Operate, Operate, Operate; A Young Surgeon in the 1970s

Review by L Flood
Middlesbrough, UK

I am indebted to Prof Shahed Quraishi, the Book Review Editor for ENT and Audiology News for commissioning a review of this book from Mr Bindi Sahota, Derby.1 I had missed this publication completely and I do treasure my memories of working with Douglas for six months in 1976, at the Royal Ear Hospital (REH) in London. I was a Pre-registration House Surgeon and he was entitled “Chief Assistant”, in practice what was then a Senior Registrar. All such titles are long obsolete and, indeed, the Hospital itself is sadly demolished.

This book is a very entertaining review of medicine and especially ENT surgery all those decades ago. This journal has reviewed a series of such autobiographies recently and all recall the days of laryngeal mirrors, sprit lamps aflame atop paper drapes, transillumination of sinuses, the head mirror and endoscopes lacking any perceptible distal lighting. O tempus o mores.

The Prelude, and especially the second paragraph, is inspiring and the author need not fear the accusation of “being a dinosaur and viewing the past through rose-tinted spectacles” I read this at a single sitting, as I passed through his early training days in the 1960s, a series of largely London posts, to his ultimate and unconventional career move in the late 1970s. I well remember the consternation that this prompted in the most senior consultants.

My personal interest was inevitably in his time at the REH, as, ultimately I too worked as a Senior Registrar there. Like him I dared to question retaining post operative patients for far longer than any logic dictated and the flak taken for any challenge to that. (The idea was of course to block beds, so they were not snatched overnight by the General Surgeons admitting emergencies). Although also not mentioned in this memoir, another practice was constant dosing with aspirin mucilage post tonsillectomy, whether requested or not. Litigation would be the inevitable result now. It was during this time that he became what he describes as an “ENT Physician”, in which he was way ahead of his time and developed an abiding interest in allergy and management of vertigo.

All expected him to move onto the prestigious teaching hospital appointment (and that in London surely, as any other location was quite unthinkable in that climate). Douglas however valued his work-life balance and took up a post as Clinical Assistant in Guildford. He quotes a peer saying “We always thought you would do something like this”, but I remember the complete bafflement of so many of the leading lights in the capital at this decision. This move allowed him to pursue his great passion for music, as shown by his many academic qualifications, including no fewer than three doctorates. He is a qualified glider pilot and a deacon of St Saviour’s Church in Pimlico 2.

This is truly a tale of a Renaissance man, who combined his love of surgery with a life of many talents. He avoided the treadmill that led to the demands and responsibility of a consultancy and recognised the need for a physician’s approach to ENT long before that became the norm. For any of us who experienced training in ENT in the 60s or 70s this is a great nostalgia trip and entertaining read.

  1. https://www.entandaudiologynews.com/contributors/person/douglas-macmillan
  2. https://www.stsp.org.uk/about-us

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