Reflections on a Career in Epilepsy

Abstract

I would not myself claim or admit to have had a ’career in epilepsy’ because I would not have known that such a career could exist. My career, properly speaking, was that of an academic psychiatrist in child and adolescent psychiatry. Butmany of my patients suffered frommanifest brain diseases and dysfunctions, and among that group were a number who also suffered epileptic seizures. As is so often the case, I had not planned such a career. It is true that, asmy experience and publications developed, it was evident that I had things to say about people with epilepsy, especially young people. But how did it come about? I was the youngest of five children born to striving parents who ran newsagent and tobacconist shops in central London. The one over which we lived was on the rear edge of the garden of Buckingham Palace. At the outset of the 1939–45 war, aged six, I was subject to mandatory “evacuation” from London. My ten-year-old brother and I were placed with a lovely family in rural midWales where we soon becameWelsh speaking. My parents also evacuated themselves to Wales in 1941 after a “near miss” from a bomb, and they farmed until 1944 when we all returned to London. But the arrival of V1 and later V2 rockets required me to return again to Wales. In 1946, I was sent to boarding school, “Allhallows” in Devon, since defunct. I came to medicine late, after two years of mandatory military “national service” spent mostly as an officer in the Nigeria Regiment where I added the experience of managing the battalion's “signals” and then managing its “transport” to my background helping in managing the family business. I had also worked briefly, clerking for Unilever Raw Materials. My applications on paperwere rejected by a large number of London medical schools (I was unaware that there might be others elsewhere) before I appeared in person to inquire about training at Charing Cross Hospital. The person who saw me was helpful but inquired whether, given my considerable height, I might play rugby (I did play rugby and said so but did not explain that my playing weight of 168 lb had been reduced to 140 lb by amoebic dysentery during threemonths in hospital in Nigeria). My first post, after qualifying at Charing Cross Hospital, (notably, at that time, located near London's Charing Cross) was as houseman to the consultant neurologist, the consultant psychiatrist, and the senior general physician. I was also to be present should the visiting neurosurgeon admit or be called to visit a patient. This broad remit, taxing at the time, proved useful over the years. The psychiatrist was impressed by my work, so after the mandatory six-month spell as a house surgeon, he facilitated me for a six-month postwithWilliam Sargant, probably the best-known British psychiatrist of his era. His view was that psychiatric disorders were of the brain rather than the mind, and he pressed hard with physical treatments and drugs. His therapeutic optimismwas astounding. He then facilitated