January 29, 2021, by School of Medicine
50 at 50: The life and times of Professor David Walker
Professor David Walker, Professor of Paediatric Oncology, began his journey in medicine as part of one of our first few undergraduate medicine cohorts, graduating in 1977. His career has taken him across the globe, but he returned to the University of Nottingham as a senior lecturer in 1990 before becoming a professor in 2005. This year Professor Walker has retired, so we sat down with him to hear some of the stories from throughout his incredible career.
What do you remember about the early years of Medicine at Nottingham? What drew you to apply to a brand new medical school?
If you speak to us from the first five years, you get a sense of being on an exciting new journey. It was a very special time in terms of relationships, those first five years were quite exciting because everything was brand new and the level of personal relationships were high and was very cooperative.
All students when they go to University, the main activity is the social activity – you go there to meet new people and to learn whatever it is you’re learning. And Nottingham in the 70s was and still is a fantastic campus University. I mean, it’s a great environment and the students had a good time. The era was politically quite tumultuous. There were lots of protests in the 70s and the University had its fair share of protests. There was a rent strike. There were all sorts of things going on politically that the University organization had to grapple with because society was in a state of revolution. The Vietnam War was coming to an end. There were all sorts of things going on politically and the University reflected that, and so that was made it interesting.
And Nottingham as a University was rising in its reputation because of this beautiful campus. And there’s no doubt that Nottingham campus, I travelled a lot around the country, that it must be the most attractive campus. I’ve always felt that Nottingham’s got one of the nicest campuses and the medical school was the first new one to be opened in 100 years.
So no one had really redesigned a medical course before they designed the Nottingham one. The people who designed it had taken a fresh look at how to teach people to become doctors and the design of the course was revolutionary. That’s really why I came here. I was excited by the design of their educational platform. And the teachers enthused you for the educational experience. And that’s carried on. I am an enthusiastic educator, because of that start. They made me think about my education. They made me think about how you could train people to become doctors. They gave me a structure and I’ve continued using that structure through my career and I write about the themes as the cell, man, community and professional development.
There was also research and then there was clinical training. And they trained us in in not only in how to not only in about the medicines and the science, but also how to communicate. And that’s at the time wasn’t very common in medical schools.
What was it like choosing to do a course at a medical school that hadn’t actually been built yet?
It was a bit of a shot in the dark ‘because the medical school actually was three years late in opening and so when we arrived at the Queen’s Medical Centre, it was just scaffolding over the other side of the road with bits of building going on. In fact, I never was a student in the medical school. I did the whole of my medical course and it opened the year after I graduated, so it was actually six years late opening.
Apparently the problem was that they couldn’t get a planning permission to do with the ring road where the A52 crosses. There was a big local planning argument and they couldn’t start the project until they got the permission, and so the whole thing was delayed. And you know, in the 1960s and 70s projects ran late quite routinely because of building standards and the way people worked there was based on unions and they’d regularly go on strike because of all the political turmoil at the time. It wasn’t a straightforward thing.
What is your most vivid memory of being a student at Nottingham?
We became very good friends, we were a very cohesive year, we were very social. I was also part of the rugby team. A lot of my friends were focused on that and that was thought to be traditional. We did some journeys as a rugby team, we went to Ireland to play rugby and they came to us. That was fairly memorable. A certain amount of beer was drunk but I wouldn’t like to confess the precise amount, and I think those were high points I think, the warmth of relationships with the people, with the team teaching us and working with us.
I think the other thing from the training point of view, in retrospect, the opportunity to get involved in a research project has been quite instrumental in the way I’ve thought about my own professional career.
It’s funny I did some work with one of the Physiology professors called Tony Birmingham and he was a specialist in pharmacology and drug action. My project was to infuse a drug into the lachrymal sacs of the eye to control the pressure inside the eye called intraocular pressure, and it was a randomised trial where I treated half the patients with a drug and the other half with a placebo. Running this infusion, I measured the pressure in the eye using a thing called a Goldmann applanation tonometer. We showed that the infusion was as successful at controlling a rise in pressure in the eye as a drop. And therefore could be used as a technique going forward. It was really quite exciting as a student doing a project like that. There were a lot of skills I had to learn like how to talk to patients, how to measure pressure in the eye, how to run an infusion system, how to collect the data and analyse it in the model and how to write it all up. It was subsequently published in two papers. And this, in retrospect, was all about delivering drugs to the eye, and the eye is the bit of the brain you can see. And then I became a children’s brain tumour specialist.
And so 30 years later, we were trying to think how drugs could work better in the brain because very few drugs get into the brain. And I’m running a consortium at the moment. It’s half a million pound consortium funded by a charity to investigate the delivery of drugs to the brain. Who could have thought in 1975 that that little bit of experimental work could be the background to me coordinating an awareness program to raise the priority to study drug delivery to the brain many years later? So that was that’s quite a notable thing from the academic point of view.
What is something you’ve found out in your career that you didn’t expect?
Childhood cancer is actually not rare. People think it’s very rare, but actually it’s quite common. And every children’s hospital has got at least one, if not two wards full of children being treated for cancer.
So it’s not rare it’s happening all the time, it’s just each individual disease is quite rare, but when you lump them altogether it’s not. Actually your risk of getting cancer by the age of one‘s 1 in 4000, by the time you’re five it’s 1 in 800. By the time your ten it’s 1 in 650. By the time you’re fifteen it’s 1 in 450, by the time you’re eighteen it’s 1 in 300, and by the time you’re twenty-one it’s 1 in 200. So actually, the risk for a child getting cancer is not small, it’s actually very significant. It’s ‘aren’t we lucky we haven’t had it as a child.’
One of the big things I’ve done is raise awareness about childhood cancer nationally and internationally, particularly around accelerating diagnosis. Getting more awareness of childhood cancer out there can only be a good thing.
What would you say to someone who is just starting out on their journey to become a doctor?
I’ve had a great career. I’ve met loads of really interesting people. I’ve travelled the world. I have worked extremely hard. I’ve been very fortunate in having a family who supported me very strongly. My parents, my brother, my wife. It’s been a family event. And for me, I’ve enjoyed establishing good quality relationships with the people I work with and the people I’ve lived with. All of that is the basis of having a comfortable career in Medicine because it’s it is challenging to be a doctor.
As a school leaver? You’ve got to realize that this is a journey of growth and development and you’ve got to build your relationships and be comfortable in yourself if you’re going to be comfortable as a doctor. The quality of your relationships are, I think, very important for that. And if you’re graduate entry, you need to be realistic about what this transition will do to you. It will definitely change your relationships with people around about you. You’ll become a different person because becoming a professional is changing from being a layperson to a professional. And that means you have a set of facts and knowledge and understanding that gives you a professional view on everything in the world, because medicine is all pervasive.
Any final reflections on your career?
The most important thing in my career has been the quality of the relationships my patients. I work with very ill children and their families and they were deeply inspiring and relentlessly positive whatever happened. It was a privilege.
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