Tom Treasure Weblog

In my blogs to date I have confined myself to issues related to the clinical practice of heart and chest surgery. I have dealt with some contentious issues but within the domain of my day job. My opposite number Cardiothoracic Surgery Network (www.ctsnet.org) blogger has covered the parsing of political paparazzi, global warming, defrauding of charities, and how George Orwell’s novel “1984” was a harbinger of dependency and the limits on choice in health care on either side of the Atlantic. Liberated by his example I will use this blog for a more seasonal purpose. But first, since George Orwell has been mentioned, I learned from a piece in Saturday’s Guardian (10th December) concerning the discovery of letters written by his first wife Eileen. Letters are less often hand written if written at all now. Eileen was the sister of Laurence O’Shaugnessy, an Irishman and a rising star in 1930s British thoracic surgery. He worked for at time with Ferdinand Sauerbruch in Berlin. Events separated them and O’Shaugnessy returned to Europe as an army volunteer and was lost in 1940 during the retreat from Dunkirk. His name appears on the war memorial amongst those whose whereabouts are known only to God. The French thoracic surgeon Michel Ribet tells this story in a letter to the journal Thorax, with an intense personal perspective (Thorax 1992; 47:842). Ribet reminds us of how much European surgical collaboration had to be rebuilt after the destruction by war of so much that was tangible and intangible.

But to return to my purpose in this blog, it is more to discuss another type of letter, the round robin letter, which families send around at this time of the year. This is a literary device in which, ever more easily thanks to electronic media, we are able to construct and disseminate an annual newsletter of our doings during the year. It typically includes a digest of family news for friends and acquaintances. It is much derided in some quarters and nowhere more amusingly than in Simon Hoggart’s books - I see that after his popular success in 2004 he has a new one for Christmas 2005. Not all agree with Hoggart. Professor Janet Treasure for instance takes a quite different view. She sees these letters as an entirely appropriate medium for the friendly exchange of news. And who can ignore the views of a leading psychiatrist, particularly one who received an NHS Gold Award this year? Those who want an introduction or an update on her recent achievements need only look to Google where she dominates most of the first several pages (I gave up after a dozen) with her writing and clinical work in Eating Disorders. Her team are spread over three sites: the in patient base at London’s famous Bethlem Hospital, the national Institute of Psychiatry on the Maudsley site, and her Professorial department at Guy’s Hospital where she is Chair. This geographically dispersed group tend to gather in our south London home which sits conveniently within the triangle marked by these notable institutions. Along with many international colleagues (to whom warm greetings) they demonstrate no problem with eating and are certainly never disorderly.

These round robin letters are mocked mercilessly by some, as distillations of selected self-congratulatory news that will cast the writer and family in a good light as the darkness of the variously named feasts of the winter solstice arrive. I intend to abide by that tradition in this blog so any spin will be positive. I do realise that readers in the Southern Hemisphere will have long days and ample light but there, it is alleged, the exiting bath water is also spun in the opposite direction. The tradition (and there is a remarkable consistency in the Round Robin form, almost like an IMRaD paper) is to list the children starting with the beloved first born. In our case this would be Sam. He has had ups and downs this year. The downs were the result of falling off his bicycle a couple of times, on the way between Sussex University campus and his home in Brighton. As a result he had broken bits of himself including teeth, small bones, his morale and some of his joie de vivre. He has recovered on all fronts including gaining high marks in his Theoretical Physics course and will be 24 years old next Saturday. Happy birthday Sam. Jean, the no less beloved second born, is in her third year, a pioneer medical student in the new Brighton school. Sussex University had a strong Psychology Department now reflected in its new Medical School (also in its third year, hence Jean the pioneer) for she is now in the unnerving position of having professors and teachers very familiar with her mother’s work. To date, connections with cardiothoracic surgery have passed relatively unremarked.

I stray from my subject. It is no chance that the titles of Hoggart’s books with their hilarious exposés of the most naff and self congratulatory of Christmas letters are entitled “The Cat Who Could Open The Fridge” and the “The Hamster That Loved Puccini” because after the parents’ career moves and the children’s achievements are told, anecdotes about the family pets follow. We could not compete there. Our London menagerie is down to the last few quail, canaries and cockatiels. As Jean moved away to Medical School and the bravado of inner London’s foxes escalated, our garden was no longer the haven it was for geese, ducks and bantam fowl. Tilly, the last surviving goose, died peacefully earlier this year, in the country at grandma’s. But with the spring, we hope to return to animal husbandry. The ten acres of Falcon Farm have been reshaped over the eight years with restored and new planted hedgerows, an orchard, a nut grove, woodland and ponds. The place has come alive with the creatures previously driven out by decades of modern farming. Our man made ponds have blended into nature and shy moorhens have nested and brought up their families these last two years. We have introduced toads and newts, probably unnecessarily because slow worms and an abundance of frogs have made their own way. Our agricultural efforts have been in the orchard and kitchen garden but so far I have not mentioned the meadow. The five acres where we have sown old fashioned grasses and wild flowers, now sheltered by woods and hedgerows, has caught the eye of a gentle, earth friendly local farmer who asks if it can be home to some in-calf Sussex heifers. What have I been waiting for? What I have needed though is the carer as well as the cows.

The European Association for Cardio-thoracic surgery (EACTS) has occupied a great deal of time this year and much travelling, almost on a par with Janet’s, and not compatible with tending cows and calves. In 2004 the travels included Turkey, Greece, Spain, France, Italy, Belgium, Holland, Florida and California and in 2005, which will be dominated by my Presidential year, so far scheduled are Ireland, Philadelphia, Chicago, Romania, Poland and Sweden. I have already referred to the devastation of Europe’s medical and scientific collaboration as a result of terrible wars of the twentieth century. We seem to have stopped counting after two. EACTS and ESTS are part of the rebuilding of medical Europe. The first wave was in Western Europe but now the Eastern European countries are a playing a large part and our annual meetings of Thoracic and Cardiac surgeons are the largest in the world. But over Christmas, I will relish a quieter time. We hope it will be family time, and on Falcon Farm.

Sam and Jean share a home in Brighton, the place to be, the place to party - but a curious deadness falls on England over Christmas. Not just England. The legacy of the war left Europe divided and caught between the influences of the USA and USSR. John le Carre in Absolute Friends describes the anarchists and wannabe urban terrorists of cold war Berlin who on Christmas Eve “experience one of those moments of self-revelation from which there can be no retreat. Already by the twenty-third of December the squat is three-quarters empty as communards abandon principle and slink home to celebrate in the bosom of their reactionary families. Those who have nowhere to go remain behind like uncollected children in a boarding school.” I hope I will never be seen as reactionary or that Sam and Jean will ever need to slink.