| Description | Prof IAN GOULD interview at the Sir Duncan Rice Library, University of Aberdeen on Monday January 30, 2023. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) IAN MALCOLM GOULD, born in Edinburgh on 6th February 1953. Retired in 2017 as Consultant Microbiologist and head of department at Aberdeen Royal Infirmary and Honorary Professor of Medical Microbiology. Then seconded back into the department as a consultant microbiologist, still as honorary professor, and with the COVID-19 pandemic not entirely disappeared, he continues in post. Family background includes grandfather and several of his grandfather’s brothers who were dentists or doctors; his grandfather’s two sons, including Ian’s father, were both doctors; Ian’s mother was a nurse; both his elder brother and sister graduated in medicine in Edinburgh. Went to school at George Watson’s College in Edinburgh, was keen on rugby and tennis. Father and grandfather were keen motorists, so as a family had at least one long travel in Europe each year. Ian dreamt of being a racing driver, also keen on Art at school; removal of Latin as an exam requirement for getting into medical school made Medicine a more likely career option for him. (0:04:01) Describes life as a medical student in Edinburgh in the 1970s; lived at home, joined the university Motor Club. Got more interested in his studies in Third Year with Microbiology, which was also his father’s chosen career, explains. Edinburgh allowed two electives, six week summer periods off. Did his first elective in 1974 in rural Nigeria on advice of Gillies, who subsequently became Professor of Microbiology in Northern Ireland; explains in detail, including working with Dr Stan Brown, an expert on leprosy, and treating Guinea Worm, and River Blindness. (0:10:10) First encounters with patients in Edinburgh was soon after doing this elective, explains. Thinks Edinburgh was resting a bit on its laurels in those days. Worked at Edinburgh Royal Infirmary, which he found a bit stuffy, peripheral hospitals much more relaxed, lists them. Recalls Prof Romanov, the Professor of Anatomy, great character, great at illustrations, explains. Mentions Gillies again, probably at the time a Reader in Microbiology, another great character. Recalls Psychiatrist Winifred Rushforth, who had corresponded with Carl Jung in Vienna; attended lectures on Dream Therapy, explains; during his Psychiatry final exam meeting a young man whose arm had been severed by a train, explains. (0:15:15) Graduated in 1976, had to do two House jobs, explains. One of his House jobs at Bangour Village Hospital in respiratory medicine, and the other was in surgery at the Western General in Edinburgh, explains. Then went to Birmingham for a six month job to continue his interest in Infectious and Tropical Medicine. Wanderlust then took over, as well as awareness he had to get post-graduate qualifications; took six months off to study for the first part of MRCP (Membership of the Royal College of Physicians), then went travelling for a few months. Had arranged a job in Canada in 1979, as a Fellow in the training programme at McMaster University in Hamilton, Ontario. Travelled first in North Africa, then in California, then by train from Vancouver to Toronto, describes in some detail travelling in California and Mexico, alludes to this being at time of start of HIV/AIDS pandemic, and how this tied in with his work at the sexual health clinic while he was working later in Hamilton, Ontario. (Ian turned out to be on call during this interview, and there is an interruption at this point so he can take a mobile phone call) (0:20:45) Describes considering staying in Canada, but deciding to come home and complete the second part of his MRCP. So returned to work in hospitals in eastern Edinburgh, bought a bachelor’s cottage near Drem in East Lothian. Got the second part of his MRCP at the first time thanks to some great teachers like John Nimmo and John Munro. Then got wanderlust again, having finished his training post as a Registrar at Edinburgh Royal Infirmary and the Deaconess Hospital with Ronnie Robertson, who had been President of the College of Physicians in Edinburgh. Decided to train further in Microbiology, got position at Whitechapel Hospital in London with David Williams, Professor of Microbiology and Surgeon Commander. Enjoyed his year there, explains. Met a nursing officer on the intensive care unit who shortly thereafter became his wife; honeymoon in Glen Tanar which he says is significant as to why he has spent most of his career in Aberdeen. Applied for Registrar post in Edinburgh, but did not get it, so applied for post in Harare, Zimbabwe; two years after end of the civil war, but they were welcomed with open arms, everyone very friendly, explains what it was like and what they did. This is 1982 and the HIV/AIDS virus has still not been described; in retrospect it was rife in Central Africa at that time. (0:26:09) His wife, who had taken a job as a staff nurse in the intensive care unit, was "up to her elbows in blood every day." Reminds him of his first experience of Africa, refers to Lassa Fever, explains. His supervisor Kennedy was medivacked back with what was thought to be Cerebral Malaria, he died, turned out to be first Lassa Fever case imported to the UK. Soon after Ian and his wife came back from Zimbabwe it became apparent that AIDS was a viral disease, explains. Also refers to two endemic diseases, Cryptococcal Meningitis - fungal inflammation of the brain - and Kaposi’s Sarcoma, both endemic and benign; but even while they were there saw a change in these diseases, becoming much more aggressive and malignant in AIDS infected patients. All became much more apparent when he returned to finish his training as a Senior Registrar in Birmingham; two years there, explains. Late 1985, had been doing some research for his consultant, Richard Wise, in antibiotic therapies, explains in detail. Sponsored by Beechams, explains about this, and the work to ferment penicillin; reveals his father was involved in this work as a chemistry student, recalls his dad telling him stories about this, and curing patients who would otherwise have died. (0:33:17) Ian says with that in mind he was doing this work, you could cure most of your patients, unlike in the 1930s, explains. His boss thought his work was good enough that it was presented at Beecham’s laboratories, explains he met "the Gods" who had first synthesised penicillin. People like George Rollason, not a doctor but a chemist by training; also took to Bob Sutherland. They encouraged Ian to present at the International Congress of Chemotherapy in Kyoto in Japan; describes going off there and what it was like. Was thinking of taking his final FRCPath, for Fellowship of the Royal College of Pathologists. But at dinner one night met Dr C.C. Smith, Dr Chris Smith, larger than life character who was an infectious disease physician in Aberdeen; encouraged Ian to apply for vacant consultant’s post in Aberdeen. Got the job in Feb 1986. (0:37:33) Clarifies his interest in the specialty of Microbiology, as he was also trained in Infectious Disease; but by the time he came to Aberdeen, that specialty was already filled by Graham Douglas, so he took up vacant post at City Hospital in Aberdeen; Ian Porter had retired, so took up second consultant post with Dr Tom Reid as the consultant in charge. Explains more about his interest in Microbiology and infectious diseases. When he came to Aberdeen in February 1986 was based at the old City Hospital public health lab, explains microbiology was changing from a laboratory base to a clinical base; antibiotic resistant infections becoming more common. (0:41:17) Describes what Microbiology in Aberdeen was like in those days; two departments, the laboratory at the City Hospital which was purely NHS and the Aberdeen Royal Infirmary department which was essentially academic overseen by Prof Hugh Pennington at that time. Explains that the two labs were really run independently, merged in 1990 at Foresterhill; describes how the two labs worked. Talks about the reputation of Microbiology in Aberdeen in those days, thinks it punched above its weight; Ian Porter had done a lot of good work, refers to history before his time, including the Aberdeen typhoid outbreak in 1964; brucellosis in cattle. (0:45:11) Speaks of the challenges he faced on coming to Aberdeen, including having to do his final exam . (Another mobile call interruption). Finishes story about his final exam, and how the stress haunted him for years. No other stresses initially in the job, however, explains; gratitude displayed that he was filling a post that had been vacant for a couple of years. Refers to teething difficulties for a couple of years due to the merger of the labs at Foresterhill, explains. Clarifies that the exam that gave him so much stress was to become a Fellow of the Royal College of Pathologists. (0:50:44) His position was a full time NHS one, along with Tom Reid; 95% of their work, did give some lectures to medical students. Talks about benefit of working for NHS, rather than being an academic. Talks through in detail what would have been a typical day for him back then, including commuting from an old croft out near Durris; dealing with the lab technicians; liaising with clinicians and GPs; if time in the afternoon, turn to research - mentions good little team of researchers at the City Lab, Katie Milne and Fiona Mackenzie. (0:56:43) Early on in his research work got involved with some European groups; first behind the Berlin Wall in 1988, went to Bratislava in what was then Czechoslovakia and found himself in the middle of the Velvet Revolution, explains. Made good contacts there, went back every year to teach; was made first Associate Professor there, then Honorary Professor of Microbiology, Public Health and Epidemiology, in the late 1990s. Led to him applying for grants in the early days of the European Commission Framework for Scientific Research, successful with help of his research team’s Eastern European contacts. After coming to Aberdeen in 1986, Ian became interested in antibiotic resistance and how to prevent it; explains in detail. Refers to relatively new European Society of Clinical Microbiology and Infectious Diseases; Ian was successful in bringing their large European Congress to Glasgow in 2003, when he was president of the congress. By that time had been applying for grants with the Framework on the new subject of Antimicrobial Stewardship; term first coined by John McGowan, an infectious disease epidemiologist from the Center for Disease Control in Atlanta, Georgia. Ian thinks he himself was only the second person in the world to write an article on this topic, explains in detail. Mentions annoyance at his doing this from a close colleague in Nijmegen, Professor of Medicine Joss Van der Meer, explains in detail. Antibiotic use defined the next twenty or thirty years of Ian’s work. (1:03:13) As result of this early work, they were invited to consult with the OIE (Office International des Epizooties), basically the Animal WHO (World Health Organisation). Explains in detail why this is absolutely critical - last time Ian calculated, over a million tons of antibiotic are being used each year around the world, the majority in animal food production. This creates resistance, and pollution; huge problem worldwide now, explains in detail. Compares it to the problem of global warming; if antibiotic resistance continues its upward trend, estimated there will be ten million deaths a year directly due to it by 2050. (1:08:40) Effect on heroic modern methods of surgery, explains. Harks back to Aberdeen in the 1880s when Alexander Ogston the Regius Professor of Surgery discovered staphylococcus, explains; Ogston was one of the first to take up Lister’s advice on decontamination of hands before surgery. Ian says time when he first qualified is now seen as the Golden Era of the Antibiotic, but in the last twenty years antibiotic discovery is not that easy any more, explains the consequences of this and need to incentivise big Pharma to develop new ones. (1:12:49) Ian’s work in AMR (Anti Microbial Resistance) and AMS (Anti Microbial Stewardship) has helped make Scotland a leader in these fields; he comments on this. Through the British Society for Antimicrobial formed working groups in UK, Europe and worldwide looking at AMS, government quickly took an interest in this, explains. Refers to General Election campaign of 2005, anti-microbial resistance became one of the top concerns of the campaign. The Scottish government formed the Scottish Microbiology Forum advisory group, explains in detail; metamorphosed into Scottish Network, antibiotic resistance work led from Aberdeen. One of Ian’s students, Dr Mackenzie, is now chief executive officer of the Scottish Microbiology and Virology Diagnostic Network, played a big part in response to the COVID pandemic. Clarifies that he became an honorary professor in Aberdeen in 2016, explains. Explains about coming back to work, not being consultant in charge of the department, fraught with problems; instead concentrating on a good patient service, a good programme for the trainees, and being allowed to do research. Explains he became head of the department in 2009 when Tom Reid retired. Talks about "a truce" that was agreed when they moved to Foresterhill from the City Lab, Tom would run the diagnostic lab and Hugh (Pennington) would run the academic lab. Comments that no one replaced Hugh when he retired in 2013, and he thinks the academic department was dissolved at that time, explains. Hamish Mackenzie got seduced into going to the Medical Education side as a professor, retired quite early. (1:18:42) Clarifies that the Dept of Microbiology no longer exists at the university, but is now 100% an NHS department. Comments on this in detail. Mentions successful Aberdeen fungal research group that were seduced away to Exeter a few years previously under Neil Gow, a big loss. Not just Aberdeen, most academic departments of microbiology have been run down or dissolved. Molecular biologists and geneticists have taken over in terms of winning the grants. Summing up Aberdeen’s contribution in this field, recalls Richard Wise in Birmingham telling Ian he would put Aberdeen on the map, explains. Comments on the most significant aspects and achievements of his career, including tackling MRSA (methicillin-resistant Staphylococcus aureus). (ENDS 1:24:29)
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