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Professor who inspired me to pick breast as my speciality

Sunday September 15 2019

BREAST CANCER

Surgery. Hedley Atkins devoted his long surgical career to demystify breast cancer by doing research on the subject. ILLUSTRATION | COURTESY 

Yusuf K. Dawood
By Yusuf K. Dawood
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Although we have left Dewsbury, there is one more incident I want to mention because it happened there, and it is relevant to today’s column.

In April 1958, I was due to finish one year in Dewsbury and planned to appear for the final fellowship examination scheduled for May that year.

I knew that courses to prepare candidates for this examination were offered at Guy’s and Thomas’ medical schools in London, and early in December 1957 I applied at Guy’s for the March course, which preceded the examination in May.

But I heard from Guy’s the course was full, so they had given me a confirmed seat on the September course and had put my name on the waiting list for the March course.

That delayed my programme by six months and put our wedding plans in jeopardy.

Assuming that I would get on the March course, I applied to leave my post one month earlier than what my contract stipulated.

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WAITING LIST

I needed permission from the Board and I had to attach to my application signatures from the three consultants I worked with to signify their approval.

When I requested Mr Oldfield to sign on the dotted line, he asked whether I had obtained a place before applying for leave.

I replied: “I have a confirmed seat at Guy’s for the September course but I am on the waiting list for the course in March.”

I added that I was deeply disappointed and keen to get on the March course and return home much earlier. “Carry on with your plans for March. A vacancy is bound to arise before then,” he replied, raising my hopes.

True enough, two days later while I was removing a cancerous kidney and was carefully ligating the large renal vein and artery, a message was delivered to ring the Dean’s secretary at Guy’s when I finished operating.

EXAMINATION

Accordingly, I rang after completing the nephrectomy and a female voice replied: “Sorry for this short notice, but can you accept a seat in the March course because a last-minute vacancy has come up?” I gladly accepted.

When I started the course, I learnt that this ‘last- minute vacancy’ had arisen because of a phone call from Mr Oldfield to the Dean; they were classmates at Guy’s as undergraduates, and friends!

The course prepared us very well for the oral examination. We were assigned clinical cases and ‘grilled’ by Mr Blackburn and Mr Glover on alternate days to simulate the clinical examination, which was a very useful exercise.

Rex Lawrie taught us operative surgery on cadavers, but it was Prof Hedley Atkins who taught us about pathology specimens — known as ’pots’ in surgical jargon — who stole the show.

In time, he rose to the position of President of the Royal College of Surgeons of England and was knighted.

LESSONS

Before I narrate an interesting episode in relation to Prof Hedley Atkins, I want to say that Guy Blackburn came as an external examiner to Nairobi, and we worked together as examiners in viva voce in surgery.

Back to Hedley Atkins. I learnt two things from him.

Number one — to remain cool in the operating theatre. While doing adrenalectomy — removal of adrenal gland, surgery advised for advanced breast cancer back then, he accidentally tore a big blood vessel and blood spurted high enough to stain his glasses.

Instead of getting agitated, he said to Sister, “Hot pack please.” He placed the pack on the bleeder and talked to us, a large audience gathered to watch the maestro in action, about the cricket match played at Lord’s between Britain and West Indies until the throbbing vessel reduced itself to a trickle and caught it and quietly tied it. He reminded me of Mr Khwaja, my first boss.

The other thing he bequeathed to me was his dedication to breast cancer.

ENIGMA

He devoted his long surgical career to demystify this disease by doing research on the subject.

I was surprised therefore that in the 10 weeks, he taught in the pathology museum and picked various specimens; not once did he use a breast cancer specimen to teach us.

So on the last day when he offered us the privilege to pick the topic for discussion, I raised my hand and said:

“Sir, you have devoted many years researching on breast cancer and yet you haven’t touched on the subject with us.”

He responded: “You have got me there son because having worked for a lifetime on the breast, I am totally confused by contradiction and controversies plaguing the subject. If either my wife or sister got the dreadful disease, I wouldn’t know how to treat her.”

Pulling the ubiquitous pipe out of his mouth, he added. “If you had asked me to talk about brain tumour, a case I have not seen for 15 years, I could have given you an erudite account of the condition.”

SUCCESS

As a result, I picked breast as my speciality when super-specialisation invaded Nairobi. And when I worked at Kenyatta Hospital, I did a lot of clinical research there.

I also spent a fortnight studying the subject at Karolinska Institutet in Stockholm under Prof Einhorn, a world-renowned oncologist, especially in breast cancer.

A week later, the final FRCS examination began. There were two theory papers, one in the morning and the other in the afternoon.

The questions demanded essay type answers, multiple choice questions were not in vogue yet. I did well in my theory papers and sailed through orals held on Thursday, May 15, when I was ‘grilled’ by 16 examiners.

The results were announced the same evening and only the numbers of successful candidates were called out.

Marie was with me when the results were announced; I simply fell in her arms when I heard No. 94 called. We were escorted to the Fellow’s Common room and signed the Fellow’s Register.

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