1.       The Pathology Department - Howard Eales
2.       Editorial - Graeme Wilcox
3.       Thanks for my Year - Barrie Davies
4.       Incoming President Steve Booth
5.       Sailing a Drascombe Lugger - Peter Gough
6.       Past Times - Donald Black
7.       Post Grad Centre - a fresh start
8.       Medical Response to International Disasters - Noor Ahmed
9.       John Frankland - Peter Chaudoir


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THE PATHOLOGY DEPARTMENT


The Pathology service was set up by Walter Dunsby in 1941, performing basic investigations for Haematology, Chemistry, Microbiology and Histopathology carried out in one room in Mill Street Hospital. During the War histopathology specimens were processed by him at Kidderminster and a Pathologist from London used to come up by train on two days a week to do the reporting, and then Dr. Dickie Marshall, Consultant Pathologist from Wolverhampton, continued this service and visited the laboratory three days a week. The workload quickly expanded and Walter took on an assistant and two other technicians, Brenda and David, who were to marry, and both have only recently retired. Walter became very much the key person from whom many doctors sought advice, and was the linchpin of the service for many years. In the meaf;ltime the department moved from one room in Mill Street Hospital to the Sunnyside site.

Following the transfer of acute services from Mill Street to Bewdley Road Hospital in 1966-67, the services became split up. Haematology and Clinical Chemistry moved over in 1970 into the first floor of the Lodge, leaving Microbiology behind. This department later moved into a room close to the Lodge which had previously been used as the Post Graduate Medical Centre (this was the time when the Post Graduate Medical Centre was built on its present site, which is now being considered for redevelopment). By this time the service was being run by ten technicians and two pathologists, the latter dividing their time between Bromsgrove and Kidderminster, and the Histology service had been centred at Bromsgrove. 

With the ever increasing workload and the need for more room, Haematology and Blood Transfusion moved out to refurbished rooms in the old nurses home and this coincided closely with the appointment of a Consultant Haematologist, Dr. Lewis. After many stalwart years, Walter retired in 1980 (but to this day still retains a close association with the General Practitioners and Hospital). David Rea was then appointed Chief in his place. By 1986, with the general expansion of the hospital service, it became obvious that there was a requirement for a Histology service on site and this was supported by an independent outside review by Professor John Hardwick. Initially this was set up next to Haematology in the old nurses home, but this building was demolished in 1989 to make way for Phase VI development and both departments were housed in a new development taking over the building and a new top floor above the old medical residence. The transfer of the phlebotomy services to the new Outpatients Department in Phase VI provided additional space which finally allowed plans to be prepared to bring all departments on to one site 55 years on. 

At the moment the Laboratory is going through the throes and turbulence of working alongside a this development, which is costing approximately one third of a million pounds and demonstrates the hospital's commitment to providing a service. Why, I hear you say, is it costing so much? I can only respond by stating that laboratory development is exceedingly expensive, with all the necessary service instalments, Health and Safety requirements and installation of modem equipment including computer links. However, we hope the pain of all this will be over by Christmas - when all departments are finally established on one site. To handle the expanded workload the laboratory is now staffed by 28 W.T.E.This has been accommodated by increased automation and efficiency with This has been accommodated by increased automation and efficiency with virtually no expansion of the staffing establishment. Laboratory aides have been introduced to replace some trained staff where appropriate, helping us to keep our costs down.

Bringing close together all the laboratories on one site will allow greater flexibility in the use of staff, and keep our costs to the minimum, an
absolute essential in this now highly competitive world. This has been accommodated by increased automation and efficiency with virtually
no expansion of the staffing establishment. Laboratory aides have been introduced to replace some trained staff where appropriate, helping us to keep our costs down. When the whole laboratory is on one site there will be a reception area on the ground floor, manned continuously during the working day. We believe this will improve the service for the Users and will negate the need for transferring specimens across the hospital site and facilitate quicker transfer of specimens to the appropriate department, helping to reduce turn-round time of reports. Already computer links for electronic transmission of results to G.P. surgeries is available and some practices are already making use of this facility. 

We live in very challenging times and Pathology in particular has been singled out by the Government for privatisation. This is a particular threat for a laboratory of small size with neighbouring larger laboratories on our doorstep and the whole of Birmingham and West Midlands conurbation within easy reach. It is- only by providing an efficient and cost effective service that it will be possible for us to withstand the intense competition. The advantages we think are obvious, in that we can provide an immediate personal service responsive to local needs. If the threats become real, we risk losing the local service and I am sure we would all live to regret this as there would be no turning back the clock if this were to

Howard Eales

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Editorial

At the recent A.G.M. of the Medical Society, it was agreed by those present to renovating, or in conjunction with the Trust rebuilding the Post-graduate Centre, the proposed costs being up to (at present) a maximum of 1/2 - 3/4 million pounds. This is a very exciting project, but it
needs the full support of the Society, and we all need to enter the debate on the issues.
I hope that all of you will consider writing to the newsletter with comments regarding the proposed project.The next year will be crucial and without all your opinions and ideas we might not come to the correct conclusions.


In a completely different vein, and whilst on holiday in Fowey last year I stumbled across on of our members, Peter Gough, in harbour with a
Drascombe Lugger. I was most surprised to find Peter so far from home and sailing such an unusual craft. He was in fact attending a Drascombe Lugger Association rally for the weekend. Here was a member of the society with a most interesting and unusual hobby and naturally I asked him to write a few words for the newsletter on the subject. There must be many more of you out there with many and varied hobbies and interests which would appeal to the membership. So please put pen to paper  and describe your hobby so that "Hobby Corner' can become a regular feature in the newsletter (article on page 3).


Graeme Wilcox

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THANKS FOR MY YEAR


In common with almost every aspect of modern life the Kidderminster Medical Society has undergone rapid and dramatic change over the last ten years - it has been modernised and manipulated to such an extent that I feel it's role is more significant than at its conception in 1893. The society, through the Post Graduate Medical Centre, has the prime medical education responsibility for North West Worcestershire; the socio-medical aspect of the Society closely adheres to and imitates the reigning president's interests and hobbies while at the same time the Medical Society Newsletter, currently in its 15th edition, keeps all members informed, and hopefully interested, of all that is going on and at the same time trying to stimulate new
ideas and the sharing of experiences.


Personally, I can only say that to be invited to be president of such a society can only be described as breathtaking. It certainly took my breath away running to the phone in Cape Coral, Florida while on holiday, to hear David Starkie asking me if I would accept such an honour. I can honestly say that it took no more than another three Budweiser beers and a little persuasion from my wife Isobel for me to ring David back to accept the honour. My presidential year has been exciting. I have always been interested in wildlife and photography but nothing I have ever achieved has approached the standard presented by John Robinson, my first guest of the year. John's current title escapes me - suffice to say Wyre Forest Wildlife Warden Extraordinaire - but he kept a capacity audience spellbound for 90 minutes with an expertly illustrated resume of what literally lives on our doorstep. Our guest in May was programmed to be Tony Redmond, Professor of Trauma Surgery at Stoke and who was going to talk about disaster medicine at home and abroad.


Unfortunately for us he was called at short notice to the former Yugoslavia to be presented with an award for his work there by government minister Linda Chalker. We were however given a superb presentation by his registrar, Mandy Hargreave, who at short notice and using someone else's slides, captivated the audience - particularly Noor Ahmed!! There followed the Medical Society Annual Dinner which was, once again, up to Spring Grove Standards. Following an excellent meal, and with wine, port and brandy flowing very well indeed, we were subjected to an hour of side splitting humour from David Gunson. It was just as well that the liquid refreshments were being consumed because with a sober mind some of the aeronautical stories we were told would have made us think twice about the next trip on an aircraft!


And so on to the Summer season and the inevitable rain on the day of the tennis tournament. But what an excellent and enjoyable day for an impressive turnout. On the other hand, the lawn bowls tournament was a washout on a sunny day and had to be cancelled because of insufficient response. Perhaps a lesson for future presidents - avoid 'geriatric' sports in close proximity to Bank Holidays. The final event of my year was entitled 'Rescue in Remote Places' by John Frankland, Medical Officer to the British Cave Rescue Organisation. Once again a capacity audience was thrilled by a magnificent presentation of slides and experiences which many of us only dream about and do not have the courage to partake in. I'm sure those of you who were fortunate enough to buy a copy of his book will agree with my thoughts!


As I have already said, a t!uly magnificent and memorable year and my very best wishes to Steve Booth the incoming president. Steve, you will enjoy your year very much and in no small part to the superb and untiring work of David Malcomson and Wendy Kingston. I will never again forget the importance of the backs of envelopes and the scraps of paper which David used as an infallible filing system and personal organiser and which were responsible for the success of the year. I truly dread the day when they decide to hand over to someone else because they will be a hard act to follow. I also wish, at this point, to express my thanks to the co-editor of the newsletter, Graeme Wilcox, for all his invaluable help and expertise. His continual nagging and encouragement ensures a continual supply of excellent articles for what is turning out to be a well received newsletter.
And finally, a quote from David Malcomson - a successful year can be measured by the number of bums on seats and there have been more bums this year than ever before. Please keep your bums active in Steve Booth's year.


Barrie Davies

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NEW PRESIDENT OF KIDDERMINSTER MEDICAL SOCIETY


I had quite a shock last Friday when I received a message from my secretary to say that Graeme had rung to ask for a copy of my acceptance speech for tonight's meeting. For some unknown reason I was under the illusion that one was a vice-president of the Medical Society for two years before becoming president, and thus I would be president during 1997/98 rather than 1996/97. I am using this as an excuse to explain why I have not yet devised a series of functions for the forthcoming year, but I would like to reassure you that my few remaining Betz cells are beginning to synapse and some embryonic ideas are starting to form. It is customary to pay tribute to the outgoing president, and in Barrie and Isobel I am sure you will agree we have had a most dynamic president and first lady, who will prove to be a hard act to follow. In his acceptance speech three years ago, Richard Taylor referred to the role of Kidderminster Medical Society in uniting doctors and dentists working in the hospital and general practice. He predicted that constrictions and differing expectations of G.P.s and particularly H.O.s would prove to be divisive, and it concerns me sometimes to note that the chasm between hospital doctors and general practitioners is beginning to widen in some areas. I do hope that by continuing to meet as we do as a combined society, which encompasses all branches of the profession that we can remain as we always have been in the past both friends and colleagues, working together to achieve the best outcome for our patients. Thank you very much indeed for the honour of being elected as your President for the forthcoming year.

Steve Booth

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Sailing a Drascombe Lugger


A two-masted yawl-rig open 18" centreboard boat, the lugger was John Watkinson's 1967 original design of the Drascombe range to provide his own family with a safe day - sailer. The spars stow within the boat for trailing and she can be launched and retrieved single handed. Her sail plan is balanced even under reduced rig of jib and mizzen alone and there is provision for mounting an outboard engine and rowlocks for a pair of oars. She is thus quite versatile and suitable for coastal passages in the right weather and for exploration of river head-waters with her lifting steel centreplate and rudder. Available in wood or GAP, with her tan coloured rig and boom less mainsail she retains the essential small boat feel without being unforgiving. In capable hands she has made cross-Channel trips, an Australian voyage and a couple of circumnavigations. A thriving Drascombe Association exists with a quarterly newsletter and numerous rallies around the UK, Eire, Brittany etc.

Peter Gough

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PAST TIMES


The changing attitude of the public towards the Medical Profession with whom, so it seems, doctors have to work with the threat of litigation breathing down their necks; whom their efforts are questioned constantly and when they have to put up with frequent outbursts of verbal abuse, not to mention actual physical violence, my mind tends to turn back occasionally to happier times'. In those now far off days most folk seemed to have a very simple and, occasionally, touching faith in our Profession (maybe not always justified). Nevertheless, allow me to recall two occasions to illustrate this, when I was a "Houseman" in Northampton General Hospital in 1937. It was towards the end of our "take-in week" with beds standing down the middle of the Wards that, one night, an old fellow as admitted with symptoms and signs of intestinal obstruction. I remember so well that his appearance reminded me of "Mr Punch" with his ruddy face and prominent nose and chin pointing towards each other. I reported to my "Chief" who came in to see him. When he had completed his examination he stood back from the bed, but, before he. could utter a word, the old chap chipped in with "Well, Sir, are you going to knife me or purge me?
Apparently that was all that he wished to know. We "knifed him" that night, but, alas, there was little that we could do for him.' I liked to believe that he died content in the knowledge that we had done our best for him and that, surely is all that any of us can do!


On another occasion, I was called down to "Casualty" to see a man who had, on examination, obvious acute appendicitis. When I explained this to him and told him that he would have to .be admitted for an operation, he looked up at mewith disappointment written allover his face and replied "Oh doctor, can't I just have an X-ray"! He made a good recovery and went home a wiser man, I hoped.


Lastly, for the sake of some of our younger colleagues who may not know this, I would point out that those "Chiefs" were Honorary Consultants. who gave their services free and without any form of financial remuneration. I was more fortunate in that I was paid 150 p.a.. with free board &
lodging, laundry and a daily bottle of beer thrown in!

Donald Black

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THE POST GRAD CENTRE - A FRESH START


"We would like the Trust and the Medical Society to work together towards a new multi disciplinary Post Graduate Centre". (Administrator)

A fresh look at the future of the Postgraduate Centre was taken at the A.G.M. The architect of the Stafford Postgraduate Centre, Jim Chapman presented ideas for the site, incorporating the Pharmacy area. He showed a variety of plans to either modify the present building, or to modify the postgraduate centre and build a new lecture hall or a total rebuild. The most expensive option was estimated to cost 700,000. The meeting agreed to look further into the possibility of a centre for Multi Disciplinary Education, which would be large enough to host Regional meetings. There will be a further extraordinary general meeting shortly to discuss the finances of the scheme after further research into sources of funding.

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 THE MEDICAL RESPONSE TO INTERNATIONAL DISASTERS

The Kidderminster Medical Society met on 8th May, 1996. We had invited Professor Tony Redmond as our guest speaker but he was unfortunately unable to make it; however the talk was delivered by his very able senior Registrar, Dr. Mandy Hargreave, and it was an interesting and enjoyable evening.


Dr. Hargreave had a difficult task; being asked to speak using somebody else's slides (which is not a situation any of us would like to be in). I thought she did this very well, although I must admit I found the first part of the talk rather uninspiring since we were shown Professor Redmond's slides of disasters in different part s of the world without the benefit of any background information or even the author's favourite anecdotes which go with each slide. The second part of her talk focused on the planning of managing disasters which was very interesting and provoked a lively discussion at the end. It highlighted the important message that" to fail to plan is to plan to fail". No plan is likely to cover all eventualities or even work successfully and the next step is to put our plans to test to see if they work in artificially simulated situations. This is a regular feature in north American hospitals and we should perhaps practice this more often in the UK. In a small district such as ours setting up these exercises will require the close co-operation of hospital doctors and G.P.s and we should perhaps form a small committee to steer this. Any volunteers? 

The talk also touched on the role of trauma centres in the U.K. Recent evidence suggests that the treatment outcomes for major accident victims treated in district general hospitals are not any different from those at the larger trauma centres. However, we're naturally disadvantaged in that we do not have an on-site .neur6sur~ical, cardiothoracic or plastic surgery service and patients have to be transferred If their injuries require such surgical intervention. We are, however, not alone fn this and many hundreds of district hospitals in the country face the same difficulties. I think it is unlikely that the situation will change much over the next decade and probably the best compromise is to enhance the trauma expertise at every district hospital which admits emergencies, and have more on-site input from the Regional Centres in the treatment of such patients. At present we have excellent support in maxillofacial and plastic surgery from colleagues based elsewhere and this option could be explored in other specialties. In my training I remember carrying my bag of external fixators many a time to an isolated neurosurgical hospital to treat patients there; perhaps this should be a two-way traffic.

Noor Ahmed

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John Frankland

John Frankland was the speaker at the Autumn Meeting of the Society. He was introduced by David Malcomson who was standing in for the president, Barrie Davies who, along with Dick Herbert, Had to respond to a BASICS call to a serious road accident. 

John is at heart a caver. He spoke in pitch darkness illuminated by a galaxy of slides. The subjects ranged fron the less publicised hazards of travel, heart attacks on mountains, altitude sickness and fluid balance and getting accident cases off mountains and out of narrow caverns - and all extremely well illustrated with humour.

Barrie arrived back in time to give a vote of thanks for an evening greatly enjoyed by everyone who attended.

Peter Chaudoir.

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