Number 2 hero

My second hero is Professor W R Keatinge (Bill). At the time of writing he is in his seventies and working part time at University College Hospital.
After I had nearly completed my pre-registration house jobs at the London Hospital, I wanted to kill some time until I started my career as a GP. This was because my first wife was younger than I and was at that time a medical student and wanted to catch me up so we would be at the same stage of our careers in medicine.
I decided I would like to do some research and heard that there was a post as Lecturer in Physiology coming up.This was in 1970. I put in an application. Shortly after that I was admitted as an emergency to the Fielden wing of the London Hospital with a nasty flare up of a pilonidal sinus that had to be operated on. Bill Keatinge was the reader in physiology at The London Hospital Medical College at the time and it was he who interviewed me. Amongst other things, he asked me if I wanted to be a “perpetual student”. I interpreted this as an enquiry into my possibly not wanting to undertake responsible work. Of course, I love learning and am now a great believer in life long learning. I think I did not want to leave the world of enquiry and research. It was an interview with a difference. I was in bed and in my pyjamas. He offered me the job which was to start at the end of my house jobs.
The job involved a pay cut from that of a house officer and this was the first of two occasions I had dropped my pay for the sake of my career.
I started to get anxious about the job as I had not read any physiology for a few years and things can change rapidly with new discoveries. I knew I would have to lecture to students, facilitate tutorials and run practical classes. At the same time I had no idea what area I would research and who would be my supervisor.
On the first day of that job I arrived at about 8.30 am and there was no one in the department. I can’t recall whether I had a room to go to. I realised as time went on that academic freedom meant not only a contract for life but the freedom to come and go at whatever time one wished. One could work at home, in the lab or in the library of the Royal Society of Medicine. One could start at 6 am or work all evening. This struck me as great but was against the work ethic I was brought up in. There were a mixture of people in that department, some with medical degrees and some without. I had the impression that those with medical degrees tended to work 9 to 5 regularly and more if necessary. Those without medical degrees worked just as hard and were just as fruitful but had a different approach to time, I felt. I am sure if any of them read this they might argue vehemently against my impression.
The head of department was Professor Kenneth Cross who was researching an aspect of physiology related to cot deaths. Occasionally he would stand at the entrance of the department. Any one who arrived after 9 am he asked to hold out their hand which he would then hit without saying anything. He had a medical degree.
I was given my own room and Bill Keatinge told me that I had 3 months to look at what was going on in the department and then decide with whom I would like to work and supervise my research. What an amazing luxury. I took this very seriously and there was some fascinating research going on, mainly on animals. One or two people told me that Bill Keatinge was a difficult person but I felt that there was a bit of competition going on to get me to help with certain people’s research work.
In the end I asked Bill Keatinge if he would supervise me undertaking some research in hypothermia. Bill was famous at that time and was one of the leading experts in the world in human cold water physiology. He had published a book entitled “Survival in Cold Water”. I think that because I had worked as a student with Professor J Z Young meant that I felt it would be an honour to be supervised by Bill. If he would be a hard task master that would only be good for me. Bill was working on the physiology of smooth muscle at that time and this involved working with pigs’ arteries. This involved Geoffrey Graham, a PhD student working with Bill, calling in at the slaughter house first thing in the morning on the way to work. The arteries were transported in a special container that kept them very cold.
I was not at all keen on doing any animal research and something to do with human temperature regulation would suit me down to the ground.. There was a room next to my laboratory that had air cooling and heating devices such that its environmental temperature could be altered and maintained steady.
Bill’s PhD student before me that worked on temperature regulation was Jim Haight. He worked on the effects of alcohol on thermoregulation in man. I read his thesis. One thing in Jim’s thesis that amused me was that he noted that the brandy in the containers carried by St Bernard dogs had a higher content of sugar in it than other brandies. Blood sugar levels tend to fall in hypothermia. I read Bill Keatinge’s book and started reading a variety of papers. Throughout this process Bill was my guide, mentor and supervisor. Unlike me, he is a very good writer and improved my writing no end by his editing. The work we did was truly joint and I was allowed to go down avenues of research that cropped up either from readings I made or ideas we had. Geoffrey Graham had the greatest respect for Bill and Geof helped me no end. Bill was Geoff’s tutor at Oxford University. Geoff had qualified in medicine and did his house jobs with great difficulty because of a significant disability affecting his mobility and necessitating his wearing callipers.
The people in the department were fascinating and each one was always willing to advise and help me. I can not mention them all and I hope I do not upset anyone by their omission from this blog. Ron Spiers was a dental physiologist and helped my look up references on salivary temperature. David Wingate was a gastroenterologist and took over the lab next door to me from Dr Barrowman, also a gastro-physiologist. Fred Smales was a dental physiologist in another lab next door to mine. He had an obsession for a while in writing a computer programme for a game he had invented. Andrew Wade was a vet by background. Towards the end of my period of time working in the department I shared my lab with Hilary Sellick who researched on something to do with respiration in newly born mice. She joined the department after a period of illness and was very kind to me with advice regarding my approach to writing the discussion of my PhD thesis. She married Andrew Wade and I went to their wedding. Her parents were very wealthy from owning a successful laundry business. The reception was at their house and I pulled up in my car to what I thought was the house. It was the lodge! I think they have left now and own a farm.
Mike Hathorn had left South Africa for political reasons and was a superb teacher. He was working on the effects of lack of oxygen on iron absorption and distribution in rats. I met him a couple\ of years ago at a dinner Bill invited us all to in the Royal Society of Medicine in London. Claire Torrie came after me and was another PhD student of Bill’s. She was awarded her PhD at the same ceremony as I.
Kenneth Cross I have already mentioned. He was married to a consultant paediatrician and his niece was a formidable nursing sister in the accident and emergency department (then called the Receiving Room). He researched in what was called the neonatal group with Drs Bolton and Goodwin. The now head of department is Mike Armstrong-James who was a senior lecturer when I worked there. He is a neurophysiologist. One summer vacation he build himself some sort of computer. We were each allowed to spend up to £10 on bits and pieces. He used this facility to buy components for this computer. One had to get the signature of the head of department for this spending. In the summer holidays, if the head of department was away the next most senior academic could sign these spending requests. Mike often ended up as head of department and could sign his own requests. Even I ended up as head of department for a week. Everyone was away! Most of the colleagues mentioned above became professors. I became a GP but now I am Professor Pavlov!!
I will get into serious trouble if Tony Barnet ever reads this. I have done a real upstairs/downstairs act and mentioned the academics first and before the technicians. The technicians I remember well were Geoff Watling (chief technician), Adran Jacobs (Bill’s technician) and Tony Barnet (senior technician, electronics). None of the researchers could have done their work without these and the other technicians. The teaching experiments and demonstrations were set up and maintained by the technicians.
Tony Barnet realised the power of the technicians and kept what he called a “black book”. If any academic was rude or demanding with him, down this would go in the black book and implement delaying tactics with ordering components or undertaking work. The fact he discussed the black book with me might have been evidence of good rapport with me compared with my colleagues, or he may have used this technique with all of us. I have to state, at this point, that Tony Barnet was my backbone for my research and that we worked really well with one another. My research, as you will read later, was a mixture of developing an electronic instrument, and experiments on humans undergoing cooling. Tony was an equal partner with me (and Bill was the overall director) in developing the Zero Gradient Aural Thermometer.
I don’t think I was ever in Tony’s black book. He once had a bit of electronics I needed flown over from the USA on Concord as he had told them it was urgent.
My research was essentially in two bits and was somewhat difficult to put together in a thesis but Bill was a great adviser when it came to writing up. I got interested in the accuracy and reliability of sublingual temperature as an estimate of deep body (core) temperature. This led me down a research alleyway where I proved that saliva increased in flow and was cooler in cold air. When I write “I” this should be “we” as although I did the experiments and thought up some of the areas to investigate, Bill was in on everything. Looking at sublingual temperature involved comparing it with rectal and oesophageal temperature. I had to work on volunteers mainly from the student population both medical and nurses. Inserting an oesophageal probe by the nose and positioning it behind the heart was difficult and uncomfortable at first. Many potential volunteers could not continue as the procedure induced wretching. One of the volunteers was a nurse called Averil. (I bet you think I am going to say that I ended up marrying her!!). Averil was one of the people who could not tolerate the oesophageal probe. She later married my wife’s half nephew (who became a pathologist) and we have seen them regularly over the years. Another volunteer was Bill himself. I was really nervous with him and I knew he was uncomfortable with the probe in place because one of his eyes was watering. However he did not complain which is typical of him. I could easily swallow the probe and did loads of pilot experiments on myself.
This work led us to think about developing a thermometer that would take the temperature of the ear canal and be unaffected by the head being in a cold atmosphere. Tony Barnet was a vital part of this project and the first prototype was on racks as tall as me and on wheels. The crux was to cover the ear with a heat pad, the temperature of the inner surface being maintained at the same temperature as that recorded from the ear canal. We called this thermometer the Zero Gradient Aural Thermometer. Loads of experiments were undertaken to establish its reliability. We decided to approach a private company and ask if it could make a neat one of these. I discussed this with one of the senior directors of Muirhead Ltd. Discussions too place in the Physiology department which included Bill. To our surprise, the company not only wanted to make a portable device but also wanted to manufacture and sell it. It eventually went on to the market and sold a few. I think one was bought by NASA. The royalties went to The London Hospital Medical College.
Bill and I published most of our work in reputable journals and there was a presentation and then a demonstration at the Physiological Society. I was a nervous wreck with the demonstration. This involved Adrian exercising his legs in a deep tank of warm water with the aural thermometer recording. Setting this up was a major task. I nearly ran for it when I spotted the Nobel prize-winner Andrew Huxley coming towards us. He asked a question and seemed happy with the answer. If one put work before the Physiological Society in this way the members voted on your work at the end of the day.
Our publications and the demonstration was Bill’s method of ensuring I obtained my PhD as the work had already been peer reviewed. I am really grateful to him for that approach.
One of the main experiments took months to plan and involved taking measurements from 28 children swimming in an indoor pool that was coolish after a bank holiday weekend. There were about 23 observers and some of the children swam breathing in to a Douglas bag which was held by an observer suspended above the head of the swimmer. One of the observers was Lt. Commander Frank Golden with whom Bill had done some work in the Navy a few years previously. In about 2003 I recorded a programme from the TV which showed the effect of a very cold environment on the presenter of the programme monitored from outside the cold chamber by Frank Golden. I thought the bloke was going to die!
I left the department to be a GP in Cheltenham and it was there I wrote my PhD up. The time arrived when I had to have my PhD viva and this was with Bill and the external examiner was Professor W I Cranston, professor of medicine at one of the London teaching hospitals. I was a nervous wreck as I knew that if the viva did not go well I could be turned down or even worse be set a whole day’s practical examination. The night before the viva I had noticed one of my graphs was not quite right. One hour before the viva was due to start Bill saw how nervous I was and sent me out to have a walk in Whitechapel. Of course the viva went OK and Prof Cranston was charming. When I pointed out the graph that was not quite right he advised me to photocopy it, alter it and glue the new graph over the old one in my bound thesis. This I did and when Prof Cranston shook my hand to say goodbye, I nearly stuck to him as there was some glue on my hand.
I continued to work in Cheltenham until I was divorced 3 years later. I decided that I wanted to go back to Physiology and discussed this with Bill and the then head of department, Professor Kenneth Cross. An advert was put in the BMJ for a lecturer in physiology. I applied and the interview was with the Dean, Sir John Ellis and Bill. I had been interviewed by Dr Ellis when I applied to be a clinical student at The London. This was an odd thing to do as I had a place in University College Hospital and I was requesting a transfer. At that first interview, the dean asked me, amongst other questions, whether I was going out with a nurse at the London. He thought that was the reason I might want to change teaching hospitals. I was not. At the second interview, he asked what I would do if after he had set up a department of general practice, would I move over from the physiology department. I answered in the negative, of course.
I was offered the job and started but the things went very wrong and I really let Bill down. After one week in that job as lecturer I realised I had made a mistake. I did not go to work and told Bill on the phone. That episode of my employment history is omitted from my CV. Bill has been the perfect gentleman about it all and never said an ill word to me. Indeed he has always praised the work we did together. I think I was under considerable mental strain after the divorce but had the great support of my wife Kathleen. We had been married only a month or two when all this happened.
I became a GP in Castleford in 1978 and retired from that job in December 2005.
About 4 years ago Kath and I were in London and invited Bill for lunch. I had booked a table down the net but we were the only people in there. Bill gave us a nice bottle of wine and told us about his adventures in Russia when he visited the coldest place on earth to do some research. He has learned Russian and reads Russian literature. He certainly is a highly and broadly educated man and I am sure this contributes greatly to his approach to research and teaching.
About 7 years ago Geoff Graham and I decided to invite all Bill’s past co- survived. Two or three years ago, Bill returned the compliment and invited those people and more to a dinner at the RSM. He paid for the lot. It was again a lovely evening and illustrated what a gentleman Bill is.At one point his entry in Who’s Who was the one after his father’s, Sir Edgar Keatinge. Bill’s first wife sadly died but in his Christmas card 2005 he informed us that he had remarried and I hope he will be very happy and to see him again soon.

We did not get a Christmas card for the first time in 2008. I discovered he died of prostate cancer in April 2008. there was an obituary in The Times: http://www.timesonline.co.uk/tol/comment/obituaries/article3889176.ece