IBM
0278 Launching Biomedical
Having got my ‘hands-on’ training in the US - such as it was - my next job was to plan the launch of Biomedical in the UK. As it was a totally new subject to me, the first thing I did was -- courtesy of IBM -- go out and buy a whole range of medical textbooks. I steadily ploughed my way through the more general books on haematology and blood transfusion, and then moved onto the specialist books on the leukaemias etc. It proved not to be as difficult as I had thought. Once I recognised that there was almost no scientific knowledge involved, and that the key process was to stain histology slides with different stains and then categorise them on the basis of the colours they went, I realised that it was more an art -- even a black art -- than a science. The next task therefore, having absorbed some of the language, was to go round the top clinicians in the UK.
I was helped in this by two facts. One, the name IBM, in those days opened doors everywhere. In the commercial field it opened the doors to the managing director's office. In the medical field it opened the doors to the top consultants. The second factor was that the DHSS (Department of Health and Social Security – then a massive department which covered all aspects of the National Health Service) - desperately wanted us to come into the UK. The only supplier of any note in the UK, before us, was Haemonetics, and the DHSS was not at all happy with their equipment.
Accordingly I started to work my way round the United Kingdom. My initial starting point was with Ray Powles at the Royal Marsden Hospital at Sutton in Surrey. Ray was the leading oncologist (cancer specialist) in the United Kingdom. He ran a very advanced unit at the Royal Marsden, which was the cancer hospital par excellence above all others in the UK. Not least, he had a whole series of very sophisticated isolation rooms where he undertook bone marrow transplantations and other chemotherapy treatments. Ray was a lovely guy, but one confusing aspect was that he had an identical twin brother who was the breast cancer consultant at the Royal Marsden. Accordingly you had to be careful for, when walking down the corridor, you were likely to greet ‘Ray’ only to find out it was his twin, who in return gave you a look of absolute bafflement.
In order to get us into the UK the DHSS was funding the purchase of a machine. Ostensibly this was for testing purposes, but it was really to be a seed project – which was why it was to be given to the Royal Marsden Hospital. Accordingly, Ray was bound to be very helpful, since clinicians then, and now, will do almost anything for an injection of tens of thousands of pounds worth of investment in leading edge technology.
From Ray I moved on to John Goldman at the Hammersmith hospital. John Goldman was a great character and also one of the top, if not the top, oncological consultants in the country. Hammersmith already had one of our older machines and soon replaced it with one of the new ones. I invited him across to dinner with some other consultants when we were at the conference in Paris and he did a superb selling job for me - far better than I ever could. From there I just travelled from one consultant to another, as they recommended me to friends and colleagues. Eventually, the most influential ones came onto the editorial panel of my magazine, Apheresis Bulletin.
Having covered some of the main teaching hospitals, I moved on to visit the National Blood Service, meeting the directors for the various regions.
In all these cases, I wasn't just learning, picking their brains, but I was also setting the basis for later sales to these organisations. In fact I did make sales to most these of organisations. The process of learning from them was a superb way of establishing the relationship that subsequently led to the sales.
As I have said, the DHSS were buying a machine in order to stimulate our entry into the UK. The only problem was that this machine had to be tested by their technical experts. Accordingly, when it arrived, it was handed over to these experts and literally taken to pieces. This was a somewhat fraught process in terms, in particular, of safety. Thus, the machine had a centrifuge rotating at very high-speed. This was protected by a cover which could be lifted. This was necessary, since each time the machine was used the operator had to fit a special (disposable) set of plastics inside it, within which the blood was separated. The safety experts at the DHSS were appalled at the idea that, when the cover was lifted - with the centrifuge running high-speed - it only cut off power to the motor and the rotor only then slowed down gradually. They seemed to be obsessed with the idea that people would stick their head into it while it was still rotating. Taking my life in my hands, I demonstrated to them that it wasn't that dangerous; simply by putting my own hand into the machine before it stopped, and not getting injured. Even so, this was not good enough for them, and we haggled for a long, long time about the safety of it. Eventually we compromised. It proved a valuable lesson in the (safety) standards demanded by bureaucracies.
Indeed, it was clear that the safety people would never have approved even a normal household kitchen. The idea of having red hot electric rings, or even worse gas flames roaring forth, in the kitchen would have turned them hysterical. The problem was that they had to accept all the hazards that already existed in normal life, but refused to add any extra to them. I well remember they changed the specification for blood products so that they reduced the contamination level allowable in machine processing by factor of 10. I applauded this, since it was obviously sensible that contamination should be kept down to the minimum, even though at a cost to suppliers. On the other hand, I was later appalled to realise that, when the blood was collected, the needle necessarily cut out a whole chunk of skin which then went into the blood bag. No matter how much the skin was cleaned, this deposited a 1000 times higher level of contamination than anything that was done thereafter. I tasked the DHSS with this. Their only comment was "We can't do anything about that, but we can reduce the contamination thereafter" -- even if it was irrelevant?
An added problem with the DHSS testing was the fact that immediately before it was due to start, under my supervision, I had had to go to New York for just one day. I got back, with the plane landing late, and having had to shave in the plane's toilet, to what was the most important meeting with the DHSS. l was nearly out on my feet, but the adrenalin cut in as usual and I managed to survive.
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