Dr John Church

Dr John Church - Lodge 1949

“A life of venture and adventure”

My father, John (or ‘Joe’), went to St Lawrence College at the age of ten. His father, Edward Joseph, was a clergyman in Cambridgeshire.  Despite having limited primary schooling, Joe started writing early, and maintained dairies that he continued with throughout his life.  His spelling at first was certainly quaint, as letters to his father show:

“Dear Papa, Ples can you send me a Dnxry [dictionary]"

“Ples send me a hokey stick… It lux like this”.  This has an elementary sketch of a hockey stick!

My father never shone as a hockey player unlike his brother, Bill, who played for Cambridge University [and features on the recent front cover of the 2018 Old Lawrentian].

Whilst at School, Joe witnessed a Zeppelin attack on Ramsgate in 1915. He reports in his diary: “Zeppelin raid. Woken up by 2am by explosions. Watched Zeppelin from opposite dorm…”

My parents were both doctors.  They became engaged in 1927.  Joe then went to East Africa to serve in a medical branch of the Church Missionary Society (CMS).  With colleagues, he founded eight hospitals in Uganda, Rwanda and Burundi in the 1920s and 30’s.  My mother came out to Africa to marry my father in 1930 in Kampala Cathedral, Uganda.  I was born in 1931 the eldest of five children – John, David, Robin, Michael and Janine.

Joe was very much a product of the medical training of the early 1900s.  He never had any postgraduate training, never read any medical journals (my mother did that and passed it on) but he was an excellent ‘bedside’ doctor.  My mother was one of the first lady doctors to be trained at the Royal Free Hospital in London. Like my father she had no further medical training.  But she learned how to do caesarean sections, and other surgical procedures, and performed them if my father was away.  They were a great team and gave us a sense of ‘venture and adventure’, reflecting their personalities and character.  Joe, before he was married, was somewhat of a daredevil, and got into a number of escapades including being nearly killed by a man-eating leopard which lunged at him and got its jaws around the back of his head, his life being saved by a young man, Kosiya Shalita.  Kosiya, years later, became one of the first Rwandan Anglican bishops.

My own early life until teenage years was in East Africa, and my early education was influenced entirely by what Africa could offer at that time.  In order to meet the needs of the children of Missionary families, my parents founded a school, the Kabale Preparatory School, of which I am thereby the oldest old boy!  This school now musters some 400 pupils, mostly Ugandans.  At age ten I had to go to Kenya, for ongoing Primary and Secondary schooling.  But the Second World War had led to a ‘brain drain’ from East Africa into British forces in the Far East.  School staffing suffered accordingly.

I came to St Lawrence College in 1946-1949, aged 15-18.  I had to work extremely hard to catch up because of the East African background. I also had to learn Latin if I was to get to Cambridge to study Medicine as my father had done.

My experience at St Lawrence felt very alien at first because I had spent my whole life in Africa up till then.  At 15 I became guardian to my brother, David, in post-war austerity Britain.  With a ration book in one hand and a Lloyds Bank cheque book in the other, we were on our own, with no clear base in this country.  We both felt very loyal to our parents’ calling but also felt rather bereft and confused.  No-one could really look after us – relatives or others.  However we got on better in the Christian environment – with the CSSM summer camps, and ‘Walrus cruises’ on the Norfolk Broads.  These cruises were started by my father every Easter, and ran for decades.  We were loyal to the School’s Christian ethos, but it was a struggle nonetheless.

There were a number of friends from amongst other East African families who were sent to Ramsgate because of its Christian foundation. These included the Hopcrafts who were farming folk from East Africa, John and Peter becoming life-long friends.  But it was difficult because we had entered the school quite late.  ‘Fagging’ was also still a big part of School life.

St Lawrence was by and large a better environment and a welcome change. David and I came in so late that we were regarded as ‘interlopers’ in Lodge. We used to go exploring at night in the tunnels under Ramsgate with torches. We found an extensive network of tunnels hewn out of the chalk that had been used for smuggling over the centuries.  We had a lot of fun down there but on looking back, it was clear that anything could have happened – it was so dangerous!

Then Donald Drew, my Lodge Housemaster, left the School whilst I was there and, as the senior pupil and a Lodge School Prefect, I was temporarily made the Housemaster, by the Head Master, Canon Perfect.  I had to cane small boys for their minor misdemeanours.  That I found extremely difficult, particularly as I also had to sleep in the same dormitory with some of them!  A lot of acrimony developed, and I felt very let down by the School for making me take this role.  However I did this for six months, and the School appointed a House Master after I left. 

David and I didn’t see our parents again until 1952 (some five years later).  Joe was also away a lot anyway so I didn’t see much of him even then.  Communication during that time was a weekly letter from us, and one by return from them. I still have these letters.  However we didn’t share with them our difficulties -  we always presented a brave face. 

I wasn’t much of a sportsman but I became Captain of Shooting, and enjoyed it thoroughly.  My younger brothers, David and Robin, were also in the Shooting teams and Robin did particularly well in the Ashburton Cup, the inter-Schools championship.  I studied Physics, Chemistry and Biology and a bit of Latin (a requirement for Cambridge at that time).  I especially remember Mr. Sanderson, the Physics teacher.  The teachers were good people – and got the best out of me.  They were very supportive and enthusiastic of me getting into Cambridge to read Medicine.

I went up to Cambridge in September 1949, and joined Emmanuel College as my father and uncles had done.  Cambridge was a revelation, and I was very well supported by the Cambridge University Christian Union.  I completed my medical training at St Bartholomew’s Hospital in London, from 1952-55.

I met my wife Rhoda as a nurse at ‘Barts’ and we were married in 1958.  We joined my parents in Rwanda in September 1959 for me to take over the running of the hospital from my father.  Despite having no further training after leaving ‘Barts’, he was a great ‘bedside’ doctor, and he taught me how to use my own senses and to practice ‘solo’ medicine – I did not do a ward round with another doctor for four years!   I learnt how to recognise medical conditions like typhoid fever simply by sensing the odour of the patients and their clothes.   

No sooner had we arrived in Rwanda but we were caught up in the first phase of the Rwandan civil war, and my plans to improve the hospital service went on hold as a consequence.  At one stage I was only one of 24 doctors in the whole of Rwanda [population then 2.5 million] and had to deal with all the carnage of the genocide that went on at that time. We moved four times in four years because we had to go where needs were most pressing, all with very limited resources. My father had had similar experiences and but with basic medical skills was able to build his hospital nonetheless in Sept 1927.  Like my father, we had no electricity, no blood transfusions, or running water.  I had to undertake surgery in these conditions in the same way that my mother had performed caesarean sections. It is incredible how you improvise though.  For example I was sure we could use tropical sunlight to make hospital linen sterile, but we had no means to test the efficacy of such!  Unfortunately there were death threats and my parents had to leave urgently, never to return to work in Rwanda.  Rhoda and I similarly effectively became refugees.

My last ten years in East Africa (1963-1973) were spent in teaching hospitals, in Uganda and Kenya.  It was tremendously rewarding, especially as our young doctors were taught to deal with everything and anything with limited resources, the very antithesis of specialist and super-specialist training in the developed world today.  The academic team in Makerere University, Kampala, were a remarkable mixture.  In Anatomy I had the privilege of using an early electron microscope, looking at skeletal muscle development and repair.  We were studying the ‘Satellite Cell of Skeletal Muscle’, which is now recognised as a resident stem cell.  I submitted my work to Cambridge University and was awarded a prize winning MD in 1968.

In 1969 I was invited to join the founding Faculty of the newly emerging medical school for Kenya, in Nairobi, where I headed up the Orthopaedic Department.

In 1973 I started applying for jobs in the UK, and was shortlisted for a number although was  considered by some as a misfit because of my ‘unorthodox’ background.  However I was offered a Lectureship by Prof Brian McKibbin at the University of Cardiff who took me under his wing.  He was working on fracture repair in sheep, and wrote a definitive work on fracture management.

I could have remained in academia but chose instead to join the NHS as an orthopaedic surgeon.

In September 1975 I was appointed as Consultant Orthopaedic and Accident Surgeon to Wycombe General Hospital in Buckinghamshire, and this became my definitive professional appointment.  This was very rewarding as, with an excellent array of colleagues, we were able to create from two earlier ‘Cottage’ hospitals a thoroughgoing District General Hospital.  My on-going research included developing a ‘modular’ concept of total hip replacement.  I was also for a while the UK Chairman of a charity World Orthopaedic Concern, which, as its name implies, is involved with the training and practice of medical personnel in Orthopaedics in the wide range of challenging environments in under-privileged parts of the world.

In 1991, aged 60, I retired from the NHS in order to revisit some of my research interests.  These included the use of maggots as cleansing agents in recalcitrant and infected wounds and ulcers.  This idea had started in Rwanda where seriously injured people could be left for days before they were found, or crawled to safety.  It was noted that some of the wounds that were infested with maggots were remarkably clean, and the patients were not dying of gangrene or septicaemia or tetanus.  Our experiences matched that of European military surgeons, including Napoleon’s Surgeon-General!   Using this research, I created my own fly culture laboratory, and helped create a laboratory preparing maggots for clinical use.  We founded the International Biotherapy Society [IBS], and the therapy, known as Maggot Débridement Therapy [MDT], is now international. 

The maggot work led indirectly into another absorbing interest, the use of ‘sniffer dogs’ to detect conditions such as cancer.  This started with a letter to ‘The Lancet’ where a young lady had a dog that was paying persistent attention to a ‘mole’ on her leg.  She sought medical advice, had a biopsy, and this revealed that it was a malignant melanoma.  The dog had effectively saved her life.

Then I was giving a lecture to senior students with the above story, when one of the students told me that his father had a dog that had shown excessive interest in a patch of ‘eczema’ beneath his trousers. He also sought medical advice and a biopsy revealed another skin cancer!

I then met a team of dog trainers from the ‘hearing dogs’ arena, and we put together a proof of principle study, training selected dogs to recognise cancer of the bladder from urine samples provided by volunteer patients.  This was highly successful and received front page attention in the British Medical Journal.  This led to the creation of a new charity, Medical Detection Dogs [MDD].  Our dogs are now being trained to recognise a range of cancers and also to alert to the crises of patients with metabolic diseases such as diabetes, or with nut allergies, and even harbouring malaria.

Throughout all this, I am indebted primarily to my parents, but also to an ‘army’ of loyal and supportive colleagues, without whom most of the above could never have happened!

Dr John Church

December 2018

Copyright St Lawrence College 2018