Bristol Medico-Chirurgical Society

Dr. Ivor Ernest Doney, MB, CHB, MRCS, LRCP, MRCGP, MFOM (RCP), FFHOM, DRCOG, DCH, DIH and DMJ.

Ivor, tell us about your background.

Well Stefan, when you first approached me about a life history I was both surprised and flattered too. I couldn’t see that I could be of any interest to anybody, but later, when I thought about it, I decided yes, my life certainly has turned out differently from the normal pattern of life. I’m an old man now. As Bob Monkhouse used to say, I’m so old, I can remember the First of the Mohicans”.

I was born in 1920 in Pool, between Redruth and Camborne, Cornwall.

Father was an inspector in the Police force in Cornwall, and so that’s probably why I like forensic medicine. I had one sister who married a headmaster – tragically she died aged 45 from a subarachnoid haemorrhage. Mother was always an inspiration.

Everybody says where were you in Cornwall? Well when you’re a policeman you’re shifted on every three years, you see. And incidentally, everybody says these days, isn’t it awful, children having to change schools. It doesn’t seem to have affected us. And then I got a scholarship to Truro School; I was a boarder there. I was interested in rugby and athletics. Never got any big achievements, but yes I was very interested in athletics. Then of course the war came.

Were you at that time thinking of medicine?

Yes, but then I also had to think how I was going to pay for it, you see, because it was expensive in those days. I also thought of accountancy and other things. To be quite honest I wasn’t sure what I wanted to do.

How difficult would it have been for a Police Inspector to put his son through medical school in those days?

Very difficult financially – I would have needed a scholarship to help out. Medicine was expensive, but strangely enough Dentistry was the most expensive course in the University in those days.

So that interest in medicine led you into the RAMC?

Partly. You see those were worrying times with a war imminent – I joined the Territorial Army in the RAMC.

Since then I seem to have been a late starter in all aspects. I took A levels, (that’s First MB,) Chemistry, Physics and Biology, at the age of thirty; that meant I didn’t qualify until I was thirty-six – by the age of thirty-six most people are well off, they’ve got a house, a car, married with family, I didn’t get married until I was aged forty. You see, I was a late starter in everything.

All right, then, why the delay? Well firstly of course the war took out six years of my life because I had joined the Territorial Army before the war began. All young men in those days were expected to do something for the country because it was clear that the war was coming, and then suddenly all the Territorials were called up into the regular army – this was before the war even started.

I was in the army for the whole of the war, 1939 to ’45. I was in the RAMC; not as a doctor, I was a Warrant Officer Class 2, Sergeant Major. I spent most of the war on troop ships carrying battalions of troops to various parts of the world. I was on and off at sea for four and a half years, and only suffered one little bombing attack, so I was lucky.

So working on the troop ships, you saw Atlantic service, you saw Mediterranean service, and Pacific Service…

All over the world we were. We would go out in convoy, usually from Gourock, Scotland or Liverpool, they were the two big exits for all the convoys. So you’d go out in convoy and on our ship we might have three thousand troops. Now their own doctors would do the medicals but we had a sick bay with beds. I’d be the Warrant Officer. We had a Dispenser and a Clerk and ten orderlies, and I was in charge of that, so I would perhaps be the ward Sister, if you like. When we were empty, we had to come back on our own, or we’d bring back families or a few sick, not many because we weren’t a hospital ship.

Where was your first troop ship journey?

I left Gourock 25th May 1941 on the “Llangibby Castle” carrying troops down to Capetown then up to the Middle East.

All these troop ships, Stefan, used to go up north to Iceland then over to Greenland, then right down that side of the Atlantic, and then we came across. The first stop was always Freetown in Sierra Leone, then down to Cape Town.

What the South Africans did for us during the war, they don’t get any credit for, just think of twenty troop ships coming in, all full of troops, been at sea for weeks, all wanting to get boozed up and in the brothels and all this sort of thing, and they treated us wonderfully, wonderfully well. You’d think they’d all come back needing treatment for venereal disease but they didn’t. I always remember South African brandy being very strong. I used to call it “Sneaky Joe” – it would creep up on you, hit you on the head and down you’d go.

Any adventures there?

Nothing special – I did catch a shark with a piece of meat on a hook once.

So then up the other side of Africa and the Red Sea and dropped the troops, the Desert Rats, off in Egypt for the eastern campaign. And then we came back empty and picked up another lot to go somewhere else. It wasn’t until after we got into Italy that we could come through the Med.

Once we went into Malaysia with a whole lot of RAF. The ship’s Captain said, I’m going to get out of here as quick as I can, and within a few days we heard that the Japs were there and those poor chaps were taken almost immediately into Japanese prison camps. All those people that we took out must have been captured straightaway.

We weren’t at sea being attacked all the time. People think that during wars soldiers were always being in combat. Much greater part of the time we enjoyed a Cook’s Tour around the world. We could even go sunbathing on the deck if there was nothing doing. I must not sound facetious. I appreciate that I was lucky. Many colleagues had horrific ordeals and many died. Convoy movements were kept secret and all letters were censored but of course everyone had tricks for letting our folks back home know where we were.

My father and I worked out all the main ports of the world and wrote them down with dozens of different first names – so Cape Town would be Fred, New York would be Charlie. The Censor would study every letter carefully but would stop when it ended “from your loving son Harold”. Father would look up Harold and know where I was. Another pal had a notepad and so did his wife, the same size as a small atlas they had. He would prick a tiny hole over where he was on the map and she would do the same when the letter arrived.

What sort of conditions were you dealing with on the troopships?

What you would expect really. Rather cramped; they slept in hammocks, which they folded in the morning. Strict daily ship inspection kept things in order. We as ship’s staff had reasonable conditions. Cabins small and cramped but alright. These were fit men and had to fight the war, you see, so it was just like general practice, really. The doctor for the battalion would come down and see the patient and then we’d treat them as they were told, so they had to have something three times a day or whatever and we’d be there to give them the treatment. That was really general practice. Coming back occasionally we might have, a couple of maternity cases but they were sent home with a midwife as well. We had perhaps twenty beds in the sickbay.

Once we’d got into Italy then the Mediterranean was virtually open except for air. The only time I got bombed was in the Mediterranean. Two bombs of some sort dented the ship a bit but no casualties. We limped into Alexandria for repairs, which took a few weeks.

And then we’d be taking troops from North Africa to Italy. And India we went to many times, and Australia and New Zealand and Burma. Brazil, the West Indies, America and Canada too.

What was your shore leave like in these places during the war?

Quite good. If you were off duty you could go ashore like tourists so we saw a bit of the main ports. I went up Table Mountain. Like any man we’d go out for a drink and to look for the girls. I don’t recall that we had much luck.

So when I was demobbed I had six medals, no special distinction but I’m quite proud of my six medals, that was the ’39-’45, the Atlantic Star, the Pacific Star, Italy Star, Victory Medal, and Territorial Efficiency Medal.

How did you get back into education after the war?

I wrote off for a FETS form (that is, Further Education and Training Scheme) and filled it in! After the war the government were very generous to returning soldiers and they gave us FETS awards which paid our education fees. The government was so generous to us when we came out of the war.

Did you feel this was a big social change – having ex-servicemen becoming doctors, who couldn’t have afforded it otherwise?

Yes. These were mature men, worldly wise, who had lived uncomfortable war years and were prepared to study. They were not young adolescents. They had developed a caring attitude, having served in the services.

How many women doctors were there in your year at Med school?

Quite a few by 1950 – I would guess 1/4 of the year. Well, I started making plans to begin my medical studies at Bristol University. Even as a youngster I had hoped one day to take up medicine but that was all stopped for the war. So Bristol University, because I’m a Cornishman and Bristol University was the only university for the Southwest.

But then I ran into trouble: I caught pulmonary tuberculosis. This was well before any sort of chemotherapy was on the market and there was no treatment for it. People were sent to a sanatorium, where the treatment was very tedious but not very onerous; you had to stay in bed in the open all the time and eat the best food you could get, so not bad really.

Where was that?

That was in Tehidy Sanatorium in Cornwall. They tried phrenic crushes, and artificial pneumothorax, both unsuccessful, but after two years I had recovered. So that was two years out of my life. So off to medical school. That was 1948.

Bad luck, I only lasted one term and the TB flared up again, so back to the sanatorium for another two years.

What was it like being nursed in the open air? What was your TB Treatment like?

There was no chemotherapy in those days. The only treatment was strict rest, open air, and good food. Wealthy people went to Switzerland. I don’t remember many of the other patients - certainly some of them would have died.

What sort of social life did you get up to as a young man in a TB ward?

There wasn’t much social life because we were supposed to rest. Radio was wonderful (no TV) I tried to keep my brain going by reading Shakespeare and Ibsen. During the 4 years I wrote two novels. They weren’t just dreadful, they were terribly awful! The publisher threw them out without even a polite comment. I tried a bit of script writing and Charlie Chester bought one or two of my scripts. (examples of Ivor’s jokes will be encountered later in the text)

I also composed all the crosswords for the Nursing Times for a year or so and some quizzes and got paid for those.

What were the nurses like?

Very nice and we did a bit of flirting – they didn’t believe we were infectious!

So I’d lost a total of four years in sickness, really. And this time I had a thoracoplasty at Frenchay Hospital with partial removal of six ribs and this time I was cured.

Who was your surgeon?

Mr Price. It was in the days when Belsey was there but I had Mr. Price. So you could say by this time I’d really lost ten years of life; six years in the army and four years in illness, so you see why I always say I was a late starter. So back to the university again, in 1950, and here again I’d been very fortunate because the university were very kind and generous to me. They could have thought I was a poor risk but they took me on.

What was the social life of students like then? Were you in digs?

Social life was different from nowadays, standards of acceptable behaviour were much more austere, we didn’t have TV to drag it down. Most students lived in Halls of Residence for a year or two and then went out to live in flats. As students we had the usual dances, jazz and jitterbugging (no rock in those days) and we had outings and flirting but there was not so much promiscuity. Most people tried a bit of illicit sex but often unsuccessfully (there were successes too). There was no sex education; students picked it up chatting secretly with others. “Condom” would not have been a commonly used word. We might talk surreptitiously about French letters – I understand the French, in a nice twist of words call them capote Anglaise. There was no contraceptive pill, no abortion laws so both men and women realised the risk of pregnancy and the SHAME of it in those days.

Food was rationed then – what did students eat?

Rationing was beginning to disappear, still plenty of queues for things and the usual quips. “Hey you, go to the end of the queue.” “I’ve been there and there’s somebody there already.”

How much did they smoke/drink? Did the ex-servicemen like yourself mix in with, or were you separate from, the younger students?

A large proportion of us smoked and drank, especially the doctors - most of whom did both. In the university generally soldiers and young students seemed to get on very well with each other. We pulled their legs occasionally. I recall once a veteran ex-serviceman said to a group that they were “going to the Union bar to partake of a drink.” “What will you drink?” said a youngster with a wink. With a wink to the others the vet said, “We’re going to take umbrage.” “Oh, can I take some?” said the student. “Yes, come along.” So one veteran went ahead and warned the barman to give him a glass of “umbrage”.

Did you play any sport at University?

I was not much for sport because of my medical history but one medic radiologist, Dr. D. Mahy, won the university high jump cup six years in succession. Nobody could beat that because most students stay only three years. Dr John Martyrossian was an excellent tennis player but there were not many good at sport in my year.

What was the student union like in those days?

The Students’ Union was a very active place but few medics were interested in it, some medics would not even know the name of the president. Those medics who did use it, and I was one of them, enjoyed it. I was interested in dramatics, music and burlesque.

So I took my first MB then, I was aged thirty, then I went on and at the end, a little set-back - I failed finals first time, and so I had to take it again in six months.

Was that due to illness or were you too busy with other activities?

I blamed other activities; dramatics, burlesque, outings, hospital pantomimes for failing.

What was Finals like in those days?

My finals consisted of the usual written papers, practical exams, and viva voce with external examiners. One student had failed several times. The external examiner said, “Haven’t I seen your face somewhere before?” “Yes, sir, here last time.” “Sorry about that, but don’t worry, I won’t ask the same questions. What was the first question I asked you last time?” “You asked, haven’t I seen your face somewhere before?”

Who were your consultants – any memorable ones?

We were taught by wonderful consultants and university teachers who weren’t counting the hours they worked. They carried on until the job was done, until their out-patients were finished, devoted people with vast personal experience who weren’t obsessed with evidence-based medicine, they relied on their apprenticeship, and clinical judgement. Especially they had compassion and weren’t looking over their shoulder for a lawyer as they have to nowadays.

I like to think their inspiration rubbed off onto us as students, we looked up to them and revered them. It wouldn’t be fair to mention names because we students were divided up into groups, or firms, and allocated to particular consultants, so there would be excellent chiefs in other groups but I wouldn’t have come across them much, but for me I recall Professor Cecil Powell teaching us physics, an amazing man. Internationally well-known, Nobel Prize winner, I would sit listening to his lectures and feel I was in the presence of greatness. Such precision and such modesty.

Another, Prof. Yoffey in anatomy also modest and kindly. Mr Bill Capper, a brilliant surgeon, dynamic, resolute and forceful, what he said you remembered. Another was Professor Victor Neale, flamboyant and entertaining in paediatrics. As students we had plenty of ward rounds, the post-mortem examinations were at noon most days. We had our own patients to report on and in addition the ward sisters would nearly always let us examine patients. Everything seemed very friendly and easy to me. I had the best of the NHS. We liked stories about our consultants. “Neighbour to surgeon: what do you operate on that man for?” “Five hundred pounds.” “No, I mean what did you discover he had?” “I told you, five hundred pounds.”

What was the life of a medical student like when you were walking the wards in those days?

I qualified then in 1957 as MB, ChB. Now at that time, you could take the conjoint board in London, MRCS, LRCP. If you failed your medical finals the first time, people would take – belt and braces – their university degree again and also go to Conjoint and take that, so in the end I ended up with MB, ChB. and MRCS, LRCP.

So at last I was a doctor, aged thirty-six, hooray! At that stage I suppose my life was different from most people’s, but hooray I had a job for life, and I’ll come back to that point later: a job for life, just note that for a moment.

Now in those days, the sort of people who went into medicine in the forties and fifties, they weren’t necessarily high-fliers or top academics; they were people who felt they had a sort of calling in life. Often they were caring people, perhaps from medical families, or they were good rugby players and wanted to play for the big hospitals like St. Mary’s or St. Mark’s. Some were religious people who later went off as medical missionaries.

And in those days in university, the students who were the high-fliers, all the people with all the As, went into the sciences, they ended up with a First in Chemistry, Nuclear Physics, Science, they didn’t go into medicine in those days.

But soon these people discovered that ordinary chaps like Doney had a job for life, whilst if you had a First in Chemistry or Nuclear Physics you had to find a job, and you had to work out the prospects, join in a competitive industry, so they began to say, hey, why don’t we go into medicine where we’ll have a job for life. So the profession began to collect high-fliers who looked at patients from a more of a scientific point of view, perhaps – I don’t know – perhaps with less compassion?

This is all my interpretation, you understand. It seems to me that these new scientific doctors decided they didn’t want to do long hours, they wanted to use their time more economically, and perhaps that’s very commendable. On the good side we have to admit that the advances in the scientific side of medicine are immense, aren’t they?

Change then began to penetrate the other professions, nurses for instance. They’re no longer nurses as nurses used to be: they’re lovely people but they don’t prop up pillows any more, or ask you if Mrs Jones had a comfortable night when they come on to work in the morning, they want to know what Mrs Jones’s blood test shows and what was on the X-ray and all that sort of thing.

You feel that the caring side of nursing as well as of medicine is under threat by today’s technological developments?

Certainly nurses want to take over work that used to be done by doctors and don’t want to plump up pillows any more.

Now, on the good side they took up a lot of work off the doctors, for instance venupuncture. Now you might say, well that helps everybody, takes the work off the doctor, helps the patient, but it involves bureaucracy. Now take the doctor taking this blood sample, I used to take that in a few seconds while I was still interviewing, I’m sure you did as well, a doctor would just take the blood as he was going on with the interview, but under the new system he has to send the patient down the corridor with a note, he has to write the note, the patient has to queue up to see the nurse, the nurse has to take the patient’s name and it all takes several minutes and not seconds. So you see, I feel there are pros and cons in the new system.

Now this is a personal thing, I’m only giving you my personal view – I think the appointment system has caused the most conflict between patients and the GPs, requiring sometimes austere people disciplining patients instead of compromising. Furthermore, an appointment system is expensive; it costs one-and-a-half receptionists simply to answer the phone, make and alter appointments, perhaps upsetting people doing it. Sometimes the voice on the phone upsets people, who then say it’s the National Health that’s going wrong.

Luckily in my practice they still do not have an appointment system, you just turn up. Yes, sometimes but not always people might have to wait a while, well so they do with an appointment system; people are often told “The doctor is running late, can you come back on Monday?”

So to get back to me, now, a doctor at last. For me, the NHS was perfect in those days. I didn’t mind long hours, I needed that to get experience and efficiency. I did two house jobs in Southmead Hospital and was on all the time, so was everybody; if you were a houseman in those days and the chief rang up he expected you to be there. And I enjoyed the doctors’ mess. You know, if some houseman in the mess would say I’ve just admitted something interesting, a lump for instance, well we would all be up there to go and see it as well. Nobody ever thought that was unusual, everybody did that.

What was your pay?

I can’t remember but it seems adequate and of course we lived in hospital accommodation. I don’t know what it’s like today but it was always fair and adequate, we didn’t expect luxuries.

What was the nursing hierarchy like?

Matron was the power house. Nursing and healthcare have suffered from her demise. She would settle problems on the spot whereas bureaucrats need a formal complaint and a committee to settle them.

Well, then I got an obstetrics job because in those days everybody wanted to get DRCOG and DCH as fitting credentials if you ever went into practice, most people would like to say I’m going to take up general practice so I want my DRCOG and DCH. I personally never got on very well with obstetrics, but I got my DRCOG, and I got more interested in neonates, and I had a good teacher, Dr Beryl Corner. Dr.Beryl Corner qualified in 1934 and is still very active in medical events and music. One thing I always remember, she taught her housemen how to get blood from the baby from the posterior fossa, now you might think that’s horrible but it’s very simple and on the other hand it is sometimes very difficult to get blood from a baby’s arm, it’s very simple from the posterior fossa, and I always remember that about Dr. Beryl.

So then in order to get my DCH I went up north to be an SHO in paediatrics. I had offers of four jobs around the country, and Mr Sam Loxton said to me, Ivor, if you want experience in paediatrics take the job up north, you’ll find some pathology there, and how right he was. The amount of pathology up there, in the north, seemed to me enormous. There were cases that I’d only read about in textbooks. For instance, babies born with atresia or obstruction of the bile duct: now I’d always read they’d die in a few months, but in Salford I had three children going for check-ups in out-patients under the age of ten - going to school, mind – they were permanently jaundiced but they were surviving.

Any other examples of pathology? What were the main conditions children came into hospital with?

Infections, otitis, appendicectomy, also surgical volvulus, stenosis, sub-acute endocarditis and rheumatic fever.

What did children die of in those days?

I recall TB was dangerous and often fatal. Children in plaster jackets for spinal TB, also polio. Ham Green had children in iron lungs for polio. Overseas malaria and smallpox were scourges.

So that was the sort of pathology I found up there compared with down south.

How were the early antibiotics used?

I gave my first penicillin injection from a ship’s sickbay in 1943 but they were available before that. Previously we had been doing quite well with sulphonamides, e.g. M and B 693.

What would you say to a parent nowadays who refuses immunisations?

They are lucky to be living in such a disease-free world because mass inoculations have removed many scourges. Yes the risks of immunisation are there but they are infinitesimal and too highly publicised

Well then I thought I would try to be a paediatrician, so I got my DCH and then I got a job as a registrar in paediatrics in Kingston General Hospital – that’s Kingston-on-Thames. While I was there the Oxford-Cambridge boat race was on, so I was able to see the start from Putney – something I had always wanted to see.

I was now a registrar, and I enjoyed the new challenge of responsibility. You see when you get to that stage you have to make decisions, you’re not told what to do, so this was something new, and of course the consultant’s still in charge but as a registrar you have to try and impress him because you’re trying for promotion you see.

Now all this time my social life was getting a bit neglected. I was forty, but the war had made everybody late with things, everybody was late in those days, and I had a nice girlfriend, Tania Betchers. She was a dental surgeon with a good practice here in Bristol. She came from Russia originally so she’d had her delays as well. Her family escaped from the Bolsheviks in 1919 and they came to the UK and later went back to Latvia, and she was educated in Latvia, she qualified in Danzig, then Stalin in 1940 took over Latvia so they all had to flee again. After the war she ended up as a displaced person, then came to the UK and had to re-qualify in Bristol. We met in Bristol University. To cut a long story short Tania (short for Tatjana) had already got a well-established practice here and I was probably a bit late going into paediatrics so we decided let’s get married and I became a GP in Bristol. I was aged forty.

An anecdote: it was a wonderfully happy marriage of two mature people marred only by the lost of our only son Christopher in infancy. Tania (short for Tatjana) was a great help and encouragement to me in my work. She was a very good dentist with special interest in people’s dental appearance. I recall we once went to a posh medical meeting in the prestigious Guildhall in London. The queen passed majestically close to us and I whispered to Tania, “Gosh, did you see those beautiful rubies and diamonds in her tiara?” Tania, “Yes, and did you see she has a little gold inlay on upper four?” Tania died twelve years ago.

I joined up in general practice with Dr Ellis-Jones in Bristol and we got on very well together, neither of us was afraid of work.

What was the attitude of the FHSA /FPC towards managing patient care in those days? Did they leave it up to the doctor?

Yes, we were largely free and autonomous. There were no concerns about targets in those days. The only check I can recall is that a doctor would come about once a year and try to keep our prescribing costs down. Apart from that so long as you worked reasonably there was no check.

How was poor performance recognised and dealt with?

I suppose there may have been some poor doctors but even today with so many rules and targets it doesn’t prevent the occasional bad apple.

What about outside work?

If we saw any part-time jobs offered, for instance, outside our normal NHS practice, we went for them. You see, as a general principle, Stefan, we felt that general practice meant not only treating sick people but also giving general medical assistance to the community. For instance, I got the post of Factory Doctor Bristol North.

Now in those days there were all over the country government-appointed factory doctors. Employers had to get a doctor to examine all young employees to see that the factories these children were coming into were not ill-advisable for them, so they had to be examined.

These were Government appointments. I got the job of Factory Doctor for Bristol North. These weren’t daily jobs, just occasional hours during the week. A factory manager would ring up and say, “Doctor, we’ve got three apprentices coming in on Thursday at two o’clock”, so we would arrange to do that.

Edward, my partner, was interested in rheumatology, so he became a clinical assistant to Dr. Kersley in rheumatology, he actually got the Charles Hastings Prize for nephritis in children and rheumatology.

Then he got a job as medical advisor for the National Westminster Bank, and he also did British Petroleum, so between us, in the coming years, we took on this occupational medicine.

In the end we were six in partnership and we all got on exceptionally well together.

The next one we took on was Remploy, now that’s occupational medicine you see. Remploy was a big firm that employed only disabled people and of course you had to be sure that they could be employed, but if you were disabled, with one arm, and you could do a job with the other arm, you would do the full week’s work, and they loved it, they could do it, and great sympathy was given to them. Remploy had a doctor, that was one I got, then I was also Industrial Medical Officer to Dickinson Robinson down here, the great big firm, Cavenham Confectionary, that’s a sweet firm, the BBC in Whiteladies Road, Colladense, a big firm dealing in cellophane, and of course Edward was with the National Westminster Bank.

Now in the afternoon we did the usual insurance exams, we’d be there at the surgery, and so we just sort of kept working through the day. Edward had several private patients as well; he would see a few of them in the afternoons. Then I took on police surgeon work with the Avon and Somerset Constabulary in about 1973.

So you weren’t afraid to put in the hours. How many hours a week did you generally work? What time did you get home?

Our surgery hours were eight to ten-thirty and four to six-thirty. We did our industrial other work in the other hours. I took Wednesday as a half day and we only had one partner in for Saturday morning surgery. I think I took about four weeks holiday a year. We never, ever employed a locum. When our practice was four or five partners we never needed locums. In the end we were six in partnership and we all got on exceptionally well together.

What were the pressures on GPs in those days – pre the 1966 New Contract?

Very unimportant. It was left to us to get on with the job. Yes, we were freer then than now.

Did you vote for resignation in the BMA ballot in 65-66?What was General Practice like at that stage when so many GPs were quitting/going abroad or back to hospital posts?

I think I abstained. I was satisfied, just proud to be a doctor. I was utterly astonished when the government decided I was worth thirty percent more.

Were you aware of a Brain Drain among doctors in the early 60s?

I heard of it but I was not aware of it. I would not have gone. The grass always seems greener elsewhere.

Did you take a half-day or day off from all this?

Yes, Wednesday half-day, and only one partner Saturday mornings.

How much holiday did you take per year? Was it difficult to get good locums?

We took about 4 weeks holiday, we never employed a locum.

You did your own night work until you retired?

I did my own night work until I retired. It always seemed relatively benign,

When there were only two of us we worked every other night. We didn’t have to get out of bed often in the night in our own practice. In contrast, a deputising service gets plenty of night calls.

We too would get calls but because we knew our patients and they knew us we could settle many things over the phone. We never went ex-directory. Just being on call doesn’t mean that you’re working all the time. When we expanded to four or five partners you were only on call once in four or five days.

How often did you have to get out of bed for a call?

When on duty I would get out of bed about once or twice a night, sometimes not at all.

What do you think of the new European Working Hours Directive?

This means that junior doctors cannot legally work long hours and has had a big effect on hospital teamwork. Consultants have difficulty in meeting their firms now because the juniors are not allowed to stay on after working overnight.

I find it quite astonishing. Plenty of other people work long and arduous hours and think nothing of it. What about their wives with three children getting up at seven a.m. and working till night? They’re not allowed to go off sick or feel tired, they have to use their brains too. What about vets and farmers with sick animals in all weathers? What about musicians, their brains have to memorise a lifetime of work. Entertainers, people engaged in catering, even the humble newsagent who gets up at four a.m. and after he shuts up shop he has his book work to do, VAT and re-stocking. He has plenty of tensions and worries too and he still has to look cheerful to keep his customers. This directive does not say much for medicine as a vocation, i.e. a caring, compassionate profession. Doctors should be careful not to exaggerate their importance.

How did you start to be interested in Homoeopathy?

We were living in Cotham at that time, we had a surgery there – I discovered that if you were qualified in homeopathic medicine you could get GP beds in the Bristol Homeopathic Hospital, next door. Wonderful, to have your own beds, you see. So I studied for the homeopathic exam and went up to London, you had to do that for two or three years, and I qualified with an MFHom, that’s Member of the Faculty of Homeopathic Medicine, and then when the doctor’s job came up I applied for it, so we now had also ten beds to ourselves.

You had the ten beds in the Homeopathic Hospital. How did you use them? What conditions did you put in them?

Ah, well, people who wanted homeopathic treatment for one thing. They’d been to see every specialist in the country and they’d come then for homeopathic treatment. And, you see, I got interested in homeopathic medicine as well and however sceptical you are I must say it seems to work in many cases. Everybody says, oh well they were in remission then, they were going to get better anyway, well perhaps that’s so but they did well. A sceptic might say the same about penicillin.

Not everybody realises homeopathic medicine is part of the National Health Service which was incorporated in the Act in 1948. You can write an NHS prescription for a homeopathic medicine.

What other sorts of cases were you taking in the Homeopathic Hospital?

You’d take in anything, you see. Suppose we had somebody who we thought we can’t get them in, you know, you ring for a bed and you can’t get them in, I thought right, I’ll take them in my beds for a couple of days if that’s the way, and sometimes they would stay longer. You had to be careful what you were taking in because you were on call for them all the time you see, so you would only take in cases that you knew you could deal with, nothing that was going to be a great emergency. Very often homoeopathic medicine would help them.

For instance, the sort of case I found beds were most useful for: people with leg ulcers, you put on all the creams you can think of and they take ages, the only real treatment is to put your leg up. I said, “Look, if you come into hospital for a month we’ll close that up for you” and they did, just kept them with one leg up, you had to give them some exercises and within weeks these ulcers cleared up. You know what a nuisance leg ulcers are in general practice. So homeopathic beds were very useful.

I would take in cases such as disc lesions needing rest and physio, also obesity and dietary problems needing supervision, chronic chest problems needing rest and physiotherapy. Also puzzle cases not getting better at home. I could take them in, do some tests and try to make a diagnosis. I could always call in the consultant if I got into trouble.

What’s your impression of the best sort of conditions for homeopathy?

For me I’d be best with eczema and asthma in children. We used to get several sent over from South Wales and it was surprising how well they did, the doctor would say “We’ve tried everything, they want homeopathic, don’t mind if you try”, and the next thing I’d see an improvement.

Homoeopathy, Industrial Medicine, Occupational Medicine; how did you acquire these extra skills?

Going on study courses and getting diplomas. All diplomas have strict criteria of study and curricula.

The question did come to me: was I really qualified to do all these things? So I decided to get diplomas in all the subjects. I already had DCH and DRCOG, both very useful for general practice. I got the DIH, a diploma in industrial health, I took two of those just to have belt and braces again, one was a DIH conjoint and the other DIH, the Society of Apothecaries, the same as the old LMSAA.

MFHom, occupational medicine, I already told you about getting the MF Homeopathic, DMJ and so on. MRCGP – I took that one later, actually, I was fifty-seven when I took the MRCGP in 1977.

So I ended up with multiple diplomatosis. I was fifty-two when I was taking the latest exams, so again a late starter, and 1957 the MRCGP. Now it might be immodest of me to say so, but I have never met anybody with more qualifications than I have. I’m only talking about diploma numbers, you know, mere diplomas, I’m not talking about higher degrees, but I haven’t seen anybody with as many as those.

What year did you take your MRCGP?

1977

Can you remember what they asked you in your MRCGP Viva?

A vast range of clinical and administrative subjects. Causes of fibrillation, causes of macrocytic anaemia, Crohn’s, side effects of steroids, breech delivery and autism.

How did you find the RCGP philosophy of general practice? (physical-psychological-social)

Fair enough, it is holistic which fits in with the principle of homeopathic medicine, which is essentially holistic. I can only remember Professor Pereira Grey in the College. I can’t remember Balint.

Were you a quick or slow consulter?

A medium speed consulter - I didn’t waste any time.

What was your average consultation time and typical number of patients seen per surgery/per day?

I tried not to rush anybody; I used to see twenty to twenty-five people every morning and every evening.

What qualities make a good GP?

I don’t know if I meet the criteria myself, but I would say a friendly, welcoming personality. Fine feathers make fine birds – a smart appearance. Patients often dress up to go and see the doctor. If a doctor looks untidy, patients may feel he is also untidy in his work. He must be knowledgeable and keep up-to-date. He should compare himself and discuss with his peers by attending clinical meetings and conferences.

What role did you play?

Definitely someone they could turn to for advice, professional or social. They didn’t want to be ordered what to do. I hope I was never dictatorial.

How do you see GP morale?

I have been retired from the NHS for 24 years so I can’t talk about recent years but I date most of the frustration from the introduction of the appointments systems in General Practice. Doctors make themselves inaccessible to patients and everybody became frustrated.

Were there enough GPs to go round?

I never noticed a shortage of doctors – that is why we could take on all the extra work. I think there are still enough, but they won’t work the hours. Being on-call doesn’t always mean work – they could do it.

Who inspired you?

I have mentioned some of my teachers already. Immense love and support from father and mother. Apart from that, my brother-in-law, Ivor Truscott, a teacher and a Bristol Chemistry graduate, encouraged me towards the end of war after he knew of my interest.

Do you recall many heart-sink patients?

I don’t really know what a heart-sink patient is. If you mean the person who was always on the doorstep, I was terrified I might be missing something and just kept referring them for second opinions. I was too scared to treat them as time-wasters.

What was your consulting style? Do you think the public preferred a paternalistic approach in those days?

Certainly welcoming and more advisory rather than authoritative or paternalistic. People do not like to be ordered what to do and do not want the doctor to get angry just because they decide not to comply. The doctor should then advise something else. The word ‘doctor’ means teacher, not dictator.

How did you handle stress?

It required determination. Life is full of stress – a baby learning to walk, a student studying for examinations, love affairs, soldiering, just living is stressful.

How do you deal with it?

Grit your teeth and get on with it. Don’t moan about it.

What did you make of the Bristol heart inquiry?

I felt very sorry for all the medical staff put at the mercy of searching media sensation. To think that top surgeons who had to work on such difficult cases were struck off and told they were not fit to be doctors seems to me incredible. No one ever mentioned all the good they had done in their lives. Regarding retained organs and tissue, this has been normal practice for centuries, but I can see the relatives’ point of view that we needed permission. I suppose nobody thought of it.

Were there many doctors in the Masons?

Yes, many doctors are Masons. I am surprised how many. Young doctors not so many. I always eschewed it, but I don’t know why, and I never tried to find out anything seriously about them.

Important afterthought – I was speaking to a medic recently who said that, about that time also, careers officers in schools started saying to students that they were going to get good A levels and so should think about going to medical school. The students had never even considered medicine and certainly had no calling to join a caring profession.

When did your diplomas come in useful?

It was very interesting. For example, when I took on one of the firms, and I won’t say which it was, they were having trouble with isocyanates giving people asthma, and the unions were up in arms, so the firm wanted a medical officer, and appointed me. But then the unions said, who’s this chap, we don’t want just a general practitioner coming up here, what does he know about factory medicine? And luckily the manager was able to say, well, he’s got two diplomas in industrial medicine and he is factory doctor for Bristol North. Will that do? And they all quietened down. The unions were satisfied with that and I got on well with both sides.

Did you take an interest in medical politics/LMC etc?

No, but I was very interested in medical associations, the BMA etc.

What were social conditions (e.g. slums, poor housing, overcrowding, employment,) for the patients like when you started in practice?

Post-war reconstruction of the NHS began soon after the war so I came on the scene when progress was well on the way with poor social conditions.

How did you deal with the financial side of general practice?

Now, we had to have an accountant in our practice. When I joined as a partner the accountant said, now Ivor, you doctors can’t make use of tax concessions that other small businesses have. What have you got? One stethoscope lasts you thirty years, so enjoy the biggest car you can afford on which you’ll get some tax relief. Get the biggest house you can afford and you’ll get tax relief on mortgages.

Choose where you want to go for your holiday. Now let us say you and Tanya say, let’s go to Rio de Janeiro. Now, you are both professional people, study all your medical and dental journals; if there are any international conferences there, you’ll get relief on that. Perfectly allowable, because it’s all post-graduate education. So we were great conference goers! We went to many, many countries over the years and over the world on conferences.

How did you manage the income from all this extra work?

We shared all the income, and that was the secret of it, Stefan, you see, we said yes one chap might be doing more work than the other but we decided not to think about it and we just shared all the money that came in.

Now I said we had a good accountant; he got at me one day and said, now Ivor, all this private work you are doing, factory work, police surgeon work, homeopathic medicine, they are all outside of the National Health and you are paying a lot of income tax on those earnings.

He said: I want you to treat all this lot as a separate business from your NHS and you must take out an annuity pension every year preparing for retirement as if that was your job. Now this year, you must put away so much. I said, what nonsense, don’t be ridiculous! I’m going to spend that cash. No, you’re going to put it away, and next year it will be more. I was aghast, you see, but how right he was! Nowadays I keep getting letters with pension cheques and I think where’s all this money coming from? But he was quite right to put all that separately. However, I suppose money wasn’t everything. If you want to know what God thinks of money just look at the sort of people he has given it to.

Now I eventually retired from the National Health early, at sixty, but carried on with all the private work and police surgeon work for another ten years. My greatest interest was in forensic medicine and police surgeon work. Tanya and I lost our only son in infancy and Tanya died twelve years ago.

So, Stefan, how do I see medicine now? Would you like a bit about that? I may be wrong, I can only just assess things as I see them. It seems to me that doctors’ attitudes have changed. Now not all, plenty of good, but a little bit of not so good as well. But the world has changed too.

You see, we were taught by compassionate teachers, consultants, professors – critics say that perhaps they didn’t teach evidence-based medicine so they must have been wrong, but they were people of vast experience with immense ability and skill and devoted people. They didn’t have to look over their shoulders to see if there was a lawyer there, they weren’t worried about the hours they worked, they got on with it until the job was done, out-patients went on until everybody had been seen.

Now all that has changed, perhaps for the better, but I feel that medicine has lost its compassion a bit. I was talking to a lady GP the other day, she said, oh no the compassion is still there, so perhaps I’ve got it wrong, but patients no longer seem to look upon medicine as being so much a noble, revered and caring profession, it’s more now part of the world of science. And that must be good because we see the amazing advances there have been. But not so good for an old-fashioned doctor like me.

How would you feel about being paid as a GP by results – e.g. by your patients’ cholesterol levels, BPs, and diabetic levels? (These are part of our new contract)

I can see the sense provided it gets results but it would be nice if they could be paid on patient satisfaction.

The public have different expectations of us now.

I think that is the doctors’ fault because they have not made themselves accessible. They say, oh no I’ll finish at five o’clock. I’ll come back to that. It’s now part of the world of science. And perhaps that’s how it should be; it’s certainly produced fantastic and amazing successes. Now I don’t think that that has changed, as you were suggesting, because of public demand. I feel we doctors have demanded more rigid rules of accessibility and less of the giving of time and patience.

Patients have got demanding because they can no longer just walk in and see the doctor as they used to in the old days, and so they have got aggravated, and they can’t argue with the doctor they have to argue with the receptionist. It’s not that we haven’t enough doctors, in my opinion; they don’t seem to want to give their time to the profession. That reduces the number available to see the patients, because they want their time off.

I know they have an enormous amount of computer work, which we didn’t have to do, and I may be wrong, but if they care so much for their patients they don’t always show it, you see. I hear, for instance, of a group of six doctors but they use a deputising service at night. Now if they care for their own patients, can’t they even be called on one night in six? If I was on duty and it was Edward’s patient they’d say “Oh, Dr. Ellis-Jones saw me yesterday” and I’d say, “Oh I know what he does, did he do…?”. So they felt they were still with the practice, you see. We lived in a different world, I suppose.

Doctors’ health has been a source of concern with our excess levels of depression, suicide, and addictions to alcohol and drugs. Were you aware of any such problems among colleagues?

Yes, a few but very few. There were plenty of other professions where people are under stress and break down; this is not peculiar to doctors.

Do you think long hours could be anything to do with those problems – which also affect our families - or do you see other causes?

I don’t understand what I call the new nine-to-five doctor who is inaccessible at other times, and you can’t phone him up and I blame the appointment system every time for causing patients disillusionment. As a result of this we have exposed ourselves to litigation, if we want our rights then patients say they want their rights. We can’t complain, but I feel there’s no going back.

What changes have you seen in society as far as patients go?

Everybody’s much more affluent, much more worldly-wise, better educated. We live in a wonderful world.

Nowadays it seems to me patients get frustrated and just turn up at hospital casualty departments with minor problems. Ken Dodd says “Aren’t the hospitals crowded these days? You can’t get a corridor to yourself.”

You had some pretty busy nights, I guess, with the police work?

Yes, but the police were a great people to work for. The public has no idea what the police have to put up with, violence, cheek and blasphemy.

People used to say to me, how can you be a police surgeon and a general practitioner? That was easy because all the police work starts after midnight. We seemed to cope. You can make it sound awful if you wanted, but don’t forget we were getting paid for it.

Tell us a bit about the work as a police surgeon. How often were you on call at the police station?

Well there were about four or five of us so then again it was only one in four or five, what’s that? It’s not much. What does a police surgeon do? The first thing a police surgeon does is examine people who are taken ill in custody. You see there’s somebody in the cell and he’s ill so you’re called, or they want to know is he mentally ill, in which case he shouldn’t be in custody, he should be in hospital, so you have to decide that. You’d see cuts and bruises and any sort of injuries, you might ask to give opinions on things medical. In other words, people ill or needing treatment in the cell would be the top priority. We also used to get called for other things such as breathalysers, taking blood for that, now it’s done by a breath test. Then you’d be called for all sexual assaults, that is rape, buggery, or any sexual assault. We’d be called for child abuse if that came up, domestic violence we were called for. Found dead we were always called for, murders and so on. Reporting on prisoners under the influence of drugs or alcohol took up a lot of time.

If anybody was found dead we would be called to certify death, anywhere in the town. If the GP hadn’t seen them recently then we’d be called, only to certify death, you see. Now if we thought, this is serious, it could be murder, well then, if you’re a police surgeon you have to realise what your limits are and call in the specialists.

For instance if the Police say, will you look at this chap’s teeth, doctor, and see how old do you think he is, he says he’s only thirteen and we reckon he’s twenty, I would look for a third molar but I might have to say, you should get a forensic opinion.

Any serious crimes/ murder cases you dealt with come to mind?

I was called to a six year old who was stabbed thirty six times by her father because she resembled her mother. I was once called to a man found dead. He was a transsexual who had injected his own breasts with paraffin wax hoping to be able to mould their shape, though he didn’t die of that. I was once called to an elderly husband and wife found dead sitting together in the back of their little car, with a blanket over their legs and a flask of coffee and a hosepipe from the exhaust, they had decided to die together.

Were there many women police surgeons in those days?

We have some very clever and dedicated ladies at national level for sexual cases but not many doing the more ordinary cases.

There was a great movement to take on lady police surgeons and some joined for a year or two. Now women doctors don’t want this work because they’re up at night. There are now plenty of ladies who are police surgeons but some of them only do the rape cases.

The difficult situation I always think about involving police surgeons is the patient in the cell who’s intoxicated and may have had a head injury.

The amount of instruction and lectures that we get on that, that would be the first thing we’d think of, any head injury you’ve got to make up your mind pretty quick because if you miss it then that’s serious. The amount of training you get for police surgeon is pretty good actually. We go to association meetings and there are always lectures on it and we’re always telling everybody we’ve got to do this the right way. I think police surgeon work was fascinating and well taught.

In recent years it’s been dealing with addicts in the cells, and a couple of police surgeons have come to grief with that.

When you think of the number of people that police surgeons have to see for drug addiction, they don’t miss too many, and there are all sorts of things, for instance, you can get a sample of urine and you can tell from that, you’ve got the various tests there that will tell you what he’s had, so you’d know, but you’re absolutely right, drug addiction is a difficult one. I’ve always felt police surgeons’ work is good medicine because don’t forget that after you’ve done your examination, written your report, it will go straight to the defendant’s lawyer and he will search it critically for flaws. You have to make sure you don’t miss anything.

An elderly lady reported to the police that she’d been accosted by a flasher outside a shop. A nasty shock, said the policeman. No, she said, I pointed my umbrella and said do those things come in adult size?

Because of Tanya you had an interest in Forensic Odontology. What sorts of cases come to mind?

Forensic odontologists are required in identification of dead bodies using ante-mortem and post-mortem dental charts for comparisons. Bite mark identification in cases of assault. And assessing the age of young people where age is in dispute. One interesting case, a headless body was found in Soho, next week a head was found in Sussex. The odontologist was able to identify from various gold crowns. As an added feature the odontologist decides to get the gold analysed to show it was the same material as the original. The result came back, not gold! So that meant the local dental mechanic had been fraudulently supplying the dentists in the area with dud gold. A big row followed.

When did you do your last night call?

1980 as a GP and 1991 for the police.

Do you think there are ways in which we’ve gone wrong as a profession?

Now a couple of controversial things. And these are controversial. I’ve headed it ‘philosophy’. I’m a bit uneasy about two aspects of present-day policy, (and you’ll be furious with me) which we doctors are promoting. Number one: smoking. Yes, of course it is harmful, but in my opinion doctors have been too dogmatic and dictatorial about it. The word doctor means teacher, not dictator. Now we doctors have set out to stop the world smoking, we’re shouting about it all the time but smoking brought much comfort to many people, peace of mind, and reduction of stress.

People will always want something that promotes tranquillity. Wine was used even in Biblical times, and if we upset nature it has a habit of hitting back. Now my unease at all our dogmatism is that I think doctors may have contributed to pushing people into drugs. We dissuade youngsters introducing themselves to fags, you know, when I was a boy if you went to a dance you took out a packet of cigarettes to offer a girl as a means of introduction. Nowadays they offer each other amphetamines and ecstasy etc. Anyway I’m sure you won’t agree with me, but I think doctors by their dictatorial attitude may just have just contributed to pushing people into drugs. Doctors have always told of the dangers and they always advised people to give up smoking, there’s nothing new about it but we did it in a compassionate way. I am uneasy about our aggressive and hysterical attitude in recent years.

Another point, I often wonder how accurate are the Registrar General’s figures on cause of death. It appears that heart problems are high on the list but if we take for example Shipman’s case, three hundred morphine deaths were recorded with the Registrar General as heart disease. Furthermore as General Practitioners with our own patients we often write heart disease when we’re not absolutely sure.

Next one, sports and exercise. We’re continually getting at people all the time to take up exercise and sport and we doctors are costing the National Health Service millions of pounds in injuries, occasional fatalities, time lost from work, cluttering up casualty, physiotherapy departments, cluttering up the orthopaedics. Now why do I say this? Well, if exercise is so good for you the geriatric world ought to be well-populated with elderly athletes and elderly footballers and elderly boxers who have been exercising themselves all their lives, but they don’t live any longer than anyone else (even with their replaced hips and knees).

Furthermore, all doctors have done insurance examinations, and when the insurance companies are asking for the history of potential candidates’ life insurance they want to know what your mother and your father died of, how much you drink, how much you smoke, what your blood pressure is, but none of them ask “How much exercise do you do?” They don’t think it’s important. They’re concerned with fifty thousand pounds and a body but they don’t think about exercise because they don’t even ask about it, and I don’t know if exercise has any provable effect on weight loss, either, and obesity, because it probably increases appetite. Now there are plenty of arguments I’m sure to prove me wrong, but I just feel a bit uneasy about those two rather dictatorial things that we doctors are doing now.

What cheek to tell a housewife with three kids bending and lifting all day that she should go to keep-fit classes. Similarly, telling some fat factory worker operating heavy machinery all day that he should take more exercise seems to me to be fatuous advice. Advise, yes, but not dictate.

Who among your teachers/consultants/fellow doctors inspired you?

Many of them. Clearly there were many other clever ones that I would not have come in contact with, from humble lecturers to deans. They say old deans never die; they simply lose their faculties.

Are you a big reader? Which journals do you read?

I don’t read books, I don’t read novels and I don’t read for pleasure. I don’t seem to have the time. The BMJ and all the police journals of forensic medicine, every time.

I don’t read everything; I go through and pick out what I want to read. I mean sometimes you go through the whole thing and the only thing that interests you is the picture in Minerva, (in the BMJ) they’re always very good aren’t they?

Best memories of general practice, best things and toughest things?

One of the best things in the NHS I recall was the domiciliary consultant service. I used it often, it was quick and efficient, the patients were very impressed and the consultants liked the money. One unusual one that not many doctors seem to know about, radiologist Dr. Penry had a portable X-ray apparatus even in those days and would do X-rays in the patient’s house. Once he accidentally fused the lights in the whole street.

One anecdote. I was doing maternity and in those days you did home deliveries, you see, or St. Brenda’s was the place for general practitioners to do the ones you wanted to take in there. We did two a week I suppose.

So we were upstairs, the midwife and I, and the baby were being born, and all the lights went out in the area. So we got a candle up there. Then apparently the grandmother down below had been ringing up and saying the lights have gone out and the doctor’s up there delivering the baby. And then with the light of the candle we’d stitched her all up, and me and the midwife went off back home. Next day it was all in the national papers that we had delivered a baby having to have a generator …

And downstairs the old lady had got a champagne bottle with some flowers in it, and a reporter had seen it and he said, Down below grandmother was celebrating with a bottle of champagne. There’s newspaper reporting for you. Another time I visited an old patient of mine with dementia in a nursing home. I leaned over the bed and said, Good morning, do you know who I am? She said, no, but if you ask at reception I’m sure they’ll be able to tell you.

Any other memories – good and bad? Everybody has their ups and downs. Rain falls equally on the just and the unjust but mostly on the just because the unjust has pinched his umbrella.

What were working conditions like in GP’s surgeries?

Most of them were very good and had plenty of everything. But a few GP’s surgeries were awful in those days - pretty flat, pretty minimal. I heard of one place where a certain lady had a single practice, she didn’t even have a couch, and no washing facilities, but that was pretty unusual.

I went to one as a locum and a person wanted their ear syringed, so I went to syringe it and there was only hot water in the tap! So I thought, oh goodness, what am I going to do? And there was a bunch of flowers in water on the shelf so behind their back I took the flowers out, poured the cold water in and emptied the syringe with that! I wouldn’t get away with that these days!

Were there many complaints in those days?

No! There weren’t many complaints, that’s the whole thing! I don’t think I’ve ever had a complaint, I can’t remember any! Oh, I must have had a few questions to answer, but certainly never got to any legal thing. I wouldn’t call them complaints: just questions, questions.

We’ve become litigation minded and I think that is because we’ve become inaccessible. They could probably have settled their complaint if they could only have got on the phone to you and said, look, blah blah blah, and you’d say, oh God, all right, I’ll pop round and see you, and it was all over.

Now, they take it through all the formal complaints procedures, because it seems to me that we’re less accessible to the public.

You would have seen the growth from mainly single-handers to group practices and the introduction of health centres: what difference has that made to the working life of GPs, do you think?

Well in our practice at Whiteladies it didn’t make any difference.

Professor Wofindon was great to bring in all these health centres, and he very much wanted us to have an appointment system, which we refused. We said, no, that’s a resignation issue for us, and he let us go on there and at Whiteladies we still don’t have an appointment system. Edward and I started out two handed then our practice grew and we took in another partner and another and so on. I think five or six is a nice number, sharing everything and you get reasonable time off if you have partners.

Are you still active on the medical meetings scene?

I’m still interested in several medical societies and go to meetings regularly. Forensic medicine conferences are my favourites, I go everywhere home and abroad, I’m going to Belgium next week, I gave a paper in Switzerland last year, last year I gave a paper in Milan last year on forensic podiatry in identification of dead bodies.

I’m also in the Bristol Medico-Legal Society, I’m in the British Medical Association, Cossham Medical Society, Homeopathic Medicine Society, and the British Association of Forensic Odontology. Because of Tanya I’m particularly interested in forensic odontology. (Medical and legal aspects of bite marks.)

I’m in the Royal Society of Medicine and the Association of Forensic Physicians, that’s police surgeons. I like to think I made one or two achievements in my profession. My colleagues made me a fellow of the BMA, I was president of the Bristol branch of the BMA, and I was president of the Bristol Medical Legal Society. Internationally I was President of the three-yearly World Meeting of Police Medical Officers in Wichita, Kansas, I was an honorary member of the Association of Forensic Physicians, and honorary member of the FMG in Holland and an honorary member of the British Association of Forensic Odontology.

How did you tackle the concept of your retirement?

Classical music: I play classical piano and I’ve got a music teacher. She says I’m Grade 8 but I think that’s because I pay her, I think I’m really about Grade 7. I go to choral concerts and classical concerts, theatre; I’m particularly interested in Shakespeare and Ibsen. And antiques - mainly silver but also ceramics, coins, pictures. You know, Stefan, if you’re a collector, a collector’s collection is never complete, so you always go on … and I go to museum and art gallery exhibitions.

Still keeping an interest in medicine, but taking up the piano a bit seriously, collecting, I go around auction sales all the time, and going to classical music and theatre, so that’s really how I approached it.

I learnt that from an old professor in Costa Rica who said, “Ivor, when you retire, don’t get up in the morning and say to yourself, what shall I do? Get up and say, what have I got to do today? And get on with it.” Just living takes up time. I’m a housewife, I’m eighty-three, I live on my own. Just looking after yourself takes up more time than many married men realise.

I don’t watch much television at all, I don’t have the time. A pal of mine, Tony Smeaton, says, “Ivor, retirement is really something for younger people isn’t it?”

Is it history? Well, as I see it – an old man – there are historical differences between then and now. Medicine now is scientific, accurate, making provable advances – so why are so many people uneasy about the NHS? The medicine they once knew was more sympathetic and user-friendly.

So there you are, Stefan, I’ve had a wonderful life and I am still enjoying it immensely, nothing spectacular and I hope you don’t find it too boring to read to the end. I’m an old man now, I’m eighty-three. There is a character in Shakespeare who says, “I have lived long, my way of life has fallen into the sere, the yellow leaf, and that which should accompany old age, honour, love, obedience and troops of friends”(Macbeth). I think that sums up the accompaniments of old age very well. I trust I have some of them.

In the club bar the Sergeant shouted, “PC Jones, you’ve spilt beer down my trousers”

“No Sergeant” he replied, “ I think it’s an inside job”.

2 old ladies chatting: “ I hear Elsie Smith died” “I’m sorry – what did she die of?” “They don’t tell you do they?” “Well as long as it wasn’t anything serious”

Dr. Stefan Cembrowicz and Dr. Ivor Doney

(Copyright Nov 11, 2004)