Hello, I'm kirsty young! Thank you for downloading this podcast of desert island discs from BBC radio four for rights reasons. The music choices are shorter than in the radio broadcast for more information about the program. Please visit bbc dot, co, dot, uk slash radio for the. my customary this week is the surgeon David. Not for most of the year he's busy bites. Clean across london scrubbing up and going about the everyday business of saving people's lives? Indeed, he's one of Britain's top vascular surgeons carrying out three different kinds of surgery at three different hospitals, it seems, however, that that's not quite enough to keep him occupied because for more than twenty years he's also taken time away.

From this demanding rolling in a chess to work in the world's crisis zones, among them, darfur, sierra leone, the congo, afghanistan and syria. All countries that have at times been war torn hell, hills, riven by savage destruction and brutal suffering. The official term for his makeshift operating room amid the carnage of war, is a surgically austere environment. In practice, it's not just the dirt lack of instruments and low blood supplies that have to be coped with, but also that medical facilities and

Doctors are increasingly victims of Messina tax being a medic runs in the family. His welsh mother was a nurse his into burmese father, an orthopedic surgeon. In fact, it was a trip with his dead to the cinema. That first sparked his interest. In life on the front line, the movie was the killing fields. He says when you go so far and of come close to death and cheated it. You get an amazing adrenalin buzz. It sends a bit crazy, but there's an element of risk taking that's not enjoyable but its euphoric. It's like drug sue em welcome David. Not that idea that proximity to death can somehow make us feel more alive is not a new one. It is an odd one, though can? Can you explain a little more about it,

Yes, I mean I've been involved in many crisis. Rarely where I'd been operating in operating, theatres and outside you can hear gun fire, and you can hear the sounds of bombs dropping and you really have to concentrate on the patient that you're operating on, but it is the fact that it's so intense and it's so dangerous, and it's so difficult gives you one gives me any way, the most incredible adrenalin buzz when I first started to over twenty years ago in I had never sperience to a war before and being involved in the middle of it all and also being very close to people that were being injured and next door to people are being shot. You realise, at the time I mean that life is so precious and so important and to try and preservatives is, is, is a woman poor thing and this surgically austere environment. What have you got? What do you have? What does it look like? Well,. when you working the unrighteous, you ve got city scanners, mri scanners, you ve got groups of people sitting,

and meetings and discuss things like called empty, tease, multi disciplinary t meetings, and you got save amounts of laboratory assistance. But here if you're really on your own, and you really have to know how to deal with the patient themselves have to deal with every single injury, every single minute, the problem without a city scan scan without memory, and you go back to what you are taught to be as a doctor with a stethoscope, your own medical knowledge, and you have to make the right decision of that patient, knowing that, in fact, if you operate on this patience, he might ill usage, for the blood that you have available to you and to the the problem is that you won't have any more for anybody else, so it's making those very difficult decisions. Let's get your music now at david, not tell me about your first choice: what is it why is it important to you? While I was brought up by my grandparents in wales, because my mother was a first year nurse when she met my father who had come, over from india and they were very poor. When my mother,

was very tiny, little village in the middle of wales, so? She wanted to complete her nursing training. My father had no money at all to look after me, so my grandparents brought me up until now. I was about four, and we lived in a small village. Cultural lack outside come out and- and I remember so vividly sitting in the back of their austin a ten whilst I was being driven from in place to another sliding on the back seat on the leather and listen some singing to each other, the song. I hmm

It's the. That was my family sung by the tree or e mail choir with the Jonathan fry string. Ensemble it's hard for those of us I don't really know the practical ins and outs of war and what it is to be the on the front line and that's most of us to understand the personal danger that you're in I I want you to cast your mind back to the syria conflict in a it was twenty thirteen you find yourself operating on a fighter from so called. Is islamic states? Can you just explain what happened

I was in the hospital and our hospitals on the front line of about hundred metres from the front line, and there was you could hear gun fighting around and Suddenly one of their patients have started bleeding profusely lost about a liter two letters of blood from a chest rain. So we took him downstairs the operator in the theater and eyes with one of my syrian colleagues, another surgeon who hadn't done that much thoracic surgery and as we did a an operation called a thoracotomy. Suddenly the door flew open and six fighters came in all with they're? Ok, forty seconds and the syrian surgeon looked at me and said just don't say anything. You literally did not open your mouth for fear of the fact that they would find out. They were now I didn't say a single word. I was shaking the whole way through and I try to physically control myself as as this was going on and one of the fighters came up. Who was there in china

of this group and in fact I suddenly realized tat. This was an isis fighter that we were operating upon and the rest of their group that there were with him were from isis, and so my colleague and said well. You mustn t disturb the senior surgeon whose operating and try and stop the beating on your colleague, and I remember so vividly my legs shaking my jelly. They stayed in for about twenty minutes with their guns or pointed towards us on the floor, but they were there not far away from us and then all of a sudden something happened outside. and six of them left their seniors say stayed in until about twenty minutes before the operation was finished, and he was happy that we had stopped all the bleeding and then he left do you care he operated on. I don't care who I operate upon you know? I think I think too, that person- maybe you know, I'd saved his life. Maybe he might have changed.

his mind about things and so the uh we're all human beings? Of course we are all too aware of that. The horrors that are perpetrated in the name of so called islamic state. I think some people will think that's very difficult to hear all the things we know about what those people are capable of, and you would say still This is a life worth saving because he may well have gone on to be fit and well and kill many other people exactly. But I don't know that you don't know that, and nobody knows that you know he may find out that he was operated on by a christian surgeon, yet in hospital. Yes, he and I hope does find out time for some music. Now David. Not tell me about your second piece of music. When I was a little boy, I was at a bit of a lonely childhood. Rarely am and spent most of my time building aeroplanes or airfix aeroplanes, and I must probably had about four or five hundred of them hanging from my top of my four or five hundred yes, yes, I had hundreds of them hanging from little bits of cotton in my bedroom

and am I then wanted to and to fly- and I actually did learn to fly- and I got a private parts- licence, the commercial policy Since I even became an airline transport pilot and flew for this company in luton call him and yet for about ten years, and this next record is leaving on a jet plain, but it's in well because most of my holidays are spent in wales, and my mother introduced me to this record yes, the

that was to ban and get I'll. Tell me, then, a little bit more david about you say you had these forty five hundred air fix models that little hanging from the ceiling of your bedroom early dexterity, The little boy who made four hundred air fix models that must have been jolly good training for what you do know difficult reports this morning, when I left it, and then I was on my own doing is poland and you know I really enjoyed the whole thing and I'm not sure where it with both hands. Yandex, yes, mammy dexterous. I can operate with my left and right hand. I was asking you during that last piece of lovely music. I was saying you know the fact that you are working in three distinct types of surgery at three big london hospitals. I said you're not upset, that's unusual. What is it about you? Do you think that has wanted to do that, while I do it because it's important to for me to keep all the spinning that if I go abroad, for example and they'll turned round and say? Well? Are you a general say when I am actually x? I work in this hospital. Are you

This is why I am actually excited. I do work in this hospital and I still got so much enthusiasm for I still love learning new things: new techniques, new operations. I love teaching it to people. I love people yo suddenly realizing gosh. I can do this. Let's go to you next choice. David knows when I was a student had difficulty. Actually, I'm not the brightest of all people, and I think you do seem very didn't that above all else. What are you talking about you not very well, you know I did have started struggling go, and I didn't get my levels first time and had to go back for a second time to have a go at them and I think that's actually. She helped me for the rest of time, but I remember, finally getting into university to do medicine, and I was delighted and I went since Andrews, and I I was at a colleague of mine a first year who shared a room with gold, he would see still my best friend We invite these those around for red pancakes by candlelight. So they came round

and, unfortunately, candles set fire to the curtains we set fire to the whole hall of residence, but luckily the fire brigade came and stopped. But, as I came that evening, wrapped up in various bandages and so on has given a shot of morphine from the doctors in such a great amount of pain, but this music came. The war and its. It's like gosh I am in Heaven. It was beautiful always remain one of my favorites the sure this way,

We are all whether she can that was later evelyn and steer ways they haven't. So David knows, I'm u qualified. As a doctor, then in the early eighties, tell me about how you became a search you were on call one night. I think it was in manchester, indeed, economic, do secondary part of your degree at manchester. Your interested royal infirmary. He received a call that there was a woman who she had a head injury. I think tell me what happiness I was. I just qualified that in six months as a harris and I went down to mention I late coming back from my leg So there are no hair surgical jobs where there was a ass near a surgical job. So I did that and was doing that for a couple of months in the near assertion am the registrar and senior registrar lived many many miles away about twenty five miles away and I'd really nice near a surgical colleague whose cause Peter stand with, and he said

may David. I need to show you how to bear whole anita. Show you how to make a hole in somebody's cranium to get rid of blood in case it happens, and I can't get there in time and so as okay peter. So he showed me how to do burn holes in there on a pace that we were operating upon hated it, and so you make an incision in the side of the head and you drill a hole to get down to the jury, which is a lining of the of the brain, and then you put this bear in which makes a whole bigger and allows things to come ass. If it's going to be bleeding so he showed and then one day he was on call- and I got a phone call from a colleague to say they had a patient and they think they've got a a bleed on the brain. So the patient came across. We did the c t scan and I looked at the scanner thought crikey. You know, there's a very big bleed on the brain and her breathing came much worse and the Nisa said I'm going to have to incubate because otherwise she's not going to make it. So I phoned at peter and said I've got this problem. He said,

you just gotta. Do it so after only doing his job for two months any but having been qualify for eight months. I stop the professor of surgery upstairs usages match the arena announcement. I says: I'm sorry, I'm going to take this patient the operating theatre, and so, as is twenty four year old. Twenty five year old doktor I started to mobilise the team. They all came down and as ice. to drilling nothing came out, and then Suddenly one of my friends said Dave Dave, other side so drill. The wrong side are then went to the other side and drill this others other hole on the other side, the head, and still nothing can Then I saw this blueness underneath the jurors meant it was subdued hematoma. again. I knew what to do so. Is peter tell me so I then drills another hole and another hole. And finally, the blood did start flow. Have respiration came back to normal, her blood pressure came back to normal, and that's the moment I thought

I'm gonna be a surgeon and how was she I mean long term. She she did find she did fine. Now, of course, your father was a surgeon. Your mother was a nurse and presumably, as you'd been growing up and talking to them about the possibility of doing medicine, they had spoken to you about their working lives. I mean what would they said t what advice had they given you? Will I really wanted to be a pilot to be really honest with you and that's? No, no, no, no you're going to be you know. So there was a lot of pressure on me for doing that, and now, of course, you know what we would tend to think these days. What's unfair, you will not find their own way. Oh no, he did the right thing. He said chase me upstairs to work. I would he would sit outside my room and he'd come to my room and sit there and watch me studying he was determined. I was gonna become a doctor determined let's have some music David, not tell me about this, then we are on your fourth of the morning, so the next one I am the themes the day, a hunter and the reason why I have chosen this is because it's one of my great films of all time. Robert Deniro

such power such an amazing amount of pure leadership, a lot of integrity and from many that just is basically a worker in in a factory. Suddenly becomes is enormously strong character. If I could have about five percent of what he has to be happy in the the, the hmm, the. The the

the the hmm. the the with him to the deal, that was kept tina, composed bystander mars and played by John Williams. Up you, ve been taking unpaid leave from the any chess than they did not comment about twenty years to go and work as we know on the front line, doing multiple type. of surgery, saving people's lives in very difficult circumstances. I want to ask about the first time that you did that it was nineteen.

Ninety three was in sarajevo during the conflict there. When you look at the pictures on the television and you sought, I've got to go as many of us will know. You know television pick. Is it only the approximation of the reality when you were there? What was it really like that? First time I much of a shock. Was it all? She was a huge the shock can remember even sitting on the aleutian aircraft landing in Sarajevo and he had about five minutes to get off the airplane, because it was one of those turnarounds and we had a nosedive into the airport found it very exhilarating to be honest, and then we got picked up by a bullet proof, msf, vehicle which took me to one of the hospitals, and I was on my own. Then in cities, state hospital in the city centre was called a swiss cheese. Hospital because I had so many holes in it who hit all the time and its first time I ever felt. you know, hang on a minute. International humanitarian law should be his help me I'm a doctor. You know why you shooting hospitals, we didn't know much about trauma the time patients would come in and Unfortunately, they die on the operating table because it was so

was one particular time I remember. I was operating on a young lad who had had a fragment injury to his major blood vessel in his abdomen, and a rocket had hit the hospital. The whole place shook and I was operating within an eighth test and a scrub nurse and somebody else and suddenly the lights went off and it's completely pitch black and so five minutes past ten minutes past. Nobody came I might know. Fifteen minutes later the lights went on and I was the only person the operating theatre everybody had left because they realized that if the hospital had been completely destroyed, we were all going to die. But nobody told me- and it was a big major moment for me- realizing that you know you probably have look at yourself, sometimes rather than the patients. Have you done that since other times, when you have to exits mid operation? gaza in two thousand and fourteen. During the israeli palestinian conflict

And I was working in one of the big hospitals in Gaza city theirs little girl that come in here is about seven who had heard restoration, it's cool bows hanging out of the abdominal wall. She'd had severe fragmentation. Injuries hub fragment was going to bladder, spleen, stomach and so on. I prepared her with ideas and so on. As some became watchmen, David. We need to go now to leave the hospital because it's going to be blown up in five minutes. And I looked at her and at the time am I had no family, I had no siblings. I had no, buddy lessing. Well, ok, I'm on my own here and I going to leave it'll go on her own too to die in the hospital, and I made a conscious I wasn't getting too so I stayed there with her and thought. Well, so you must tell me what happened? What happened

all the staff in the operating theatre left. I was there with the initiatives, and I looked at the iniquitous and I said to him: you want to go. He said now I stay with you and so the two of us to stay there. We operated waiting for the bomb to explode onto the hospital, nothing happened, and three or four days later I've got a picture of me in the little girl right. We're gonna, take a break. We're gonna have music David, not an tell me that this is your fifth one of the morning. So I've done this job for many years and I really love it, and I also left the rolling stones. I've been sitting five times from the los angeles rose, bow to manage the city football club and one of his It was which I really really nuggets given shelter, and I take it with me when I get my visits

the that was the rolling stones and didn't shouting. He said David, not that you will take this on your many ships around the world, just sort of comfort you, through these extraordinary situations that you ve been sharing with us this morning. I want to ask you David about? You speak so disarmingly calmly. All these utterly extraordinary circumstances.

post. Traumatic stress. Disorder is very well documented, certainly among people who are working in the military and indeed people in emergency services. You ve been subjected to so much trauma so much human distress. The very west That human beings can do to each other. What has been the effect upon you? I do suffer, there's no doubt about it, takes me about three months to get over a mission, sometimes, and sometimes I'm very angry and and and that's part of their post, traumatic stress, I think more recently, I have suffered severely when I came back in two thousand fourteen, almost psychotic post, traumatic stress- and this would be one- violent rages in flashbacks and trying to contain the yeah, a small little tiny little ember will somebody says coming to me will grow into this fire which grows into a furnace which grows into something uncontrollable evil. As at

You ve been given no be for your work and- and I know that you had you did- was it if you put in your lunch with the queen yes and saw this was just when you come back and hat were suffering. This terrible episode had lunch, so I I came back around october. The fifth two thousand fourteen and ten days later, I found myself sitting in buckingham palace with the queen and she was sitting on my rights and our sitting on her left and when it came to my turn to start talking to her. So then I heard you just come back from Aleppo. I said yes, I have, and if you consider coming back from where I just come from, it was the hope, the hostile what was being blown. Yes, everything around me was paid

being shelled and I coping with children that were badly really badly damaged and she must have detected something significant because I didn't know what to say to her. It wasn't that I didn't want to speak to her. I just couldn't, I could not say anything so she picked all this up said well, shall I help you? I thought: how on earth can the queen helped me and all of a sudden, the courtier It's brought the cookies and the corgis went under the neath the table and she went to one of the courtiers and said to him: can we open up that please, and so she opened up this lid and they were loaded skits, and so she got one of the biscuits and she broke into and said o k. Why did we feed the dogs and so for twenty minutes? The queen anne I during this lunch just fed the dogs

and she did it because she knew tat. I was so seriously traumatize. You know that the humanity of what she was doing was unbelievable and didn't help here. Very much so I think stroking animals touching dogs, feeding them and we just talk about dogs and how many she had and she was so warm and so wonderful and I'll. Never forget it. Let's music David, not but this one here, six disk. This is a record which I am I I've been round the world fixing people and I suddenly got to stay probably where think I probably needed fixing myself and something quite remarkable happened to me, which I'd never in a hundred years. Thought would happen, but the record is cool. Excuse to

the that was coldly and fixing you said David is we went into this? piece of music. Something remarkable happened. You'd said for many years that you did what you did, because you didn't have a wife and family. you do know you do. We now have a wet. Sadly, it happens quickly and swell is remarkable, I remember thinking that when I was in Gaza that I was public die here, because I'm a big

if the shelters- and it was- and I somebody a reporter asked me, what's it like to work in gaza- and I said well, it's like the apocalypse. I thought it was like the apocalypse, it felt that the the shell too, that we were in was shaking, and I thought I'm not going to survive this and I'd matter girl at eight. A m charity event in just a few weeks before that, and I thought gotcha nice across the table. Now I never thought anything of it, but then I thought hang on. I'm not gonna survive this. I dont really think. I'm sorry I'll, send you an email, so I sent an email said. I met you I remember you giving me your card and I just want you to know that. Thank you very nice. I would never have done that. Had I not thought I was going to die and and so she sent me an email backs. It will mean that we meet up- and I said well fair enough and I met her outside it

keep station and it was just. I is either her when they say it's love at first sight it was love at first sight so had- three weeks with her. Until I went off to Syria and it was remarkable- you have adopted now called called molly and Of course, you must have been there when molly was born, were you involved often in mind, was brilliant, because SAM may, when ellie was pregnant, she was twenty eight weeks pregnant. This earthquake happened in nepal and she so utterly supportive. She could see we achieved and she tells me David if you really need to go, go and I'll be I'll call you. If I anything happens, I went off for three weeks in a pool for the earthquake when she was pregnant. My came back and, of course, than she had some.

Problems are needed as his errand section. So it was fantastic because my colleagues, my colleagues, had worked with the twenty years. It Chelsea Westminster heeded this his errand section by an east, his colleague hard work. twenty as he did the anesthetic. So I was surrounded by friends. It was a joy moment. Let's have some music David, not tell me about you, you're, seventh, clarity,. Is all about ellie, and it's about how and I came back from that from Syria. After six weeks, she was at the airport waiting for me

and you just listen to this- just listen to me. The the

yeah The no, to missus clear deluding plate, thereby James roads. So David, not many of us, the the characteristics have you will have in common with lots of other surgeons and doctors and gps, and a nurses and people who work in rna chess and want to do the best for the patients that they have. what's going on in your head. That makes you think we have got to leave this and take it somewhere else. I think you because you're doing good, where you are

am doing good, where I am but other than this lots of other people. That you know can do my job but out there with the knowledge I have you know. If I don't go, Those patients will die, whereas if I stay here, I'm not hugely one hundred percent required was there. I am and that's a difference. Along with your wife ellie you ve decided together to set up a charity, the david, not foundation. Its purpose is to train doctors locally for the sort of the matter sees that you ve worked in the last twenty years. Yes it, but we. I run this course of the royal college of surgical, surgical training for the austere environment cause. I will say one another source as well definitive, surgical, trauma skills course, but it costs money, to go on this course and so alien. I set up this charity, which actually will pay for certain skimmed all over the world and will send them back with all this information. We actually take a small part of the cost to the front line and we just trains, thirty surgeons, which came over the border from Syria.

So ellie is a chief executive, I'm the chairman. We do have a group of trustees and I'm at city lights to say that I'll patron is baroness betty boothroyd. You are somebody who has consistently called for humanitarian corridors in syria in order to allow the aid medical help it and so on, and so on so many of these calls are so mackey, not just syria, so mucky and complex when you pipe up and get involved, how able do you think you are to be set up to be thoughtful and useful in those circumstances, ethically, I mean I've tried very hard and I've tried writing things. I've tried talking to people. I tried a media to try and change the politicians ways of thinking they. I've been like a house of commons recently and

Some politicians do says me, David, we are listening to. You know, keep going cause we are listening to, but it doesn't change anything really and it needs politicians to change wars as the only way it's going to work. But until that time I shall work so damn hard for the humanitarian point of view to help those people there that also realizing. That does not huge mass I can do, but I can bring it to the attention and they'll, be nobody save on the desert island. There would be no moments. So while there might be some high drama but it'll just involve you, nobody to stitch up, nobody's head to drill, and I will you do on your own on a desert island. well. I said this to ellie the other day. I said I'm going to cope very well. She was really upset that that would able to cope on my own, but I I will be able to cope on my own. I'm I'm very happy with my own solace and I won't have any problems. Tell me that a final discussion david- not so am it has to be about molly.

and are chosen good golly, miss molly by little richard, which is probably the best of luck in love, music. I think one can Listen to the little richard gully, miss molly right, David heated, the books. I give you the complete works of shakespeare and the bible. To take to this island and you get to take one other book along with them. What's it going to be well, I have great difficulty in languages

and I really want to learn arabic and so I'm going to take care of arab. He must boot, which is a a book about her learning, arabic, okay, that's years, then you're allowed a luxury. Let me take my fishing rod with me, cause I'm going to catch that elusive salmon, which I've never caught. We shall give you that if you had to save just one of these eight discs that you've chosen today, which one do you think it would be while it would have to be good golly miss it will give you back then at David. Not thank you very much for letting conceal your desert island discs. Thank you. The

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