Dr. David Owens graduated with first-class honors from the University of Liverpool in 1967, marking the beginning of a distinguished and fascinating career in medicine. Over the decades, Owens has made significant contributions to the medical field through his work in hospitals in Liverpool, London, Bangor, and Ysbyty Gwynedd. Reflecting on his medical journey, he shares his experiences and memories along the way.
“I was born towards the end of the Second World War and brought up in post war Newborough in southwest Anglesey. The community was almost entirely Welsh speaking and had changed little in the twentieth century. The men worked either on the land or went to sea and women stayed at home looking after the children and undertaking other domestic duties. The church and two nonconformist chapels were at the centre of the community. None of the houses had electricity, water supply or WCs until the early 1950s. Tuberculosis was prevalent and many of those affected spent long periods in sanatoria. Unemployment rates were high and many of the families were poor.
I attended the village school from the age of three and have vague recollections of using a slate tablet for writing, at least during the first months. My parents who ran one of the village shops were keen for me to have a good education and arranged for me to have extra private lessons in preparation for the 11+ examinations. However, these examinations were cancelled when Anglesey County Council introduced a series of Comprehensive Schools on the Island, one of the first local authorities to do so.
In 1955, I started in the Comprehensive School in Llangefni. I loved my time there and enjoyed studying the sciences especially, but also languages, history, geography, woodwork and sport. I played fullback in the school rugby XV and wicketkeeper in the cricket XI and, in 1962, I went into the Sixth form to study Chemistry, Physics and Biology. As I was the only one studying Biology, I joined the Botany and Zoology classes; the practical lessons with various dissections of frogs, dogfish and rats maybe sowed the seeds of my future career in medicine! However, my ambition at this time was to embark on a university degree course in marine biology having been enthralled by the variety of marine life around the coast of southwest Anglesey.
When the time came to apply for a university degree course, the idea of marine biology was abandoned, and medicine came to the fore, much against my father’s wishes as he believed that I would not be able to cope with an intensive five-year degree course. Liverpool seemed the most sensible choice as the Welsh connection with the city was so strong. Many young people went from north Wales to teach, to train as nurses and doctors in the city. Another factor which may have influenced by choice was that my mother when she was about 10 years old developed osteomyelitis and non-union of a fractured tibia after an accident in school and was eventually cured after extensive surgery at the old Royal Southern Hospital by Mr Bryan McFarland who later became Professor of Orthopaedic Surgery.
After passing my A level examinations in Chemistry, Physics and Biology (with distinction), I commenced my medical studies in Liverpool in 1962 determined to succeed and prove my father wrong!
Moving to a big city from a small rural community was a major cultural change for me. The weather seemed drier and colder, the sounds of the city were never ending, and the buses came along every five minutes!
The language was also different, and it took me a little time to get used to the Scouse accent. These clearly were major changes in my life.
I well remember arriving at the Medical School to register and meeting one or two other very nervous new medical students. In the first year the emphasis was on human anatomy with five of us dissecting a male corpse. Probably the first time any of us had seen a cadaver. There were also lectures and practical classes in Organic Chemistry and the lecturer was Professor Jackson whom I met about 12 years later at a symposium on bilirubin at the National Institutes of Health in Bethesda, Maryland. The Department of Physiology was famous for discovering gastrin, an important gastrointestinal hormone regulating gastric acid.
In second year, we were shown our first patients by Dr E T Baker-Bates in the monthly applied physiology classes at the Liverpool Royal Infirmary. These sessions were always informative and entertaining.
I worked very hard for my second MB and was awarded prizes in Anatomy including the Sir William Mitchell Banks medal.
My first clinical medical firm was with Drs Sanderson and Robert Evans at the Royal Southern Hospital. The senior registrar was Dr Ronnie Finn, and the registrar was Dr Rodney Harris who later became Professor of Clinical Genetics at the University of Manchester. Dr Finn was one of the research workers who later worked on anti D treatment for Rhesus incompatibility. The second clinical firm was two months of surgery with Mr Clifford Brewer and Mr Raymond Helsby at the Royal. This gave me the opportunity to assist Mr Brewer in theatre whenever the opportunity arose, something that I really enjoyed.
The next clinical attachment in medicine was on Dr Emyr Wyn Jones and Dr John Robertson’s firm with Dr Clive Aber as Senior registrar and Dr Peter Brunt as registrar. This was at a time that a two-bedded coronary care unit was established. Dr Aber went on to become consultant cardiologist at Hull Royal Infirmary and Dr Brunt became a Gastroenterologist at Aberdeen looking after members of the Royal Family during their stay at Balmoral.
Two teaching sessions that spring to mind include one organised by Professor Sheehan and Dr Baker Bates.
During the session, a student would be asked to comment on a pathological specimen and the likely symptoms that the patient would have had in life. For a good answer, Dr Baker Bates would give the student half a crown - 12.5p in today’s money.
The second event was held in the almost subterranean lecture theatre in the old Royal. All students would be allocated a patient, take a detailed history, perform an examination and then present their findings in front of a full lecture theatre. Many students found the experience quite daunting, but we all learned a lot and it was excellent practice for the final examination.
I graduated MBChB with first class honours in 1967 and was awarded the J. Hill Abram Prize in Clinical Medicine, the Derby Exhibition Prize in Clinical Surgery, The Orthopaedic Prize, the Sir Robert Kelly Gold Medal in Surgery and the O.T. Williams Prize for the best results in the final examinations. My intention after qualifying was to specialise in orthopaedic surgery. However, in my final year I worked as locum house physician on the Professorial firm of Professors Clarke, Weatherall, David Price Evans and Dr E T Baker Bates. The registrar was Dr Cliff Sissons who showed me that clinical medicine was more interesting than I thought.
Consequently, I applied for the post of House Physician and was appointed to start in October 1967.
In those days, the number of emergency admissions was few and far between and the bulk of the work was writing up and managing elective admissions.
There were no phlebotomists, so much of the house physician’s time was taken up taking blood samples with glass syringes and reusable, often blunt, needles! Ultrasound, CT, MRI and flexible endoscopes were well into the future. However, this was the early days of chemotherapy for leukaemia which was being evaluated and developed by Professor Weatherall.
As a very junior member of the team, one had very little idea of the important research work being undertaken in the University by Professor Clarke and his academic team. Clearly major advances were being made by them in preventing disease caused by Rhesus incompatibility, thalassaemia and pharmacogenetics. Professor Clarke also did very important research with the Professor of genetics Philip Sheppard on polymorphism and mimicry in the Peppered moth and went on to become President of the Royal College of Physicians and was knighted. Professor Weatherall went on to Oxford as Regius Professor of Medicine and he too was knighted. When Professor Clarke retired in 1972 David Price Evans became Professor of Medicine and head of Department.
After completing my six months as house physician, I worked as house surgeon to Professor Stock and Mr Ian MacPhee. Some traumatic events for both the patients and me are etched on my memory from this time. One was when a large cardboard box arrived on the ward containing a haemodialysis machine which the consultant said I was to use to treat a young man in renal failure, a very stressful act for a newly qualified doctor.
The on-call rota was one in three and usually there were three of us covering all the wards and Casualty and there were no senior doctors to help. The working week was 80 to 90 hours.
Nevertheless, the first pre-registration year was a happy year and as the house officers were all in residence, we were able to support one another, and the camaraderie was excellent. However, we were all on a very steep learning curve.
I successfully applied for an SHO post with Drs Richard McConnell and Wilfred Cook at Broadgreen Hospital. At this time, the early days of gastroenterology, the Nuffield Unit was being built where endoscopy and gastroenterology outpatient clinics were held. The work with Dr McConnell I found most interesting, and I acquired a lifelong interest in gastroenterology. About a year later, I was promoted to Medical Registrar working with Drs Findlay, Honey and Baker-Bates. Dr Findlay was the hospital superintendent who had been awarded the George Medal for his services to the injured when Mill Road Maternity Hospital was bombed during the second World War.
In the autumn of 1970, my wife and I moved to London where we both worked at the Royal Free Hospital. She worked as a staff nurse in the outpatient clinics, and I worked in the world-famous liver unit as registrar to Professor (later Dame) Sheila Sherlock. This was a very exciting place to be working with research fellows from all over the world.
The unit was researching into acute liver failure, primary biliary cirrhosis (as it was then known), autoimmune chronic liver disease and renal problems associated with chronic liver disease. Patients with rare conditions were referred from all over the world.
The unit was assessing the value of extra-corporeal pig liver support for patients in acute liver failure in conjunction with the Royal Veterinary College. Although the first few patients survived, the next 7 or 8 perished so the project was abandoned. Liver transplantation was in its very early days.
Part of my research project was evaluation of the effects of markedly reduced calorie intake on bilirubin levels in humans. However, I first needed to learn how to measure bilirubin levels in the unit’s research laboratory in the famous “hut on the roof” using my own blood. Despite my repeated attempts I couldn’t get it right, the values always being too high. The Professor of Biochemistry then took over and after a few hours announced that my technique was fine but that the reason for my findings was that my bilirubin level was raised as a result of Gilbert’s syndrome.
One of my most onerous and stressful duties was to organise the clinical examination for the MRCP every three months. The Professor insisted that we had a different “long case” for each of the candidates which was easier said than done. On one occasion I found one very interesting patient in the neurology clinic who said that he was more than willing to help out. I took Professor Sherlock to see all the patients and introduced the patient from the neurology clinic whispering quietly that he had Hansen’s disease, leprosy in other words, whereupon she blew her top and refused to continue until he had been taken out of the ward. She obviously was petrified of contracting the infection!
After two years in London, I returned to the University of Liverpool as temporary lecturer in medicine and honorary senior registrar at the Royal and Broadgreen Hospitals. Professor David Price Evans was Head of Department and Dr E. Antony Jones commenced working as Senior Lecturer. Having developed an interest in bilirubin metabolism I continued with my research in the field supervised by David Price Evans and Antony Jones; I studied patients with chronic liver disease and patients with Gilbert’s syndrome using carbon 14 labelled bilirubin and analysed the disappearance curves to determine liver uptake and clearance rates under various circumstances and was awarded an MD for the work in 1975.
My next post was at Walton Hospital where I was appointed Consultant Physician with an interest in gastroenterology in 1975. However, when a vacancy came up at the old Caernarfonshire and Anglesey Hospital in Bangor, not far from where I had been brought up, I applied for this and was appointed in 1978. In 1984, Ysbyty Gwynedd, a new district general hospital was opened. Consultant staff numbers expanded at a rapid pace and when I retired in 2014, there were 12 consultant physicians on the staff, all supported by junior medical teams. Within the medical directorate there was a pulmonary function lab, haematology and oncology unit, coronary care unit and cardiology lab, renal dialysis, stroke unit and a comprehensive gastroenterology endoscopy service which I was largely responsible for setting up.
When I look back, it is a sobering thought that when I qualified, the technological advances that have occurred in medicine were non-existent. Ultrasound scanning was just beginning, fibreoptic endoscopy was yet to come and coronary angiography, computerised tomography and magnetic resonance imaging were years away.
Some of the medical conditions that were common when I qualified such as rheumatic heart disease, syphilis, and tuberculosis have largely disappeared only to be replaced by degenerative conditions such as cerebrovascular disease, dementia and other diseases of the elderly. I do believe that it’s been a privilege to have been a doctor.”
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