Tom Goodfellow

Will the royal colleges change or perish?

In 1974, as a fresh-faced houseplant at The London Hospital (not Royal in those days) I was attached for six months to the firm of Mr Alan Guyatt Parks, a name well known in the annals of proctology. I believe (although I may be wrong) that it was he who coined the aphorism: “There are two sorts of people in this world: those with piles; all the rest are liars”. But he certainly pushed forward the surgical frontiers of the rear end, if you get my meaning.

The great man operated on a Monday; consequently all his patients were admitted over the weekend which meant, in effect, that I had no time off for the six month duration. Of course this would be illegal these days but it seems to me we were made of sterner stuff forty years ago.

It was the responsibility of the houseplant to telephone ‘Sir’ on a Sunday afternoon in order to inform him of the admissions for the following week. There is a story, possibly apocryphal, of a courageous doctor who telephoned him from a coin-operated box – no fancy technology in those days – in an underground station in central London. While giving a summary of the patients the background noise suddenly increased in intensity as a tube train pulled in. Mr Parks commented: “Doctor, you are in the hospital aren’t you?”

The unfortunate doc, sensing immanent doom, immediately jumped on the nearest train and made it back to Whitechapel just in time to greet his boss as he arrived to do an unannounced ward round.

Mr Parks was formally knighted in 1977 for services to the rectum. But like all great men he lived on another plane and, kindly as he was (and a deeply committed Christian), my existence barely registered with him. Indeed I remember one day while I was humbly holding a retractor for him in theatre (a minor anal procedure so the more important members of the team were elsewhere) the ward sister came to the theatre door with a query about another patient. “Get the houseman to sort it out, where’s the houseman?” he retorted in a rather belligerent manner.

Rather shamefacedly I admitted that it was indeed I, the missing houseman, who was standing next to him. “Oh, oh” he muttered, “Well, err…” That was the end of the matter and I think he was genuinely mortified.

My other abiding, but affectionate, memory of him was a post ward round tea break with all the team in Sister’s office. He dunked his Rich Tea biscuit overlong and as he removed it from the cup the soggy mess fell onto his smart RCS tie. All those present then spent the next ten minutes trying desperately not to disintegrate into uncontrollable hysteria. Happy days!

He was elected president of the Royal College of Surgeons in 1980 but tragically suffered a major myocardial infarction in 1982 at the age of 62. Despite emergency cardiac surgery in St. Bartholomew’s Hospital he died on November 3rd. I was a cardiothoracic registrar on the unit at that time although I was not involved in his case. His premature death was a tragic loss to both his family and the profession at large.

To be president of a noble royal college was, in those days, a very great honour and the incumbents were generally held in very great respect. As a junior doctor they seemed to me like distant gods inhabiting celestial regions and pondering the mysteries of the universe while we mere mortals scuttled around doing the donkey work. How things have changed!

They are now mostly my near contemporaries and fellow coal-face workers who, by luck or judgement, have ascended slightly higher up the greasy pole than me. I am certainly on first name terms with the current president of my own royal college (RCR), and although we have an excellent relationship I am certainly not in awe of her (much to her relief I suspect).

But things seem to have changed in the way in which college presidents are viewed by large chunks of the profession, and it is definitely a more hostile climate. Time-serving, gong-seeking toadies are some of the more moderate descriptions I have read. Indeed many are now asking of royal colleges the Willie Hamilton MP question about Princess Margaret, “What is she for?”. Many view the traditional ceremonies, gowns and gongs as irrelevant and unnecessarily expensive in these financially stringent days.

Much of the disillusion was triggered by the MTAS and MMC debacle when many juniors believed that the colleges had not challenged the government over the disastrous implementation of these schemes. More recently some were demanding that the colleges take a much more political stand over the Health & Social Care Bill. With some exceptions they were accused of passivity and complicity with the government while the legislation leading to the destruction of the NHS as we know it was formulated. There are increasingly strident voices demanding that colleges be made more accountable to the views of their members and fellows and that they become more proactive in the formulation of health policy.

The world is changing and it seems to me that the colleges must change with it or perish. My own college is shortly to have an election for its next president. Through the grapevine I have learned of at least two candidates and both have an excellent, although quite different, record of service to the college and the specialty. But while I am trying to decide who to vote for I keep wondering why they would want the job. Look what it did to Sir Alan Parks!

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2 Responses to “Will the royal colleges change or perish?”

  1. Bob Bury says:

    When I was a surgeon in the RAF, I worked with a consultant who was a great admirer of Alan Parks – everything had to be done his way, including haemorrhoidectomies (do people still do those?). In fact I suspect it was Sir Alan who coined the aphorism that my then boss used to use concerning this far from easy operation, requiring a neat excision of the three pile-bearing areas, leaving a trefoil of raw flesh with intervening skin bridges.

    To determine whether you had got it right, you applied the criterion that: ‘If it looks like a clover, your troubles are over – if it looks like a dahlia, it’s a failure’.

    And you’re right about the Colleges – that’s the choice they have.

  2. mdrxcw says:

    I can only share your view regarding the annual subscription to a Royal College as being mostly superfluous. As a non-London resident it is not possible to use the (listed) building – though how many consultants these days have time for reading rooms and butterys etc. The library, though commendably ‘on line,’ doesn’t subscribe to major journals in my field (though I think you can get the Danish Journal of Sexual Health….)
    I asked recently how one could go about getting rid of the (subscripition) Fellowship and received an amusing litany of how I would have to send my Certificate back and could no longer use the post-nominals etc. but, I could if I stayed, have some M+S vouchers. Says it all really.

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