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Transforming Healthcare Podcast Transcript

In 1845, as the potato famine began in Ireland, Queen Victoria was in the eighth year of her 64-year reign and the Queen’s Colleges of Belfast, Cork and Galway were incorporated.

Four years later, when the Belfast college opened, there were five members in the Faculty of Medicine with a total of 55 students. Now there are 560 faculty members, teaching 2000 students. So in our 175th year, let’s take a journey back for a few minutes of snapshots of some outstanding medical people and their times.

When I think about the history of Queen’s, I think about the Whitla Hall. I think about the untold thousands of students who’ve trooped through its doors since they were first opened in 1949.

I was one of those students, almost 50 years ago, going to graduation ceremonies, exams,  conferences – the list goes on. But how many of us ever paused for a moment to wonder about the man who gave the Whitla Hall its name?

William Whitla was a boy from County Monaghan who entered Queen’s as a student in 1870. He would go on to become one of the most important figures, of any era, in medicine in this part of the world.

He graduated MD with first class honours in 1877, was appointed Professor of Materia Medica in 1890, a post he held for 29 years, he was knighted in 1902.

He also built an international reputation through the publication of several important medical textbooks. They were printed in many languages and earned him a lot of money. That, plus the income from his practice and other sources, made him very wealthy indeed.

All of this would be to his university’s benefit. Whitla was a generous man who appreciated the opportunities Queen’s had given him – and he wanted to help pave the way for the students and staff who would follow.

Among much else, he part designed and paid for the Whitla Medical Institute and endowed the Chair of Pharmacology. In his will he even bequeathed his own home to the university as a residence for future Vice-Chancellors and on top of that he left a large sum to construct the Whitla Hall.

The history of medical education at Queen’s is the story of men and women like Whitla, each in their own way dedicated to the lives of others and to the advancement of medical science.

There have been legendary figures – people like Sir John Henry Biggart whose influence over everything that happened in Northern Ireland medicine, both undergraduate and postgraduate, was absolute and total.

He was Dean of Medicine for a quarter of a century. He would tell his students, ‘Don’t come to me when the trouble has broken around you. Come when the clouds are on the horizon.’ And in an increasingly complex world, he retained a simple philosophy – ‘There is only one medical problem – that is the sick patient.’

By the mid 1940s, the Queen’s Medical School was the largest in Ireland and the fourth largest in the United Kingdom. We were attracting interesting visitors at that time too.

Sir Alexander Fleming, the discoverer of penicillin, came in 1944 to give several lectures. Since the great man’s voice was a bit weak, the organisers put in a request to hire a PA system – £15 would do it - but the university secretary turned them down. The following year, Fleming won the Nobel Prize. I bet they had a PA system that day!

One of the talks Sir Alexander gave was to the Medical Students Association. So what sort of students were they? I wonder how many of them were female.

It hadn’t been easy for women to make progress in the early years. They didn’t get into the Medical School until the late 1880s, which was about 30 years after the first male students were admitted. The first female student was Miss Jean Bell, admitted to classes in 1889, but by the time the 20th century arrived, women were beginning to make their mark.

Among them - Beatrice Helena Lynn, who graduated MB in 1923 and was elected FRCS in 1928. For 32 years until she retired in 1964 she was an eye surgeon at what was then the Ulster Hospital for Children and Women.

Down the years, there have been outstanding innovators, both men and women, and it’s been my great privilege to know some of them personally.

There’s Professor Mollie McGeown who spent her life doing such fantastic work for kidney patients. In 1959 she set up Northern Ireland’s first dialysis unit with a machine that was virtually home-made. She would develop what became known as the Belfast Recipe, a protocol to reduce the high level of mortality from infection after transplants.

I worked with Mollie in my early years as a consultant surgeon. She had tremendous drive and leadership skills – always putting the patient first. She was remarkable in all respects and I held her in the highest regard.

In Mollie’s day at Queen’s women were still in a minority. Today they account for about 60 per cent of our medical students.

Then there’s Professor Frank Pantridge, inventor of the portable defibrillator, the man who’s known worldwide as the father of emergency medicine. Who knows how many lives his genius has saved.

As a cardiologist he was well known to us all as junior doctors – an outstanding war record, a prisoner of war, awarded the Military Cross. A remarkable innovator who realised that most deaths from heart attack occur from arrythmias in the first hour – hence his development of the cardiac ambulance and the defibrillator.

He had a gruff exterior – indeed at times he was a very ‘direct’ physician – but beneath it he was a caring man who, like Mollie, always put the patient first – another hero for us as young doctors.

More recently, I think of my close friend and colleague, the late Professor Paddy Johnston, our former Vice-Chancellor. His great talent and personal drive led the modernisation of cancer care throughout Northern Ireland and advances in health sciences research here at Queen’s. There’s a cancer research building named after him also.

Sadly, these three are no longer with us but they have left a wonderful and lasting legacy that we all can share.

Dip into the university archives and you find some fascinating figures. Take Sir William McCormac, a student in 1851, who became a notable surgeon on the battlefields in France, Serbia and South Africa. He became renowned for his work and publications on how to treat gunshot wounds.

There have been many Queen’s medical graduates since then who have followed that same path with the same skill and dedication. Many of us spent years in operating theatres dealing with the dreadful consequences of the Troubles. The late Sir Ian Fraser put it this way – ‘Although much may have been gained during the advancement of surgery during this time it has been at too great a price.’ Nonetheless, surgical techniques developed and honed through those dark days of The Troubles are now in routine practice in other conflicts throughout the world.

But what will be required of the doctors and surgeons of the future and how are we equipping them?

Medicine and our patients have changed totally over the past 175 years.

Our older population means more cancers, more patients with multiple conditions.

Knowledge of diseases, their causes and their treatments is doubling in each decade.

Patients and their families have knowledge at their fingertips on their mobile phones.

Our course in medicine is changing to meet these needs – case-based learning, integrated placements, increased family medicine and the availability of a world-class simulation centre opening in a few months.

Our doctors will have to be flexible in their careers, resilient and able to deal with uncertainty. But above all else, despite the advent of remote learning and teaching in this Covid world, we at Queen’s still hold dear the premise that we’ve had for almost two centuries - that our patients teach us much.

We still appreciate the great value of the good role model – hence we believe strongly in ‘real’ clinical placements. We use a blended model - modern technology combined with face-to-face teaching and real patient contact.

Is it not ironic that when we began our university journey 175 years ago the great disease killers were pandemics of cholera, smallpox, typhus, yellow fever and the bubonic plague? We thought we had conquered infectious diseases – but now in 2020, our 175th anniversary year, we have a pandemic of the new infectious disease – Covid 19 – which has changed the world in the past nine months.

I have no doubt that our current students will graduate well-trained to face these and other new challenges in the decades to come.

I began medicine at Queen’s University 50 years ago. I believed then and still believe now that it has been a wonderful privilege – and as Lord Moynihan, the doyen of British surgery in the early 20th century, said in 1936… ‘’it has all been great fun and I would willingly do it all again.’