Reflections on turning 50

Reflections of an ageing academic. #MSBlog #MSResearch 

"As you all know by now I turned 50 on Saturday. After four wonderful days with family and friends, and no real work except quiet contemplation, and reflection, I am ready to face the next 50 years of life."

"I grew up in South Africa a child of second generation immigrants. My father was Italian; his father was from Luca, in Tuscany, and my grandmother from Naples. My mother was English; her maiden name was Williams, a Welsh name. My maternal grandfather's family came from a Cornish tin mining village. He travelled to South Africa to work in the goldmines. My maternal grandmother was a Carrington and her family immigrated to South Africa from Greenwich London. I had no idea that I would return to some of my roots and become a proud Londoner (I still feel like a foreigner whenever I leave London). For those of us who live in London we are witnessing another golden era in its wondrous history. It is such an exciting time to be living in London; so full of promise. I don't want to change it for anything."

"Reflections on getting older:  I was always wanted to be a zoologist and decided on medicine when my father became ill. He had chronic renal failure, presumably from an autoimmune disease that started when he was a teenager. He went onto peritoneal dialysis when he was 43; I was 12 at the time. Two years later he was on haemodialysis and 8 years later had a kidney transplant. I go on a lot about expert patients; my dad was the first one I knew. When he saw the physical state of of kidney transplant recipients who sat next to him in clinic he made a decision that a kidney transplant was not for him. This decision was made 
in the pre-cyclosporin era when immunosuppression to prevent transplant rejection was managed with steroids and azathioprine therapy. Almost all  transplant recipients looked like Michelin men, or woman, they were large and fat as a result of being on high-dose steroids. Once my youngest sister turned 18 and cyclosporin had transformed transplant recipients lives my father went onto the transplant list and was very lucky to receive a transplant 3 weeks later. Cyclosporin was a truly transformational drug. My father was not prepared to accept the side effects and complications of steroids, but when he saw how cyclosporin had revolutionised the field he changed his mind. I have been fortunate to see a similar thing happen in my chosen field of MS; the emergence of highly-effective DMTs has changed MS. I beginning to see the rumblings of a revolution in how MSers and MSologists are adopting the new treat-early treat-effectively strategy!" 

"Regrets: I have several personal regrets; that are not for discussion here. The main one is not running and exercising more. I am always referring my patients for exercise programmes telling them that exercise is good for brain health. This is something I plan to put right now that the my running injury I acquired training for, and running, the London marathon 2 years is on the mend. I regret not spending more time with family and friends. It is difficult compromise, and balancing act, when life is so short. I have promised to work less and spend more time at home."

"Failed ambitions: None really, I am still living my ambition. However, at a professional level I wish I had realised sooner that public health is the one field you can have the biggest impact on health. I am increasingly moving into public health. I want to prevent MS and the only way to achieve this is via public health initiatives. One of my NHS heroes is Sir Muir Gray, a public health consultant. Sir Muir says 70 is the new 50. If this is true I have sufficient time to make a difference. We have identified three environmental risk factors that increase your risk of developing MS; why are we not doing anything about it? We need to work out how these three factors interact to cause MS and start testing hypotheses."

"Resolutions: I need to learn to say no and start a hobby (or two). I spend far too much time thinking about and doing MS. Palaeoanthropology; I want to know more about the origins of man. I had a very privileged education. As a medical student at the University of the Witwatersrand I was taught, and inspired, by Professor Phillip Tobias. Those of you who were taught by Phillip Tobias will know what I mean. Professor Tobias studied the Olduvai Gorge fossils and produced a two volume thesis on Homo habilis, who at the time was our first direct human ancestor. Professor Tobias' infectious enthusiasm  has led me to acquire an interest in evolutionary medicine, which in turn has helped me as a teacher. Slow food; I passionately believe in the slow food movement. I want to grow my own vegetables and focus more on cooking. The obvious question is will I have the time to do this?"

Homo habilis

"I would like to thank my family and all my colleagues and friends for making my Birthday so special. As I reflect on 4 days of celebrations I can only say I don't feel old; it seems as if life has only just begun. To quote the author Terry Pratchett '...inside every old person is a young person wondering what happened.'."