Edinburgh 1932 1969 1978 1995
Leeds 1924 1979 2004
Newcastle 1933 1971 1989
Oxford 1947 (Resurrection meeting)
Manchester 1948 1967 1988
Belfast 1954 1976 1997 2012
Norwich 1961 1984 2002
RNH Haslar 1970 1992 2000
Birmingham 1964 1974 2013
Sheffield 1973 2003
Lake District 1985 (spring)
RAF Halton 1985 (autumn)
Bury St Edmunds 1993
Tunbridge Wells 2001
Ashford (Middlesex) 2006
1972 Westminster Hospital and the Royal Army Medical College, Millbank
1975 St Bartholomew’s Hospital
1977 Royal Postgraduate Hospital, Hammersmith
1980 Guy’s Hospital
1983 Middlesex Hospital
1987 Homerton Hospital and St Mark’s Hospital
1999 St Mark’s Hospital (Northwick Park) & St Mary’s Hospital, Paddington
2006 The Charterhouse (Enthusiasms – see text)
2009 St Marks and Northwick Park
2014 St Mary’s (Imperial)
Scroll down for reports of meetings
In 1924 Leeds was the site of an inaugural meeting of a dozen provincial surgeons (calling themselves the Junior Surgical Club) who had approached Sir Berkeley (later Lord) Moynihan to seek his help in establishing contacts with Continental colleagues, from whom they thought there might be something to learn after their own experiences at Casualty Clearing Stations in the First World War. Twelve of the fourteen founder-members accepted an invitation by Sir Berkeley to his home town for a three-day programme of operations, demonstrations and discussions. On the evening of Wednesday 17 July he sent a list of cases to each member at the Metropole Hotel and arranged to meet them at the Infirmary at 0930 the next day. He wrote to the Honorary Secretary W W Wagstaffe thus: “ I conceive my chief role in surgery to be the training of other men to do work better than I can do it myself: so you will see some of my “boys”, who I hope will convince you that I have not laboured in vain.”
The first business meeting, with H H Sampson in the chair, was held in a private room in the Metropole Hotel hired at a cost of £4-3-10 whilst postage and telegrams accounted for a further 4s 2d. It was formally agreed to call the group the Travelling Surgical Club (the TSC) and limit the initial membership to practising “surgeons who had served overseas in the great war” [sic]. It was also “resolved that the Club meet once a year at a place and time to be decided at the previous meeting. The general idea shall be to see the work done in clinics especially abroad.” The annual subscription was fixed at 15/- (fifteen shillings).
Sir Berkeley consented to honour the Club as President, and although he did not attend any subsequent meetings he offered his blessing and support, sometimes in writing. At the first Leeds gathering in 1924 he entertained his guests to a historic dinner in his home where one of them later recalled that a silver bowl of red roses (or possibly carnations) had been displayed on a black tablecloth.
The initial aim to meet foreign surgeons has been maintained annually apart from notable exceptions. There was a hiatus due to the Second World War, the visit to Israel in 1977 was cancelled as was the one in 1985 to Dallas (both possibly because of the expense), and most recently the plug was pulled on the visit planned (and arranged) to Greece in 1991 because casualties were expected to be received in UK hospitals from the Gulf War. It was in 1932 that the Society first broke with the tradition of travelling exclusively overseas (apart from the inaugural 1924 meeting in Leeds) by going to Edinburgh. It is not known why the original intention in 1932 to visit Rome and possibly Paris did not come to fruition – though cost or a lack of host arrangements may have played a part on this and later occasions – nor apparently was any precedent intended to be established by holding a meeting within the UK. However it was observed afterwards that “The visit to Edinburgh will be memorable because there we saw, in a clinic at home, a demonstration of surgery which equalled, if it did not surpass, anything seen abroad. This was the more remarkable in that we did not see the work of one chief and his assistants but something of the whole surgical staff. ” The meeting was hosted by J J M Shaw, a pioneer plastic surgeon (who sadly died in 1940 of shigella dysentery during the Second World War). Operations and demonstrations were supplemented with a visit to the Museum of the College of Surgeons where the Society met “Mr Gregg among his beloved skulls, many of whose owners he seemed to have known intimately.” On 7 May 1937 an Extraordinary Meeting was held at the Caledonian Hotel in Edinburgh during the annual meeting of the Association of Surgeons, apparently to discuss future membership of the TSC.
The Travelling Surgical Society (as the organisation will be referred to henceforth, although this name was only adopted in 1988) did not convene again in “Auld Reekie” until 1969 when they were guests of Archie Macpherson, who also arranged the further meeting in 1978 at which John and Pat Cook entertained members to drinks and a buffet supper at their home, to meet Archie and his sister. He was also present at the latest visit, in 1995, attended by 58 people when our host was Alasdair MacGregor. With four meetings, Edinburgh has thus been the most frequent UK venue apart from London. Having also been the one to usher in the era of home visits, it is no surprise to learn from the minutes of the AGM in 1937 that “the Hon Secretary was instructed to ….. invite two guests to attend the tour each year, irrespective of the number of members attending, and that each year one of the guests should be from Edinburgh and one from some other provincial city.”
Encouraged by the success of the Edinburgh visit in 1932, and confronted by failure of the plans to visit Rome and Bologna, the Society met the following year in Newcastle on Tyne where a difficult anterior resection was witnessed, and surgery on the cleft palate discussed. The next meeting there was in 1971 in the spring, the intended trip abroad (to Portugal) being postponed due to the untimely death of Professor Basto Lima. In 1989 the Society again visited the Royal Victoria Infirmary, where Professor Ivan Johnston and his staff gave an overview of the surgical department’s history and research activities, followed by clinical papers.
Manchester hosted the first post-war meeting, in 1948, following a business meeting of members convened on 4 July 1947 during the annual meeting of the Association of Surgeons in Oxford. In Manchester operations were watched in the Royal Infirmary and the Christie Hospital, where papers were also presented. The Society returned in 1967 and amongst other talks was one given by John Charnley on his Sterile Operating Theatre. Manchester was again visited in 1988 when Roger Marcuson hosted the meeting in The Hope Hospital, Salford (a town from which William Worrall Mayo emigrated as a “horse and buggy doctor” to America where his two sons William and Charles went on to found the famous Mayo Clinic in Rochester, Minnesota). Papers with clear surgical messages were presented, and Miles Irving emphasised that some patients are too sick not to have an operation when threatened by the Four Horsemen of the Apocalypse (Haemorrhage, Fistula, Sepsis and Obstruction). Massive sepsis requires surgical drainage, the gut must have its blood supply protected, and spinal instability due to metastatic disease may warrant early fixation even in terminal patients.
Belfast has received the Society on four occasions, the first in 1954 when the host was Ian Fraser, later knighted as President of his College. The group arrived there from Dublin where three members were elected to the Society: Fred Hanna, Brian Truscott and Sinclair Irwin, and the Report for 1954 states that “it would not be out of place to mention the great kindness and friendliness shown us by Mr and Mrs Sinclair Irwin, who did everything to make our visit in Belfast a happy and memorable occasion.” In 1976 Sinclair and Betty Irwin arranged the Belfast visit, and in 1997 it was the turn of their son Terry with his wife Jenny. Northern Ireland’s static population and its legacy of terrorism made for interesting surgical papers at the Belfast City Hospital, followed by a tour which included the Giant’s Causeway. Happily our visit in 1997 coincided with an IRA ceasefire preceding the first peace talks for 75 years. Travel was facilitated by Belfast’s two airports to which members flew from the increasingly numerous ones on mainland Britain, and it is therefore interesting to note the comment in the Report for 1954 on the Irish visit that “Air travel is rapidly becoming the principal mode of transport for our members”.
In 2012 the TSS visit to Belfast (attended by thirty-nine in total) was again hosted by our Secretary Terry Irwin with his wife Jenny, aided by TSS member Paul Blair, at the Royal Victoria Hospital where papers were heard on new approaches to cancer, trauma management, gastro-intestinal failure, repairing abdominal wall defects and managing metastatic disease. Urinary tract stone management was discussed by endo-urologist Trevor Thompson, elected to the TSS during this visit. There was advice on how to handle the trainee in difficulty, and on the meaning of professionalism to the modern surgeon. The final event was dinner at the Houses of Parliament, Stormont, with Unionist MP Ian Paisley (junior) and MLA Basil McCrea, after they had shown us round their historic building. After this visit the TSS travelled by coach to Dublin (the meeting there is covered under Ireland, in the International Visits section of Past Visits).
Portsmouth was the venue in the autumn of 1958, the first year the Society held two meetings, a regular annual practice now since 1967. It was hoped that those who did not attend the spring meeting in Turkey because of the distance might come to a meeting closer to home, and so it proved. Bernard Williams arranged the 1958 programme, which involved all three Portsmouth hospitals and included a pioneering Syringe Service, forerunner of the now universal central sterile supply. Problematic rare clinical cases were presented and discussed. Finally, members had the opportunity to see over an aircraft carrier. Home meetings were held every three years thereafter until 1967, then annually.
Birmingham was visited in 1964 (Guy and Janet Baines) with papers at the Queen Elizabeth Hospital. Further papers were heard in 1974, on a variety of subjects including Arnold Gourevitch’s account of his experiences in the 1973 Yom Kippur war (on 6 October – the Day of Atonement) in which forward resuscitation was followed by the rapid air evacuation of casualties to base hospitals in Israel.
Cardiff was visited in 1968, hosted by Mr and Mrs Hilary Wade for this fourth triennial meeting. Cases were presented at Cardiff Royal Infirmary, followed by unusual urological malignancies and dissertations on thyroid and parathyroid disease. The next day (Saturday) short symposia were held on gastric surgery and then on breast cancer, chaired by Professor Forrest. It was felt that the Welsh National School of Medicine had got off to a flying start. Newport was visited in 1991, our host being Martin Price Thomas, son of our former President Sir Clement Price Thomas (in whose memory we were to hear an eponymous lecture in China in 2007 during our joint visit there with the RCS).
The Royal Naval Hospital, Haslar (across the harbour entrance from Portsmouth), received the Society in 1970 and in 1992, and finally in 2000 by which time its name had been contracted to the Royal Hospital, Haslar. These occasions were infused with naval history, including presentations on Haslar and its military past, Lord Nelson’s injuries and Sir James Watt’s biography of James Ramsay (naval surgeon and morning star of the anti-slavery movement). Haslar is itself being consigned to naval history, with the proposal to develop the Centre for Defence Medicine in Birmingham and leave Haslar as a civilian facility serving the environs of Gosport and Alverstoke. Already service patients are being treated elsewhere, in the six Military Defence Hospital Units located as wards in civilian hospitals.
London, with its large population and many hospitals, has been the most frequent venue for home meetings although it was not until 1972 that any meeting was held in the metropolis, perhaps because the purpose of the original Travelling Surgical Club was to ensure discourse between provincial surgeons. The meeting in 1972 was held at the Westminster Hospital, the stamping ground of the Society’s President Sir Clement Price Thomas (who sadly died that year) and was organised by Robert Cox (himself later to become President of the TSS). A symposium on Head and Neck Cancer was followed by eclectic presentations. Papers were also heard the next day at the Royal Army Medical College, Millbank.
The proposed visit to Israel in the spring of 1977 being cancelled, there was a record attendance in October of 34 surgeons and 29 wives for the meeting organised at the Royal Postgraduate Hospital, Hammersmith, by Selwyn Taylor, at that time Vice-President of the Royal College of Surgeons. He personally performed a parathyroidectomy, whilst Crawford Jamieson did an expert profundaplasty and Professor Calnan wrought plastic magic on a nose and finger.
St Bartholomew’s Hospital was host in 1975 in the Audio-Visual Aid Department (otherwise known as the Robin Brook Centre), to a meeting arranged by Sir Edward Tuckwell and James Robinson. Sir Francis Avery Jones gave a talk on Gastro-intestinal Bleeding, which he said was best managed by an enthusiastic physician and a reluctant surgeon. He later spoke after dinner at the Barber-Surgeons Hall on its history and treasures. Guy’s Hospital was host in 1980, starting with a party in the Highgate home of Randy and Mary Beard. Ian McColl gave a challenging paper on Medical Audit, beginning with a quotation from Alexander the Great: “A multitude of physicians have destroyed me.” He also volunteered the aphorism from Ecclesiastes that “Whatever is unknown is assumed to have greater potential.”
Adrian and Sylvie Marston hosted the meeting in 1983 at the Middlesex Hospital. The papers covered vascular, endocrine and gastrointestinal research and operations. The newly-opened Homerton Hospital was visited in 1987. The Society was also taken by double-decker bus to St Mark’s Hospital in Mile End where lateral sphincterotomy was demonstrated on closed circuit television, and presentations were heard on a variety of topics, mainly gastro-intestinal though a little vascular crept in. Bus journeys have a curious history for the Society, showing a predilection for excitement but happily not injury: at the Homerton hospital the vehicle got stuck on a hump in the road, and at the Charterhouse it became impaled on scaffolding. Nor have trips abroad been without incident!
London was also the venue for the largest ever meeting of the Society, held in 1999 to celebrate its 75th anniversary. The three day visit was hosted jointly by our President James Thomson and Secretary Geoffrey Glazer, at their respective hospitals. There was a tour of St Mark’s Hospital in its new surroundings (the grounds of Northwick Park Hospital with its distant view of Harrow), the move from Mile End largely credited to our President. Papers were heard, and closed circuit television again used to display a procedure from the operating theatre. This was followed by a day of marvellous papers at St Mary’s Hospital in Paddington which culminated in a presentation to James Thomson in recognition of his services to both the hospital and the TSS. The first evening we dined in the Archbishop’s Palace at Lambeth having toured its library, and the next evening in the Apothecaries Hall. The apotheosis was a celebratory black-tie dinner in the Royal College of Surgeons whose President Sir Barry Jackson – our main guest and speaker – presented the Society with a copy of Lord Moynihan’s personal compilation, Truants. This slender but historic book, detailing those who left medicine and became famous in other spheres, had been bought in 1936 (the year our founding President Lord Moynihan died) by Bob Nevin, also a former President of the Society. The book joins many memorabilia retained by the TSS.
In 2006 under the new Presidency of David Ralphs, the Society accepted the invitation from James Thomson – former Secretary and President of the TSS – to visit the Charterhouse of which he was Master, on a Saturday in February. 39 attended, many staying in the Nuffield residencies beside the Royal College of Surgeons where our visit began with a tour of the Hunterian Museum guided by an ever-sprightly Professor Harold Ellis. There followed a reception, lunch and afternoon at the Charterhouse, of which there was a guided tour before four non-medical “Enthusiasms” were presented by five members. The day was rounded off with a champagne reception and formal dinner at the Worshipful Company of Barbers, thanks to William Shand (our own past-President) who enlightened us on the history of this Company of which he was both a past Master and Warden.
Sheffield was visited in 1973 when the theme was gastroenterology; clinical and research papers were presented. Our hosts were Mr Derek Randall and his wife Zoe. The next visit, hosted by Bill and Grace Thomas in 2003, saw Sheffield’s hospitals united as a single Trust, and performing well together. Presentations on surgery, ethics and managerial matters were rounded off with an engaging talk by Andrew Raftery on the Sport of Kings. Finally Chatsworth House was toured.
Leeds was next visited in 1979, hosted by Mr David Pratt and his wife Libby, St James’ Hospital being the obvious venue and the papers being the first to be given in the new Clinical Sciences block. We returned in 2004 as guests of our fellow-member and Professor of Surgery Pierre Guillou who gave us an instructive day enlivened by the professorial contributions of iconoclastic liver surgeon Peter Lodge and innovative scoliosis surgeon Bob Dickson. We visited Harewood House.
As already mentioned, the Oxford meeting of the Association of Surgeons in 1947 provided an opportunity on 4 July for members to meet up again after the Second World War. At their business meeting they confirmed that the Club should continue (with a preference to enrol older members) and plan future events (such as the visit to Manchester the next year). Those present included A J Blaxland, W Anderson, G T Mullally, B C Maybury, P Mitchiner, Wilson Hey, J B Haycraft, Herbert Williams, Julian Taylor, H H Sampson and Clement Price Thomas (who subsequently became the group’s President) with J B Hunter in the chair.
The Club’s first clinical meeting in Oxford was held in 1981, the programme being organised by Malcolm Gough, who gave each member his “History of the Radcliffe Hospital” and with his wife Sheila entertained the Society. Professor Peter Morris (subsequently knighted as President of the Royal College of Surgeons of England) of the Nuffield Department of Surgery chaired a Grand Round, introducing Dr Waltke from Wisconsin who presented the case of a woman with a massive umbilical hernia stretching to her knees, successfully repaired with Marlex mesh despite significant co-morbidity. Professor Morris discussed the Radcliffe Hospital’s experience of carotid body tumours. Gastrointestinal problems, vascular prostheses and risk factors for breast cancer were also reviewed.
Liverpool was the venue in 1982, the Society convening in the Liverpool Royal Infirmary on the first day of our host’s tenure as Dean of the Medical School. He was of course Professor Robert Shields – knighted in 1990 and subsequently President of the Royal College of Surgeons of Edinburgh, and then President of the TSS – who himself gave the final paper, on injection sclerotherapy of oesophageal varices, after cases were presented and a wide variety of papers heard, ranging from gastro-intestinal motility to the Toxteth riots.
Norwich first welcomed the Society in 1961, when this second of the triennial home meetings was hosted by Norman and Alice Townsley; also present was founder-member Mr A J Blaxland. Operations were watched in the theatres opened by the Queen four years previously, replacing those destroyed by enemy action. Some giant urinary calculi were demonstrated, together with relevant X-rays; the Norwich Stone Collection is of course famous in its own right. Mr McKee, an early pioneer of hip arthroplasty, showed a film of his technique using acrylic bonding. The Diamond Jubilee meeting in 1984, hosted by Alan and Doreen Green, had a record attendance of 76 and began with a visit to the newly opened private BUPA Hospital. Choral Evensong was attended in Norwich Cathedral (as it was at the later meeting in 2002). The scientific meeting the next day was held in the Teaching Centre of the Norfolk and Norwich Hospital and included a clinico-pathological conference, an erudite account of skin conditions of surgical interest, the Musings of a Dean, and a broad spectrum of other papers including the Norwich Union address, on Reflux Gastritis, delivered by Professor W H Brummelkamp from Amsterdam, the first overseas guest of the Society. Senior physician Dr Anthony Batty Shaw (a noted medical historian) talked on Norfolk’s Surgical Heritage – from Flint to Stainless Steel, tracing Norwich’s surgical progress over four millennia, including early she-surgeons. The meeting ended with lunch at the Wroxham home of Norman and Alice Townsley.
The 2002 meeting in Norwich was held in the magnificent new steel-and-glass Norfolk and Norwich hospital built under the Private Finance Initiative. The Imaging Department demonstrated its Picture Archiving and Communication System which dispenses with hard copy and was developed at a cost of several hundred million pounds. PACS was to be rolled out to all NHS hospitals in due course. Papers were heard on this and other topics, and the new facilities were toured, including the Day Unit and the circular theatre recovery area. A restful final lunch was enjoyed at the riverside home of hosts David and Diana Ralphs, ending two days which had begun with a visit to the Lotus car factory.
The Lake District was the venue for the spring meeting in 1985, the falling pound proving too big a deterrent to the planned trip to Dallas. Nigel Keddie both hosted and reported the meeting at the West Cumberland Hospital which serves the population of Whitehaven and Workington. The programme included a discussion of the Basis of Radiation Risk Estimates by the senior medical officer at Sellafield, intercostal nerve cryotherapy at thoracotomy, and West Cumberland neck (nodular goitre). The Lake District was toured in two Mountain Goat coaches.
RAF Halton was visited in the autumn of 1985, with discussion of Surgery in the Armed Forces, the mobile RAF hyperbaric unit, trauma and urology. Ronald and Margaret Brown hosted the meeting, including dinner in the village hall opposite their house. Waddesdon Manor – one of the Rothschild homes – was visited, as was the Cathedral and Abbey Church of St Alban. This meeting was thought to have been the first to hold a dinner graced by black tie and formal Service dress.
Cambridge was the venue in 1986, with Alastair and Anne Smellie as hosts; champagne from his garden cellar was much appreciated. The meeting was held in the lecture theatre of the Clinical School, and included presentations on the History of the Cambridge Medical School and of Cambridge Surgery, followed by a comprehensive symposium on transplantation chaired by Professor Sir Roy Calne. Friday’s dinner in Queen’s College was followed by Saturday lunch in Pembroke.
In the only visit to Nottingham, in 1990 as guests of Chris and Ann Pegg, an informative spread of lectures was heard in Queen’s Medical Centre with a topical review of the cause of injury in the M1 air disaster. On 8 January 1989 a Boeing 737 had crashed onto the motorway whilst approaching the East Midlands Airport within the confines of which we were staying at the Donington Thistle Hotel, where our annual dinner was held after an illuminating lecture on Robin Hood. The next day we visited Southwell Minster, its font and mediaeval windows destroyed by the Puritans who forbade baptism and any hint of idolatry.
In 1993 we visited Bury St Edmunds, where Andras and Alex Barabas hosted a reception and supper at their home. An interesting morning was spent in the operating theatre and there was a tour of the recently-opened stand-alone day surgery unit. Finally a Newmarket veterinary surgeon talked about surgery in racehorses, rounded off with a visit to a racehorse stud.
Our visit to Canterbury in 1994, hosted by Bob and Valerie Heddle with supper at their local pub, began with a guided tour of Howlett’s Zoo by a well-informed vet. The meeting in the Medical Centre at the Kent and Canterbury Hospital included a discussion by the East Kent coroner of the disaster at Zeebrugge where the roll-on roll-off ferry Herald of Free Enterprise had rolled over because its bow-doors were left open. There was also an X-ray quiz, an infrequent but welcome mind-stretching exercise giving radiologists free rein. The chance was also taken to visit Canterbury Cathedral and finally the Eurotunnel Exhibition at Folkestone.
Southampton was hosted in 1996 by Howard Steer and his GP wife Janet at the General Hospital where a variety of papers – several reporting original research – were presented on malignancy, immunology and genetics as well as on gastro-intestinal (Helicobacter especially) and endocrine disease. 55 members and wives attended, and enjoyed visits to Wellow (Florence Nightingale’s place of burial) and Wilton House, Mottisfont and the ruins of Beaulieu Abbey, next to Lord Montagu’s museum celebrating the motor-car.
Chester, the former Roman stronghold of Deva on the River Dee, was the venue in 1998, with Linda de Cossart as host. On the first evening we enjoyed a meal at her favourite Chinese restaurant, though it would be nearly ten years before we had the chance to taste one in China! A wide range of stimulating papers was heard in a packed meeting in the Countess of Chester Hospital, a particular highlight being the talk on genito-urinary medicine when no detail or double-entendre was spared. An extensive coach tour of North Wales followed.
Royal Tunbridge Wells hosted the Society in 2001. The traditional arrival party was given at the home of Tim and Gail Williams, who delighted in phoning his father Bernard with greetings from the assembled company. A day followed of presentations in the Kent and Sussex Hospital, including one from a solicitor (Pamela Horner, wife of member Joe) on What it Means to be a Professional, highly relevant in these days of accountability and litigation. The visit ended with a tour of Chartwell, Winston Churchill’s beloved 80-acre home in Kent.
The visit to Plymouth in 2005, hosted by Professor Andrew Kingsnorth and his GP wife Jane, was the first to this great naval port, and took place in the bicentenary of the death of Lord Nelson at Trafalgar, recalled in the guest lecture by Professor Harold Ellis, with shibboleths shattered in a reflective talk by a naval historian. There were other eclectic presentations at the formal Friday meeting which was held in the hotel on the Hoe where we had magnificent views over the harbour. The Thursday afternoon was spent at the shorebase HMS Drake where we saw a mock disaster village, used for training sailors – both home and foreign – in managing humanitarian catastrophes; we also toured a modern frigate, HMS Chatham, which subsequently laid a wreath off Trafalgar. Dinner beneath military portraits in the Commando Barracks Mess was a splendid formal affair. The meeting was rounded off with lunch in the Kingsnorth’s beautiful garden.
In 2006 we stayed in Weybridge for our first visit to Ashford, Middlesex, where our joint hosts were Joe (and Pamela) Horner and Brian (and Loveday) Ellis. Brian has since taken on the role of Assistant Archivist, recording photographically the activities of our Society which on this visit included a tour of the historic Brooklands racetrack and Air Museum, with supper upstairs in the Bluebird room. Ashford is close to Heathrow, and the Airport was the subject of several presentations including in-flight medical care, the new terminal 5, drug running, and air accident investigations. We also had a talk from the Hospital Trust’s Chief Executive Glenn Douglas. On the Saturday there was a guided tour of the Royal Horticultural Society’s gardens at Wisley, followed as usual by lunch.
2007 also found us at a new venue, namely Salisbury where the old Infirmary is now an apartment block. We stayed at two hotels within walking distance of Salisbury Cathedral whose 404 foot spire – the tallest in England and mediaeval Europe – could be inspected from within. In the Chapter House was seen that great declaration of individual freedom, the Magna Carta of 1215. The scientific programme in the postgraduate centre of the modern low Salisbury District Hospital opened with a talk by the Trust’s Chief Executive Frank Harsent on training consultants, vigorously debated and followed by clinical presentations on limb reconstruction, childhood obesity and spinal injuries amongst much else. We then visited the Spinal Treatment Centre, which services England’s south-western quadrant. The final talk was on robots in medicine, before dinner at the exotic Larmer Tree, a landmark said to have once sheltered King John and his hounds.
2008 was the year of the first ever visit to the West of Scotland, the meeting being hosted in Glasgow by Graham and Anne Sunderland who organised it with some lovely touches (our logo on the menu and miniatures; Highland soap for the ladies; a piper for our formal Reception). 37 people attended, the distance being no bar thanks to modern air travel, trains and motorways, despite the escalating price of oil. During a stimulating academic Friday at the Royal College of Physicians and Surgeons of Glasgow (our host was on its Council and had pioneered the surgical skills laboratory there) we had evidence-based presentations on Enhanced Recovery after Surgery, talks on Leadership and Professionalism in Surgery, and a session of closed circuit television to watch a laparoscopic sigmoid colectomy by consultant colorectal surgeon Graeme Smith, with commentary and discussion. The TSS Registrar’s Prize, now an established annual session, was won by Karen Stevenson for her paper on de novo induction of hepatic / biliary cells in vitro from a common pancreatic adult cell, holding possible promise in the distant future for those with failing livers. A TSS Bursary for a trainee to travel with us on future foreign visits was detailed at our Annual Business Meeting, as was Iceland as the prospective venue in 2009.
On the social side, we stayed at the Millennium Hotel on George Square in the centre of Glasgow. Whilst the surgeons met at the RCPS Glasgow the ladies exulted over a dynamic free-ranging talk in his internationally acclaimed studio by 49-year-old sculptor Sandy Stoddart. Our whole group had met on arrival on Thursday to visit Glasgow’s nearest whisky distillery, at Auchentoshan, followed by dinner at the RCPSGlasgow in the Main Hall of these historic premises, surrounded by portraits of many early members including the founder Maister Peter Lowe. Our black-tie dinner was held the next evening at Glasgow’s Science Centre beside the Clyde, and the Society was toasted by consultant geriatrician Professor William Reid, shortly to be Postgraduate Dean in Edinburgh. Our final excursion, on the Saturday morning, was to the Pollok estate with its Burrell Collection of art, sculptures and tapestries. This concluded a visit of which, like Charles Dickens, we could say “”I have never been more heartily received anywhere nor enjoyed myself more completely”.
October 2011 was our first visit to Aberdeen, an acknowledged centre of surgical excellence where many members of the TSS gained their early surgical experience.
We had a superb academic day in the Suttie Centre in Aberdeen Royal Infirmary on the Foresterhill University Campus. The academic programme was organised by Tim McAdam who had trained in Belfast under our Secretary Terry Irwin. The offshore oil industry has made Aberdeen busy and wealthy, but the memory of the Piper Alpha platform disaster in 1988 still loomed large and had stimulated psychologist Professor Rhona Fin to examine decision-making in tight situations, especially surgical, and this she discussed at length. Then our host Professor Zig Krukowski took a critical look at Evidence Based Medicine, amply illustrated and making a plea for clinical judgement to be accorded due weight. Senior Lecturer Mr Paddy Ashcroft discussed orthopaedic technology, new joint replacements of the hip or knee sometimes failing the test of time: prudent assessment was indicated. Single port surgery was reviewed most elegantly by Mr Irfan Ahmed, and obesity surgery and its challenges and options were examined by Mr Duff Bruce as bariatric services in Scotland could not cope with the potential demand.
Surgical care in remote and rural locations was comprehensively discussed by Gordon McFarlane, one of three surgeons with wide expertise at Gilbert Bain Hospital in the Shetlands, while medical care throughout Scotland was critically examined by colorectal surgeon and assistant medical director Mr Terry O’Kelly.
The Registrar’s Prize was won by Craig MacKay for demonstrating that screen-detected large bowel cancers tended to be less advanced, more frequently left-sided and more amenable to laparoscopic resection than those presenting with symptoms. Of the five other presentations, Colin Richard’s was laboratory based in Glasgow and showed the apparently protective effect of CD8+ T-cell infiltration at the margin of colorectal cancers, independent of any systemic inflammatory response.
The ladies joined the meeting for the final two presentations, on war surgery by two retired orthopaedic surgeons. Tom Scotland delivered a riveting account of the wounds sustained in the Great War and the improvements in care resulting from the Thomas splint and the influence of Aberdeen orthopaedic pioneer William Gray, insufficiently recognised whilst Thomas Jones was rightly acknowledged for saving many lives with the Thomas splint for compound femoral fractures. Retired Aberdeen orthopaedic surgeon Ken Mills delivered with dry wit his recollections of the short shambolic session of surgery at Suez in 1956.
On the social side, we had a talk on Gemstones by geologist Helen Plumb, organised – as were many of the activities – by Professor Krukowski’s wife Margaret, and the next day the ladies visited Crathes Castle. They then joined the surgeons for the talks on war surgery and the formal dinner in the Gordon Highlanders’ Museum where Regius Professor of Surgery Jimmy Hutchison’s after-dinner speech was a model of one-liners, hitting the collective funny-bone. Lunch was apparently held here the next day for the C-in-C of the Regiment the Duke of Rothesay, after HRH had unveiled a statue in Union Street honouring the Gordon Highlanders. The roads were later opened and we dispersed variously after seeing round the Maritime Museum with its mammoth model of the Murchison Oil Platform and many insights into the life of oil workers and the dangers they have had to face. Aberdeen is indeed an interesting city with a powerful surgical reputation and provenance.
In September 2012 the TSS had its first ever visit to Leicester where the Trust currently includes Groby Road Hospital, the General Hospital, Glenfield and Leicester Royal Infirmary (LRI).
The meeting was hosted by plastic surgeon Dr David Ward with his wife
Louise. He chaired the academic meeting, held in the Education Centre of the
LRI, where the presentations were most original: the excellent results from
extracorporeal membrane oxygenation (ECMO) in the management of neonatal
respiratory problems, and of adult swine flu especially, a ‘third’
inguinal hernia recognised at laparoscopy by hepato-biliary surgeon David Lloyd who also promoted his Lloyd Release of the medial end of the inguinal ligament for sportsman’s groin, caval involvement by renal carcinoma (avoiding
bypass if possible), and the genetic background (slender but identifiable) to abdominal aortic aneurysms. Sacral
neuromodulation for faecal incontinence complemented previous similar presentations (in Salisbury and Geneva) and we were exhorted not to resect possible sarcomas but to suspect the diagnosis, resist resection, biopsy and refer to a specialist unit. The metabolic effects of obesity surgery were discussed as were the plans to reconfigure (i.e. reduce the number of) vascular
units and to implement Local Education Training Boards. Of six contenders, James Hunter won the Trainees’ Prize for his presentation on the benefit of hydrogen sulphide in renal ischaemia reperfusion injury. Two excellent presentations on reconstructive plastic surgery, in peace and war, reflected our host’s own surgical specialty.
Of the two guest lectures, Dr Sam Alberti (Director of Museums and Archives at the RCS England) gave an overview of museums and morbid curiosities, starting with John Hunter’s house and collection in London, and veterinary surgeon Paul Watkins comprehensively covered ‘the Veterinary Surgeon at War’ who often had to act as medical officer. For our two-day visit we stayed in central Leicester at the Belmont Hotel on New Walk, toured the New Walk Museum (dating back to 1849) and enjoyed an evening at the Space Centre (reaching the limits of the Universe). The formal dinner was at Oakham House with guest speaker Stephen Dorrell, MP. Saturday morning was spent on the Grand Union Canal at Foxton Locks and its Inclined Lift, where we had lunch at The Boathouse.
The pattern of our home visits, held every year since 1966, is now well-established. We arrive on a Thursday in late September and visit one or more local sites of interest that afternoon before an informal reception and supper. We usually stay as a group in one hotel, or occasionally two. Attendance is normally well over 30 and sometimes up to 90, offspring and rival meetings permitting.
The Friday all-day scientific meeting is highly instructive, embracing a wide spectrum of topics, mostly but not exclusively surgical, and is usually held on hospital (or occasionally hotel) premises. The programme now includes the annual TSS Registrar’s Prize (a handsome cheque), to encourage original work and professional presentations which are required to be succinct and to time. Operating theatre visits, case presentations and radiology quizzes are infrequent components of contemporary visits but there is often a final lecture on a topic of general interest that might catch the imagination of our whole group, the ladies joining the surgeons for this after a day visiting local places of interest to them. The black-tie evening begins with a reception followed by a group photograph and culminates in our annual dinner attended by an outside speaker, often of repute and rarely surgical unless of exceptional wit!
On the Saturday morning there is the Annual Business Meeting if it was not held the day before; much is debated, and approved new members are formally welcomed. Finally there is a visit to a site of outstanding interest ending with an informal lunch for those who stayed the course.
The fourteen original members of the Junior Surgical Club would surely be proud to see how far their intention “to meet once a year at a place and time to be decided at the previous meeting” has now been extended, in both time and place. Perhaps even Lord Moynihan would agree that of all his “boys” and travelling groups – he promoted at least four of the latter – the Travelling Surgical Society has been the most active, at least in maintaining those links that our founder-members held dear and in promoting ourselves and reviving our lessons and memories through annual Reports and most recently on the comprehensive web-site (now www.travellingsurgeon.org). A lot has been achieved since 1924 when that inaugural meeting in Leeds set the stage for a few British surgeons to visit their peers throughout the world.
TSS Birmingham 2013
In 2013, for the third time in its history the TSS visited Birmingham, and again the venue was the Queen Elizabeth Hospital. This time, however, our destination was the new Royal Centre for Defence Medicine (RCDM) which combines on a single site the facilities for advanced surgical care of all three Armed Forces, together with research activities overseen by our local host Air Commodore Alasdair Walker who with his wife Christine ensured we had a superb couple of days. Staying in the heart of Birmingham at the Copthorne Hotel on Paradise Circus, we were linked by a pedestrian bridge to the station and other inner city amenities. We could thus walk to Birmingham’s acclaimed Art Museum (it has 5000 works all told) where the collection of Pre-Raphaelite paintings was outstanding, and here also was to be found a portrait of Dr Ash, founder of Birmingham’s first General Hospital.
The scientific programme was held within the RCDM in a modern lecture theatre with card-controlled access. The day began with an overview of the organisation by Air Marshal Paul Evans, Surgeon General of the Armed Forces, and was then devoted to audit and research around severe trauma, for which our troops in Afghanistan were at serious risk, from Improvised Explosive Devices especially. The seriously injured were taken as quickly as possible, usually by helicopter, to Camp Bastion where major surgery (such as amputation) could be life-saving and resuscitation allowed evacuation back to the UK for urgent care and subsequent rehabilitation, the latter at Headley Court. We had the unique experience of hearing the personal testimony of a Royal Marine who survived triple amputation (both legs and his dominant right arm) and now had a normal family life: no, a supra-normal life for he has been travelling the world as a speaker and personal trainer, unaided and without a wheelchair. Mark Ormrod’s most moving matter-of-fact account of all he had been through, delivered without notes whilst ramrod upright on his pylons, was a unique ‘guest lecture’ well deserving the first ever standing ovation from the TSS. He embodied all that the Armed Forces aspire to, concluding a day of research results and audits of military surgical care which is benefitting the civilian management of major trauma. The Registrar Prize was won by plastic surgeon Major Mark Foster for his presentation on the inflammatory response. Our scientific meeting around military medicine was most apposite in this year preceding the centenary of the outbreak of the First World War, which gave rise to the TSS in 1924.
The social activities included an excellent curry on our first evening, tours by our partners to the Jewellery Museum and the Birmingham Botanic Gardens, and a superb formal dinner at stately Hagley Hall on our last night. The next day we made our way north-east of Birmingham to the National Memorial Arboretum on 150 grassed acres. Here a visitor centre, chapel and multiple monuments, trees, woods and gardens commemorate the deaths and severe disability inflicted since 1945 by armed conflict, terrorism or natural disasters on British subjects, and those who served Britain, honouring everyone who has suffered thereby, whether or not this was in the course of duty. This vast area – shortly to be doubled – is dominated by the hundred foot wide circular Armed Forces Memorial, which has a vertical slit in its wall through which sunlight passes to alight on the sculptured wreath in the edifice’s centre at the eleventh hour on the eleventh day of the eleventh month each year – Remembrance Day.
TSS London 2014
TSS Middlesbrough 2015
Our first visit to Middlesbrough (17-19 September 2015) was the fourth to the North East of England, the previous three having been to Newcastle (1933, 1971, and 1985). Our host was David Macafee with his wife Vicky. The venue was the James Cook University Hospital (JCUH), a PFI new build (incorporating two previous district hospitals) and flagship for the eight hospitals of the South Tees Hospitals NHS Foundation Trust with a catchment population of 1.5 million. A tertiary Major Trauma Centre, the JCUH contains all major and regional specialties as well as having teaching responsibilities, both on site towards senior medical students and for staff to teach at other units.
Our academic day in the JCUH Academic Centre included the management of trauma (pre-hospital care, the triaging of injured patients and who should be managed in the regional Major Trauma unit itself, advice on cardiothoracic trauma), with some military input too. Reflections on neurosurgery were followed by details of the supra-regional vascular birthmark service (mainly using intra-lesional bleomycin) and of military deployment during the African Ebola outbreak. The Registrar’s Prize was won by Shaj Wahed for his paper on sentinel lymph node assessment in oesophageal adenocarcinoma.
In the afternoon we learned of an aggressive cystitis attributable to ketamine abuse, advances in robotic surgery for colorectal and pelvic cancer, progress in the management of aortic aneurysms, the regional bariatric service, and the changing role of the general surgeon, in plastic surgery especially. The meeting was well attended by civilian and military surgeons, and provoked discussion about training and specialization.
We toured Durham Cathedral, first seeing precious original anatomy and medical books in the adjacent College Library. The ladies went to the ancient village of Helmsley with its castle and walled garden. The Society dinner was at the restaurant of the Cleveland Tontine, on the old Yarm to Thirsk turnpike. Informed by James Thompson about the Carthusian Order, finally we had a guided tour of the ruins at Mount Grace Priory on the Saturday morning, and the opportunity to ascend Roseberry Topping in the afternoon – after all, it had inspired James Cook.
TSS London 2016
This tenth TSS autumn visit to London, hosted by Professor Barry Powell and his wife Jill, was the first to St George’s Hospital in Tooting, a former infectious disease complex to which it moved from Hyde Park Corner in 1980. The meeting was attended by a record 60, under the Presidency of Terry Irwin and outgoing Secretary Brian Ellis.
The scientific meeting in the Education Centre concentrated on St George’s hospital’s role as a Level One Trauma Centre (part of the London network), its bariatric surgery, changes in vascular surgical training, the role of sentinel lymph node biopsy in managing penile carcinoma for which the hospital was a regional unit established from scratch, and reconstruction of the abdominal wall. The latter two topics reflected the team work between plastic surgeons and other specialties. Our Price Thomas Fellow Prosanna Sooriakumaran discussed robotic pelvic prostatectomy and his own experience in Oxford. The Registrar’s seven prize papers also reflected St George’s hospital’s surgical research interests and was won by Kate Stenson for her presentation on Endo-vascular Aneurysm Sealing with Parallel Grafts. Global Disaster Management was reviewed by Jim Ryan, and Lt Col James Grant gave a personal view of medical care in Iraq and Afghanistan during 2007-2013. The scientific day was rounded off with a remarkable talk by neurosurgeon Henry Marsh, world-renowned for his book Do No Harm (now available in 22 languages) in which he unashamedly discussed his career failures as well as successes; he exhorted us to be honest around mistakes though there were many issues to be resolved, including the approach of the GMC.
The social side included a tour of Wimbledon’s world-famous Lawn Tennis Club, which hosts the only grass Open Championship, and at a remarkable profit. The ladies visited the ancient Surrey estate of Polesden Lacey, 25 miles from central London and now under the National Trust. The Society dinner was held in the RAF Club, Piccadilly, attended by sixty people with neurosurgeon Henry Marsh the guest speaker. On the Saturday, many had the guided tour of Hampton Court.
TSS Cambridge 2017
On 14-16 September
2017 we had our second TSS visit to Cambridge, and it was unusual on several
fronts. Because we had no local TSS host, our own David Ralphs of Norwich
conferred with Cambridge’s retired Professor of Surgery Andrew Bradley who
arranged for his transplant successor Professor Mike Nicholson to supervise our
scientific meeting. Held in the lecture theatre of Trinity Hall College, the
four sessions covered a great variety of topics, starting with an overview of the
evolving Cambridge Biomedical Campus which will facilitate close cooperation
between clinicians and scientists. There were then presentations on abdominal
wall reconstruction, the management of upper gastro-intestinal perforation by
vacuum drainage, managing necrotising pancreatitis with delayed surgery without
prior antibiotics, the diminishing role of axillary lymphadenectomy in breast
cancer, an overview of free-flap breast reconstruction, multi-visceral
transplantation, ‘robotic’ laparoscopic surgery for resectable renal cancer,
screening for and management of aortic aneurysms, hepato-biliary challenges, experimental
studies on the regulatory pathways in the gut, and ex-vivo perfusion of the
kidney and other donor organs for transplantation.
The final session
consisted of six presentations for the Trainee Prize which was won by Surgical Research
Fellow Dr Patrick Trotter who promoted the use of organs from donors with treated
hepatitis C whilst other speakers touched on surgical training and medical
student Olivia Sharpe discussed her elective experience of plastic surgery in
Phnom Penh. This full scientific day
underlined the strength and assured future of research in Cambridge, in transplantation
especially but in other fields also, and it was unsurprising the programme
over-ran by an hour.
The social side
started on our arrival at the Quy Mill Hotel with a two hour visit to the
National Trust property of Anglesey Abbey (now a private house and estate), and
ended on the Saturday after the Business General Meeting with two hours on the
River Cam beyond The Backs aboard the custom-built riverboat Georgina on which
we had fish and chips and a detailed commentary. On Friday a tour of the heart
of Cambridge had been enjoyed by those
not at the science session. Our formal reception and dinner, arranged by Mark
and Janet Watkins in the elegant black-panelled dining hall of Queens’ College,
was held on our first night. On our second night, guests at the dinner in our hotel
were Professor Andrew Bradley and his wife Eleanor (Dr Bolton), Professor Mike
Nicholson and his scientific assistant Dr Sarah Hosgood, orthopaedic surgeon
Professor Andrew McCaskie (the current Professor of Surgery) and hepato-biliary
surgeons Mr Raj Praseedom and Mr Paul Gibbs (who is also a transplant surgeon).
In Cambridge our President was Terry Irwin. This was the first home meeting arranged
by our Secretary Simon Mellor, and was a great success on all counts.