Audio transcripts from Blog - Whispers from the archive

Sir Charles Fletcher tells of treating the first ever patient with penicillin:

Now the first thing was to see if by any chance this drug, which had been so harmless to mice, might be acutely toxic to human beings. And the remarkable thing is the first thing I was asked to do was to find someone who was dying, inevitably dying of some disease, in whom it wouldn't really matter... if the first injection proved fatal. We wouldn't do it that way nowadays at all, but at that time it was done. And I found a very nice lady who was unfortunately dying of disseminated cancer and I asked if she would mind having an injection of a new drug that might be helpful to people, although I didn't say it would help her, and she agreed to the injection. So Florey came along with an ampule of the drug, with Witts, and we went into the ward, filled this ampule with this yellow fluid, because the extract was yellow in those days from the yellow excretion of the mold from which penicillin was grown, and I got a syringe out and injected it into the vein of the patient. And about three hours later she had an acute raise of temperature, she had a rigour fever, so that showed that the penicillin at that time had a pyrogen or something that produces fever in it. And Florey worked away in the laboratory with rabbits to get rid of this, to purify it still further and get rid of it, and then he had a substance from which he had removed the pyrogen as shown with rabbits. And then I had the job of finding out which way this penicillin could be given. Obviously we tried by mouth but it was destroyed in the stomach, we tried by the other end of the alimentary canal, by rectum, and we decided that the only thing we could do with the very scarce supplies then available was to take it intravenously. Now, what about a patient? Well the Radcliffe infirmary like all hospitals had a septic ward and I went down there to find somebody who had a serious infection with a germ which could not be cured by other drugs but penicillin might cure, and there was a policeman there, a delightful man, who had been in having septicemia with boils breaking out all over him, he'd lost one eye from the poison, he had boils all over him and he was in a desperate state, and we started penicillin and it was absolutely miraculous. The next day he said for the first time that he was feeling better, his temperature came down, and so it went on for four or five days, and then the supplies of penicillin were so scarce that I used to collect his urine in the evening each day and bicycle with it over to the Dunn Laboratory where Chain and Florey would be waiting to hear the latest clinical news, and I would give them this urine and they would extract the penicillin so that the patient could have on the third day the same penicillin he'd had on the first day. But in spite of this it was necessary... on the third or fourth day the penicillin ran out and it hadn't completed curing his infection. The poor man then deteriorated and died about a week later.

 

Dr Brandon Lush remembers treating the casualties from Dunkirk

In May 1940 the medical officer in charge of the hospital got a message to say that within 24 hours we would be receiving a train load of dozens of casualties from Dunkirk. And so we had to evacuate practically all the civilian patients from the hospital and we were divided up into teams. Because I’d done surgery I was allocated to the surgical team. We had pairs of them, I and one other did surgery and two others did anaesthetics, taking in turn, two others did triage sorting the patients out and so on. So in 24 hours we organised to deal with all the Dunkirk casualties, oh and of course two others did blood transfusions. And miraculously we dealt with the whole lot and the way it worked, well most of them had metal fragments that needed to be removed, although, I’m not sure all were necessary, and the way it worked was the anaesthetist… we had two operating tables in the theatre and one surgeon and two students and one anaesthetist, and the anaesthetist would anaesthetise the first patient while the second patient was put on a table, and then the surgeon would get down to whatever was necessary by way of operation, removing foreign bodies, setting fractures, putting in plates or what have you, and then he would move to the second table where the patient was already anaesthetised and I would finish doing the sewing up, and the same it went on and so forth. I think, other than for what you might call toilet purposes, I think we hardly left the theatre for the next 24 hours, and by and large the end results were excellent.

 

Dr Norman Jones remembers helping to establish the first renal unit at St Thomas’ Hospital:

It was easy to be blinkered in nephrology; when I was a junior doctor, certainly as a student and junior doctor, kidney failure was just death, there was nothing else, and this revolutionised that, even the primitive methods by today’s standards of the later ‘60s. In ‘68 for instance, the normal sentence, in a sense, for regular haemodialysis, was 15 hours three times a week, and if you developed certain complications, like neuropathy it was more, and that was a tremendous chunk out of the week. I remember when our unit was being built and it opened in the summer of ’69, we were granted the use of two rooms in the intensive therapy unit at Thomas’, in which to do our dialysis and we could obviously only cope with a very few patients, but by the time that we could move into the new unit, we had seven people on regular dialysis going through that pretty well non-stop little unit, but what I do remember is that when we had our, and of course methods were nothing like as sophisticated then as they are now, but when we had our 21st birthday party as a renal unit, five of those seven were there, 21 years later. That, I think, is one of my happiest memories.