Updated 8 Sept 2016
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A History of Portsmouth Hospitals - Anaesthetic Department.
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A History of Portsmouth Hospitals
- Anaesthetic Department.
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by Dr Robert J. Palmer MB, BS, DRCOG, FRCA.
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FORWARD.
The following is a brief history of the anaesthetic department at Portsmouth.
Unfortunately records of the origins and development of the department have
not been kept. Therefore I have largely had to rely on the memories of
retired members of the anaesthetic department, medical and secretarial, and
also doctors from outside the department and theatre and nursing staff,
both still working and retired. On completion I am intending to circulate
this to as many as possible so they can proof read it so to speak and
inform me of errors I have made or inappropriate statements before it is
finalised and put on the departmental web page and forwarded for
publication. I can be contacted at:
 or 0788-993-7799.
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ABOUT THE AUTHOR.
I was first approached about writing a history of the anaesthetic department
at the Portsmouth Hospitals by the then clinical director of the department
Matthew Wood.
Although interested I declined as I had too busy a clinical
work load at the time to do justice to the project. I was asked again by the
anaesthetic museum curator
Sharon Holland
in late 2011. Being then part
time and a lot less busy I jumped at the chance before it was offered to
somebody else. It has always surprised me that it has not been done before.
I began with interviewing retired members of the department, mainly
anaesthetists but also members of the nursing staff and ODP’s. The first
person I interviewed was
Donald MacDougall
as I knew I would receive a
friendly reception. As time passed I became a little bolder. I have heard
some great stories which being of an inquisitive nature has been enjoyable.
Some are not so wholesome and for obvious reasons I can’t include them in
this dissertation. I envisage the process will take some 2 years. I hope
you enjoy reading it.
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Dr Robert Palmer
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There have been four main hospitals in Portsmouth.
The Royal
The Royal Hospital in 1849
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The Royal pub
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The Royal Portsmouth Hospital was sited in Commercial Road Portsmouth and
was founded in 1849. The hospital once had a “Lock Ward” for the confinement
of ladies of ill repute under the Contagious Diseases Act of 1863. It was
closed in 1979.
By 1975 operating at The Royal had rationalised to general
surgery and orthopaedics. It also had the accident and
emergency department and initially a 4 bedded
resuscitation unit for trauma cases later developing into
the first intensive care unit in Portsmouth.
Louise Bird
the wife of former Medical Director
Alex Bird
has a video of its last day of operation. The hospital was demolished and
the site developed by Sainsbury’s. The public house opposite was renamed
"The Royal"
The Royal Hospital Haslar.
Royal Hospital Haslar
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Haslar Royal Navy Hospital, circa 1842
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It was situated in Gosport and opened as a Royal Navy hospital in 1753.
The phrase "Up the Creek without a paddle" is a naval expression which originated from Haslar Creek and meant
you were injured in battle during Napoleonic times and sent home for medical attention at Haslar, where you could be
kept indefinately.
It had a long and distinguished record in the care of service personnel
both in peacetime and in war and also particularly more recently in the
care of the local population. Latterly from 2000 to 2009 medical and
nursing staff from Portsmouth NHS trust also worked at Haslar.
Eric Birkbeck
who was in the anaesthetic department at Haslar has written extensively
on the history of Haslar. It was a fine hospital with a military culture
of cleanliness, a beautiful setting, fine listed buildings, ample parking
space, and after cessation of acute medical intake no long term stay
patients, therefore no problems with finding a bed for elective surgical
patients. Its military status was withdrawn in 2007 and in the face of
considerable local opposition and controversy and not a little sadness it
was closed in 2009.
St Mary’s Hospital, Milton.
St Mary’s Hospital, Milton
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See document #1. It began as an infirmary in 1898. It played an important
role during the Second World War. After the war it needed a rebuild and
expanded. The twin operating theatres were opened in 1954.
Three Honeywell theatres for general surgery, chest
surgery, urology and renal were opened in the mid 1960's.
All were replaced by the new block of theatres above a new
imaging department opened by John Major in 1990. There was
also an Intensive Care Unit opened which Bruce Taylor was
appointed to run. This subsequently amalgamated with the
Intensive Care Unit at QA which had opened after the
closing of The Royal in 1979.
Subsequently
further theatres, the fine maternity block, and the paediatric building
were opened. Operating theatres at St Mary’s were friendly and efficient.
In 2009 the acute services were closed and moved to the new PFI build at
QA hospital. St Mary’s is now a community hospital. The paediatric building
houses the community hospital and the maternity block remains. Much of the
remainder of the hospital including the theatre complex, anaesthetic
department and wards have been razed for a housing development, though the
Education Centre remains and can be accessed via Rodney Road. The rest
of the hospital on the other side of Milton road which used to house the
renal unit, which included ventilated patients, has been turned into a
school and housing development.
Queen Alexandra Hospital.
Queen Alexandra Hospital
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See document #2. It was originally a military hospital and built between
1904 and 1908 to replace an earlier hospital which stood in Lion Street
in Portsea. The demilitarisation of the hospital began in 1926 when it
was handed to the Ministry of Pensions to care for disabled ex servicemen.
The Second World War saw the first civilian patients admitted. Following
the creation of The National Health Service in 1948 the majority of its
beds were transferred to its auspices by 1951. In the 1960’s it became a
District General Hospital. Princess Alexandra officially opened the new
hospital in 1980 (see photo with
Dr Larson)
and the accident and emergency department was opened at QA. Patients were
transferred from the Royal in March 1979. A new private finance initiative
extension-cum-rebuild at QA by Carillion was signed for in 2005 and
completed on time in the summer of 2009 with the opening on 15th June 2009.
Patients were transferred from Haslar and St Mary’s into spacious modern
wards including the maternity and paediatric unit, and new operating
theatres. We now have the advantage of all services (except dermatology
which is still at the time of writing at St Mary’s) on one site, though
there is sadness inevitably at the closure of Haslar and St Mary’s. We
also are experiencing the difficulties associated with the high number of
long term patients in QA (over 80%, which is very high for the UK) and
the degree of illness in patients presenting to the A and E department
(again very high in comparison with other hospitals in the UK and meaning
many need to be admitted), resulting in a reduction in the number of beds
available for routine activity and impacting adversely on surgical activity
and funding. Together with the crippling debt owed to Carillion this is
seriously undermining the prospects of obtaining foundation status.
Other hospitals.
Anaesthetic services have also been
provided by the department at several other hospitals over
the years.
Gosport War Memorial Hospital
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Coldeast Hospital, Sarisbury
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- The Gosport War Memorial Hospital where GP
anaesthetists seconded to the department have worked along
with other members of the department until the mid 1990's.
- Coldeast Hospital where there has been a handicapped
dental clinic and ECT sessions.
St James Hospital
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Portsmouth & S. Counties Eye & Ear Hospital
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- St James Hospital where
there have been ECT sessions.
- The Portsmouth and Southern
Counties Eye and Ear Hospital in Grove Road North (in an
old convent), which closed in 1971.
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Part 1 THE EARLY YEARS 1948 TO 1970.
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ANAESTHETIC DEPARTMENT.
The earliest information I have about the
department is a letter from
Dr Philip Bromage
See document
S03
where he describes a busy practice in late 1940’s and
early 1950’s when he lived in Southbourne and he and
Dr Brian Sandiford
had a hectic practice extending from Worthing to Midhurst and Portsmouth
and the Isle of Wight doing a lot of mileage with a portable Boyle’s
machine and cylinders in the boot of their car for nursing home and
domiciliary surgery.
Philip Bromage
(see also photo) was one of the the fathers of epidural anaesthesia which
he learned from
Massey Dawkins
in London. I believe he performed the first obstetric epidural in the UK
in Chichester. In the mid 1950’s he left to become professor and chairman
at McGill University Montreal. In December 1976 I sat my US exam
with
Dr Bromage
in Burlington, Vermont and despite having to relearn all his basic sciences
at 56 he passed. He subsequently worked in Denver, Delaware and Saudi Arabia
and was living in northern Vermont.
The aforementioned
Dr Brian Sandiford
was a consultant anaesthetist at Portsmouth. See
photo S05
which may be of him. He, with Jim Hamer-Hodges, looked after the iron lungs
at St Mary’s during the polio epidemic, which were on the site of the
subsequent renal unit. He retired in 1965 and I believe died in 1974.
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From David Steward received 06jul2014
Hello Robert,
I just wanted to tell you how much I
enjoyed reading your history of the anaesthetic dept in
Portsmouth. I was struck by how many of the very
significant players in the specialty had connections the
department. I served as a house surgeon at the Royal
Portmouth Hospital in 1959 with Mr Tom Fenwick and Mr Paul
Murray. Brian Sandiford always looked after Tom
Fenwick's lists. Brian had a limp and was very much into
tinkering with anaesthesia ventilators, which were then
in their infancy (and perhaps developing prototypes -
possibly there was even a "Sandiford ventilator"?? ) .
He never got into trouble but on occasion things seemed
to come apart a bit. I remember that once he had quite a
bad fall in the theatre and there was concern as to
whether he was hurt. Unfortunately I cannot remember
the name of Mr Murray's regular anaesthetist but do not
recognise it on your list - the only thing I remember
about him was that he had a Rolls Royce! When later I
went to North America and took up anaesthesia I became
quite friendly with Phil Bromage and visited two of his
departments as visiting Prof. He talked enthusiastically
of his days in Portsmouth with an anaesthetic machine in
his car boot. (On one junket giving lectures on a cruise
he and I won first prize in a fancy dress competition).
Really enjoyed your history of the dept - thank you
for doing this,
David Steward.
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From Colin Olford received 28dec2014
I had occasion to be Googling the "Royal" earlier this week & happened
upon your history of the Anaesthetic Department & I thought you may, or
on the other hand may not (!) be interested in my contacts with Dr Sandiford
in my youth, & also some gossip & idle chat about the "Royal" in '64/'65.
I'm pretty sure we have never met but I'm Portsmouth born & bred, & after
PGS went to the "Middlesex" qualifying in 1964 & after a five year
flirtation with the RN returned & was a GP in Pompey until I retired in
2003. At times early in my career I worked in all three of the local
hospitals & look back on my times serving in them with not only affection
but also gratitude.
In 1964 my first pre-reg job was at the Royal as HS to Tom Fenwick & Paul
Murray followed by a brief locum for Tom & Mr Wiggins-Davies at the old QA.
I then was a House Physician at Haslar prior to registration but worked
for dear Mike Kettle at SMMH as a HS after my time in the RN in order to
take my D Obst.
I first met Dr Sandiford when I was 16. David Steward refers to his "limp".
In fact he had a left hemiplegia with spasticity of both upper & lower
limbs & I think was in trouble with his back quite a lot. He certainly at
times found his disability frustrating. I gather from Janet that he was
treated with "Gold for arthritis" during or just after WW2 & suffered some
adverse reaction giving rise to his problems. By the way Paul Murray's
regular anaesthetist in 1964 was Dr Merlin. I don't remember his car but
as Brian Sandiford had a Rolls Royce perhaps there is some confusion
or all doctors were far from poor!
I believe Dr Sandiford was a GP initially in Feltham but moving later to
Emsworth which must have been the time he was working with Dr Bromage.
By the time I met him he was a Consultant working in the Portsmouth
Group & lived at 55 Clarence Parade. He had also previously owned a
Nursing Home in Lennox Road South which had been run by his wife's sister
who in common with Mrs Sandiford was an SRN.
My main reason for starting all this was from my own observations to
amplify his great enthusiasm & interest & care for paralysed polio
patients. Prior to the rise of the Renal Unit SMH East Wing was the
"Infectious Diseases Hospital" & there was at least one ward catering for
"Iron Lung" patients in the 50's. Dr Sandiford spent a fair bit of his
time on their welfare & was particularly keen on getting them home to
suitably modified domestic arrangements. He taught me the technique of
"Frog breathing" which could be used short term by compromised patients
if there was a power cut or some other problem with their ventilators, &
as a 16 year old I visited the unit & was introduced to spirometers &
lung function tests & on one occasion we drove out into the sticks
somewhere to see a young chap who he'd got home to a reasonably independent
life away from institutions.
By the time I started at the Royal he was not working with Tom Fenwick
(who would have been the surgeon who Margaret Cox remembers throwing
instruments around) & I must confess I cannot recall who anaesthetised
for Tom's lists except that it was a full time anaesthetist & things
always ran smoothly. As mentioned Dr Merlin always worked with EEPM. The
other two general surgeons were JDY "Judy" Younghusband & Bernard Williams.
The "Fenwick" on-take was on a Tuesday & that was the afternoon that JDY
had his elective list. He was a meticulous dissector & would spend hours
for instance removing much of the GIT from the pharynx distally for Ca
oesophagos before anastamosing disparate distant cut ends whilst I
nervously sat on the day's emergencies (with my registrar at QA) awaiting
access to theatre. He always worked with I think Don Argent who would
quietly read during the procedure. However JDY liked to chatter & on one
such occasion enquired of the patient's age which attracted the reply
"He was 56 when we started"......
I have other yarns about the Royal but largely surrounding some of the
characters who were consultants in other specialties. However I remember
Chris Linton well & June Shanks who was a kind, helpfull & generally
lovely colleague.
I'm still in touch with Tony Higgins who worked in the orthopaedic team &
the old A&E for several years. He subsequently worked in Jersey for many
years & resists any use of computers. I'm due to call him some
time soon & will pick his brains and/or put him in touch if appropriate.
Reading your history of your department stirred many memories particularly
of the Royal which was a community hospital in the true sense of the word.
Many of the patients I dealt with then & in my early days in practice
had never been north of Portsbridge. The hospital community itself was
small & we all knew each other & pulled together. The new QA has all the
bells & whistles but no soul!
Kind regards
Colin Olford
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Dr Brian Sandiford
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From Janet Williams received 29dec2014
Dear Dr. Palmer,
I was very interested to read some of your account of the Royal and the
history of the anaesthesia department; I have a lot more to go. Seeing
many familiar names stirred up old memories. My father frequently would
bring another doctor home for a drink at the end of the day, and "shop"
talk dominated the conversation. My parents entertained at regular
intervals and colleagues and spouses were often part of the group. My
father took me to the Bromage's house many times where I rode their donkey
while father visited. I was also remembering touring the Royal, and
other hospitals where my father worked, on Christmas morning. I remember
the surgeons all dressed up carving turkey in the wards, and beating
hasty retreats to avoid running into the Lord Mayor's party.
My father died December 19, 1974. A postmortem showed he had liver
disease, believed to have been caused by the early anaesthetic gases.
After my mother died in 1994, my sister and I found newspaper tributes
to my father after he died. I have no idea where any of that stuff is,
but I presume I brought home some of it. I will see what I can find that
might be of interest to you. Please let me know if there are any other
details you would like to know.
Good luck with your project -
Janet Williams
Searsport, Maine
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Dr Colin Birt,
was an anaesthetic SHO in the department from 1961-62. He subsequently
became a consultant in Southend, and helped Bob Young in establishing
the obstetric epidural service in Portsmouth (Bob Young served an attachment
in Southend in 1974). Colin remembers how helpful Jim Hamer-Hodges was
when he had problem cases out of hours.
Margaret Cox
was a theatre sister at QA between 1953 and
1961, when she became assistant matron. Miss Delacourt was
matron from 1950 to 1966 and lived in Delacourt House
which is named after her. Margaret remembers the
anaesthetists in 1953, Dr MacDonald, Harry Lee, Brian
Sandiford, Phillip Bromage, Kenneth Ross, Hugh Boyd, Paul
Merlin, Jim Hamer Hodges. At that time the NHS was sharing
QA with the military. Some of the surgeons would throw
instruments and the champion was Thomas Kenwick, a general
surgeon. She also remembers Walter Wiggins Davies, a
urologist, who liked the windows to be open and played
jazz music while he was operating.
Dr “Jim” Hamer-Hodges
was a very important figure in the history of the anaesthetic department
at Portsmouth and is deserving of a chapter to himself.
See
S05
his obituary
in the BMJ and refer to text for document by Colin Birt
an extensively researched document by
Dr Colin Birt,
Consultant Anaesthetist in Southend and who trained under
Dr Hamer-Hodges
in Portsmouth.
Dr Birt
presented this document to the History of Anaesthesia society in 1988.
See
photo S09.
See Colin Birt's resume in documents
S41 to S45.
Also I have a video of Dr Hamer-Hodges
anaesthetising children probably in the mid to late 1950’s and a video of
his technique for GA Caesarean Section. He was a trainee in Portsmouth from
about 1950, and a Consultant from about 1953 until he died aged 42 in 1961
during the South Western Obstetric and Gynaecological Society meeting in
Portsmouth. His landmark paper “general anaesthesia for operative
obstetrics” appeared in the British Journal of Anaesthesia in 1959, and
was revolutionary. In it he describes the head up, thiopentone,
succinylcholine, intubation, oxygen, nitrous oxide technique for Caesarean
Section. In 1961
Sellick
added cricoid pressure, and with minor modifications this technique survives
to today for GA for Caesarean Section. At the time facemask anaesthesia was
the benchmark. He also was interested in neonatal resuscitation. At this
time paediatricians did not come into theatre and it was the responsibility
of the anaesthetist to resuscitate the newborn if necessary. Between 1950
and 1955 he gave virtually all the general anaesthetics for operative
obstetrics in Portsmouth. His son is a retired colorectal surgeon living
in Edinburgh.
Jim Hamer-Hodges
trained at St Mary’s Hospital, Paddington and fell foul of the dean
Charles Wilson
(Lord Moran, Churchill’s physician) for taking players in his beloved
rugby side out on runs with the medical school hare and hounds club.
Hamer-Hodges
encouraged his juniors to participate in his obstetric anaesthesia research
and he ignited their interest in obstetrical anaesthesia.
Dr Jeffrey Selwyn Crawford
(See
S10 and S11)
was a trainee in Portsmouth in 1957 and worked under
Jim Hamer-Hodges.
This subsequently became his abiding interest and he developed the
anaesthetic services at Queen Elizabeth Hospital in Birmingham and was
internationally renowned in the field of obstetric anaesthesia. He
repopularized spinal anaesthesia after its long period in the doldrums
in the UK following the Wooley and Roe case.
He died aged 66 two weeks after his retirement.
Both he and
Jim Hamer-Hodges
were heavy smokers.
Dr Michael Tunstall
(See S12) was a registrar in Portsmouth in the late 1950’s and he
returned later for the first part of his senior registrar rotation with
Oxford. Again he was inspired by
Jim Hamer-Hodges
and while at Portsmouth he showed that oxygen and nitrous oxide could
be mixed in one cylinder (entonox) which previously had involved using
4 cylinders (liquid and gaseous oxygen and nitrous oxide) and persuaded
the British Oxygen Company to produce the new cylinder which despite
initial reservations they were able to do.
Dr Tunstall
was the first to use entonox clinically at The Royal. He also produced a
video of awareness during general anaesthesia for Caesarean Section which
I have a copy of. He became Consultant Anaesthetist in Aberdeen and died
in 2011.
As we enter the 1960’s the Anaesthetists at Portsmouth were as follows.
Dr Hugh Boyd,
who had been a GP and was a Senior Hospital Medical Officer (SHMO) and
probably subsequently a consultant was an afficianado of succinylcholine
infusions as were many anaesthetists of his time. I believe he was
chairman of the department for a while and that he retired in about 1974.
The aforementioned
Dr Jim Hamer-Hodges and
Dr Brian Sandiford.
Dr Kenneth (Daddy) Ross
who had also been a GP and was a SHMO, and also probably subsequently a
consultant. He was popular with the nursing staff. He was for some time
the head anaesthetist and was succeeded by
Don Argent.
He suffered ill health towards the end of his career and retired in 1971.
Dr Paul Merlin
who had been an SHO in the department and also a GP and who was a SHMO.
Dr Mike Glossop
was an anaesthetist in the department and described a
cuffed tracheostomy tube (the "Glossop tube") which was the subject of a publication in The Lancet in 1966.
Dr Peter McDonnagh
who lived at 37 Bowes Hill in Rowlands Castle and who’s wife
Jill McDonnagh
was the doctor in charge of the Casualty Department at The Royal.
subsequently moving to QA in 1979.
His son
was at medical school (St Thomas’s) with
Kathy Torlot.
Sadly
Dr McDonnagh
died in 1966 at a relatively young age.
Dr Don Argent,
who succeeded Kenneth Ross
as chairman of the department and subsequently in 1970 became Medical
Executive Committee chairman with his own secretary. He was also Regional
Director of Postgraduate Studies for Wessex. He had qualified from
Middlesex Hospital in 1947. He retired in 1975 at 65 and died in 1981.
(See S14).
There was a practice at the time (early 1960’s) which is vividly recalled by
Jane Spendlove,
formerly head theatre nurse in the happy and functional St Mary’s theatres,
and who started at St Mary’s in 1962 when she was 18. It entailed
anaesthetising private patients in the private wing at St Mary’s in their
beds with thiopentone and succinylcholine and intubating them with red
rubber tubes with metal connectors, then rushing them to the nearby theatre
ventilating them on room air with an Ambu bag. These were the days before
recovery rooms and patients would be taken back to the ward sometimes with
a Guedel airway in place and hopefully a chin lift or jaw thrust if
necessary. If there was a cardiac arrest on the wards at St Mary’s an
anaesthetist was found and along with a Boyle’s machine, laryngoscope, and
again a red rubber endotracheal tube and metal connector rushed to the
patient in need.
422.
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Dr Chris Linton
was appointed Consultant Anaesthetist in 1962
(see S15 and photo
P00). He had
been a senior registrar in Norwich. Despite it taking 10 attempts to pass
his primary fellowship he emphasises that he passed his finals at the first
attempt. In 1968 he took a one year sabbatical working with
Dr Christian Barnard
in Cape Town. He worked with the orthopaedic surgeon
Robin Denham
(in fact they continued to work together until 1991 at BUPA hospital,
Portsmouth where he was also RMO in his late 60’s). Together they founded
the British Medical Pilots Association and
Dr Linton
continued flying until 87 years of age. On one occasion he and
Mr Denham
landed a plane on the Eastern Road missing the nearby airfield which is
now a housing estate.
Dr Linton
is proud of the fact that apart from a hernia repair he never had a day’s
sickness in 24 years. He retired from the NHS at 65 in 1986, and continued
working in the private sector (see above) until he was 70. At the time
of writing he is alive and well at 90 living on Hayling Island.
Dr Richard Nainby-Luxmore
(soapy) (see photos) was appointed Consultant Anaesthetist in the early to
mid 1960’s. He had been in the military. He liked paediatric anaesthesia
and was chairman of the department from 1973.
when he took over from Alex Larson to 1975 when
Richard Lethbridge took over. There was a suggestion from
orthopaedic surgeon Robin Denham that surgeons should
appoint their own Consultant Anaesthetists to do all their
lists and those of their registrars, take leave at the
same time as the surgeon and be rewarded with that
surgeons private practice. Dick Luxmore told Robin Denham
where he could put his suggestion in no uncertain terms.
He retired in 1991, and died some 15 years later.
Dr Bob Stewart
was another ex military anaesthetist who worked as a locum consultant in
the department for 3 years in the early to mid 1970’s. He was an engaging
personality and good company but sadly died at a relatively young age.
Dr David Dickson
was an associate specialist anaesthetist in the department and joined in
the late 1960’s. He was at St Andrews Medical School with
Don McDougall. He was a keen cyclist, but sadly suffered two serious
cycling accidents, the second leading to his early retirement.
Dr Richard Lethbridge
was the cousin of
Nainby-Luxmore
and was appointed Consultant Anaesthetist about 1968. He was meticulous and
would have pleased today’s management as he was scrupulous about hand
washing.
He was chairman of the department in 1975.
He left for family reasons in the late 1970’s or early 1980’s to
work in Bathurst, New Brunswick, Canada.
Dr Robert Buchanan
was on the Oxford, Portsmouth Senior Registrar rotation. In the late 1960’s
he became SHMO in anaesthetics in Portsmouth awaiting a Consultant job to
be advertised. He was a hard working, popular and innovative anaesthetist
who had constructed a digital pulse monitor. Sadly he died suddenly in 1969
at age 37 (S16 and photo
P34).
Received from Rowena Ahyee-Hallsworth 09jul2014
Dear sir,
I am making contact to thank you for your beautiful
history of the Portsmouth Hospitals. In the early 1970s I
worked as a senior registrar in anaesthesia at the
Portsmouth group hospitals, one of the 2 youngest to be
appointed. I came in from overseas with my British husband
to set up home and family. After a few years we then moved
overseas again, and again!
I am researching for a presentation that I have to give
which includes my very active life. Indeed one great part
of it was working with Alex Larson in that so busy
department, (and catering and organising for our Christmas
party the first year ) stands in my memory. I do so
remember working that blood gas machine wow; long time
ago.
I am now retired from Anaesthesia and Surgical Intensive
Care and am winding down my office patients in pain
management. They take a long time.
Rowena Ahyee-Hallsworth. FRCA
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Received from Janet Hurst 22aug2014
I received a letter on 22/8/2014 from Janet Hurst who
worked as a staff nurse at The Royal from 1970 to 1975, 3
of the 5 years on night duty, and she gives some
fascinating
insights into her experiences. She says operations were
carried out as soon as possible if they were emergencies.
Wednesday nights were The Royals night for emergencies.
During her time there the volume of work necessitated
appointing full time night staff. She talks of the
individual anaesthetists.
Don Argent was a tall no nonsense man and strong as an ox.
Dr Boyd does not receive the most favourable comments and
would deal with more than one patient at the same time.
David Dixon she liked very much.
Barbara Green likewise was very popular.
Maggie Evans was very professional and no chit chat.
Alex Larson was also no nonsense, but liked by the staff.
He was kept particularly busy with his 4 bedded "intensive
care" unit upstairs where sister Johnson was in charge.
She was very efficient and organised the pantomime and
coach outings.
Dr Lethbridge was quiet and conscientious
Rachel Blackburn was the senior anaesthetic nurse.
Chris Linton had a sense of humour and was popular.He had
a Mach 1 car and gave the nurses rides in it.
Dr Merlin had a glass eye, and she does not remember him
well.
Dr Luxmore could be frightening but was a good
anaesthetist and well liked. Disturb him in the anaesthetic
room during induction at your peril. On occcassion the
anaesthetic nurse
didn't get there in time and was locked out.She remembers
a little ditty:
"When Soapy Luxmore gives his gas a nurse is by his side,
They tiptoe in and close the door,then lock it from inside,
And we are left a wondering just what they have to hide,
While we are working in theatre."
He was excellent with children.
Kenneth Ross was also popular, though sadly he had
Parkinsons.
June Shanks worked mainly with Betty Shelswell, Consultant
Orthopaedic Surgeon. Dr Shanks wore a white belted coat
overall.
Graham Hollister was a trainee who got a Consultant job in
Canterbury.
Dr Mustafa was larger than life and totally unflappable,
and she recounts how he saved a member of staff.
Isobel Mconnichie was a dear Scots lady.
She also talks of other trainees, Freda Stockings, a
force to be reckoned with, Malcolm Wade and the sad John
Stevens who died tragically when I was an SR in
Southampton in 1975.
Her PS was that the young female staff liked Bob Young.
I have her original letter which runs to 10 pages.
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Received from Charles Gillbe 27mar2016
My time in Portsmouth by John Gillbe
I am intrigued by your history of the anaesthetic department in Portsmouth
in which I was an SHO from February 5th 1975 until April 1976.
I came to anaesthesia by a circuitous route. I had been interested in
central neurotransmission as a medical student and the natural way of
pursuing this interest professionally was to continue my association
with Dr Tim Crow, my supervisor, who became head of the Clinical Research
Centre in Psychiatry at Northwick Park Hospital. On completing my house
jobs in 1973, I realized that I lacked the maturity to go immediately
into Psychiatry, looked for a holding position and became a medical SHO
in Leicester, at the now closed Groby Road Hospital. On completed that
year I developed a wanderlust and spent a few months at Royal Brisbane
Hospital, where amongst other things, I found that my resuscitation
skills were poor, and whenever things got really difficult, the arrival
of the ‘gasman’ always calmed the troubled waters. I decided that six
months of anaesthesia would enhance my usefulness. Six months eventually
became forty years.
My appointment itself was by a process that could not happen now. For
social reasons I wished to live near Portsmouth and applied for jobs at
Chichester and Portsmouth. As luck would have it, the Chichester interview
was the earlier by one day. I was interviewed and asked to wait, summoned
back in and offered the job. I explained my dilemma. An immediate
‘phone call established that I was likely to get the job in Portsmouth
the next day, someone else was appointed at Chichester and I was duly
appointed at Portsmouth.
The training of SHO’s was, to put it mildly, ahead of its time. To put
that into context, John Moon had just been appointed, Ian Sutherland,
Barbara Green and Maggie Evans were young consultants and the Department
was essentially run by Phyllis, who was quite capable of re-allocating
trainees to lists when necessary for service reasons. SHO’s started with
twelve weeks in an essentially supernumerary capacity (reduced by a couple
of weeks if learning was fast), and allocated largely to the younger
members of the Department during the day. At night, we were expected to
do on call work, but this could be with the registrar of our choice.
I attached myself to Ken Cooper, a New Zealander who was shortly to return
thereto, who was a good teacher and in addition held the enlightened view
that not much was learned after midnight, so I was sent to bed around
then. There were three hospitals in which the trainees were involved,
The Royal, St Mary’s and Queen Alexandra, but initial experience was
largely at St Mary’s. Exposure to obstetrics was reserved for the
six-month mark of training, but paediatrics in those days was not accorded
special status and lists were frequently mixed, starting with the
children. After twelve weeks the novices joined the on-call roster.
The on-call system in 1975/76 was distinctly unusual. The first on call,
an SHO or registrar, covered emergencies in all three hospitals. The
obstetric on call, a more experienced SHO or a registrar, was resident at
St Mary’s and looked after the obstetric unit and cardiac arrests at
St Mary’s. Since there was no critical care unit, this was significantly
titular except in the case of the renal unit, situated at the extreme
eastern end of the hospital and in those relatively early days of dialysis
required a sprint of a few hundred yards to attend patients with
hypocalcaemia, a state that the excellent nurses had invariably corrected
before we arrived. After a couple of weeks of obstetrics one learned to
ask for Dr Young’s epidural sets since they were the only ones that gave
a reliable loss of resistance. He had set up the obstetric epidural service
in the previous year or so and there was still resistance from some of the
older obstetric staff who maintained that good analgesia may obscure
significant symptoms, really as a cover for the view that childbirth
should be painful as a punishment for earlier pleasures. When the first
on call required advice or a higher level of skill he phoned the
consultant on call. On the other hand, if he simply had a stack of cases
in different hospitals that looked as if its over-running would impede the
next day’s work, he called the reserve on call, who was one of the three
non-consultant career grades (David Dixon, June Shanks and a further lady
whose name I have forgotten) or one of the three senior registrars. It
was not considered ‘good form’ to involve the reserve of the consultant
too often.
A little about people
Bob Stewart, whom I believe died of lung cancer in the late seventies or
early eighties, left most patients breathing spontaneously: he extended
the bag section of a Magill circuit so that the bag was in the anaesthetic
room and he could sit there smoking and monitoring the patient at the
same time. His patients did well. I think the reason he was a long term
locum was that having spent much of his life overseas (Canada?) he lacked
the FFARCS.
Ian Sutherland, not only used 2.5% thiopentone, but used it initially in
a ten ml syringe. He was a keen sailor and had a significant fund of
risqué jokes.
Dr Boyd, a consultant by virtue of the fact he was a GP anaesthetist prior
to the inception of the NHS in 1948 was such an enthusiast for
suxamethonium infusions that on at least one occasion when I was there he
failed to stop it on return to the ward. An instruction in neuromuscular
blockade that we could have done without. I think he retired in 1976.
Dr Lethbridge emigrated in 1976, I think and this was largely due to
despair at the state of the UK at the time.
Alex Larson ran the intensive care unit, situated at the Royal, into which
trainees were not permitted. He advised me that the only two journals that
I should bother reading were the Lancet and the NEJM since anything of
serious importance was published in one or other of them. He was probably
correct. More contentiously he advised me to leave seriously ill acute
abdomens breathing spontaneously on ether so that I would have no trouble
reversing them. His advice in this regard was unique and consequently
ignored. He was a particularly unflappable anaesthetist. I recall on
one occasion in the pain clinic when seeking the coeliac plexus, he
administered local anaesthesia either intravascularly or intrathecally,
I forget which. Un-flapped, he resuscitated, arranged for a short term bed
and sent the patient home later that day. He anaesthetized Bradmore’s
thoracic list in the days when rigid bronchoscopies were usually done
under local anaesthesia and post-thoracotomy analgesia amounted to a
very few increments of 5mg of pethidine on the basis that more would
depress ventilation to an unsafe degree.
There were three senior registrars, of whom I recall Peter Spreadbury,
Kit Eatock, who became a consultant at Banbury and subsequently in
South-West Scotland and Rowena Hallsworth, a Trinidadian. Rowena’s
husband was Welsh, and spoke with a welsh accent which happens to be
similar to that of Trinidad; she was relatively accent free and was
teased when she went home about marrying a true Trinidadian. Of the
registrars, I remember Talud Khan, Jan Kwiatek, a Pole who subsequently
worked in Germany and Mervyn Ross, whom Rowena Hallsworth memorably
described as talking like a telegram. Amongst the other SHO’s were B Padi,
a Ghanaian, and Colin Goodchild, who was the next to be appointed after
me. He went on to be an academic anaesthetist in Leeds and then Monash,
Australia before branching out into commercial pharmaceuticals. Adrian
Ruddle was also an SHO with us for a while.
Equipment
By the standards of the time, the equipment was usual. There were no
capnographs or pulse oximeters in those days. Monitoring was entirely
clinical apart from intermittent manual blood pressure measurements with
an oscillotonometer, the face of which proudly boasted of its invention
by Dr H von Recklinghausen (1867–1942). There was one ‘bouncing ball’
ECG oscilloscope monitor for each group of theatres. One arterial line
was inserted in the sixteen months during which I worked in Portsmouth,
by Bob Young, who was anaesthetising a phaeochromocytoma. It was a
performance that required a week’s preparation. Ventilation in theatres
and in the ICU was carried out by an East Radcliffe ventilator which,
unnervingly, performed perfectly whether or not it was connected to a
fresh gas source. The anaesthetic machines were old but serviceable.
Those in the Royal were equipped with a vapouriser in circuit circle
system, but the machines themselves all had halothane Mark II vapourisers
and a Boyle’s bottle which was used variously for ether, trichloroethylene,
or for those of an adventurous temperament, chloroform, a bottle of which
had been left in the anaesthetic room at the Royal by Dr Argent, who had
retired a year or two earlier.
Clinical Practice
As I recall, intubation was commonplace. The drill for failed intubation
in obstetric surgical delivery was to use deep ether on a mask. Halothane
was regarded by some as too expensive for routine use, so ether and
trichloroethylene were preferred. Gallamine, an otherwise poor
neuromuscular blocker was used by some to relax patients whilst breathing
spontaneously, for instance for anal dilatations, a technique known as
’a touch of flax’ (Flaxedil was the trade name for gallamine.)
Althesin was a new drug, albeit a fairly short lived one. There was no bar
on trainees, even at SHO level working in remote sites even in paediatrics.
During the summer months, in order to maintain the clinical throughput,
all trainees who had done their three months’ apprenticeship would do
solo lists. There was no doubling up. A night on call was followed by a
‘library period’ the next morning since there was doubt about the
contractual legality of permitting time off after a night on call.
Weekend call started on Friday morning and finished on Monday morning when
the week’s work would begin. There were still patients, about half a
dozen, I think, who had become paralysed during the polio epidemic that
was terminated by the vaccines in the fifties, and who had a semblance of
life in iron lungs.
The strike
During the strike of the winter of 1975-76, the consultant staff were
supportive. We agreed to maintain emergency services by working a
forty-hour week, so there was no elective anaesthetic work carried out
by trainees. This had no effect on our rate of pay since none of us
worked a sufficient number of hours, I think eighty-four, to claim
overtime in the normal course of events. Waiting lists were so long
then that I doubt if there was much material difference to them either.
As for me, I learnt my trade in my sixteen months in Portsmouth. I moved
to the Westminster, where I was clearly more experienced than all but a
few of the other trainees, and the successively to the Brompton, The Royal
Free, Queen Square and back to the Brompton where I was a consultant
for three decades. I do not think I could have had a better grounding
in the art of anaesthesia than I had at Portsmouth
|
Dr Alex Larson
On September 24th 1964 an interview was held for a new Consultant
Anaesthetist on the forthcoming retirement of
Brian Sandiford. In 1984 Larson submitted his CV.
See Dr Larson's CV in S23 to S29,
also see
photo P01, documents
D1 to D7 and
S18 and S19.
430. Seating plan for Interview
 |
431. Alex Larson letter of appoinment
 |
There were 1439 beds in the three main
hospitals (689 at St Mary’s, 511 at QA and 239 at the Royal). The permanent
anaesthetists comprised 6 Consultants (probably
Brian Sandiford,
Don Argent,
Kenneth Ross,
Hugh Boyd,
Chris Linton and
Peter McDonnagh,
and 2 SHMO’s (probably
June Shanks and
Dr Merlin).
There were 2 SHO’s, 3 registrars and 1 senior registrar. The consultants
each did 9.3 sessions a week and the SHMO’s 7.5.The population served was
440,000. The successful candidate was Alex Larson.
432. Alex Larson with Princess Alexandra 1979 on opening of QA.
 |
He was probably the most important and influential person in the history
of the anaesthetic department. He was aged 37. He was born
in Canada and came to England in 1934 aged 7. He qualified from Durham and
during his anaesthetic training spent a year as a research fellow in
Philadelphia. He was very innovative, set high standards, did not suffer
fools gladly, and worked enormously hard by todays standards. He
established the pain clinic in Portsmouth in 1967, which after Liverpool
may have been the second pain clinic in the country. He developed a variety
of nerve blocks including intrathecal neurolysis, percutaneous cordotomy,
hypnosis, acupuncture and an epidural morphine service for intractable
pain in cancer. The pain clinic began at St Mary’s with just two half day
sessions a week, but increased to one every day, and remains a thriving
concern to this day.
433. Wessex Regional Hospital Board
 |
In 1965 there was an urgent need for intensive care beds in Portsmouth. At
that time the only facility was a 4 bed resuscitation unit for trauma at
The Royal. This unit lacked medical cover and there was no sense of
direction. Initially Alex spent most of his spare time in the unit, and as
a result was eventually nominated consultant in charge. For the first five
years he provided sole emergency and routine cover. Junior staff was
refused, and only after a written parliamentary question were 2 anaesthetic
registrars appointed. In 1970 planning and commissioning of a new 12 bed ITU
at QA was undertaken with Alex in charge.
It was initially at The Royal and moved to QA in1979, with a smaller unit
on B6 at St Mary’s. Despite working in a high tech
environment he emphasised the virtues of basic clinical history and
examination. He ran the handicapped dental clinic until 1978 when he passed
it on to
Donald MacDougall.
He gave anaesthetics for chest surgery at St Mary’s using double lumen tubes
and helium, and also for mitral valvotomy.
He was a keen and effective teacher, lectured regularly, established a
course for nurses in anaesthesia which became accepted as a national
standard, ran a course for Portsmouth ODA’s from 1967, was involved from
1972 with the Wessex course which became a national standard, and was
associate dean of medicine in Portsmouth for many years. He taught the
medical students from Southampton as postgraduate dean, for which he was
given a part time secretary housed in a portacabin and funded by the
University of Southampton. He was chairman of the anaesthetic department
from 1967 to 1970 and 1971 to 1973. It beggars belief that one man could
have done so much. His greatest epitaph is the benefits he conferred on
the people of Portsmouth and South East Hampshire that have endured to
this day. He retired aged 60 in 1988, not in the best of health from all
the years of hard work. In his retirement he enjoyed art and wood carving
and gained a grade A in art and design at age 65. He died in 2009 at age 81.
Professor Gary Smith
represented the hospital at his funeral.
439.
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440.
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Part 2 PHYLLIS’S TIME 1970 TO 1990.
|
Phylis Seymour
(see S20 and photos
P05 and P35)
was appointed secretary (probably the first) to the
anaesthetic department in March 1970. At this time the Consultants and
SHMO’s were
Dr’s Boyd,
Merlin,
Ross,
Argent,
Larson,
Lethbridge,
Linton, and
Nainby-Luxmore).
There were 4 SHO’s, 5 registrars, one attached to the ICU, and 2 senior
registrars. She shared the only office with the senior registrars in the
old part of St Mary’s, opposite the twin theatres which were used for
gynaecological procedures being near the gynae wards. The Honeywell theatres
were at the end of the main corridor, later to be demolished and housed in
a new building upstairs (now all sadly demolished in 2012). The office had
a small window and a skylight. The ambulances used to back up with the
patients being delivered to the nearby wards and theatre. The fumes from
these vehicles would drift in as they usually left the engines running.
Apparently when the doctors came into the office during the evening to
collect their mail and theatre lists putting the light on aroused the
cockroaches which fortunately didn’t come out during the day. Phyllis
recalls however one jumping up from under the cover of the typewriter
one morning and rushing around the desk. An old computer was put in a
room opposite the office (organised by
Derek Pounder)
but unfortunately it was stolen.
Chris Linton
was in the habit of coming in to the office and singing to Phyllis which
I suspect she quite enjoyed.
The Consultants took it in turn to be chairperson of the department. There
was not the luxury of a photocopier and if needed one had to go to a
separate building. Phyllis was encouraged to use the duplicator which was
housed in the gynae building nearby. The department provided anaesthetic
cover for The Royal, St Mary’s, QA, Gosport War Memorial (often the GP
anaesthetists), St James for ECT’s (about to move to Havant in 2013),
Dentals at Coldeast (subsequently ECT at The Meadows at Coldeast also to
move to Havant), and anaesthetic assessment clinics. When the move to QA
took place in 1979, with the advantages of extra space, weekly tutorial
meetings were held on Tuesday evenings and once a month in the mornings.
There was an exchange arrangement with Southampton for 2 senior registrars
for 2 years. With the growth of the anaesthetic department Phyllis was
allocated part time help after assessment.
Eileen Shorthouse
was an early part time assistant and later
Beverley Hancock
of whom Phyllis has fond memories.
In 1970 there were two new consultant anaesthetic appointments.
Dr Barbara Green
(see photo) was a popular personality. She did sessions in the intensive
care unit and was chairperson of the department from 1981 to 1984
approximately. She shared a consultant post with
Dr Sutherland
towards the end of her career and together they were known as
Dr Greenland,
which could on occasion result in confusion. She retired in 1996 and sadly
not long after was taken ill in Spain.
Dr Bruce Taylor
acting beyond the call of duty accompanied her back for treatment in this
country.
Dr Maggie Evans
(see photo) was a personality and was an effective chairperson of the
department between approximately 1984 and 1987, and ran the anaesthetic
assessment clinic for a number of years. She had a pony and trap and a
steeplechase horse at Fontwell Park together latterly with a large
acreage at May’s Coppice Farm, and thankfully declined forcibly a very
substantial offer for it from a developer. Prior to this she lived at
Woodbine Cottage in Havant and part of her property was successively
lived in by
Jane Watt-Smith,
Anne Thornberry and
Julie Bourne.
She retired relatively early age 57 in 1993, and sadly died around 2009.
In 1971
Dr Bob Young
(see photo) was appointed consultant. He was carefully questioned about
the state of his health at interview, both physical and mental, as there
had been problems of this nature in the department. There was also
interest expressed in his ability to stand up to surgeons. He passed with
flying colours on both counts. He was often asked to do the difficult
cases. Also he was in charge of maternity anaesthesia for some 10 years.
In 1974 he served an attachment at Southend under
J Alfred Lee and
Colin Birt
where he was involved with obstetric epidurals. When he came
back to Portsmouth he initiated the obstetric epidural service. He also
began spinals for Caesarean Section and taught
Anne Thornberry
who later headed the obstetric anaesthesia service in Portsmouth. He was
chairman of the department from 1978 to 1981, and was medical director
from 1992 until his retirement aged 61 in 1997.
Dr Ian Sutherland
(see photo) was also appointed Consultant in 1971. He was 39 when appointed.
He looked after the HDU/respiratory unit on B6 at St Mary’s from 1973 to
1979. In 1974 he stopped the use of 5% thiopentone, changing to 2.5%. He
was also involved with the renal unit at St Mary’s from 1971 to 1981, and
in the planning and development of the intensive care unit at St Mary’s,
which opened in the late 1980’s. He was chairman of the department from
1975 to 1978, taking over from
Dr Lethbridge
and being succeeded by
Dr Young.
Between 1974 and 1979 he was in charge of departmental education. Also
in the mid 1980’s he was the guiding light in the formation of the private
anaesthetic group in Portsmouth which was based on the Plymouth model
where he had been a senior registrar and which has run successfully for
27 years and most importantly has ensured that there is no compromise of
NHS duties by consultant anaesthetists in Portsmouth and no interdepartmental
conflict; a fine testimony and a model for other departments which have
struggled in this respect. He also for many years organised the departmental
Christmas social events in the medical centre at St Mary’s. He retired in
1996 aged 65 after job sharing for his final years with
Barbara Green.
Dr Donald MacDougall
(see S21 and S22#21, and photo
P11)
was appointed at 40 in 1974. He had worked for five
years in Sweden. He was always a perfect gentleman and well liked. As
there was already a Don in the department
(Don Argent)
he was known as Donald. He was chairman of the department from 1987 to 1990.
He took over the handicapped dental clinic from
Alex Larson
in 1978 and was associated with it until his retirement aged 63 in 1998.
Anne Turrall
(see photo) was appointed consultant in 1977, on the retirement of Hugh Boyd.
She retired at 60 in 1998
John Moon
John Moon (see photo P02 and
section in text)
was appointed consultant in 1975 aged
33, to replace Don Argent. There was some discussion by
the appointments committee whether he was too young, but
fortunately good sense prevailed and he was duly
appointed. He had been my senior registrar when I was a
registrar in Poole in the early 1970's. He was innovative
and had an encyclopaedic memory. He was for many years
from 1978 in charge of anaesthetic equipment, and was the
first formal departmental tutor from 1981 to 1984 when
David Desgrand took over. He was chairman of the
department from 1990 to 1992. When Portsmouth became a
trust hospital in 1992 he became the first clinical
director, a position he held until 1997 when again Dr
Desgrand took over. This became an increasingly onerous
position and a separate chairman of the department was
created to help share the load. He retired on December
31st 2000 at 58. In recognition of his substantial
contributions to the running of the department for so many
years the department at St Mary's was named after him. It
has now been demolished but the plaque bearing John's name
is displayed for posterity in the Anaesthetic museum at
QA. (see photo P43).
John Moon writes on 4 Nov 2012:
Throughout my time being involved with Anaesthetic equipment, and
presumably since, the dept. received tremendous support from the Medical
Engineering/Electronics dept.
Initially under John Saunders, and on his retirement Stuart Scott, even before
PC days. they had a very comprehensive inventory of equipment which was
of great help in keeping an eye on what was where and what was needing
replacement. Besides that they were very skilled in carrying out repairs to
equipment so that it was returned to safe use long before it would have been
if we had had to depend on outside repair engineers.
Yours
John [Moon]
|
454. Peter SPREADBURY
|
Peter was appointed consultant in 1976. He had been a fellow senior
registrar with me at Southampton where he rotated with Portsmouth (and I
Winchester). He had sessions in the intensive care unit. He was chairman
of the department in 1996. He retired at 59 ¾ in 2002.
|
Dr Joe Shannon
(see photo) was also appointed consultant in 1976
on the resignation of Richard Lethbridge.
He was almost exactly the same
age as both
Peter Spreadbury and
John Moon. He was chairman of the department in 1992 and retired at 60
in 2002.
David Desgrand
was appointed consultant in 1982. He is conscientious, hard working and
always willing to help colleagues, see photo
P13. On appointment the hospital was under
the South East Hampshire Health Authority and
Dick Bishop
was the hospital manager, an approachable and savvy administrator. The
cogwheel system was in effect with a main medical advisory committee and
with departmental chairpersons as representatives. There were three senior
registrars in the department, two rotating with Southampton and one with
Oxford. Junior on call comprised intensive care on call, maternity on call
at St Mary’s, and a first and second on call at QA as well as the consultant
on call.
David Desgrand
was departmental tutor from 1984 to 1989 and clinical director from 1995
to 1999, succeeding
John Moon
in both roles.
Dr Derek Pounder
(see photo) was appointed Consultant in 1983. He set up the day surgery
unit at St Mary’s and at QA with
Chris West
administrator and
David Barnard
maxillo facial surgeon. He worked increasingly in the chronic pain clinic
and developed a national and international reputation for percutaneous
cervical cordotomy, principally for patients with pleural mesothelioma.
In this he worked with
Ed Neville,
Consultant Chest Physician. He was also involved in the running of the
private anaesthetic group for which his wife
Liz Pounder
was the principal secretary as she remains to this day. He retired in
2012 at 63.
Professor Gary Smith
(see photo) was appointed Consultant in 1987 on the retirement of
Chris Linton
in 1986. On the retirement of
Alex Larson
in 1988 he took over as head of the intensive care unit. Initially he had
seven anaesthetic lists and two sessions in intensive care per week.
Drs Green and
Spreadbury
also had two intensive care sessions a week. Gary’s working practice was
clearly far too heavy and he tells me the most onerous part was his weekend
responsibilities in the unit which of course were in addition to his week
time work. Under his leadership the unit became more high tech and
importantly there were dedicated intensive care nurses who were not shared
with the coronary care unit as previously. There was one nurse per patient.
Arterial lines and central lines were used more frequently and the
ventilators improved. At this time there were also ventilated patients on
the renal unit at St Mary’s and ward B3 at St Mary’s. A dedicated ambulance
for transferring patients between the QA and St Mary’s units was set up with
two transfers per week on average. There were times when the transfers were
somewhat hairy owing to the speed of the police escorts. There were six
intensive care beds at QA. St Mary’s started with a small two bedded ICU
unit in a side room on a ward where patients could be ventilated. Several
anaesthetists took turns to cover this a week at a time. This then
metamorphosed into first a four bedded section on another ward and then
to a new four bedded unit when the new theatres were built which is when
the ITU consultants started covering it.
In 1990
Dr Bruce Taylor
(see below) was appointed as an intensive care consultant with two
anaesthetic sessions a week, and effectively
Gary Smith and
Bruce Taylor
ran the units together.
Dr Peter McQuillan
was the third intensive care consultant starting in 1994, and subsequently
the number of intensive care consultants have expanded exponentially to the
current 14, which illustrates just how hard
Alex Larson,
Peter Spreadbury, and
Barbara Green in the early days and
Gary Smith,
Bruce Taylor and
Peter McQuillan
latterly worked.
In the late 1980’s CPAP was first used at QA intensive care unit, and a new
Hewlett Packard monitoring system introduced. The first haemofiltration in
Portsmouth was performed by
Gary Smith and
Bruce Taylor in the early 1990’s.
Gary Smith
was instrumental in the development of the
ALERT course
(Acute Life
Threatening Events Recognition and Treatment) starting in 1999. This
became internationally recognised. In 1993 he was the co-author of the
textbook Anaesthesia A to Z (now Anaesthesia and Intensive Care), which
became a best seller for trainees and examiners alike. In 2006 along with
Roger Killen and
David Prytherch
he developed the vitalPAC system,
a hand held computer based system for
the early recognition of patient deterioration, now in use in other NHS
hospitals. In 2003 he planned and developed the Portsmouth Hospitals
“Training, Education and Assessment by Medical Stimulation” (TEAMS) Centre,
based in the Quad Centre building and was director there for eight years,
During his career, Gary won several national awards for patient safety;
was named “NHS Innovator of the year” in the NHS Leadership Awards 2010;
the Intensive Care Society Whittaker Award in 2011; and the Humphry Davy
medal by the Royal College of Anaesthetists in 2012. He was involved from
2001 in the simulator suite at QA.
Gary has also been in charge of the Portsmouth Cardiopulmonary Resuscitation
service from 1988 to his retirement in 2011. A truly remarkable list of
achievements.
Dr Anne Thornberry
(see photo) was appointed Consultant in 1988. She represented the department
in my interview in 1992 when she asked me if I was interested in research.
Of course I had to tell a little white lie which has always worried me.
Anne was a senior registrar in Portsmouth from 1985. After appointment as a
consultant she took the lead role in obstetric anaesthesia as “Coordinator
of Obstetric Anaesthetic Services”, and revitalised the service. This is
explained succinctly in her attached synopsis
(see in text section) and provides salutary
reading. She was departmental tutor from 1989 to 1994, deputy regional
adviser for Wessex from 1994 to 1995 and Wessex Regional Adviser from 1995
to 1997. She became a college adviser and examiner in 1993 and is still
heavily involved with the college in 2012. Sadly for the department she
moved to Gloucester for personal reasons in February 1997 (her husband was
and is a Consultant Maxillo Facial Consultant in Cheltenham).
In 1989
Dr Pete Rogers
was appointed Consultant (see photo
P21).
He had been a novice at Southampton when I was
a senior registrar in the mid 1970’s and tells me I taught him gas, oxygen
and halothane bog standard anaesthesia. He was largely involved with the
pain clinic during his 22 years at Portsmouth, mostly at St Mary’s but
latterly at QA. He was chairman of the department in 1996. He retired in
2011 to work in The Princess Margaret Hospital, Akrotiri, Cyprus.
Dr Bruce Taylor
was appointed Consultant intensivist in 1990.
See photo P18 and section in the
text
He did 2 anaesthetic sessions
a week and shared the considerable intensive care load with
Gary Smith,
having a particular commitment in the 4 bedded new ICU at St Mary’s. Some
record of his activities are recorded earlier. On more than one occasion
Bruce saved patients lives by his steadfastness and determination
when everyone else
had given up, the most notable being a girl who had a slow bleed from a
splenic rupture after being kicked in the stomach and by the time she
presented was nearly moribund. Over the next few weeks Bruce bullied
remorselessly all and sundry especially the surgeons and eventually after
several weeks and many operations to everybody’s amazement except Bruce
made a full recovery. He worked for the government on preparations for a
possible bird flu epidemic in the late 2000’s and at the time of writing
is president of the UK intensive care society.
During Phyllis’s era there were a number of sub consultant grade
anaesthetists in the department.
Dr June Shanks
(see photo) was popular among the staff and worked in the department for a
number of years. She probably retired around 1989.
Dr Jayabalam
(see photo) was a very capable anaesthetist who could be entrusted with
all cases and was an associate specialist with the fellowship. He retired
in 2008 at 64 after many years in the department.
Dr Hector Arthur
(see photo) came as a junior from Dorchester in 1979. He was a competent
affable anaesthetist who subsequently became a staff grade. He tells of
his travels with the obstetric flying squad from St Mary’s. He retired a
month short of his 67th birthday in 2007.
Dr Elaine McMurragh
(see photo P08)
was appointed in 1973. She developed with
Dr David Barnard and
Thelma Arthur the handicapped dental clinic at Coldeast in 1985 and worked
in it until 1995. She retired in 1997.
078. Maggie PAGE
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I started as an anaesthetic SHO at Portsmouth in 1968 having done house
jobs and some obstetrics and gynae in London. No formal interview, just
shown around by Dr. Don Argent, head of the department at that time. I
lived in the “mess” where we had excellent breakfasts and dinners in our
own private dining room. I remember Dr.Maggie Evans, Dr. Barbara Green,
Dr.Ian Sutherland and Dr. Bob Young were all fairly newly appointed
consultants and very helpful to me as a new recruit. I also remember some
of the older consultants like Dr. “Daddy” Ross and Dr. Boyd—the former
was already suffering from Parkinson’s disease but miraculously never
missed a vein! My duties were mainly between St. Marys and the old Royal
hospital—there were many trips over to the Royal in the night for
orthopaedic emergencies which I had to cope with, tho’always with a
consultant or registrar on the other end of a phone. I also had to be on
call for the Flying Squad for domiciliary obstetric emergencies—quite
scary to be whisked off in an ambulance with blue lights flashing to give
an anaesthetic in somebody’s bedroom—mainly for conditions such as a
retained placenta or a forceps delivery, but once I clearly remember giving
an anaesthetic for undiagnosed twins with Mike Kettle the consultant
obstetrician at the other end—quite horrendous now in retrospect and would
never be countenanced today. Somehow I survived, as did the patients and
I really enjoyed my year in anaesthetics, taking the DA before I moved on
to do paediatrics and more obstetrics and gynae. Before leaving for an
assistant post in general practice in Basingstoke. I returned to Portsmouth
when my new husband was appointed as a consultant in 1971, and I was
pleased to be able to continue to do 3/4 anaesthetic sessions per week in
QAH and SMH and the Gosport War Memorial hospitals, combining this with
general practice –this of course is no longer possible today.
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Dr Sam Bhonsle
(see photo) was a staff grade. He was a personality and retired at 65 after
over 20 years in the department in 2007.
Dr Rowena Ahyee-Hallsworth
was a Senior Registrar in the department in the early 1970s,
one of the two youngest to be appointed.
Dr Julie Bourne
(see photo) was a junior in the department in the late 1980’s and
subsequently had a permanent sub Consultant grade position in the
department. She worked also in the pain clinic. She is feisty and a
favourite of mine. She moved to Western Australia with her family several
years ago where she is still working.
Dr Kanchu Chada
(see photo) was a staff grade in the department who retired in the late
1990’s at 51.
Dr Farraq
(see photo) who was a staff grade on the Isle of Wight who worked one day
a week at St Mary’s.
Dr’s Riley,
Simon Wernicke,
Philip Gray,
Tart and
Griffiths
were GP anaesthetists who often worked at Gosport War Memorial Hospital.
Dr Damian Timms
was also a GP anaesthetist who had been a junior in the department.
Dr Louis Castilla
was a staff grade who left in the early 1990’s to become a GP in Cosham.
In 1964 there were 6 Consultants, 2 SHMO’s, 2 SHO’s, 3 registrars and
2 senior registrars for a total of 15 anaesthetists in the then 3 main
hospitals. There may have been a small number of additional part time GP
anaesthetists (see above).
By the time Phyllis left in 1990 there were 15 Consultants including
2 intensivists and 8 possibly 9 sub consultant grade anaesthetists, a
total of 24 permanent anaesthetists, plus junior staff.
Now in 2013 there are 61 Consultants including 14 intensivists and 9
sub consultant grades, for a total of 75 permanent anaesthetists, plus
31 junior staff, for a total of 106 anaesthetists. This represents
approximately a 6 fold increase in nearly 50 years (assuming GP
anaesthetists in 1964), a sobering statistic.
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Conceived, written and copyright © 2012, Robert Palmer,
All Rights Reserved.
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Compiled, formatted, hyperlinked, and hand-coded
2012 by John Palmer,
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