| Description | Dr ANDREW HUTCHEON interview at Sir Duncan Rice Library, University of Aberdeen on Wednesday November 16, 2022. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) ANDREW WILLIAM HUTCHEON, born in Aberdeen 79 years ago. Retired at age 65 in 2008, as a Consultant Medical Oncologist in charge of the Anchor Unit. Educated at Ferryhill Primary School in Aberdeen. Secondary education at Robert Gordon’s College in Aberdeen. Left there in 1962. Mother was Deputy Matron at Stobhill Hospital in Glasgow, father was a master grocer. Together they opened a nursing home in Aberdeen, major source of family income. (0:01:40) Recounts reasons for choosing medicine as a career - mother’s influence, plus being impressed by the doctor who treated him for scarlet fever. Also interested in mathematics, liked trying to work out problems. Started studying medicine at Aberdeen University in 1962. Was then a six year course. Recounts what medical students studied then. Third year students, into the wards, really exciting, dressed in suits and ties, with stethoscopes. Still teaches medical students, but they are not as well dressed nowadays as we were. (0:03:30) Explains posts held since graduation. Woodend Hospital in Aberdeen, surgical job at Balfour Hospital in Orkney, then general medical rotation post for three years in Glasgow. Went through various disciplines, great experience. Then appointed lecturer in medicine at Glasgow University. Explains acquiring his MD, looking at red cell survival in malignant disease. Explains to succeed in hospital medicine you need to get various qualifications. MD was one, as a physician need membership of the Royal College of Physicians, passed that in 1971. MD (with Honours) on 7/7/77 (7th July, 1977). Ambition to be a consultant in General Medicine. But became clear specialisation was important. Explains reason for choosing oncology, influence of 1975 appointment of Ken Calman to new chair of medical oncology in Glasgow. Explains medical oncology traverses the whole of medicine. Trained with Ken Calman, also seconded to Royal Marsden Hospital in London. At stage of career of beginning to look for consultant jobs, few and far between, not like now when there are a lot. Three jobs came up, in Aberdeen, Stirling and Vale of Leven. Appointed to Aberdeen post in 1978, explains remit was to develop non-surgical cancer services. (0:07:56) Recalls what it was like to study medicine as a student at Aberdeen University. Taught extremely well. Some lecturers not that great, but some really superb. For example, Peter Brunt in Gastroenterology. Really just the Medical School on its own, and Foresterhill then was tiny compared to how it is now. Talks about relationships between staff and students. Nicely strict. Fortunate to have quite small numbers for clinical teaching. Talks about hours he worked when qualified. Worked hard, recounts typical day. Every second day on for 24 hours. Recounts taking a call during the night, then being woken later by a staff nurse because a second call could not get through as he had fallen asleep with the phone in his hand. Recalls once falling asleep on a patient’s stomach. Recounts how he came to work for two weeks over one Christmas and New Year, no breaks. Consultant was Tommy Morgan who told him he was not to let any students prescribe even a drink of water. Recalls working as a Senior House Officer in Glasgow. Had to do wide range of jobs. (0:13:50) Describes how Oncology developed in Aberdeen in the 1970s. Called Radiotherapy Unit previously, now Clinical Oncology. Two surgeons in those days, Jimmy Philip and Ian Kernohan . Two radiotherapists, Ian Kirby and Tarun Sarkar. Haematology Dept established and developed by Audrey Dawson and Bruce Bennett - both superb. Audrey also treated some of the cancers that would respond to chemotherapy. That was what it was like when I came in 1978. In 1979, there was the Croom Report which recommended cancer centres round Scotland for non-surgical treatment of patients. Describes how when he arrived in Aberdeen, beds were at Ward Three, Woodend Hospital, totally unsuitable for
cancer patients, had to go by ambulance to Foresterhill for scans and radiotherapy. Describes having to mix up chemotherapy drugs in a sink. He and Audrey Dawson, and Brian Jappy, head of the Pharmacy Dept, thought this was poor practice and set about changing things. Describes procedures. (0:18:30) Describes how things changed in Aberdeen in discipline of Oncology over his years working there. Managed to obtain beds in Ward 46 at Foresterhill, right next to Haematology Ward. Eventual aim to get a dedicated unit for Haematology and Oncology . Refers to CRAG (Clinical Resource and Audit Group) report of the 1980s. It drew up protocols for management of each cancer. We all got together and decided optimal treatments for surgical and non-surgical treatment of patients with cancer. A major advance. Surgical treatment developing as well. Specialisation started. Talks of developments in surgical techniques, and reconstructive surgery. Talks of how changes took place in Radiotherapy - cobalt units replaced by linear accelerators. Medical Physics Dept had major role in treatment planning. In 2015 First Minister of Scotland came and opened the new unit. Medical Oncology also progressing, explains. Gives example of breast cancer, explains what they were looking at in terms of analysis and treatments. Back then, for example, samples for oestrogen receptor analysis had to be sent to Edinburgh, could take weeks to get results. Now everything done at Foresterhill. Talks in detail of work identifying other receptors in treatment of breast cancer. (0:25:10) The first professor of Cancer Medicine, Jim Cassidy, who developed the lab work in Aberdeen was appointed at that time, there for about five years, then he moved back to Glasgow. Genetics Dept now a key area in cancer treatment, explains. Explains that anyone appointed as an NHS consultant gets university status, and he is a senior lecturer in medicine. Job very busy, but liked to do some research, main interest is breast cancer. Explains prevalence of breast cancers in North-east Scotland. Main aim to shrink the numbers of inoperable breast cancers and to make them operable. Goes into detail about this work. Recalls in 2003 being asked by his equivalent at the MD Anderson Hospital in the United States to give a prestigious lecture about his work on breast cancer, real feather in his cap as well as for Aberdeen University. Principle of shrinking down breast cancers to make them operable has now been extended to other cancers. Not taking total credit for this, he was part of a team, explains. Mentions importance of pathologists Ian Miller and Simon Payne. Also did research on ovarian cancers, his colleague Marianne Nicolson took over management of some of the lung cancers; did some research on malignant melanoma earlier in his career, also testicular cancer. Have societies in Scotland we started up when I was an Oncologist, we discuss the management of patients all the time. (0:31:30) Thinks one of the major advances was multi-disciplinary meetings in all cancer specialties. Held weekly, at lunchtimes. Explains all about who was involved, including students. Working out optimum management for each patient. Other major advance was in Radiology. Then talks about his work in treating prostate cancer. A lot of the public think medical oncologists only prescribe chemotherapy, but there are other aspects including endocrine treatment for cancer. Talks about colleague Ian Kernohan using radioactive isotope Ytrium, implanted through the nose to destroy function of the pituitary and to stop hormonal production. Surgical removal of the ovaries was also performed in premenopausal patients with breast cancer. Talks about prostate cancer being treated by orchidectomy, as well as the drug Stilboestrol, which had the unfortunate side effect of increasing risk of heart attacks. Now these treatments are history because we have effective drugs which switch off testosterone production. Treatment of cancer throughout his career became much more targeted. Immunotherapy also used. (0:36:07) Describes in detail a typical working day when he was a consultant. Was single handed consultant till about 1986, when Derek King was appointed to a post that was 50% haematology and 50% oncology. Around 1994 Derek’s post became purely haematology, particularly paediatric haematology. Mentions colleagues Marianne Nicolson and Marcia Ratcliffe. Had specialist nurses for cancer, that was another development. Recalled Val Bain. Patients sometimes don’t want to ring up the doctor, but will contact the specialist nurse. Mentions sarcoma, muscle cancer. (0:40:45) Talks about what he was trying to achieve. Ultimate aim was to have the unit in one area - haematology, oncology and the out patient services. In late 1980s and 1990s they were still spread out all over the hospital. Andy tried to get dedicated wards to get all the units together. Pays tribute to Alex Cumming who was then chief executive of Aberdeen Royal Infirmary. A great manager, he got funding for this, and eventually managed to get a unit together - 36 beds and a separate outpatient department for giving chemotherapy, and chemotherapy nurses. Recounts how the name of the unit was thought up by his colleague Marianne Nicolson - the Anchor Unit, standing for Aberdeen North Centre for Haematology, Oncology and Radiotherapy. Just as he was retiring, the Emergency Care Centre in the hospital opened, and the unit was moved to Wards 112 for Haematology and Ward 114 for Oncology. 25 beds, most single rooms, ideal for nursing patients with cancer. (0:43:53) Talks about how management changes over the years affected his specialty. When he was a young doctor, doctors had a major influence in the running of the hospital. Sandy Michie was the medical superintendent and had a small management team. It worked brilliantly. The consultant staff knew what needed to be done, and would work hard. Waiting lists minimal and red tape minimal. Had wards with auxiliary nurses, state enrolled nurses, state registered nurses. Explains how this worked in detail. There was a ward sister, a matron, wards were spotless, hospital ran brilliantly. Over the years, probably with political involvement, this changed - explains the result, including cutting the number of nurses and beds. Thinks the health service is now terminally ill. Highlights the number of managers in health service now. (0:48:22) Talks about how relationships between patients and doctors developed over the years. Tape recording of consultations with patients introduced. Talks about how the Friends of Anchor was formed in 1997. Talks about how he and Alan Reid, then public relations officers for the hospital, went to speak with Jimmy Milne, boss of the Balmoral Group, to become chairman of this new charity. Balmoral funds the running costs of the charity, so that everything raised goes to patient care. Provides equipment for the hospital and university, research funding for anchor research fellows and a major well being service for in patients and out patients. explains in detail what has been achieved, including part funding two new chairs of cancer medicine at the university, professors Val Speirs and Ann Kiltie. Every year have a thankyou event for fund raisers at Institute of Medical Sciences. Explains he is the vice-chairman and founder of Friends of Anchor. Explains in detail about fundraising efforts, and also using patients as models for fundraising shows at the Beach Ballroom in Aberdeen. This event is called Courage on the Catwalk and is a sellout every year. There is also an equivalent show for men called Brave. Raises six figure sums, people in North-east and Orkney and Shetland are very generous. Also mentions CLAN (Cancer Link Aberdeen and North). Provide accommodation for patients, particularly those undergoing radiotherapy, which can last for a month. (0:56:42) Talks in detail about contribution Aberdeen has made to cancer treatment. [later added during correction process - Stuart Douglas defining Christmas disease]; Maggie Cruickshank managing cervical cancer; Hans Kosterlitz’s work on endorphins; David Parkin gynaecologist, screening and treating patients with ovarian cancers; many contributions to multi-centre studies. Always encouraged patients to take part in research studies. They are closely monitored and do well. Talks about Scottish and UK wide research on breast cancers, also talks about treatment of rare cancers, centre chosen for this is in Leeds. (1:00:51) Talks about time doctors get to spend with patients. Talks of clinics running over time. Talks about relationship for doctors between working for the National Health Service and Aberdeen University. Talks about his voluntary teaching duties and responsibilities, favourite was bedside teaching with small groups of students. Still does this on Wednesday mornings during term time. Wishes more of his retired colleagues would do the same. All the doctors now on contracts, some like teaching, but some find it a bit of a chore. Retired doctors have a wealth of experience. (1:04:46) Talks about how oncology in Aberdeen now compares with 1978 when he started. There were two radiotherapists, and he was a single-handed medical oncologist. Department has developed, there are now four consultant medical oncologists, and they are trying to appoint a fifth. Each consultant has an area of speciality. There were two clinical oncologists when he arrived, there are now ten. Cancer treatment has transformed depending on the cancer you are discussing. Still some resistant cancers, but new immunotherapy treatments now having a major beneficial effect on these cancers. In haematology some of the leukaemias and the lymphomas are being treated by chimeric (animal) T-cells to treat the cancer. Cancer vaccines beginning to make a comeback. (1:08:40) Talks about new building developments on the Aberdeen Royal Infirmary Foresterhill site. First one is the Anchor Centre, only for out patients due to open in August 2023. Friends of Anchor want to have an input and provide facilities for patients, trying to raise £2 million for this. The other building project is the Baird Centre, due to open 2024, which will replace the old maternity hospital. (ENDS 1:10:12)
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