50 Years of Emergency Medicine:
Who inspired you?
This year we are celebrating the 50th anniversary of the inception of Emergency Medicine. As part of our celebrations we are commemorating inspirational figures and are asking you to tell us who inspired you and why.
It could be anyone – local, regional, national or international – or could be more than one person. Did you work for them or with them; did you want to be them or a bit like them? What was the most important thing they taught you? What did you admire about them?
Send your thoughts on your Emergency Medicine inspirations, either with your name or anonymously, to firstname.lastname@example.org or add yours to the comments section below.
Below are your memories and inspirations.
“I was a first year medical student at the time of the inaugural Casualty Surgeons’ gathering in 1967 but I suppose that, even then, I aspired to a career dealing with accidents and emergencies. Short of a full set of memoirs it would be well nigh impossible to do justice to all who have inspired me in my career. So this will be a brief pen portrait of my A&E heroes with apologies to those for whom space precludes a mention.
“As a young medical student I was in utter admiration for Ken Easton, general practitioner at Catterick, the founder of the North Yorkshire Road Accident After Care Scheme and, eventually, of BASICS. Many will recall images of him in his white coat struggling to save the lives of lorry drivers haemorrhaging while trapped in their cabs on the A1 roundabout near his surgery or will have read of his political lobbying endeavours to bring about improvements in roadside emergency services. His BMJ articles collated as ‘Road Accidents and the Family Doctor’ were visionary and, years later, I still practised some of the techniques he described – including blind digital tracheal intubation – and kept my roadside medical kit in the home-made wooden box together with the short spinal board both of which he invented. Ken had a rare warmth and understanding for his discipline; were it not for his words of encouragement to stick at it (delivered over a glass of sherry in his home one Friday night after his church choir practice and on my way home from Edinburgh following my third failed attempt at the primary Fellowship) I would not be writing these words today. Ken insisted that, whilst his own contribution to emergency care was that of a competent all-round general practitioner. A&E was a hospital specialty predicated on a rigorous programme of specialty surgical – and medical – training. This was at a time when many thought that Casualty Surgery was a convenient bolt-hole for retired medical missionaries who had fallen off the mainstream Consultant ladder.
“I narrowly missed learning under Maurice Ellis personally though his reputation at Leeds General Infirmary – and elsewhere – succeed him. He valued the contribution made by medical students, then known as surgical ‘dressers’, to his Casualty Department. When not sitting next to him as casualty patients ‘shuffled along the bench’ (4 hour waits and targets being unheard of in those days!) they would be suturing wounds, dressing burns or plastering fractures. Even during ‘standbys’ for accident ‘Crash Calls’ the students would have the designated role of providing intravenous access with ‘Father’ Ellis standing at the department door with stopwatch in hand timing the performance of his multi-disciplinary team.
“It was David Wilson (later joined by Michael Flowers) who took over the LGI Casualty from Maurice and he continued the undergraduate training programme (6 weeks full time) instituted by his predecessor. As a fifth year medical student selected as a medical officer for a Schools Hebridean Society expedition to Mingulay, a remote, unoccupied island in the Outer Hebrides, I approached David for help and advice. He introduced me to the ‘instant’ Plaster of Paris fracture bandage; to emergency blood transfusion bags and the Eldon card for emergency cross-matching; and the Tauranga Thomas splint for femoral shaft fractures.
“As things worked out I found myself working with David first as a Casualty Officer, then as his first Registrar, then as a Senior Registrar. I appreciated the way he empowered his junior staff (though always being available for assistance and advice) and as someone who had demonstrated an interest in pre-hospital care I was allocated the task of organising the Major Incident Flying Squad equipment and procedures for the hospital. David facilitated the weekly departmental teaching when the department was covered by clinical assistants – a system I continued as a Consultant. He initiated research (e.g. injuries caused by glass) and he assigned educational projects to junior staff and students (I was given the task of mentoring one talented undergraduate on producing a series of teaching charts and short videos on the underlying anatomy of clinical practical procedures).
“The developing specialty was influenced by a number of greats within the infant Casualty Surgeons’ Association. One thinks of Edward Abson, Howard Baderman, Sheila Christian and David Williams among others. And, of course, William Rutherford from Belfast – one of the wisest persons I have met. He brought a philosophy to the specialty spiced by profound understanding and wry humour. Some examples:-
- On sectarianism in Northern Ireland – “The only wall bigger than the security fence around the [Royal Victoria] hospital is the one around people’s brains”
- On recovery from minor head injuries – “Those that do best attribute their injury to an act of God rather than blaming someone else”
- On falls from casualty trollies (the subject of a masterly short paper delivered to the CSA clinical meeting) – “The main reason patients fall off casualty trollies is that they don’t want to be on them in the first place!”
William led the UK study on the medical effects of seat belt legislation, the results of which informed the definitive legislation. And, significantly, he championed my AGM bid for a change in name for the specialty from Casualty to A&E (a proposal fiercely contested by some of its die-hard founders) and his well-reasoned discussion paper ‘A Rose by any other name’ helped to win the day.
“A few years ahead of me in a self-determined A&E training programmes was Keith Little, first as a registrar with John Collins at Derby (the home of the first Accident Flying Squad), then as the head of the department at the Chester Royal Infirmary and finally as Edinburgh’s first A&E Consultant. As a registrar myself, I visited Keith in Chester where I was impressed with the organisation of his department with instrument shadow boards in Resus, streaming of majors from minors and an almost car assembly line approach to the resuscitation of the acutely ill or injured.
“There were some “external” greats also who, though their contribution to the specialty was indirect, it was, nonetheless, equally significant.
“Peter Baskett, anaesthetist at the Frenchay in Bristol – an inspirational workaholic and acknowledged leader in the field of resuscitation, pre-hospital care and major disaster management. As a registrar, I had the temerity to ask the advice of Peter (then an almost complete stranger to me) on the copy for a short paper I wished to submit to the Club of Mainz on Entonox (a subject on which Peter was the acknowledged expert) in the Emergency Department. In the next day post my draft was returned full of comments and amendments in red ink and a note “Well, my dear chap, you did ask”.
“Another founder member of the Resuscitation Council was Douglas Chamberlain of Brighton – a life-long friend and mentor – whose work on early defibrillation and ACLS is legendary.
“Judith Fisher is noted for her cyclonic drive and energy and her huge network of friends and correspondents in Disaster and Emergency Medicine across the world.
“There have been many others: Miles Irving who gave up a day of surgery to personally promote the academic side of the developing department at Hope Hospital, Salford to potential trainee candidates. Howard Champion (of Trauma Score and MTOS fame) whose geographic streaming and interdisciplinary organisation of level one trauma care at the Washington Hospital Center was exemplary and whose structured approach to ATLS and the immediate surgical salvage of the critically injured strongly influenced our practice – both civilian and military – today. I returned from a short visit to Washington minded to replace our MAST suit with a Lebsche knife and Satinsky clamps!
“There have been other figures closer to home who may not be so well known in A&E but who have had a significant influence on my personal career development. They include StClair Logan, general and vascular surgeon at Dewsbury; John Potter, Neurosurgeon at Oxford; Denley Clark, retired general surgeon and A&E caretaker consultant at Pinderfields Hospital, Wakefield; David Price, head injury specialist and John Settle, burns specialist, both also at Pinderfields. And, during my time in Scotland, Colville Laird, BASICS GP; Keith Porter; Ian Haywood; Tim Hodgetts and John Scott.
“And some of my own trainees and working colleagues including, of course, Alastair McGowan, Robin Illingworth, Mike Clancy and Alison Gourdie. In 1992 Alison planted the idea of my move to Scotland to direct the Scottish Ambulance Service: tragically Alison’s promising career as a new consultant at Stirling was cut short by her death in a plane crash in Nepal when she was embarking on her long-time ambition to trek in the Himalayas. I hope successive holders of the Alison Gourdie Fellowship will have taken a moment to reflect on the short contribution of this remarkable doctor to the emerging specialty.
“I have been out of front-line emergency practice for about 20 years but as I reflect on the 50 years of the specialty I still get a buzz as I reminisce on the characters (whether included or, for lack of space, omitted) who have shaped the specialty and made it as exciting today as it was, in its own way, 50 years ago.”
“Having done my first ‘A&E’ job in 1988, it’s worth acknowledging the changes over the years.
“EM started as a branch of Surgery, now arguably, it’s a branch of Geriatric Medicine!
“The most influential and inspirational individual for me was Dr Keith Little – he always knew the answer to any clinical situation, yet professed to not have an encyclopaedic knowledge (and I believed him!).”
Shah M Rahman
“My inspiration was Prof. Robin Touquet at St Mary’s Hospital, who in our first week in medical school advised us ‘to always look after your oppo’ – as good advice on our first day on the wards as it is at 4am in the Emergency Department.”
“There are lots of bright outstanding characters in EM but the person who has inspired me most is Dr Ian Kendall in Swindon ED.”
“A large DGH to ‘the fastest growing town in Europe’, Swindon has the usual issues with exit block staffing & unrealistic expectations. I was a junior SHO with career guidance who had decided that EM was for me.”
“Dr Kendall welcomed me into his department, helped me get an anaesthetic job& progress through exams (prior to the robust EM training programme we now have) and supported me clinically.”
“A quietly spoken man, Dr Kendall was always there, encouraging juniors, supporting the nursing staff & seeing patients with a calm professional manner.”
“There are many ‘giants’ in UK emergency medicine, but to me Mr Kendall represents the bedrock on which our speciality is based-honourable hard working clinicians whose aim is to make a difficult situation better.”
“I was strongly inspired by Dr Leo Murray the solo ED Consultant in Ayr Hospital while I was a Junior Doctor there in the Nineties. He strongly supported us all, regardless of what specialty we were based in.
“Dr Murray was consistently highly energetic, enthusiastic, available and approachable. He encouraged us all to gain experience by being involved with patient care right from the start of their journey. For example, when I was working as an Orthopaedic, Surgery or Paediatric SHO he would call me down to ED to get involved early-on with the care of the patient being referred to us. This is a great model that seems to have been lost. I also spent 6 months working with him as an ED SHO and gained a huge amount of knowledge and ideas directly from him.”
“Working with Cliff Mann (Former College President) inspired me to ED (when I did a locum as an F2 Doctor).”
“I am inspired by Dr. Reda Gonnah a leader of Emergency medicine in Kuwait.”
“I was inspired by Dr Amanda Wellesley and Dr Fiona Barratt, whilst working as a baby F2 in St Richards Hospital, Chichester.
“Thanks to their support, I decided to leave surgical training and pursue EM as a career.”
“My biggest hero in EM is probably Art Kellerman. How: his studies of gun homicide and suicide published in the New England Journal of Medicine were brilliant science, selflessly courageous and globally important.”
“Alistair McGowan inspired me to enter EM. He was a superb teacher and a great clinician.”
“My heroes were Mr Anthony Barker, St George’s (I went into A&E because of him & he taught me the art of ED shop-floor situational teaching) and Mr Kambis Hashemi, Mayday, (he taught me a modern A&E Consultant’s role). I was their SR between ’83-’84 (George’s) & ’85-’86 (Mayday)”
“As a student doing the ‘Casualty ‘ attachment in my teaching hospital I never saw the orthopaedic surgeon who was supposed to be in charge of the department. There was a registrar who seemed to be on duty, or at least in the hospital, for much of the time but he was widely regarded as being in a dead-end job.
“My first contact with a proper A&E professional who it was possible to admire was Ian Stewart in Plymouth. I worked for him as an SHO in 1979. Ian was one of the original 32 consultants whose appointment launched the specialty in 1972. This is not intended as a biography or even as a proper appreciation, but merely a memory of how he appeared to some of the people who worked with him so long ago.
“At a time when consultants could seem as rather distant and forbidding figures to a very junior doctor Ian was completely different. He was on first name terms with his team, and indeed with everyone else in the hospital from the cleaners and porters to the most senior consultant. He was completely unpretentious and treated everyone the same. This in no way diminished the respect in which he was held in his department and throughout the hospital. Plymouth had at that time a group of old-style Casualty nursing sisters, as tough as any I have worked with since, and they all thought he was marvellous. Ian could have firm views and even we could see that he was not always right, but you knew he would always listen and be fair, helpful and supportive. He took an interest in our welfare and careers and showed that he cared about his team.
“Long before it was generally recognised, Ian knew that barriers between senior and junior staff make for unhappy doctors and unsafe working practices. He got things done without worrying about unnecessary bureaucracy. I originally went to see him for an informal chat to see if there might be any jobs coming up, and when I later phoned Cis, his long-suffering secretary to ask when the posts were going to be advertised she told me I had already been appointed.
“Ian seemed to be incapable of being idle and led from the front. He had trained as a surgeon and continued to have occasional theatre lists. If there was disagreement with the inpatient surgical team about a patients management he would sometimes sort it out by taking the patient to theatre himself, with post op care in the short-stay ward. He was very much of the ‘ just get on with it’ school. He would suddenly appear when we were all tired and overwhelmed by work, he would sit down and rattle through the patients at amazing speed to clear the waiting room.
“Although there was another consultant Ian was for practical purposes on call almost all the time and insisted on being phoned at home if there was any problem at night. If you didn’t he would be bound to hear about it the next morning. When you phoned him a frequent response was simply ‘I’m coming in!’ And so he was, with the blue flashing light on his car that the local police chief allowed him to use.
“It was very much his department and we were proud to work for him.
“The specialty has moved on a lot since then of course and there was much that was bad about the old days. Ian Stewart was not only an ‘old style’ consultant whose personality dominated his department, but also an enlightened and empathetic leader who valued and understood his team. I felt very fortunate to have worked for him and have tried to bring some of these lessons to my own practice.”
Dr Carl McQueen quite simply changed the course of my life. We met during my time at Derby A&E and bonded instantly over our love for emergency medicine and especially pre hospital care.
He took me under his wing and taught me so much about the nuances and art of being a good doctor. His enthusiasm, kindness and smile was infectious always making the shift not just bearable but fun. His work ethic and drive were of the highest standard. He had a strive for perfection and a determination to deliver the highest standard of patient care.
I have met very few doctors who are as kind, passionate and brilliant as Carl, he is one of the only doctors I have worked with that I would walk through fire for. It is a privilege to have worked along side him and called him a friend.’
Having trained exclusively in the West Midlands I was lucky enough to be influenced by a number of truly inspirational consultants. Richard Morrell and Caroline Park were two such consultants who continue to inspire both trainees and Consultants in the region, their positive impact on Emergency Medicine in the region is remarkable.
The individual who has given the greatest inspiration to me is Aidan MacNamara. Aidan is an EM Consultant in the Heart of England Foundation Trust and was the Clinical Director there for well over 10 years. During my time working for Aidan he showed all of his team how to deliver excellent Emergency Care. He led by example with a combination of a phenomenal work ethic along with a truly enviable depth of knowledge and clinical application. You would always know when Aidan was on the shop floor as the teams work rate would step up to try to reflect his.
As a Clinical Director Aidan was remarkable is his ability to unite a team and move the department in a constructive and innovative direction. He had a uncanny knack of nurturing areas of real interest in his colleagues, giving them the autonomy to develop them, whilst providing much appreciated support if and when needed. And underneath all of this, it was accompanied by a superb dry sense of humour.
Aidan is a great inspiration to me and I am very thankful to him for demonstrating so well what it takes to be a truly excellent leader and clinician.
Ian Anderson at the Western Infirmary. As a medical student his favourite phrase was “we can sort this better than them (the specialties)”
Chris Cutting:”I’m not as clever as them (the specialties), but I’m here …!”
Dr Rachel Parish is my #EM50 inspirational person, balancing her EM career and training, while being an international sportsperson shows that work and life can be put into the balance!
Working with Rachel in the ED is both supportive, inspirational, and motivating; everyday is a school day yet you are encouraged enough to make time for the things that really matter to you in your world. She is exceptionally supportive of junior members of the team and encourages those who are considering a career in EM to go further and dream as big as they wish.
I have had much a work-life career dilemma sorted by this young star who has given me the attitude of “nothing is impossible if you believe it so”. Following in her like an eager little SHO thirsty for knowledge, she has turned into one of my best friends who pushes me to achieve whatever I want to achieve in life and my career, consistently challenging why something should be a restriction when it can obviously be strung into the balance of work and life.
How she manages to win medals for the country while coordinating the flow of patients, and teaching at the same time, in one of the busiest times that the specialty has ever seen shows just how well she has it sussed. To all those inspirational EM lady hero’s this ones joining you and inspiring those of the future along the way!”
Ray McGlone was a fine role model for all emergency medicine physicians.
Dr Vijayasankar here at Peterborough for all his effort in running MCEM / MRCEM courses in India and the recruitment it has brought. We are probably only a couple of years away from seeing our first recruits becoming Consultants (exams pending) – and I think he deserves some recognition.
Dr Shanthi Siva
When I was new to the UK, Emergency Medicine on itself as a specialty was new to me. Dr Chris Moulton was my educational supervisor, who inspired me through his clinical and academic activities.
Your Other Inspirations
- John Heyworth for his vision for the College and specialty
- Inspired by @TJCoats – humble @ffolliet – Creative @sandnsurf -visionary
- Inspired by @eoconor209 for being such a role model and mentor
- Inspired by Jo Hartley and Bruce Finlayson amongst others.
- Inspired by @Damian_Roland @garufflewis @rachrwlnds @SJisinterested @sintydavid @sumacca
- Inspired by @crawfordmccguff3 @magnusharrison @LeechCaroline and @carrings
- My 1st EM inspiration (of many) was an ER attending on my elective
- Inspired by @JAB300363 =always smiling.
- I’m inspired by @WisniackiFiona for promoting excellent alcohol care
- Inspired by the ability to make such a massive difference to patients in such a small space of time.
- I was inspired by the mantra of “need to get it right the first time”.
- Inspired by Prof Kevin Mackway-Jones – there for me from day 1 and still is
- Clifford Mann for grace under pressure
- Cliff Mann – indefatigable enthusiasm and effective communication
- My entire ED team because they always go the extra mile for their patients and each other
- Ray Daniels (deceased) a true gent
- John Coals (deceased sadly) another of the first group – built the foundations for #ED_COCH
- Ray Daniels – one of the first. A dry wit and an acute sense of decency
- Alistair McGowan – cool leader
- David Williams – commitment to developing the specialty
- Norman Kirby – commitment to developing the specialty
- Rebecca Mallinson (ST6) Registrar – Southampton ED. Excellent clinical and compassionate practice
- Rob Summerhayes – Registrar – hard working, good rapport with patients and always happy to help
- David Yates. Academic, Intellectual, Philanthropist.
- Peter Driscoll, a giant and pioneer of the specialty
- Ray Daniels – one of the first. A dry wit and an acute sense of decency
- I’d also nominate John Coals (deceased sadly) another of the first group – built the foundations for #ED_COCH
- The entire emergency medicine team at the South West Acute Hospital in Enniskillen and the passion, commitment and dedication they have to provide 24/7, safe, high quality emergency care to the most remote and rural communities in Northern Ireland was my inspiration to train in Emergency Medicine
- Emma Christmas – so hardworking- doesn’t stop and always does it with a smile on her face.
- Dr Emma Greenwood
- Dr Olly Bannon – great consultant, mentor and teacher
- Nida Suri (Watford) – she is so passionate about EM + incredibly dedicated. She motivates me to keep doing EM!
- Everyone here today! (Case Reports study day 29.06.2017)
- Prof Jason Smith (Derriford Hospital, Plymouth) My first example of trauma team leader, so calm, inspiring, great leader & mentor.
- Everybody who remains committed.
- My children – for their tolerance + flexibility like all children worldwide
- Dr Junaid Razzak, Emergency Physician, Pakistan & USA – setting up a prehospital service in a developing country.
- Ellen Jones – consultant, Birmingham – training committee chair + education champion.
- Katherine Henderson. A woman at the top of her game who’ll go to bat for her team.
- The teams I work with couldn’t function without each of them and the influences they have.
- Dr Rob Galloway – calm, collected, makes medicine fun.
- Self-motivated / front line management.
- Dr Ruth Brown – St Mary’s Hospital ED Consultant – knowledgeable, excellent leadership skills. Treats all colleagues equitably.
- Jay Rathore – most hardworking Dr I have worked with! And excellent clinician.
- Dr Sinead Campbell Gray – EM Consultant in Belfast – for being a passionate and positive role model in EM!
- Dr Steve Block for his amazing care and compassion to staff and patients.
- Diana Hulbert – positive, inspirational, lifts the mood of the department
- Diana Hulbert – Always positive and enthusiastic which uplifts the team
- Eliz Molyneaux – she makes more of a difference in a day than I do in a year.
- Lynn Williams – 1st ever mentor
- Helen Keeton
- Louisa Chan – balancing EM / ICM and PHEM
- Dr Adel Aziz, Ed Consultant in Southampton, as he is the kind of consultant that I would like to be, as I have never seen anyone more supportive than him.
- Neil Robinson, Insightful, Knowledgeable, Humble but totally awesome.
- Mike Clancy – thoughtful approach to EM
- Mike Clancy – cool, calm, controlled.
- Gary Cumberbatch, evidence based, encouraging, wise, kind.
- Harry Adlington – Accurate, considerate, always approachable, good advice.