| Description | Prof ANTHONY SEATON CBE interview on Thursday January 26, 2023. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) AΝΤΗΟΝΥ SEATON, born on 20th August 1938 in London. Was Professor of Environmental and Occupational Medicine at the University of Aberdeen when he retired in 2003. Family background includes several medics; father a doctor in tropical medicine, paternal grandfather was a surgeon and general practitioner, and great grandfather was a surgeon. Education interrupted by the war and bombing, family lived in Liverpool, father away in the Army, his mother took the family away from the bombing to Harrogate in Yorkshire, where his father’s mother lived. Went to to a private prep school in Harrogate, then got into a public school in Lancashire called Rossall. During this time father came back, not seen him for six years. But knew he was a doctor, made up his own mind that was what he wanted to be; explains about writing a school essay in defence of the National Ηealth Service, which was about to come into being. Talks about his interests at school, English, Latin and Maths, love of writing - still writes every day - keen on sport, rugby, hockey, cricket, shooting. His other career choice would have been to teach; ended up being both a doctor and teaching. (0:04:36) Studied medicine at Cambridge, explains. At Cambridge became hooked on rugby and rowing, did three years of medical studies, explains. Then went to Liverpool to do the next three years of clinical studies. He was the oldest of five children, father lived in Liverpool, first time he had lived together with his parents. At Liverpool learned proper medicine, a superb place to go to learn medicine. Lots of hospitals, lots of ill people, lots of opportunities for learning the subject, the teaching was great. Recalls bacteriology Prof Downie from Aberdeen; Cruikshank, another Scot, very good at teaching pathology. Lord Cohen of Birkenhead was the prof of Medicine. Probably best person he came across in Liverpool was David Weatherall, who became Regius Professor at Oxford, great teacher and inspiration. (0:10:11) Recalls first encounter with patients as a medical undergraduate; a young girl who had cancer and no one had told her, a sad memory. Graduated from Cambridge. Had applied for a job at Liverpool Royal Infirmary with Dr Robertson and Dr Emyr Wyn Jones, house physician was his first job. Explains about doing locums; as consultants got to know you that improved your chance of getting a job; doesn’t remember applying for a job, explains. Wanted to follow this up with a surgical job, but did not get that and was encouraged to apply for job in orthopaedics, which was his second job and was great fun. (0:14:37) Explains that back then there was a thing called Occupational Medicine; he was always interested in the effect of the environment on health, right back to his student days in Liverpool when he heard two lectures that made a big impression. One was by Lord Cohen, who drew attention to a book called “Mirage of Health”, explains. Another was by Donald Hunter, a London doctor famous for a book he had written about diseases of occupation. Anthony’s aim was to pass the Membership of the Royal College of Physicians, had to do this to become consultant physicians, he did that in the minimum time, at a time when it had a ten per cent pass rate. That set him on the road to becoming a proper physician. Deliberately applied for jobs in lots of specialties, explains. Eventually got a Senior Registrar post in Cardiology in Liverpool. Also had a year in Stoke on Trent as a Junior. (0:18:38) In Neurology, which was the other of his two ambitions, ran into a consultant he did not like, explains this was because the consultant spent his whole time doing private practise of which Anthony did not approve; explains what happened, including not being able to go home early from the clinic when his wife was in labour. Then got job in Cardiology; very interested in the relation between cardiology and respiratory medicine, did his MD on that with very fine consultant called Colin Ogilvie who became a great friend. Colin then arranged a fellowship for Anthony to go to America (to University of West Virginia in 1969), explains this was to continue studying pulmonary circulation. Got there and discovered a unit studying pneumoconiosis. Promoted to Assistant Professor of Medicine, had wonderful time doing research and a bit of looking after patients. So became a chest physician there. After two years there had amassed a series of papers on coal workers and coal workers’ lung, but ambition was always to become a consultant in the NHS, so started applying and job came up in Cardiff, where he became a consultant chest physician. Explains he was never an occupational physician, but had an interest in occupational causes of diseases, particularly lung diseases, spent eight or nine years as a consultant in Cardiff (0:24:15 ). Wrote book on occupational lung diseases, became well-known in that field; National Coal Board (NCB) (by then renamed British Coal) medical service offered him job as Director of the Institute of Occupational Medicine (IOM) in Edinburgh; accepted on condition he was allowed to be a part time consultant, arranged an honorary post for himself with with Dr Norman Horne, explains. In 1978, and for the next ten years, became an honorary Senior Lecturer at the Dept of Medicine at Edinburgh University and an honorary Consultant Physician at the City Hospital in Edinburgh; explains in detail about his responsibilities, including his previous time in Cardiff, at a time when Respiratory Medicine was developing very rapidly. Main job was running the Institute, explains. Talks of research into effects of coal dust. Also gave some lectures at the University of Dundee during this time. (0:29:29) Talks about his experience in America, and what he felt he brought back from that to the UK. Clinical role limited in the US, explains what he did; ethic of hard work. West Virginia a very backward state, but had a superb hospital and university set up, explains. Realised he didn’t want to work in a system where patients had to pay for their care, came back to work in NHS, ironically only for a short time in Cardiff in a paid role, otherwise honorary NHS positions. Explains why he came to work in Aberdeen in 1988; friend told him about post of professor being advertised there; about to be made redundant by the Coal Board from his current job along with the rest of the Institute. So rang Derek Ogston, who was either Vice-principal or Dean of Medicine at the time in Aberdeen; asked about applying for a part-time post as Chair of EOM (Environmental and Occupational Medicine), applied and was accepted, now with jobs in Aberdeen and Edinburgh, explains. In 1990 managed to make IOM an independent charity, Anthony took redundancy and a pension from the Coal Board, enabled him to do part-time role in Aberdeen, explains. (0:36:09) Explains what the Dept of Environmental and Occupational Medicine was like when he took over as its head in 1988; hadn’t really got going, explains. In a rather ramshackle building at back of the Medical School; two storeys, most occupied by a physiologist; two Senior Lecturers, Steven Watt and John Ross, clinicians very into hyperbaric medicine; technician George Henderson; and a helpful Secretary. No room for Anthony, explains he moved a photocopier to make his professor’s room. Not set up as a functioning department, no research programme going, apart from exercise physiology; so starting from scratch. Anthony had been heading up a research institute, so was involved in a lot of research, but little opportunity to do his own; his work had been mostly supervisory, explains. This was his first proper academic post; had to teach, do research, and do some clinical work as a clinician. Aberdeen had very good respiratory service, he offered to help, clinical load was very light. Had to build up a research programme, and a teaching programme; explains in detail. Managed to persuade then university Principal George McNicol of business case for two part-time lecturers; came from the IOM, occupational hygienist called John Cherry, and ergonomist John Graves. Set up Masters’ courses in Occupational Hygiene, Occupational Medicine, and Ergonomics; first two became important components of the department’s work. (0:42:15) Anthony also felt strongly about undergraduate teaching; medical students get a raw deal when it comes to Occupational and Environmental Medicine, explains. Wonderful opportunity in Aberdeen, General Medical Council had just introduced a new curriculum stressing just these things, explains. The heads of various non-acute medical departments in Aberdeen got together and wrote a curriculum that in his case introduced Environmental and Occupational Medicine from Year One in Medical School; proved a great success; General Practice central to this whole thing, Lewis Ritchie a close colleague in setting this up. Explains how the course worked for students; whole concept of the workplace and the general environment and their effects on health infiltrated into them throughout the curriculum. By the time Anthony retired, he feels they had the best teaching in these subjects anywhere in Britain. (0:46:52) Deals with question of how long it takes to get a research programme going from scratch in his specialty, five years, if you’re lucky; explains in detail, difference between studying rats and populations. But he wasn’t starting from scratch, had a background in research; interested in asthma, air pollution, start of his research there was oil seed rape, explains, start of a lot of research on how to measure things like particles in the air. Describes how he came to start studying air pollution, contacted by Bob Maynard who had been one of his students in Cardiff, and was now Senior Medical Officer in the Dept of Health in England. He was looking for someone to chair a committee on air quality standards. Anthony went down to visit Dept of Health and Environment in London at just the time he had come to Aberdeen. (0:51:48) They chose suitable people to sit on the committee to tell the Government about what air quality standards they should set, explains government in a hurry to do this ahead of similar European legislation. Explains about the sort of professions on the committee and how they went about their work. Government accepted all their recommendations, and they went on to become European standards, which the present government is doing their best to get rid of them. It led the world actually, explains. Thinks his own big research breakthrough was to understand how a very small amount of air pollution can have a profound effect on health, explains in detail; incredible that people can die of a heart attack from inhaling tiny particles. (0:56:58) Anthony realised it could not be the weight of particles that did it, what you see when you look at them under a microscope is things that look like viruses; a Eureka! moment for him, explains in detail about Lungs thinking they had to put up a defence against them. Told three friends about his idea in a pub in Edinburgh, they discussed it, and he then went home and wrote a paper which The Lancet published within weeks, this was in 1995; been cited three thousand times so far. Says it is the single most important thing he has ever done, explains consequences; but Aberdeen almost totally unpolluted, so main studies were done in Edinburgh and Belfast. Talks about how this research has developed, now looking at neurological effects of air pollution, for which there is significant evidence, Alzheimer’s disease. Recalls how he had a heart attack himself while he was Chairman of the British Thoracic Society for a year, when he went down to London in 1989, not had one since. (1:01:58) Also talks about his asthma research, which he started in Cardiff, explains. Wonderful opportunity when he came to Aberdeen because George Russell, a Reader in Paediatrics, had done series of studies of schoolchildren in Aberdeen showing asthma was increasing among children, and no one knew why, explains; part of his life has been wondering why things happen, explains. Realised what had decreased was amount of fresh fruit and vegetables that people eat, published hypothesis that as this decreased so asthma in the population increased. (1:05:57) Got together with the Rowett Research Institute, who had a track record in nutritional research, and created questionnaire that would tell them what kind of vitamins people were eating; explains how this was used in studies, including involvement by a female PhD student from Saudi Arabia, who proved very able, got her PhD. Some interesting studies published on diet and asthma, showing relationship to Vitamin D and Vitamin E. Then got a grant to start a study of population of pregnant women, explains; had extremely able research assistant, Coreen Bodner; she recruited all these pregnant women. Turned out to be ground-breaking research, explains, first demonstration that the diet of a pregnant woman influences the risk of asthma in the children. After Anthony retired the research was taken over by Dr Graham Devereux, who got a personal chair in the department; he followed up the children till they were fifteen, explains; both the air pollution and the asthma research were very successful. (1:12:21) Says he knew nothing of the previous history of the Dept, under Prof Nelson Norman, except he knew the discipline of hyperbaric medicine was very disputatious; got this information from his friend in Dundee, Philip James, explains. Anthony took the post on the explicit understanding that he was not an expert on hyperbaric medicine, explains; two experts in hyperbaric medicine when he joined the department, Steven Watt and John Ross, explains how he and they worked together. Anthony met Nelson Norman, didn’t discuss his particular problem with the university, although knew there had been one, explains; kept out of hyperbaric medicine, comments on those who did it; explains one of his responsibilities was for training in this area, but never really understood what they were doing or who was paying them; explains his strong impression of what was going on. Recalls going to the helicopter underwater escape training facility; interesting because he was an active scuba diver at the time. (1:18:18) Agrees with Nelson Norman’s assessment in the written history that the Dept was a difficult fit for Aberdeen University, explains; university given money, got a physiologist who wasn’t interested in underwater at all, he was interested in exercise; talks about the other posts that were created; explains in detail the discussions he had when he was being interviewed for the job of Professor. Learned later that the trouble was all personality-related rather than scientific-related. Addresses the question of whether he felt supported by the university administration when he was head of the department; initially yes, at Dean level, that changed when the Dean changed, found he was positively obstructed; but had long experience of this, having worked for the National Coal Board that was desperate to get rid of the institute he was in charge of. Felt sympathy and support from Prof Ogston. The medical hierarchy; got support from Andy Rees when he became Regius Professor, he had been a student of Anthony’s in Liverpool. Breakthrough for Anthony came when Duncan Rice became Principal, explains in detail; felt they had support from the top; had developed very good relations with the other professors in the Medical School. (1:25:38) Explains in detail how the department developed and changed during the fifteen years he was its head; from nothing to a department with an international reputation on air pollution research and asthma research; realising influence of his teaching. Continued lecturing at Edinburgh University after he retired, explains. In occupational medicine the influence of the Department was worldwide, explains. Recalls retiring in 2003, in a sense a relief, explains in detail; emphasis on grants and how much money you had brought in, all became very business-oriented, destructive to scientific endeavour, explains. Determined to keep on working, explains; main activity now is writing, explains; includes writing for the Scottish Review, run by Kenneth Roy, explains in detail how he came to write for it because he was annoyed by an article Kenneth Roy had written about the health service; Anthony’s greatest interest in life is writing; wrote weekly commentary on COVID; has also been writing about climate change for thirty years. (1:35:32) Sums up what he feels he achieved leading the Dept of Environmental and Occupational Medicine for fifteen years. Proud of what we achieved, set Aberdeen’s name up in the world of asthma and air pollution; mentions George Russell again, and Steve Turner, who is Professor of Paediatrics, is continuing working in this field. Regrets that the university wasn’t able to continue supporting a department, explains. Hopes that the role of teaching we set up continues; the post-graduate part has gone; the research in asthma will continue. But in a way it’s a disappointment, explains. What he is very pleased about is that Aberdeen Medical School is among the leading three in the United Kingdom from the point of view of student approbation; likes to think he played some part in that, a residual effect of their department. Talks of his hopes of his youngest grand-daughter studying Medicine in Aberdeen. (ENDS 1:40:15)
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