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Why I became an occupational physician ...
As a schoolboy, I often worked during my holidays—painting and decorating (I once painted part of Buckingham Palace), forest work in Wales, as a wool sorter and in a timber yard where I fell off a stack and broke my wrist. My worst job was in an insurance office. I went down a coal mine in Yorkshire which was terrifying and as a medical student in Edinburgh visited a factory making tractor tyres by hand which was even worse.After house jobs in Warwick, Paris and Edinburgh where Professor John Gillingham told me politely I would never be a neurosurgeon, I did MRCP and moved to Canada where I worked as a doctor in logging camps, asbestos and tungsten mines.
I had set my mind on going to South America so learned Spanish and wrote to President Allende of Chile asking him to give me a job, which he did but his untimely demise days before I was due to cross the border from Bolivia brought that plan to an end.
I came back to Britain, worked briefly in general practice then replied to an advertisement for a Spanish-speaking British doctor to set up medical services for the Majes project in Peru. This, one of the largest hydro-irrigation schemes in the world, was dramatic and the infrastructure was poor. We travelled on mule for the first few months, some of the work was >4000 m in altitude and I was one of the only two expatriate doctors.
Accidents were terrible due to bad roads, weather and reckless driving and conditions on the dams and in the hard rock tunnels were appalling. Occupational lung and skin disorders and public health problems of dysentery, scabies and sexually transmitted diseases were rife in the 4000 strong local workforce. The expatriates suffered culture shock, high altitude disorders and drank too much. I was given much support in my amateurish efforts to cope with all this by Griffith Pugh, the physiologist who designed the oxygen supply for the 1953 Everest Expedition.
Encouraged by him, I came back to Britain in 1977 with an interest in environmental physiology but then came under the influence of Richard Schilling, Corbett McDonald and Bob Murray at the London School of Hygiene. This was my introduction to occupational medicine and how to do it properly.
I did the MSc/DIH course and the diploma in tropical medicine and spent a year working in Africa trying to apply what I had learned. St Thomas' was a logical next step!
I have never really planned my career, just tried to make the best of chances as they came up. I once read that Alexander Fleming had the same approach: looking back on those moments in his life when he could have gone in one direction or another, he invariably made the choice for reasons which, later, seemed trivial. I have the same philosophy. I did not discover penicillin but have been lucky enough to have an exciting, varied and fulfilling medical career.
e-mail: David.Snashall{at}gstt.nhs.uk
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