| Description | Mr DAVID CURRIE interview at the Sir Duncan Rice Library, University of Aberdeen on Tuesday August 22nd, 2023. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) DAVID GORDON CURRIE, born on the 19th September 1949 in Qumbu in the Cape Province of South Africa. Retired in 2012 from the post of Consultant Neurosurgeon at Aberdeen Royal Infirmary. Family background, a lot of medics, explains. Father a doctor, mother a midwife, both born in what is now Malawi. Went to primary school while family in a remote place on the border between what is now Zambia and Tanzania, could only get an English-speaking school by boarding in Rhodesian State boarding schools. Went to primary school in a place then called Fort Jamieson, went to secondary school in the capital of Zambia, Lusaka . Came to Scotland for higher education, had to do Scottish Higher exams in order to get into Edinburgh University to study Medicine, went to John Watson’s School in Edinburgh as a boarder, explains. Interests at school were mainly Arts subjects, History and Literature, well taught in Zambian schools, which were not particularly strong in the Science subjects. Explains that because of his father it was assumed he would pursue a career in Medicine. Got into Edinburgh University in 1968, thanks to a Labour government introducing student grants. It was a six-year medical course in Edinburgh in those days, really enjoyed it. (0:06:13) Recalls first encounters with patients, started clinical part of the course in the old Leith Hospital, now long gone. Had tutorials there, and were told if they wished to come back at night they could speak to patients. His first patient was an old vagrant, explains. Recalls people who inspired him, did his long surgical attachment in one of the Edinburgh Royal Infirmary surgical wards; fairly harsh environment, not particularly friendly, but they took his interest in surgery quite seriously, morale-boosting. Also did block on Social Medicine, now called Public Health, teachers were all in the Communist Party, explains. Describes in detail why he decided to become a Surgeon. Had some ambitions to do some form of overseas aid, and thought he could be most useful as a surgeon rather than a physician. Describes how he later had doubts about being a surgeon, and how he abandoned plans to become a General Practitioner. (0:10:12) Recalls in detail how after graduating in 1974 he did a very harsh surgical house job, with extraordinary responsibility, in Wards 11 and 12 of Edinburgh Royal Infirmary. Then went on to West Lothian to do a medical house job, realised it was as near to Third World medicine as you could get in Scotland, explains. Describes the sort of surgery he was doing in those days. Then still with a mind to doing some Third World voluntary service David did Obstetrics and Gynaecology out in West Lothian, did Accident and Emergency and then General Surgery. Was told he could have the General Surgery Senior House Officer job as long as he worked for the Fellowship exams in Surgery. Then was prompted to apply for a job in Fort William, explains. Describes the kind of surgery he was able to do in Fort William; dealing with trauma from climbing and the roads, and a lot of big burns, explains. Carried on studying for Fellowship exams in Fort William, but thought he better get some other specialty experience, arranged a week in Edinburgh visiting the Neurosurgeons, explains it was a waste of time! (0:15:18) Went to Falkirk Royal Infirmary in 1981 to do Orthopaedics, both his fellow Registrars were Indians and were great orthopaedic surgeons and taught him a lot. They were not greatly valued by their consultants, says "they were just the Indian cannon fodder at the time" who staffed a lot of the NHS, David owes them a great debt. Describes in detail the sort of operations he was doing at that time, mostly dealing with trauma. Recalls particular case of a small boy who had fallen off his bike, was initially quite well and then started to vomit, started to lose consciousness, indications he was suffering from a clot on the surface of his brain. Could not contact his consultants, had to perform a Craniotomy having only read about it in his studies for the Fellowship exams. Describes what happened when he could not stop the bleeding. A neurosurgeon from Edinburgh said he would help, young consultant arrived by police car with a nurse. Consultant was James Steers, who addressed David politely as "Sir", child later taken to Edinburgh where he made a good recovery. Describes how in later years he repeated the procedure, this time as a Consultant, when he was called by an Orthopaedic surgeon to Falkirk to help deal with a similar problem. (0:20:07) Recalls how he came to work for a year starting in 1982 as a Registrar in Neurosurgery at the Western General Hospital in Edinburgh; floundering at first, but by end of the year he realised the benefits of Neurosurgery, explains. Had by then given up on the idea of Overseas Aid, his wife was not enthusiastic about it. He went to Douglas Miller, who was the Professor of Neurosurgery in Edinburgh at the time, who said he thought it would be a good idea if David stayed with the specialty. Said there was no job in Edinburgh, but there was a job which hadn’t been advertised in Aberdeen for a trainee, and suggested he speak to them. David drove up to Aberdeen, smitten by it from almost his first view, explains. Was interviewed by Bob Fraser, who was in manner and character much more like an Aberdeenshire farmer than a neurosurgeon; offered him the job. Worked with Bob Fraser and his junior colleague Chris Blaiklock, David liked the democracy of medicine in Aberdeen compared with Edinburgh. Explains that after a few months he had not been paid, began to worry, mentioned it to Bob Fraser who said he had better go and speak to the health board treasurer, who was Alec Cumming, who subsequently became chief executive. Alec Cumming knew nothing about him, but sorted everything out! In Aberdeen there were two consultants, and one registrar, who generally worked all day every day. It was much more like a general surgery job than in Edinburgh, he loved it, and wished he could stay in Aberdeen. Next step in those days was Senior Registrar, which would then lead to a Consultant’s job, but all four posts in Scotland were filled, senior colleagues told him he had to apply for every job going in the UK. Job came up in London, somewhere he did not really want to work. Was interviewed in London for this job, sprinted back for train to Aberdeen. Got a call the next morning while he was in operating theatre with Bob Fraser, offering him the London post. Describes the move as a rude shock, everything compared to Scotland was broken down, scarce, but a huge amount of practical experience. (0:26:56) Clarifies what he was joining during his year in Aberdeen, a Department of Neurosurgery with two consultants and a trainee. But shared a ward with Neurology, and there were two Neurologists; functioned really as what you would call a Neurosciences department, explains. Clarifies in detail what he was doing during his three years working as a neurosurgeon in London. It was a South London rotation; the Maudsley Hospital was in fact a tertiary psychiatric hospital, explains neurosurgery in Scotland and England tended to find accommodation in psychiatric hospitals when it first started; then the Brook Hospital which covered the South-east of England, wooden shacks, shabby accommodation, but a real centre of excellence; and we also had to service the big teaching hospitals, Guys Hospital and Kings College Hospital. As the Senior Registrar David was the senior trainee, had junior colleagues to supervise. But the Consultants did not live in London, so out of hours the Senior Registrar copped the lot! Packed the time with operative surgical experience, explains, including about the sort of operations he was doing. Explains in detail about how Neurosurgery is regarded in the medical profession. Covers neonatal surgery, care of the elderly, trauma, cancers, congenital abnormalities, skeletal surgery, what is generally known as functional surgery, doing things to the brain to remedy malfunctions such as epilepsy, pain, movement disorders, psychosurgery for things like severe depression an obsessive compulsive disorder, explains. Very varied and general specialty. Although in his time they did not work greatly with other specialties, they had a shared interest in things like spinal surgery with the orthopaedic surgeons. Become more common now to have combined teams doing things, but was considered a bit lame in those days to have to call in help. (0:33:51) Talks in detail about why he came back to Aberdeen in 1986, this time as Consultant. No prospect of a job in Scotland till Bob Fraser’s successor resigned and went back to England. David was not adequately trained, but job was kept open for some time, he interviewed for it having just completed his training, and got it, really grateful to be back in Aberdeen. Explains what the unit that he was rejoining was like at the time. David came into Neurosurgery at a time of fairly revolutionary change. Just a bit earlier the Operating Microscope had come into use, which made operating inside the head a lot more practical and successful. Chris Blaiklock introduced it he when he came to Aberdeen as a Consultant, he had been a trainee in London where the first CT (Computerised Tomography) scanner was developed. Chris had a fairly revolutionary effect on Aberdeen, explains this was also at time that Professor (John) Mallard was inventing the MR (Magnetic Resonance Imaging) scanner, and Chris Blaiklock was the first neurosurgeon to use a clinical MR scanner. So Aberdeen had some very important early experience that other centres lacked. Pays tribute to Chris Blaiklock, but there were just the two of them, so David left very much to his own devices. Nursing staff were outstanding, explains. The other peculiar thing about Aberdeen was ventilators and ventilation, explains in detail the significance for Neurosurgery. The neurosurgical ward was the intensive care unit in those days for the whole of Grampian, supervised by the two Neurosurgeons and their Registrar. (0:39:26) Explains in greater detail about the revolution in Neurosurgery in the 1970s. Prior to this one of the major problems neurosurgeons had was identifying where the tumour or other abnormality was in the brain. Could use Clinical Psychology; when it came to imaging, could use Angiograms by injecting dye into the blood vessels supplying the head, explains, unpleasant procedure that could provoke Stroke in the patient; or could inject air or dye into the brain itself, by doing a lumbar puncture, explains this involved manoeuvring the patient, sometimes upside down to get the air into their brain. David never witnessed this procedure, but gives graphic description of what it was said to be like. Then CT scan arrived and overnight you could look at the patient’s brain without interfering with them. The Operating Microscope brought everything into good visibility and good light. Then the MR scan came along, comments on the first Aberdeen images. Modern MR scanners’ images look as if you have taken a cleaver down the patient, can see every detail. Thinks he got job in Neurosurgery in Edinburgh because it was then seen as an unsuccessful specialty; new results in imaging made it much more successful and competitive to get into, jokes that now he probably wouldn’t get into it! (0:44:46) Explains in detail the areas of specialty of Neurosurgeons and Neurologists; neurologists the physicians dealing with the nervous system. In the early days of Neurosurgery, the mainly general surgeons that came into the specialty relied very much on the neurologists to tell them where the abnormality might be. It was unusual in the rest of the UK for them to be housed in the same ward, unusual but very sensible, explains. Talks in detail about his responsibilities as a Consultant Neurosurgeon, and how it was very important to him that he was working for the NHS. Neurosurgery in Scotland largely a Left Wing specialty, explains. Recalls going into Guys Hospital in London when he was working there, and seeing a patient who would be described as a vagrant surrounded by a group of young doctors at the peak of their training, and their focus was on man that society would regard as trash, that sums up what the NHS means to him. (0:49:20) Explains in detail why as a Consultant in Aberdeen he also took on responsibility for paediatric neurosurgery, pituitary surgery and surgery for chronic pain. His colleague Chris Blaiklock took on a lot of management posts during the Thatcher reforms (a reference to then Prime Minister Margaret Thatcher); there was a push to get clinical management. Chris Blaiklock became Director of Surgery, in addition to his day job, he was overloaded, so David said he would take as much off him as he could, explains. Very few neurosurgeons do the full gamut of neurosurgery, but they used to do. Talks about challenges of paediatric surgery, operating on very small patients, had to get glasses. Talks about neurosurgical nurses he worked with. Also very dependent on neuropathologists, explains. Also hugely dependent on specialised anaesthetists, explains. (0:54:03) Talks in detail about the reputation of the Neurosurgical Dept in Aberdeen. He was proud of the public service ethos, explains; waiting times in Aberdeen much less than elsewhere in UK. Describes in detail how a typical day for him changed over the decades. Talks about the teaching duties of the consultants, given honorary Senior Lecturer status by the university; he had no real teaching experience, had to make it up as he went along. An interesting challenge. (1:00:46) Talks about how when he started as a consultant, Neurosurgery and Neurology were housed together in Ward 40 at Aberdeen Royal Infirmary. Talks in detail about the most difficult cases and challenges he dealt with during his career; cerebral vascular surgery, dealing with aneurysms, satisfaction from getting a good result. Memorable patients the ones who had fairly bleak outlook from the haemorrhage and who did well. Recalls most striking one being a woman who was sent up from Stracathro Hospital for a scan, explains in detail what happened; speech almost back to normal, but now spoke with a strong German accent, despite being from Montrose! (1:07:48) Talks about advantages of having so many medical specialties all on one site at Aberdeen Royal Infirmary; being able to call in colleagues from other surgical specialties, major trauma a typical example, explains there was a Trauma on-call system. Talks about chairing the working group on the provision of services for chronic pain in Scotland, in the late 1990s, does not think much happened as a result of their report, chronic pain remains a poor service in Scotland; although a very good pain clinic in Aberdeen. Explains in detail what chronic pain requires. Some intrinsic pain conditions; David had a particular interest in trigeminal neuralgia. He thought those sort of services should be based in regional centres round Scotland. That’s still a wish. (1:13:40) Talks about their being a much greater degree of understanding, in General Practice particularly, about chronic pain; thinks specialist pain treatment services within the teaching hospitals is what’s currently lacking. Talks in detail about Neurosurgery’s role in treatment of chronic pain; cordotomies, including the success of the first time he did one. Talks about his role in leading the campaign against Scottish government attempts to centralise Neurosurgery in the Central Belt in the late 1990s; Labour Scottish government review of acute hospital services led by Sir David Carter recommended a number of specialties be centralised, including Neurosurgery. But David and his colleagues took a different view, neurosurgery not esoteric, a lot of it was everyday stuff, explains. Ignorance among some of the people involved in pushing for centralisation about where things were in Scotland, explains. David believed in keeping things as local as possible, and central where essential. SNP government then came in and overturned the whole thing. (1:21:38) Talks about the department and research, thinks it was something they were poor at, explains why, but mentions national research they were involved in. Describes how staffing changed in the department during his career. In 1990s appointed a third consultant, before that was on call every other night. When third appointee moved back to Ireland, the then chief executive - thinks it was Richard Carey - suggested appointing two more. Allowed more off duty time and sub-specialising, explains. There are now five consultants and five registrars. But waiting times for some things up to two years, finds this baffling. Talks about neurosurgery procedures that are no longer done in Aberdeen. (1:25:59) Talks in detail about the great pride he had in the way his department served the North of Scotland. Recalls his first trip to do a clinic in Inverness, with Chris Blaiklock. Gives his views on the current state of neurosurgery in Aberdeen, thirteen years after he retired; thinks it is pretty good, but he is bothered by the long waiting times; people in Aberdeen now more inclined to sub-specialise, teaching of trainees excellent. (1:29:10) Gives his thoughts on the current state of the NHS; not doing well, even in Aberdeen, explains. Comments on issue of private practice. Talks about how as someone who first came to Aberdeen in 1983, he now lives in the Aberdeenshire village of Tarland and has fondness for the Doric dialect; recalls early encounter with Doric at an outpatient clinic; and how patients in the North-east, unlike elsewhere, expected doctors like him to make the shift from Standard English. Tells anecdote about a neurologist colleague trying to understand what a woman patient was telling him. (ENDS 1:34:24) |