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Oxford medicine THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI O X F O R D M E D I C I N E . J U LY 2 0 0 5
From the President I can, without doubt, claim a great success the first annual Oxford Osler lecture brilliantly delivered by John Bell, Regius Professor of Medicine, on the 23rd of April 2005. “Will Genomics change Oslerian Medicine?” Answer “yes”, very much so. It will be enhanced. Diagnosis will become more precise, treatment better targeted, management of patient and family improved and the potential for doing harm reduced. For example, we now have 10 or so defined varieties of type 2 diabetes each requiring a different approach. We have the prospect of being able to define a malignancy with such precision that therapy can be almost personalized to the individual. All heady stuff, but to keep a perspective, it is still Public Health that holds centre stage. John Bell reminded us, it is fifty or so years since DNA was defined and fifty years since Richard Doll first published his evidence of the link between smoking and lung cancer. In terms of “lives saved” Richard Doll wins hands down.
Two dinners, fully subscribed, followed at Rhodes House and Green, and our guests included the new Vice Chancellor, Dr John Hood (whom your president found to be a highly agreeable and relaxed dining companion) and Dr and Mrs John Spalding (see page4). We were also delighted to welcome some of those who had graduated through the medical school in 1960. Do come to the September meeting designed to mark the 100th year since William Osler came to Oxford as Regius (details enclosed) and sign up for dinner in Christ church afterwards. Partners and spouses are always most welcome at OMA events. I hope very much that we will fill Christ Church hall as a tribute both to Sir William Osler and to Oxford medicine.
University On the University side, there has been publication of two very important green papers, one on an Academic Strategy and one on a Governance Structure. The Academic Strategy estimates the standing of the University and proposes that, in general, the University is in the top 3 – 5 universities in the world. It also states that teaching and research activities jointly run at a deficit of around £100m a year. This is clearly unsustainable. The paper proposes recruitment of the best staff and students as a vital component of the strategy, and also proposes restructuring departments which are under-performing. A key aspect of both
From the President
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Division news from Dr Kenneth Fleming
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OUS Travel programme 2005–2006 . . . . . . . . . . . . . .3 Queen’s Birthday Honours List 2005 . . . . . . .3 Dr John Spalding in conversation . . . . . . . . . . .4 Oxford Osler Centenary September 2005 . . . . . . . . .7
J.M. Holt
Inaugural Osler Centenary Lecture 2005 . . . . . . . . . . . .8 OMA Events Diary 2005–2008 . . . . . . . . . . . . . .9
Division News The last three months have been a particularly busy time for both the University and the Division.
Contents
these sensible proposals is much increased Personnel functions. In particular, regular review of an individual’s contributions to teaching, research, administration, etc. and connecting this to rewards, or the opposite, where appropriate. Review of academic career progression is proposed, which by suggesting a systematic promotion pathway, would be a major change for Oxford. There are proposals for increasing income and reducing costs and for jointly distributing the University’s HEFCE income for teaching and research between the colleges and divisions, using the same criteria. A variety of other important issues are addressed, one of the most important of which is to re-balance the numbers of under-graduate and graduate students, by increasing post-graduates and decreasing under-graduates.
Oxford Developments Obituaries
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Division News
In general, the University is in the top 3 5 universities in the world
The Governance Structure proposals have just been published. These suggest very radical change. First, there would be a Board of Trustees, all 13 of which would be external to the University, although largely alumni. As Trustees, the individuals would be in the position of “to take all final decisions on matters of fundamental concern to the institution”. It is envisaged that direct responsibility for corporate matters, (finance, audit, etc.) would be dealt with by the Trustees, while all academic matters would be delegated to a separate Academic Council. This Council would be large (around 140) and incorporate all Heads of Colleges, Divisions, a group of departmental heads and an elected group of 40 members of Congregation. This Council would be the forum which the collegiate university jointly decided academic policy, thereby addressing the problem of parallel (and potentially divergent) decision-making between colleges and divisions. Beneath the Council, there will be sub-committees, divisions and departments, as at present. The Trustees would delegate to the Vice-Chancellor executive powers for the day-to-day running of the University, which would be exercised in conjunction with the Pro-Vice-Chancellors, Heads of Divisions and representatives of the Colleges. Doubtless there will be many differing opinions on the contents of both Green Papers and I strongly urge all to read them carefully and to participate in the ensuing debates. These Papers are amongst the most important in the recent history of the University. In parallel with the Green Papers, there has been provisional work on a J-RAM (a formulaic methodology for distributing HEFCE T/R money to Divisions and Colleges). The objective of this is to provide the same financial incentives and disincentives to both Colleges and Divisions, as opposed to the current situation. This is likely to produce much greater alignment of decision-making between the two parts of the University, and taken with the arrival of Giles Kerr as Director of Finance, will produce significant changes to the methodology of drawing up budgets, with greater understanding of our income and expenditure and costs and prices. Lastly, on University matters, the implementation of the two major management systems, OSIRIS (finance) and ISIDORE (students) continues to be a struggle. Slow progress has been made on the OSIRIS system, but much remains to be done. The ISIDORE system, which is confined to graduate students for the moment, has had a difficult admissions round. It is clear that the demand of processing a large number of applications, in a short time period, did not maximise our ability to admit the best students. This must be
avoided in the future and much work is being devoted to this. Division Within the Division, the most significant event in teaching was the first implementation of the 2nd BM exam in Medicine, in January, rather than June. This went well. A pleasing aspect of the 2nd BM was that the first cohort of 4-year, graduate-entry students sat the exam and all passed, with one student gaining a distinction prize. In research, the announcement by HEFCE of the preliminary criteria for the 2008 Research Assessment Exercise is of vital importance, as is the fact that staff from the Division will be members of virtually all the relevant sub-panels. In total, twelve members of the Division will be part of the sub-panels, with Andrew McMichael (Infection and Immunity) and Ray Fitzpatrick (Health Services Research) being panel chairs. Staff On recruitments, Professor Gilles McKenna, Henry K. Pancoast Professor of Radiation Biology and Oncology, University of Pennsylvania, has accepted the post of Professor of Radiation Oncology. Professor McKenna is from the UK originally, but has worked in the USA for over 20 years. This post will result in a major expansion of our capacity in radiation biology and oncology, since Professor McKenna will also be honorary director of the MRC Unit of Radiation and Genomic Stability, currently based at Harwell, and the Gray Institute of Radiation Biology, currently based in Mount Vernon, London. Both these activities will move to Oxford in due course and will markedly increase our research capacity, particularly in the translational arena. Professor McKenna will be accompanied by Professor Ruth Muschel, who will be coming to Oxford as a CRUK/MRC Professor in Cancer Biology. All these changes are part of our continuing policy of reinforcing research in the cancer arena. The major thrust of the policy will be in place when the planned NHS cancer hospital on the Churchill site is finished in 2007 and Division’s Institute for Cancer Medicine is built and opened next door (around 2008). A chair in Cancer Biology remains to be funded, having been identified in our Research Strategy as one of the top priorities for the next 3 – 5 years. Professor Alastair Buchan started as Professor of Geratology at the end of 2004. Alastair was a student in Oxford in the 1970’s and has been based in Calgary for the last ten years. His major initial priority will be to develop a fully-fledged acute stroke unit. He, jointly with Professor Hugh Watkins, is also actively drawing up plans for a vascular clinical research unit, which will pursue clinical research in vascular disease,
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in both the cardiovascular and cerebrovascular arenas. We anticipate that there will be a call for such clinical research facilities by the Department of Health and the Wellcome Trust sometime in 2005 and we wish to use this opportunity to increase our clinical research, to link our current activities with the NHS and to provide a unified structure to deal with all the current regulatory complexities of clinical research.
by the King Faisal Foundation for their work on “Tobacco Risks on Human Health”. Dr. Ann McPherson, Department of Primary Health Care, received the BUPA Foundation Communication Award for DIPEx www.dipex.org a health information website that features a broad range of patients’ experiences as well as evidence-based health information. Congratulations to them all!
Finally, there have been several prizes for members of the Division in the recent past. Professor Waldmann has received the European Haematology Association’s Jose Carreras Award 2005. Jointly, Professor Sir Richard Doll and Sir Richard Peto have been awarded the 2005 King Faisal International Prize for Medicine,
Dr. Kenneth Fleming Head of Medical Sciences Division University of Oxford May 2005
OUS Travel Programme 2005-2006 The Oxford University Society provides an extensive Travel Programme for Oxonians, their partners and friends. All trips offer you the chance to sample new cultures, gain unique experiences and enjoy the company of other like-minded alumni. All tours are accompanied by an expert Oxford scholar, who will enhance your enjoyment of the destinations you visit.
A good holiday is one spent
The new Oxford University Society travel brochure has just been launched! This brochure is intended to give you a preview of the trips arranged for 2006, so that you can begin to plan your next holiday. Trips arranged for 2005 which still have availability have also been included. As places are limited, early booking is highly recommended. New trips for 2006 include an opportunity to view the next solar eclipse in Egypt, and a leisurely barge cruise in Burgundy to learn about the art, architecture and wines of this area. There is also a gulet cruise around Rhodes and the neighbouring islands, or if you want to go further afield, you could enjoy a luxury cruise to Barbados, Martinique or Costa Rica. Special rates have been negotiated for Oxford alumni. We have also planned a cultural tour to discover the gardens and temples of Japan. If you would prefer a short break,
among people whose notions of please enquire about the trips to Tallinn and Bratislava in 2005. All tour operators make a donation to us for each Oxonian traveller, and these funds help to support the continuing work of the OUS on behalf of all Oxford alumni. We have also recently been able to give a number of travel awards and maintenance grants to current students. Your participation in the programme is therefore greatly appreciated.
For your copy of the new travel brochure, please contact Cathy Tennent: travel@ousoc.ox.ac.uk or tel: 01865 288087.
Queen s Birthday Honours List 2005 OMA sends warmest congratulations to Professor Muir Gray, NHS Director of Knowledge Management and Programmes and Director UK National Screening Committee, who received a knighthood in the
Honours List and to Dr Theo Schofield, GP and Director of Communication at the Ethox Centre, Oxford who was awarded an OBE.
time are vaguer than yours. J.B. Priestley
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Dr John Spalding in conversation … JMK Spalding MA, DM, FRCP. Formerly Consultant and Research Neurologist for the United Oxford Hospitals. Highly respected for his work on artificial respiration and disorders of the autonomic nervous system between 1950 and 1977. He is now too old to continue sailing and indulges his passion for birds and gardening.
Why did you come to Oxford? I was born in London but was brought up in Lyme Regis and Oxford. I went to school at Summer Field’s, then Eton and New College where my father had been a student.
In desperation I said I want to be a doctor
Why medicine? When I was at school our Matron used to invite us to tea – four at a time. Quite soon the conversation would languish and she would ask ‘What are you going to do when you grow up?’ I thought up three possibilities, but the other boys got in first with them! So in desperation I said ‘I want to be a doctor’ and ever since I have thought ‘what a good idea!’ I came up to University having done minimal science at school but with a view to reading medicine I struggled through science prelims. I then read Greats on the advice of my father and housemaster, another struggle because I had not done Honour Mods. I therefore did not know enough Latin and Greek to read the texts with ease. I got my degree in1939 and then I started doing Anatomy. How did the outbreak of war affect your career? I was half way through dissecting an arm when I was called up and asked what I wanted to do. I said I want to stay in something medical, and became a medical orderly in the RAF. That was not terribly inspiring so I became a theatre orderly which taught me about instruments and sterilisation. The radiographer wished to progress elsewhere so I took over from him. I knew how to develop and fix films, I was given half a morning’s instruction and I bought (for 5 guineas, a lot of money then) Miss Clarke’s detailed book of instruction. After I had done radiography for some time, I was posted to the RAF Hospital at Halton on a course to learn how to do it. I was useful there as I could teach my fellow students and save the permanent staff from having to do so. After two years in this country, I was posted abroad. I got as far as the docks at Liverpool when the medical section of the convoy was taken off the draft. I later learned that that convoy was the last to go into Singapore. I doubt I would have survived is I had been on it. Soon after that I was returned to my civilian occupation as a medical student, and came back to Oxford.
The family home was then in South Parks Road opposite the Dunn School. It has long since been demolished to make way for a very ugly laboratory. The house was run by my elder sister and housed a series of evacuees including Charles Williams and Gerald Hopkins, both authors working for Oxford University Press, and Barbara Ward a young economist later baroness Jackson. I did my clinical degrees at the Radcliffe Infirmary, only a few years after it became an undergraduate teaching hospital. There were about ten of us in each intake so we saw plenty of patients. At first there were no war wounded there but it was busy as the general hospital for the neighbourhood
When war casualties began to arrive what was your remit in the hospital? I remember standing outside our front door with an eminent biologist. He could see activity in the Dunn School and said ‘Why are they not doing something useful for the war?’ He did not know that they were isolating penicillin for the first time and demonstrating its therapeutic value. Of course we now know that instead of working for the war they were discovering penicillin. Soon after D-Day casualties from the invasion of Europe came to the wards specially reserved in the Radcliffe Infirmary. Penicillin was available but in very small quantities as a very impure powder. Since antibiotic resistance had not developed even the tiny doses available were valuable. As medical students our duty was to dissolve this valuable material and inject it into the wounded. It was hoped that we could do this with more or less sterility. Why neurology? As it was wartime when I was a medical student most doctors were in the armed forces. House Physicians (HPs) were scarce and usually there was only one shared between two firms and one registrar. Senior medical students could become student HP’s and I did a student job for Professor Ellis, the Regis Professor. In fact the firm was run by Alice Stewart, a very bright lady who later became a well known epidemiologist. After that I became HS to Hugh Cairns and it was while I was working for him that I learned about Neurology. He was a neurosurgeon and suggested that I should pursue a surgical career but I told him I was too clumsy. Cairns continued to advise me until his early death in office. It was at his suggestion that I did a job in pathology job under Robb Smith and also went to Hampstead General Hospital to learn about life in a small hospital. I got a job at Maida Vale Hospital for Nervous Diseases, where my principal boss was Russell Brain, author of the standard text book on neurology, and later Lord Brain, President of the College of Physicians.
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It was then that I met my wife. Micky Wilkinson who has also been a medical student at Oxford was a registrar at Maida Vale. She had been at school with Elizabeth Falle, also a doctor. This is how Elizabeth and I came to meet and get married. The treatment of polio has made you very well known I returned to Oxford as research assistant to Ritchie Russell. Ritchie, a neurologist in Edinburgh, had come to Oxford during the war to St Hugh’s Military Hospital for Head Injuries where all military and RAF cases of head injury were cared for. Cairns had wisely organised this concentration of skills in the management of such cases. After the war Cairns persuaded him to stay in Oxford. Ritchie set me to work on small gunshot wounds of the visual radiation and visual cortex. I added a bit of anatomy and got my DM from this. Another interest of Ritchie was acute anterior poliomyelitis or polio. Polio had occurred between the two wars in this country and the rest of Europe from time to time but it wasn’t a major problem. It affected children and was know as ‘Infantile Paralysis’. In America however it was well known and affected adults. A high profile patient was the future President FD Roosevelt who got polio in 1921 and thereafter needed a wheelchair. The March of Dimes program was established to deal with the disease and years after the war vaccination finally prove successful. After exposure to polio virus one person may develop recognisable symptoms and ninety nine have few or no symptoms. They may however excrete the virus for up to 6 weeks. So it is very likely that the Americans soldiers, the G.I’s, brought polio over to Britain in large quantities during the war period. Anyway, after the war Britain and the rest of Europe experienced major outbreaks of polio. In Europe most countries had a number of ‘iron lungs’, and in 1938 Lord Nuffield supplied every hospital with a basic ‘Both’ [pronounced like ‘cloth’] respirator. It resembled a coffin from the end of which the patient’s head protruded. It was powered by a huge electrically operated bellows which sucked the air out of the coffin allowing atmospheric pressure to push air into the patient’s lungs. Expiration was passive. These saved some lives but usually the patient died because those who needed a respirator generally had trouble with their swallowing. They could not swallow their saliva or food and perforce inhaled it instead. The Danes believed that polio, spread by faecal contamination of food, would not affect their clean country so they had no respirators. When they had a major outbreak H.C.A. Lassen, Head of the Infectious Diseases Hospital in Copenhagen and Bjørn Ibsen, anaesthetist, argued that a patient paralysed by polio
was much like one who was paralysed with a curare for an operation. The patient could therefore be kept alive in a similar way by intubating the patient and simply squeezing the bag of the anaesthetic machine. They hired medical students to squeeze the bag in relays. The intubation tubes had cuffs on them so that secretions did not get into the lungs. The tubes of those days were irritant to the larynx so within days a tracheostomy was needed though which to out a cuffed tube. The system was known as intermittent positive pressure respiration (IPPR). Ritchie Russell had already set up a unit at Stoke Mandeville where he provided artificial respiration because nobody else locally did. The orthopods looked after polio but would not admit patients in the acute stage when they were infectious, but this was when they might die. The paediatricians took patients in the days of Infantile Paralysis, but they would not take adults. The isolation hospital took such patients but did not have the staff or facilities to care for those with life threatening polio. When Lassen published his paper Ritchie saw that we must provide IPPR and that we needed to do it in Oxford. We started in an ENT side ward at the Radcliffe Infirmary but soon moved to the Churchill Hospital at first in a former air raid shelter. Then the Polio Fund, a dynamic institution, built us a unit of four two-bed wards, the Respiration Unit. Ritchie asked Macintosh, Professor of Anaesthetics, for an anaesthetist to join me in looking after the patients and he chose Alex Crampton Smith. We could not hire medical students as Lassen had done so we needed a machine. Dr Edgar Schuster who had been making apparatus for the physiologists said, “Tell me what you want it to do and I’ll make a machine. I will never make two because anyone can copy it, but I will never make two because anyone can make a copy but I will make improvements until it is right.� He was as good as his word and his work led to the commercial production of East Radcliffe Respirator. (East was the manufacturer not a point of the compass. It was a splendid respirator because it was absolutely basic. A nurse could look at it for a couple of minutes and understand it exactly. If anything went wrong she would know and know what to do about it. It had a simple device to change it from mains to battery operation so you could take your patient up to X-ray – or bring one back from Nigeria. If you blow atmospheric air or worse still air from cylinders into the lungs you dry the secretions and it becomes impossible to suck them out of the airways so John Marshall and I devised a hot water humidifier which became a standard part of the respirator. These pieces of apparatus remained useful until the advent of electronics made everything easier and more efficient.
Tell me what you want it to do and I ll make a machine
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We were now able to treat polio with every prospect that the patient would survive but any polio patient who needed to be ventilated was left with some permanent disability. A don continued his distinguished career but some patients were left with no spontaneous respiration and no active movement below the neck. We enabled them to live at home, permanently attached to their respirators and able to be moved about in a wheel chair but it was hard on their relatives. Some patients achieved a useful life but one, I suspect, committed suicide.
The treatment of Tetanus also presented many problems for you. Tetanus was still occurring in those too old or too young to have received immunisation in the armed forces. When the disease is fully developed all muscles go into spasm so that respiration ceases just as oxygen demand is at its highest. Treatment with curare solves the muscle spasm but I had seen as a student that a curarised patient could not be kept alive in a tank respirator. IPPR however made it possible to maintain the patient until the disease subsided after a few weeks.
Of my seniors those who influenced me most were Hugh Cairns and Ritchie Russell
You became interested in the autonomic nervous system Our first patient with Guillain-Barré syndrome was a teenage girl. We settled her down on a respirator and invited her parents in to see her. When they reached her she was unconscious. They were not worried but we were horrified. The reason was that her blood pressure was very low and was rectified by tipping her head down. Tetanus presented the opposite problem. Blood pressure could rise very high; perhaps 260/140, for long periods and the circulation would fail. These abnormalities of blood pressure were unexplained so we tried to find the cause. In the late 1950’s electronic devices were just becoming available and we were beginning to be able to measure pressure and flow in arteries and veins. The results were obvious – in retrospect. In Guillain-Barré syndrome the motor and sensory nerves fail and if the autonomic nerves are also involved, motor and sensory, control of the blood pressure is also lost. In tetanus there is massive discharge along lower motor neurones. If this also affects the sympathetic nervous system vasoconstriction is huge and the blood pressure is huge too. The Polio Fund built us a laboratory near the Respiration Unit. One channel of recording then needed a box of electronics about 12”x15”, heavy, and we used four channels. They were mounted on a massive trolley which was just possible to push up the slope at the Churchill.
Because we had facilities for testing the autonomic nervous system, which was still rare at that time, patients with other autonomic problems began to be referred to us. Theses included those with Shy-Drager syndrome in which patients faint unless they lie flat. We did what we could for them and were able to throw light on the pathology with the aid of Dr David Oppenheimer who made careful studies of the spinal cord. Together with colleagues from Stoke Mandeville we also looked at patients with spinal cord damage. They have problems of autonomic function both from loss of control from the brain and of over activity in the isolated section of spinal cord. Whilst all this clinical work was being carried out I was also a modest member of the Nuffield Committee which then provided the money for the medical school. Its efficiency was striking compared to some other committees. I also found myself on the Council of the Royal College of Physicians.
What have been the most rewarding things you have worked on? The development of artificial respiration was exciting and important as leading to the universal use of ‘life support machines’. Investigating disorders of the autonomic nervous system became a long term interest and was enjoyable because other people had not yet come on the scene. We were also lucky in that drugs to treat autonomic disorders were becoming available. Of my seniors those who influenced me most were Hugh Cairns and Ritchie Russell. Of my contemporaries Alex Crampton Smith was much the most important. When he was allotted to be the anaesthetist for the Respiration Unit he happened to live next door to me. We discussed problems of artificial respiration at leisure so that we had a policy when the problems actually occurred. It was educational too to see him tackle successfully the most forbidding problems of intubation. When Elizabeth and I retired we had the chance to sail further in our 36’ Westerly ketch to Ireland, the Hebrides, La Rochelle and Copenhagen. Alex Crampton Smith also kindly used to invite us on his boat in the Mediterranean. We became interested in sea birds while sailing and when those days were over we saw more birds in as many places as possible including Africa, India, the Galapagos and Antarctica. Now I see mostly garden birds. I am converting to digital photography and trying to master the wonderful improvements that a computer can make to a photograph. I read anything from Jane Austen to Harry Potter and historical novels such as Pompeii.
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Oxford Osler Centenary September 2005 23rd September 2005 Osler Centenary Seminar
‘Symposium Osler’s diseases, then and now�
3pm to 5.30pm Osler McGovern Centre, 13 Norham Gardens, Oxford
10.50 Professor David Warrell. Introduction. 11.00 Professor Richard Moxon: “Osler and Pfeiffer’s bacillus� 11.20 Professor John Wass: “Osler, pioneer in thyroid replacement� 11.40 Professor Hugh Watkins: “Osler and heart disease� 12.00 Professor John Reynolds: “Osler’s therapeutic nihilism� 14.00 Professor Nick White: “Osler’s favourite fevers: malaria and typhoid� 14.20 Professor George Ebers: “Osler, a true father of neurosurgery� 14.40 Professor Simon Wessely: “Osler and neurasthenia� 15.30 Professor Sir John Grimley-Evans: “Osler, and Oslerism� 15.50 Dr Ken Fleming: “Oxford Medicine 2006 and beyond� 16.10 Oxford Medical Alumni: Annual Meeting
A seminar, convened by Professor Terence Ryan, for a limited number of OMA members and for “Friends of 13 Norham Gardensâ€?, will enable those who are especially interested in Osler in Oxford to examine in a little more detail the archives and the building. Professor Ryan will talk about some of the archives held at 13 Norham Gardens and the newly prepared DVD, “Osler and Oxfordâ€? will be shown. In addition there will be two short talks by: • Dr Ian Gregg “Osler and Asthmaâ€? • Dr Nicholas Dewey “Osler’s Literary and Bibliographic Interestsâ€?. Numbers are limited to the size of the seminar room and places must be booked in advance. For further details please contact Jayne Todd.
Grand Reception, 6pm to 9pm 13 Norham Gardens, Oxford – home of Sir William Osler There will be a drinks reception during which there will be opportunity to view some of the rooms at 13 Norham Gardens which was Osler’s home during his time at Oxford. Various documents and artefacts relating to his life and work will be on display in Sir William’s study which remains as it was during his time here.
24th September 2005 Osler Centenary Meeting “Osler’s Diseases, then and now.� Academic Centre, John Radcliffe Hospital, Oxford Professor Michael Bliss, from Toronto, author of a highly praised recent biography, will give the Inaugural Oxford Medical Society lecture to be followed by a symposium on 'Osler's Diseases then and now,' in which some of Osler's favourite diseases and ideas will be reconsidered from a 21st century perspective. 9.15 9.20
Dr JM Holt: Welcome and introduction to the day’s programme Professor Michael Bliss, University of Toronto: “ William Osler in Oxford, 1905–1919� The Inaugural Oxford Medical Society Lecture. An historical account of Sir William Osler's memorable years in Oxford.
Family Tea Parties • A Family Tea Party for graduates of 1995 and their children will take place at the medical students centre, Osler House, in the grounds of the John Radcliffe Hospital on 24 September 2005 between 2pm and 4.30pm. Take this opportunity to meet your friends and enjoy tea and home made cakes, whilst your children play in the Osler House garden. Soft drinks will also be available. Numbers are strictly limited to 100 (adults and children) for this event, and must be booked in advance. • A Family Tea Party for graduates of 1980 and their children will take place at 13 Norham Gardens on 24 September 2005 between 2pm and 4.30pm. Take this opportunity to meet your friends and enjoy tea and home made cakes, whilst your children play in the garden. Soft drinks will also be available. Numbers are strictly limited to 40 (adults and children) for this event, and must be booked in advance.
Osler Centenary Banquet 7pm for 7.30pm, 24 September 2005, Christ Church Hall All alumni of the medical sciences and their guests are welcome at this very special banquet to mark the centenary of Sir William Osler in Oxford. There will be special reunions for those who qualified in medicine in 1980 and in 1995. To book your place at any part(s) of the Osler Centenary please contact Jayne Todd at Oxford Medical Alumni.
To book your place at any part s of the Osler Centenary please contact Jayne Todd at Oxford Medical Alumni
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Inaugural Osler Lecture and Dinner 2005 The lecture was given at the Medical Sciences Teaching Centre in South Parks Road and the atmosphere was set when students who were undertaking part of their final examinations were at the same time able to mingle with some of the 300 alumni and friends of Oxford Medicine who had come to hear a stimulating and thought provoking inaugural lecture given by Regius Professor of Medicine, John Bell. The audience which spilled out of the lecture theatre and into a large overflow space included alumni from 1945 to 2004, members of the current teaching and undergraduate body, members of the Oxford research institutes, visitors from North America, South Africa and Europe.
Inaugural Osler Lecture and Dinner 2005
Two dinners were held at Rhodes House and Green College to accommodate all those who wished to be part of this important moment in Oxford Medicine. OMA was honoured to greet the Vice Chancellor, several heads of house, Sir Richard Doll, Sir Roger Bannister and many other distinguished guests amongst the glittering array of Oxford alumni who gathered for dinner. A special reunion was held for those who had graduated in 1960 for some of whom this was their first visit back to Oxford.
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Oxford Medical Alumni Events Diary 2005-2007 23 and 24 September 2005 Osler Centenary Meeting For full programme see page 7 26 April 2006 Oxford Osler Lecture to be given by Professor Christine Lee Professor of Haemophilia, Director & Consultant Haematologist Royal Free Hospital, London 27 April 2006 Annual Osler Dinner 7.30pm, Rhodes House, Oxford
28 and 29 September 2007 7th Annual Oxford Meeting This meeting will be convened by Professor Adrian Hill and the theme: Cancer 29 September 2007 7th OMA Grand Reunion Dinner For more information on any of the above events contact Jayne Todd Tel (+44)1865 221690 Email jayne.todd@medsci.ox.ac.uk Website www.medsci.ox.ac.uk/oma
23 and 24 September 2006 6th Annual Oxford Meeting Medical Sciences Teaching Centre, Science Area, Oxford The theme for this meeting will be: Mental health and the Neurosciences
Contacting OMA Address: Oxford Medical Alumni Medical Sciences Office John Radcliffe Hospital Oxford OX3 9DU Email: jayne.todd@medsci.ox.ac.uk Enquiries: 01865 221690
24 September 2006 6th OMA Grand Reunion Dinner at Pembroke College, Oxford
Fax: 01865 750750
27 April 2007 Oxford Osler Lecture to be given by Professor Peter Ratcliffe 27 April 2007 Annual Oxford Osler Dinner 7.30pm, Rhodes House, Oxford
Oxford developments Diana Stent has recently been appointed to the development team for the medical sciences division. Diana comments that, “It is a happy return to this glorious City as I read geography here in the days when St Hugh’s was still a woman’s college and full grants were available. Oh happy times! I am looking forward to meeting alumni and sharing with you the exciting vision for Oxford Medicine and, if you are interested, my latest holiday news – Mali next!” Diana has returned to Oxford after 5 years senior fundraising experience in the voluntary sector and before that 18 years in the City (mostly in corporate strategy and business development roles).
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Obituaries Dr Michael John Halsey MA D.Phil It was with sadness that we learned of the death of Dr Michael Halsey on 19th February 2005. Michael was a much loved and respected colleague and will be greatly missed. His funeral, attended by his family
and friends, was held at the church of St. Peter and St. Paul, Deddington on Wednesday 2nd March 2005. Our thoughts are with Michael’s wife, Elizabeth, and family.
Dr Charles Roger Norman Roger went up to St Peter's to study medicine in 1962 and his clinical training was undertaken at St Mary's, Paddington but, some years after qualifying, his medical career was cut short by serious illness. He recovered enough to involve himself, in a voluntary capacity, with various charities in St Albans where he lived since the mid 1970's. It seems tragic that a further devastating,
Dr Leo Wollner Consultant Physician in General and Geriatric Medicine, Oxford 1963 –1989, b 1924; qualified 1951 Guy’s Hospital Medical School; MA (Oxon) 1971; FRCP (London 1974), d 8th February 2005 Leo Wollner had a long and distinguished medical career, and was one of the founding fathers of Geriatric Medicine, building on the basis provided by some of the earlier pioneers with whom he worked, including Drs Woodford Williams, Phillip Bedford, and Lionel Cosin. Leo was born in Vienna and in 1938 escaped, with his sister, to England at the age of 14 yrs. Living first in Cornwall, he studied by correspondence course and at Birmingham Technical College, eventually gaining a place at Guy’s, where he won several prizes. In the early years after qualifying he was introduced to geriatric medicine by Professor Witts, Nuffield Professor of Medicine at Oxford, and spent 6 months at the Cowley Road Hospital. After Senior Registrar appointments in both geriatric and general medicine
and rapidly progressive illness, should take his life at a comparatively early age. His courage in coping positively with the adverse circumstances that beset him for a long period of his life was an inspiration to his close family and to the wide circle of friends he had in St Albans. Died 22 March 2005
in Sunderland and Newcastle, he was appointed to a Consultant post in geriatric medicine at Stoke Mandeville Hospital before moving back to Oxford. Leo will be remembered by many for his important contributions to the development and standing of geriatric medicine, and for his research into accidental hypothermia and temperature regulation in the elderly. He organised a highly regarded training programme that attracted young doctors from all over the UK, such that when he retired he had probably trained more consultant geriatricians than any other centre. Leo also espoused the emerging principle of integrating geriatric medicine with general medicine, with joint training in both disciplines, and played a large role in the development of this approach in Oxford. He helped to change the image of geriatric medicine, attracting high calibre doctors to work with the elderly. Leo Wollner was a physician for whom nothing was too much trouble when caring for his patients. He was also devoted to Sylvia and his four children. He will be fondly remembered by his many friends and colleagues.
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A Tribute to
Dr Sheila Callender
her. Then after the war finished she helped to lay the foundations of the success of the NDM with
MD St Andrews, D.Sc Oxon, FRCP, Consultant
Physician and Clinical Reader in Medicine, one time May Reader and Fellow of Wolfson College. I was one of very many aspiring young physicians who passed through the junior ranks of the Nuffield Department of Medicine in the late fifties and sixties who carry an enormous debt to Dr Sheila Callender who died at the age of 90 in August last year. Her field was haematology, though she described herself, correctly, as a general physician. Her expertise and international distinction in haematology spanned iron metabolism, iron deficiency and diseases of iron overload, B12 and folate metabolism (her gold medal MD thesis was on megaloblastic anaemia of pregnancy) and thereby coeliac disease, inflammatory bowel disease and liver disease. In the malignant blood diseases, she was a leading member of the early MRC trials to compare different chemotherapeutic approaches in the acute and chronic leukaemias, myeloma, Hodgkins Disease and the lymphomas. But all of her expertise, drive and intelligence were practiced very much within the framework of general internal medicine where the breadth of her knowledge was truly phenomenal. Sheila Callender came to Oxford from St Andrews and Dundee as the equivalent of the SHO to the NDM in 1942, four years or so after it had been established under the leadership of the first Nuffield Professor of Medicine, L J Witts. She was on the house (there were just three housemen in medicine at the time in the Radcliffe Infirmary) when penicillin was first administered to a patient, and one of her immediate seniors ,a sort of research registrar, was one D A K Black, later President of the Royal College of Physicians, also from St Andrews, who I believe was very protective and very fond of
John Badenoch, Sidney Truelove and later Donald Acheson where real evidence based medicine was born. Later, as a consultant, her juniors knew they had to really know their patients and have clear evidence backed ideas on management (those NDM case presentations could be pretty tense affairs!) but, always, she set a superb example in the care of patients, many of whom were young and facing difficult diseases, and their families. By 1965, when Witts retired and Paul Beeson came over from Yale as the second Nuffield professor, Sheila together with Sidney Truelove represented the clinical and research backbone of the NDM. On account of Sidney Truelove’s somewhat eccentric interpretation of working hours, it was Sheila, always around and available, who provided the continuity that enabled Beeson to adjust quickly to his new environment and build dramatically on Witts’s foundations. Then, in 1974, David Weatherall arrived as the third Nuffield professor and right away, notwithstanding her seniority and daunting distinction, they became firm friends and he inherited an immensely generous helpful and loyal colleague to whom I know he feels highly indebted. Sheila was, without doubt one of the principal foundations upon which the success of the NDM was built. On retirement in 1980 Sheila started a second successful career, breeding showing and judging English Mastiffs, utterly terrifying dogs, which she continued well into her eighties. She leaves her husband, Ivan Monostori, who came to Oxford as a refugee from Hungary, and who over nearly 50 years of marriage gave her unfailing support and shared her interest in the English Mastiff. JMH
...her juniors knew they had to really know their patients and have clear evidence backed ideas on management...
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Dr Charles Kent 1953 - 2005 An appreciation of an extraordinary life
...we will never forget his unswerving support for his friends...
It was standing room only in the magnificent church in Crediton, Devon on April 4th 2005 as we said goodbye to Charles Kent, a man who achieved so much in his life of only 51 years. The congregation was an amazing mix of his patients (Charles had been a GP in Crediton for more than 25 years), friends from his days in Oxford both as an undergraduate (Worcester 1972-75) and at the Clinical School at Osler House (1975-78). Many were there from the rugby world and none of us who saw the game will forget Charlie’s try against Scotland on his debut for England in 1977. They came to say goodbye from his home-town rugby club of Bridgewater and Albion (where his England Shirts hang on display), from Rosslyn Park and from the International scene. And yet, despite these honors and his many, many other talents (all the more remarkable for a man who had diabetes since the age of 19), he was a truly humble man. Academically, he was no slouch either and was in addition a music scholar at school, where he played the organ to a high level. He was a menacing presence on the squash court. In later life he was outspoken in his support for his patients, a passionate advocate for nuclear disarmament and a keen critic of what he saw as the meaningless tiers of bureaucracy in modern day medical practice.
For those of us who were his contemporaries as undergraduates and beyond, we can look back with delight at memories of his huge smile, at the booming laugh and irreverent humour. We still smile at memories of “Team Bow Tie Day” on our first medical firm in 1976, our response to the pomposity of one particular consultant, and remember Charlie’s comradeship and the pleasures of playing rugby with him for Osler House (where we kept him in the scrum to avoid too much damage to the opposition). We felt he was our “Crash Ball Charlie.” In particular, we will never forget his unswerving support for his friends through times since, both good and bad. To his wife Cathy of 30 years and his son Joe (training in the West Country like his father and Grand Father before him), we can but let you know once more how much he was loved by us all. As we send again our deepest condolences, we also give our thanks for the honour of sharing our times with a gentle giant whose golden life came to a sudden and tragic close at the age of 51 on Exmoor, riding one of his beloved horses.
You always knew where you stood with Charlie. Nothing he did was ever half-hearted. Opinions he held strongly and he was forthright in the manner with which he dealt with political issues inside and outside of medicine. He fought like a terrier for the things he believed in and was no stranger to controversy. And yet he was always the consummate English country gentleman. He loved the West Country and its moors and coastlines and for years never left to travel beyond his beloved home counties of Somerset or Devon where he chose to set up practice. He ran a hobby farm and on several occasions would host his chums from Oxford and take us out on his horses. In later years when circumstances allowed, he toured Australia with Cathy and it’s typical of the man that he would make us laugh even at the thanksgiving service over a photo of a parrot perched on his balding head.
Oxford Medicine is produced by the Medical Informatics Unit, NDCLS, University of Oxford. Telephone +44 (0)1865 222746. Ref: OxMed0705/7700
Graeme Rocker, Dalhousie University, Nova Scotia, Canada