Friday, 5 May 2017

Britain is still a country for and says "Bravo" to an old allergist with a guardian angel and zest for life called Dr Bill Frankland

Bill, who is 105 years old, was interviewed by Justin Well on the BBC Radio 4 'Today' Programme this morning and said that in answer to the question "How is it that he's lived all this time ?" He replies : "I've been so near death so many times but I've always just escaped alive." He went on the say that he is still : "Fascinated by medicine in general and allergy in particular which is my subject, but there's so much to learn all the time : reading a lot about modern advances." He added that he still "sees some grateful patients I've been seeing forty years." In his continuing career, he said he attends conferences, reads journals and has a secretary to deal with his paper work. What he didn't say was that it is a career in medicine which began when he was an Oxford undergraduate 87 years ago and one that has earned him the epithet of 'The Grandfather of Allergy.'

If he had been given more time he might have told us that :

He was born Alfred William in Battle, Sussex, in March 1912, the youngest of four children and identical twin of brother Jack and born premature, the wrong way round and weighing three pounds one ounce and “was wrapped up and my cot was a chest of drawers" and later reflected : "perhaps this was one of the occasions I was lucky to escape death" and remembered that "father was very poor and my mother had been left a great deal of money, in fact in her early twenties, because she had a very good singing voice, she actually spent one year in Switzerland studying singing" whereas his father, who he admired, liked very much and always looked up to, had studied Classics at Wadham College, Oxford.

Bill was brought up without his Father's continued presence between the age of two and six, when he was absent serving as an Anglican Army chaplain in the First World War and recalled : 'He finally went off to Alexandria and later Cairo, where he was in a hospital ship. He used to send these lovely postcards of the Sphinx and the Pyramids and they were beautiful.'

After the War the family moved to Cumbria when his father became rector of St Mary's Church, High Hesket and Bill had a privileged and what he called,  "Victorian"
childhood, in the Lake District, brought up in a nursery and "was looked after by a nanny and she organised your life" and outside the home, enjoyed long walks and helping with the harvest.

He was motivated from an early age to become a doctor and recalled when he spent four months in bed after drinking unpasteurised milk and had his tonsils removed : "my sister and my brother and myself all had bovine tuberculosis and a doctor came to Penrith to see us, but he just kept us in bed. He'd no idea what was wrong with us, but we had a fever and I didn't like this doctor and I thought : 'Why should this silly old man, that's what I thought he was, be a doctor ? He doesn't know how to deal with children' and I thought : 'If I'm a doctor I would know how to deal with them as people."

As soon as he was old enough, was packed off with his brother to St Bees, a Tudor-founded, independent, boys' boarding school in Cumbria where he recalled : "every winter we did one of the Gilbert and Sullivans" in which, in the absence of girls, he enjoyed singing as a treble and was in the same year as rugby playing, Gus Walker, who would later become the 'One Armed Air Marshal' having lost his arm when 30, trying to rescue the aircrew of a crashed Second World War bomber.

He formed his childhood ambition to study medicine,  partly because he didn't have much contact with other people, apart from his twin brother, and saw a medical career as providing "the opportunity of meeting lots of people", and was inspired, as a teenager, by reading 'The Story of San Michele', the 1929 memoirs of Swedish physician Axel Munthe, which covered his association with Louis Pasteur and Guy de Maupassant but also poor, Italian immigrants in Paris, plague victims in Naples and Nordic Lapplanders.

At the age of 18 in 1930, Bill won a scholarship to read medicine at Queen's College, Oxford and  as part of his training, joined St Marys Hospital, Paddington in 1934 and applied for the position of
'house physician' in the Eye Department which "was a risky thing to do because you were kept very, very busy. You put on a long white coat, everyone called you ‘Doctor’ and you acted as a doctor for six months - even though you were still a medical student " but did it because working there he'd seen "a blonde girl with beautiful eyes and thought, “I must get to know this girl” " and as a postscript added : "Anyhow, I got to know the girl, and we were finally married in 1941. I’m a slow worker!"

On the outbreak of the Second World War in 1939, Bill joined the Royal Army Medical Corps and found his father's 'Sam Brown' officer's belt from the First World War and wore it 'whenever I could, including when I got married. To me, wearing it was carrying on a tradition that there are things worth fighting for. We were told to fight for our country and this is what we were doing and I was lucky that I was an officer and so it was a privilege to wear something that he had worn in the First World War.'

In 1941, serving as a captain, he was given two day's training in tropical medicine and posted to Singapore along with 35 other doctors and after arrival after a two month voyage in a troop ship, recalled : "I and this other doctor (cabin mate, Captain Parkinson), went to an Indian field hospital and when we'd been there for three days an officer came along and said : "There are two hospitals, one is at Tanglin and its largely dermatology and some VD and the other is the Main Military Hospital. The job there will be an anaesthetist." We both wanted to go to Tanglin, so this officer got a coin out and he said to me "Frankland, call." I said : "Heads" and it was 'heads' and therefore all was well and I went Tanglin."

In Feb 1942 with the Japanese invasion of Singapore and surrender of the British Army, Bill became a prisoner of war and heard that Parkinson, sent to the Alexander Hospital, had been killed because, when it was overrun by Japanese troops "they murdered everyone in the operating theatre including the patient who was unconscious. So this was one of the occasions where, literally, a spin of a coin, saved my life" while he himself  was sent to Changi Prisoner of War Camp : "It was an 18 mile march, but I went by lorry with my patients. There was a lot of dysentery and after six months we were all starving. I was looking after one of the dysentery wards and saw little of the Japanese. Our guards were mostly Koreans and later Indians.”

Bill found his fortunes took a turn for the worse when, in 1943, he was transferred to a work camp based at a British Artillery Barracks on Blakang Mati Island, known then as 'Hell Island', where he was looking after 200 sick prisoners and found that if his "sick parade got too big, too large, the Japanese non medical private, if the patient could stand up and didn't faint, would say : "Out to work" the following day, but of course, they were so severe and I knew this would happen. I had to be myself really severe and put people up to work because they wanted people to work for them and that was that. They didn't mind how ill they were."

He recalled : "We lived off meagre rations of rice and everyone suffered from gross starvation. All we could think of was food. When we could, we ate rats, mice and dogs" and chronic dysentery, malaria, dengue fever and starvation beriberi were rife amongst the prisoners, coupled with the relentless forced labour instigated by captors who,“If the men’s behaviour was bad, the Japanese would bash the officers. They would line us up and just punch us in the face. The best bashing I ever had was when I was knocked unconscious. I didn’t feel much but when I got up I realised I had lost a tooth" and shortly after, he was escorted to a Japanese hospital to use a microscope to diagnose some malaria cases, his own having been confiscated, and while there suffered an inexplicable and unprovoked attack, by a private soldier who beat him about the head with a chair and protecting himself with his arm, ran to the officer in charge of the hospital who stopped the assault.

After 18 months, Bill was able to practise his Christianity in public, half a day every fortnight, in a church service led by an Australian padre, where he found reference to "give us this day our daily bread" a challenge because "when you haven't seen bread for three and a half years, this is difficult", but, with the other communicants, sufficed with bread fashioned out of rice and wine made from fermented pineapples.

After the surrender of Japan in August 1945, Bill was so emaciated that even sitting down was painful : “just bones on a hard seat" and he was flown, in a convoy of three Dakotas, one of which didn't make it after they hit a storm over the mountains of Southern Burma, to Rangoon for rehabilitation and a ship home and at the age of 33, after 42 months of hardship and violence he returned to Britain in November, where on being asked whether he "wanted to see a psychiatrist ?" said "no, I want to see my wife" and thought : "'Well I'm alive and this is marvellous' and I decided I'm going to forget everything I've gone through. I want to forget everything and not speak about it and to my wife and when the children were born I never spoke at all about what my experiences were like as a prisoner of war."

He was discharged from the Army in 1946 and rejoined St Mary's Hospital where he "was starting, as it were, a new life and I didn't want to think about all the nasty experiences" and although he had been intrigued by how desensitised the Japanese prison guards had been to native insect bites, stuck to his chosen field of dermatology until he saw the opportunity "of getting a little more expertise in a subject which at that time I knew nothing about. So I started in the Allergy Department and after six weeks liked it so much I went to Dr Freeman, my chief, and said, ”Could I be full time?”  and "after a short time I was looking after what was called the “Experimental Ward”. Therefore, I had to see Professor Fleming every morning at 10 o’clock to talk about the patients. But we never talked about them as he wasn’t interested in clinical medicine. He was a fascinating man in so many ways, and extremely clever. I really enjoyed these 10 o’clock meetings."

Bill was approached by Fleming who had been asked to produce a second edition of his book on penicillin, 'the bible of treatment of infection' , who said to him : “Frankland, you’re going to write this chapter on penicillin reactions. I’ll give you a week to do it; 3,000 words - not more; and not more than 30 references " and when he'd read it, said "I’m not saying that I agree with everything that you have written, but I’m not going to change it, except your very last sentence on the last page." I had written: “With the increasing use of penicillin, it is to be expected that allergic reactions will become more common.” He crossed this last sentence out and wrote in his beautiful handwriting 'With increasing use of penicillin, reactions due to impurities will become less common.' And that’s what’s in the book. To some extent, he was right - but I was also right!"

He had already been instrumental in the creation of the 'British Association of Allergists' in 1948 when he took over from Dr Freeman and "inherited all his expertise" and with the help of a botanist was keen to provide his London patients with information about pollen levels on any given day and times of year when levels would tend to be highest and from 1953 was able to send weekly London pollen counts to members of the British Allergy Society and in 1954, made his greatest breakthrough with the results of a double-blind trial involving 200 patients with grass pollen sensitivity, which suggested that the active vaccines were much more effective in reducing allergy symptoms than inactive ‘control vaccines' and broke new ground in its use of 'randomised, controlled methods and a standardised approach to every patient.'

With his Department seeing over 6,000 patients a year, Bill undertook a series of trials which proved that antihistamine tablets neither helped nor increased pollen asthma and published the results in 1955 and in order to produce a supply of grass pollen took over the largest pollen farm in the world, originally started by Freeman in 1911, in which "We produced pollen not only for experimental purposes, but we also sold pollen to America and Spain and so on. The pollen came, for the most part, from Timothy grass. I loved going down to the farm to see how to collect pollen."

In 1955, he experimented on himself by being bitten each day by the South American blood-sucking insect 'rhodnius prolixus', so he could document his own allergic reaction and "let it have a meal once a week. I kept it in my car and the first thing on monday morning before going to my department it would have its first meal" and after eight meals had "severe anaphylaxis and I had to have three injections of adrenaline" in fact “All I could do was hold up three fingers to indicate the doses of adrenaline the nurse should inject me with""It was a very severe reaction. At one point when I couldn't speak I had a feeling of impending doom. You think you're going to die and I thought that, but no, interestingly, I didn't" and used his research to enhance understanding of how long injections of allergens would need to be given to achieve desensitisation.

In 1961, Bill persuaded Britain’s media to include the 'pollen count' in weather forecasts and the following year, at the age of 50, became the Director and Consultant of the Allergy Clinic at St Mary’s Hospital, carried out insect and latex allergy research and was increasingly convinced that the rise in allergies resulted from increased cleanliness and the levels of hygiene in modern life, his so-called 'Hygiene Theory', and that failure to expose children to enough pathogens in infancy hindered the development of the immune system and “Allergy is immunity gone wrong. You are not making antibodies against infection; you are making antibodies against allergens” and so opened up the possibility of radical new treatments for lifelong sufferers by using small doses of an allergen to retrain the errant immune system.

Having retired from his job at St Mary's Hospital at 65, Bill started work as an unpaid consultant in the Department of Medicine at Guy's Hospital in 1977 and in 1979 was invited to give a consultation the new President of Iraq, Saddam Hussein in Baghdad : "They told me he had an allergy and he was being treated with various desensitising injections. But he wasn’t allergic at all. His problem was that he was smoking 40 cigarettes a day. I told him to stop. I thought because he was so addicted he wouldn't give it up and he said : "When are you coming to see me again ?" and I said "I don't think you're going to stop smoking and therefore I've no intention of coming to see you again", but strangely the following morning when I was waiting for my plane a little man came up to me and said : "Someone you're interested in has done what you wanted him to do. When are you going to come and see him again ?" He gave up smoking the day I saw him. I heard some time later that he had had a disagreement with his Secretary of State for Health so he took him outside and shot him. Maybe I was lucky.”

He worked at Guy's for the next twenty years on peanut anaphylaxis and paediatric allergies and after retiring at the age of 85 in 1997 continued to participate in academic life, attending conferences and publishing articles in journals and in 2012 when he became a centenarian appeared as an expert witness in a British court in a trial in which the accused claimed that a vehicle crash in which he was involved was caused by his losing control following a bee sting and gave his opinion that the 'delayed-response reactions' to bee stings only occurred after there had been 'initial symptoms' following the sting and since, in this case there had been no such symptoms, the accused was found guilty as charged.

In 2012, Bill said : "I try to keep up with everything, in fact, since I reached a hundred I've produced three academic papers that's a little unusual, but I so like medicine in its various forms and I still see some patients who I've treated for a large number of years and I still enjoy seeing them and I go to conferences if  I'm well enough, but I always say : "If I didn't continue doing what I call medicine in its broadest aspect and seeing all that is going on what would I do ?""

In 2013, he flew to Singapore with his daughter and visited the Kranji Memorial "to pay my respects to those who lost their lives. It was very quiet in November and I was all on my own. It was quite emotional."

Two years later he appeared in an episode of the BBC 2 tv series 'Britain's Greatest Generation', was awarded an MBE for 'Services to Allergy Research,' appeared on BBC Radio 4s 'Desert Island Discs' and was briefly interviewed for ITN News and was the oldest old soldier present at the parade of veterans on the 70th Anniversary of VJ day in Central London on August 15th of that year, 2015.

Bill said of his wartime captors : “If I hated them it would do me harm but it wouldn’t do them harm, and secondly, I am a Christian and I was taught not to hate.”

and : "Ive been very lucky. I always say I must have a guardian angel looking after me because I've been so near death so many times, but I've always escaped. I've been lucky and I've never been depressed"

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