Belfast, United Kingdom
|John Daniel Alexander Robb, FRCS (1932-2018) Source: Mr. John Robb|
When I qualified in medicine at the Queen’s University of Belfast in 1968, Northern Ireland was a curious cocktail of sectarianism and garden parties. I soon discovered that winning the medal in surgery was not such a bright idea when I began my postgraduate career as Professor Harold Rodgers’ single-handed house surgeon. Harold invited me for tea beforehand to inform me that he expected me to be continuously on duty for the next three months. This news caused me to involuntarily crush the biscuit I was holding, which then splashed into my teacup. I muttered that a gentleman would not have done that, to which Harold replied: “No, a gentleman wouldn’t have drawn attention to it.” In his office, Harold had photographs of all his former house surgeons whom he referred to as his “Rogues Gallery.”
Harold was a church-goer, and I soon learned to make myself scarce at lunchtime on Sundays, because it seemed that his conscience was pricked by sermons. He would arrive in the ward after church for an impromptu ward round and then decide to do some operating. One morning I was in the administrative office when I was asked to sign an Oath of Allegiance to the Crown and the Statelet. I was averse to signing it because, having just taken the Hippocratic Oath, I felt my first allegiance was to my patients. I mumbled something about an emergency in the ward and said I would return, vowing henceforward to give the office a wide berth. To my surprise, I was not chased for my signature, perhaps because I did not fit the stereotype whom the signing of the Oath was designed to humiliate.
At that time, the medical staff of the Royal Victoria Hospital (RVH), where I was based, was entirely Protestant, despite its siting on the edge of wholly Catholic west Belfast. The Mater, the main Catholic teaching hospital, lay a couple of miles away and, although pre-clinical teaching was integrated, clinical teaching was largely segregated until 1971.1
The one factor to brighten the tenure of my first post was the arrival of John Robb as the new consultant surgeon (See Image 1). John had tutored me during my recent student days, and I held him in high esteem. Despite John’s senior position to me, we were on first-name terms, but in those days John was “Sir” to me in front of the patients.
John had qualified in 1957 and gained his FRCS in 1961. In 1966 he drove to South Africa, where he worked in non-European hospitals in Durban and Johannesburg.2 John recounted how one of these, Baragwanath, had the dubious distinction of being the “paraplegia capital” of the world, thanks to thieves inserting sharpened bicycle spokes into people’s cervical spinal cords so that they could not offer resistance when being robbed. His travels must have sharpened his acuity for spotting social injustice, and the experience he gained in treating gunshot wounds was to be useful sooner rather than later because the “Troubles” arrived in earnest the following year.
Their onset can be traced back to the murder of two young Catholics by the Protestant Ulster Volunteer Force in 1966, and to the Civil Rights demonstrations which began in 1968: “the Year of Revolt.” These particularly centered on Derry, where violation of civil rights was rife. This culminated in the “Battle of the Bogside” in August 1969, and the violence spread to Belfast later that month 3
By then, I was a senior house officer, manning the cardiac ambulance of the great cardiologist Frank Pantridge, when he was developing the portable defibrillator.4 John and I were on surgical and medical take-ins, respectively, on 14 August 1969, the night the Troubles erupted in Belfast, half a century ago. I did not see much of John that night because he was constantly operating and I was busy elsewhere. Harold Rodgers was in his element. He had seen lots of action in World War II, about which he told a good story against himself. He was operating in the field on an injured soldier with signs localized to the right iliac fossa, when he found blood seeping from the left upper abdominal quadrant. He extended the opening upwards and removed the offending organ in what became known as “The Rodgers Incision for Splenectomy.”
That night, Harold and his registrar stepped onto the Falls Road and commandeered a bread van to look for casualties. The only “casualty” they were offered was someone with a “wee touch of pleurisy.” Luckily, perhaps, for them, the main action was taking place lower down the Falls Road where a boy was shot dead that evening, with a further six gunshot deaths during the early hours of 15 August.4
|Lecture Poster, 1973 Source: Alun Evans|
Driving home next morning was surreal, and also disturbing, with trees felled and paving stones piled up in desperate attempts by the local people to defend themselves. That day one Loyalist doctor marched out onto the barricaded road outside the hospital and declared it open, “In the name of the Queen.” The previous night, at least twelve factories had been destroyed; over 100 homes had been wrecked and another 300 damaged by petrol bombs.4 Senior colleagues, who had lived through the 1930s, were apprehensive about the future, whereas we young ones had no idea just how bad things would get: three decades later, 3,636 people had been killed.5 As I write this, with Brexit uncertainty, and the threat of the return of a hard border on this island, I am apprehensive about the future.
It was not until February 1973, when I attended a lecture John gave in Edinburgh, that I learned what had befallen him that night. It was entitled “Riot Medicine” and I kept the poster advertising his lecture (See Image 2). I have since bequeathed it to the Linenhall Library in Belfast, which has a comprehensive collection of political ephemera relating to the Troubles. In his lecture, John reported that by then there had been forty-six disasters at the RVH; in those days a “disaster” was officially defined as fifteen or more people arriving at the emergency room (A&E) simultaneously.6 William Rutherford, the A&E surgeon, had established triage as casualties came through the door to ensure that surgical intervention was deployed most effectively. John then described how he had removed eleven bullets from his patients on 14-15 August 1969. He had taken the bullets home and later placed them in his bank manager’s safekeeping; he then went on holiday to Co Kerry.
After a few days he received messages from the Royal Ulster Constabulary (RUC), who wanted the bullets returned. These bullets had almost certainly been fired from Browning machine guns by the B-Specials (a branch of the RUC). John temporized and asked a friend, a human-rights lawyer in London, to whom did the bullets belong? The answer came that the bullets were the property of the victims. John accordingly wrote to each one asking for their permission to relinquish the bullets. Permission was duly received from all but two of the “recipients,” for they were generally keen to receive compensation for their injuries.
I should also like to highlight John’s observations after the Abercorn Restaurant bombing in March 1972, when two young women were killed and over 130 people injured. An anesthetist working in the RVH recognized his daughter’s body when it arrived there. John had had to perform many amputations that day, some of them multiple. It caused him to venture onto the media to observe: “You cannot create a healthy society from one which has been dismembered.”7 That autumn he established the New Ireland Movement and issued a 50‑page pamphlet, with an introduction by fellow surgeon Jack Kyle, the great rugby player. It was entitled “New Ireland: sell-out or opportunity?”8
The term “New Ireland” had historic credentials, having been used by Dr. William Drennan in the late eighteenth century, in relation to the United Irishmen.8 Drennan, an enlightened Presbyterian like John, also coined the phrase, “the Emerald Isle.”9 In the pamphlet, John reviewed Irish history, discussed the way forward and the benefits of peace, and set out a timetable to achieve this. Unsurprisingly, many staunch Unionists recognized the “sell-out” rather than the “opportunity.” Ten years later John founded the New Ireland Group, whose primary aim was to promote dialogue, consensus, and reconciliation. Charles Haughey invited John to be a member of Seanad Éireann and he served as a senator from 1982 to 1989.2
John in his sixties also mastered Irish:2 this was the language which had been exported to Scotland and became the Scottish Gaelic, but the lowland Scottish settlers of the seventeenth century plantation of Ulster brought with them an English dialect called Scots-Irish.
I regard John Robb as a giant of Ulster medicine: he was an inspiring teacher and would have made a great professor of surgery. Instead, he ended up working in a country hospital, but this reflected his credo that hospitals should be sited in the community. I am afraid that John’s breadth of vision was too wide for the more blinkered members of our profession to accommodate. Sadly, John died after a long illness last year.
And what of Harold Rodgers? Until his retirement in 1973, I used to get sporadic notes from him requesting my photograph to hang in his Rogues Gallery; these I callously ignored. Fittingly for someone who contributed much to the Christian Medical Fellowship and medical care in the third world, he then took up a post in Nigeria.10 In conversation with John, many years later, I learned to my great joy that there had been just two photographs missing from Harold’s Rogues Gallery: John’s and mine.
- Evans A. Health in Belfast: the vital statistics of poverty. In: Boal FW and Royle SA, eds. Enduring City: Belfast in the twentieth century. Belfast: Blackstaff Press; 2006.
- Obituary, Mr John Robb: Country general surgeon dedicated to politics of conflict
resolution. The Irish Times. February 24, 2018:12.
- Bardon J. Belfast: an illustrated history. Belfast: Blackstaff Press; 1982:277-312.
- Sherlock B. Pioneers in cardiology: Frank Pantridge, CBE, MC, MD, FRCP, FACC.
- McKittrick D, Feeney B, Thornton C, McVea D, Kelters S. Lost lives: the stories of the men, women and children who died as a result of the Northern Ireland troubles. Edinburgh and London: Mainstream Publishing; 1999:1474.
- Rutherford WH. Experience in the accident and emergency department of the Royal Victoria Hospital with patients from civil disturbances in Belfast 1969-1972, with a review of disasters in the United Kingdom 1951-1971. Injury. 1973;4(3):189-199.
- Robb JDA. The Irish News. March 6, 1972:1.
- Robb JDA. New Ireland: sell out or opportunity? Belfast: BARDICBOOKS, Armagh (For the Author); 1972.
- Newmann K. Dictionary of Ulster biography. The Queen’s University of Belfast: The Institute of Irish Studies. 1993:68.
- Clarke RSJ. The Royal Victoria Hospital Belfast: a history 1797-1997. Belfast: Blackstaff Press; 1997:180-183.
ALUN EVANS, MD, trained as a physician before turning to epidemiology. In 1982 he became Principal Investigator of the WHO MONICA (MONItoring in Cardiovascular disease) Project in Belfast. He was elected to the Steering Committee of MONICA in 1990 and chaired it from 1994-7. He led two EU-funded projects: one to complete MONICA; the other, a pooling of cardiovascular cohorts in twelve European countries; and was a partner in sixteen others. He published several hundred papers, in 2004 co-authoring the Third Edition of the WHO Monograph: Cardiovascular Survey Methods. His current focus is on the social history of medicine.