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Why I became an occupational physician ...
The more I think about it, the more I feel that the answer to this question dates back to way before I knew what ‘occupational medicine’ meant. At school, I enjoyed and excelled in the sciences, especially chemistry and physics. I set up a laboratory in the basement at home and used to carry out experiments with chemicals I bought from pharmacies or fireworks factories. (I found the contents of ‘chemistry sets’ to be relatively innocuous and unchallenging.) Very naively I endeavoured to have available as many ‘antidotes’ to my chemical collection as I could muster.In my last year of secondary school, I decided to read medicine, although at that stage I was more fascinated by ‘cure’ than by ‘prevention’. I considered medicine to be a science (albeit very applied) rather than an art. When I started medical school, I was disappointed at how much anatomy and how relatively little chemistry featured in my preclinical years. In my clinical undergraduate training, my lengthy efforts at history taking gained praise and notoriety in equal measure, as I strove to find out ‘what patient had the symptoms’. Much as I enjoyed pharmacology, I was very concerned about the disproportionate efforts of the medical profession in treating inflammation or cancer, rather than in discovering and remedying the external insults which may have brought about these conditions. In the ‘industrial medicine’ lectures, I was taught about ‘PULHEEMS’ and this did not enthuse me much, but the seeds of knowledge of ‘occupational disease’ began to take root in my fancy.
I recognized that I was as inept with surgical instruments as with racquets, and 2 years after qualifying I secured the Membership of the Royal College of Physicians. Luck and serendipity played a part, since on being appointed a houseman at the Brompton Hospital in London, I was assigned to Anthony Newman Taylor's firm. I made it a point of learning as much as I could about the jobs and chemical exposure of his patients with occupational lung disease. His mentorship made me ponder about my future specialization. After a medical registrar rotation, and research on the bronchoalveolar mast cell, I took advice from Ian McCallum. He helped me recognize the potential breadth of the work of an occupational physician and identified the ‘good training jobs’—where I could become competent both in the influence of health on work as well as the converse. I therefore applied for a job at the Institute of Occupational Medicine. Fortunately, as I later discovered, Anthony Seaton moved my application into the ‘short-list’ pile. I landed the job in which I was to learn a great deal from him. There was no computer on my desk in those days but a large sheet of blotting paper. On it, I endeavoured to draw the chemical structure of every hazardous agent that I came across in my research or in my practice as an occupational physician. I no longer have the blotting paper but I still have the habit.
e-mail: raymond.agius{at}manchester.ac.uk
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