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Election time comes every five years in the United Kingdom. It is usually a time of excitement and trepidation as people wonder what will change, for whom and over how long, depending on which party might win power. Usually it is not very much, for only a few people, over a long period of time. British people by and large do not like sudden changes; it makes everyone nervous.

This was no exception at the Large Teaching Hospital when a far more important figure than the UK prime minister was retiring from her role as an old-guard oculoplastic consultant. She was very well liked and involved herself in every facet of the running of the department and in the build up to her retirement there was a change of mood amongst the medical staff, nurses and even patients. Medical staff would mutter about how they would be unable to cope with the workload while nurses were concerned she might be replaced by a less genial and competent consultant. Patients were increasingly emotional as the deadline for her retirement approached and the gifts they brought in were inversely proportional in number and expense to the days that she had left to work.

I saw a patient with a carotico-cavernous fistula that caused orbital symptoms such that the optic nerve was compromised. As I began my hunt for the Queen of the department and every single person I came across who would point me ever closer to her exact location made comment about how sad it was about her retiring, I ruminated that this was more of a change of monarch than prime minister. Certainly the length of office was more similar, the mystery of her position more spectacular and certain rites at the beginning and end of rule more arcane than perhaps we fully appreciate at first.

One of the most important of these is the ‘leaving party’. This is not, as one might imagine, simply a party to celebrate somebody’s career. There are important rituals. There was a presentation from an eminent professor about the retiree’s life and career, along with the merits of the Open Eyes electronic patient records system. There were drinks bought by consultants for juniors as a recognition that these were extraordinary times and we were all in it together. The giving of presents and cards had the feel of tribute to the divine kings of old but finally the most important part of the ritual came: the speech.

Dignified and graceful she stood up and thanked everyone, numbering more than a hundred, for their attendance. A few jokes were made and compliments given, but the handover of power was the highlight. Her fellow oculoplastic consultant, younger than her but also well liked and very skilled at his work, was sitting at the front of the room. She looked directly at him, praised his skills and professionalism, wished him and the department well, and then she touched him on the right shoulder. Perhaps to the untrained eye the shoulder touch might have been a simple friendly good luck gesture of kindness. Perhaps I am reading too much into it, but along with the regal affair of the event, as it was held in an exclusive members club in Cardiff, it seemed to have innate value of itself. A blessing. Catholics always enjoy their status as the ‘proper’ Church as each pope has been blessed by their predecessor right back to St Peter and Christ himself.

“People who command automatic respect and are comfortable in their position are the ones most likely to use their human names rather than hide behind professional titles.”

After the speech there comes the ‘mingling’. Increasingly intoxicated ophthalmologists and eye department staff wandered around chatting about subjects increasingly divorced from day to day work and hospital gossip. The one big change was the status of the new King as he wandered from table to table, drink in hand. Everybody was happy for him, could not wish for a better person to lead the service. There would be a new consultant appointed to fill the vacancy in turn and one day they might end up the monarch but that was the distant future and everybody was relieved that a major change of power had just taken place and the world had not imploded. The sun would rise the next day.

A few days after that a card arrived in my inbox. In fact, everybody who attended was sent a card, personally written by the retiring consultant. For me the most striking thing was not the vast amount of work that must have been involved in writing so many personalised cards in such a short space of time. They were all written in legible handwriting too, something I could never achieve even if I had a year. No, the most striking thing was that she signed off using her Christian name alone.

It seems that those people who command automatic respect and are comfortable in their position are the ones most likely to use their human names rather than hide behind professional titles. Almost never does anyone dare to reciprocate but the fact that she had put her first name down hit me like a hammer blow. Better to sit at the end of the table and be invited to sit at the head than sit at the head and be asked to move down, I remember from long ago Sunday school lessons. Humility is the counter to Pride, the deadliest of all deadly sins. Perhaps I am being unfair on recently appointed consultant colleagues, those most likely to insist upon full use of their titles. You can only give to charity if you have enough savings. A person who has worked in a department for decades has a vast store of goodwill upon which to draw so these gestures of humanity cost little perhaps, while a new consultant who does likewise may impoverish himself into looking like a registrar.

I had seen handovers of power before, but none as important or impressive as this. When Queen Elizabeth vacates the throne it will have much less importance in the lives of those who work at Cardiff Eye Unit than the retiring of the oculoplastic Queen. It is a useful time of reflection and introspection for us and examination of our role in the world around us. The ebb and flow of time for us mere mortals can be measured in such units as the reigns of long serving important consultant colleagues. The Queen is gone. Long live the King!


The views expressed are those of the author and do not represent those of the editorial team or the publisher.




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Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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