Dr Len E. S. Carrie
1990-1993 - President
Len Edwards Scrymgeour Carrie was born in 1931 in Sale, Cheshire. His father was a general practitioner, born in Arbroath and educated at Aberdeen University Medical School. His family moved to Kent in the mid-1930s, and at the outbreak of the Second World War Len and his brother were evacuated to Kingussie in Scotland. He finished his education at Watson's School in Edinburgh and in 1949 entered Edinburgh University Medical School. He received his MB ChB in 1955. After houseman posts in the Edinburgh Royal Infirmary and the Royal Victoria Hospital, Bournemouth, he completed his National Service as a Medical Officer in the RAF. On his discharge from the RAF in 1959 he took an SHO post in anaesthetics at Bournemouth.
I had been doing anaesthesia for two weeks, and had a caesarean section to do, so I called one of the new young consultants in. After a while he said ‘How long have you been doing anaesthetics now?’ and I said ‘Two weeks.’ He said ‘Well, it's about time you were doing your caesarean sections by yourself, you know.’ I didn't dare call him in again.
Dr Carrie received his Diploma in Anaesthetics in 1960, and the Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons in 1963. In the same year he moved to Oxford as a registrar in the Nuffield Department of Anaesthetics, where he remained for the rest of his career. The head of the NDA, Robert Macintosh, made a lasting impression:
One of the great joys and terrors was when Sir Robert descended on one of the anaesthetics rooms and proceeded to give one of his anaesthetics. He never in my experience gave a ‘normal’ anaesthetic. He was always experimenting clinically, and then of course he nearly always descended on one of the unfortunate surgical registrars or senior registrars. They, of course, were terribly junior to the Professor, and they just had to cope with the anaesthetics as best they could. It was great fun, and quite irreplaceable nowadays, I'm sure.
Macintosh had made the NDA a major English centre for regional anaesthesia:
We used regional anaesthesia for some fairly hair-raising techniques, very major ear, nose and throat procedures, and even laryngectomies were done quite routinely under regional anaesthesia... Major gynaecological surgery like pelvic floor repairs or vaginal hysterectomy were routinely done under spinal anaesthesia. The surgeons expected them because they got more often than not an excellent operating field with very little bleeding, and this was unmatchable by general anaesthesia. They were also quick, of course, compared with epidurals. On a busy operating list, spinal anaesthesia could be extremely effective in five minutes whereas few epidurals would be doing anything like a similar job in twenty or thirty minutes.
Obstetric anaesthesia in the NDA at this time was generally carried out by the junior anaesthetics staff. Caesarean sections – both elective and emergency – were performed under general anaesthesia:
They would probably breathe nitrous oxide and oxygen and probably some trichloroethylene because it didn't relax the uterus like halothane did, and ongoing muscle relaxant. Not much obstetric surgical work was done under regional anaesthesia in those days. Major gynaecological procedures, yes, but not obstetric.
In 1968 Dr Carrie was appointed Consultant Anaesthetist in the NDA, with responsibility for obstetric anaesthesia and pain relief in the Oxford region:
There were virtually no consultant anaesthetics sessions in obstetric anaesthesia. The obstetric anaesthesia was being mostly done by junior staff. Analgesia was being run by the midwives and the obstetricians. I had one session in obstetric anaesthesia when I was in the Radcliffe Infirmary, and it wasn’t much use, because it was a Friday afternoon when things were not at their most acute on the labour wards. It was when the John Radcliffe aternity Unit opened in 1972 that I was given sessions and there were some other anaesthetists given the odd session, and it became better organised and the pain relief, as well as the anaesthesia, became more the province of the anaesthetist.
He joined the OAA at its second meeting, organised by Donald Moir, in Glasgow in 1970. Throughout the 1970s and 1980s he worked on regional anaesthesia and analgesia, and in particular on the rehabilitation of spinal anaesthesia. His paper, ‘Spinal Anaesthesia – An Alternative Route’, read to the second OAA symposium at the University of Warwick in 1979, advocated the use of this technique, and he was also involved in the development of ‘pencil-point’ needles to reduce the problem of post-spinal headache.
Dr Carrie was President of the OAA from 1990 to 1993. He retired in 1997 to live with his wife in Cumnor, Oxford. RB
