Trevor A. Thomas
1996-1999
My career in Anaesthesia began almost accidentally. I was seeking an SHO post in Obstetrics but the one I fancied was not available for some 6 months. Needing gainful employment I was happy to be offered a post in Anaesthesia at the Birmingham General and the Queen Elizabeth Hospitals and I surrendered to the joys of the early independence and multiple challenges of anaesthesia. I hesitate to admit how little training time had passed before I was sent off, alone, to "just pop over and anaesthetise a Caesarean section 'across the road'. That was at the 'old' Birmingham Maternity Hospital. Youth knew no fear and fortune did, fortunately, favour the bold.
I travelled after Birmingham and, after six or seven years including a year in the Toronto Hospital for Sick Children finished back in Bristol.
Ten years after my first 'experience' of Obstetric Anaesthesia I was a very junior Consultant of three years standing in the Department of Anaesthesia of the Bristol Royal Infirmary. A new Dept of Obstetric Anaesthesia was being set up at the new Bristol Maternity Hospital. Anaesthesia was experiencing a bit of difficulty with the Professor of Obstetrics of the time. I'm sure he would be pleased to be described as 'a little touchy if not down right cantankerous'. My only significant contribution to Obstetric Anaesthesia at the time had been to co-author the first paper advocating sodium citrate as the antacid of choice for pregnant women. That seemed to suffice and 'the boy' was asked to 'just pop up the hill and sort it out'.
Sorting it out involved setting up the new Obstetric Anaesthesia Service and it was axiomatic that to do so the support of like minded colleagues was essential. Bob Johnson was one such and together we joined the OAA; as I recall in 1974. By 1980 Bristol was hosting the annual meeting, the first OAA meeting to offer topless opera as part of the programme - scientific? I'm still not sure.
By then I had been inveigled onto the Committee by Andrew Doughty, first as Minute Secretary and then following Barbara Morgan as Hon. Sec. Taking over from such an organised person should have been a sinecure but the hand-over occurred just months before the OAA's second overseas meeting - in Paris. It was a unique experience.
I 'looked after' 3 Presidents, Andrew Doughty, Tom Bryson and Donald Moir, each unique, eminent and fun in their own way, before handing over to John Thorburn.
In 1984 I was the boy again, this time to Jeff Crawford and Donald Moir in Sri Lanka. Providing a course in Obstetric Anaesthesia with the two of them in the developing world was a real education and a model for future forays to disadvantaged parts of the world.
In the Spring of 1978 I took up the responsibility of the Regional Assessor in Anaesthesia for the South West Region to the Confidential Enquiries into Maternal Deaths. I continued with that commitment for the next 24 years, finally becoming one of the Central Assessors and a member of the Editorial Board for the Enquiry's triennial Report. I believe this was possibly the most important 'extra-curricular' activity that I engaged in during my career. Prior to 1978 anaesthesia was the third commonest cause of maternal death, about 10 deaths per year. The Confidential Enquiry Reports identified the causative problems and I was fortunate to be in a position to promulgate the information that I gleaned from the Enquiry process and speak, around the world, about possible solutions to the problems. The dissemination of the facts and their interpretation over the next 25 years paralleled significant changes in Obstetric Anaesthesia and a decrease in maternal mortality from anaesthesia. Whether I am correct in claiming cause and effect for these associations I know not but, between 1997 and 1999, there were only 3 'anaesthetic' deaths in the United Kingdom, a major improvement from any viewpoint.
From 1975 to 2000 the department in BMH [later St. Michael's Hospital] flourished. We managed to launch computerised Anaesthetic Records [in the 1970's on a main frame computer much to Andrew Doughty's amusement] and published an average of more than one scientific paper per year.
In the same period I was fortunate to be invited to write a number of chapters on various aspects of Obstetric Anaesthesia.
Finally in the second half of the 1990's Anita Holdcroft and I collaborated and wrote a book using Jeff Crawford's title, 'Principles and Practice of Obstetric Anaesthesia and Analgesia'. In 1996 I became President of the OAA, again taking over from Barbara Morgan, how history repeats itself!
It was a privilege to serve the OAA in this role and to have been a member of what I still regard as the premier association of Obstetric Anaesthetists in the world. TAT
