Australian Biography

Donald Metcalf - full interview transcript

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You described how, when you were a little boy, you used to watch the military parades and the planes going over in wartime. Did that affect you later?

It affected me during the war because as a high school boy, just like Hitler Youth, you envisaged the possibility that if we got invaded, you could be in the army fighting. So I learnt how to shoot, how to blow down trees with dynamite and [it] was very much on my mind, much more than schoolwork, so I could identify all the planes that people used, all the tanks and weapons and ... and so I think that carried on. Then as I got older and the war finished, the first flood of books were about World War 2, and then slowly you evolve into military history per se, like the Napoleonic wars or the, you know, the battles at sea. I've always had that part of my mind that was interested in it. Now you shouldn't, as a doctor, you shouldn't be fascinated by killing and fighting but ... but you do. So my favourite wars are the Punic Wars, between the Carthaginians and the Romans.

As an adolescent boy you were interested in this. Were you looking forward to the possibility that you could join in the battle or were you ... ?

Not really, I was determined to do whatever I could but it was not a good time, it was a patriotic time, it was pretty desperate, 1941. So, that was a phase and later on it was just interest. And they're still interesting. I sort of have two things I read — detective stories of an unusual type and military history — and the book I'm reading at the moment combines both of them, oddly, Thieves of Baghdad, which is a story of a US marine, who's a lawyer, tracking down who stole all the artefacts out of the Baghdad Museum. It's a good book so far.

Is the detective story interest part of the investigative mind that brings ... that you bring to the bench?

I don't know, I don't worry about who did it. What I enjoy is reading writing that is elegant and says everything in ... in a line or two. So authors like Nicholas Freeling, who wrote the Van Der Valk series, or the Henri Castang series, just had a way of describing people in Holland ... or in France is it? And elegant writing. Who did what? It doesn't worry me. Now the thing about me is I have a very poor memory and I can re-read one of those books a couple of weeks later and not realise that I have read it, so I can enjoy it again, I know the author's good, I know I will enjoy it and I read it again, still don't know who did it. So it's not that sort of detective story.

You've mentioned your poor memory a few times. Seeing as you mentioned it again, can I ask you, if you have a poor memory, how do you deal with the fact — does that come into play — when you're looking down the microscope and wondering if things are different than what you've seen before?

It does and I think I've had four episodes now where I have noticed something strange, a new phenomenon, I've deliberately set up experiments to repeat it and been able to repeat it, so big excitement, new discovery, worked my way through the whole thing, got to the point of being able to write the scientific paper and then realised I'd done all that before. And had no memory of it, there was the paper written, maybe five years ago. Now, I can only imagine that all of us think in a circular manner and so I wonder whether ... everyone else has this ability to say, ‘Hang on a minute, I've done that. Stop.’ And I can't do that. So I think, ‘Oh great idea. Let's do it and yes I can repeat it, yes it's true.’ So that's a bit disconcerting that, that poor memory.

Most people's memories get worse as they get older, maybe yours will get better?

Um, couldn't ... couldn't get much worse. No, in general you can remember things that matter. Arguments you've had with fellow scientists. Disasters you've had with papers that got rejected. Things that turned out to be wrong. And you remember all those things.

Can I ask you, at the ... what you were doing when the war ended?

I'd just finished high school. The war ended in the Pacific in August, September, '45, and that was, you know, November I'd finished high school for the second time. So I was getting ready to be a medical student.

You told us how you remembered the start of the war with the Menzies announcement on the radio. What do you remember about the end of the war?

I remember the celebrations, we were in Tamworth, so the main street in Tamworth, which I think is Peel Street, was just full of people, driving up and down. Ah, yeah, same everywhere. Do I remember the next day? Yeah, all of those things are going on, you remember troop trains full of people with yellow faces because they'd had Atebrin tablets for malaria and so on, but that was daily life. It did have an impact in country towns. Either people you knew were in the army or troop trains were going through, convoys were going through, or in Tamworth there was a base where you got trained to fly, so you couldn't avoid it.

Your father didn't go to the war?

No, he was in a protected occupation, being a teacher. My grandfather was a professional soldier, he was at Gallipoli and in France and he was then, even during peacetime, in the army.

You also described to us the effect that it had, having parents who were so interested in education, and that that meant that they were very concerned about whether you were focusing on your schoolwork. Did it spill over into everyday life at home? Did you ... were there ways in which they took care of your education around the place?

There were occasions where I was struggling with a particular subject and they would round up somebody to help me with it. Um, or if they could do it, they would help. I don't remember being set rigorous times, ‘You will now do your homework between 4 o'clock and 6 o'clock.’ These were simple times, you know, we had a radio, by then. And there were programs on the radio, I suppose, that I listened to at about 5 or 6 but I don't remember a set time where I had to do homework, it wasn't rigidly laid down like we did with our kids.

What about your father's education himself? You said he was always educating himself. Did that spill over into the way that he communicated with you?

Ah, sort of. He was doing a Bachelor of Arts through Melbourne University and to do that you had to go to Canberra each year to do your exams because Canberra was a branch of the Melbourne University then. So he used to memorise things by having them printed on cards in the cow bail, as he was milking the cows. Ah, he'd be reeling off quotations that he was planning to use in his essays in the exams.

Did you have chores around the place? Were you there in the cow house with him?

Oh yes. Yes, all kids had chores in the country, I had to collect the cows, when we lived in Wallerawang, our cows were let loose in the golf links, I had to round them up each night from the golf links, we had a couple of hundred chooks that we had to feed and, yeah, there were jobs, wood to collect, we collected our coal for our fires from the railway line that ran out the back of us from the collieries, all sorts of jobs. And then ... then, you know, later on, jobs as a shop assistant at weekends and Christmas time at the local shop, and working in the local factories, I made all the dehydrated potatoes for Europe, for UNRA [United Nations Refugee Agency], at a factory in Tamworth. It was a great boring job, soldering the lids onto the cans of dehydrated potato. Every summertime there was a job of some sort or other.

When was the first time you looked down a microscope?

In ... probably in first year university. Probably at a specimen of plant leaves in botany.

Not at high school?

No. There were no microscopes at high school. No. There's nothing, Bunsen burners, retorts, remember.

Looking down the microscope, at that botany specimen, did you have any idea how many hours of the rest of your life ... ?

No. No, I didn't. But the specimens were great. I think they were onion leaves or something. Plant cells are marvellously regular, solid walls and line up in rows, looked great. I like patterns.

So from that moment you thought looking down a microscope was a good idea?

Don't remember that. I was too intent on trying to pass botany and get the hell out of it.

Leaping ahead, to when you decided to try for the Carden Fellowship, at that time that you applied for that, were there other applicants?

I don't ... I don't know, to be quite honest, I think ... rather think not, I think I'd been rounded up as a possible candidate, they were getting desperate to find somebody and I was it or they were going back to the drawing board I think. So I was doing a surgical residency then with the worst surgeon at Prince Alfred. And they chose residents with enough mental toughness to be able to put up with his terror tactics. He would electrocute you when you were doing the operation because the gloves were thin and he'd put the diathermy on you if you were a bit slow and he'd — thoo! Your hand would flick back. So it was in the middle of a chest operation when a nurse came in with a telegram saying that I'd been offered that fellowship. So that was dramatic. I told him to get stuffed, actually. The surgeon. Everyone backed back in the operating theatre. I thought, if this is cancer research, it's good.

What did you say to him?

I'd just had enough of him bullying me. The odd thing was he didn't behave as a bully in private hospitals, it was just at Prince Alfred, just unspeakable. He's dead now, I hope. Won't mention his name.

How did he react to your telling him?

Quietly. I think it was the first time anyone had fought back with him. But I just said, ‘I have another job and I don't give a damn what you do or say. Good afternoon.’ The specialists now are totally different but surgeons in those days were God. You know, you could have a patient opened up and the wrong instruments were out so they'd just walk off, have a cup of tea. Leaving the patient wide open, I don't think that happens any more, there are no prima donnas. Maybe there are. Life was tough then.

During this period that you were doing your clinical work and you were dealing with patients yourself, how did you get on with that? How did you like that interaction?

I thought ... I quite liked it. I think we were so badly trained that by the time we were residents we were pretty incompetent and dangerous. And depended on the senior resident, the one that was a year ahead, to sort of hold your hand and keep you out of trouble. But that aside, patients were fine. They were interesting people.

How was your bedside manner?

I've no idea. Quite good I think.

I'm interested in whether or not you found the idea of interacting with patients less appealing than the idea of interacting with a microscope?

No, I quite liked patients and I ... because of working in all sorts of strange jobs during a studentship I, you know, was familiar with most people, and having a class of people who ranged in age from 60 to under 20, all sorts of different backgrounds, interacting with all sorts of people didn't worry me at all. I enjoyed that. And that's a bit unusual, because I keep asking all my medical graduates who are starting off in research, ‘Is this what you really want to do or would you rather work with patients?’ And almost all of them will say, ‘I want to work with patients, I can't stand this.’ So it's unusual to find somebody who's quite happy to be doing both. Now, you know, being a doctor for patients isn't all beer and skittles, there's some pretty horrible jobs you have to do, but no, I used to quite like it. What I didn't look forward to is spending my life doing, say, gastroenterology or doing gynaecology, I thought this ... this was ... would be terrible to be doing this day after day, taking out appendices, taking out appendices, next day, next day, next day. So that's why I thought, if I'm going to stay in clinical work, I actually want to go into the haematology department, the blood disease department. Because it was more interesting. I don't think it was running away from patients, it was just that I couldn't brook the idea of taking out appendices, day after day. This was terrible, I thought. Ah, was I right? I don't know. But I sense that this does happen and that's why a lot of surgeons stop working in the late 40s, 50s, they ... it's repetitive and it's a bit boring. Or else they made a lot of money.

When you went down to start work at the Hall Institute, and you were sort of contracted as the Carden Fellow, what ... what were you ... what did you ... what was on the contract, what did you agree to do as a Carden Fellow?

I've never looked but it's cancer research, that's the name of the fellowship, Carden Fellow in Cancer Research.

Let me just remind you, you did say in one other interview that you signed on to something to find a cure for cancer?

I think they asked me.

Okay, I'll ask you that again.

They asked me, I'm sure during the interview, they asked me what particular sort of cancer research did I want to do, and I certainly wanted to work on leukaemia. Why? Because it was a blood disease and interesting. Why? Because nobody ever survived with leukaemia. It's a good job to try and tackle. Um, now all young people start research with an idea of curing something and I was no different so I most certainly would have said, I want to cure cancer. Ah, but everyone I interview now when pressed will say the same thing. It's only a year or two later, you see ... begin to realise, this is ... it's a little bit tougher than this. Um, a lot of people in our institute aren't medical by training and they don't have this attitude at all. They really do it, they say, because of curiosity, they want to understand how the body works, how the cells work and this is worrying to us because it means they don't really think about patients with diseases and there's a new term now, translational research, which is supposed to take laboratory research to the clinic. And that sort of person is supposed to work and think all the time, ‘What about Mrs Jones? Is this, what I'm doing, going to help her in that disease?’ And my view is that everything ... everybody in the building should be thinking the same way, there shouldn't be any such thing as translational research. It's what everyone should be doing, you're not there for your own entertainment and you're not there to figure out how butterflies work, that's going on somewhere else, you're there to figure out disease and to fix it, prevent it if possible. I'm almost sure I would have said that right at the beginning. It's not such a strange thing to say. I wouldn't hire anyone who said, ‘I want to do cancer research because I'm interested in the way a cancer cell works.’ I say, ‘Good for you but go and do it somewhere else.’

So in finding ... do you think there ever will be a cure for cancer?

There are cures right now. For you've got to remember cancer is a hundred different diseases, they all have different causes and some, like skin cancer, you could be sued if you can't cure it, some, like cancer of the pancreas, where there's no cure, and so you've got a whole range and in the middle are things like, let's say cancer of the uterus, where yes, you ... if medicine's good and surveillance is good, you can cure most of them. So, the answer becomes complicated, and in the case of leukaemia, some sorts of leukaemia, you could just about say are curable, period. If you can't do it you haven't done your job properly and in other cases, you say, well, we haven't got a cure for that. So will it get better? Yes it will. Which one will improve? I can't tell you that. But some will and it's creep, creep, creep up.

What about the causes, how close ... how much closer are we to finding out about what causes cancers?

Yeah, that worries me. It worries me because the molecular biologists for more and more cancers are saying, ‘These cells are cancerous because they've got this mutation and that gene is wrong and that gene's wrong.’ And, you know, you couldn't possibly fix that cell, you can't get in there with your little fingers and fix that gene and that gene and that gene. So you say, ‘How did this happen?’ And they say, ‘Well, the body makes mistakes every time a cell divides, it's got to duplicate every one of those 30,000 genes and they just make spelling mistakes.’ Now there are mechanisms that go up and down the gene that say, ‘Whoops, you've got an A there and you should have a T, correct it.’ And it does that. But no mechanism's perfect. So it's quite common, one in a thousand cells will be ... have some wrong spelling in the genes. Is that a cancer cell? Well, sometimes it is. Now you say, ‘Well, if it's just inevitable you make mistakes, the cells make mistakes, cancer's inevitable.’ That's what Burnet said, that's correct. And if that's true we can't prevent cancer. And that's what, as doctors, we are supposed to be trying to do, prevent people getting cancer. And that's a very gloomy way to argue and the conclusion says, it's ... life's not going to change. Every day, new patients will come into hospital with cancer, can't we do anything about it? Then you've got the people who say, ‘Listen, all those cancers due to cigarette smoking, you can stop cigarette smoking, you can stop getting lung cancer.’ That's true. All of the cancers of the bowel are basically because we're eating cooked food and when we cook the food we make these chemicals that cause cancer. Let's not eat any cooked food any more. Well, there are some people who can do that, most of us can't. So that's a half-and-half one. What about the melanoma and the skin cancers? Do we have to go out and get brown in the sun? Well, we don't, we like to but we don't have to, so you could prevent that. But then you've got a whole bunch of other cancers where we haven't got the faintest idea why the cancer comes, and no notion of whether you can do anything to stop it. And so the answer's a mixed one, the answer in one line of arguing says, ‘Look it's inevitable, cells have to divide, they're going to make mistakes, the surveillance mechanisms aren't perfect.’ You're in trouble. And the older you are, the more mistakes you get so cancer's commoner when you get older.

It's logical and it's correct and the other people who say, ‘Well no, there are all these outside causes that make that more ... happen more often and more quickly, let's stop those causes.’ And they're true too. So the answer maybe is if we're very smart, we could prevent all cancer until the age of 150. But then they'll happen. Now if we live to 150, we've done our job, perfect prevention of cancer, no more of us will ever get cancer. Now that's possible. So it's a complex answer, isn't it? You ... you have to keep trying to figure out what are the things that make mistakes more often? Happen more often? Are there such things and the answer probably is, yes. And can we eliminate them and still live a normal life? Some of them anyway and if we live to be 150, tough luck, we'll probably get a mistake and get a cancer. That's my view of it.

Do you think we'll ever be able to live to 150?

Do I feel that? I don't know. Maybe we can. Maybe we can.

Would you want to?

That's one of life's tough questions, isn't it? I always feel that the Almighty was a bit unfair to us by giving us awareness of our mortality and giving us mortality too. So you sort of ... you have a desire to live for an infinite time and you have to accept the fact that you're not going to and that ... that's a tough set of asks. So if somebody says, ‘Well I can't stand the stress of that, I'm going to smoke to ease the stress.’ I can't say, no that's ... that's stupid. It is a bad scenario that humans have consciousness and mortality. We're getting rather gloomy.

Well, I suppose we can't ever really talk about a life without talking attitudes to mortality. I wonder what you ... what you think about that. You said, the Almighty made a mistake, do you think that? Do you have any conviction that there might be a life after this one?

I'd like to think so but I'm not ... not overly convinced by the evidence. None of us are. What you can ask yourself from time to time, if you ever stop working and start thinking about what you're doing or what you think you're doing, is why bother? Why bother to cure Mrs Smith's cancer of the breast? She's 75, she's going to die anyway, why not just die of that? That is an argument. If you ... if you have a finite lifespan does it much matter? Now, there are some ways of dying that are pretty nasty and you'd want to avoid that if you could, but if you died of a sudden heart attack, that's probably a nice way to go. So would you do cardiological research and the answer usually you come up with is, well, if you're 85 or 90 there isn't much point in trying to find out the nature of that disease. But if the same disease happens in a 35-year-old or a 25-year-old, that's a reason for trying to figure it out and prevent it. So I think that's the way medical research workers sort of convince themselves that, yes, it is worthwhile to attack diseases, try to find what their cause is, prevent them, even though we're all going to die. So the argument is, let's think about the children, let's think about the young adults, let's think about the middle-aged adults and solve their problems, and when you get to be 95 and you've got problems, you say, ‘Well I've had a good innings.’ Because inevitably you ... we're not magicians and we can't actually make people live to 150 yet, maybe we can one day.

What are your own thoughts about your own death?

I don't have any. I don't have any. It's going to happen. My colleagues say I will be found dead working at the microscope and they're going to embalm me and just have me there as a permanent ... permanent warning, I think. No, it doesn't do to dwell on such matters, I think. Basically it's an insufferable position to have to have consciousness and mortality. That's my view. But we put up with it.

You said you were brought up Presbyterian, and that your wife's of a different religion. Do you practice any religion at all, yourself?

No. No. I find that religion's a little bit curious. I think that children should be taught religion. I find it curious that you are expected to have the same religion as your parents, because it's not a genetic trait. There's no reason on earth if your parent is a Catholic, why you should be a Catholic. That's not biological sense. But that's the way it goes, so you're brought up in a family ... with a particular religion and my figuring is, well, okay, you've got to learn about the basic facts and basic ways to behave and the moral standards expected of humans, but once you've learnt them why do you have to be told that once a week for life? Once you've got it straight? That's it, you don't get taught to ride a bike every week for life; once you've learnt to ride the bike, that's it. So, I am afraid that I regard the religious establishments as being sort of self-sustaining things that are really concerned about their own survival and progress. So, why take part? Now, if I knew nothing about it, I would sit down and start reading and figuring it out, I think, and reaching my own conclusion about it. So, you could say, well, you're not anti-religion, you just figure that once you've learnt it and heard all the arguments, ah, just that's it.

Some scientists believe in God and others say it's completely irrational and there's no evidence. Where do you sit in that debate?

I don't get into that debate, I haven't ... that's one of those things that if it amuses you to argue about that, that's fine. There are lots of things you can argue about and speculate about if you have a mind to it. What would happen if the Prussians hadn't arrived at Waterloo in time? Same thing.

And one you find more interesting?

One I know a little bit about because it happened.

You've lived through quite a long period of history and seen a lot of changes in that time. Can I ask you about the changes that occurred in the way research in medical science is conducted since you began in the '50s?

I think if you walked into a lab in the '50s, and walked into one now, the most obvious thing you'd see is a great increase in technology. You'd be surrounded by complicated looking electronic pieces of equipment, you'd see people looking at television monitors and 50 years ago you would have seen people working with a pipette and a test tube and Bunsen burner and perhaps a fertilised egg. So they're the obvious things. Now, what's not so obvious is that 50 years ago, you would do your experiments, probably by yourself. According to your training, that's the sort of experiment you'd be doing. Nowadays you work in teams and there might be 10 people in a team for this project or 30 people and all the little pieces of the jigsaw are being collected by them and it fits together into a more substantial story. So the jobs being tackled are a lot more complicated and they need a lot more manpower and they need a lot more technology. But are they the same sort of questions? Well, in general they are, it's not that you're asking different questions, it's now you've got a power to answer some of them and if you're sensible you realise that you're getting yourself in deeper and deeper water that you don't understand and there's plenty left to discover but ... so that's ... it's more complicated. Interestingly, things change that you wouldn't expect. When I first started to go to medical meetings, if you disagreed with somebody, you stood up and said, you know, ‘What you said's wrong.’ If you were a bit more aggressive, you'd say, ‘You're a liar, I don't believe that.’ And an enormous fight would start in the audience. I've seen people drop dead during these confrontations and just be dragged out by the feet and it goes on. There was real passion in science. You go to a meeting now and nobody will get up and say boo. So I was at ... in San Diego giving a lecture to 9,500 people, 9,500 people in one room. And did anyone stand up and say, ‘I don't believe the second slide you showed us. That's not right.’ Well, why doesn't this happen? Well it ... at my figuring is that it doesn't happen because you can't destroy somebody publicly, because there are too many people in that group whose livelihoods depend on the reputation of that person and their ability to get funds. So you're destroying the lives of 10 or 20 people by destroying them. I think that's why it's happening but that's something you'll notice. If you go to a medical meeting now, there is no nastiness, nobody gets up and says, ‘I don't believe that, that is the greatest bunch of rubbish I've ever heard.’ But you did 50 years ago.

Is there value lost in losing that?

The excitement's lost. There used to be some pretty ... I mean, 50 years ago, in my field there were maybe 50 or at most 100 people working and you knew them all, you knew he was a wild man from Poland and don't cross him or he'll ... he'll do his block or you know he's ... he's a smoothy from England. Um, and now, you probably know as many people but you have to realise there are 10,000 people in that field or could be regarded as being in that field. So you don't know them all. And you have your immediate colleagues, you have your friends amongst them and the others are unknowns. So it's become a little more remote, it's not possible ... it's no longer a family affair. And that, I regret that a little bit. I don't mind it, I don't much care what other people are doing or saying. So, the meetings go on and, ah, I go on.

[end of tape]

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