Transcript: Episode One - On the Origins of the MSc: Standing on the Shoulders of Giants
00:00:00:00 - 00:00:15:10
Speaker 1 - Dr. Gary Kerr
Hello and welcome to the Medical Genetics and Genomics podcast from the University of Glasgow.
00:00:15:12 - 00:00:47:03
Speaker 1 - Dr. Gary Kerr
I'm Dr. Gary Kerr, and I'm an alumni of the Medical Genetics master's program at the University of Glasgow. And I'm joined today by Dr. Douglas Wilcox. Now, before retirement, Dr. Wilcox was senior lecturer and honorary consultant in medical genetics at the University of Glasgow, where he was the director of the master’s in Medical Genetics program. Dr. Wilcox was also Director of Education at the Yorkhill Division of Greater Glasgow and Clyde Health board, and the lead clinician at the Scottish Muscle Network.
00:00:47:05 - 00:00:49:19
Speaker 1 - Dr. Gary Kerr
Douglas Wilcox, hello and welcome!
And you're still friends today with Professor Malcolm?
00:00:49:21 - 00:00:57:04
Speaker 2 - Dr. Douglas Wilcox
Thank you very much, Gary. It's great to be back, although, obviously, the surroundings have changed a little bit since I was last at the university.
00:00:57:08 - 00:01:04:12
Speaker 1 - Dr. Gary Kerr
Absolutely, yeah. It's a very different campus to what it was, certainly, when I was here. How does it feel to be back at the university?
00:01:04:14 - 00:01:25:16
Speaker 2 - Dr. Douglas Wilcox
Well, it's not the first time I've been back. Recently, I volunteered to take part in research for falls in the elderly, and I've several times visited the old physiology building. But it hadn't changed at all since I was here as a student in the 1970s. Whereas, I hardly recognize this part of the university at all.
00:01:25:18 - 00:01:43:03
Speaker 1 - Dr. Gary Kerr
Yeah, it's looking amazing, the university just now, and it's almost unrecognizable from what it was back in the day. Douglas let's go back to 1979. [Dr Douglas Wilcox: Yes.] You graduated with your medicine degree. What inspired you to go into medical genetics?
00:01:43:05 - 00:02:12:04
Speaker 2 - Dr. Douglas Wilcox
I think it was probably in first year. Professor Malcolm Ferguson-Smith, who was head of genetics in Glasgow at that time, gave some very inspiring lectures and I just knew that that was what I wanted to do. So, I dropped out of medicine at the end of second year, and I did a two-year intercalated BSc in genetics, and that included Aspergillus and mice, and you name it.
00:02:12:06 - 00:02:41:04
Speaker 2 - Dr. Douglas Wilcox
And I thoroughly enjoyed it. Absolutely! It just got me. And it was just at that point where restriction enzymes had been discovered. So, I knew there was going to be a future and being able to analyse DNA using these things. And it was just such a coincidence in some ways, that I had been at the university at the time that Professor Ferguson-Smith was giving that lecture -
00:02:41:04 - 00:02:43:09
Speaker 2 - Dr. Douglas Wilcox
And that's definitely what set me off.
00:02:43:11 - 00:02:46:01
Speaker 1 - Dr. Gary Kerr
00:02:46:04 - 00:02:59:20
Speaker 2 - Dr. Douglas Wilcox
Oh, yes, I in fact - I sent my congratulations to himself and his wife, who celebrated their wedding anniversary yesterday. We're friends on Facebook and we occasionally have a long phone call as well.
00:02:59:22 - 00:03:12:00
Speaker 1 - Dr. Gary Kerr
Fantastic! Professor Malcolm Ferguson-Smith’s obviously one of the big names in medical genetics. I was very familiar with the name and the person when I was studying medical genetics. What impact has he had on your life?
00:03:12:04 - 00:03:39:17
Speaker 2 - Dr. Douglas Wilcox
Oh, a huge impact. Basically, I was standing on the shoulder of a giant, I mean, Professor Ferguson-Smith and other people of those years, like Professor John Edwards from Oxford, too many to go through, but they truly were giants who created a subject. And even although there was no career for a doctor in medical genetics at that time, remember, Professor Ferguson-Smith was a pathologist.
00:03:39:19 - 00:03:54:15
Speaker 2 - Dr. Douglas Wilcox
Malcolm said, “Don't worry, don't worry. I will make sure you're alright. Just come into genetics. I know you want to be a doctor rather than a scientist, but”, he said, “that's not a problem. Just trust me.” And I trusted him and it all worked out.
00:03:54:15 - 00:04:12:03
Speaker 1 - Dr. Gary Kerr
Fantastic! It’s great to have those role models and mentors in our lives. From the early days of your career, Dr. Wilcox, you were involved with clinical research in Duchenne muscular dystrophy, and also on lab research on the topic too. Where does your interest in muscular dystrophy stem from?
00:04:12:07 - 00:04:44:00
Speaker 2 - Dr. Douglas Wilcox
It came from, in particular, one day in accident & emergency, which literally was situated where this table is now at the Western Infirmary. And it was late at night, and this young lad, about 14 or 15, was rushed down, and he was basically in a state of respiratory arrest, and I managed to intubate him and get him ventilated with what's called an Ambu bag, someone else was working on his heart.
And to balance all of those things, you know, you must be quite an organized person to be able to, you know, find the time and to manage such a complicated diary.
00:04:44:00 - 00:05:19:10
Speaker 2 - Dr. Douglas Wilcox
We got him resuscitated for a few minutes, but ultimately, he died. And one of the things I noticed was that there was nothing of him, he was just skin and bone, no muscles. And I had to go and break the news to his mother. And basically, there were tears in my eyes. I mean, as a doctor, you can't divorce yourself from the terrible tragedies that befall. The lady was such a clearly loving lady, and she was holding her son in her arms, her dead son now.
00:05:19:12 - 00:05:50:03
Speaker 2 - Dr. Douglas Wilcox
And she said, “Don't worry, doctor, I know that you did everything you could. I've been expecting this for so long. He's got muscular dystrophy, and it was the Duchenne form.” And I just knew that point, “Well, that’s such a terrible thing to have happened. I wonder if I could do something to try and make things better.” And so, I spent my whole career with a prime interest in the muscular dystrophies.
00:05:50:03 - 00:06:05:23
Speaker 1 - Dr. Gary Kerr
It’s such a sad story but thank you for sharing it with us. Over the years you must have come across many similar situations and interacted with many patients with muscular dystrophies and their families as well. What sort of impact is that had on your life?
00:06:05:24 - 00:06:39:07
Speaker 2 - Dr. Douglas Wilcox
It's very rewarding to be able to make a difference, and some of the most remarkable things were when we first started to be able to do carrier detection more accurately. The relief on the majority of young women's faces in a big family that maybe had six boys with muscular dystrophy in different generations. The relief when you told them that they were very unlikely to be a carrier.
00:06:39:09 - 00:07:09:03
Speaker 2 - Dr. Douglas Wilcox
I'm actually still in touch with some of my former patients from those days [Gary: Wow!] and it's been very, very rewarding. Obviously, it is distressing, and of course, I've known so many youngsters who have died before their time. And even now when the life expectancy of Duchenne muscular dystrophy, for example, is much greater than it was. They still die before they reach their full potential.
00:07:09:03 - 00:07:31:15
Speaker 2 - Dr. Douglas Wilcox
It's very hard in some ways, being a doctor, but you have to balance becoming too involved emotionally - and you do get emotional in the heat of the moment. But my career was so rewarding from the patient side. But of course, when I was younger, I also went into the lab as well.
00:07:31:17 - 00:07:48:03
Speaker 1 - Dr. Gary Kerr
And yes, so you did go into the lab. So, you know, not only were you a clinician, but you were, of course, a lab scientist. Can you tell us, Dr. Wilcox, about your time in the lab? You were, of course, part of the team that found the first recombinations and deletions within the Duchenne muscular dystrophy gene.
00:07:48:03 - 00:08:09:23
Speaker 2 - Dr. Douglas Wilcox
That was so exciting! I mean, it really was. I mean, this is what being in science is all about. And I started off by going out to collect patient samples and assess the patients to make sure that they really had the right conditions. And that's very important for science. You don't want to be doing research on a sample that's not the disease that you’re interested in.
00:08:09:23 - 00:08:38:02
Speaker 2 - Dr. Douglas Wilcox
Unfortunately, the person who was supposed to be doing the lab side became unwell and left. And so, I thought, “Well I can do that. I’d been watching what she was doing. I can do that as well.” Now, in those days, lab genetics was very different from what it is now. I mean, we hardly had a computer, I think, with a super brain computer.
00:08:38:03 - 00:09:11:16
Speaker 2 - Dr. Douglas Wilcox
Which was one of the very early computers, with 8.5-inch floppy disks and things like that. Anyway, we used a lot of chemicals. And because I was male, I was allocated making up some of the dangerous solutions. One of them was formamide, a chemical, causes all sorts of birth defects and things. And another one was phenol, which was used for the DNA extraction.
00:09:11:19 - 00:09:40:18
Speaker 2 - Dr. Douglas Wilcox
Formamide was used to make the hybridization mix because in those days we analysed DNA, as I said, with restriction enzymes and then ran the fragments out on a nitrocellulose filter and then used blotting paper to suck things from the nitrocellulose filter up. It was a very long, complicated business, and so we had these very dangerous chemicals.
00:09:40:18 - 00:10:08:04
Speaker 2 - Dr. Douglas Wilcox
They were kept in what's called the cold room. And it was a room with no ventilation at all. And you absolutely stank of formamide and phenol. It was... it really wasn't a great working environment. And then there was the electric shocks, because before you put the DNA fragments on to the nitrocellulose filter, you run them out on the gel, which is obviously still done now.
00:10:08:04 - 00:10:32:06
Speaker 2 - Dr. Douglas Wilcox
And so, it's a lot of high voltage floating about. These things just didn't have the safety attachments and things that they have now. And there was high speed centrifuges. And I remember one of my colleagues forgot to put the screw down on top of the rotor and it was, I think, 30,000 rpm. And I said to him, “What's this?”
00:10:32:08 - 00:10:51:06
Speaker 2 - Dr. Douglas Wilcox
It was the top of the rotor. And he looked at me and unfortunately, he hit the brake. He should just have switched it off and let it slow down. But he hit the brake, the rotor jumped off inside the thing. And this huge centrifuge, which is the size of several deep freezes, started jumping up and down all over the room.
00:10:51:08 - 00:11:15:23
Speaker 2 - Dr. Douglas Wilcox
It was a very exciting time. But equally, getting the data out and seeing the results on the gel. It was so exciting. There wasn't an hour of the day that I wasn't in the lab at some point. And I remember, one time, going down to clinical genetics meeting and I hadn't got these... it was my first deletions, and I hadn't got the gels developed yet.
00:11:16:00 - 00:11:38:15
Speaker 2 - Dr. Douglas Wilcox
And I got them out about 4 o’clock in the morning. There was no instant cameras in those days, digital, you had to do it with a sort of Polaroid camera, and make a slide from that, and I catch the plane at
5 o’clock down to London, get out to wherever it was, and then present it. So exciting!
00:11:38:17 - 00:11:55:10
Speaker 1 - Dr. Gary Kerr
Wow! It sounds amazing! And, yeah, interesting to hear about what labs were like. I can really hear the passion that comes through in your voice when you speak about your patients that you've had over the years. Can you tell me more, Douglas, about some of the challenges you might have faced working with patients?
00:11:55:10 - 00:12:33:07
Speaker 2 - Dr. Douglas Wilcox
It was very difficult, Gary. Because these were disabling conditions, and they'd obviously been in their families for several generations. I remember one family; the grandfather was a minister in the Church of Scotland. And as you came down through the generations, they had descended the social and economic scale. So, they were struggling with day-to-day life because of the enormity of trying to cope with physical and mental disability, with very little help.
00:12:33:09 - 00:13:08:03
Speaker 2 - Dr. Douglas Wilcox
And so, to ask someone in that situation to come up to a clinic to give a blood sample for research just wasn't going to happen. So, I started going out to visit them, and sometimes I would maybe just visit their GP practice and see several patients from different families or even from the same family. Sometimes I would go to a local cottage hospital, sometimes I would go to their homes and eventually ended up...
00:13:08:03 - 00:13:31:02
Speaker 2 - Dr. Douglas Wilcox
I would just go directly to their homes, and I learned a great deal about life from that, about just how hard it is for people who are born, without all the advantages in life that I’d been born with. And to see their day-to-day struggle, it just fired me up with even more determination to try and help these families.
00:13:31:04 - 00:14:02:12
Speaker 2 - Dr. Douglas Wilcox
And I couldn't afford a car at the time, so I had a motorbike, and I used to go on my motorbike. In the West of Scotland, the weather isn't great. So, I rode my motorbike, waterproof stuff on, and I would park around the corner and take it off and then ring the doorbell so they didn't necessarily have the motorbike coming to the door because I wasn't sure how that would go down. But actually, very quickly, they soon got the idea that Dr. Wilcox comes in a motorbike.
00:14:02:14 - 00:14:25:10
Speaker 2 - Dr. Douglas Wilcox
I would gather up all these blood samples from the extended family because we were doing linkage studies. So, it was a lot of blood in those days, you know, and I would need to make sure that absolutely everything was labelled properly at the time. And it's easy to do in a clinic. But in the home situation, it's much more difficult because they're more interactive when you've got someone in their own home rather than when they're a patient in the clinic.
00:14:25:10 - 00:14:50:19
Speaker 2 - Dr. Douglas Wilcox
So, I'm on their territory, so I had to make sure everything was all labelled and everything. And then how did you get them back? Well, I used Marks & Spencer's bags. And the freezer quickly filled up with Marks and Spencer's bags until we could get the DNA out.
00:14:50:19 - 00:15:14:17
Speaker 2 - Dr. Douglas Wilcox
But that did give me the ability to get more complete multi-generation families that were informative than anywhere else in the UK or the world. And that was why I was able to present 98% of the world data. It was because I had gone out and got the bloods from all the key family members.
00:14:17:19 - 00:15:40:20
Speaker 2 - Dr. Douglas Wilcox
And I could be quite tired at the end of it because emotionally, it's much harder when you're dealing with someone in their own home and it's very difficult to leave. So, I had to work late a lot of the time. You can't just dash in and out in ten minutes like you, maybe, see someone at the clinic. It's, you know, two hours was a minimum visit just for a couple of bloods.
00:15:40:20 - 00:16:29:06
Speaker 2 - Dr. Douglas Wilcox
And if there were several members of that family, more than that. You know, you're talking about an afternoon or an evening. So, it was it was very, very rewarding work. But that collection of samples that was given voluntarily for research was absolutely great. One problem I had and one problem that pushed me in to the MSc was that I when I was off with severe gastroenteritis and infection, in 1986. I was off for some time and when I came back, a former colleague had removed my best samples and taken them to North America.
00:16:29:08 - 00:16:52:20
Speaker 2 - Dr. Douglas Wilcox
And I had come back thinking, I will be able to catch up with my research because I've still got all these samples, because they were a unique resource. But again, that's life. These things happen. And if it hadn't been for that, I might never have got involved in the wonderful thing for me, in my career, which was the MSc.
00:16:52:20 - 00:17:05:12
Speaker 1 - Dr. Gary Kerr
Wonderful! And I love that story that you were turning up to patients’ houses on your motorbike, taking away the samples on Marks & Spencer's bag. You definitely sounded like you were one of the coolest doctors around in Scotland at the time.
00:17:05:16 - 00:17:24:20
Speaker 2 - Dr. Douglas Wilcox
Well, you see you've got to be very careful because most... In our community, most of the people coming to the door would be from the health and the social and they wouldn't necessarily be welcome. So, I had to, you know, make all sorts of arrangements beforehand. And it was in the days before email and social media. So, I had to be by phone call.
00:17:24:20 - 00:17:57:08
Speaker 2 - Dr. Douglas Wilcox
And they didn't necessarily have phones in those days, these families. So, you had to phone a relative and do it all. So, the organization - I had a very complicated paper diary and calendar so that it would all fit together. And then I had to do it and tie in with the research because when you were doing Southern blotting, which was a technique we used in those days, it was a very long, drawn out process and I had to be about for several things.
00:17:57:09 - 00:18:13:06
Speaker 2 - Dr. Douglas Wilcox
You had to label the probe with the tritiated thymidine at exactly the right time when it was as hot as anything, because it just arrived. So, I was manipulating all these things. It was just like a big jigsaw puzzle, but in three dimensions.
00:18:13:07 - 00:18:21:14
Speaker 1 - Dr. Gary Kerr
00:18:21:18 - 00:18:47:07
Speaker 2 - Dr. Douglas Wilcox
Indeed! And the organization, as both of you will remember from my desk, I worked on the three-dimensional filing principle. Everything on my desk was on a place, and I knew I could just pick it out. The problem was, whenever you put things into filing envelopes and put them away, that was when things got lost. Maybe very tidy, but things got out of mind.
00:18:47:09 - 00:18:54:17
Speaker 2 - Dr. Douglas Wilcox
So, three-dimensional calendar, three-dimensional filing system on the desk. Piled high.
00:18:54:19 - 00:19:10:11
Speaker 1 - Dr. Gary Kerr
A great system! If it works, it works! So, during those days, you were doing some exciting research on the DMD gene. You know, you'd found the first recombinations and deletions. What other exciting advances were being made in the world of medical genetics at that time?
00:19:10:11 - 00:19:34:14
Speaker 2 - Dr. Douglas Wilcox
Well, I'm glad you said the world of medical genetics, because it really was a world thing. I mean, there was things happening all over the world. It wasn't just here in Glasgow, and it wasn't just in the lab, it was in the clinical side as well. We’d begun to recognize genetic syndromes and even the rare ones. And then as computers were developed, people worked on databases.
00:19:34:14 - 00:20:06:08
Speaker 2 - Dr. Douglas Wilcox
I did a simple one, myself, to look at the features of a rare syndrome. And then the idea was that you could feed what features you saw on your patient, and it would match up with the different syndromes who had those features. And then, it made diagnosis even without molecular probes much better. Cytogenetics was expanding and the resolution that they were able to find things.
00:20:06:08 - 00:20:39:02
Speaker 2 - Dr. Douglas Wilcox
In fact, one of the first deletions that we found in the dystrophin gene was observed by my colleagues and the cytogenetics lab just from routine banding, not from any fancy stuff. And so, it just shows you how good the people that were in this team were. And it was a very exciting time because the probes that we were using to study DNA were also being used to label chromosomes.
00:20:39:04 - 00:21:06:19
Speaker 2 - Dr. Douglas Wilcox
And FISH was coming in and painting of chromosomes, which is an incredibly visual thing compared with running a Southern blot, which is... it's not so aesthetic. So, it was just it was fabulous! And you would come back from a meeting having made contacts and heard about new things and, “Oh, I've got some patient family DNA I could give you” and “Oh, we could... we have that probe.”
00:21:07:00 - 00:21:36:08
Speaker 2 - Dr. Douglas Wilcox
It was just that the international cooperation, it was fabulous! The only downtime I had was just that I showed through a lot of linkage recombination events that Becker muscular dystrophy, the milder form of Duchenne, was likely to be at the same locus on the short arm of the X. But all the previous studies had suggested it was down at the bottom of the X chromosome, Xq28.
00:21:36:08 - 00:22:10:06
Speaker 2 - Dr. Douglas Wilcox
And I was at a meeting in the Royal Society of London, actually, and I presented my data and this guy, who was clearly of the old school, disagreed with everything I’d presented. And I was so pleased because I was just a young rookie. I was so pleased when Professor John Edwards from Oxford stood up and he said, “I rather like Dr. Wilcox's presentation. After all, he has just presented 98% of the world data.”
00:22:10:08 - 00:22:11:09
Speaker 1 - Dr. Gary Kerr
Wow, incredible!
00:22:11:09 - 00:22:23:10
Speaker 2 - Dr. Douglas Wilcox
And that was Edwards of Edwards Syndrome. Now, I mean... And then he invited me to give the same talk at Oxford. You know, that's just how things happened. It was a whirlwind of excitement.
00:22:23:12 - 00:22:39:03
Speaker 1 - Dr. Gary Kerr
And I think, you know, one of the exciting things that was also happening is that the advances in the lab were also driving advances in the clinics as well. And Dr. Wilcox, you were the lead clinician at the Scottish Muscle network. What did this involve?
No. No, no, no. I was one of the founders of the MSc. What basically happened was Malcolm Ferguson-Smith, through his research reputation, was attracting huge numbers of inquiries about PhD studentships. And clearly, we didn't have the staff to do that. Now, I'd been teaching in the public health course, and I knew that they did a masters. And I’d suggested to Malcolm a couple of times, maybe an MSc would be a good thing.
00:22:39:05 - 00:23:17:07
Speaker 2 - Dr. Douglas Wilcox
Well, right at the beginning, I realized that muscular dystrophy was a condition that affected more than the muscles. It affected the brain, affected the heart, affected the lungs, you name it. And I realized that if we were going to make a difference, we had to have teams of doctors and therapists and other professionals, even psychologists, for example, all working together and helping the patient and the patient, and their GP couldn't possibly negotiate this in the health service.
00:23:17:09 - 00:23:44:07
Speaker 2 - Dr. Douglas Wilcox
So, partly through the work that we've done in the lab, we managed to get some funding from the Muscular Dystrophy Campaign, the main charity, and they originally wanted to fund us to set up a muscle centre in Glasgow, as they had funded in various other cities. But I knew a muscle centre in Glasgow wouldn't reach someone out in the Outer Hebrides, never mind Edinburgh.
00:23:44:09 - 00:24:17:09
Speaker 2 - Dr. Douglas Wilcox
So, I had this idea that if we could set up a network of professionals across Scotland, we could then manage to share information. So, for example, a respiratory physician in Stornoway could phone up and get advice from a respiratory physician in Edinburgh or Glasgow and find out the best way to manage without the child in a wheelchair and his family having to come all the way to Edinburgh or Glasgow.
00:24:17:09 - 00:24:37:16
Speaker 2 - Dr. Douglas Wilcox
And amazingly, it’s still running, and I retired in 2011. That's the thing I'm very, very proud of because it was something new that I created. What I was doing in the lab was really, as I say, on the shoulders of giants and colleagues. This was something I thought of myself.
00:24:37:18 - 00:25:04:08
Speaker 1 - Dr. Gary Kerr
Fantastic! It sounds like an amazing network and, you know, really positive for people living with various muscle conditions. Dr. Wilcox, I want to move on and, talk about the master's program in Medical Genetics. Of course, you were one of my teachers on the program. You've had a distinguished career, in teaching. Am I right in thinking that you set up the MSc or were you one of the first people...?
00:25:04:10 - 00:25:34:08
Speaker 2 - Dr. Douglas Wilcox
00:25:34:10 - 00:26:07:05
Speaker 2 - Dr. Douglas Wilcox
And Malcolm always saw an opportunity and the MSc was started in, I think, I can't remember exactly when. Now, it was probably about 1984. And I was in there right at the beginning and I just loved it. And straightaway, it wasn't just students from the UK, it was students from all over the world. Now, I like traveling and I like food from all over the world, so I was just in the right place.
00:26:07:07 - 00:26:46:00
Speaker 2 - Dr. Douglas Wilcox
And also, the other thing about it is it depended on so many other people in the department, university, and also health service. In a way, I was sort of being a catalyst, a wee bit, like I was with the muscle network. And bringing people in, who could contribute something which they maybe didn't think of themselves as necessarily going to make a big difference to an MSc course, but actually what they had to say was vitally important.
00:26:46:02 - 00:27:15:20
Speaker 2 - Dr. Douglas Wilcox
And I eventually took over running it after Professor Ferguson-Smith left and I went to Cambridge and Professor Mike Connor took over running the MSc. But he was very active trying to expand the NHS side of medical genetics at that time. So, he said, “Douglas, do you fancy giving that a bash?” So absolutely!
00:27:15:22 - 00:27:24:24
Speaker 2 - Dr. Douglas Wilcox
I didn't need a second invite. So, there we go. It’s all in the past, but I'm glad to see it still running, like the muscle network.
00:27:24:24 - 00:27:29:19
Speaker 1 - Dr. Gary Kerr
Indeed, indeed, it is still running. What did you enjoy the most about your teaching days?
00:27:29:20 - 00:28:00:20
Speaker 2 - Dr. Douglas Wilcox
Well, I've always enjoyed teaching, and in fact I was a teacher even before I came to the university. I was an assistant Scout leader. I also, once I started university, I was in a summer job with the National Trust as a Ranger naturalist, and I was teaching members of the public about natural history. And then obviously when I started working in medicine, you know, in those days, see one, do one, teach one... That's one that has improved again.
00:28:00:22 - 00:28:44:07
Speaker 2 - Dr. Douglas Wilcox
And so, I was involved in teaching younger doctors than myself, and I just loved the interaction of seeing someone finally understanding something that’s quite difficult, or seeing someone suddenly realizing their preconception of a problem was only from a very focused viewpoint. And there were so many other ways that you could look at the problem. And that's why the international nature of the MSc, I think was so fantastic, because you could see people from all sorts of different countries and cultures and religions, you name it, and diets.
00:28:44:09 - 00:28:56:22
Speaker 2 - Dr. Douglas Wilcox
It was just a very, very positive experience seeing people being able to use that knowledge. It was just so, so rewarding.
00:28:56:24 - 00:29:17:01
Speaker 1 - Dr. Gary Kerr
And I remember from my days in medical genetics, and it was a very international class. And I know that yourself and the team around you had organized some sort of international events for us to...
And kindness was definitely something which, for me, shone through on the course from everyone who taught in the course, you know, and I think, you know, the medical genetics course and the team around that course at that time, I'm sure still today, you know, really are an example to other masters programs.
Speaker 2 - Dr. Douglas Wilcox
With food!
Speaker 1 - Dr. Gary Kerr
With food! You know, food was a central element of it. And it was great to try all of these new foods and to share cultures and break bread with people, you know, from different countries and cultures.
00:29:17:05 - 00:29:40:20
Speaker 1 - Dr. Gary Kerr
And for me, you know, that was, you know, a great part of the MSc program. One of the things that I did, Dr. Wilcox, as I was preparing today, was dig out my own notes from my days from the course of 15, 16 years ago, whenever it was that, that I graduated and I came across my clinical genetics folder, which was a class where you taught us every Wednesday morning.
00:29:40:20 - 00:29:43:11
Speaker 2 - Dr. Douglas Wilcox
Wednesday morning, my favourite day of the week!
00:29:43:13 - 00:29:59:16
Speaker 1 - Dr. Gary Kerr
And, you know, it touched on, you know, what you said there about, you know, sometimes, you know, for me, it was in those classes, the that the penny dropped. So, I'm looking at my old notes on introductory Baye’s examples and I think, you know, it was in those classes that I was able to do it and to make those calculations.
00:29:59:22 - 00:30:02:20
Speaker 1 - Dr. Gary Kerr
Can you tell us about those Wednesday morning classes?
00:30:02:22 - 00:30:32:10
Speaker 2 - Dr. Douglas Wilcox
It was something I started right at the beginning. We had all sat down and said, “Well, we need to put this subject in, this subject in, this subject in...” and I said, “But what we need is something to link all this together.” And I said, “What about if I just bring a couple of case notes from the clinic? Different subject every week”, and I would just tackle that, and we can talk about cytogenetics.
00:30:32:10 - 00:30:57:20
Speaker 2 - Dr. Douglas Wilcox
we talk about molecular genetics; we can talk about clinical genetics. And it sort of brings all the loose ends of genetics together into one. And it was a wee bit like, again, the muscle network sort of multi-disciplinary thing. And it just latched. As I was working with them, not just teaching, but in the clinics and also in the lab as well.
00:30:57:20 - 00:31:05:06
Speaker 2 - Dr. Douglas Wilcox
So, I was boiled. I mean, it was such a wonderful environment to work in. It really was.
00:31:05:08 - 00:31:12:03
Speaker 1 - Dr. Gary Kerr
What do you think made that great culture in the medical genetics department? You know, down at the Duncan Guthrie Institute.
00:31:12:03 - 00:31:48:23
Speaker 2 - Dr. Douglas Wilcox
I mean, when the department started, the only thing that was medical genetics was one of these old-fashioned towel dispensers in a toilet with a roll of cloth that goes round and round, and that was the first thing that was labelled medical genetics. And then there was a portacabin and things. So, it started small. And as it grew, naturally, people were sort of becoming very close colleagues and friends and an environment that was growing initially fairly slowly.
00:31:48:23 - 00:32:14:18
Speaker 2 - Dr. Douglas Wilcox
And it wasn't just like you were suddenly dumped in a whole new strange environment with hundreds of people. It was a real community of like-minded people. You had to be enthusiastic. Some of the people that didn’t like that moved on. But what it meant was that the people that were left were truly, truly interested in genetics.
00:32:14:20 - 00:32:45:17
Speaker 2 - Dr. Douglas Wilcox
And because it was medical genetics, even the people who were from a science background came to meetings where they would learn about how this sample that they'd worked on the lab was actually being used to help a family. And I would feed back to the scientists, in fact, sometimes I would introduce the scientist who done this test to the family.
00:32:45:19 - 00:33:11:06
Speaker 2 - Dr. Douglas Wilcox
It's not possible on every occasion, of course, but just... it was a fabulous, cohesive, single minded group of people. I mean, obviously some people didn't leave, and, you know, you know, it could be stressful at times, but it was, at the end of the day, the most exciting time of my life.
00:33:11:08 - 00:33:29:11
Speaker 1 - Dr. Gary Kerr
00:33:29:13 - 00:33:37:20
Speaker 1 - Dr. Gary Kerr
Douglas, it's interesting you talk about the multi-disciplinary muscle network. Was there anything from this network that you were able to bring into your teaching?
00:33:38:01 - 00:34:10:07
Speaker 2 - Dr. Douglas Wilcox
Oh, absolutely, Gary. One of the things that was happening at that time in the university was the medical curriculum was being redeveloped and they began to think that they should replace every single lecture with a thing called problem-based learning. And I have to say, I was a bit sceptical at first and, because I thought we were doing a good course, just with traditional lectures and problem sessions, which are not the same as problem-based learning.
00:34:10:09 - 00:34:50:00
Speaker 2 - Dr. Douglas Wilcox
Anyway, I actually became involved in the redevelopment of the new curriculum, and I was very privileged to be able to travel to Maastricht University and see some of their medical students putting PBL into practice. And remember, this is in their second language, English. And I was absolutely blown away by it. It was the - everything that I had been thinking of trying to improve in the existing MSc course, I could see PBL would come and help increase the communication between the students.
00:34:50:00 - 00:35:16:16
Speaker 2 - Dr. Douglas Wilcox
The students would learn from one another. It was a real-world problem, much as my Wednesday morning problems were real-world problems, but this was different. The students would be setting the learning objectives themselves, and I came back so enthusiastic that I actually started problem-based learning on the MSc course several years before it started in the new medical curriculum.
00:35:16:18 - 00:35:45:17
Speaker 2 - Dr. Douglas Wilcox
So, we were able to feedback, you know, things that worked and didn't work - to the medical curriculum. And what we did was we tended to mix students up. Some of them might have done basic science like chemistry, some of them might have done life sciences, some of them might have done medicine or dentistry or veterinary medicine, some of them might have done social sciences.
00:35:45:19 - 00:36:34:02
Speaker 2 - Dr. Douglas Wilcox
And we would mix the students up with their background. We always had a lot of mature students, so we mix them up to make sure there was different ages. And obviously we were an international course. So, we mix them up country wise as well. And so, we ended up with just this really dynamic form of problem-based learning, which, I think, the course just seemed to - that was when the course began to really expand, because I think what was happening then was that students who’d been on the problem-based learning part of the MSc were feeding back to their friends and to their own home universities.
00:36:34:02 - 00:36:37:06
Speaker 2 - Dr. Douglas Wilcox
This is something that you might like.
00:36:37:08 - 00:36:47:13
Speaker 1 - Dr. Gary Kerr
We've spoken about what you enjoyed about teaching and, you know, we've spoken about the Wednesday morning sessions. Were there any challenges you found in teaching, and if so, how were you able to overcome those?
00:36:47:13 - 00:37:16:11
Speaker 2 - Dr. Douglas Wilcox
Well, yeah, I mean, I'm deaf and I'm, in fact, I'm now profoundly deaf, but when I was teaching, and I had hearing aids, it was very, very difficult to hear students. And so, I had to learn to lip-read. And that was fine until - fortunately, COVID wasn't a thing at that time. COVID just completely and utterly knocked me off because you couldn't see people's lips.
00:37:16:11 - 00:37:42:01
Speaker 2 - Dr. Douglas Wilcox
So, I couldn't understand what they were saying. But it was a - that was a real challenge. And I hope I didn't make too many mistakes by not hearing exactly what someone had said. But that was really the only thing that I found difficult about teaching. I just loved it. I was in my element.
00:37:42:03 - 00:38:06:22
Speaker 1 - Dr. Gary Kerr
And it really shone through. Over your career, you have received several awards. You received the NHS Health Council awards in 2006, the Human Genetics Society Research Prize in the late 80s, and the Lifetime Achievement Awards from Muscular Dystrophy UK in 2014. What did these awards and recognition mean to you?
And you mentioned, you know, you're part of this boy's life. You said, you know, you were part of my early career and training on the master's in Medical Genetics. Douglas, you've had a huge impact on many people, you know, personally and professionally, over the years, you know, all of those graduates, of those patients and families coming through the labs.
00:38:06:24 - 00:38:40:00
Speaker 2 - Dr. Douglas Wilcox
Well, it's interesting. The clinical genetics one happened because I was really the first person who was a doctor in the UK who got so involved in the lab. I was a pioneer. My other clinical colleagues weren’t doing the amount of lab work that I was doing. So, I realized that I was a pathfinder, and that's why I got the Clinical Genetics Society prize, and it was great to be awarded.
00:38:40:00 - 00:39:20:02
Speaker 2 - Dr. Douglas Wilcox
I think John Edwards was behind that. It was great. I really enjoyed that. The other ones are different because they were from patients, normal people. And the Health Council one was from a group of families in the West of Scotland who I'd got to know, actually, over several generations by that time. And I was really, really, really humbled because when you look at the people that won those awards, they all seem to be much more prestigious than I was.
00:39:20:04 - 00:39:50:12
Speaker 2 - Dr. Douglas Wilcox
So, I was very humbled indeed, and it meant a great deal. The Muscular Dystrophy Campaign one they are a great charity. And I worked as a volunteer on their Scottish Council committee to do fundraising and organizing research and supporting the national charity. I worked for them for about 30 years. I mean, there are so many great names that have won the Lifetime Achievement Award before me.
00:39:50:14 - 00:39:58:00
Speaker 2 - Dr. Douglas Wilcox
I just - to be walking in the same shoes as some of those people, it's very humbling.
00:39:58:02 - 00:40:17:07
Speaker 1 - Dr. Gary Kerr
Well, it's testament to the great work that you've done and the distinguished career that you've had. Dr. Wilcox, as a clinician, as a scientist, and an educator. And actually, you know, I think I speak for many, you know, young academics, early career researchers, who sort of look to you and think, you know, how did you manage to do all of this?
00:40:17:13 - 00:40:26:13
Speaker 1 - Dr. Gary Kerr
So, I wonder, do you have any advice for early career researchers, those who are trying to balance multiple roles and spin multiply plates? How can we do it all?
00:40:26:15 - 00:41:04:23
Speaker 2 - Dr. Douglas Wilcox
It's very, very, very difficult. I mean, if you have a partner, obviously you need to support your partner because say you're embarking on a PhD in those three years, you have to become the world expert. So that's, a real, real challenge. I think you have to have something that interests you if you're not interested or you don't have that spark of enthusiasm to act as a catalyst that you need when you're feeling tired, I think you need to think about whether it's the right thing.
00:41:05:00 - 00:41:30:11
Speaker 2 - Dr. Douglas Wilcox
The other thing is, that academic life is a pyramid like that with a professor at the top and so many undergraduate students down here, it just doesn't make sense. And so, you have to recognize that not all of us are going to be the professor at the top. I was never a professor. You need to recognize that there are other alternatives.
00:41:30:12 - 00:42:06:24
Speaker 2 - Dr. Douglas Wilcox
And the other thing about an MSc or, PhD is that they are learning skills. Okay, you have become the world expert after a PhD in a tiny little bit of knowledge, but actually, a lifetime's work is going to extend far more than that. So, what you want to do is you want to be able to be flexible as you have been flexible in your own career. I followed your own career with great pride that I was somewhat in there at the beginning.
00:42:06:24 - 00:42:39:11
Speaker 2 - Dr. Douglas Wilcox
But you also need to be lucky. There's a whole range of different conditions that need to be in place for someone to have a highly successful research career. And let's be honest, most people don't ever become head of a big research department. But there are so many careers and all sorts of different branches along the way that you know you don't need to be worried, but you always need to look at the opportunities that are coming along.
00:42:39:11 - 00:43:04:11
Speaker 2 - Dr. Douglas Wilcox
And it's a bit like standing at a station with different trains coming. If you never get on the train, you're not going to go anywhere. And that that actually is what a boy with muscular dystrophy told me. He said, and it was a very humbling thing. He said, “Doctor, I keep having this dream. I'm at the station with my school friends and they're all getting on the train, and I've been left behind.”
00:43:04:13 - 00:43:29:21
Speaker 2 - Dr. Douglas Wilcox
And that was one of the first boys with muscular dystrophy that I saw as part of a research project, and I kept in touch with him for a long time. He’s sadly dead now. But I'm still in touch with his family. And what a thing to say. And that's - he was about 7 or 8 years old when he told me that.
00:43:29:23 - 00:43:50:06
Speaker 2 - Dr. Douglas Wilcox
So, his friends were getting on the train, and he couldn't get on the train. So, it was a metaphor for life, and he was being left behind. So, I had, fortunately, I had this clinical drive as well as these other things like the scientific interest. So, I had multiple prods boosting me along the way.
00:43:50:08 - 00:44:13:17
Speaker 1 - Dr. Gary Kerr
00:44:13:19 - 00:44:15:04
Speaker 1 - Dr. Gary Kerr
Do you keep in touch with them?
00:44:15:06 - 00:44:34:19
Speaker 2 - Dr. Douglas Wilcox
Oh, yeah. I mean, various ways, mostly by Facebook. I've got to say, you know, there's a lot of bad stuff said about social media, but it's also great and it's great to see how people develop. And it's not just the careers, it's the children. You know.
00:44:34:21 - 00:45:03:13
Speaker 2 - Dr. Douglas Wilcox
And the sporting activities, you know, it's just, it's life. I think having been involved in the university, it is a unique opportunity to be in touch with so many people from all over - that when you retire, and I had to retire early, I wasn't - I didn't retire through choice. When that gets taken away from you, it's a huge gap and void left in your life.
00:45:03:15 - 00:45:07:24
Speaker 2 - Dr. Douglas Wilcox
So that's why something like Facebook, I'm all for it.
00:45:08:01 - 00:45:15:22
Speaker 1 - Dr. Gary Kerr
So, you mentioned you are retired. Do you mind me asking, what caused you to retire? And, you know, are you enjoying retirement?
And things are going well now? You're happy in retirement?
00:45:15:22 - 00:45:44:04
Speaker 2 - Dr. Douglas Wilcox
Oh, first of all, I'm enjoying retirement immensely. Absolutely. I had no intention of retiring early. What happened was... It actually goes way back to 1986. And I was very keen on windsurfing, and I caught a very nasty infection, Vibrio Vulnificus, which is one of these flesh-eating bugs related to cholera.
00:45:44:06 - 00:46:19:19
Speaker 2 - Dr. Douglas Wilcox
And I got a terrible gastroenteritis - blood in my bowel motions for about 6 or 7 weeks. I got a horrible infection in my hand. I've still got the scars where they were able to actually save these two fingers because they thought it might... because I had blisters from windsurfing, and it got infected. And I got referred to the infectious diseases hospital and I got the treatment for it, but it left me feeling very, very, very tired.
00:46:19:21 - 00:46:53:01
Speaker 2 - Dr. Douglas Wilcox
And, over the years, I became more and more tired. In fact, latterly, before I actually retired, I had to drive in before the rush hour started because I was too tired to drive in the rush hour. So, I had to drive in. And I would obviously work from the point I arrived, but I couldn't. I had to rearrange things so that I didn't travel in the rush hour. And I had no idea, the doctors were very good.
00:46:53:01 - 00:47:21:09
Speaker 2 - Dr. Douglas Wilcox
My GP referred me from 1986 until now, until I retired, sorry. I was referred to nine different consultants and not one of them came up with a diagnosis. And as a doctor, you're not supposed to diagnose and treat yourself. It's very, very, you know, you get struck off for that. So, after I was retired, I no longer had that pressure.
00:47:21:13 - 00:47:56:00
Speaker 2 - Dr. Douglas Wilcox
And I began to think. And then, that’s it. Haemochromatosis. So, I went to see my GP and my GP said, “Haemochromatosis? That's rare as hen’s teeth. And we've got 22,000 patients in this practice and only one person’s got haemochromatosis.” So, my wife took a blood sample from me because she's a retired doctor as well. And I went down to genetics at Queen Elizabeth and I kind of went up and said, “Please, do you think you could analyse this?”
00:47:56:02 - 00:48:38:16
Speaker 2 - Dr. Douglas Wilcox
And they did. And it was haemochromatosis. And interestingly, haemochromatosis, it's to do with iron absorption. You absorb too much iron. The defective protein is actually part of the HLA system. And so, it affects immune system things as well. And in particular, it makes you sensitive to Vibrio Vulnificus infections. And I'd probably had the infection three different times; the first time from eating raw oysters, the second time from wind surfing, and the third time from eating mussels that were cooked, and each time a bloody diarrhoea that lasted six weeks.
00:48:38:18 - 00:49:11:00
Speaker 2 - Dr. Douglas Wilcox
So, I don't eat shellfish now. But it was interesting that all the things I’d had, the fatigue, the joint problems, the deafness, the numbness in my hands and my feet, the constant itch were all related to haemochromatosis and the treatment didn't start until after I'd retired. And it's just a shame and it's very ironic, you know, being a geneticist.
00:49:11:02 - 00:49:38:08
Speaker 2 - Dr. Douglas Wilcox
Why didn't I think of it sooner? Well, one of the doctors did say to me, “We'll need to do iron studies.” And I’d assumed that they'd been done but apparently, they hadn't. So, I'd never thought about it again. And actually, Mike Connor, who was professor after Malcolm Ferguson-Smith, he and I worked together in the clinics for, I don't know, a combined 66 years, something like that.
00:49:38:10 - 00:50:07:04
Speaker 2 - Dr. Douglas Wilcox
And not once had either of us been referred a patient with haemochromatosis. And this is the commonest genetic condition in northwest Europe. I sometimes think if I'd been diagnosed early before, all these problems developed, what might have happened. But you can't go through life thinking like that, so it doesn't bother me in the slightest. I thoroughly enjoyed everything about being with medical genetics.
00:50:07:08 - 00:50:10:21
Speaker 1 - Dr. Gary Kerr
00:50:10:23 - 00:50:39:08
Speaker 2 - Dr. Douglas Wilcox
Oh, retirement is wonderful. It's payback time. I'm just back from a wonderful holiday in Jersey, where I was swimming in all sorts of different beaches, and eating far too well, and I've got time to still go windsurfing occasionally, and I sea kayak round the West coast, round the islands and I just love walking, and I've had to stop going up and down mountains because my knees are knackered.
00:50:39:08 - 00:50:41:20
Speaker 2 - Dr. Douglas Wilcox
But that's not the end of the world.
00:50:41:22 - 00:50:42:17
Speaker 1 - Dr. Gary Kerr
And I love seeing those photos of the sea kayaking and everything on Facebook. So, long may they continue. Is there anything else you'd like to tell us, Dr. Wilcox?
00:50:42:19 - 00:50:44:19
Speaker 2 - Dr. Douglas Wilcox
A great time. Retirement.
00:50:44:21 - 00:50:55:12
Speaker 1 - Dr. Gary Kerr
00:50:55:14 - 00:51:28:19
Speaker 2 - Dr. Douglas Wilcox
Yes, I think there is. And it’s actually to extend my thanks to all the students who chose to come to Glasgow, particularly in the early years when we didn't have the reputation that the course has now. Because I'll tell you something, Gary. Overall, I've probably learned much more from the students than they learned from me. And one of the things I learned at a very early stage was this business of being able to look at a problem from different perspectives.
00:51:28:21 - 00:51:38:19
Speaker 2 - Dr. Douglas Wilcox
That's what it's all about, the international community. And that is my thanks to the students.
00:51:38:21 - 00:52:03:11
Speaker 1 - Dr. Gary Kerr
Well, Dr. Wilcox, on behalf of the students and all of the alumni, I want to pass my huge thanks to you. You've had an incredible impact on me personally and professionally and so many others, you know, from just, you know, turning up as a young kid, you know, doing a master's program and then, you know, not only did I get my degree, it’s as if someone awarded me my confidence, during that course as well.
00:52:03:11 - 00:52:20:20
Speaker 1 - Dr. Gary Kerr
And I felt really welcome and included. And it was during that course, I thought, “D’you know what? Maybe, maybe actually, I can do a PhD”, having sort of struggled through an undergraduate degree, the pennies all dropped during the masters. And that's thanks to you. You know, you have had a huge impact on many of the alumni.
00:52:20:22 - 00:52:34:22
Speaker 1 - Dr. Gary Kerr
So, on behalf of the alumni, Dr. Wilcox, I want to say thank you so much. Thank you for sharing your stories with us today. And thank you for being an amazing lecturer and mentor to so many people over the years.
00:52:34:24 - 00:52:36:24
Speaker 2 - Dr. Douglas Wilcox
Gary, thank you very much indeed.
00:52:37:01 - 00:52:54:15
Speaker 1 - Dr. Gary Kerr
Thank you.