Robert Palmer's autobiography

Updated 15 Aug 2015

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Robert Palmer's autobiography 1973-1982

Chapter 13

1973 to 1976

age 29-32

Index

▲ Continued from 1970 ▲

In September 1973 Valerie and I had a holiday in France (the yellow MGB broke down unfortunately). Subsequently Valerie went to Bristol to do her midder nursing training. I moved into the penthouse accommodation at Poole General and started swatting for my final fellowship. The exam was in January 1974. Typically before I knew the result I applied for a senior registrar job rotating between Winchester and Southampton. I passed the exam (just), and the interview for the job was just 16 days later and their first question was had I passed. When I said yes they gave me the job, such was the competition or lack of it back then.

103 Isle of Purbeck, Summer 1974

107 Poole Harbour, Good Friday, 1974

Brother John writes:
I moved into 29 in January 1968, sharing with a friend from Plessey. A year later he decided to get married and left. I found someone else to share the rent. He was a strange guy and left. Repeated with another guy, who was also strange and he left. About 1973 the bungalow owner, an Italian, arrived and announced he wanted to sell the bungalow. Being comfy after 5 years, I offered and bought the bungalow for Ł5,000 furnished. Half of this came from Robert, who supplied Ł2,500 cash. I continued living at 29, with occasional visits from the co-owner (Robert). Around 1974, Robert announced he wanted to withdraw his share in 29, I think to help him buy another bungalow nearby, number 6. By then 29 was valued at Ł8,000, so I paid Robert Ł4,000, for which I got a mortgage on 29. From Robert's viewpoint he had made a profit of 60% in 2 years or less. Soon after, my Aunt Win died and I inherited a business property and cash. Mum said, don't buy a swank car, pay off your mortgage, so I did. Best advice I've ever had, I'm still living in the bungalow after 49 years, and it may fetch Ł250,000 today. Robert's Ł2,500 half share would today be worth Ł125,000 if he'd left it in, an average increase of 100% per year.
At the end of February 1974 Aunt Lucy died and Valerie and I went to her house at 16 Star Street in Ryde to arrange moving some of her effects (including the cabinet and nice antique chairs). Mum had asked John but he had a squash game, hence the attached comment in her diary “bloody squash”.
I started my senior registrar job at Winchester on Monday 1st April 1974, and was resident in the mess at Holdaways. The Consultant anaesthetists were Dr Boddington (soon to retire and be replaced by Bob Buckland), Noel Thorpe who took early retirement on grounds of ill health and was replaced by Roger Cloonie, Ken Harrison who was head of department, John Bowen and Kate Packer.
I was playing water polo for Southampton and playing a lot of squash at Winchester squash club. I was captain of their second team. John Bowen once asked me if my work was interfering with my squash.
In August 1974 I went to Vaenersborg and Trolhatten in Sweden to do a 3 week locum. I was a little uncomfortable not being able to speak the language although most of the Swedish people at the hospital spoke good English.
I had also joined the Territorial Army (I joined while I was at Poole in 1973) and was Medical Officer for the 2nd Wessex TA unit based at Brock Barracks in Reading.
In mid October 1974 I stayed with Valerie in Bristol where she was doing her nurses training, and that is when and where Susannah was conceived. In mid November Valerie and I set a wedding date (I suppose you could say it was a shotgun marriage, though it was probably just the push I needed). Valerie’s mother thought a date in 1974 was best so we settled on Saturday 14th December at Broadstone parish church. In the wedding photo 64 left to right are Aunt Gert, Mum (looking non too pleased, she said later I had been entrapped), Roger who was best man, myself and Valerie, Mattie Nunn, JCP, Norman Nunn, Barbara Nunn.

64 Broadstone parish church, 14dec1974
Aunt Gert, Mum, Roger Pearce, RJP, Valerie, Mattie, JCP, Norman, Barbara

At the wedding reception Roger’s girlfriend Linda dropped a bombshell, she told Mum that Valerie was expecting!
We did not have a honeymoon because there was a prior arrangement for me to go to RAF Sharjah to do a locum as a general duties medical officer in the TA.
After my year in Winchester (during which I lived in the mess) I moved to Southampton General Hospital for my second year as an anaesthetic senior registrar. Valerie moved down and we lived in hospital married accommodation in Laundry Road at the back of the hospital. During my year there I earned extra money by doing GP night and weekend shifts. I remember on one occasion being called to a house where a somewhat overweight late teenage girl was experiencing severe abdominal pain. The family were all downstairs in the living room. I was having difficulty making a diagnosis until I realised the pain had an episodic character, and indeed soon after she delivered a healthy baby to everyone’s incredulity in particular her own as she had no idea she was pregnant.
In anaesthetics we rotated round neuro, paeds, and cardiac at The Western Hospital, which was not my favourite.
On 16th July 1975 Susannah was born by LSCS at Southampton General Hospital. It was Category 1 and Andy Dewar was bought out of the bar to supervise the GA. The surgeon was the senior lecturer.
Round about this time I sat my ECFMG as I had decided I wanted to go abroad and the USA was a possibility. I passed.
In October I did a TA camp at Knook.
I was still doing a lot of GP deputising.
Susannah’s christening was on Sunday 11th January 1976 in Southampton. Sam and Des Henley, John and Charles and Frances Holme came and they can all be seen in the attached photo in Laundry Road.

104 Susannah's christening, Southampton 11jan1976

In March 1976 Valerie, Susannah and I went to the continent including a visit to East Berlin, followed by a trip to the Mary’s hut.
Also around this time Tom Mcaughey from Montreal General Hospital came to Southampton to see me and lined me up for a one year clinical fellowship there starting on 1st April 1976.

Chapter 14

1976 to 1978

age 32-34

Index

105 Sue+RJP, Montreal, July 1976

106 Sue in the Park, Montreal, Feb 1977

We lived at 6666 Fielding, NDG, Montreal which was a small one bedroom flat. I was a clinical fellow and was resident on call every other night. It was moderately busy. Tom MaCaughey was the head of department, though he didn’t do much clinical work. Malcolm Dunkley was one of the Consultants and he invited us to his cabin on Chazy Lake in upstate New York on more than one occasion. Rod Binsted from Australia was the other clinical fellow and his wife was Libby. Later Gill Farnsworth came over as a clinical fellow.
Not long after starting I flew back for a GP anaesthetic job interview in Guernsey. I was offered the job but turned it down.
I joined Point Claire water polo club and also I played a lot of squash.
In the summer we went to the Olympics which were on the far side of Montreal.

I had one of my worst cases when I was there and I still get flashbacks.
It was a middle aged lady having a laparotomy and she was on a portable Bennett ventilator. We did not have anaesthetic assistants, but there was a nurse watching and inexcusably I said I just had to nip out to the loo and would she watch the patient. I was gone longer than I should (I got a sandwich out of the machine as well as a wee), probably about 4 to 5 minutes. When I got back the surgeon immediately said the blood was dark. What had happened is that the ventilator had an on off button on the front which it was easy to knock and then it would be turned off and the patient, who was paralysed, not ventilated. This is what must have happened around the time I left. She hadn’t arrested fortunately, but was a little slow to wake up, but seemed ok afterwards (I wonder if she did cryptic crosswords!). Anyway it was a wake up call and I never did that again in my career.
In the late summer we had a holiday in our old VW and I seem to remember went all the way to Tennessee and back.
In the autumn I applied for and got my USA green card, as I was thinking of going to the States. In December 1976 I went to Burlington Vermont and sat and passed the US FLEX exam (federal licensing exam). I then put an ad in the JAMA (journal of the American Medical Association) and the phone never stopped ringing with job offers which Valerie had to answer. She was not too keen on the idea of going to the USA.
On 25th January 1977 Carla was born by LSCS. It was Robbie Burns Day.

I was doing a case during Valerie’s operation.
It was a carotid angiography under GA on a patient who had had a subarachnoid haemorrhage). I inadvertently gave neosynephrine instead of neostigmine at the end of the case (the ampoules were identical in colour and a neosynephrine ampoule had been erroneously put in the rack instead of neostigmine but that is no excuse and it was my responsibility to read the label of the ampoule properly). My mind was on other things though. She did not seem to come to any harm thankfully.
Round about this time I decided I did not want to go back to the UK though I had to serve out my 3 months notice at Southampton. There was a one year locum Consultant job advertised in Victoria BC which Valerie agreed to as she knew Samantha Henley’s sister Beverley who lived there with her husband Bob and daughter Corrine. I applied for and got the job, to start in August 1977, therefore returning to Southampton for May, June and July 1977.
When I got back to UK I successfully got an immigrant visa for Canada (thanks to Guy Screech who’s locum I was going to do while he went sailing in the Caribbean).
Peter Horsey at Southampton got me my CSST (certificate of completion of anaesthetic training which made me eligible to apply for a Consultant job in the UK). However I was not planning to do that, partly because of lack of confidence and partly because Mum had always said “ go to N. America, particularly the USA”.
Valerie and I with Sue and Carla now went back to living in Laundry Road. Photo 108 shows Valerie and myself with the two girls in the garden at Laundry Road.
In the summer of 1977 Carla was christened, see photo 109. It shows a smiling Mum aged 69 (she had by now accepted my marital state, was much more cheerful as the photo shows, and was planning to come to Victoria with Aunt Doreen to stay with us in September, she was still living with Aunt Dorothy in Robinson Drive, Worksop, Uncle Billy was in a care home). Also in the photo are Helena and Will Bien, Roger and Linda, Anne Hughes, John, Barbara and Valerie myself and the girls).

109 Carla's christening, summer 1977

On Sunday August 28th 1977 we flew to Victoria BC via New York and Vancouver (see photo110 of the four of us at Heathrow, I am wearing my “male chauvinist tie”). When we arrived Susannah said her first words “outside its raining again”.

108 Southampton, May 1977

110 Heathrow to Victoria, Aug 1977

Shortly after arriving I went to the BC board of medical registration and they couldn’t understand how I had managed to get an immigrant visa, an inauspicious start.
We lived at 692 Beaver Lake Road which was Guy Screech’s small holding, including chickens and a dog Casey (soon to be run over on Pat Bay Highway unfortunately). As the Screech’s hadn’t left yet we spent the first two or three nights in a camper van.
Mum and Aunt Doreen arrived in September not long after we had settled in. I don’t think Aunt Doreen stayed long (she was with her sister in a flat in Vancouver). While Mum was with us we killed the chickens by decapitation (which Guy Screech had given the go ahead for) and had a spinning deplucking machine. Guy Screech’s son helped. It was rather gruesome but amused Mum. Also see photo 112 with myself, Mum and the girls on the stony beach near Victoria.

112 RJP, Ena + girls Sep1977 Victoria

Mum also went down to Portland, Oregon to see Angela MacLachlan.
I joined the squash club and Valerie played tennis at The Oak Bay Recreation Centre and became a “triple Oak Bay ace”. We were friendly with the Nixons, and saw a lot of Beverley and Bob.
We bought a red setter called Missie who is with us outside 692 Beaver Lake Road in photo 113. Also in photo 111 myself, Susannah and Carla on my 34th birthday in Victoria.

111 RJP, Sue, Carla 29jul1978 Victoria

113 Beaver Lake Rd 1978

There were about 9 anaesthetic Consultants, but no juniors. We had a rotating on call system. At first I wanted to be resident on call, but was quickly disabused of that as it would set a precedent. Beaver Lake Road was some distance from the hospital and maternity would be a worry, but I can’t remember ever rushing in. The job was not particularly arduous. Like at Montreal we had no one to help us and had to set up everything ourselves. There were no nurse anaesthetists as in USA.
As we both liked Victoria I started making enquiries to stay on. However my British FFARCS was not recognised (it may have been in the Yukon!) and the Canadian board would not let me sit their exam without my doing a one year job in medicine. So it was a non starter. I did talk to Jim Gerry the chief of anaesthetics but there was nothing he could or would do. I then started applying for jobs in Portland, Oregon but none of the private hospitals were interested and the only job offers I got were at the Veterans Administration Hospital, and the Kaiser Permanente, neither very attractive. So I wanted to look elsewhere. Valerie was not keen, but said she would accept 2 years in the Pacific North West of the USA, Virginia or New England. So I targeted these areas and got offers to interview me in Patchogue, Long Island, NY, Springfield, MA, and Worcester, MA, and a hospital in Boston. On February 17th 1978 I got the ferry to Port Angeles, WA, the greyhound to Seatac airport in Seattle, and flew to Newark, NJ. I went first to Patchogue, which I didn’t like, then Springfied which again I wasn’t too happy with, then Paul Harges took me out to supper in Worcester, MA, offered me a job which I accepted, so I never went to look at the Boston job. My British qualifications were fully recognised.
We left Victoria for Worcester Memorial Hospital on Monday 21st August 1978.

Chapter 15

1978 to 1980

age 34-36

Index

118 Nigel Theaker and Ford Fairmount March 1979

58 Kitchen at Spring Street

We had a rental in Whitinsville, south of Worcester. Shortly before we left Victoria the owners of the rental asked if we could only stay for a short time as they had an offer on the house. We agreed. In return I think it was rent free. We arrived at Logan including Missie the dog. We had sold the Mazda rotary engine car before leaving Victoria. The owners of the Whitinsville house met us at Logan and drove us down to the rental house.
The first priorities were to buy a car (I bought a black Ford Fairmont with no extras, see photo 118) and find somewhere else to live pro tem (we got in to Day’s Lodge in Worcester). There were lots of other things to be done like going to the Board of Medical Registration in Boston. We also started looking for a house to buy and very quickly found 196 Spring Street Shrewsbury with Helena Nelson. It was a "contemporary on one floor". Valerie liked it. We paid $95,000 for it.

115 Valerie in kitchen, Spring St

116 Back of Spring St, Autumn 1979

I started work very quickly of course. The attending anaesthesiologists were Paul Harges, Sami Abdou (soon to be ousted), Tom Roy, Leo Hochman, Kassim Docrat and Hashmukh Vankawala who started the same time as me. There were 7 CRNA’s (nurse anaesthetists) who were Anne Guardiani, Blanche Couillard, Maria Ma, Judy Manfredo, Kay Oliver, Nancy O’Leary, and a seventh soon to leave, and replaced by Leanne Chabior.
I quickly started playing squash at Worcester Polytechnic Institute which also had a swimming pool. I played for the WPI team in the Massachusetts league and that first year we won our division (see photo 72 taken in spring 1979, back row left to right Roy Astley #2, Peter Allan #1, myself #4; front row left to right Bill Sprout #3, Ken Harvey #5).

72 WPI team, Spring 1979

114 Carla, Spring St, Sep 1978

There was no water polo so sadly that was the end of my water polo days (I had played occasionally in Victoria for the University team there).
We became friendly with Sunny and Ed Fletcher the couple over the road. They had a daughter called Laurie and a swimming pool which we were encouraged to use, and they were like family to us.
The Dunkley’s had moved to Martha’s Vineyard and we visited them on many occasions.

57 Spring St June 1979

75 RJP at Memorial

Not long after starting at Memorial in 1978 I had a near miss
in the obstetric suite. It was a Portugese speaking lady for a LSCS under epidural. Back then we were required to teach the OB residents how to do epidurals. The male resident sited the epidural and inserted the epidural catheter (which in retrospect was sitting in an epidural vein but that was not apparent right away). I injected a LSCS dose of 0.75% marcaine (this was before it was banned by the FDA of the USA). She had a grand mal seizure but fortunately her heart did not stop. I gave her a GA and mother and baby were well. I had the uncomfortable experience of having to present the case to the obstetricians at their M and M after.
I used to do weekends on at The Hahnemann hospital up the road from Memorial. Sally Hooton (a friend of Valerie’s from school) lived in Rhode Island and we got together a lot over the years. Valerie went to Shrewsbury Episcopal Church and she made a lot of friends from there.
When we were in Southampton we were worried about Susannah possibly having a squint in her left eye. We saw John Tudor who was a SR in ophthalmology at Southampton General, and he said everything was ok. When we got to Worcester I took her to see Reid Roberts, an ophthalmology attending. He said she needed an operation to correct a squint. The first operation was not a success and the squint was much worse after. So a second operation was necessary. Preop he asked me if I wanted her to go to Boston, but I said no. Bob Gise assisted him for the second operation which was successful
At Memorial Hashmukh Vankawala and I set up an obstetric epidural service, which was too successful (nearly 70% of Mums had one), and led to many sleepless nights on call, but boosted our bank balance.

On Friday February 13th 1979 I had another near miss.
It was a 42 yo morbidly obese female patient for diagnostic laparoscopy, surgeon Tom Pokoly. I induced her with thio, sux, intubated her and ran her on nitrous oxide, oxygen and halothane with a sux drip. The drapes were over her face (I hadn’t clipped them on to the iv pole so I couldn’t see her face). I was filling in the chart when I noticed she was bradycardic with ectopics from the sound of the ECG monitor (no pulse oximetry back then). I threw back the drapes and she was navy blue. I quickly pulled out the tube, bagged her with 100% oxygen, and reintubated her. She then exhibited decerebrate rigidity. I gave her 500mg of iv thiopentone (barbiturates were treatment for a cerebral hypoxic episode back then) and ventilated her in ICU overnight. That night we had a Belgian anaesthetist staying with us, but I was consumed with worry. Fortunately she was ok the next day, extubated and went home.

On Friday 14th December 1979
we flew to Sydney for a holiday principally with Valerie’s family. Sadly it was an ill fated venture. On only our first full day there we went to Maroubra beach (see 130). I was amazed at the size of the waves and went in for a swim leaving Valerie and the girls on the beach.

130 Maroubra Beach, near Sydney
I rode one of the waves (body surfing) which broke and I was dumped head down into the seabed and sustained an acute flexion injury of my neck resulting in a C6 C7 fracture dislocation. I managed with difficulty to get back on to the beach. My left thumb was numb and my neck was very painful so I knew that I had damaged my neck badly. I lay face down on the beach. The lifeguards came but I wouldn’t let them turn me over. I supervised my transfer face down on a stretcher to fortunately close by Prince Henry Hospital which specialised in spinal injuries.

Prince Henry Hospital, Sydney, closed in 2001, and the site has since been sold for a housing redevelopment.

131 .... I had a unifacetal dislocation with 30% subluxation of C6 on C7 ....

I was taken to their emergency department and refused to let them move me until the consultant neurosurgeon arrived. I was terrified of being quadriplegic. Quite soon John Matheson the Consultant Neurosurgeon (see photo 117 of him recently) came.

40 Prince Henry Hosp., Sydney 1979

117 John Matheson recently

He held my head while I was turned over and supervised the taking of X rays. Then he shaved my head, inserted Crutchfield tongs and attached them to a pulley and weights and put up a drip. I was then moved to a treatment area. Later I was rexrayed and the substantial slippage of C6 on C7 (see photo 131) had not reduced. He then put valium and pethidine in the drip which reduced the spasm in my neck muscles and it popped back into alignment thank goodness. I was eternally grateful to John Matheson and took him, his wife and daughter to supper in Wickham in 2014. In fact I had a unifacetal dislocation with 30% subluxation of C6 on C7. The treatment nowadays is surgery because traction carries the risk of where there is disc rupture the disrupted disc with traction can impinge on the cord with neurological damage. John Matheson said when I saw him in 2014 that in most cases traction is the best way forward as surgery has its own not inconsiderable complications. When I had a cervical myelogram back in Worcester MA after my return I was told I had an unusually wide cervical canal which is why I had no neurological deficit. I was moved to the general ward where I laid terrified for 6 weeks. They said I was the best patient they had had. While there I was visited by Cate Waterhouse, Geoff Talbot who flew down from Brisbane, and Michael Sacree. I was on a Stoke Mandeville bed which broke down after 5 weeks or so, but they managed to find a replacement. When the 6 weeks were nearly up the tongs came out, but they were not replaced and I stayed still until the 6 weeks were up. I then was rexrayed in flexion and extension and they were happy with the result and I was discharged with a large collar on (see photo 119).

119 RJP with large collar and Valerie's Mum early 1980

Chapter 16

1980 to 1982

age 36-38

Index

When we got back to USA after Australia in March 1980 I started work again fairly quickly, but had to wear a collar for a fair while. I continued to get aches in my neck for the whole of 1980 but it slowly got better.
Mum came over for the first of many visits in late spring 1980. I learnt about bees from a farm in aptly named Breakneck Hill road, and bought 2 hives and set up colonies. I also built a chicken house and kept chickens, although the racoons killed them periodically (there were no foxes in the USA).
We became friends with the Dunn’s, Ed and Eleanor and their three daughters who lived close by, also the Groves, John and Sue who lived in Princeton MA, and Judy and Dennis McMullen who lived in Westborough. Valerie played tennis with Judy.
As my neck was not 100% I held off playing squash for some 6 months, and when I did start again I joined the C team instead of the B team. Our team was Sam Woolford #1, myself #2, Denis O’Neil #3, Greg Ota #4 and Ed Davis #5. As with the B team we won the MA championship in the spring of 1981.
In the summer of 1980 I joined the New England Masters swim club and started going to swim meets, which I kept up for the rest of my time in USA. Another thing we joined was the Australia and New Zealand Society where we met Nutty and Graeme Reeves.
In 1980 Susannah started school at Spring Street primary school just up the road. The yellow school bus would pick her up from no 196 in the morning and return her after school. It was a very efficient arrangement. Her school mistress was Mrs Dadonna. I also went back to UK on average twice a year for two weeks at a time, and this became a pattern for the next 10 years.

122 RJP on mower 1981

Ed Fletcher was Father Christmas in 1980 and delivered my sit down mower (see photos 120, 122). I also shared some piglets with him (see photo 121).

120 Ed with mower Xmas 1980

121 Ed Fletcher with piglet

Work wise Paul Harges stepped down as chief of dept and Hasmukh Vankawala (who was Burmese, but trained in UK) took over. Tom Roy moved to Dallas. We hired a new colleague Joe Blanco, more about him later.

I had an“interesting case” around this time.
It was when I sited an epidural and committed the cardinal sin of pulling the portex epidural catheter back through the Tuohy needle which was still in the epidural space. Back then the Touhy needles had sharp ends and the last 2mms or so sheared off and was left in the patient. I was the only one who knew. I should have told the patient but I didn’t because I rationalised that there was no evidence that it would cause any harm if it was left in the patient’s epidural space, and there was a risk I might get sued, and/or she develop a neurosis about her back.

Around that time Valerie had a minor op at Springfield, MA (the anaesthetist was 1956 Melbourne Olympic gold medallist in the 200 butterfly Bill Yorzyk).
We had Christmases with the Bridges, Norman and Cindy, and the Woodleys, Tish and George.

123 Dec 1981 at McMullens

124 Spring Street School 1980-81. Sue & Diana Dunn, Mrs Dadonna's class

We had a problem with a new anaesthetic attending Paul Harges took on without input from the rest of the group. He always wore long sleeved gowns, scratched his arms a lot, often needed bathroom breaks and the surgeons were unhappy with him (he had twice had an unrecognised oesophageal intubation). He was on his probationary year which was normal practice. One morning when I was in the maternity unit I phoned the hospital in Texas which he had come from and spoke to his colleague asking him point blank if he had a substance abuse problem. His colleague would not answer that question but let me speak to one of their surgeons who immediately said he was a Demerol (pethidine) addict.
We “let him go.” He moved to Wing Memorial Hospital in Palmer, MA where they had suspicions and called in the federal narcotics squad who found syringes, drugs etc in his locker. He committed suicide. Later I learned that our best CRNA had on request injected him iv I think with a drug on at least one occasion. I was dumfounded.

125 Carla's birthday aged 4, 1981

126 Feb 1982, Sue, RJP, Missie at Spring St

In 1982 when Hashmukh left to join Tom Roy in Dallas I became head of the anaesthetic department at Memorial. When the vote took place Paul Harges and Leo Hochman voted for Kassim Docrat and Mohammed Mushtaque and Nick Ranno voted for me. Hashmukh had the deciding vote and voted for me.
Head of department was somewhat of a poisoned chalice. I still had a full share of clinical work. The hardest part predictably was “human resource management”. I remember interviewing for “disciplinary reasons” Judy Manfredo and Kathy Blanchard and each time they burst into tears and I hadn’t a clue what to do next. When I had a similar interview with Martha LaRose she verbally attacked me with a character assassination, and then handed in her notice.

Also in 1982
... I was called down to maty in the middle of the night to be faced with a morbidly obese and heavily pregnant black lady having a concomitant attack of bronchial asthma and thrashing around on the operating table, and with the surgeon Alan Albert jumping up and down like Rumplestiltskin shouting “foetal distress, get her to sleep, get her to sleep “.
I had visions of my career ending there and then. Nevertheless I managed to get a cannula into her, gave her thiopentone and succinylcholine and with great difficulty intubated her, although there was a short period when I was not sure the tube was in the right place, but thankfully it was.

69 RJP's 38th birthday 1982

127 Kate August 1983

See photo 69 of my 38th birthday in 1982. At work I was busy with visits of the JCAH (Joint Comission for the Accreditation of Hospitals) and the beginnings of Quality Assurance. Anne Guardiani helped me a lot with all these chores.
We used to make regular trips to Marblehead where we visited the Reeves and Tony and Anne Solley (Tony Solley had been an anaesthetic trainee with me at Poole and Southampton).

▼ Continued in 1982 ▼

Updated 15 Aug 2015