Friday, 10 August 2012


Working with Ken Dodd in 2011 on “A young person’s guide to the orchestra” (Britten)

      From the start as a student at Guy’s I had much less interest in medicine than in music, so got involved in the very active Guy’s Music Club with John Winter, (baritone), Tom Sherwood (organ) and with a  lot of support from Charles Baker, (cardiologist and fanatical opera-lover).   The Chapel was a good auditorium for concerts, and we did several oratorios in Southwark Cathedral and Chapter-House.   The artist Mel Dean drew me from behind (it’s always been my best aspect), conducting GHMC in Haydn’s Creation. 

      After qualifying I was houseman with Butterfield and Brock. The 1962 Consultants’ Dinner was memorable: as residents, David Barker and I were editors of the Guy’s Gazette, and he had become cynical about the ethics of private practice of some Guy’s Consultants.    David was asked to reply to the Guy’s toast on behalf of the Residents and he chose “Dare quam Accipere” as his text. Clearly there was trouble ahead, and Prof  Butterfield, concerned that David might ruin his career with an immoderate speech, sent a note: “Barker, be careful”.    The note was sent back: “Butterfield, f*** off”!    As I remember it, David’s speech was sharply critical, but did him no material harm.    The other thing that happened that night, after the consultants left, was the traditional, annual and spectacularly drunken riot causing the near-destruction of the College, again!   Since Gladstone had told the Governors in the 1870s to raze this unedifying building, it seemed a bit unfair that our attempts to do so remained unrewarded by the Board.     Indeed, we were fined and to raise the £1,500 repair bill, we organised the first Ball at the newly-opened Hilton.

A warm sense of loyalty to Guy’s persists into middle age, atavistic but special, probably because the clinical teaching was excellent and a good time was, generally, had by all. To quote our contemporary, Tom Lehrer, in recalling his “Bright College Days (1958):
                                                                          Turn on the spigot,
                                                                          Pour the beer and swig it, and
                                                                          Gaudeamus igit -

              Butterfield, despite my risqué representation of him in Tony Bron’s brilliant Residents’ Play, put me into Harry Keen’s lab in the Department of Experimental Medicine – God how things have changed - and I became interested in type 1 diabetes.    My first research paper (Diabetologia. 1;1. (1964)) was co-authored with Harry and John Jarrett and involved culturing individual rat islets of Langerhans, each little speck painstakingly dissected out by me.    Thus I learned how to operate, and my peers encouraged me also to think.    Surgery seemed the right path; transplantation, then highly experimental, lured me.    After training at Guy’s, Cambridge and Harvard, I was appointed foundation Director of the Mersey Regional Transplant Unit at Liverpool in 1971.

             Unwittingly, I had started out on a professional path already trodden by several very distinguished Guy’s graduates:   Peter Gorer FRS, a lecturer in pathology who taught us second year microbiology, was the true father of modern clinical immunology.     In 1937 he had discovered the histocompatibility complex (H2) in the mouse, the publication of which triggered the genetic research which revealed the equivalent complex in man, the HLA system, a thorough understanding of which is crucial to success in tissue grafting.  Richard Batchelor, (q. 1955) in the Guy’s pathology department performed crucial studies in elucidating the HLA antigens.    Sir Roy Calne FRS (q.1953) famously discovered Imuran, the first usable immunosuppressive in human transplant recipients, and later the safer and better drug, Cyclosporin;  at Cambridge he developed the first successful liver transplant unit in Europe.   To this day Roy holds up Russell Brock as his role model, for his brilliance and tenacity whilst developing heart surgery.

In the early ‘70s the survival data on kidney transplants were dire, and improvements only came gradually with better anti-rejection drugs and an expanding (though never adequate) organ donor pool.  I retained myinterest in diabetics receiving dialysis.  In the early days of the transplant programme we observed that following a kidney graft diabetics had a much higher than normal risk of death due to coronary thrombosis and postural hypotension.  Yet their survival on dialysis was miserable and short-lived, and islet transplants did not work.   Clearly a different approach was needed.  A new concept was developing in Minneapolis and in 1982, in very high-risk, young, diabetics we turned to simultaneous pancreas and kidney transplantation as a way of stabilising the blood sugar, osmolality and metabolism during the dangerous post-operative period.  This complex but successful procedure has become standard in those vulnerable patients fit enough to survive it.

My retired state now allows much more music – I have been conducting the Crosby Symphony Orchestra for 30 years and have formed a semi-professional madrigal choir in the Vale of Clwyd.   Ken Dodd has performed several times with the CSO (see picture above), and this July I conducted “Belshazzar’s Feast” by William Walton with the Royal Liverpool Philharmonic Choir in the Philharmonic Hall. 

Me  with Artemia
Paula  with Crumpet

Paula my wife is a retired research immunologist who worked in the School of Tropical Medicine. Life on our small-holding in the Vale of Clwyd is perfect. Paula breeds horses and I look after the alpacas. 






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