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Spotlight interview: Professor Sir David Hall

 

With a long and illustrious career in medicine, we are extremely proud to include Professor Sir David Hall (RGS 1956-1963) among our notable Reigatians. Indeed, one of his most significant appointments was as President of the Royal College of Paediatrics and Child Health (2000-2003), where he advised the Department of Health on a variety of topics including screening, SureStart, child protection and adolescent health.  

 

Briefly describe your journey on leaving RGS? 

A few weeks after my 18th birthday I arrived at Kings College in the Strand, by moped from my lodgings in Clapham. I was about to start what was then called the ‘pre-clinical’ period of study to qualify as a doctor – a Bachelor of Medicine and Bachelor of Surgery. This involved a lot of very detailed anatomy (including dissection of cadavers), physiology, biochemistry and pharmacology. I had the opportunity to spend a further year studying for a BSc in pharmacology with five other students, among them my future wife Susan. This was followed by three years at St George’s Hospital at Hyde Park Corner, though much of our work was at Tooting Hospital. After qualifying, Susan and I worked in London and Canada; we were both keen to study infectious diseases and work in Africa but our initial plan to go to Uganda was abandoned when we realised that Idi Amin was wrecking the country. We had both read a great deal about South Africa, including perhaps the most famous book to come out of that country, Cry the Beloved Country by Alan Paton.  After much heart searching, we applied to work at the Baragwanath Hospital in Soweto, the massive black township south west of Johannesburg. I specialised in paediatrics and neurology while Susan set up and ran a family planning and women’s health service in Soweto. In 1976 we came back to London where I completed my training and was appointed consultant at St George’s, while Susan became a consultant in public health. We moved to Sheffield University in 1993 and retired in 2005.   

What inspires or motivates you? 

Like most doctors I always enjoyed the challenge of a complex case, often in collaboration with colleagues in other disciplines such as radiology or biochemistry. Medical school in the 1960s followed a traditional model that had probably changed very little since my cousin trained at St George’s twenty years earlier. Consultants expected us to know all the patients in their ward and to know what tests and treatment they had – so when I started my first house job in Croydon, I had the confidence to deal with most admissions and I still remember many of the patients I looked after. I also enjoyed psychiatry teaching at St George’s and as I got older, I sometimes got more satisfaction from making a diagnosis and solving a problem that was not due to organic disease, both in children and in adults. For example, I remember in Canada demonstrating to a young man convinced that he was having a heart attack how all his symptoms were due to anxiety. Even in retirement I continue to keep an eye on the medical journals, particularly during the COVID pandemic and, in the midst of this massive tragedy, the pace and creativity of the research effort (both medical and sociologicalare fascinating and humbling.   

You’ve had a long and varied career, but can you pinpoint one job that stands out as the most rewarding?  

I don’t think so – I have enjoyed all my jobs and most have had their highs and lows. But I do have particularly happy memories of my year at the Queen Elizabeth Hospital for Children in Hackney. I was assigned to the Connaught Ward – where my mother trained as a nurse in the 1930s. Every night the resident staff went round every ward with the night sister, Sister Lincoln. We argued and debated the diagnosis and care of each child and listened respectfully to Sister who had seen it all before, many times. More than once she whispered the correct diagnosis in someone’s ear. It was a small hospital, and we were a good team. The hall porter was an old-style Cockney and had a good eye for recognising a seriously ill child. There was a pub next to the hospital and on the rare occasions when we had a quiet hour in the evening we could slip out for some refreshment, knowing the porter would discreetly call us for anything urgent! That sounds shocking now – but it was nearly 50 years ago, and a different world! 

What do you feel is your greatest achievement?  

I am tempted to say structuring a happy family life so that Susan could pursue her career as an epidemiologist in infectious diseases and our two daughters could achieve their career goals. Professionally, I suppose it was challenging the received wisdom on screening young children for disabilities and helping parents to achieve an accurate diagnosis and a good management plan. When I worked for Dr Hugh Jolly at the Charing Cross hospital, I became interested in the problems of recognising disabilities early, a task that often fell to doctors working in child health clinics in the community. I reviewed the difficulties inherent in this process in a British Medical Journal paper written with a colleague at Guy’s and this led to a series of working parties, supported by the Department of Health, which resulted in new policies and much new research. Perhaps the most interesting challenge was to do with early recognition of hearing impairment in babies. Cochlear implants had dramatically improved the outcome for infants born deaf. One of our recommendations was to invest in screening of all new-born infants and, aided by the expertise of a brilliant audiological scientist, we persuaded the Minister to support this.   

You worked in Soweto in the 1970s and returned to South Africa to enjoy your retirement – what have been the most notable changes over those 50 years? 

In the 1970s it seemed that apartheid would be the political system for ever. My wards at Baragwanathwere full of very sick children – tuberculosis, measles, gastroenteritis, severe malnutrition, rheumatic fever, meningitis etc. The women attending Susan’s clinics were also often very sick as well as requesting family planning advice. Non-white people were subject to the PassLaws, the Immorality, Act, the Group Areas Act and much else besides. We were privileged to be at Baragwanath on 16 June 1976 when the Soweto uprising began, but it took another 18 years before democracy finally came to South Africa on 27 April 1994. We will never forget the sight of people queuing to vote for the first time. The honeymoon period of majority rule under Nelson Mandela did not last very long – when Jacob Zuma became president, corruption spread rapidly, and the result now is poverty and hunger that in many areas is worse than it was in the 1970s. Measles has largely disappeared due to vaccination,but the HIV /AIDS epidemic has replaced it and TB still kills more every year than COVID-19.

You and Susan continue to work on local child health and literacy projects near your home in South Arica. Do you think you’ll ever completely switch off and retire? 

No – why would we? To quote Cecil Rhodes, ‘So much to do, so little time’! The structure of DNA was elucidated in 1953 when I was eight years old and our biology master told us about in the Third or Fourth form at RGS. Now we know the exact structure of the human genome and there will soon be molecular scissors to remove and replace faulty genes. We also know far more about brain function and development in the young child – and that poverty and loneliness, ignorance and illiteracy are equally important in understanding the origins of disease. South African children have among the worst literacy and numeracy in the world with huge differences between the white and non-white population groups and our small Rotary Club partners an NGO called Wordworks in supporting and developing a literacy project in several townships in the Western Cape.   

If you could go back in time, is there anything you would do differently? 

I would have liked to work for a few years with an outstanding research team before becoming a consultant. When the main workload is patient care it is difficult to establish major research projects. But as for a career outside medicine – no, I can’t think of a better job.  

What advice would you give current students with an interest in medicine and related studies? 

You are living at a time when all the sciences are progressing faster than ever before. Recognise how lucky you are. I hope you will have the excitement, the sense of awe that I still have when I look at those original pictures of the double helix, the exquisite fine detail in an MR scan or the latest research in robotics. And I hope that while you revel in the excitement of scientific advances in medicine you will never forget that much of the sadness in the world is man made rather than due to diseaseI think also that you will see changes in society’s attitude to death and we will eventually have assisted dying legislation similar to that in many other countries – that will present new and interesting challenges for health care. 

It’s over 50 years since you left RGS. What does being a Reigatian mean to you? 

It is only in later life that I realise how fortunate I was. I had outstanding science teachers but I also know now that our generation of schoolboys was remarkably tolerant. There were quite a few eccentric boys in my class, indeed maybe I was regarded as such. Our masters were also tolerant – most had been through WWII and they were not likely to be intimidated by a classroom of 30 boys. I’m also grateful for the school’s insistence that the science stream should include exposure to English literature, particularly poetry, which I would probably never have read otherwise.  

In 2020 RGS launched its Nightingale Fund, for which you have been a valued advocate. Why do you think this is such an important campaign? 

In 1963, thanks to the superb science teaching at RGS, I achieved the three A levels required by St George’s Medical School to train as a doctor – the best job in the world. Fifty-seven years later, it is a privilege to support the Nightingale Fund, helping young people from disadvantaged backgrounds gain access to the same exceptional education that I enjoyed. I am sure that these children will contribute to advances in medical science that I cannot even imagine. In the words of Nelson Mandela, ‘Sometimes, it falls upon a generation to be great. You can be that great generation’. 

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