| Description | An interview with Mark TAYLOR, a married man with two sons, who is a Consultant paediatric nephrologist, born in London and now living in Birmingham. Mark TAYLOR’s father was a Engineer & inventor, born in England and his mother a Headmistress born in England. In the interview, he talks about …
'MS2255/2/110 TAYLOR, Mark logged by Bernadette Shortt
01
I was born in London in 1948; I was brought up in a village in Kent known as Pratts Bottom. I was brought up in a bungalow originally owned by my grandfather.
50” My father’s first wife died, he then married my mother, and there was a 15-year age gap between them.
1.10 My father was an engineer and inventor, he invented a butterfly valve for the flow of gas in pipes and sea light packing for barring in ships. This was our main income.
1.50 – My father became ill in 1954 with diabetes. There was a recession in Britain; heavy industry was in decline. He became an employee of an electrical company.
2.15 My father died of a brain tumour when I was 11.
2.25 – my mother was an Essex girl, a music teacher who taught children in the Blitz years. She was a land girl during the war years taking children to the countryside.
2.50 – Parents married in 1947
3.00 – Mother became Headmistress at a Church of England Junior School where she served till retirement.
3.30 – Strong Church of England values, many Orthodox friends though.
02
I am the eldest of 2, I have a brother 2 years younger than me, and he went into medicine like me.
School – Passed 11+, attended a grammar school, two bus rides away.
50” Strengths of school – Wonderful zoology master called Freeman who wrote several texts on embryology. He inspired a zoology set; career move then was to go into medicine. In 5 years 7 people went into medicine.
03
At the age of 14, I decided to go into medicine.
04
High selection criteria to get into medicine. In the early 1960s I applied to individual medical schools.
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Contribution towards living costs was essential. Great mix of people at the school.
2.00 Interview in Birmingham was different to that in London. Story: what’s the hardest thing about being a doctor ?. .. I said learning to live with your mistakes. . There was recognition across the table and I knew that I had been accepted.
06
First impressions of Birmingham - End of 1965 put up in the Grand Hotel. I was impressed by the leafy greenness of Birmingham and felt that I could live here. I changed my mind quickly because for students it had absolutely nothing . . . the pubs would shut on Sundays, everything would shut at 10 o’clock the city centre was dead. “It was a hard working city of hard working people.”
1.40 – It didn’t appear to be multiracial just working class.
2.30 – Social life around the campus – Being examined every 10 weeks meant little time for high jinx.
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Description of 1st year.
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Science came first and people came second unlike today’s training. We trained at the General Hospital and Queen Elizabeth Hospital.
50” We sewed up wounds in the accident and emergency unit which medical students are not allowed to do today.
1.15 – Story about clairvoyant stabbing . . ..
2.00 – Sister Clancy calming down a noisy patient.
3.00 – “People are weird and you start to see them like that!”
09
Psychiatry was one of my favourite areas.
2.15 – Worked in mental hospital in Warwickshire, first time I heard senior doctors describe patients as being mad. I fell out with everyone in the hospital because of their arrogance.
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Mental hospital was in Worcestershire.
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Subject of ENT.
Paediatrics – placement at the children’s hospital
2.30- Children’s hospital in 1970 – No liver services or chronic care, simply medical surgical wards.
3.15 – Little girl: parasite from dogs - story – Seeing poverty in little girl's house, houses without internal bathrooms, poverty of furniture etc.
1970s illnesses – rickets, lead poisoning in children was every day cases.
12
Student life – Student rebellion – Birmingham’s Vice Chancellor got locked out of his office and furniture thrown onto the street. Police were called to the campus.
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I qualified in 1971 and it was an anti-climax.
20” Had to sign Hippocratic oath, little formal ceremony though.
1.10 – Started in the Walsgrave Hospital Coventry, then to Hereford.
1.35 – Hereford story
2.43 – Description of Herefordians.
3.25 – Well-being was seen as a gift in those days, not as a right.
4.00 – Doctors were held in greater esteem in Hereford than Birmingham.
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Worked as a locum in Hereford for a while, dissatisfied with standard of practice.
30” Story about little girl who was developing viral meningitis.
1.0 – Became annoyed that I couldn’t treat her myself, instead I had to write a letter and send her off to the hospital to be treated.
1.25 – Went back to hospital-based paediatrics.
1.50 – Power of medicine
2.15 – As junior doctors then we had much greater freedom than we do now.
15
Worked in Coventry for 3 years.
25”Became member of the Royal College of Physicians.
40” Travel – Wife Mary and I went to the West Indies, paid by the Jamaican Government.
2.30 – We practised poverty medicine rather then tropical medicine. We saw tetanus, diphtheria.
3.15 – Very disorganised health care in Jamaica, no immunisations. Story about measles vaccine.
4.25 – A lot of violence during the general election, people were stabbed.
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Bob Marley story . . .. Bob had been attacked.
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Coming back to England.
1.15 – Wanted to become an oncologist.
1.50 – Became a Nephrologist at the Children’s Hospital, current position today.
2.40 – Year out in Melbourne.
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Children’s Hospital memories
25” Early day’s specialism in paediatrics hadn’t been considered.
1.0 – Describes changes/developments in paediatrics.
2.10 – Introduction of research.
2.40 – Changes in surgery – Surgeons would come from the QE hospital.
3.10 – Specialism in surgery was seen to be absurd.
4.00 – Development of liver transplants.
4.30 – Under funding has always been a major problem.
4.40 – Unsatisfactory conditions.
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Nephrology was spread out across 3 hospitals.
10” Story about public outcry after Professor White news story to develop dialysis for children. Initiated political interest.
30” Fragmented service between Children’s Hospital and East Birmingham Hospital.
1.20 – Children’s transplants only took at place at the Queen Elizabeth hospital. It was a disaster: the nursing . . .. Anaesthesia was not appropriate.
1.50 – Great need therefore to have transplants at the Children’s hospital.
20
Tony Barnes started transplant service at Children’s Hospital.
40” Talks about current practices in detail.
1.10 – Rickets – 1980/81 children were given pills to combat rickets.
1.50 – Our success has now been our downfall . . .. Because it is relatively straightforward but not easy to take on children who have kidney failure but who have had many other problems as well.
2.20 – It’s this complexity which is the penalty of success.
2.50 – Talks about complex children’s cases.
21
NHS – No recollection of what medicine was like before NHS.
35” NHS has the right philosophy.
40” “My experiences in Australia and America tell me that it is still one of the most exciting human experiments ever.”
1.0 – Describes the history of NHS in detail.
2.30 – Aware of the value of the NHS.
2.30 – Describes medicine in post war year – Drug for heart failure, 2 antibiotics, such as Penicillin, basic anaesthetics, morphine for pain relief.
4.00 – Contrasts with medicine today.
4.30 – People's attitude towards medicine today – health was a bonus, grateful for any health. Post Thatcher health has become a right.
One of the questions I get asked is . . .. “Is this the right treatment or am I being limited in what I can have under the health service?”
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I have to explain whether this is the right treatment or is it a compromise.
20” They ask this because they perceive that they have a right as a taxpayer, they pay for it and like an insurance policy they are cashing in and they want to know what they have got.
30” This attitude isn’t wrong but neither is the old.
40” People are better informed now, which is a good thing.
1.30 – My job is to make people aware of the options and advise which is the best form of treatment.
2.00 - Importance of central funding. Compares system with America.
23
NHS has always been under- funded.
30” Public would like to see more money spent on NHS. Story about public questionnaire . . .. Would spend another penny on tax for a better health service.
2.00 – NHS under the Conservative Government.
2.25 – Children’s Hospital became a trust, the most expensive Children’s Hospital to run after Great Ormond Street.
24
Labour Government hasn’t changed the NHS yet.
20” Emphasis is placed on where the money goes.
30” Explains auditing procedure.
2.00 – Measuring standards isn’t the answer.
2.30 – Bristol surgeon case.
25
Government has taken on responsibility of trying to inform people more.
1.40 – Issue of consent – Patients do have a right to knowledge the problem knows when to stop.
2.15 – Example case – Doctor explained all the side effects to parents of a child who had a disease. Having heard of the side effects they said they would rather the child have the disease. “Knowledge that is demanded is paralysing people from making the right decision.”
3.00 – “Doctoring is about empowering people not taking power away from them.”
3.40 – Retention of organs – Alder Hey case
4.00 – Describes post-mortems
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Alder Hey case continued
Describes situation where a doctor tries to inform distraught parents about the state of their child after a post-mortem.
2.45 – “I wasn’t aware that parent who had lost their child would worry about an organ which was not buried along with the rest of the child.”
3.15 – Didn’t realise that parents wanted all child’s tissues back – use example of appendix.
3.50 – Shock about reaction to the Alder Hey case.
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Doctor’s have failed to move with the experiences of a patient.
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Level of complaints – Story - 4 years a patient had renal problems, started dialysis, had a transplant. New kidney worked but then patient died 4 days after the transplant. Post mortem revealed he had inflammation of the heart muscle.
2.10 – The parents sued, their perception was that the hospital was at fault, they took private prosecution against me and the transplant surgeon.
3.00 – Personal experience sees child’s death as an assault.
3.40 – Is health is seen as a right then death is seen as an injustice, when the right is withdrawn someone must be punished.
29
Personal judgements and the need to explain things thoroughly.
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Typical working week – Walk around wards, discuss problems with team, private consultations with problem cases.
1.15 – Clinics
1.45 – teaching – I am a tutor for the hospital, organising tuition of the juniors and making sure the seniors are up to standard.
2.10 – reading literature.
3.00 – Research into kidney disease.
4.00 – Animal rights activists object to our experiments.
31
Legislation surrounding experiments on animals.
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