning we got quite friendly. <Chuckles> And he took me to the National Dental and taught me how to do gas, oxygen and triline for simple extractions, and he gave me the tip that this would do for almost every simple thing in the casualty department, Colles’ fractures and things like that, but always assess your patient first and if it looks as if it’s going to be a big, swarthy chap, give him 20 milligrams of intravenous pethidine first and then give the same anaesthetic. So I gave this gas, oxygen, triline, with or without pethidine. And it was more successful than the asphyxia that the other housemen were giving. The casualty officers started to ask for me and that was when I began to feel probably I was quite good at it. Serendipity really! <Laughs>

I:           But you didn’t go straight into anaesthetics?

P:         No. I was still thinking of doing general practice, at that stage, which was my initial thought. I did a couple of locums and then soon realised that I didn’t want to do general practice, and by that time our first child was on the way so the next move was really to find a job with married quarters. There were very few of them around in those days so we looked – and preferably an obstetrics job, because I thought to be doing an obstetric job at that time might be a shrewd move, so we just looked through the journals until we found the first one that came up and that was at Farnham in Surrey. It was a mixture of obstetrics, gynae and paediatrics and it had a little house that went with it, so that was great. When my son Michael was delivered, he was delivered by the consultant obstetrician who I was working with, so that all worked out very well.

In those days you weren’t allowed to be anywhere near as a father, of course. I was in the pub with the registrar, whose duty was to keep me out of the way!

But during the gynae lists the SHO didn’t have much to do except writing up D’s and  C’s and things, and I started wandering up the other end of the table to see what the anaesthetist was doing. It was a consultant-based service then. They had four consultants, or three hospital consultants and a GP who used to do a couple of sessions, and particularly the three NHS consultants were all extremely nice people and very keen to teach. One in particular was a great mentor of mine, Elwyn Mendus Edwards. There was a chap called James Anderson and there was Colonel Bill Scriven, who was out of the army. And they started to help me learn and just as I came to the end of my obstetric job, they got permission to appoint an SHO in anaesthetics, so they said, ‘Well why don’t you stay?’ And that was virtually the interview!

I:           And you were able to keep your little house?

P:         I was able to keep the little house and I moved up to the top end of the table. And then they said, ‘Well of course if you’re serious about this, you’d better start thinking about the primary.’ And because they had been used to running the service as a consultant-based service, they used to send me off for study time and I used to help them out at nights and weekends. I carried on doing casualty anaesthetics at nights and weekends and they were delighted not to have to come in for every Colles’ fracture, and of course being given that amount of time, I did a correspondence course and I got the primary.

And then Mendus Edwards said, ‘Well, why don’t you apply for a job at Guildford?’ ‘cause he was on at Guildford, as well, and there was a rotating registrar job coming up between Guildford and Charing Cross, with the first year at the Guildford Group and then the second year at Charing Cross, so I was lucky to get it because there wasn’t a strong field from the Charing Cross end, which would have trumped any upstart like me! <Laughs> But it meant that we moved then to a house in a place called Christmas Pie, just off the Hogs Back between Farnham and Guildford, Wanborough. I used to have to go to Haslemere Cottage Hospital to help out if there were any obstetric emergencies down there. It was a place run by the nuns and GPs came in and did the surgery, and there was one very hot summer night when I was called down there to give an anaesthetic for a manual removal, and the GP who was doing the procedure suddenly said, ‘I don’t feel very well’ and promptly fell on the floor, collapsed! So I was left having to sort him out as well as go and do the other end of the procedure, so I got one of the nuns to hold the mask on and I went round and scrubbed up and finished off the manual removal, which I had done before in my obstetric job so it wasn’t very difficult, and threw a bucket of water over the GP!

<Laughter>

The funny thing was, the next day I went to see the patient and she was in fits of laughter about it, and her only regret was that she hadn’t been awake at the time, because she was a farmer’s wife and she’d done lots of manual removals on cows, and she just would have enjoyed being awake to hear this …

So the only other similar experience I had once, going back a bit, was when I was a houseman at St Pancras, a double-decker bus drew up in the front drive and the bus conductor rushed out and said, ‘A woman’s having a baby on my bus’ and being a geriatric hospital, we weren’t very well equipped for this, but the night sister and I rushed out and there was this woman writhing around on that long seat that …you remember on the lower deck, and nobody would get off because it was the last bus, <laughs> and so we had to drive this bus to UCH and fortunately we got her there before she delivered.

I:           And then they could continue their journey home.

P:         Yes! <Laughs> The bus driver said, ‘This bus ain’t stopping before UCH!’

Some of the year was at the Milford Chest Hospital, where I was exposed to anaesthesia for chest surgery with again three different consultants coming in and using three different techniques. There was a lady called Ruth Mansfield, who was on at the Brompton Hospital, and she was still using endobronchial blockers, which never seemed to stay in the right place <laughs>, and there was a chap called Geoffrey Way who was using single lumen endobronchial tubes, Magill tubes, and Elwyn Edwards who was using double lumen tubes, and so I saw everything, and I saw local anaesthesia for the thoracoplasty and things like that.

I:              Now just to get the date right, we’re talking now about the mid-sixties?

P:             Yes, I think it was from January 1964 to February 1966, that two-year stint. The first year at Guildford and the second year at Charing Cross.

I:              And these were paralysed ventilator patients having thoracic surgery?

P:             Yes.

I:              Were you using a volatile agent or not?

P:             Yes, we were using halothane.

I:              That was the standard.

P:             That was the standard agent in those days.

I:              And what relaxant were you using? Curare?

P:             Curare or … I think it was mainly curare, a bit of Pancuronium I think.

I:              Probably just coming in.

P:             Yes, maybe.

I:              A bit early.

P:             But it was there that I wrote my first papers, with Dr Edwards. We decided to look at oxygenation during thoracic surgery, and it was in the days when you had metal Cournand needles that you had to put in, and then you had to take the arterial samples in glass syringes and put them in ice, and then drive over to the branch of St. Thomas’ hospital nearby at Hydestyle, which had a blood-gas machine, Astrup, and did all the bubbling and everything. So I don’t know how accurate the samples were by the time we got them, but we did get a paper accepted in Thorax on oxygenation, and another in Anaesthesia. So that was my introduction to scientific methodology then.

I:              And you enjoyed that?

P:             I did like that, yes. I could see that there was a lot of fun to be had in finding out new things.

I:              And when did you take the final fellowship?

P:             I took the final during that period in… I suppose it was 1965 I think. Fortunately got that.

I:              And once you’d got that, were you told that that was it, you had to think about going somewhere else?

P:             No. I think that the two-year rotation was a discrete rotation, and when it came to the end there was no guarantee of any further job. So I moved up to Charing Cross for the second year. Towards the end of that a stand-alone registrar job came up at Great Ormond Street, which I applied for. I didn’t get it the first time it came up, but I got it the second time.

I:              Did you have a particular interest in paediatrics already then?

P:             Well, having done a job with some medical paediatrics in it down in Farnham, I was quite interested in children and I thought the anaesthetic side of things, the children I’d anaesthetised in the general course of events in the last two years, particularly ENT work and so on, I thought that was a very interesting area. I don’t think I had thought at that time of getting a job at Great Ormond Street, a permanent job, but I thought it would be good to do six months children, and of course as soon as I got to GOS I realised that I fell in love with the place, and with giving anaesthetics to children. So at that stage it became a more serious possibility, although I didn’t think that I’d be likely to get a consultant job, because they were very few and far between.

I:              Did they encourage you, as a registrar at Great Ormond Street, to carry on with your research interests?

P:             Not particularly, no. They had this business of having to call on all the surgeons and people when you applied for the job. You had to go and knock on the door of all the surgeons that you were going to work for and all the anaesthetists, you had a whole list of around twenty people you were supposed to call on before the interview, and I met a chap called Gerald Graham, who was a respiratory physiologist, did the cardiac catheters and things, a cardiac physiologist really, and when I was talking to him I had the temerity to ask him if there was any opportunity for research, and he said, ‘Certainly not, dear boy! You’re applying for a clinical job.’

I:              Oh! Interesting. Different.

P:             <Laughs>

I:              So that takes you up to what, the end of ’66?

P:             Yes. I then got a senior registrar job rotating between Great Ormond Street and UCH, so I was back to my old teaching hospital. I had a fairly rough interview for that. I think it was in September ’66, because they didn’t like the fact that I’d never done an SHO job at the teaching hospital. You know, this young man coming in from the country … why hadn’t I done an SHO job at my own teaching hospital. <Laughs> But I did get the job and I was very much supported by the GOS consultants, particularly Bill Glover, who became a great friend and mentor, who was the first of the fulltime paediatric anaesthetists there, because the older consultants were on at adult hospitals as well. There was Bob Cope, who was on at UCH, there was Sheila Anderson, who was on at St George’s and the Atkinson Morley, and there was Bernard Lucas, who seemed to be on everywhere! And there was a lady called Peggy Hawksley, Margaret Hawksley, who had a seven-session appointment, who was married to a physician at UCH, but it was Bill Glover who was the first full-time paediatric anaesthetist appointed there, and he and Ted Battersby, who was appointed after him, were really beginning to take a grip of the anaesthetic department over a 24-hour period and were looking after the ventilated children after cardiac surgery and things like that, whereas these people who came and did their lists and went away again had no commitment at nights and weekends other than a sort of nominal one, and everything had been run by the senior registrars in those days. So Bill was a great supporter and I got this rotating job, and it rotated every six months between GOS and UCH, and you kept going backwards and forwards until you got a consultant job.

I:              And by this time your family numbered …

P:             We had three children by then, yes, a boy and two girls. Michael was born when were in Farnham, Susan was born at the Aldershot Military Hospital when we were at Guildford, home of the British army, and Jane was born in Kingsbury when I was working at UCH.

I:              So that’s a lot because you must have had a heavy on-call, even as a senior registrar.

P:             Yes, we were doing alternate nights and weekends, effectively.

I:              But in the middle of your rotating job between GOS and UCH, you actually went off to the States?

P:             Yes. Well at that stage the possibility of getting a consultant job at GOS was beginning to arise because Peggy Hawksley, who I mentioned before, was likely to retire. We knew that her husband, John, was retiring from UCH, and so … and they were planning to move down to the West Country, so the likelihood would be that she would retire, although she was keeping her cards very close to her chest, and had he not survived I’m sure she would have carried on ‘cause she was younger than him. And I had applied for a job at Alder Hey previously, because they were the only two places really that had the sort of paediatric anaesthesia that I was interested in, and a job came up at Alder Hey when I’d only been a senior register for a year, and rather tongue in cheek I went and applied for it. I didn’t expect to get it, but it showed that I was interested, seriously interested in paediatric anaesthesia. So Bill Glover said, ‘If you really want a chance of doing this job, you really need to go abroad and learn some anaesthesia for cardiac surgery, because that’s what’s going to be needed particularly.’ And he had been to the Mayo Clinic when he was in a similar position and he knew people there, so he suggested that I might like to consider going there, and he wrote and facilitated that opportunity for me getting a fellowship, and I got a Fulbright Travel Scholarship and we went out there to the Midwest, with three children, came back with four. <Laughs> And we had a great time there, I must admit. I originally was intending to do six months of anaesthesia and six months of intensive care, but whilst I was out there I met a wonderful man called Kai Rehder, an ex-patriot German who had just set up, having been an anaesthetist at the Mayo Clinic for some time, he had just set up the research department of anaesthesia at the Mayo, which was going to look at pulmonary physiology, and he invited me to be his first research fellow, but he wouldn’t take me for less than six months, so I negotiated with GOS to extend my stay to 15 months in the end, and I cut down the intensive care to three months, so I did six months anaesthesia, three months intensive care and six months in the lab with Kai, doing human physiology, one lung anaesthesia on human volunteers that were paid $50 a time to have an endobronchial anaesthetic… which is what they did in those days.

I:              But no surgery?

P:             No, no surgery, just the anaesthetic.

I:              And they were paid volunteers from …

P:             From the hospital staff. A lot of nurses, nurse anesthetists and people. And we turned them into various positions and studied the distribution of ventilation and perfusion.

I:              This must have been approximately the time that West was writing his book on pulmonary physiology.

P:             Yes, and one of the beautiful things about being at the Mayo Clinic was that it had such a reputation that people used to turn up, Jerry Mead used to turn up, who was one of the Comroe people, and there was a man called Ward Fowler, who was there, who had also been one of the authors of the Comroe book, and he was the overall supervisor and Guru that Kai used to go to for advice when we had problems with some of our research methodology. Very good teacher. In fact very strict, because I remember doing a whole-day study on a patient, we had this paper write-out, UV paper, and I had this big trace to show him, and I went to show him this trace and he said, ‘Which way is inspiration?’ And I said, ‘Oh, it’s the way.’ ‘Where does it say that?’ ‘Oh, I haven’t marked it.’ ‘Oh, what a pity,’ he said, and rolled the whole thing up and put it in the bin. My whole day’s research was wasted because I hadn’t marked it – I never made that mistake again!

I:              No, I’ll bet!

P:             But there was a wonderful afternoon seminar when you’d get these people, there was a chap called Earl Wood, who’d designed the human centrifuge and done the early cardiac catheter work, and he and Jerry Mead were there having an argument about the measurement of plural pressure, and whether it was more accurate with water-filled catheters that you put into the pleural space or air-filled balloons – and Earl would get up and give this big dissertation on the blackboard of why it was important to do it with a water-filled catheter, and then Jerry Mead would get up and say, ‘Well that’s all very well, Earl, but let me show you … if you were right, the lungs wouldn’t be the shape they are.’ And then he went on to describe his theory. And just being a fly on the wall when this sort of debate went on by the leading respiratory physiologists of the time was terrific.

I:              How wonderful. And when did the call come to go back?

P:             Well the job came up when I had about three months left to go at the Mayo, so I had to fly back for the interview and the NHS paid my fair from Heathrow to Great Ormond Street!

I:              But you had to pay to get from the Midwest?

P:             I had to pay from the Midwest to Heathrow, yeah, which wouldn’t have been very funny if I hadn’t got the job, but fortunately I did get the job, so we went back and … the last three months I knew that I was coming to do this job.

I:              Very helpful. Must be very easy then to finish off and do what you… and enjoy what you’re doing, knowing that you’ve got a job to come back to.

P:             Yes, and the people at the Mayo were very good because they knew that I was interested in trying to get this job, but afterwards they said, ‘Had you not we would have been putting the pressure on you to stay.’

I:              That’s very nice. So what sort of sessions were involved in the job that you’d got back at GOS?

P:             I had a couple of cardiac sessions and I had some general surgery, some orthopaedic surgery and some ENT, and I had one day a week at the Queen Elizabeth Hospital in Hackney Road, which was part of Great Ormond Street in those days, and the night and weekend cover was also at Hackney Road, so I wasn’t on call at Great Ormond Street at night, I was on call for Queen Elizabeth’s, where quite a lot of the neonatal surgery was done actually. And that was quite a heavy commitment because there was only one other consultant there, so again I was doing alternate nights and weekends as a consultant for ten years, and going in for all the neonates. We moved into the Essex area to try and be a little nearer to the Hackney Road. It was also convenient that that was where our families, my wife and I, both our families were out in Essex, and it was also the cheapest area of London to live in.

I:              But you started an Essex boy, so you carried on being an Essex boy.

P:             Yes. So we came back, just crept into Essex in Woodford, where we’ve been living ever since.

I:              Tell me a little bit, if you don’t mind, about the sort of paediatric cardiac surgery you were doing. So we’re talking about 1969, 1970 onwards. So in the early days, what was the paediatric cardiac surgery?

P:             Well, a lot of it was palliative surgery. There were a lot of things called Blalock-Hanlon operations for transposition of the great arteries, which Eoin Aberdeen, one of the cardiac surgeons there, was very interested in. And these were done at very short notice to make an artificial ASD to improve the circulation between the two sides of the heart. In the transposition you haven’t got enough mixing between the oxygenated and deoxygenated blood, so it wasn’t a cardiac pulmonary bypass operation, it was a quick enclosed snatch, but I remember doing four of them one night, up all night doing them. And Blalock shunts, simple ASDs, VSDs, we were beginning to do transpositions, doing what’s known as the mustard operation for transposition, that Eoin Aberdeen and David Waterston, who were our main surgeons there, were amongst the world’s leading experts on. They had the largest series I think at one stage, in the world, of transpositions. And they all ended up with tracheostomies, because Eoin had also developed a great interest in tracheostomy in infants and showed that it could be done safely, and there was a Great Ormond Street tracheostomy tube that we put in. So in those days it was very unusual to leave a tube down, an endotracheal tube down, any length of time, so at the end of the operation the tracheostomy was done and the child was taken to the ward with a tracheostomy tube. And in fact it was in the early seventies that there began to be an interest in prolonged nasotracheal intubation, mainly pioneered by the people in Australia, the Adelaide Group and the Melbourne Group, John Stocks was one of them, and we had a big series, began to develop a series of leaving tubes down. It was very interesting because there was an argument about how long you could leave them down without getting subglottic stenosis ‘cause a lot of children ended up getting stenosis afterwards, well, a significant proportion anyway.

I:              Were these still red rubber tubes we’re talking about?

P:             They weren’t for long-term, no. Initially they were, but then fairly soon they changed to being plastic tubes, Portex tubes. But the real factor that emerged was that it wasn’t really a time factor, it was a question of the size of tube. We were putting down tubes that we were accustomed to putting down for anaesthesia, which were too big for prolonged intubation, and we began to put down slightly smaller tubes and always insisted on having a slight leak around them when you ventilated. They were un-cuffed tubes, and that really solved the problem of subglottic stenosis. So we wrote up quite a bit series of those.

But then of course a lot of the children were stuck on ventilators afterwards, because as they hadn’t had corrective surgery, only palliative surgery, they often had pulmonary hypertension and higher pulmonary blood flows. We did another operation that was quite commonly done, banding of the pulmonary artery. It was just a bit of string round the pulmonary artery and it was pulled until the child looked blue and then it was released a little bit. It was a very subjective operation and a lot of the children had high pulmonary blood flows and you couldn’t wean them off the ventilator. Some of them were on their ventilators for years.

I:              Really?

P:             Yeah. And they were all on these big Engstrom ventilators that Bill Glover had got over from Sweden. I think, looking back on it, we damaged a lot of lungs by over-ventilating them unfortunately, but we did keep them alive. Very much to my regret, I missed an opportunity to have my name in lights because we used to wean these children from the ventilator. The regimen was to try and get them to do five minutes breathing on their own on a T-piece every hour, and then if they did that, you’d prolong it to ten minutes, fifteen minutes, and there was a child there who’d been there for a couple of years and I remember his name to this day: it was Emmanuel Despotopoulos. Mrs Despotopoulos, who was over here from Greece and lived with him for all these two years, one day she said to me that she’d noticed that if she held the end of the T-piece, the open end of the bag, and increased the pressure in it, he could manage the five minutes much better.

I:              PEEP.

P:             Yeah. <Laughs> And I said, ‘Oh, you shouldn’t do that.’ And a few months later George Gregory described PEEP and CPAP.

I:              <Laughs> Gosh!

P:             Shows that you should be more observant!

I:              You were still publishing though?

P:             Yes, I was. I was very lucky because, looking back it was sort of serendipity but this lady, Margaret Hawksley, who retired, had only got seven sessions, as I think I said, and so with four children that wasn’t enough really to live on in London, and I was looking for other work. I didn’t have much in the way of private practice, checked my phone every day but it didn’t seem to ring much, and I did a few locums, one of which was with your namesake Michael, Michael Ward, who had been a surgeon on the Everest Expedition 1953 with Hillary and Tenzing and John Hunt, and he was a consultant surgeon at St Andrew’s Hospital in Bow and I did a Monday-morning list with him for a year or so as locums, but there were a couple of paediatricians there, Archie Norman and David Hull, who later became Professor of Paediatrics in Nottingham, who were just setting up an infant lung function department at Great Ormond Street with a research fellow called Tony Milner, and they said, ‘Why don’t you come and help us ‘cause you had this experience in America?’ So Tony and I focussed on the neonatal and infant side of it, the first year or life, measurement of lung function in the first year of life, and we built a whole-body plethysmograph, converting an old Drinker ventilator which we got out of a basement store. So we began to be able to measure lung volumes in that and we also developed some oesophageal balloons to measure pressures. And of course I had the access to take these measurements into the post-operative care ward because there was a lot of interest in trying to find out why these children after cardiac surgery couldn’t be weaned off the ventilator, so my joining the team opened doors to these paediatricians that they couldn’t get before. And looking back on it, you’d never be allowed to do it now because we wheeled this Drinker ventilator into the ward and put babies inside it and measured their lung volumes – shut the lid <laughs> but we didn’t have any complications. It was very safe and I had built an in-dwelling T-piece system into it so that you could still ventilate the child even when the lid was shut. But we didn’t have much in the way of ethical approval in those days.

But then I got some funding to do one day a week from the locally organised research fund from the hospital to spend one day in the lab with Tony, and then when that ran out I got a three-year grant from the British Heart Foundation for doing it, and then suddenly one of these funny notices came round from the Department of Health, asking if there was anybody who was doing a clinical service funded by research money, and we were getting a few referrals for the lung-function testing so rather tongue in cheek I put in for two sessions, and it must have been just the sort of money they had because I then got a permanent NHS day a week to make up to nine elevenths, with a day a week in the lab to doing what I was enjoying doing anyway. So I then became a consultant in anaesthesia and respiratory measurement. And that went on until the Chair.

I:              Well you were Sub-Dean at the Institute of Child Health. How did that come about?

P:             Yes. The Dean really was looking for a new Sub-Dean. There’d been a change of Dean and he wanted a teaching Sub-Dean to take care of the post-graduate educational programme. And as I had a bit of flexible time, wasn’t doing much in the way of private practice, it was a lunchtime conversation, he said, ‘Would you like to be the Sub-Dean?’ You know, that was how things went in those days. I did that for a while and enjoyed organising post-graduate courses and things for paediatricians and people of all disciplines, so I was really just administering it.

I:              And most of the undergraduate education was at Great Ormond Street, or was it?

P:             No, there wasn’t much undergraduate education there. It was virtually all post-graduate.

I:              So no medical students to get in your way?

P:             No. Sadly – I think it would have been fun. We had the occasion elective, but very, very occasional.

I:              You gave me a CV which suggests you then became Chairman of the Division?

P:             Yes, I was chairman for a three-year period. It was a sort of rotating chairmanship. With Buggins’ turn I became chairman. <Laughs>

I:              <Laughs> Did you enjoy it?

P:             Erm … yes, I did … yes. I quite enjoyed administration.

I:              Why, then, did you change your title in 1991? You were appointed Portex Professor of Paediatric Anaesthesia.

P:             Yes, well that was again serendipity because I had by that stage managed to persuade a lady physiologist who had been a nurse and had then become a respiratory physiologist at the Hammersmith Hospital working with Simon Godfrey and had got a PhD in respiratory physiology, who was a mother of two children and who was out of work because Simon Godfrey, who was Jewish, went to Israel, and she couldn’t carry on at the Hammersmith and nobody seemed to want a part-time physiologist, but I knew how good she was and I snapped her up, managed to get some money for her to come and work part-time in the lab with me.

I:              That’s your lung-function lab?

P:             In the lung-function lab, yeah, with Tony Milner and me, and we again got soft money for her for a few years, but it was running out in the late 1980s. At the time when the College was just moving from being a Faculty of the Royal College of Surgeons to becoming a College, and then becoming a Royal College and Michael Rosen, who was then the President, appointed me as Chairman of the Fundraising Committee for the new College, because he said, ‘Ah, you come from Great Ormond Street. They’re good at raising money!’ You can imagine how he spoke. Anyway, as part of this fund-raising effort, he had a fund-raising dinner and I found myself sitting next to a chap called Alastair Easton who was the managing director of Portex. And during the conversation we talked about my research and everything, and I happened to mention I was looking for money for Janet Stocks, who was this lady, and he seemed more interested in that than in Michael’s attempts to get money for the new College, so he said, ‘Well we might be able to do something about that. I’ll let you know.’ And then he went off down to Hythe and a couple of weeks later I got an invitation to come down to them at Hythe and talk about this, and I walked into this room where I expected Alastair Easton to be chairing the meeting, but he wasn’t, he was halfway down the table, it was being chaired by a chap called George Kennedy, who was the MD of Smiths Industries Medical Systems, the parent body, and there were a lot of important people there, and anyway, there in the conversation he said, ‘Well, you want this money for this …’ senior lecturer I was trying to get, but he said, George said, ‘In who’s department will this be? Who’s funding the professor? We don’t really want the Portex Senior Lecturer in somebody else’s department. We’d rather have the Portex Professor.’ <Laughs> So I said, fortunately thinking on my feet, ‘cause I had actually been offered a personal chair before then and I realised that wasn’t a good idea, because I thought I was a consultant with a reasonably good research reputation as a consultant, and without any extra resources just being called a professor, I was then going to be a rather poorly regarded professor, because I was suddenly going to be judged by other standards. And so I said, ‘No, you can’t appoint a professor in isolation. If you want to establish an academic department, that would be different.’ So he said, ‘Well how much would that cost?’ <Laughs> I said, ‘I require notice of that question!’ So he said, ‘Go away and cost it.’ So I went off to the Dean and we sat down and we wrote out a costing for a professor and a couple of senior lecturers and a lecturer and a technician and a secretary, and it’s quite a lot of money, and we sent this off. Anyway, heard nothing for three months and then just before Christmas I got a phone call from George Kennedy and he said, ‘We’ve just had a board meeting at Smiths Industries and we’ve looked at your application and it’s about ten times as much as we thought it was going to be and we’ve cut it down a bit, but it is about to be the 75th anniversary of Smiths Industries and we want to do something that gives our shareholders a warm glow and so we’re going to fund you for ten years.’

I:              Gosh!

P:             And we’re going to build in 7% inflation, which was what was predicted and rapidly became a grossly generous estimate. So it started I think in 1990 as £150,000 a year and it went up to £300,000 a year by the end of the 10 years. But then of course that money went to the university and then the university did a search for the Chair and eventually came back and asked me if I would take it. And it was a bit difficult to say no at that point, having been involved in it! But it was just being at the right place at the right time, and actually it fitted well with my other commitments because by that time I was on the Council of the College, my colleagues were very good at covering me when I was away, which was an increasing amount, but suddenly there became an opportunity to advertise my job, my clinical job, take the chair and offer them an additional three clinical sessions out of the Portex money, which is what I did. So suddenly I didn’t feel that I was being a burden to them. In fact I was contributing to the department.

I:              And you stayed in that role until 2000?

P:             Yes. I was 63 by then and it was coming to the end. We’d just negotiated another five years and I thought that was a good time for somebody else to get their feet under the table and establish the relationship with the firm, because that was very important, and Monty Mythen took that on. I was very glad that we were able to keep the Chair in Anaesthesia because the Dean was talking about moving it to cardiology.

I:              But wasn’t Monty based on UCH?

P:             He was. He’s basically an adult anaesthetist, intensivist, but he agreed to have his office at Great Ormond Street. He moved his office to Great Ormond Street, so he did spend a lot of time acting as the head of the department, although his clinical base was at UCH. Obviously it would have been ideal if we’d have found a paediatric anaesthetist who could fulfil it and there were one or two people who showed some interest, but nobody really who was seriously interested who had the credentials, because the academic base of paediatric anaesthesia is very thin, really.

I:              The academic base of adult anaesthesia in this country’s pretty thin.

P:             Well, exactly. And I thought it was better to keep it in anaesthesia, even if it was adult anaesthesia, than to let it go to another specialty. And I don’t regret that. And in fact the department has gone from strength to strength and Monty has continued to keep links with the firm and it’s still funding them on a five-yearly rolling basis, but it’s now agglutinated, the department, into groups and themes at the Institute of Child Health, and it’s now in the cardiorespiratory theme as a department of anaesthesia, critical care, pain management and respiratory medicine, all in one unit.

I:              Sounds impressive.

P:             And Janet went on became the professor, she got a personal chair and she became the head of the unit for a while, and it’s now headed up by a chap called Chris O’Callaghan who’s a paediatrician, a respiratory paediatrician, but that doesn’t worry me really. The Portex money still goes into the anaesthesia part of it. So I think it’s been a huge success really.

I:              I think so too! I think mm.. I agree with it.

P:             It was lucky because I was finding a bit of a struggle as an academic to meet the criteria, the HEFCE criteria of the university, ‘cause I wasn’t a trained academic. I’m a clinician. I’ve dabbled in research and I think got quite a good research record for a clinician, but HEFCE, The Higher Education Funding Committee, was increasingly looking at only funding people who were looking at one cell at a time rather than whole bodies, and anaesthesia has suffered from this in general, not being able to get supported, because it’s clinically based, and the Dean of the Institute of Child Health was trying to get the highest university profiles possible, so he wasn’t at all keen on clinical research either, and neither was he keen on his professor going off and being on the College Council, ‘cause when I was appointed Vice President he said to me, ‘Well you can’t expect me to congratulate you.’ It’s the first thing he said. On the other hand, Portex were delighted, because they wanted the publicity, so my background with the College involvement and so on, fitted in very well with the people who were funding me, which is what I felt was important.

I:              Well you have very kindly come on to a whole different area that I’d like to explore in a moment, which is all these Council memberships and so on, which we can do in a second, but before we leave your clinical work, I’d be interested to know, I think you’ve told me what your first anaesthetic was already, you’ve told me what your first combined anaesthetic operation was; looking back on your clinical career, what was one of the bits that sticks in your mind that gave you the greatest pleasure, sitting here now, looking back on it? Was there a particular case or a particular incidence that …

P:             I think the cardiac surgery gave me the most satisfaction, seeing the improvements in mortality and the ability to do corrective surgery and –

I:              Rather than just palliative.

P:             Rather than palliate, and therefore seeing people breathing at the end of the operation and coming off the table and not having to be on ventilators, and in parallel the development of intensive care as a more proper specialty. But I mean I’m very glad to have had a whole variety of clinical experience including a bit of private practice, which I did until I had the chair, because at Queen Elizabeth’s there was a plastic surgeon there called Raoul Sandon, whose anaesthetist died, she was a lady called Dorothy Halstead, she died a couple of years after I was appointed, and he said, ‘Would you like to take on my plastic list at Queen’s?’ Lips and palates and things. But he said, ‘It would also mean taking on my adult private list on a Tuesday evening,’ which when I was on a seven-session contract and struggling for money with four children was very helpful! It wasn’t mega-bucks but it was a regular Tuesday evening commitment, used to go on till about midnight, but it was good money, and it was regular money. I think I got £5 for the first anaesthesic I did there! <Laughs> Or guineas, it would have been guineas of course.

But I did enjoy doing plastic surgery, I enjoyed lips and palates very much. I think that’s quite a satisfying area, to see the reaction of the parents after you’ve closed a cleft lip is great.

I:              A lot of people might say that’s not plastic surgery, that’s paediatric surgery.

P:             Yes, but it’s done by plastic surgeons.

I:              Yes, it is indeed.

P:             And I think probably the most satisfying thing in answer to your question, is the relationship with the parents actually. And that’s one of the reasons why the cardiac surgery was so satisfying, because you got to know the parents for quite a long period of time and they became friends, which of course can be incredibly tragic as well if things went wrong, but I’m still in touch with, Christmas card levels, with the lady whose child I looked after for years, who had congenital thoracic dystrophy, and she couldn’t breathe properly, and we made a portable ventilator for her so that she could go out into the park and wander around. She did very well until she became a teenager and then her lungs didn’t keep up with her growth spurt and she died in mid-teens.

I:              Sad.

P:             But lovely family. In fact they took her home and they had the whole house adapted so that she could be ventilated at home, one of the first children we had responsibility for going home on a ventilator. They stayed up, husband and wife, they stayed up at night with her, one of them was always at her bedside 24 hours a day for about six years or something, terrific! But that was very rewarding to see that sort of commitment.

And I suppose that linked with the end of my career, the research, probably one of the most satisfying research contracts I had was to do the phase 3 Sevoflurane trials for paediatrics, because we were the only department in the country that did those, and to see how Sevoflurane was taking over from Cyclopropane as a non-explosive induction agent, that was a very rewarding experience. There can’t be many people who’ve gone from chloroform to Sevoflurane I don’t think.

I:              Not very many.

You’ve talked about your clinical work really and your research work, but a great chunk of this CV, the whole … more than a third of the middle section here, is on your honorary appointments. You’ve called them honorary, I don’t think they are really … starting with the Association of Anaesthetists, where we’re sitting. How did you get involved in that? In 1982, in the middle of what must have been a really busy clinical role, what made you stand for the Association?

P:             Well I think it was my colleagues again, particularly Ted Battersby and Bill Glover, the two younger consultants that I’ve spoken about, felt that it was time that there was somebody else on the national scene from Great Ormond Street, ‘cause Bob Cope had been an examiner and had been on the board of the faculty, so they really pushed me into applying for the Association Council. That was the first thing. And I got onto that, so I was on that for four years from ’82 to ’86.

I:              Well four years was then the standard Council member period, wasn’t it?

P:             Yes. When I was appointed they were still in BMA House in a little office <chuckles> there, and Mike Vickers was the President, and it was at the time when there was quite a lot of controversy about whether there should be an independent College, and I was bearded by Michael Vickers fairly early on, asked what my views were on the independent College, and it was pretty clear to me what views I was expected to have! <Laughs> He was very pro independent College, but there were quite a lot of people who weren’t. And I was put onto the International Research Committee I think and the editorial board of Anaesthesia for a little while. But during that time we looked at Bedford Square, and I remember Tony Adams and I walking round the building when it was virtually a building site and being converted, so that was an interesting period to be on that.

I:              Did you have any involvement with what I think was then called JAG/GAT? Group of Anaesthetists in Training.

P:             No, I didn’t really.

I:              OK, and almost the same time you were involved with the Paediatric Association.

P:             Yes, in 1973 the pressure came from a couple of Scots anaesthetists to set up an International Paediatric Association. Most of us at Great Ormond Street were against it I think it’s fair to say, because you have to remember there were hardly any specialist associations in those days. I think the obstetric anaesthetists had been founded, there was a neurosurgical travelling club but virtually no other association. But it was thought that it would be a good idea to have some sort of group where the full-time paediatric anaesthetists in this country could meet each other, ‘cause we never met Jackson Rees and the people from Liverpool from one year to another and only knew by reputation what they were doing up there, and it seemed a good idea to think about getting a national … I think originally the idea was a sort of travelling club really, fairly informal thing, and so Bob Cope hosted a meeting at his club, he was a member of the Oriental Club in Stratford Place, and I remember sitting there with Bill Glover and Ted Battersby and I think there was Jackson Rees and Gordon Bush, Tony Nightingale from Liverpool, and it was in the days of power-cuts when the trade unions were fighting with the government to try and get more pay for the miners or something, ‘cause we had power cuts during these meetings and continued by candle-light I remember. But anyway, we did establish the Association of Paediatric Anaesthetists in 1973 and so I became a founding member of that, and then later on took over from Gordon Bush as the secretary/treasurer and eventually became President in 1993 I think, ’93-’95 I did.

I:              So you were on the Council if you like of the Association of Paediatric Anaesthetists before you became a Council member of the AAGBI?

P:             Yes, I was, yeah.

I:              So you had two roles?

P:             Yes! <Laughs> Glutton for punishment.

I:              Absolutely! And then when did you get involved in the College?

P:             I applied to be an examiner about the same time, 1982, about the same time as I was on the Association Council, I became an examiner and then when elections came up for the College I applied for that and got on Council. 1986 I think I got on Council and I continued, it was a 16-year stint in those days, it was 8 plus 8, but there was general feeling that that was too long. I did 12 years I think. I went on till 1998. I chaired the part 3 exam committee for a few years after Alastair Spence and I have the distinction of being the person who stopped them drinking alcohol at lunchtime.

I:              Why did you feel the need to do that?

P:             I think it was a general move from the College that this was not a good thing. It was quite strongly resisted by some examiners <laughs> and I only achieved it by getting the College to agree that … or it was the Faculty I suppose in those days, that the money that they were saving could be put towards alcohol at the examiners’ dinner once an exam, so I think that was probably one of my greatest achievements! Although I probably feel more proud in introducing the OSCE, ‘cause I was responsible with Penny Hewett, and the exam secretary at the time, in changing from the clinical long case, where the examiners brought their own patients, and very unstructured, to moving to this objective structured clinical exam, which was being pioneered by a chap called Ronny Harden from Dundee, and he came to the College and explained what it was about and then I went over with Jackie Willetts who was the exam secretary, and we went to Groningen in Holland to a meeting of the group called ASME, the Association for Medical Education.

I:              Examinations …

P:             Yeah, and there was a big conference on structured examinations, and on the way back in the plane I found myself sitting next to a senior police officer who was introducing it into the police force, and he invited me down to Bridgend to the police training college to see how they were piloting it. They were a couple of years ahead of us and they were just introducing it into the promotional exams for sergeants, and they had a very good teaching suite there where it was all closed-circuit television and you could watch the candidates going round, and they taught us a lot. He was very helpful and so it was a big change I think, it was quite a lot of work, and we made a video on it and sent it all round the country so that the candidates all got a very good idea of what the changes involved. We introduced it into the final first of all, but it now sits much more comfortably in the primary I think.

I:              You became Vice-President of the College?

P:             Yes, I was elected Vice-President, I was fortunate to become Vice-President of the College in 1991. I did two years from 1991 to ’93.

I:              And you enjoyed that?

P:             Yes, it was a great privilege to be Vice President. I worked with two very different Presidents. I did a year with Michael Rosen and a year with Alastair Spence as President, both successful Presidents and a delight to work with.

I:              And then the GMC called. I’ve got a feeling this is something to do with that hangover back in the very early days where you spent some time doing law or a form of law?

P:             It wasn’t really, although I think I had been interested in the regulatory side to some extent, but I hadn’t really done anything active, but actually again the real reason was that Cedric Prys-Roberts became President and he had been the appointed anaesthetist on the GMC, and he said, ‘I can’t carry on doing that. Would you like to take over?’ So I became the appointed anaesthetist on the GMC, which was in the days when there were over 100 members of Council, when Robert Kilpatrick was the President of the GMC, and I stayed on in that. In fact I’m still working for them now.

I:              It’s a very different organisation.

P:             Yes, it has changed enormously.

I:              For better?

P:             Er … it’s hard to say. I think that having 105-member Council was totally dysfunctional, and the BMA voice was always very dominant in Council meetings, it was a hard job being President and trying to keep the BMA at bay, but there were advantages, one of which was in amongst those 105 people there were three currently serving members of Parliament and they made a lot of difference to getting Acts of Parliament changed, particularly the performance procedures, which I became involved in. As you probably know, from 1858 till 1980, about the only way you got struck off from the GMC was being naughty, doing something … misconduct, infamous conduct it used to be called – and in 1980, and I think I can rightly claim that it was largely as a result of the influence of this Association and its sick doctors scheme, that they realised there were doctors who were a potential danger to patients because of their health, and they managed to get a change to the Medical Act to introduce the health procedures. That was before my time. But then in 1995 they made the third major change, which was to introduce the performance procedures, and it was largely due to the efforts of a labour MP for the Welsh Valleys, a chap called Gareth Wardell, who went round Parliament and persuaded all parties that it was non-contentious legislation and got it laid on the table, as they say. It would have been several years later I think getting through if he hadn’t worked so hard. And this was to deal with doctors who were not guilty of misconduct and were not sick but whose patterns of performance were a potential danger to the patient, and probably I think the most difficult area to assess, and so they set up working parties under Dame Lesley Southgate’s leadership, she was a general practitioner, Professor of General Practice, with subgroups in every specialty, to develop the methodology for assessment under her overall structure, and I chaired the anaesthetic working party with people from the College and outside. Jean Lumley was a very useful member of the College I remember, and John Searle. I was amazed that such a disparate group of people as doctors are, in all the specialties, were able to come up with such a standardised method across all specialties. And so I suppose that became my main area of interest within the GMC, although I was on other committees. You get elected, in those days you used to get elected to every committee and these huge voting papers went round to all these hundred people voting for everybody for everything. I served for a period on the Education Committee, which was very interesting. I chaired the CPD board for a while. But my main commitment was with performance, and then I took over from Donald Irvine as chairman of the committee on professional performance for five years. When I left the GMC they kept me on as an advisor, and I’m still advising one or two days a month on methods of assessment. I’m not doing anything clinical. I think you have to be quite careful when you’ve retired as long as I have. But I have given up my licence to practice now, and so I wrote to the GMC and asked them if they felt it was the time to stop advising them and they said no, they’d like the continuity because a lot of these organisations don’t have people with a very long-term memory. They’re changing staff every three or four years, and so hopefully I can help them, prevent them from reinventing the wheel!

I:              We’ll have to watch this space to know the outcome.

A couple of other things that I noticed. The Bar Council, you were the first lay member of the Bar Council.

P:             <Laughs> Yes.

I:              How did that happen?

P:             Well that was an appointment from the GMC because the barristers, bless them, decided that they ought to be doing something towards CPD, which they had never done before, and they wanted somebody from a group that had more experience, and so they approached the GMC and the President asked me if I would do it. So I became their lay member, and it was fascinating to see them struggling, dragging their barristers shouting and screaming into 12 hours a year of CPD.

I:              12 hours?

P:             That’s what they started with. We managed to persuade them to go … I think they probably do more.

I:              Good lunches I would have thought.

P:             Er … I never had them. I got invited to a dinner once … but …

I:              And then honours and awards, and I’ve highlighted a couple but you may like to tell me which, of all the honours and awards, and you’ve received quite a few in your career, you’re most proud of.

P:             I’m very proud to be an Honorary Member of this Association and to be given the John Snow Medal. I think that’s wonderful. It was an honour to have the Hewitt Lecture, to be asked to do the Hewitt Lecture for the College, which I did in 1999, and then to get their gold medal, which was fantastic.

And the Honorary Fellowship of the Royal College of Paediatrics and Child Health was rather special too.

And I suppose it’s also a great honour to have an eponymous lecture named after you at Great Ormond Street. They’ve now got the David Hatch Lecture, at which they give a little medal away every year. I thought you had to be dead to get one of those things but I looked in the Telegraph the other day and I wasn’t in the obituaries, so I suppose …

<Laughter>

I:              I highlighted the Royal College of Surgeons’ Christmas Lecture. Tell us a bit about that, I’m fascinated! <Laughs>

P:             Oh! Well, that was a thing they did every Christmas, they invited somebody to talk to a whole group of school children in that huge Lumley Hall at the College of Surgeons, and I was asked to do it one year. I gave them a talk on anaesthesia and what it’s like to be an anaesthetist. Great fun. They gave me a little medal for that. Yeah.

I:              That’s very nice. Wonderful. And I want to draw this towards a close but there are a couple of things I can’t let go, ‘cause one thing you really haven’t mentioned, which I think is one of your greatest pleasures in life now, and that’s your magic. Certainly it’s given me a lot of pleasure!

P:             <Laughs> Well I wish I’d taken it up earlier, actually. It is a great hobby. It’s becoming a bit all-consuming. My wife’s very patient with me I think, and I think there’s a risk I might bore people with it, but I had a magic set as a kid, as you do, but I never thought about it again until after I retired, and my sister had her 60th birthday and she had a conjurer for a family party that she got out of the Yellow Pages, and he was so bad that on the way home … he had no charisma at all and he couldn’t keep the kids’ attention and his tricks were all rather tired, and Rita said to me on the way home, my dear wife, ‘You can do better than that!’ So that started me off and I went to a magic shop down the Clerkenwell Road and bought a few tricks, and they run a monthly lecture associated with the shop so I started going to that, just for my own fun really, and then I did meet a guy who was the secretary of the Fellowship of Christian Magicians, who came to the church that I’d been brought up in in Shenfield, doing a show, and over a cup of coffee afterwards he said, ‘Why don’t you join the Fellowship of Christian Magicians?’ I never knew there was one. But they do tricks with a message for school assemblies and things like that and so I got involved in that and they have a one-week conference every year at a conference centre, High Leigh usually in Hoddesdon. And so I started going to that and I have recently won a cup, won the Stage Magic Competition there this year, so I’m the 2014 Stage Competition winner! <Laughs> I’ve got a huge great cup at home! And I became Secretary of the FCM. I suppose I find it hard to say no sometimes! But then this gentleman, Steve Price, said to me, ‘Why don’t you have a go for the Magic Circle?’ You have to be sponsored by two members and he … and another member agreed to sponsor me, and you then have to audition and perform for ten minutes in front of other magicians, so it was a bit daunting but I think I crept in … there are three judges marking you and only one is marking you on the technical ability with the tricks. The other two are on the entertainment value and the patter, which I’m probably better at than I am at … as you’ll well understand … than I am at the tricks. But no, it’s a wonderful club to belong to and I’m now the Welfare Officer for the Magic Circle, which is a great privilege. I get in touch with all sorts of magicians that are on hard times, and a lot of them are on hard times financially because many of them were self-employed and never made a lot of money and now they’re on a state pension and trying to keep odd jobs going, and there’s a lot of illness amongst senior members, so it’s a privilege to be involved with that. And I now call myself Professor Whizzo and I perform for charity and I raise money, I raise about £1,000 a year or so for charity.

I:              That’s good.

P:             It’s not an awful lot.

I:              Well I’ve sat at tables with you at various Association dinners and it’s always been our pleasure to sit next to you, because you always do a trick at some point during the dinner. My wife says to me, ‘I hope David’s on our table again when we come up to the Association.’

P:             Well you’re very kind!

I:              Do you think there’s a place for making it an essential part of anaesthetic training in order to keep patients amused these days, with so many patients being awake during surgery.

P:             Well I’ve been thinking about this actually and funnily enough at the College dinner earlier this week I was talking to Liam Brenan about it, because I’ve been wondering whether I couldn’t develop a little talk to give to the anaesthetic department at Great Ormond Street about distraction therapy and the use of magic, and my only problem is that I don’t know how that squares with my oath to the Magic Circle not to give away any secrets! <Laughs> I think we could find a way around that. But I am seriously thinking of … funny you should ask it, because Liam seemed quite keen and I’m seriously thinking of how I could do that, but I think I’ll probably talk to the President of the Magic Circle about how I can get round the rule that you can’t divulge secrets or you get chucked out.

But I do find it’s a great hobby. I have one or two other hobbies. I’ve been playing squash for many years but my knees won’t let me play much now, play a bit of badminton and I’ve got a couple of Tupperware boats down on the east coast and do a bit of sailing, and I’m very involved in the church, but basically I think magic is the sort of hobby you can go on doing until you drop almost, ‘cause even if your legs pack up and you’re in a wheelchair you can still do it. There’s a wonderful man of ’95 at the Magic Circle, a chap called Fergus Anckorn, who was a prisoner of war of the Japanese in Burma Railway, he’s just written a book, The Conjurer on the Kwai, but he’s still teaching me tricks. He taught me a trick last week, which is amazing.

I:            That is astonishing. And your children?

P:           Yes, I’m very blessed. We’ve got four children, as I say. The two girls live within a ten-minute drive in the Woodford area and the two boys in Hertfordshire, and I’ve got eight grandchildren. My oldest son is a sound engineer, recording engineer, and my oldest daughter is the head of a special needs school down in Thurrock, so I suppose she’s the nearest to medicine. The other two are in IT. We all go on holidays together in the summer. There were 29 of us last year.

I:            Oh wonderful, that you get on so well.

P:           Well … for a week we can, yeah. We go on canal boats sometimes too, some of us. We’ve been rather nutty about canal boats for the last thirty years and we hire a canal boat once or twice a year.

I:            But not for all 29 of you?

P:           No, no! That has to be for a select, small group!

<Laughter>

I:            Is there anything that you would like to mention – this is your opportunity now to introduce anything else that I haven’t asked you?

P:           I think possibly the only thing I would just say is I still think it’s nice to keep the links with the surgeons. I’ve seen the move from a Faculty of the College of Surgeons to the independent College, and it’s sad to me, although it was inevitable and I supported it fully, it’s slightly sad that our links with the surgeons are weaker. I was the last anaesthetist to be a full member of the Royal College of Surgeons Council because we had three seats on it, but that gives me life membership of their dining club <laughs>. I try and go along occasionally to that and it’s a typically surgical dining club. They have a chairman who gives an autobiographical account of himself after the meal, which is sometimes very interesting, sometimes less so! <Laughs> And when I became chairman I gave an account of surgeons who’d ruined some of my best anaesthetics.

I:            I know the sort!

P:           Which was quite fun. But no, I think you’ve covered everything I wanted to talk about and I’ve had a very fortunate life. I think a lot of it has been serendipity. I still feel I’m a bit of a fraud really ‘cause I’ve bluffed my way through life I think. But everybody’s been very kind to me. I’ve also had a very good opportunity to write. I love writing and Ted Sumner and I wrote standard textbooks on neonatal and paediatric anaesthesia, which my colleagues at Great Ormond Street have continued. The paediatric book is now in its third edition, and so I mean we’ve been very, very fortunate and I think I’ve had a wonderful career. I look forward to living a little bit longer and doing a few other things.

I:            Well thank you very much for coming today. I think we’ve been very fortunate to manage to capture your life on tape. I’m very grateful on behalf of the Association. Thanks.

P:           Thanks Mike, very much.

<Interview ends>