| Description | Prof JAMES FRIEND interview on Monday January 16 2023. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) JAMES ANTHONY RITSON FRIEND, born on 2nd June 1938, in Edinburgh. Retired in June 2002 as a Consultant in Thoracic Medicine, and Professor of Medicine. Father from North Devon, came back from First World War, went to Bristol University, did Maths, became teacher at school in Essex, where he met James’s mother; she had done degree in English at Royal Holloway College. Father then went to Oxford, did degree in Zoology; first job after that as a Lecturer in Zoology at Edinburgh University; department at King’s Buildings on the south side of Edinburgh, family home was near there; James the third of three brothers. No medics in his wider family. During Second World War parents decided it was not safe in Edinburgh, spent four years living in Peebles. His father obsessed with idea that his three sons go to a top university like Oxford or Cambridge; only day school in Edinburgh that offered the English exams that would allow that was the Edinburgh Academy; all sent there, all did end up going to Cambridge for their first degrees. James has no great affection for Edinburgh Academy, terrible culture of physical punishment, explains. (0:04:49) At school he mainly went in for Sciences, had superb Chemistry teacher, one of the nicest of the teachers; explains about him. But thing that most moved him towards Medicine was his mother dying of leukaemia when he was 13; James was one of her carers. Started studying Medicine in Cambridge, at Gonville and Caius College, where his older brothers did Maths and Geology respectively. Explains he got a scholarship to Cambridge, important for getting a grant from the Scottish Education Dept. Life as a medical undergraduate at Cambridge was fine, although taken aback by some of the social attitudes, explains; his roommate’s surname was Percy, who commented his family had never liked the Scots. James confesses he did not get a very good degree, his father was shocked, thought he had been slacking, explains. Decided because his father was alone in Edinburgh that he would move back there to do his clinical training. (0:11:07) Among lecturers he recalls from Cambridge was R.R.A. Coombs, very good early immunologist; because James had hay fever, Coombs got him to donate a pint of blood so he could work on it. Explains he got a BA degree from Cambridge, in Natural Sciences, the medical degree was later from Edinburgh, graduating in 1962. Enjoyed his time studying in Edinburgh, explains; thinks there were about 130 people in his class in Edinburgh, of whom about 30 were women. Class divided into three big groups; all expected to spend some time in a hostel in Chalmers Street, so they could attend a lot of deliveries at the Simpson Maternity Hospital, part of the Royal Infirmary; James ended up in the group that also contained all the women, still in touch with one or two of them. Joined the Edinburgh course in Fourth Year, explains about his contacts with patients then. Students were encouraged then to spend vacation time working in other hospitals; James spent time at Peel Hospital in the Borders, Bangour Hospital in West Lothian, and also at Edinburgh Royal Infirmary and the Western General. (0:16:40) Memorable lecturers at Edinburgh included Sir Derrick Dunlop, Professor of Medicine and Therapeutics. Also very nice Neurologist called J.K. Slater, did memorable lectures on Saturdays at noon, that students or the recently-qualified could attend, featuring some of his neurologically unwell patients. Talks in detail about final year, and beginning to think about where you would like to do your House jobs. James worked on Derrick Dunlop’s ward, and with his successor; recalls a formidable Ward Sister, recounts story of her telling a Staff Nurse to make him some scrambled eggs as he had been working all day with no food; that Staff Nurse, Elizabeth Sim, became his wife about three years later. Did his House Physician and House Surgery jobs at the Royal Infirmary, then his Senior House Officer in General Medicine at the Western General Hospital; recalls doing the latter with Prof John Strong. Then came back to job in the Renal Unit at the Royal Infirmary, exciting because it was the very start of Renal Dialysis, and Kidney transplantation. (0:21:20) Explains he started specialising in Respiratory Medicine about 1968. Specialisation with the greatest prestige at the time was General Medicine, so thought he would apply for a Registrar’s post in that at the Royal Infirmary; but a bit worried if he did not get it, so also applied for a post in Respiratory Medicine, very much saw that as second best; both interviews on same day. James got the Respiratory job, incredibly fortunate as he ended up working with two of the very best people he ever worked for; John Crofton, who was particularly into TB (Tuberculosis); and Andrew Douglas, explains. John Crofton eventually got a knighthood, established the treatment of TB with triple therapy, explains; became James’s mentor for the rest of his career. Andrew Douglas was one of the best diagnosticians, explains. Crofton and Douglas, towards the end of the three years he was with them, thought he should move on to get a Senior Registrar job, recommended one in Oxford which he got; had about five years in Oxford, explains; also did a year of research studies in Seattle in America, went with family. Then the (Consultant in Thoracic Medicine) job came up in Aberdeen when he was back in Oxford, applied and got it, 1973. Had seen bit of Aberdeen on family holidays, explains. (0:27:37) Explains about the discipline of Respiratory Medicine, and the importance of TB to it; a lot of his predecessors were almost exclusively looking after people with TB, explains history, including sanatoria. Refers also to tobacco and troops during the First World War being provided routinely with plentiful supplies of Woodbine (common brand of cigarettes at the time), and got into smoking; women didn’t really get into it in a big way till the Second World War. It meant that 20 years after the First War there were increasing chest problems with smokers; chronic bronchitis, air pollution in the cities as well; lung cancer shot up, but not till 1950s did people realise it was being caused by smoking. It was well established by Sir Richard Doll, in his research on doctors, explains. Needed more facilities than sanatoria, so moved back more into general medical hospitals; therapy for TB also meant you did not need to be in a sanatorium for two years. Talks about growth of TB again in the wider world, and misuse of the effective drugs; TB organisms becoming resistant, big problem in places like Russia; spread of HIV (human immunodeficiency virus) also a factor. (0:32:44) Describes the department when he took it over in 1973 from Eric Barnes, who had had TB himself; explains a lot of those working in this field had been recruited by the disease itself. Joined Robert Fraser, who with Eric Barnes had been TB officers for Aberdeen and Aberdeenshire. Had beds out at Tor na Dee Hospital. But when James arrived it was decided he needed beds in a more acute setting; provided at the City Hospital, explains; when Robert Fraser retired, his successor Joe Legge also got beds there; eventually all moved up to Aberdeen Royal Infirmary. Clears up confusion caused by date typos on his CV. Explains he did outpatient clinics in Banff; explains that at one time there were three "almost consultants"; one, called a Senior Hospital Medical Officer, Douglas Kay, did clinics in Peterhead; the other colleague did them in Elgin. James went up every fortnight to Banff during his time in Aberdeen. (0:37:03) Explains about what he did during his time in Seattle, and what he brought back from there eventually to the job in Aberdeen. Went there on a scholarship from the Medical Research Council; mainly laboratory research, explains what it entailed. Does not recall any particular challenges when he arrived in Aberdeen. Talks about how the department in Aberdeen developed during his time; developed quite speedily. Fortunate when his colleague Joe Legge came; got on very well, people regarded them as being interchangeable. Senior Hospital Medical Officer Douglas Kay retired, got another consultant post then, so three of us then. Dr Graham Douglas also had responsibility in infectious diseases as well. Lots of things happening in developments; CT scanning; fibre-optic bronchoscopy, explains; measurement of pulmonary function got more sophisticated. Another very interesting thing was they got involved in quite a number of occupational lung diseases. Explains about the nature of lungs, and their surface area. (0:41:49) Saw number of interesting diseases; stationery factory at Dyce that made envelopes, made workers ill, explains why; had a lot of farmers with Farmer’s Lung, explains, worked closely with the university Agriculture Dept, Drennan Watson a huge help; people in a fish factory in Torry getting asthma, explains. Did a lot of work on asthma, because quite common; James did papers on self-management of asthma by patients. (0:44:38) Unsure about cause of rise in asthma, lot of allergies, air pollution doesn’t help. Explains about how his work divided between the NHS and the academic side; virtually all for the health service. Chest Medicine did not have a high status at the time, explains. Did gradually begin to include a bit of research in their work, explains. Recalls how they were offered and accepted files that were about to be thrown out, containing old trials involving children in the past who had chest diseases. Wonderful thing was they were able to follow up virtually all these patients and what had happened to them and their asthma, explains. Likes to think the status of Respiratory Medicine has improved. (0:48:56) James an active anti-smoking campaigner and member of ASH (Action on Smoking and Health), explains about this in detail. Talks about setting up a club, called Smokebusters, aimed at children in their last year or two of primary school, and the first year of secondary school. Explains how it worked, including benefits, and how the long-term results were disappointing. James has never himself smoked. Not impressed with current trend of Vaping, explains. Talks about his work at national level. British Thoracic Society, has research committee he got involved in; became Treasurer, and President. Also a Scottish Thoracic Society. Around the time he retired he chaired a committee called the government Scientific Committee on Tobacco and Health (SCOTH), produced big report about passive smoking. Talks about introduction of laws in Scotland and England to make smoking in public illegal, been a big benefit, explains. (0:56:13) Talks about his involvement with Chest, Heart & Stroke’s research committee. Thinks he was incredibly lucky, loved his work, upset for his colleagues now, seeing the muddle of the health service, explains. Explains why he retired in 2002 at the age of 64. Had absolutely excellent Senior Registrar called Owen Dempsey; James retired to give him the opportunity to apply for his consultant’s job. Praises him as his successor; set up website called Aberdeen Lungs, now 12 consultants in Respiratory Medicine in Aberdeen. (0:59:53) Describes in detail his involvement in a court case involving anti-smoking; around time he retired was approached by ASH to be a witness in a case about a man called Alfred McTear who had been a smoker for much his life and died of lung cancer in his late forties or early fifties (Summariser’s note: Prof Friend later checked and Mr McTear died at age 48). Turned out to be major test case in Edinburgh, as McTear had asked his wife to pursue Imperial Tobacco; James was in the witness box for a week, explains. One of the other witnesses was Sir Richard Doll, who had proved tobacco caused lung cancer. Judge eventually decided case against Imperial Tobacco was invalid, and there was no definite proof that smoking caused lung cancer, and he thought that the witnesses for Mrs McTear were clearly biased because none of them were receiving fees for their time giving evidence. Left James with a dim view of the legal process, explains what he did. (1:04:10) Talks about his non-medical interests, including being President of the Friends of the Cruickshank Botanic Gardens at the university. Interest in music, played the piano, was member of the Aberdeen Bach Choir. Got up to Grade 7 piano exams after retirement, but unfortunately his motor neurone disease has now forced him to give up playing the piano. First diagnosed two and half years ago; at the time he still managed some hill-walking; but in last six months has progressed, explains. Talks about his interest in hill walking and being President of the Cairngorm Club between 2014-17. Talks about bee-keeping post-retirement, explains this followed his purchase of a small steading near Braemar; retirement present from his colleagues was a bee suit and a beehive; explains he kept bees till about eighteen months ago. Had moved them to Lochwinnoch when he moved there with his second wife Ann. Has handed the bees over to his son in Edinburgh. (ENDS 1:10:21)
Summariser’s note: During the correction process of the first draft of this summary, James realised his recorded interview was missing some extra information about his two wives. He sent the following note by way of explanation: "My dear first wife Elizabeth died in 2005 of a bowel tumour, but gave me clear instructions that if I were to meet somebody really special, she would be very happy for me to “go for it” and get married again! And indeed, I married Ann Kerr in 2017 and moved to live with her in Lochwinnoch, where I feel very fortunate!"
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