In contemplating the original name of the Association, it occurred to me that it might be interesting to readers of all geopolitical hues if I were to drill down a little into the ‘GBI’ bit. I am, as are we all, indebted to Dr John Cahill’s chapters on the Irish Standing Committee in Safety as We Watch [1] for highlighting that, right from the very foundation of the Association in 1932, colleagues from Ireland have been very much to the forefront; indeed, as Henry Featherstone said in 1946 “There was a general desire that colleagues in Éire should be able to join the Association and a number have done so” [2].

This followed Featherstone sending one hundred personal letters to individual anaesthetists in the UK and Irish Free State¹, inviting them to attend the Association’s foundation meeting in London [3]. Many Irish doctors, especially anaesthetists, completed their higher professional training in Britain (and, to this day, many who have completed their training in Ireland still pursue post-training Clinical Fellowships at UK centres of excellence), to mutual benefit.

So, when did this ‘cosy linkage’ all begin? Well, in an attempt to condense almost 900 years of a complex shared-history relationship into one or two pages, we must first consider what happened in a picturesque little spot about five miles from where I live on the South Wexford coast, back in the year 1169. Bannow Bay is a remote, secluded inlet on the east side of the Hook Peninsula, about seven miles north-east of Hook Lighthouse. This shallow inlet of shifting sandbanks may well already be known to those of you who hail from the ‘sailing classes’ and who may make occasional forays towards the Fastnet Rock, where your maritime charts will likely have warned you not to pull in to Bannow Bay unless very experienced [5]. This is the location of the first landing of the Anglo-Normans in Ireland, and the deserted bay has accordingly been described as an Irish ‘historical touchstone’.

But why did the Anglo-Normans come to Ireland? After all, although the Norse had invaded and assimilated some three centuries earlier, previous potential invaders including the Romans had declined to do so. The Romans had conquered Britain but the then-Governor of Britannia, Gnaeus Julius Agricola, contemplated an invasion of Hibernia and calculated that he could achieve victory with just one legion and auxiliaries but decided not to proceed, possibly due to a simultaneous Scottish uprising or a recall to Rome – in any event, they never came.

However, in 1169, the King of Leinster (anglicised as Dermot McMurrough) was deposed and fled to England, having been exiled by the High King of Ireland (anglicised as Rory O’Connor). Determined to regain his territory, he travelled to Aquitaine where the Anglo-Norman Plantagenet King of England, Henry II, had his French residence. Although French-speaking Henry was more concerned with his French territories than with the British Isles, he had nonetheless been contemplating an invasion of Ireland since 1155, apparently tacitly approved by the English Pope Adrian IV, one Nicholas Breakspear. Controversy remains as to whether Adrian’s communication to Henry (the now-infamous Papal Bull, ‘Laudabiliter’) was interfered with and altered by the emissary who was transporting it, a certain monk named Gerald of Wales (Geraldus Cambrensis), in order to promote a course of action involving invasion of Ireland. In any event, Henry invited Dermot to seek assistance from his knights in England and Wales, and Dermot, having failed to attract interest among the Norman lords of England, persuaded Richard FitzGilbert de Clare, Earl of Pembroke, to come to his aid, for a promise of “land and money, horses and armour, gold and silver”. Richard, better known as ‘Strongbow’, was an experienced military campaigner, continuously battling the native Welsh. The price he extracted from Dermot for his services was succession to the Kingship of Leinster following Dermot’s death, to be assured by marriage to Dermot’s daughter Aoife. Strongbow rounded up two half-brothers, Robert FitzStephen and Maurice FitzGerald, set sail from Milford Haven, and landed in Bannow Bay on 1 May 1169 with 30 knights, 60 men-at-arms and about 300 bowmen. A day later, Maurice de Prendergast landed with 10 knights and 60 bowmen. This small force was reinforced by Dermot himself with another 500 soldiers. Together, they besieged the Norse-Gaelic seaport of Wexford (Waesfjord in Old Norse). Wexford surrendered after two days to the superior new weaponry of the armoured knights with their longbows. Thus began the first Anglo-Norman colony in Ireland, and the rest, as they say, is history.

Constraints of space will, of necessity, require that I hold over accounts of other major Anglo-Irish historical events until next year’s Irish edition of Anaesthesia News, but we may reference a few as we ‘fast-forward’. These will include mention of, inter alia: Henry VIII; Oliver Cromwell (the latter figure, I believe, has been misunderstood by history, both in Britain and Ireland²); Henry Grattan and the Dublin Parliament in the years immediately preceding the Act of Union 1800, Daniel O’Connell, and several failed ‘revolutions’ along the way³. In terms of the various ‘revolutions’, it is interesting to speculate that in 1916, if General Maxwell (Officer Commanding British Forces in Dublin) had not insisted on subjecting the rebel leaders to Field Court Martial and execution by firing squad (which was procedurally incorrect, given the provisions of the Defence of the Realm Act 1914), and instead simply imprisoned them, then public opinion and popular support might not have swung behind the rebels, and Ireland might still be part of a United Kingdom. But more about that next year.

Meanwhile, irrespective of geo-political designations, Irish and British anaesthetists have far more in common than separates them, and the AAGBI is one ‘union’ that all sides will want to see continue and prevail, for our mutual benefit.

David Honan Consultant,
Department of Anaesthesiology and Intensive Care Medicine
Wexford General Hospital, Wexford

References 

1. Warde D, Tracey J, Cahill J. Safety as we watch: anaesthesia in Ireland 1847-1998. Dublin: Eastwood Books, 2022. 
2. Featherstone HW. The Association of Anaesthetists of Great Britain and Ireland. Its inception and purpose. Anaesthesia 1946; 1: 5-9. 
3. Boulton TB. The Association of Anaesthetists of Great Britain and Ireland 1932-1992 and the development of the specialty of anaesthesia. London: Association of Anaesthetists of Great Britain and Ireland, 1999. 
4. eISB Irish Statute Book. Medical Practitioners Act 1927, 1927. https://www.irishstatutebook.ie/eli/1927/act/25/enacted/en/ (accessed 29/12/2022). 
5. eOceanic. Bannow Bay, 2022. https://eoceanic.com/sailing/harbours/14/ (accessed 29/12/2022). 
6.  Robertson G. The tyrannicide brief. London: Vintage Books, 2006.

¹ It must be remembered that, although the Irish Free State had been in existence for ten years by that time following the enactment of the Anglo-Irish Treaty signed in 1921 and coming into force on 6 December 1922, Ireland comprised a Free State of 26 counties with Dominion status within the British Commonwealth. King George V remained as Head of State in Ireland, a Constitutional position that did not change until the approval by the People of the 1937 Constitution, and the subsequent unilateral declaration of a Republic in 1949. Up to 1927, doctors in the Free State were still registered with the GMC in London via a Branch Council in Dublin [4]. 

² The reader is invited to read a book by Geoffrey Robertson QC that, although looking primarily at the story of John Cooke BL, the barrister who was tasked by Parliament to prosecute King Charles I in 1649, does incidentally give one of the best collateral accounts of Cromwell’s motivations that I have yet encountered – possibly because it was written by a barrister and not a historian [6]. 

³ Grattan and O’Connell both argued that the Act of Union 1800 must have been void ab initio, as whilst a parliament is empowered to legislate it arguably does not have power to abolish itself in order to cede legislative power to a different assembly, without reference to the people.