Reality behind research: 21 years of oral history with Wellcome Witness

Thousands of scientific papers are published every year, reporting on interesting results, but the standard format – introduction, materials and methods, results, conclusions, references – leaves little space for the social context of the work. For over 20 years, the Wellcome Trust has been supporting Wellcome Witness seminars, which bring together key figures in research to discuss the stories behind the discoveries. Professor Tilli Tansey discusses the Witness Seminars, and on the occasion of the publication of the 50th volume in the Wellcome Witnesses to Contemporary Biomedicine series, reflects on some of the highlights and the remarkable people she met along the way…

Dr Tilli Tansey and Sir Chris Booth, at Witness Seminar on post-penicillin antibiotics, 1998 © Wellcome Library, London

On 24^th September 1993 we did an experiment in the Wellcome Building at 183 Euston Road. ‘We’ were the Wellcome Trust’s History of Twentieth Century Medicine Group (initially me, Sir Christopher Booth – a retired clinician, and Mrs Wendy Kutner – our secretary for two days a week). The group was set up by the Wellcome Trust in 1990 to try to bring together historians, scientists, clinicians and others interested in studying recent medical history. The aforementioned “experiment” was our first ever Witness Seminar, on the topic of monoclonal antibodies.

Monoclonal antibodies were discovered in the 1970s when it was shown that a single clone (i.e. of genetically identical cells) grown in culture, could be treated so as to produce pure, specific antibodies, which opened up exciting new possibilities of precisely targeted forms of medicine. This was an important discovery to explore and we wanted to get behind the rigid structure of the published scientific papers to hear from those who were there at the time. What really happened, and how and why? What were the key experiments that influenced the work? Who were the main players (including those lesser known names)? What went right, and – what one rarely hears about – what went wrong?

As well as being an important medical discovery, here was another reason we wanted to discuss monoclonal antibodies. The techniques had never been patented in the UK, although American scientists seized on the discovery and did get patents. By the late 1980s this had become a ‘scandal’, seen by some as another example, like the ‘loss’ of British penicillin to the USA in the Second World War, of the inability of naive scientists and their institutions to exploit discoveries commercially.That afternoon, 21 years ago, was fascinating – our witnesses included the two principal scientists involved, César Milstein and Georges Köhler who shared the Nobel Prize in 1984; contemporary colleagues and rivals; administrators and journalists. They were all open and frank (although not necessarily in agreement) about the development of vital techniques in the lab, the role of key personnel, and in particular the role of patents and commercialisation in medical research.

The whole meeting was recorded, transcribed with permission from the speakers, and the tapes and transcript were deposited in the archives of the Wellcome Library for the use of future historians.

We realised that this approach provided insights, details and discussions not available elsewhere and planned a few repeat experiments. In 1996 we decided to publish the edited proceedings, and the following year a volume, optimistically labelled as ‘one’, appeared.

With the continued support of the Wellcome Trust, initially in-house, then at UCL and more recently at QMUL, we continued to develop this technique and have published nearly 60 meetings, mostly in the series Wellcome Witnesses to Contemporary Medicine (formerly Wellcome Witnesses to Twentieth Century Medicine).

In line with the open policy of the Wellcome Trust, all of our material is freely available for use by others.

Over the past 20 years, over 1400 people have contributed to our seminars, including several Nobel Laureates, clinicians and scientists of practically every medical specialty, and patients, technicians, nurses, and journalists, amongst others. I am convinced of the power of this technique in allowing many authentic but diverse voices of modern biomedicine to be heard and proud that we have been able to record the voices behind some great discoveries.

Over the years there are some particular favourites, a few of which I’d like to share.

Dr Ethel Bidwell and Dr Charles Rizza at Witness Seminar on haemophilia, Feb 1998 © Wellcome Library, London

One of these is from Dr Ethel Bidwell from our meeting on haemophilia. She was extremely reluctant to attend, telling me over the phone when I invited her that she had nothing to contribute. But I knew, from reading the journals of the time and from a casual conversation with a haematologist friend that she was the person who, in the 1950s, had discovered factor VIII, the first reliable treatment for haemophilia, and I wanted to hear her story.

Fortunately I managed to persuade her to come, and when she arrived we persuaded her to talk about her early work. Trained as an enzyme chemist, she joined the MRC Blood Coagulation Lab in Oxford to work on gas gangrene, but finding no-one there interested in her work, she decided to see if she could ‘make something from animal blood’ to treat haemophiliacs.

Ethel described the primitive conditions in which she collected blood from the local abattoir, where the slaughterhouse men always wanted her to have blood from the prize animals that won rosettes. She reckoned that ‘ancient old cows were much better’.

Page on haemophilia in volume 50

After pouring the blood into a big glass Winchester bottle she would strap it to the back of her Vespa scooter and gingerly ride back to the lab, constantly worried that she would have an accident and the blood would spill all over the road.Another memorable witness was from the same meeting, Clifford Welch. Himself a mild haemophiliac he described how life ‘severely shook up’ in 1930 when he was five and triplet brothers were born, all of whom had haemophilia. He vividly described the limited availability of treatment, the frequent trips to Barts Hospital in London, as one or other brother, sometimes two or more together, were admitted. He gave a particular mention of the ‘miracle’ of blood transfusions from their mother that saved their lives on numerous occasions.

Dr Usama Abdulla and Mr Thomas Brown at Witness Seminar on obstetric ultrasound, March 1998, © Wellcome Library, London

Tom Brown, a star witness at the seminar on Obstetric Ultrasound, recalled his early days as an engineer in the Glasgow shipyards, working on using ultrasound as a non-destructive way to detect flaws in metals being used to build submarines. Hearing that the Professor of Midwifery was trying to find ways of visualizing the foetus in utero, Tom looked him up in the phone book, gave him a call, and their initial conversation led to the collaboration that developed the machines and procedures that are now routine in every ante-natal department.

These are the sort of insights that we aim to capture – the personal tales and memories that have no space in traditional scientific publications, but shed light on the reality of iconic research.It is not only individuals, but sometimes whole groups that are particularly memorable. We have held a number of meetings to examine the history behind large scale survey work, including NATSAL (National Survey of Sexual attitudes and lifestyles); ALSPAC (Avon Longitudinal Study of Parents and Children); and the work of the MRC Epidemiological Research Unit in South Wales. The little-heard voices of the interviewers themselves provided intriguing details.

Wendy Williams described how, before working on NATSAL, potential interviewers had to be ‘desensitised’ by listening to every known term connected with sexual activity so they would never be surprised by anything during an interview. After this two-day barrage, several male interviewers dropped out feeling unable to continue, whilst most of the women remained.

It’s not always easy to track down all the people that we’d like to hear from. Locating the scientists and clinicians who were involved in particular fields is comparatively easy, since even in retirement they can usually be traced through their former institutions or professional organisations. To find the less well-known contributors however we have to be a little more creative, using pension and social clubs, Christmas card lists, friends-of-a-friend-of-a-friend connections, for example.

ALSPAC Witness Seminar at the Wellcome Trust, London, 2011 © Wellcome Library, London

Finding one technician can lead to others; one patient may be in touch with fellow sufferers; one fund-raiser can link us with associates; and one retired midwife may keep up a lively correspondence with friends that suddenly gives us access to a wide network.Sometimes, we are simply too late – the key figures, whether well known or not, are no longer with us or no longer able or willing to travel to London to participate. Conversely we have occasionally been too early – in a still active field appropriate contributors may be too busy or impatient to take an afternoon off to consider the historical dimensions of their work.As we celebrate our 21st birthday, we are publishing the 50^th volume of Witness Seminars. This anthology of extracts from all our previous meetings is titled ‘Monoclonal Antibodies to Migraine’, reflecting the scope of biomedical subjects we have tackled over the years. These include issues of professionalisation and specialisation within medicine, such as the creation and impact of sports medicine; medical physics; intensive care and clinical pharmacology.

We have heard from eye-witnesses involved in the development and use of new treatments for conditions including haemophilia; leukaemia; cystic fibrosis; and peptic ulceration. The development, problems and potentials of treatments including hip replacement surgery; heart transplants; and renal dialysis have all been debated, as have the impact of technology such as obstetric ultrasound and NMR and MRI.

As the Government Chief Scientific Adviser, and former Director of the Wellcome Trust, Sir Mark Walport says in his foreword, this volume is full of gripping vignettes and stories – we hope you’ll enjoy reading them as much as we have enjoyed collecting them over the years.

Now supported by a Wellcome Trust Strategic Award, the project continues until early 2017, focussing on five main themes: clinical genetics; neurosciences; global and infectious diseases; ethics in medical research and practice; and medical technology. With so many topics to explore, perhaps the 100^th volume will be along earlier than expected!

You can find out more about the Wellcome Witness series on the History of Modern Biomedicine Research Group’s website or you can follow them on Twitter or connect via Facebook. The Makers of Modern Biomedicine project is supported by a Wellcome Trust Strategic Award.