The visit to the USA was considered very rewarding in 1981, when eleven surgeons and eight wives travelled the furthest distance the Society had ever ventured. In Richmond, Virginia, where James Robinson had once worked and now orchestrated the Society’s visit, members were welcomed by Thomas Nelson Page Johns (known to one and all as Tommy) and his wife Helen, an ex-New York tennis champion. The English contingent visited the 300-bed private Johnston-Willis Hospital, founded in 1909, which had moved to its present site in 1980. 315 doctors had admitting rights. Here good surgery was seen in well-equipped theatres. A similar private hospital, the Chippenham, was also toured.

At the hospital of the Medical College of Virginia, the Society was welcomed by Professor Lazar Greenfield who told them that Thomas Jefferson had tried to start a medical school in the eighteenth century by importing doctors from Europe, but they were massacred by the Indians. The medical school was re-established in 1837, and received state assistance and its current name in 1853. This lively centre, with much on-going research, was currently being re-built. In Charlottesville, the University of Virginia Hospital was visited, an old building with cramped facilities where surgery was observed in its 16 operating theatres. The social and sightseeing aspects of the visit in 1981 were quite exceptional.

By contrast, on our visit to Washington in 2003, we were hampered by new legislation intended to protect patient privacy which severely constrained any hospital tours in the civilian sector, though our visits to the Walter Reed Hospital and United Services Military Universities were highly instructive. Although we were not entertained by our hosts, a splendid programme of sight-seeing and dining was arranged by our Secretary, whose military connections proved invaluable.