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The hospital environment: St George's Hospital garden

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Avoiding getting too specialised
Harold Lambert Physician
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Well, I think it was partly accident because in- infectious disease, I think I mentioned, gastroenteritis could be any dashed thing- label. I always used to say to students don't say gastroenteritis, say diarrhoea, or diarrhoea and vomiting, because then it stands you back from committing yourself to a particular line of diagnosis. I mean, a rather pompous thing to say but, I mean, I think it was useful to say it in that way. And we had a huge number of referrals, for example, fever, you know, what is it? And, you know, as you can see I'm very interested in the analysis of difficult illness, the actual trying to follow a pathway which gets you to the right place without, without damaging the patient in the process and I think it was that rather. I was compelled to stay as a generalist but, I mean, obviously, there were more and more things I didn't understand and would refer to somebody else. Yes. But I suppose what comes across is also that, that you refused not to see the person sitting there? Yeah, I suppose that's right, yeah. Whereas I think a lot of people already reduce a case to- I mean, I mean, having, having been the other end, becoming- starting- walking through the door and being a person and, and then sitting down and suddenly becoming a case, you've already, you've already lost a lot of yourself. Yes. And you're not a case, you're a person but of course you have to be a case in order to, to link in with other cases and that, that's- Yes, that's right. Actually you're quite right. For that reason I don't like the word case. You know, you're using it to show what it means but I tend to jib and shudder a bit because it exactly does that, takes you away. The very process of getting into a hospital, that awful escalator, you're in on this thing. I mean, I know in my own psychology I would go to endless lengths to deny that I was getting ill in some way. Once I'd done it I would say, okay, there it is, get on with it and I'd be okay then about, you know, having an operation or, or doing- but I'd certainly try and avoid getting on the escalator if I could.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: infectious disease, diarrhoea, vomiting, analysis of illness

Duration: 2 minutes, 10 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008