Dr Horton decided on medical career between age of 5-7 having tossed a coin and deciding ‘heads for medicine, tails for law’. She made sure in came down heads. She qualified as doctor in 1948, and worked in London, Cambridge, Edinburgh and Hong Kong. She is a former Vice President and Honorary Secretary of AAGBI and Past President of the History of Anaesthesia Society. In this interview she discusses her training and her work in Nigeria and Hong Kong. The full transcript is available here.
Beginnings & Decisions
I was born on the 28th of October 1924 and I was born in Weymouth, Dorset, where my father was a surgeon and my mother had been a nurse. My mother had been a nurse in the army in the Queen Alexandra’s Imperial Military Nursing Service and she met my father in 1915 and they got engaged in 1916 and married in 1917.
Well, I had already decided before I went to school at the age of nine and a half, I decided when I was about five or six that I was going to study medicine. One morning I heard my mother say that Tom (my brother) was going to be a lawyer, they had decided that. So I thought, ‘Well, if they’re going to decide what Tom does, I shall decide what I do.’ So I went into our little sitting room and I tossed the coin and it was going to be heads for medicine and tails for law. I made sure that it came down heads and so I decided to do medicine.
“I tossed the coin, it was going to be heads for medicine and tails for law. I made sure it came down heads”
I had already made an initial decision: obviously it was going to be something medical and I didn’t really like nursing. I had observed that the nurse, the ward sisters, they’d had a different sort of social status from the doctors and also I didn’t like bed pans, I didn’t like the smell of bedpans and my mother ran the house rather as though it was a ward in the Edinburgh Royal Infirmary.
At University College they took 20 women in the first year and 40 men. And of the 20 women only nine were going to UCH, University College Hospital and it was going to be the first nine in the Second MB results. And so the rest of us went to the West London.
The West London had set up as a medical school in 1938… initially it was for women only and they took, again, the overflow from Kings College, they had much the same arrangement at Kings College. I enjoyed the whole practical course there. There were certain individuals who were great characters, particularly surgeons. There was Mr Green-Armitage who was the obstetrician, he was a great character. Mr Roach who was a great character, he was the logical surgeon. And then there was Spencer Paterson who was the psychiatrist, he was the first person to use ECT without anaesthetics.I was always more interested in surgery because my father was a surgeon and I had spent a lot of time at home, once I had persuaded him to allow me to go the hospital with him. I had spent a lot of time watching him and the other surgeons who operated at the local hospitals. I was very, very fortunate because I don’t think now they would let a 17 year old into the theatre.
Surgery vs. Anaesthesia
I qualified with the MCRS LRCP in July 1948, just after the Health Service had started and a friend said, who was just finishing her post as a house surgeon, “why don’t you apply for the house surgeon position?”.
I enjoyed it, again although it was an all-women hospital but there male registrars. Well, they were all ex-service, they’d all been in the services and so they were very mature men but the actual mess, the residents mess, was all female. But I enjoyed it, we enjoyed ourselves. I was more interested in surgery than I was in the medical specialties – but I thought it was very necessary to do a house physician post.
So in the British Medical Journal I saw an advertisement for a Casualty Officer and Addenbrooke’s Hospital in Cambridge. So I thought, ‘Well, that will be very useful, it will be very useful to be a casualty officer.’ It’s a post where, again, in those days you had to make up your own mind, you had to decide, you had to make decisions quickly.
First of all we had to do minor operations like reducing Colles fractures, opening septic fingers. Then I had a minor operation list, all on my own, circumcisions, removing sebaceous cists, all sorts of things. And I knew that then I must decide on a career track. Now, what was I going to do? I was interested in surgery, I didn’t think that I would ever pass the Primary Fellowship… Primary Fellowship was an extremely difficult exam.
“Well, I’ll try this anaesthetics and see”
Dr Aileen Adams was the registrar at the time and she suggested I might like to apply for an upcoming vacant post as a Resident Anaesthetist. And that was my first anaesthetic post. I was there in Cambridge for another year. I thought, ‘Well, I will try this anaesthetics and see.’
And while I was there, they were just about to build Addenbrooke’s, which is an enormous hospital. We were then in Trumpington Street in a smaller, really just a small district general hospital. And they had just started up a neurosurgical department and they had appointed Mr Walpole Lewin who was then the neurosurgeon here in Oxford and so I went over to see Walpole but it was quite clear that he wasn’t going to appoint me, that he wanted somebody who’d done a lot of research. He wanted an academic person rather than a practical anaesthetist.
“We’re not having another bloody woman.”
So for various reasons I then decided that I really must get a consultant post. My mother had not been well so I thought, ‘I must find a consultant post where I can also look after my mother.’ I tried for a post in Bournemouth – we were then living in Bournemouth – but I didn’t get that because, again, they always appointed people from the southwest metropolitan region. Then I looked at another post in Brighton. This is quite interesting because I went down to see Rex Vinning and he said, ‘I’m sorry Jean, we’re not having another bloody woman.’ So I didn’t apply to that.
And then I saw this post for a neurosurgical anaesthetist in Edinburgh. I knew about the fame of Norman Dott who was the chief neurosurgeon and that’s all I knew about it. I didn’t know very much about Edinburgh Royal excepting what my mother had told me about Edinburgh Royal Infirmary. And so I applied and I was shortlisted and so off I went to Edinburgh. I went to Edinburgh for virtually ten years, except for the year that I took out to go to Nigeria.
It was the time of Nigerian Civil War, the Biafran War. You couldn’t travel out too far, you couldn’t go further than Benin. A number of our colleagues were in the army, they had to do a time in the army. We also had to anaesthetise soldiers.
I was Senior Lecturer and so I was therefore deputy to the professor and head of the department. Routine anaesthetics, I gave anaesthetics for just about every specialty. We also had a system whereby for one week in every month we would take charge of the small intensive care unit and at the same time cover the obstetric department. And there was a very well structured teaching programme for undergraduates, not just undergraduates, and for trainee anaesthetists. A very well organised programme and there was a diploma in anaesthetics of the University of Lagos.
We went to another meeting of the Yorkshire Society of Anaesthetists at Waterton Hall. Waterton Hall was the home of Charles Waterton which is where the man who brought home curare [lived]. There was a whole meeting about curare and so we were having lunch and Andrew said, ‘I’d like to come for a walk. Come outside for a walk.’ So we went for a walk in the garden and Andrew said, ‘Will you come now to Hong Kong?’ I was able to retire from the health service which I did when I was 59, and went off to Hong Kong. I spent six years in Hong Kong. I wanted to work until I was 65.
And so again the hospital that we were going to work in was the Prince of Wales hospital in a town called Sha Tin. And Sha Tin was just a new town, it had been built on reclaimed land and it was a completely new hospital, it was a completely new medical school, so we were the first people to move into this hospital. It was very, very exciting actually, very exciting. I haven’t been since 2002 but I did go nine times between the time of coming home, which was the back of 1989 and 2002.
“We founded the Hong Kong College of Anaesthesiologists”
I think the changes there will be absolutely fantastic. The last time I went there were young men who came and spoke to me that I had interviewed when they were school children for entrance to medical school. They were Consultant Anaesthetists.
We had to train operating department assistants, we had to train the nurses, we had to train undergraduates, we had to train the postgraduates. So we taught all these people and also we founded the hospital.
I’m very proud of the time spent there and not only that but we did found the Hong Kong College of Anaesthesiologists. At one time, this was when John Zorab was president of the WFSA, you were supposed to give a very large proportion of your profit from meetings to the WFSA and we said ‘No way are we giving …’ I think we gave a very small token to the WSFA, kept all the money and with it founded a Hong Kong College of Anaesthesiology.
The first year I decided that I wouldn’t come home at all, it’s rather like not being home sick, I decided that I would work solidly for a whole year before I came home. And then I thought it was always extremely important because I was not far off retirement and it’s extremely important to maintain your contacts. It’s very important that you keep up your friendships. And so I thought it’s no use going away for six years and then coming back and expecting life to be exactly the same.
The Association of Anaesthetists
I was Honorary Secretary when I was still in Cambridge. I was Vice-President in the Association while I was in Hong Kong.
I had been responsible for the basic organisation of a Junior Anaesthetist meeting. This is before it was called GAT, it was called The Junior Anaesthetists Group. First of all I found council meetings absolutely daunting, absolutely daunting. Ann Muir who was the Executive Secretary, she was wonderful. But otherwise I didn’t think it was a particularly welcoming group. It was very hard work. It was while I was still immediate Past Honorary Secretary that I decided to go to Hong Kong. I was made a vice-president, having gone to Hong Kong.
I’ve been extremely busy ever since my retirement.
The History of Anaesthesia Society was again founded by Tom Boulton, Ian Mclellan and Adrian Padfield and it was founded in 1985. We decided that we should form a society to research the history of anaesthesia and this is when it was said, they said, ‘You’ll never keep it up. You’ll run out of things to say.’ Well, we haven’t. 20 years later we haven’t run out of things to say.
“I am more proud of passing the A-Level Spanish at 79 than almost anything else”
I’d always enjoyed French at school, but I was getting a bit embarrassed about my ability to speak French and back in Cambridge I noticed that there was going to be a new class called Brush up your French. Prior to that nearly all my friends, naturally, had been anaesthetists or other doctors and I was starting to make new friends who were not doctors. Now they say you can’t make friends when you get older, this isn’t true; I have made lots and lots of new friends outside medicine.
Then we were going to go for our international symposium in anaesthesia, the venue was to be Santiago De Compostela in Spain. So I decided I would learn Spanish. I got my A-Level in Spanish. I am more proud of passing the A-Level Spanish at the age of 79 than almost anything else.
I think I was very fortunate in my career. I was just very fortunate in the various jobs that I applied for. It was a wonderful experience to have been at east Grinstead a wonderful experience to have been at Great Ormond Street and then to have been in Edinburgh was another wonderful experience
The other thing I would say was that there was no real discrimination against a woman except when I had this ‘Not another bloody woman.’ But that’s only because if you are a woman doctor, you have to work very hard and you have to prove that you are not always just going off to have your hair done or various other things. The men went off to take the children off to school just the same. So I think there was no discrimination. And the other thing I was very fortunate in going to University College London, where again there was no discrimination and we had a mixed union, medical students union. It was just very fortunate.
“I was very fortunate in my career”