PRIVATE FRANK NOLAN EXTRAORDINARY JOURNEY THE GREAT WAR MEDICAL SERVICES 1 MEDICAL SERVICES 2 AMBULANCE TRAIN MILITARY HOSPITALS
WAR AND MEDICINE WHEN THEY SOUND THE LAST ALL CLEAR GROUP CAPTAIN DOUGLAS BADER GROUP CAPTAIN DOUGLAS BADER CBE DSO '
THE MEDICAL MEMORIES ROADSHOW
‘To understand where we are today
We have to know where we have come from’
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PROFESSOR
ROBERT ROAF
MA, MchOrth, BMBCh, FRCS, FRCSEd,
Professor of Orthopaedic Surgery
1964-76.
"Professor Robert Roaf was one of the world’s leading spinal surgeons -regarded by the British Orthopaedic Association as one of the subject’s greats - and one of the last known two British pre war Himalayan climbers."
"He came from a distinguished academic family. His paternal grandfather was a Canadian barrister. His father, who served in the army as a Medical Officer in the Middle East in the Great War, had won a scholarship to Liverpool University where he was to become Professor of Physiology. His mother’s family can be traced to Edinburgh. Her father was appointed young to the Chair of Natural History at the newly founded Liverpool University."
"The Roaf's antecedents came from Kent and one ancestor was a Ships’ Carpenter at the Battle of Trafalgar."
"Robert Roaf’s early childhood was spent in London and his memories of the Great War were, “Awful food and air raids when mother would take all three children to bed, thinking it best that if bombed we should all die together. When my father returned in 1919 I didn’t know him at all.” Aged 10, Roaf suffered bad pneumonia leaving him with recurrent asthma and applying for life insurance in 1939 was given a life expectancy of 60.Aged 13, he won a scholarship to Winchester from prep school in Swiss Cottage. He found the curriculum in those days, based on classics, very narrow. “To enjoy public school one had to be very good at sport. It was a Spartan life in those ancient cold stone buildings with no amenities.”
"In 1931 he won a further scholarship to Balliol College, Oxford, to study physiology and biochemistry. “The financial crisis that year halved the family income and the effects on so many were so severe that I doubted the capitalist system.” He did not enjoy Oxford, finding the lectures boring and tutorials uninspiring but he appreciated the collegiate system where one could meet people from other disciplines. Taking first class honours he decided against becoming an academic as he wanted to be different from his family. For the next few weeks he worked in the Bargoed valley, South Wales and although an atheist he was deeply impressed by the Quakers who helped the locals during the poverty of the great depression. He later became a Quaker himself."
'In 1933 Roaf encountered someone who changed his life. During a vacation he was researching rabbits’ adrenal glands when visiting an aunt, an honorary lecturer in the department of zoology at Liverpool University. “One day Marco Pallis, a friend of my aunt’s, visited. He was about to set sail for India with a mountaineering party for the Himalayas and he invited my aunt to inspect the expedition equipment and I acted as their chauffeur. I met Marco’s brother an expert on oriental art which was new and interesting to me.”
"In 1934 Roaf’s parents moved from London to Liverpool where he finished his studies. In 1935 he was delegated to a medical conference in the Soviet Union."
"Just before departing he was invited by Pallis to join his next Himalayan expedition as medical officer to climb in Sikkim and thence to Tibet, “The one condition being that I learn enough Tibetan to handle all the local patients who inevitably turn up in camps. Looking back I’m not sure why I accepted as it really wasn’t a good career move.”
His aunt was Catherine Herdman and as she was the granddaughter of Alfred Holt - Blue Funnel Line, she was able to arrange a free passage to India for the whole expedition on one of his cargo boats.
"In Leningrad Roaf, commenting on the city’s shabbiness, was told it was pointless making improvements as the city would be destroyed in the coming war with Germany. Leaving the USSR he went to Switzerland to train with professional mountain guides in snow and ice work before embarking for the Himalayas."
"Roaf’s experiences in the then non-mechanised, totally self-sufficient environments of Sikkim and Ladakh were overwhelming which left a lasting memory and he developed a life long interest in Buddhism, oriental arts and a love of the Himalayas. It affected his career. “In India I saw many medical conditions virtually unknown in England, especially deformities. This may have influenced me to become an orthopaedic surgeon. Also, then, long before anti-biotics, there were very few effective treatments and orthopaedics had good results.”
"Returning to England, finding it hard to readjust to an industrialised world, Roaf completed his Oxford degree six months later. Becoming a Quaker in 1939 he registered as a conscientious objector. After air raids on Liverpool, though, he decided he could not continue to eat food brought to Great Britain at the expense of sailors’ lives and joined the Merchant Navy as Ship’s Surgeon. “Looking back, though, the Peace Movement had no effective answer to Hitlerism.” He was invalided home at the end of 1943 with recurrent undulant fever and worked the last two war years in an emergency hospital in Winwick, near Warrington, where he encountered Jim Seddon and his ideas that orthopaedic doctors should specialise."
"Next taking a degree in orthopaedic surgery at Liverpool he was appointed assistant surgeon at the Liverpool Royal Infirmary in 1946, “A time of hardship, as before the N.H.S., consultants at voluntary hospitals were expected to take only small fees in expectation they all had lucrative private practices.” He also worked at Alder Hey Children’s’ Hospital, The Royal Southern Hospital, Liverpool, and Chester Royal Infirmary. "
"Early in 1947 Roaf was appointed to the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry. “This was a stroke of luck as Dott and Alexander had just published a paper on treating Pott’s Paraplegia and Oswestry had several patients suffering it due to tuberculosis of the spine. We had many good results of direct surgery.” Also, in 1947 he had a revelation from treating a 14 year old girl patient with a severe scoliosis – [an abnormally curved spinal condition of congenital origin or caused by trauma or disease of the bones] – who had had the conventional treatment of posterior bone fusion six years earlier. Roaf observed that this had been completely the wrong treatment.
"After much detailed research with his colleagues he developed new methods of operating through the chest to correct such spinal deformities from the front. It took years to be accepted – but these are now standard procedure worldwide. Roaf commented,"
“Heretical views, especially in medicine, are never welcome.”
“In 1951 I had a vivid dream that I would work in a country I’d previously visited; characterised by long, slow railway journeys. Misinterpreting it I started learning Russian.”
"In fact, the next year Roaf was approached to set up a post-graduate training programme for 18 months at the Irwin Hospital, Delhi, India, as part of the Colombo Plan. “I don’t know why I said yes as it was yet another bad career move, but in September 1952 I sailed from Tilbury with my wife and our four children aged 2 to 10 accompanied by two physiotherapists.” Roaf encountered a vast number of unexpected problems but made many life long friends, some of whom had been students in Liverpool, and he deepened his interest and knowledge of Indian arts and culture."
"He immediately arranged for an Indian successor so as not to outstay his welcome. He visited many parts of the country to lecture, advise and operate. Before leaving the sub-continent, the Roafs sent two of their children home for their education on a Comet aircraft, which was to explode on its very next flight. “There were questions of sabotage in the House of Commons. I remember a minister stating there was 100% security, but in fact Delhi airport at that time was little more than a landing strip and there had been no security at all. From this I learnt never to believe a politician."
"Returning home in 1955, Roaf was appointed Director of Clinical Studies and Research at Oswestry then in a run down condition with a chronic nursing shortage, although with improved general health, tuberculosis and polio patients had disappeared. Scoliosis patients were treated from around the world and with colleagues Roaf attempted to increase specialisation but because of the hospital’s then structure, this could not be achieved."
"Although having decided not to become an academic, fate intervened in 1963 when he was appointed Chair of Orthopaedic Surgery at Liverpool University at the age of 50. The previous incumbent, [Prof. Brian McFarland] after long illness, had died relatively young and Roaf’s older colleagues persuaded him to apply, “They seemed for some reason to think I was the obvious successor. I suppose I applied because I have always been inquisitive and I wanted to know how a university worked.” He had many problems sorting out the department and helping many foreign post graduate students. "
"Well before the concept of GAP years he promoted the idea that students should “Do something adventurous and imaginative during their ‘electives’ – the Liverpool School of Tropical Medicine being very helpful. I was also dragged into outside activities and represented the university at the General Medical Council which I felt was then run by a caucus out of touch with junior doctors.”
"He was appointed Pro Vice Chancellor, gaining an insight into university administration and was persuaded to be chairman of the staff-student committee at the height of the 1960's student troubles. Retrospectively he did not think he had been good at either mediation or as chairman and wondered why he’d accepted these roles. Meanwhile, he continued with work at Oswestry."
"In 1960, Roaf was invited by the British Council to make a long teaching tour of Japan, Thailand and Burma. “One could not have experienced a greater contrast than between orderly Japan and utterly chaotic but very interesting Burma. The British Council further invited Roaf to visit, lecture and treat patients in Brazil, Cuba, Egypt, India, Iraq, Libya, Malaysia, Nepal, Singapore, Sri Lanka, USA and USSR, all of which he also found to be very educational. The country which most impressed him medically was Cuba, “Other countries’ hospitals teach one much about their social conditions.”
"Roaf also gained wisdom from female nursing staff, who, for instance explained that spinally deformed teenage girls were far more concerned about the apparent asymmetry of their breasts, due to deformed rib cages, which they can see, rather than about the prominences in their backs, which they cannot."
'In the 1960's, at the height of the Cold War, he was invited by the Soviet Union to perform his new and highly successful scoliosis operation. He thoroughly enjoyed his trip to Moscow and was always sorry that despite Herculean efforts he was never able to obtain permission from the Soviet authorities for the Russian medical team to visit him in Oswestry. Official
permission would be given, only to be cancelled at the last moment.
"He retired aged 63 in 1976. “I no longer had the same enthusiasm and had seen too many others just batting out time; also, statistics show that retiring slightly early gives a much greater life expectancy.” However, he was soon to make a six months teaching tour of Malaysia before finally retiring to Chester."
"Roaf’s main publications include ‘Scoliosis’ (1966), ‘Posture’ (1977), ‘Spinal Deformities’ (1980) and with Leonard Hodkinson he co-wrote ‘Textbook of Orthopaedic Nursing (1971) and ‘The Paralysed Patient’ (1977). In addition, he edited and contributed to various works on orthopaedic mechanics including ‘Implants in Surgery’ and patented a spinal implant device. He contributed a paper on the Pallis expedition ‘Ladakh in 1936” to the Proceedings of the International Colloquia on Ladakh (1995) and “Sikkim in 1936’ for the ‘Alpine Journal 2001’."
"He was recognised by many honorary fellowships and memberships of medical associations worldwide. "
"In 2003 he was delighted to receive researchers from the Namgyal Institute of Tibetology, Gangktok, Sikkim, who interviewed him about his experiences of their country in 1936."
"In advanced age, the esteem in which he was still held could be observed in the almost forelock tugging deference extended to him when he chanced upon former colleagues and students, many of them now eminent in their own right. Despite this, he remained an exceedingly modest man who declined official honours."
"Apart from deafness Roaf remained in general good health.
"In latter years, Roaf would brew coffee against a kitchen timer – of such strength that, upon returning home, his supper guests would need a stiff drink in order to sleep."
"In 1939 he married, “An extremely tolerant wife”, nee Ceinwen Roberts, from Anglesey. “Why she put up with me is a mystery – the main burden of bringing up our four children fell on her.” She predeceased him, aged 94, by a week. "
SIKKIM 1936
"By modern standards Marco Pallis’s Himalayan expedition of 1936 was a modest affair. Transport, clothing, equipment and local conditions have all changed drastically since then. Pallis had climbed extensively without guides in the Alps and had led a previous Himalayan expedition. A gifted musician and fine linguist, he took interest in Tibet in 1933 and became an outstanding Buddhist scholar. His climbing companions Richard Nicholson and Jake Cook joined him along with Freddy Spencer-Chapman, a man with immense powers of endurance."
"Although a relatively inexperienced mountaineer, Roaf was invited as medical officer. He had to learn basic Tibetan from Pallis in order to treat numerous patients who would inevitably arrive at camp in remote areas."
"Each paid a £14 fare to Calcutta. They embarked on SS Recorder on 22nd February 1936. “Travel by cargo boat could be delightful, but food was poor.” They stayed a night in Calcutta at the Great Eastern Hotel and next day took a train to Siliguri, thence by taxi through the lush vegetation of the Teesta valley to Kalimpong where they put up at the Himalayan Hotel – the family house of David MacDonald, now an old man and former British Trade Agent Gyantse, Tibet. Roaf recalled, “There was no plumbing, and like many first time visitors to India, Cook and I had enteritis and the simple commode system could not cope with the extra load. Kalimpong was known as the spy centre of Asia with its ethnic mix of Sikkimese, Indian, Tibetan, Nepalese, Bhutanese and Chinese.”
"In the capital of Sikkim, Gangtok, Pallis and Roaf were entertained by the newly appointed Political Officer, Basil “B.J.” Gould (later knighted for his diplomacy at the Installation of the current Dalai Lama in 1940). Gould had a private talk with Pallis to inform him that his travel request for Tibet could not be forwarded, and worse, that the Maharajah of Sikkim had refused permission to climb either Simvu at 22,360 feet, or Siniolchu, at 22,620 feet, their mountaineering goals. Roaf recalled, “It looked as if our journey had been wasted. Somewhat later, we discovered Gould was to lead a high profile diplomatic mission to Lhasa and understandably did not want others getting in the way.” However, much to their relief the Maharajah, in consultation with Gould, relented."
"The secretary of the Himalayan Club in Darjeeling helped select 20 porters, three, who had been on Everest, were automatically selected. The rest had to run up a hill and the first 17 were accepted. The expedition lived mainly off porridge, rice, dahl and chappatis and when climbing almost entirely off pemmican. As usual, porters were paid by the day and consequently were reluctant to do full stages. Pallis was skilled at handling their tactics and often made them laugh and carry on."
"Roaf found Sikkim an exceptionally beautiful country, it being possible to go from tropical to arctic conditions in two days, “From Mangan one can see the river Teesta at 2,000 feet together with the summit of Kanchenjunga at over 28,000 feet. The main difficulty on the trek to base camp was leeches. The first we knew of them would be our heads dripping with blood or our boots filled with it.”
"Reaching Lachen village at 10,000 feet the expedition was blessed by a saintly ‘Tulku’ – a Buddhist priest, and recruited 30 more porters for work on the Zemu glacier. “The village headman was a skilled negotiator and drove a good price. He consulted me, complaining that when he drank excess brandy his eyes watered. A previous English doctor had made the foolish suggestion that he should drink less and he hoped I was not equally silly.”
"Having acclimatised, an attempt was made on the northwest ridge of Simvu. Roaf found skiing on the lower slopes much less tiring than plunging through thigh deep snow. He recollected, “Recreational skiing at 20,000 feet was enjoyable but making kick turns was exhausting.” Advanced base was established on Simvu Saddle where the climbers cooked for the porters, since a primus stove in their hands was considered too great a fire risk. “On the Saddle,” Roaf reminisced, “I had a very curious experience, looking south all I could see was mist, yet I had the impression I could see through it and perceive the teeming multitude of the plains below and knew that in some mysterious way I would be linked with them in the future. And so it happened, from 1952 to 1998.”
"While the climbing party attempted the summit – they failed due to an impassable chasm – Roaf returned to base with the porters where he found a crisis between arguing Darjeeling and Gharwali porters. Some had decided the climbers would all be killed on the mountain and so they could steal all their possessions. When Roaf returned alone, “They were convinced all other British were dead. The only problem was how to dispose of me and I had a very anxious night. Fortunately, by pure chance news came that a Lt. Harrison, whose seriously ill climbing companion was being carried down to Gangtok, would arrive soon hoping to join us. No more plotting after that.”
"Both Simvu and Siniolchu were first climbed, after strenuous effort, later that year by Paul Bauer’s Bavarians on 23rd of September and 2nd October."
"In retirement Roaf visited Tibet and the Indian Himalayas on several occasions, often to visit Tibetan refugee settlements, usually accompanied by one or more of his family. His last visit to the Himalayas was in 1998 at the age of 85."
(Taken from: - 'Robert Roaf - Pre-eminent professor of orthopaedic surgery and pre war Himalayan climber and traveller.' by Roger Croston.
By Kind Permission of: - Roger Croston)
EPILOGUE!
"Professor Robert Roaf's Son and Daughter in Law - David and Cathie Roaf travelled to Sikkim to scatter his ashes."
"Having done so they returned to the Hotel where they were staying and David asked the Hotel owner if he could get rid of the Urn for him."
'NO NO' said the hotel owner
'I will keep my rice in it!'
(Epilogue Taken from an interview with David and Cathie Roaf - 16,08,18)
