Dr Peter Wallace: Intensive Care in Scotland | Association of Anaesthetists

Dr Peter Wallace: Intensive Care in Scotland

Dr Peter Wallace: Intensive Care in Scotland

Dr Peter Wallace is a retired consultant anaesthetist from the Western Infirmary in Glasgow and a Past President of the Association of Anaesthetists. He was a specialist in intensive care and cardiac surgery and helped to establish the emergency ITU transport service in Scotland. In this interview he discusses his career in clinical work and in administration and politics with various Associations and Committees

“I was born in 1945 in Troon, which is a small town in the West of Scotland, of a family who had no medical background. My parents owned a small hotel in Troon, and I was brought up there. It became licensed in the 1950s and that was the downfall of my father, as alcohol led him astray and he died when I was 16. My mother lived into her nineties and ran the hotel with my brother. I think I was clearly a “mistake” as my brother and sister were 10 and 12 years older than me!  My sister was a bright girl, Dux of Marr College, the secondary school in Troon and she was the first in the family ever to go to university, where she got a first class honours and a PhD in mathematics.

“I went to primary school in Troon. I actually had three or four months off when I was six; I had polio and was locked away in the local infectious diseases hospital for three to four months. There were four or five of us got it, I think it was the last outbreak and I ended up reasonably normal. One boy died, one ended up deaf and one ended up with a bit of paralysis. I remember bits of that and it only really came back to me when I was training in medicine and I saw someone having a lumbar puncture done and I remembered it happening to me …. That  was, I suppose, my introduction to medicine.  I think I must have been a bright wee boy as I was moved up a year, which I remember as being terribly traumatic – aged nine, leaving existing friends and going into a class of “big” boys and knowing no one. Thereafter, although I remained in the top stream I was never a star.”

Medical School

“I had no intentions of doing medicine at Marr College, where I went to secondary school. I was reasonably good at maths and scientific things, terrible at language but very good at art, and I wanted to be an architect. In the senior years however you couldn’t do science and art at the same time so I gave up art after pressure from my family. In my 6th year I had no idea what career to pursue and it was the Rector of Marr College that suggested I did medicine and I just went along with it. In 1962 I got into Glasgow to study medicine and spent six years there. In a hall of residence to begin with, and then seven of us bought a flat. My granny had just died and left me £250, so that went into the flat in the west end of Glasgow. Four medics and three lawyers and we were an extremely lazy group of students. One person went to clinics rather than everybody going, and I don’t know how we got through the exams but eventually I did, qualifying in 1968.

“I really didn’t know what I wanted to do at that stage. I did a house job in medicine in Glasgow but I had trouble getting a surgical post and I went to Kilmarnock Infirmary, a district hospital in Ayrshire which was close to Troon. There were only two consultant surgeons, no students and minimum junior staff but that was one of the best things I have done. There were two Sisters in the surgical wards from whom I think I learnt more in six months than I did in six years at university. It was a great job and I thoroughly enjoyed it. I also got to know an anaesthetist there, Graham McNab, who actually came from Troon where I came from, although I didn’t know him at that time. I did a lot of theatre work and I quite liked watching him working; I liked him as a person and he was also respected in the theatre suite. I didn’t realise it at the time but in retrospect that’s when an anaesthetic career must have entered my subconscious.”

“Can you help me get a job in anaesthetics?”

“I then went on to do six months in obstetrics and eventually got my D.Obs.and I think at that stage I was drifting towards being a GP. I didn’t want to settle down yet, and thought what else can I do? My girlfriend at that time, later my wife, had started anaesthetics in another hospital in Glasgow a year before and she was quite enjoying it and when I was two-thirds through my obstetrics job and didn’t have anything coming up, I phoned Graham McNab in Kilmarnock and asked ‘Can you help me get a job in anaesthetics?’ He’d come from the Royal in Glasgow and he knew the Professor there and phoned on my behalf and I got interviewed.”

‘A job in anaesthetics…’

“I started Anaesthetics in February ’70….and liked it. They were all a good bunch and it was a big teaching hospital. There was Professor Alex Forrester, who was a funny wee man who clicked a pen all the time. We didn’t see him to do much clinical work, but he’d had done a lot in anaesthetics and we knew the Forrester spray, which he’d introduced. He had been involved in ventilating polio patients in the fifties and he’d been across with an infectious diseases consultant to Copenhagen after the Copenhagen outbreak and there were photographs of that. Donald Campbell, who started intensive care in Glasgow, and later was Dean of the Faculty and also President of the Glasgow College, was one of the senior consultants. I got involved with a chap called Walter Norris who became my mentor. He unfortunately died aged 47 after an acoustic neuroma. Walter was a very active guy academically and did a lot of sedation research assessing pre-medication and I got involved as his “boy”, to do his pre-meds mostly I think. I had several publications with Walter concerning premedication and postop pain from the time I was an SHO till I was an SR and I missed him greatly when he died.

“It was a good training in Glasgow. The Royal had most things in it, but there was a separate obstetric hospital, separate paediatric hospital, separate neurosurgical hospital, and you did three months in each of those. Jennifer my then girlfriend came to work at the Royal and indeed got the registrar post I had applied for!  We got married in 1971 and actually passed our Fellowship at the same sitting in 1973.The Royal had a rotation to South Africa and we should have gone for a year but Jen got pregnant and we put it off which in retrospect we both regret. I got an SR job in the Royal and was there till 75/76. The SR job, I think looking back, was the time you felt most confident; you could do almost everything, from cardiac surgery, obstetrics, intensive care and every other specialty  –  but very insular now looking back – the Royal Infirmary was the Royal Infirmary; we were wonderful, we were better than everyone else in Glasgow and better than Edinburgh.

“The  senior registrar job… was the time you felt most confident you could do almost everything… from cardiac surgery to obstetrics”

“I went out on rotation as a locum to Falkirk when I was an SR and I enjoyed working in a district hospital at that time. I had kept in touch with McNab in Kilmarnock, and there was a job in Ayrshire coming up. I had enjoyed doing paediatrics as a Registrar in Glasgow, but you had to go back for another three months as SR to do your Higher Training. Ayrshire had a small paediatric hospital and I suggested that I could go there and do my Higher Training. Ayrshire were delighted. They’d never had a Senior Registrar and I thought it would get me known there for the next job coming up. So I went down to Ayrshire and I enjoyed that. It was a tiny hospital with two consultant anaesthetists and did most things although the more complicated cases were sent up to Glasgow. Although I was meant to be doing paediatrics they moved me around various hospitals. I was almost turned against it because at that time there were a number of consultants in district hospitals that had chips on their shoulders, you know – ‘He’s from a teaching hospital, he’s down here as a clever Senior Registrar to tell me what to do, and I know what to do. I’ve got a Fellowship same as you.’ And that almost turned me against it, but I overall it was good experience.

“I completed my training in ’76 and there was a job coming up in Ayrshire. I applied and was the only applicant. At the same time there was a job coming up at the Western in Glasgow, which was at the other end of the city, at the kind of snooty end, and I think it was Donald Campbell said, ‘Just apply for it to keep your nose clean’. So I applied for it but I was still intending to go to Ayrshire. I had two different CVs because the Western job had intensive care in it and the job in the district was general surgery and gynaecology. So I went along to the interview for the Western , with another SR of my era and two more senior SRs, one of whom worked at the Western, had done intensive care and it was her job, we all thought. I can still clearly remember it, we were interviewed in the morning and they said ‘If you phone at 2 o’clock, we’ll tell you who got the job.’ So we went to a pub across the road. The girl I thought was going to get the job had driven me in, in the morning, to the interview and I can still remember saying ‘I’ll go and phone because it’s not me’ as the two more senior SRs there assumed that one of them was going to get it. I went and phoned up, I can still see it – it was a corner box in the pub. I said ‘Who got the job?’ ‘You got it, Dr Wallace.’ And I had to go back and tell this girl, who then had to drive me back home. And then I had to phone McNab in Ayrshire who had become a good friend, and tell him that I wasn’t going to take the job with him. I thought if you went to a district hospital at that time it would difficult to get out although it became easier later on. But if I went to a teaching hospital and didn’t like it I thought I could always move because there were district vacancies around. We had looked at houses in Ayrshire, my wife, who had started doing part-time anaesthetics again, could have got a part-time job and I had joined Royal Troon at great expense because I thought I was going to go down there, and then suddenly my life changed and I was at the Western Infirmary.”

Intensive Care

“Alastair Spence was Reader at the Western at that time, and I’d gone across when I was still an SR in the November/December of ’75, to do a research project with him for Entonox in post-operative care. It’s one of my regrets that we never got it published because it was actually quite good.  There were cylinders of Entonox and cylinders of placebo gas and it didn’t make any difference what was in the cylinder but if you’d a cylinder you’d less pain than the guys who didn’t have a cylinder!. I did two months there doing that and that was at the same time as I was appointed to the job at the Western.  I started as a consultant in the Western on 1st January ’76. I really was viewed as an outsider from the Royal. No consultant had ever been appointed to the Western from the Royal, although there’d been consultants going the other way. It was a smaller department and it was more traditional and more orientated towards private work than the Royal.  Pinkerton who became President of the Association had been boss there, and I think listening to people like Donald Campbell he perhaps should have been the first professor in Glasgow rather than Forrester at the Royal. But the guy at the Royal got more support from the surgeons and others.

“So I started there and the job had intensive care in it, which I swore I’d never do, I really hadn’t seen that as my future. I also had two sessions of cardiac surgery in my job plan. Cardiac surgery at that time was done in Glasgow at the Royal Infirmary, where I’d done a lot, and also at Mearnskirk which was a fairly peripheral hospital and had been a TB place originally. They wanted to bring that into the Western, and I was the first person at the Western to have cardiac sessions in my job plan although they didn’t become active for some time and I did orthopaedics in the interim.

“The job had intensive care in it, which I swore I’d never do, I really didn’t see that as my future”

“The intensive care unit of the Royal had been totally anaesthetic run. At the Western there had been a lot of opposition to setting up a separate intensive care unit, the physicians really didn’t want their patients taken away from them, and in the anaesthetic department there were very few people keen on doing intensive care. An intensive care unit had eventually emerged out of the respiratory unit. The boss was a respiratory physician, there was Iain Ledingham who was a surgeon really but who then became a clinical physiologist, and he had a big research background and was the dominant character plus two anaesthetists and I was the fifth person. It ran well and I obviously worked there till I retired but it was always being viewed from the general anaesthetic side as a bit odd; these silly buggers who want to do intensive care rather than just give anaesthetics. We did a day a week – I ended up as the junior one and I did Fridays for the next five years and we shared weekends on call, and with holidays it was basically one in four. So it was quite a hard but I enjoyed it and got into doing intensive care. Although I’d done a lot at the Royal I’d never really meant to specialise in it but it has all worked out well.

“Ledingham got involved through the hyperbaric chamber in the Western, which had been there for some time, originally to look at nitrous oxide as an anaesthetic and then for using various hyperbaric oxygen treatments for lung problems, gangrene, sepsis and various bits and pieces like that He had the first blood gas machine in the hospital so he was obviously someone intensive care wanted. He set up a research group of three registrars who were called the “Shock Team” They were there to do research in sepsis to begin with but they then started transporting ITU patients. The Western was meant to be redeveloped and they built another hospital, Gartnavel, three miles away which ran in conjunction with the Western. The only ITU was at the Western so surgical patients at Gartnavel had to be transferred backwards and forwards. Iain set up a transport service using his three research registrars which grew into a service for all the Glasgow hospitals and then for the West of Scotland from Stornoway to Stranraer.

“The transport service grew into a service for all the Glasgow hospitals, and then for the West of Scotland from Stornoway to Stranraer…”

“I was still of the mindset that I was an anaesthetist who did intensive care rather than an intensivist, which Ledingham saw himself as, and I regret that I didn’t work closely enough with Iain. I did get involved with him to some extent because of my history of having worked with sedation in pre-medication. Iain, because of his research reputation was suggested as someone who might be interested in Propofol sedation in intensive care. Iain asked me to get involved with that and we produced one of the first papers about Propofol sedation in intensive care. Iain and I also did a chapter in Recent Advances,- “the Changing Face of Sedative Practice” which was quite well received.. The sedative stuff I should have done more with because I was interested in it and Iain at that stage had these three registrars who were there, able to do the work.”

“So Intensive Care was my bread and butter at that time, but then cardiac surgery came back to bite me on the bum”

Cardiac Surgery

“So intensive care was my bread and butter at that time but then cardiac surgery came back to bite me on the bum. I went in ’76 and for the next couple of years they’d been trying to get the cardiac surgical unit started in the Western, and my two sessions became active and I had to start the cardiac surgical service in 1979. Which was really against the wishes of the majority in the anaesthetic department who were not keen on intensive care or cardiac surgery – “no, we don’t want that in my hospital sort of thing. ‘waste of money, waste of time.”  I went back to the Royal to relearn it and I also came to London and Bristol I think. I went to the National Heart for a couple of weeks to get my hand back in and then went back and started. I thoroughly enjoyed that stage because the surgeon I worked with was a lovely guy, but not an organiser, or administrator and I had a free hand in setting up much of the service. I and a senior physics chap really generated all the equipment by borrowing it because the money was going to come and going to come but didn’t. Money had gone into cardiac surgical registrars but not anaesthetic services at that stage, and we borrowed ventilators and monitors and bits and pieces from various equipment companies round the West of Scotland, and got it going. I’ve still got the anaesthetic chart from the first bypass in 1979.  And looking back, my technique hadn’t changed very much from 1979 to when I retired in 2005. I used fentanyl rather than morphine, but the rest was much the same!

“I’ve still got the anaesthetic chart from the first bypass in 1979…by the time I retired we were doing 1000 bypasses per year”

“One of the senior surgeons at the Royal was coming across to become professor, to add on to the local guy. He was actually quite forward in wanting automated monitoring… this was as computers were just coming in and looking back, he had the right idea. There was a big machine in the corner which went and picked up pens and drew graphs of BP etc, red one for that, blue one for that and it was fascinating to watch. Part of our existing recovery room became the cardiac intensive care unit which I had a big hand in designing together with this new professor who was not the easiest of people to get on with. Looking back I had quite a lot of responsibility for a young consultant and I learned a great deal in dealing with and negotiating with this guy and other administrators and managers.  Unfortunately we couldn’t staff the cardiac ITU and it was run by the surgeons with an anaesthetist on call. There was the odd dispute but overall it worked well.

“I did all of the bypasses for the next 18 months or so, plus the post op care and takebacks. I was the only consultant anaesthetist at that stage, with SRs helping. Eventually another two consultant anaesthetists were appointed plus more later to provide a full service and by the time I retired we were doing over 1000 bypasses a year. I was still doing Mondays which meant I was in every Sunday night doing premeds. Eventually there were three or four cardiac anaesthetists who did the cardiac on call. I continued doing my day list till I retired but my on call became only for general intensive care which I had continued doing throughout this period. I worked with a number of cardiac surgeons over the years and got on well with most of them. A relationship developed where you relied and trusted each other. One of them started doing a lot of private cases but I never fancied that and never did a private case throughout my career. My kids thought I was daft as we could have been much better off if I had!

“Overall my main responsibility remained intensive care and more than half of my time was intensive care plus two sessions for cardiac, and I also had two general surgical lists. In the late 80s Iain Ledingham took early retirement and went abroad. Till then the ITU consultants were physician, surgeon and three anaesthetists but on Iain’s departure we had trouble finding a surgeon who wanted to come in. By chance I met a guy called Willie Tullett who’d been an SR with us from respiratory medicine but was now a consultant in A&E. I asked him “do you fancy doing intensive care?’ and he said, ‘Yes’. So Willie came in and he was the first A&E Consultant in Britain to do intensive care. He’s still doing intensive care and sat on the Intercollegiate Board so I feel I had a hand in broadening out intensive care in the UK.”

ITU Transfers

“When Iain left, I think I was Chairman of the Division and the “Shock Team” consisting of two anaesthetic registrars plus a surgeon were then homeless and they came into the anaesthetic department. They were still transporting critically ill patients around and it had developed to provide a service for the West of Scotland eventually moving 300-400 patients a year. It was good from the management’s point of view as it meant that you could ‘safely’, in inverted commas, move patients around if you’re short of beds. It also saved using staff from the base hospital. There were five intensive units in Glasgow at that stage, and another dozen round about the West of Scotland, and we could use them all if needed. I took over the Shock Team and expanded it to four or five registrars and then got it included in a training scheme where registrars from the West of Scotland came through for three months at a time. The problem with that was they got experience in transferring tricky patients but there wasn’t the year-long time to do research which there had been before. They did keep producing a number of audits and various things and thanks to them I became a national “expert” on transport of the critically ill. I did often admit that actually I had only ever transferred one myself, when I was an SHO in the Royal Infirmary. There was a head injury who had to go to neurosurgery and I was sent down to do this and I still remember hand-bagging this patient all the way.  Later, because I’d taken over this transport team and I then got involved in the Intensive Care Society, I wrote, with other colleagues, guidelines on transportation and produced various papers/chapters about transport of the critically ill and gave numerous talks about it.

“Most of our patients were from the West of Scotland, within an hour or two by land ambulance. The Scottish Ambulance Service provided a mobile intensive care ambulance, and provided drivers. There was also a fixed wing service, for the far islands and Inverness, although few helicopters at that time. I remember a call from Stornoway and one registrar on the shock team was ready to go but the other had problems and two always went. I then got someone else on call, I think obstetrics, to do a favour and fill in. That was Friday night. I never thought anything about it, until I went in on Monday morning. The Shock Team had got back on Sunday! The flight up to Stornoway had taken three attempts to land and the pilot wouldn’t take off again. So this girl who’d done a favour was in Stornoway for two nights and then came back the next day!  I met her not so long ago, I said, ‘I’m awful sorry about that! I really feel guilty.’ She said, ‘It’s alright. You gave me a bottle of champagne the next week!’ I don’t remember that at all!”

Administration and Politics

“At the same time I was getting more involved in administrative and political things. That started off in the Western department, when I became Secretary and then Chairman of the division and also Chairman of the Hospital Medical Committee. Then the time came when we were moving to Trust status. They wanted me to be Clinical Director and I saw it as a challenge – that would be the early nineties and there were battles in the hospital where we were all meant to be competing with each other and financed separately. I had the longest title as the Clinical Director of Anaesthesia, Theatres, Intensive Care Medicine and Pain Relief Services! There was a very aggressive surgical CD who I squabbled with, and I had a wonderful ability to get under his skin – it was one of the great pleasures in life. I remember a meeting where he said, ‘Now, it’s only the Directorates with beds that can have influence and vote”.  He had forgotten I had eight beds in intensive care so he lost and I was a hero to the labs and radiology people.

“I enjoyed that time. I had a budget of £12 million and you got all the bits and pieces of business manager and nurse manager and a separate secretary. It worked quite well with an enormous nursing and medical staff but it took a lot of time and I had a fair bit of responsibility. The only thing I didn’t like was we used to have half-past-seven meetings in the morning on a Friday and I hated getting up at that time. I got on reasonably well with the Chief Executive, who was a woman who’d come from running a shoe factory, believe it or not, and she wanted me to stay on but I’d always said I’d only do three or four years and in the end I did five. My regret at that stage was that the guys that I’d thought I’d been grooming to take over, the people just three or four years under me, didn’t want to do it for various reasons and younger, less experienced folks took over.

“Could you tell our visitor the hotel’s been bombed…”

“Meanwhile I had got involved in various committees in Glasgow, mostly anaesthetic and ITU advisory committees and I chaired most of those over the years. I was Secretary of the Scottish Society of Anaesthetists in the eighties into nineties, and was a National Panellist going around hospitals for consultants appointments .I also got involved with the official College visits to anaesthetic departments, which I enjoyed.  I remember going to Northern Ireland and we were out at Craigavon and had a phone call saying, ‘Could you tell our visitors their hotel has been bombed’.   When we got back there were soldiers all over the place with guns. The bomb had gone off on the fourth or fifth floor and we were on the third, so all our stuff got covered in dust and then they said, ‘The hotel’s fine from the sixth floor up. You can go to the eighth.’ No way!        And I felt sorry for the Northern Irish at that stage because up till then during the troubles visitors had stayed at individuals’ houses and we were the first ones they felt safe to put in hotel and then it all went wrong and we had to go and stay with colleagues again.

“I got involved also, either then or later on, with the Joint Committee between the Association and the College, the Good Practice Committee, which had a joint liaison group which went out to trouble shoot in hospitals that had problems. I used to go with Willie MacRae to places where there were personal disputes or “rogue” anaesthetists .It often showed how stupid and pathetic doctors can be at times. I learnt a lot from Willie MacRae at that time. He was a very shrewd guy.

“I got elected to the Intensive Care Society and I can’t remember why I wanted to do these things. Probably just big-headedness or something like that.”

“Then I got elected to the Intensive Care Society and I can’t remember why I wanted to do these things. Probably just big-headedness or something like that. I stood four times for the Intensive Care Society before I got on the Council and I look back and think why the hell did I do that? I don’t know. It was a time that it was expanding.    Alistair Short raised money to get ICNARC, the research and audit body, set up and they got premises in the BMA and the Intensive Care Society moved in with them. I became President – Alistair Short really should have taken over as President, but he was involved with ICNARC and was also Secretary.  I had a hand in getting the   Society  more organised and formalised and also helped set up an official trainees group. Paul Lawler came in after me and it became much bigger.

“At this time I sat on the Joint Committee for Intensive Care Training and later the Intercollegiate Board. I have regrets about that period because I fell out with them a bit over their priorities. At that time 95% of people doing intensive care were anaesthetists but the Intensive Care Society and the Joint Committee’s obsession seemed to be with other 5%. I came from a unit with physicians and surgeons working in it, and I would encourage other specialties to get involved but I wanted to concentrate on training the 95% better. At that time the College really didn’t do much to encourage that and I think they could have done more. I also could have handled it better and think I was seen as a bit of a Luddite. I had nothing against intensivists coming in, but at that time, in the nineties, there were only four or five full time intensivists in Britain.

“In the ’90s, there was only four or five full time intensivists in Britain.”

“The Intensive Care Society had been at Bedford Square with the Association, then moved out to BMA House with ICNARC then come back into Bedford Square and planned to move with us to Portland Place. The College offered  them facilities in their new building, so the Intensive Care Society went off to the College, which long-term I’ve not had any problems with especially with the development of the Faculty but at the time it hurt a bit. The Pain Society stayed with us for a while but they also moved eventually to the College

“I had been elected to the Association in 1992, again after four attempts!  I became Secretary when Morrell Lyons was President, while we were till in Bedford Square. It was a time that we needed to move for more space and there was a great fuss over looking for a new place. At the same time I think the whole structure of the Association changed. Bedford Square was a little homely group. There were I think six or seven staff at the most with one boss lady but it was largely run by the non-exec Council members here once a week, particularly the Secretary and President. When I was Secretary I was doing all the minutes of the Council, Advisory and the E&R as part of the job. For various reasons a number of staff left and we had an interim manager called Toby Simon. He, I think turned things around – he got the secretarial staff to do the minutes – Weeee, I don’t need to do the minutes any more!  He also organised proper pension arrangements and other administrative structures and stuff like that. He was at hand to appoint our first Chief Executive, who was a guy who came from the RAF. Toby had come from the London Fire service where he was answerable to a group of non-exec councillors and understood that collegiate structure. Our first Chief Execs, I think, found it difficult to work under a Council of “amateurs” who turned up once a week and they really wanted to be a “real” CEO and boss in charge of everything. The first one lasted about year and then we had another interim manager, David Pointet, who was good and had a major hand in buying Portland Place and also advised on the future management structure. After problems with the first Chief Executive it was proposed that we should appoint a part time 3/4 day a week “General Manager”. However with the purchase of Portland Place there was an enormous amount of organising during its refurbishment which resulted in the new appointment evolving to full time and being termed a Chief Executive again! To be fair the lady appointed did an excellent job in restoring and redeveloping Portland Place and seemed to have the staff working well. I took over as President in 2002 and unfortunately just a couple of weeks before the official opening of the house she left abruptly without warning and with some unpleasant undertones. To this day I still do not know or understand what motivated her sudden departure. In the ensuing panic we depended on the hard work and dedication of the remaining staff to ensure the Opening was a great success – which it was. Thereafter we adopted a flatter management structure with senior staff taking responsibility for their individual departments. This worked well for a time but further evolution is always required and administrative developments since then seem to have been well received and successful.”

Anaesthetic Practitioners

“I’d been involved with the Audit Commission report in the nineties which examined the shortage of anaesthetists in Britain and suggested looking at anaesthetic nurses/practitioners. The Association produced a “glossy” concerning the Anaesthesia Team, which said we didn’t see a position for non-medical anaesthetists at “this time”. Then it came back, I think when I was Secretary. We found that the Department of Health, the NHS Modernisation Agency and the College had been working together to plan developments of the anaesthetic team, including possible introduction of anaesthetic practitioners. We were shown the draft and were allowed to make some suggestions, but the Association had not been properly involved.  Anyway It appeared they were going to go ahead, whatever we did, and were we to be involved?  I was President by this time and I still remember it came up at Council and the general attitude amongst the Council was against the proposals. My feeling was really if we stuck our head in the sand it was going to happen anyway and we should get involved and influence the outcome. I remember thinking If I take a a vote I’m going to lose so we’ll just review this next time. Eventually we did get involved with the group that developed anaesthetic practitioners who came up with a pilot scheme in several places to train ODPs or science graduates. I think we did have an influence on ensuring that there was always a supervising anaesthetist around and in setting other conditions for their activities. Birmingham produced a training scheme and there were two or three places that started training a few practitioners. I was involved in that till I retired, and then I thought I was away from it.

“After I retired however, Peter Simpson phoned me up saying, ‘the Scottish Office wants to look at anaesthetic practitioners. We want you to chair a committee.’ I thought oh no, I don’t want it but eventually said, ‘I’ll do it for two years.’ In that time we set up a Scottish training scheme, at Edinburgh, on the same basis as England, with supervised ODPs and science graduates. It’s not taken off as anticipated but I think it was necessary to do it at the time. And one of the things I’m proudest of is changing the Practitioner title which had caused confusion. I was chairing the “Anaesthetic Practitioners Group” and there was another group in the Scottish Office looking at Physician Assistants for other Scottish specialities, GPs and A&E in particular. And I said, ‘I don’t see why ours should be practitioners and you’ve got assistants.’ The Scottish Office was reluctant and the College wasn’t keen to change but I persisted and basically bullied the Scottish Office people into changing our ones from Anaesthetic Practitioners to Physician Assistants (Anaesthesia). And once we had done that up there, it was adopted in England as well. So I feel that’s my major contribution to the Anaesthetic specialty!”


“Before I was 60 I remember my mother saying two things to me; she looked at me and said, ‘You’re going grey son. You’re the first fat Wallace that ever went grey! They all died first.’ And then another time she decided I was drinking too much; ‘You remember you come from a family of wee fat men that drank too much and died young!’ So I’d always had this at the back of my mind, and doing my genealogy  there’s only one other male Wallace that’s ever lived beyond seventy which I’ve now done. So I was determined I was going to retire on my 60th birthday although as I said, I still enjoyed work. I don’t know how I was coping, I was up and down here every week, which was hard going plus continuing clinical work in Glasgow – but you just did it. And I retired at four o’clock on Friday 21st January 2005 which was my birthday. I was still involved at the Association for a while after that which I haven’t regretted.  Workwise I stopped clinical work altogether but I kept the Association going for another year or so. I think I was Past President and I chaired the Anaesthesia Board for several years after that and for a couple of years I also did the Practitioner thing in Scotland.

“My retirement is full of five or six Gs: that’s golf, grandchildren, gardening, gin, gluttony and Google.”

“I’ve taken to retirement. I feel at times that life is all self-indulgence and I should go and do something useful. My wife keeps saying I should go and join the Community Council and things like that, but I never got round to it. I always meant to do it. I’ve got this glib thing that I say, – that my retirement is full of five or six “Gs” – that’s golf, grandchildren, gardening, google, gin and gluttony!  With these I have no trouble filling time at all, plus I’ve played the clarinet on and off for years and keep practicing and I have started painting again and go to regular classes. I have even sold a painting and won a prize at the Association Meeting!

“Regrets? I’ve had a few. I regret not doing more research and some of the papers with registrars which I never finished, and that affected them. I regret I’ve been an aggressive little swine at times, I mean I did have the small man syndrome I’m sure, and chips on each shoulder. I used to use that as a joke at times – ‘I’m a well-balanced Scotsman, I’ve got a chip on each shoulder and a glass in each hand!’  I’d like to have spent more time with my kids but that was part of being up and down here so often; I missed a lot but no doubt I would do it all again.

“My achievements… I’ve lived to 70! Nearly 71 now. I think being President of five associations and societies, the Association was the biggest one. I coped here, I would say it was alright, but in fact I had a bad year because we were moving here, there was a lot going on, and then these anaesthetic practitioners started coming around again. And it’s a matter of just keeping the ship going and keeping it calm. Calling them anaesthesia physician assistants I’m quite proud of. I don’t know what else, it was just to get through life. I’ve got here!”

“I’m a well-balanced Scotsman, I’ve got a chip on each shoulder and a glass in each hand!”

Further reading