MW: This recording has been made on the 1st of December, it’s on track 81 and Dr Michael Ward is going to interview Professor William Mapleson, otherwise known as Bill Mapleson, at the Association of Anaesthetists.
Professor Mapleson, can I start right from the beginning and ask you to say just a few words about where you were born, when you were born and a little bit about your family.
BM: Well, I was born on 2nd of August 1926 in 10 Newly Gardens, West Ealing. I think it may even have been a home birth; I don’t actually have a record of that but it could well have been in those days. My father was an insurance clerk with the County Fire Office who had their premises right on Piccadilly Circus and the firm has now been taken over two or three times but the County Fire symbol still hangs outside the entrance to his offices, and so whenever we pass by I metaphorically take my hat off to it. My mother Amy Parsons, she looked after me superbly, worried about my health which was not really good as a small child and I had a sister, ten years older than me, Margaret, and a brother eight years older, Geoffrey. Margaret is still alive at 94, very frail, being looked after by her son Martin. Our brother sadly died five to ten years ago.
MW: Tell us a little bit about your education.
BM: Well my parents didn’t quite agree on the start; my mother wanted me to go to a private school, my father wanted me to go to a public school, state school but they compromised that I went to a private school for two years and then went on to state primary. I was forever going to a new school; I went to the private school for two years, then I went to the infant’s state school, so that was another new school and after a year going up to the junior school, we were on holiday for the first week of that first term so I was the new boy. Then in 1937 we moved to Amersham because my father was approaching retirement and didn’t want to tramp the streets of West Ealing in his retirement, so we moved out to the country at Amersham, now the end of the metropolitan line. And so I had a sort of special test for entry to the Dr Challoner’s grammar school in Amersham which was a major reasoning in choosing Amersham rather than any other town on the Metropolitan line. And so they were prepared to accept me and we’d moved sometime in June and I thought ‘Oh this is lovely, I shall have another extra weeks summer holiday.’ ‘Oh no you must go to the primary school here’, so that was another new school just for a month. And then the grammar school was something like my fifth new school, but apart from that, everything was fine.
MW: And then you had a conventional stay at Dr Challoner’s and what were your best subjects?
BM: Maths and physics. I quite enjoyed geography and I didn’t like history. We all did French from the first year and of course English. The tradition of the school was to start Latin in the second year but the new headmaster said no more Latin, so I was spared that.
MW: But you were already physics and mathematics, they were your best or your favourite subjects?
BM: Well, (laugh) in the junior school it was one end of term or end of year exam; the first two papers were arithmetic and mental arithmetic and I was there for those and I even got 100% for both of them. For all the rest of the exams, I was off sick so they gave me an average of 100% for all subjects.
MW: Wow, that’s an interesting story.
BM: But at the end of secondary school, there were a few challenges. I was fortunate to have, at least from the third form onwards, a very good teacher for physics, mathematics and he was a career master, so it was an enormous benefit to me. He was a good teacher, he got his pupils interested and he knew what was the right advice was for me when it came to careers.
MW: In retrospect, it certainly was the right advice.
BM: Yes. When he first asked me in the sixth form ‘Well what do you want to be when you leave school?’ I was thinking of some sort of engineering after I got over wanting to be a steam train driver. In effect, he said ‘You will go to Durham and read physics’ and he was absolutely right, that’s just what I needed.
MW: Why did he choose Durham?
BM: Oh, well he was a Durham graduate and his logical argument was that Durham is the most collegiate university in the country. A higher percentage of students live in college in Durham than in Oxford or Cambridge at that time at least, if not still.
MW: So when you went to Durham, was that the first time you’d left home?
BM: Yes, well there was a slight difference in that services were complaining that they were getting all these graduates coming into the service, graduate physicists, but they didn’t know anything about engineering drawings, so we all had to go to a one-month engineering drawing course in Newcastle which was then part of the university of Durham. The problem is though, I’ve never had any occasion to make any use of it.
MW: What year did you go to Durham?
BM: 1944. And so I got delay of national service, though not to do a full degree, I was a radio bursar. They gave me a bursary of £120 a year to cover the lodging in the college and fees. We had it cushey in those days, compared to now. That was to be a two-year course of physics with a bias towards radio communication. But within the first week in Durham the professor called us into the lecture room to say ‘decision has been taken by the government that you could complete your full three-year BSc in physics and then go on and do your national service. So I really had the best of both worlds, my timing was perfect.
MW: Well done. And the degree you got was a BSc in physics, 1947.
MW: And then did you have to go straight from there into the national service?
BM: Yes, for two years.
MW: Tell us a little bit about your service career.
BM: For some reason I tried the Navy first for a short service commission, which was a three year commitment instead of two but I think you got paid a bit better by opting for that. But they decided they didn’t want me so I had to go to the RAF and apply to be considered for a commission in the RAF and they literally said well, all right but if you don’t get it, you could go into the army, or go in as an airman. Anyway, fortunately I managed to scrape through the officer training course and in the RAF, I learnt all about radar, which became very useful later on because the radio at the university was all sine wave electronics whereas radar was all pulse electronics, quite a different thing. I attended a course on radar and I was then posted to teach that course but after preparing my lectures for it, they decided that: ‘we are not going to do that course anymore for UK air officers in the RAF but we’re going to run a course for overseas air force.’ So eventually I did get to teach one course of overseas air force officers; about half of them from Norway and about half from India and a couple from Greece, all speaking very good English. It was a very interesting experience, very useful practice at lecturing and explaining complicated ideas to people not familiar with them, which stood me in good stead for explaining the principles of physics to anaesthetists.
MW: Two years you were assigned to that task and did you enjoy it?
BM: I enjoyed the teaching and I hated the parade ground stuff for the orderly officer routine, it wasn’t me at all.
MW: And where were you stationed?
BM: Partly Debden in Essex, but mostly Yatesbury in Wiltshire. And that was splendid because my other obsession is theatre and they had a lovely small hanger that had been converted into a lovely theatre, it even had a royal box. Because an uncle of mine was an opera singer with Carl Rosa and so he put on wonderful operas when he was stationed there during the war and they had a visit from someone from the Royal family. So they had a royal box built and then in the officer’s mess there was a freeze all the way around the wall of cartoons of officers including my uncle John who was immediately recognisable.
MW: Well, I’d like to come back to your fascination with the stage a little later on if I may. So what happened at the end of your time in the RAF? So we’re now onto 1949.
BM: I’d taken a precaution before leaving Durham in ’47 to go and see my professor and to say goodbye and to thank him for what he had done for me. And so at that time I was thinking seriously of going on the stage professionally; not acting but stage management and lighting. But having had a lot of opportunity for doing it amateur in the RAF, I wondered, well having done the work with radar I thought that this is all rather interesting and I wondered if I could do a PhD. So I made some enquiries and I seemed to be favourably received and then out of the blue I received a telegram that said ‘Come to the Durham on such and such a date for research studentship.’ So I thought well what’s that? Anyway I went and it appeared that this was a studentship for financial support that would support me through doing a PhD. So I told them a little bit about what I had learnt about radar and they decided that they’d like to take me on, so that was how I got on to do the PhD in atmospheric electricity.
MW: Right and the connection between atmospheric electricity and radar?
BM: None at all there, well not directly. Well yes it is because the title of the thesis was “point discharge in atmospheric electricity” and most people would have heard of St. Elmo’s fire, which I believe can be seen in the high mountains of the Alps in a thunderstorm of not lightening, but discharges from sharply pointed object and very likely that was the burning bush that Moses saw. And that occurs in thunderstorms because there are very intense electric fuels between the ground and clouds, but even in fair-weather, there is an electric field throughout the atmosphere that the surface of the Earth, in fair-weather, is something like 100 volts per meter so that if you could pick up a voltage probe one metre above the surface of the Earth and another at the Earth, completely isolated, you could measure the voltage without draining it, you’d get 100 metres. Alternatively, you have some device intermittently exposed to the field and then shielded from the field so that, that generates a voltage which is recorded so you could measure the electric field. So I built that machine to measure the electric field, then to get point discharge under those conditions, you have to raise your point to 50, 100 or 200 metres, which I did by means of a meteorological balloon filled with hydrogen, 365 cubic feet cylinders of hydrogen to fill the balloon. And then record the discharge current and the field and look for relationships between them.
MW: So you anticipated the production of natural electricity that everybody’s looking certainly for at the moment?
BM: Well I don’t think it would be much use as the current was measured in microwaves.
MW: Oh dear, another idea bites the dust. Do you remember any particular colleagues or any anecdotes to do with your PhD studies that you’d like to share with us?
BM: Well, there were other PhD researchers; there was a chap, Wally Whitlock and I think the paper on the machine for measuring the electric field, I think that was a joint paper with him. There was another chap whose name I forget who was studying “transition from laminar to turbulent flow in water” and he was injecting tiny drops of oil into the water and then using early electronic flash to take rapid sequence photographs so that he could say the path followed by each little drop of oil in the water, gradually increasing the flow to see how the transition occurred. At the time, I had no idea that it would be very relevant to anaesthesia.
MW: So that takes you to three years to do the PhD? And then when you…
BM: Yes. At that time it was sort of officially reckoned that two years was enough when in fact the studentship was for two years but the sort of feeling was becoming that really everybody did need three years for it. And I think somehow they found some funding for the third year for me.
MW: Did you have any time to indulge your stage passion?
BM: Oh yes, very much so. They were keeping an eye on me because I had spent rather too much time on that as an undergraduate but it was agreed that the students performed in what was called the assembly rooms, in Durham, which was an old theatre with a small stage with a proper fly tower so you could fly scenery and up in the fly floor, under the boards I found a very old programme, which went into the files here, whether it’s still preserved, I don’t know. So that was in the undergraduate days, very primitive, didn’t even have proscenium curtains so you had to borrow a curtain either from one of the local cinemas or one from the local schools. But going back for the research, the University was getting money post-war so they refurbished it and re-equipped it as we did a lot there and the first major production there was Hamlet but not a straightforward Hamlet, I think it was Oxford that had done the first quarter version of Hamlet, which is either a pirated edition according to some authorities or an acting edition according to others. That is very interesting, I didn’t see that production but it was supposed to be very interesting but language is supposed to be not as good as in the first folio so the Durham production used the scene sequence of the first quarto but with the language of the first folio. So that was a remarkable first for Durham, and I think the man principally responsible for that was Ron Lane who directed it and he eventually went professional.
MW: And what part did you have in that?
BM: I did the lighting for it.
MW: You were the lighting man?
BM: Yes, the supervisors had said ‘Well I think the best thing to do is to agree that this last week before the show goes on be regarded as part of your summer leave.
MW: But all good things come to an end and you had to find a proper job and I don’t mean that disparagingly when I say a proper job but you know what I mean. So tell us a bit about how you found your next job.
BM: Well, I was sort of getting towards the end of the PhD when my supervisor said ‘Well what are you going to do when you’ve finished?’ And I said ‘Oh, well I hadn’t really thought about it much, maybe some sort of medical application in physics will be interesting. ‘Oh well there’s something on the notice board, something in Cardiff, go and have a look.’ So I went and had a look and it said: “Wanted in the Anaesthetics Department in Cardiff, someone with a wide knowledge of physics, physiology or pharmacology”. So I thought ‘Well that should do to get some interviewing experience.’ So I went and they seemed to like me even though almost every question they should ask me about ‘Have you done something’ or ‘Do you know anything about something else?’ I said ‘No, no sorry’. But I think he was impressed by the fact that I was a pure researcher and I think my rivals were more applied physics and he fancied the fundamental, probably, in the mould of Epstein in Oxford. So I was offered the job but to my acute embarrassment I had to make the first real decision of my life prior to that, I’d done what I was told so my supervisor advised me ‘Remember, your interviewing them just as much as they’re interviewing you.’ So we had it very cushy in those days so I said ‘Well I’d like to think about it overnight’, so I talked to my supervisor the next day and decided that ‘Well yes’ and I wrote to them and said ‘I think it would do for five years’, that was now fifty-eight years ago.
MW: So when did you start in Wales?
BM: Well it was 1952, October.
MW: And did you move in to accommodation that they found for you?
BM: Yes, they found some digs in Shirley Road in Cardiff, which I booked into but in my undergraduate years, I was in College. But for post-graduate years I was in digs, two miles outside Durham in Langley Moor, the home of an ex-miner and his wife, who put four inches on my waistline in three years; I’d been brought up to eat everything on my plate but her basis was that if you ate everything on your plate, she wasn’t giving you enough.
MW: Did you know anybody in Cardiff when you moved down there?
BM: No, nobody at all but, a fellow lodger with me came from somewhere not actually in Caerphilly but, he knew a home in Caerphilly but took lodgers and so that was very good. So after a fortnight in Shirley Road, I moved out to Caerphilly and stayed there for two years.
MW: Tell us a little bit about the work that you were doing then at the beginning?
BM: Well, the first project was to measure the relaxant action of Gallamine triethiodide, which was the first synthetic muscle relaxant for Curare and at that time it was thought important to have a relaxant that we had control over and weren’t dependant on importation. And so that meant the way Mushin wanted it done was to stimulate the ulnar nerve at the wrist to produce contractions of the short muscles of the thumb. So we needed a stimulator and a means of recording the force of the contractions. And Ken Hillard built up a device in consultation with me for recording the contractions and Mushin had had a grant from the Association to buy a stimulator. And I said ‘Well, £250, you could buy an awful lot of electronic equipment for that, I could make one for you’. So I used the £250 to equip an electronics lab and buy some components and we made our own stimulator which could do what in those days were much more fancy things than the commercial machines.
MW: We’d better not tell the Association about the misappropriation of funds in 1952. I think they’ll forgive us, I forgive you.
BM: But it did the job.
MW: I’m sure it did.
BM: And the results were published in Anaesthesia.
MW: And was this on volunteers or on patients?
BM: On volunteers. We did try using it on patients, we didn’t ask patients for permission in those days but, I mean it was difficult to, you needed to prevent, I mean it was simply a string attachment between the thumb and the recording device so that had to be fixed but even if you managed to fix it to the operating table, people bumping against the operating tables, messed it up so it was all done on volunteers and anaesthetists in the department or Ken Hillard, the technician.
MW: Yeah I was going to ask you who Ken Hillard was, he was the departmental technician.
BM: Yes, he was the great strength. He had an excellent workshop, machinery and did first class work for making gadgets.
MW: Did you get on and do much more work on muscle relaxant?
BM: Yes we did go on and M&B had a new agent, just had a number I think, they claim was much faster acting than Gallamine and indeed it was, but the results were very variable in different volunteers and in some the wearing off of the relaxation, it would wear off a bit and then it would re-increase again and then wear off so it never made the market.
MW: Why was Gallamine so called?
BM: No idea.
MW: I used to work for Dr Archie Galley at Kings and he used to tell us that it was named after him, and I never knew if he was telling us fibs, or just wishful thinking on his part, or what.
So you must have known, or got to know, quite a lot of anaesthetists not just the ones in Cardiff because you used to go and present some of your papers.
BM: It was a while before that happened. I don’t think I ever presented any of that early work on relaxants.
MW: So you spent fifty years working in the department?
BM: Fifty-eight years. But I officially retired eighteen years ago, well nineteen years ago now but I still go in twice a week.
MW: And where was the department based when you started?
BM: Oh, it was in the Royal Infirmary in Cardiff and then we moved out to the University Hospital in 1971.
MW: The university department is now a very large department.
BM: Yes, yes it is.
MW: And you were still the holder of the Chair for the whole of the time you were there. When did you get the chair?
BM: Well I got the chair in 1973 then I became Emeritus when I retired.
MW: I’ve got to ask you about your work on breathing circuits. Tell us how that came about please.
BM: Well, when I was waiting for volunteers for my real research Mushin came in and drew out, initially, four semi-closed breathing systems. He said ‘have a look at these Bill, and see if you can work out what conditions are required to eliminate or minimise breathing.’ That was a big worry at that time. And then later on I added the Jackson Rees modification of ASTP so if instead of a leak in the bag, you have a valve by the bag then that becomes just a variation on the others so that gave the five systems. He didn’t tell me anything about it, he just drew the diagrams and said ‘See if you can find out how they work.’ Well I had to have some means of distinguishing them so I just labelled them A, B, C, D, E and as a result seemed to become the only person to make his reputation in anaesthesia on the strength of his knowledge of the alphabet. But I’m repeatedly accused of classifying the system. But just labelling them A, B, C, D is not a classification it’s just a nomenclature, it’s just a means of distinguishing them. There was a chap from South Africa, whose name I can’t recall, who did classify them into afferent reservoir and efferent reservoir systems.
MW: It was Donald Miller
BM: Yes that’s right, yes.
MW: You had the benefit of something that most anaesthetists probably had never done before and probably still don’t bother to do and that is we just get given a piece of equipment and we use it. We don’t really ask how it works or what it’s doing, we take it on trust but you actually looked, examined and worked out how it was working, what made it work in a sense, why or what you needed to do to make it work. That was important.
BM: The major thing of that time was automatic ventilators in the early days, there were automatic ventilation of the lungs which John Nunn of the department irreverently called the puffing bible. And that was in the days when automatic ventilation was a novelty and people were designing ventilation from all sorts of bits and pieces, anything that would make gas go forward under pressure for a time and then shut off and allow expiration, any possible mechanism that could do that was tried out. In fact in Cardiff we tried making one out of a milking machine by just reversing the action so instead of sucking intermittently it blew intermittently. I don’t think we ever got round to trying it on a patient but we established that the principle was possible.
But the fun in that time was looking at the mechanism and Ken Hillard would draw out a good drawing, showing the relationship between the parts and how they moved and I’m studying that, worked out and saw how all these different ventilators began to work in terms of flow and pressure and volume characteristics, which was sort of something that I was very much familiar with in relation to valve characteristics in the days before transistors. You could hold books full of valve characteristics, how they related, how the current flow related to the voltages on the various electrodes. That led to the classification, not nomenclature, of flow generators and pressure generators and pressure cycling and volume cycling and time cycling, so that in the book, I wrote a couple of chapters, one developing these concepts and explaining them and then another saying the application of those concepts in general terms and then for each ventilator there is a description of how it worked in mechanical terms and then I did a functional analysis. So aiming to make the ventilators more directly comparable one with another and that went on to a second edition in which I did some lab testing of some ventilators to show how well the actual performance matched what I had divined theoretically from the mechanical structure. And then the third edition included some more new ventilators but I don’t think we did any further testing. We did start on a fourth edition during Mushin’s lifetime, he was very keen to have another go and it usually came down to Mike Harmer and I working on that. And we had done accounts of perhaps ten or twelve ventilators or something like that but there were two problems; one was that at that stage Mike decided that he really must get on and finish his MD if he was going to have any hopes of getting the Chair when it became available and also we were losing heart a bit because instead of ventilators being a whole variety of mechanical gadgets, they were all becoming basically a device that would drive gas forward and then a lot of electronics, controlling how it did it so that if you worked out the functional analysis of a ventilator as its supplied now, next week they may change the software and do something entirely different.
MW: Difficult. Well thank you for doing all that work. As you were describing it, I have to say, I had flashes of my Fellowship examination going through my mind and all the horrors that were associated with it. It really was the work that made your name though wasn’t it, the circuits?
BM: Yes, in complete astonishment I regard you, well just a little pot boiler theoretical thing while I was waiting to do my real research. Nobody remembers my real research at all.
MW: Well, you mentioned your real research. Tell me what you saw as your real research.
BM: Well the measurement of the relaxant action.
MW: How many publications have you had now?
BM: It’s about one hundred peer review research publications and if I include everything like abstracts and letters to the editor, items in the church parish magazine and one or two themes in minor computer journals, I think I’ve just got up to two hundred and fifty.
MW: Of which of those are you most proud?
BM: I suppose I have to include the original breathing system paper because of the notoriety it achieved. Other than that I think the theoretical papers and perhaps the experimental ones on uptake and distribution of volatile anaesthetic and even, I’ve done some on pethidine with one research assistant, Norman Davis and did quite a lot on Propofol in association with Barbara Weaver, the veterinary anaesthetist in Bristol. So with, the basic modelling depends on the physiology of the subject and the solubility of the different agents in the various organs and blood in the body. And from searching the literature, quantifies that for humans back in 1960 and then subsequently Allen Stuart and Peter Elliott the research assistants on the MRC project quantified it for the dog and then Barbara Weaver and Gerald Stanton in Bristol quantified it for the horse. So we’ve had models for humans, dog and horse. And when metoxyfluorane came in, the first incarnation of that model was the electronic model, the electronic arrangement passive network of capacitors and resistors; capacitors representing the storage capacity of the organs of the body to store anaesthetic and the resistors, we’ll think better of the inverse term the conductance’s, the ability of the ventilation to transfer gas anaesthetic from mouth to lungs and the conductance from the lungs to the capacitors representing the tissues to be proportional to the transporting ability of blood flow to the areas (organs and tissues). So that immediately translated to a new electronic analogue which was fine for me because I understand electronics but for anaesthetists, at least at that time, I think these days most anaesthetists would be happy to make sense of the electronic analogue but at the time that I did that was not appropriate for that and so I converted it to a water analogue which has proved invaluable for teaching. They’ve never existed physically; it’s always been diagrams, now it’s been a video.
MW: I think we have a copy of the video here, if we don’t, we should get one. Can we get a copy?
BM: Yes, either from Abbotts who funded it or from the video department in Cardiff.
MW: Trish will make a note, thank you very much. Whilst all this was going on over the period of your fifty-eight years you collected quite a lot of, what should I call it, rewards, not financial rewards but honours and I’d like you to say just a few words about some of the moments when you were honoured by the profession, both in this country and outside I believe.
BM: Yes, well I think that the first sort of real thrill came from getting my DSc in Durham in 1973. I thought that ok PhD’s are becoming two a penny now but yes that’s really something a bit special so I took the family with me to receive the degree but then in the same sort of way there was the Honorary Membership of the Association when I retired in 1991 and then some years later, Honorary Fellow of the Royal College of Anaesthetists. They had given me the Faculty medal sometime and also the Dudley Buxton medal that was very nice.
MW: Do you have them on display?
BM: Faculty Medal and the gold medal from the Association, I keep hidden in a draw to bring out for the Association dinner and for the Royal College dinner each year. The Clover medal and the Elias Berg medal which was for the Clover lecture that I gave to the Royal College, was virtually asked to repeat as the Elias Berg Memorial lecture in New York. And they gave me a plant but they spelt my name wrong.
MW: Well they’re American. There’s also a Mapleson medal though, isn’t there?
BM: Oh yes that’s the Anaesthetic Research Society who decided they wanted to do that. That was wonderful
MW: But I think you were involved right at the beginning of the beginning of the Anaesthetic Research Society.
BM: Oh yes I was a founder member. John Nunn and Ronny Walmer and one or two others and probably Dave Smith from the Research Department of Anaesthetics on the sixth floor of the Royal College of Surgeons, paid a visit to Cardiff once and I had had a letter from them about this proposal to form an anaesthetic research group and I’d been thinking about it and John Nunn talked to me about it during that visit and I said “well yes, I think I would like to join”, and he said can I take that as a verbal agreement to come and I said yes indeed and I never looked back.
MW: Well you must enjoy them because I have heard that you went to virtually all of them for many years.
BM: Yes in the first hundred I, only missed five and promised to do better in the next hundred but I’m afraid I haven’t kept that promise.
MW: Do you have any say in to whom the Mapleson medal is awarded?
BM: No I think that’s done by the committee or the council of the ARS who consider – I think there is some kind of award, a paper award, for each meeting and at the end of the year they pick up the one to qualify for the medal and if I’m there at the time they will usually ask me to present it which is rather nice.
MW: That’s very nice. And what professional bodies have you maintained membership of or have you had membership of over the years?
BM: Oh, well the first one was the Institute of Physics because one of the lecturers in Durham was very keen on that and I thought that I suppose I ought to and I’ve kept that up and now I don’t have to pay because I’m retired but I get the House Journal. And I think I probably joined that while I was still a research student and then soon after arriving in Cardiff, the anaesthetics department was on top of the Hospital Physics Department so I learnt about the Hospital Physicists Association and joined that, which at that time were partly trade union and partly an academic institution. And then the Institute of Physical Sciences in Medicine was started and that took over the academic aspects of what had been the HPA, the HPA became essentially a trade union organisation. Then following that, the Biological Engineering Society started, I joined that and eventually those two academic institutions merged to form the Institute of Physics and Engineering in Medicine, which is associated with the Institute of Physics. So that’s all the sort of basic physics aspects. And then of course in Anaesthesia the Honorary membership of the Association, Honorary Fellowship of the Royal College and Fellow of the RSM and that’s an interesting story because after I’d been in Cardiff for about a year Mushin said the Society of Medicine are offering free membership for a year for people who are, not medically qualified, but working in medicine. I’ll see if I can get one for you and I said “oh yes please” so he got it extended for a second year and he got it extended for a third year. And then they said “well do you want to join?” and I sort of looked at the fee and thought I suppose if I had three years free membership perhaps I should. Because quite a lot of interesting research went on at the meetings of the anaesthetic section of the RSM and so I would go to quite a few of the meetings and the department would pay the train fare. So that was very valuable, then when I retired they said, well do you want to buy life membership. And I looked at the amount of money and thought that’s a lot of money, well how long would I have use of it? Well I’ve got my lump sum on retirement, yes I think I will by golly that hss paid off handsomely.
MW: Wow I was going to say, well done, good investment.
BM: If we could indulge our theatre going in London, when we spent about one night in ten at the RSM domus
MW: Wow. And what about offices, have you held many offices in those bodies that you’ve mentioned?
BM: I think the only office I’ve held was Chairman of the committee of the Anaesthetic Research Society. it was in those days. It wasn’t Chairman of the Society; it was chairman of the committee. Then one subsequent Chairman of the committee started calling himself Chairman of the Society but then of course he had to be the president so it was no longer a committee but a Council.
MW: Now, you have alluded to your family but you haven’t actually given me any details of your family. When did you get married to Doreen?
BM: When I got to Cardiff I was still finishing writing my PhD and analysing the results so each lunchtime, I would go over to the Medical Statistics Department and use their electrical calculator which could add, subtract, multiply and divide! So I would churn away at that each lunchtime till I crunched all the observations and got that written up. And I think you will know that I shall certainly want an amateur theatre group to join in Cardiff, so I went to see what was on and it soon became evident that Everyman Theatre was for one to join because they were doing the sort of plays that I was interested in. And one of the plays that they were doing, The Drunkard, a Victorian Miller drama and as the lady playing the lead female role was miming all her parts: ‘This loaf of bread, this jug of wine’. I thought this is a really avant garde company that don’t bother with props, certainly the one I will join when I finish my thesis. And when I joined it I saw the lady and I complimented her on this and she said oh that wasn’t planned, its just my stage manager let me down that night. This is a very remarkable woman if she can do that on the spur of the moment, I must get to know her better and for the first time in my life, I looked to see if there was a ring on her finger and there wasn’t, and so that was Doreen.
MW: That’s a lovely story.
BM: So we married in ’54.
MW: Tell me about your family.
BM: Well, yes, we had a daughter in 1955 and then, Doreen was an only child, and she said we mustn’t have an only child. In a sense, I was sort of an only child because my sister was ten years older and my brother eight years older. I got on very well with them, probably annoyed them from time to time. So we tried for a second child and we tried and we tried and we did all the various tricks that are supposed to help. Eventually Doreen said this is not going to happen. Then, of course we had one that was Roger in 1963.
MW: So often happens that way doesn’t it?
MW: And did they choose to follow in your footsteps, either of them?
BM: Well I did persuade Jenny to go to Durham and read Physics, I don’t know whether she’s quite forgiven me yet because her boyfriend went to Hull.
MW: Oh dear!
BM: But I realise now that I was probably being too prescriptive but the sciences and maths, she was good at. She liked art but that seemed to point to that and so she did it and she did well in Durham. And then she soon after got married, as soon as she had finished her degree, fairly soon started a family and then once that was established, she decided to go in for teaching, but only in a primary school. And I thought well that’s a bit of a waste of a physics degree, a primary school but later I thought well I don’t know because if she’s giving those kids a sound beginning on maths then that’s excellent work for a physicist to do because if a child once gets left behind in maths, they’ll virtually never catch up. So I think that in that sense she has followed. My son Roger, really not at all because he likes people rather than things and so he’s a trading standards officer in Warrington and doing really well at that.
MW: And grandchildren?
BM: Yes, my daughter had a son and a daughter and another son who’s just in his second year at university.
MW: Not physics though?
BM: No. Well he started doing music and music technology which meant that they would have liked him to have better physics results in his A- levels but they accepted him. But towards the end of the first year, he found that the physics element was getting a bit much for him, so he switched to a straight music course which obviously still involves a lot of technology. He’s doing very well and he’s one of the few students who can make money during term time by playing professionally for gigs with The Bachelors. He’s their first choice drummer.
MW: How wonderful.
BM: And my son had a daughter and a son fairly close together but the daughter Claris, will be going up to secondary school next September and her brother’s two years behind.
MW: Is there anything that you haven’t achieved that you regret? I’m not saying that you won’t do it in the future but looking back over the fifty odd years in Cardiff are there any projects, any particular aspects of the work that you wanted to do and couldn’t for one reason or another?
BM: Quite a few papers that reached a fairly advanced stage, other things got crowded in and I felt like I better get on with those. I’ve got quite a few unfinished papers, which are not worth finishing now because they wouldn’t be of great interest. I would have liked to have been able to do more on updating the distribution of pharmacokinetics in general. I didn’t do badly; I had excellent support from Mushin, but there was no one, none of the anaesthetists in the department were especially keen on that. But I think I might’ve done more in that way if there had been someone like that. But I’m not complaining about it, I’ve had a wonderful time and have lived a charmed life.
MW: And is there anything that I haven’t asked you about, that you are particularly keen that we include in this oral history of yours?
BM: Perhaps I could say something about some of the people that I’ve collaborated with.
MW: I’d very much like you to.
BM: The very earliest days in the department, Sam Galloon a South African, he was interested in the more physical aspects of anaesthesia. I don’t think we ever did any major projects but certainly he was a good colleague in that way. He would take part in volunteering experiments. Especially Dennis Waters, he was the most remarkable man. Mushin told me that he achieved the highest marks ever in the Fellow of the Faculty of Anaesthetist’s exam and he was very bright but he had all sorts of things wrong with him medically, so he could never get any medical insurance and we did a few things together in the department. He said those breathing systems; will they work the same with control ventilation? I said oh I hadn’t thought about that, oh we should do that. Terry and I looked at it theoretically and between us would make measurements on patients. He also became interested in exponentials, which crop up all over the place in anaesthesia and he wanted me to collaborate with him with a clear explanation of exponentials and the anaesthetist. In fact the Association reproduced that paper some twenty-five years after the event. And then later he went off to head the department in Ibadan, Nigeria, he was a senior lecturer and I’ve learn that he’s still revered there even though he left there many, many years ago. Sadly he died but the extraordinary thing about him was that he had a stroke and when he had recovered sufficiently enough to write to me, he gave me a recount of how this happened and how he felt as if he was talking about one of his patients totally unconnected with him.
BM: Over the years he would write to me from some hospital bed or other saying I’m in here for a little while having something attended to, I’ve been thinking about so and so and I got so far but I can’t get any further. Can you help me?
BM: Research Assistants who are, has been experimental work on uptake and distribution, the first two of Val Fluke and David Evans and Val Fluke is still using which is kindly called ‘the Mapleson Model’ for making calculations for deep sea divers. The solubility of which the gases were in was so small that instead of talking about blood gas co efficiencies she talks about gas blood co-efficis. Then Alan Stewart and Peter Alett is a physicist, and Val Fluke was the physicist from Durham graduate. Alan Stewart, a physiologist and they did the work on dogs. We were trying to really tie down experimentally critical items in the model, to give it a really good test of the model. And then much later on, Norman Davis with quite a mixed background, he started in botany and programming and we took him on for programming to adapt my model to injected agents, which he tested in terms of pethidine. Not the laboratory information to quantify the model for Pethidine and then set the model to mimic the conditions of published results with pethidine and get a match between what the model predicted and the results. And Bob Shawcoat from the USA came over on the recommendation of Rick Syco who had spent a year in Cardiff in the early days on computer controlled anaesthesia and he stayed on to do a PhD in it. And we got a big MRC grant for that to buy our own minicomputer, which was about 6 feet tall.
MW: It must have been a fascinating period to be doing the sort of work you’d done because of the enormous explosion of electronics and processors and things of that nature.
BM: Well in those days if you put up a good project to the MRC and explained it clearly, you’d almost certainly get the money. Now you have to sort of, all A*s but you may still not get the money because they haven’t got enough.
MW: Apart from going to the theatre a lot more, what other plans do you have for the future? Are you not directing any more research?
BM: Oh well yes I’m still involved.
MW: You are. I thought you were.
BM: Another major collaborator: Dennis Smith in Leeds, well he was in the research department in the Royal College and then he moved to Leeds with John …….., (1.08) who I mentioned when he got the chair in Leeds, and he was interested in nitrous oxide and wanted to see whether he could experimentally demonstrate the concentration effect. And so he anaesthetised two volunteers: himself and one other with nitrous oxide, various concentrations and various atmospheric pressures, (he went up to Glasgow to use their pressure chamber so they could get a direct comparison between 100% nitrous oxide at one atmosphere and 50% nitrous oxide at two atmospheres) and other variations. And he presented that to the ARS and said that he hadn’t been able to show the concentration effect clearly and experimentally. So I asked a question, I said do you think your results will be consistent with a good theoretical model? And he said well I haven’t got one, and I said well I have, so he handed over all his data to me and I put that into the model and his data was absolutely superb, he’d been working on this for several years before he got a method of measurement that satisfied him. So he had a weight spirometer so that each inspiration took gas volume from the wedge that were actually inspiring prescribed mixture from the bag, so the width spirometer came down, then expiration, the expirate went to the outside of the bag and pushed the weight spirometer back out. So we had accurate measurements of every inspired volume, every expired volume and even the volume change within each second of time. And also end tidal concentration measurements so it was superb data. So I’ve modelled that, found out some interesting things about how FRC varies under these conditions with bizarre breathing patterns from one of the volunteers. And having got that going I realised, well wait a minute we’ve got information here; if we assume that loss of consciousness as defined by ceasing to respond to a beat by pressing a button, if we assume that loss of consciousness occurs at a particular partial pressure of nitrous oxide at some site of action, we’ve got the information here to estimate the perfusion of that site of action. And I said whatever the tension is, it’s going to be the same in every experiment for one individual but it’s going to get there at different speeds depending on the inspired partial pressure. And we came up with an estimate of 1ml per millilitre of blood flow per ml of brain tissue which was five, plausible, but rather wide confidence limit, it could be as little as a quarter or as much as four. So we said that what we really need to do is have a larger number of subjects and anaesthetise them all once rapidly probably with an inhalation agent and then again slowly. And that would provide a really good data set for narrowing those confidence limits. But that never occurred with Dennis but about three years ago, Gordon Drummond from Edinburgh wrote to me and said would I support this research project that he wanted and write a letter of support for this research project in which he was going to do just that. So of course I wrote and he got the support he needed and he did the experimental work. The only trouble was that, the experimental design was excellent but he used the Datex S5 for all the measurements, measuring flow in and out of the lungs and the concentration of oxygen, CO₂ sevofluorane and recording ECG. Now I’m sure the S5 is an excellent machine for clinical use but it’s not that suitable for research because every minute or two, it takes a second and a half off to check its zero flow and every ten minutes or so, it takes ten seconds off to check calibration of the concentrations. And it parcels all the data up in one second of packets and occasionally it drops a packet or two so you’ve got total gaps. Fortunately he has a good relationship with the Datex engineers and they indicated how he could extract further information from the record, which would tell him when a packet had been dropped, how many had been dropped and exactly when. So at least we knew where all the gaps were and I’ve been patching all those numerous gaps over the last three years off and on.
MW: So this is still a work in progress?
BM: Yes so we’re getting somewhere near the point, I think another year and I’ll be ready to start putting data into the model.
MW: Wow. We shall look forward, very much, to seeing your next publication on the Sunday. Professor Mapleson this has been an absolute fascinating, what is it, hour and a half now and I think we’ve got everything we could possibly hope for, unless there’s anything that you realise we’ve left out, anymore?
BM: Well yes one thing, a very general interest. A lot of minor publications have come in terms of sampling of blood and gases which relates to the point of general interest there, which I think is something that I included very much in lectures on physics of anaesthesia, particularly measurement and that is that it doesn’t matter how good your measuring instrument is, how accurate, how reliable, it won’t do you any good unless you provide it with a valid sample of the thing you’re trying to measure. Where a whole host of pitfalls in that and I have got, there’s quite a collection amongst my papers of things of cases where I have explored, various instances of that, like can gases be dissolving in the syringe while you’re waiting to analyse the sample.
MW: There are sort of similarities in many ways in computer science as well where the information put in is totally dependent on the person that’s actually putting it in. I mean I’m just trying to see analogy between the fallacies that could arrive where something has gone unrecognised.
I just like to express on behalf of the Association now, thanks to you for your time and your good humour and for your contribution. The one question I was going to ask you and would like to round off this by asking you; have you ever had the misfortune to be on the receiving end of an anaesthetic?
BM: Oh yes.
MW: And did your knowledge of what was involved, did it worry you or did it make you feel comfortable and confident?
BM: I had absolute confidence in my anaesthetists.
MW: Wow, I think that’s a very nice note on which to end, thank you very, very much, thank you sir.