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A DANCE THROUGH THE FIRES OF TIME

9508 MEDICINE – THE 1970s part 3

Having had problems with Keith, my manager in the GSD marketing group, and not least having non-concurred against most of the management team, I was not surprised when he volunteered me for a new job in GSD.  Although it was supposed to be an opportunity for me, I knew that in reality Keith - my boss in the marketing group - wanted to get rid of me because he couldn't control me. Perhaps even worse, he probably thought that - as a more experienced marketing man than him – I was a threat to his position. Not unsurprisingly, what he was offering turned out to be one of those jobs that nobody wanted.  This was understandable since it was totally outside the promotion line and clearly was not one that would not be well supported by management.  In this latter respect at least they were wrong. This job was to be the IBM Biomedical representative in the UK, though in fact its job description was to be much more like being the divisional manager for Biomedical in the UK -- albeit the staff in the UK was just one.

As you will also expect, I was not very happy about this.  Nobody is happy when they feel that they are being pushed into a job. Having said that, I had a number of people leaning heavily on me who were quite senior in IBM, so I had at least to appear to be going along with the idea. Accordingly I went off to Paris, to the European headquarters, for a briefing before I made my decision. The office was not actually in the main part of the European headquarters but was in the Avenue Wagram, just by the Arc de Triomphe, where IBM European headquarters had an annex on the first floor of an office building.  Even so, it looked like any other IBM office. That was one thing about IBM, wherever its offices were located they were the same -- and everyone spoke perfect English.

In a couple of offices there the European end of Biomedical Group had started just a few weeks before.  I was interviewed by the Len Naroskin. He was the general manager of Biomedical in Europe, such as that was, and also by Mike Martin who was his assistant -- and scheduled to be my competitor in the UK. They did their best to impress me with the potential, and persuade me to join.  They were desperate for bodies, since almost every country had exactly the same problem – nobody wanted the job! 

It soon became obvious that Mike Martin was intent on becoming my boss; whether in Paris or in the UK.  Needless to say I was not terribly impressed with any of this and returned to the UK to report just this. It was at this stage that John Steele, the personnel director, involved himself.  Basically, he asked what I needed; and I poured my heart out.

There were several other reasons for my nervousness.  It was obvious that the main part of the job would be selling. I had gratefully escaped from the stresses of selling a good few years before; and I didn't really want to get back into that. The net result, in this case, was that David Steele made the deal worth my while considering. I always got good deals out of him. In essence I was most worried about going back on quota, that is on commission. As line sales I had to be on quota, so the deal quite simply was that my quota guarantee would be 90 percent but my salary would be uplifted by 10 percent.  This meant that I was losing absolutely nothing in salary, and potentially had 10 percent extra to gain -- which I did frequently. So the main problem was solved.

The other problem – mentioned above - was that I, like many people, was very nervous about the medical environment.  In particular I was very nervous about how I would react to loads of blood sloshing around in my vicinity.  In fact I needn't have worried, since this never troubled me in practice.  But it is also true to say that biology had been something that I had dropped very soon in my school career! But then ignorance of the topic was never known to hold IBMers back!

I still feared that it was a peripheral organisation for IBM.  Len talked excitedly about what a great opportunity it was and how it would be a great money earner for IBM. But it was clear to me that – in the UK at least - it had to be treated as an exercise in PR rather than a sales opportunity.  Indeed, when I got back to the UK that is exactly how I treated it, over the following years.  I emphasised, to everyone right up to the board, that we were in it to save lives -- and wasn't it wonderful that IBM could do that!

I was still dubious, even when I got back to the UK, but the final sweetener from John Steele was that I would be allowed to choose my own boss!  This was the only time I ever had the privilege of choosing my own boss, and I would recommend it to you if you ever have the opportunity.  I chose Derek Haslam, who was at that stage the head of marketing staff. I had worked for him previously, and I reckoned him to be an excellent manager.  I was right. He proved to be the second-best manager I've ever worked for, after John Eliot, and that's praise indeed. It was one of the best moves ever made by me.

I eventually conceded defeat, and agreed to run Biomedical in the UK -- though clearly it was mainly a selling job. 

Ultimately the Independent Business Units, of which IBM Biomedical became the first, were the legacy of John Opel; who used them as an attempt to introduce 'intrapreneurship' (most popularly then promoted by Peters and Waterman). In the event they were largely unsuccessful in this role; though they may have contributed to the overall environment of 'change' within IBM; and provided the Personal Computer which – at the time - by itself justified the whole programme.

But the antics of Frank Cary, and particularly of John Opel, during the late 1970's, were quite shocking to some IBM'ers - exactly as they were intended to be! After the success of GSD as a gadfly, there was a twofold need: to create further such stimulants and to explore the new branches of high‑tech business that lay outside the main highways that IBM was following.

The first vehicle for this new adventuring was (eventually) to be the creation of Independent Business Units (IBU's), away from IBM's normal bureaucracy, to flower as completely new and independent businesses - unadulterated by the rest of IBM.

With the one notable exception of the Personal Computer, none of these IBU's in the event had any real impact on IBM's overall business, or to any great extent on its organisational structure. The best example of what took place in the IBUs was Biomedical Group which, as well as being the first IBU (both to be created and to die), was furthest from IBM's traditional business.

The earliest roots of Biomedical lay in the personal tragedy of one of IBM's development engineers; George Judson. One of his children contracted Leukaemia shortly before Judson was due for a sabbatical, funded by IBM, working on a research project of his own choice. The research project he chose was to develop a device (the IBM 2990) which could harvest white cells from donors, to support Leukaemia patients; in order to keep them alive.

At the same time as the work on the blood products was taking place, in the early 1970's, in another part of IBM yet another scientist was also working outside the normal scope of research; though in this case closer to conventional computing. Ray Bonner was developing one of the first artificial intelligence programs, designed to analyse ECG's (ElectroCardioGraphs) to the same standards as a consultant cardiologist.

Thus the origins of Biomedical Group, as with so many more conventional IBM products, lay with individual enthusiasts; independently developing products outside IBM's mainstream product plan.

One of the plants considering the competitive tenders for some of these products was that of Systems Supplies Division (SSD), in Dayton (New Jersey). Not long before SSD had been at the heart of IBM, for it produced the millions of punched cards that had been IBM's cash cow for more than four decades. In the 1970's business, however, was declining, as IBM's concentration increasingly turned to computing. Accordingly, the vice president in charge of SSD , 'Van' Hoesen, had a problem and for most of the 1970's he avidly searched for any new business that could be slotted into SSD. So SSD, an otherwise dying division, became a hotbed of innovation.

Searching for these new products, Van started a campaign to win the first (2991) product 'mission', though SSD did not have any significant history of machine production. One key factor, though, was that the products being tendered for also comprised a substantial element of on‑going income from the related supplies. Indeed, in the case of the blood products, the annual supplies income could easily run at a rate approaching the capital value of the machine! It was a situation that was familiar to SSD, brought up on the similar philosophy inherent in the punched card business. Van won the mission, probably due to his enthusiasm – he was one of the most charismatic managers I have worked with - and assisted by the fact that the business was much less attractive to other plants.

It would appear that chance, being in the right place with the right proposition at the right time, aided by the inevitable enthusiasm of Van, eventually (after a number of years of small scale operation) swayed the Central Management Committee (CMC) into expanding this 'pilot' operation into the 'Biomedical Group'; though it was not to become the first Independent Business Unit (IBU) until later.

In the beginning the Biomedical manufacturing unit was part of the SSD plant in Dayton, New Jersey. There, among the punched cards and diskettes, the first IBM high‑tech medical equipment was built! Rather to the surprise of those concerned, production went relatively well throughout the life of Biomedical Group. Despite the lack of experience there were no insurmountable manufacturing problems.

Perhaps one reason for this was it was that  production was limited to a relatively small amount of assembly work, with rather more testing and quality control. The machines were built as far as possible from standard (tried and tested) components. The remainder, which could not be bought off the shelf, although designed by IBM, was generally sub‑contracted. IBM had a commendable, and highly profitable, philosophy that it should only manufacture something itself when all other possible sources were exhausted. If it could find another company which had the manufacturing capability to at least match the quality and price that it could achieve, then IBM would not manufacture itself (unless its overall position might have been exposed by single sourcing).

My first activity was to go to the United States.  Thus, within a few weeks, I found myself on a plane to New York; the first time I had ever been to the USA. In some respects this was, in 1978, most people's dream. Very few people went to the States in those days. Indeed, it was unusual even for anyone from IBM UK to go there. I remember flying across the Atlantic full of excitement and apprehension.  I had once had a dream about flying to Chicago for a day.  This dream ultimately came true; albeit in two legs. I once did fly to the US for one day, but to New York, and I did later fly to Chicago. But this first trip was to New York for a couple of weeks. Accordingly it was something of a thrill sitting in the jumbo crossing the Atlantic. 

We landed at JFK airport, in brilliant sunshine.  As I got out of the plane I could see, in the distance, the towers of Manhattan with the sun behind them.  I have to admit it was a thrill. Even better, I was able to take the helicopter shuttle across to Newark airport.  That was in the days when the shuttle -- a twin rotor machine with 20 seats or so - was still running.  They later banned it, since it crashed too often and killed too many people!  As evidence of the problems it faced, I later went on one trip on it where the stewardess had to spend the whole time holding the door shut!

Landing at Newark airport, I picked up my car, the first time I ever driven a left-hand drive car.  To make life easier, I chose an automatic but that actually caused problems.  I drove tentatively down to the New Jersey Turnpike and just as I was going on to it I decided I wanted change gear. But of course I couldn't do that! I pressed the brakes hard instead of the clutch, and the car nearly nosedived into the tarmac.  That taught me a very quick lesson. Thereafter I was happy driving in American traffic. The New Jersey Turnpike was astounding, with six lanes each way, split into two roads of three lanes each. On it I drove down to the Princeton area where I was going to stay at the Hilton and, surprisingly given the fact that it was 3,000 miles away from home, I very easily found this.

Indeed, as it was the first time in the US, I staggered into the Hilton Inn with my time clock five hours out of kilter.  I went to my room which I found was quite comfortable.  And then I realised that I was incredibly thirsty. No problem at all, since there were drinks machines on every floor; except that they only took coins and of course all I had was notes!  After an hour or so of searching, I found someone who could change my dollar notes and I was able to quench what was by then a raging thirst. This is one problem the inveterate traveller cannot avoid. I have lost count of the number of times I needed change when I arrived in a new country and could find nobody to change my notes!

When I went down to dinner, however, I was immensely impressed.  The service was excellent and the food was superb. It shows you just how much difference the impact of the individual member of staff makes, since - on later visits to exactly the same restaurant - the service was awful and the food was disgusting!  But at that time it was my first experience of American food and service.  As I sat down I was immediately offered a glass of ice water and that was an experience I had never had in the UK. Equally the steak I had was superb. Steak is one thing the Americans do well, though now I like best New York Strip Steak.

The following morning I finally made my way to the plant. This was one of IBM’s Supply Division plants, which normally produced punch cards. These had, in the old days, been the basis of IBM's profits.  But now, with the advent of magnetic media, this was the last of such plants within IBM.

The biomedical section was very small part of the plant.  Indeed, it was barely bigger than a large room, where the blood cell washers were assembled by hand.  It was almost a craft industry, though it grew somewhat larger later on. 

The teaching was conducted in the conference suite of the plant as a whole.  The cell washers had been the main business of biomedical for a decade or so, along with a few of the old-style cell separators.  The American sales-force had been converted from punch card salesman, and hence they found it much easier to sell the simple cell washers to blood banks in the US -- since these required very little technical expertise.  Thus, the main business of IBM Biomedical in the US then was such cell washers.  When the much more sophisticated cell separators were introduced, they had considerable difficulty in selling these. On the other hand, we in Europe, starting with these as our main product line and with a much more sophisticated sales force recruited from the DP Division, did much better. I, in particular, made a specialty of selling these.

They were friendly lot though, and I enjoyed several evenings out at the local bars with them As I was to find out, being part of Biomedical was very good way of getting under the skin of the American way of life

From there I drove to the other side of New York, to Mount Kisco, where the head office of Biomedical was -- and where development team for its ECG machine was based.  It always seemed a nonsense to me that the two parts of such a small group should be on opposite sides of New York. It took three to four hours travel between the two, since once you had taken the New Jersey Turnpike, which is fast enough, you then had to thread your way through streets of Manhattan before you got to the Parkway on the other side.  It was these streets of New York which took the longest time.  Being somewhat cynical, I guessed that the main reason for headquarters being in Mount Kisco was that – before being sent to IBM’s equivalent of ‘Siberia’ for having an affair with one of his subordinates - the director in charge of the group was very ambitious; and Mount Kisco was only just down the road from Armonk - where the IBM headquarters was!

But it was a nice enough town.  We stayed at a little old hotel there, which had comfortable enough rooms -- though not luxurious.  We used to eat there in the evening; the usual steaks but, like many US hotels, they had a superb self-selection salad bar.  It took me some time to realise that the Americans do not have vegetables with their main course, as we do, but instead have a salad course before this.  Accordingly, their salads were excellent

Breakfast though was taken at the local diner. This was a great cultural experience, with its pancakes and maple syrup and a side order of crispy bacon.  It was then the American way of life to go out to the local diner, perhaps on the way to work, for your breakfast. I found it very good value and very good food.  The problem was that it already was a disappearing feature of the American townscape.

At the head office we were indoctrinated into the strategy and sales plans - and everything else that drove the various parts of  IBM forward.  Although they talked at length about how independent they were, and how much freedom they had, it seemed to me that it was just like any other division of IBM

The new ECG machine, when we got to it and were allowed into the very secret development area, was an interesting machine. It was a mobile ECG machine, albeit a very big and heavy one, which incorporated a computer which was able to analyse the ECG which had been taken.  IBM had been working on this, under Ray Bonner's team of programmers, for the best part of the decade. His expertise meant that he was recognised as the world’s top guru in this field.  It was a miracle of miniaturisation for those days, though the computer was an old one -- deliberately so, in order that the bugs had been sorted out. Nobody can justify using such a machine, which holds the ability to decide between life and death, potentially having even a single bug.

The concept was very good. It later was complemented, for larger hospitals, by lighter carts which fed into a Series 1 computer.  The idea was that it saved the cardiologist the drudgery of reading every individual ECG.  The reality was that, as it turned out, cardiologists actually liked reading ECGs -- and accepted this role as a badge of office.  Accordingly, I had considerable difficulty selling these machines in the UK when they came out -- though Germany proved a  much better market, due to its employee screening programmes.

At the weekend I had my first day in New York, doing the Grey Line tour of the sights and going out to the Statue of Liberty. To my surprise, I was not impressed with the Big Apple, as it was just starting to call itself.

From Mount Kisco I drove down to JFK, to take the plane to Houston.  The highways, especially interstates, were as good as any British motorway.  Thus, I was happily relaxing, and doing nice gentle 70 miles per hour, when I saw, in my rear mirror, red and blue flashing lights.  I pulled over and got out to stand by the car as the Highway Patrol man approached me.  He was just about to start to write the ticket when he said “You realise you were doing seventy miles an hour”. I, believing that honesty is always the best policy, especially when the facts are obvious, said “Yes. I'm sorry. I forgot that I wasn't in England. I won't do it again”. As I said this I could almost see the thoughts crossing his face, as worked out that I wasn't an American.  His next question was “Where are you going”. My reply was “To Houston then to Washington and then to London”.  More confused emotions passed over his face, as he realised there was no way this ticket was ever going to get me into the court.  He stood back, pointed sternly at me and said “Well don't do it again” and let me go on my way!

Houston, when I got to it, was a fairly typical American city -- or so it seemed to me.  I had difficulty locating the hotel. I kept asking whether Gloucester hotel was, pronouncing it in the English way, only eventually to realise that the Americans pronounced it as the Glowsester!  The hotel was five-star and it was luxurious to the extent that in the bathroom my I even had an iced water tap!.  Even so, when I turned the television on -- set to the public broadcasting channel -- what should I see but Dad's Army! 

The next morning I met with Mike Martin, who was also in Houston for training on the cell separator.  Together we went to the MD Anderson hospital, which was the cancer hospital in the Southwestern Medical Centre -- a very big and very well resourced collection of hospitals.  We were there to meet with Jean Hester who was the consultant who had the most experience of cell separation.  She was a real guru, and a driving force behind the extending use of these machines.  Originally it had been developed for harvesting white cells to support leukaemia patients in particular, and the MD Anderson children's wing was full of leukaemia patients.  Thus, I was thrown in the deep end, because my first exposure to cancer was with young children, most of whom were certain to die. Having said that, I found that – like doctors - you had to distance yourself and not get involved in their personal tragedies.

We eventually located the prototype of the new machine, which was about to be launched worldwide.  It was a very impressive machine, and did incredible things in terms of separating the patient’s blood into its various components. I was to spend the next five years teaching consultants in the UK to do just that.

One evening we went off to meet Jean Hester herself, who was recuperating from an operation, in a 'local' restaurant.  With this experience, I began to appreciate what the Americans meant by 'local' – even despite the 55 mph speed limit. We must have travelled about an hour and a half through the suburbs of Houston before we came to this restaurant.

Fortunately, everywhere we went we were cosseted in air-conditioned comfort. This was as well since the temperature was 100 degrees and the humidity was 100%. As we came out of the hospital to get into our car it was literally like walking into a steam bath. It was humid because, although we Brits tend to think of Houston as being somewhere in the middle of Texas, Houston is actually on the Gulf of Mexico. Mike and I even drove down to Galveston, its port, though there was nothing to see but mile upon mile of refineries.

I left Mike behind, as I was to go round a selection of customers with the Biomedical salesman in Washington.  I landed at Dulles, and took a taxi to the hotel - as directed - along the Beltway.  When I got there, however, no one knew anything about me. They kindly pointed out, however, that there was another branch of the hotel on the Beltway -- it was just 50 miles away on the other side of Washington!  So off I went, to the correct hotel.  I arrived there in time for the happy hour, something that was not then a feature of British drinking -- especially where the drinks were served by waitresses dressed in very short, frilly, skirts.

I had time the following morning to visit the mall in Washington, and see almost all the sights – the only time I did so, even though I later attended Millennium Project meetings there.

I went out with the American salesman in the afternoon, down to Baltimore. There we looked at a couple of the cell washing machines that his customers had, and we talked at length about his job.

When we got back to my hotel we found, however, that I didn't have a bed for the night!  Accordingly, there was a frantic rush as he took me to Dulles airport again. I managed to get an overnight flight back to England. We took off as a thunderstorm raged all-round us with lightning everywhere.  Maybe it was symptomatic of the future of the division -- although I had a very happy five years before I eventually killed it.

The marketing side of the operation, in the US, looked very much like an SSD branch, with a few elements of marketing staff thrown in. This was not surprising where all its founders originated in SSD sales. In true, and generally commendable, IBM style the management of the new 50 strong sales force was given to the original half dozen salesmen who had originally started up the operation, several years before it had been promoted to being an IBU. This had one major drawback. Their own experience had been exclusively on an earlier product (the IBM 2991) for which there was, at least in the US, a market with a very closely defined set of selling requirements (which were, surprisingly for a medical market, relatively non‑technical). The new management had been locked into this rather rigid environment for half a decade (a very long time indeed in IBM terms). The markets for the new 2997 and ECG machines were very different. They required a great deal of in‑depth technical knowledge, combined with considerable flexibility in the sales story. In practice this change of style proved very difficult for these managers to handle; particularly at a time when they were also learning how to manage their new sales‑force. As a result the US organisation continued to sell the 2991 in the main, where the rest of the world sold mainly the other products (since these were proved to be the bigger sellers). Thus the traditional base of all IBM operations, its US Domestic business, was undermined by a relative failure to develop the newer markets.

IBM was sometimes successful in these marginal areas, but this was usually due to the impact of a small group of enthusiasts, or even one individual. Arguably the PC emerged from such a process. In Biomedical this factor was evidenced by the UK, which - under my management - became the world leader in the 2997 market, eventually achieving a 90% plus market share within the UK, and perhaps as much as half of IBM's world-wide sales, by becoming the internationally recognised centre of leading edge competence in the new medical science of apheresis. I sponsored my own learned medical journal, together with international symposia and medical research which led to major breakthroughs. At the same time a rather differently motivated group of individuals in Germany made that the centre of IBM's ECG expertise. One of the failures of Biomedical Group was its inability to capitalise on these developments and transfer these expertises and enthusiasms between countries (and in particular to the expertise starved US). This was something in which - even in its prime -  'Big Blue' rarely excelled. IBM was superb at sharing expertise within countries, but this broke down at the national boundaries. This was the price of maintaining the country identities.

This leads naturally on to how Biomedical Group handled the problem of organising the World Trade countries. As the formation of Biomedical Group, and of most of the other IBU's, was US based, the international drive largely bypassed the traditional World Trade organisation; and showed a surprising lack of sophistication in the process. Indeed it showed many of the naive failings that accompany the first moves overseas by any new venture. At its crudest it betrayed signs of being based on a remarkably insular 'little America' approach. Biomedical senior management looked at the map of Europe, saw that it was about the size of Texas and accordingly set up a sales operation based on a single 'branch' located in the main town (Paris in this case) with 'salesmen' in the local territories (i.e. countries). The relevance of the red lines (showing the national boundaries) was lost in translation! This insular view eventually reached its most ludicrous extreme when a US despatcher shipped a machine for Germany into Lisbon (where IBM Portugal didn't even market the products) because that was the part of Europe closest to the US. The country it was really destined for was expected to send a van to pick it up!

There was, on paper, a perverse logic to the decision. The logistics said that, at least in the initial stages, the individual countries could not profitably provide their own support to the level needed.  The chosen solution was to centralise this support on the 'branch' in Paris. The structure of this 'branch' was, however, in this case set by a World Trade precedent, which was alien to the US concept (which was in any case clearly unworkable). The nearest previous European international equivalent was seen to be the Support Centre; designed in theory to provide very high level technical back‑up for all, but in reality supporting the minor countries (with the majors providing their own support, but carrying most of the costs). The eventual outcome of this was that the European 'head office' had as many staff in Paris as there were on the ground in the countries. In the absence of a conventional workload they justified their presence, in best Parkinson tradition, by reinforcing the (supposedly minimal) bureaucratic element of the Support Centre role. As a result they actually required bureaucratic support from the country personnel; and lengthened considerably the communication processes with the US.

The only countries that managed to avoid this trap were the UK and Germany; where, once more, strong individuals, backed by strong (and involved) country management, established their own nationally based operations with (illicit) communications direct with the US. Their secret, in both cases, was simply tapping into the existing national organisations, and redirecting their resources (a sure recipe for success within IBM). The important role of the informal structures, and communication processes, that permeated IBM (even between countries) was thus most practically validated.

It is too easy to see IBM as a multinational ruled in all things by Armonk; with the countries merely being its servants. Biomedical showed that the true picture was much more complex. It was very definitely the countries that laid down the law to their national groups, not the centre; even where the operation was so relatively unimportant to them. I was faced, at one international meeting, by a disbelieving General Manager of Biomedical (who reported direct to a sub‑committee of the IBM Central Management Committee at Armonk) when I had to answer one of his 'instructions' with the statement that I would do my best to persuade my country management to support his 'request'. I knew very well from experience (even if he, attending one of his first such meetings, didn't) that the decision was theirs, not his!Having received 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 1,000 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.

In the early days of Biomedical most of our meetings took place in Paris, where our European HQ was. This became something of a routine.  Thus, late at night - carrying hand baggage only so I could get rapidly through the terminals - I would fly to Paris; to Charles de Gaulle airport.  There I caught the shuttle bus into Porte Maillot, where I stayed in the hotel above the terminal.  The hotel was something like 500 feet high and had superb views over Paris.  On the other hand, I was so tired -- and so blasé -- that I never opened the curtains to see the views. 

The following morning I would go in by the Metro, to the Arc de Triomphe which was the next stop along the line, and walk down Avenue Wagram to an ordinary IBM office where we had our meeting. The only difference from my normal day to day work was that, in the evening, we had excellent meals in the best Paris restaurants.  Having said that, even these posed problems. They always started too late and I always ate too much. As a result I nearly always felt uncomfortable afterwards.

The routine changed when we had one meeting in Germany, in the Bavarian Alps above the snowline.  It was at a skiing hotel, immersed in the snow. As such it was more interesting, and we enjoyed a number of additional pursuits.  Thus there was a competition for shooting, in which I won second prize -- my performance had declined from Imperial College.  Other than that I can only remember – about the meeting - that, in terms of politics, the nurse who had come aboard to provide technical expertise was starting to throw her weight around. Len relied on what she thought, even though she didn't know that much.

My one really memorable experience occurred when we had a spare a few hours. I decided to go up the mountain by the nearby ski-lift.  I set out, dressed only in my pullover and trousers since it was a nice day, going up the ski-lift only a few hundred feet – as I thought - to the top of the nearby hill.  Unfortunately, as I started up it, it started snow. What was worse was that, as I came to the top of the hill, I realised to my horror that it the ski lift went straight of the top of the mountain; without any stops on the way. As I got finally the top, I was frozen to the marrow and barely made it back down again. 

The next meeting was rather more adventurous, but actually saved money.  Thus we met in Stockholm and had day-long meeting there.  Then we caught the overnight boat to Helsinki.  It turned out that sleeping on the boat was much cheaper than sleeping in a Stockholm hotel.  In Helsinki most of the party met in the morning and then had the afternoon of sightseeing -- Pat was with me and went on this sightseeing.  Unfortunately two or three of us, from the leading countries, were called to an emergency meeting and I never got to the sightseeing. 

That night we went back Stockholm, again by boat.  It was notable for being caught in a very strong gale, with the waves reaching eighty feet; as high as the bridge.  On the other hand, as these were very large ferries -- something like 60,000 tonnes -- it wasn't actually appreciable when you were lying down.  Accordingly, for once in such conditions, I didn't feel very sick.  On getting off though, when I stood on dry land, I found the land swaying underneath me; as a result of spending so many hours in an unstable environment.  I was amused to hear one of my colleagues explaining, to a senior IBM manager, that the reason that the whole of Stockholm was swaying was that it was built on piles. He hadn't realised that the effect was the result of our own experiences..

Each year I made a trip to the States to meet with the people in the factory and development laboratories.  Latterly we went to see the ECG machine being developed in Poughkeepsie.  For once management had taken a sensible decision and shut down the Mount Kisco operation, but - under threat of losing its senior engineers - it had moved ECG development not to Dayton in New Jersey but to Poughkeepsie in upstate New York.  It was pleasant enough driving up there, perhaps most notable for having breakfast at the diner on Westchester County airport.  It was still a traditional US diner and served the excellent food you could still could get in such places.  It is a pity that they seem to have disappeared since then.

For once I stayed in central New York. Previously I had stayed out of New York and had to drive in to experience the sights New York.  Even so, I had taken in all sights; from standing at the top of the World Trade Centre to driving through Harlem.  But I never got a real feel of New York -- and in fact I rather hated it.  This time, staying at the Hilton on the Avenue of the Americas, essentially on the edge of the Rockefeller Centre, I got a very different feel of New York.  This was despite the fact that the Hilton hotel, with a thousand bedrooms, was soulless -- and someone stole my alarm clock from my bedroom.  But, for once, I got some feeling for what central Manhattan was about. In particular, on the Sunday, I went to Fifth Avenue and watched the Greek Day parade.  Literally thousands of the families with children paraded past in their Greek finery.  I found it a very emotional sight and almost came to tears a number of times.  It was then that I understood the commitment by the ethnic communities in America to their own nations.

One of the lunacies of Biomedical Group took place, however,  when they insisted that I fly to New York for just one day. They were having a conference for everyone in Biomedical Group, right down to the cleaners on the shop floor; and they wanted the overseas countries to be represented as well.  They hired the Hilton hotel in the Meadowlands in New Jersey, just outside Newark, and took the whole factory there.

My only role was to stand up at one point in the proceedings. Thus, the vice president started this part of the proceedings by saying “…and from the rest of the world”. This was  followed by a list of countries. As each country was introduced, its team stood up – to the cheers of the audience, Thus, at the point where this extended to "...and from the United Kingdom, David Mercer", I also stood up bowed to everyone, and then sat down again. That was the sole reason I had to travel backwards and forwards to the United States in just 36 hours!

Having said that, I made the most of the visit. I was in the middle of bringing the first machine into the United Kingdom, in order for the DHSS to test it, and I was able to talk to all the technical experts in the group about these tests.  This did, therefore, short-circuit a lot of questions, so the trip was not totally wasted.  Even so it was one of those idiotic gestures that companies are wont to make. 

It was, though, personally significant from another point of view.  Flying across to New York I picked up a book to read on the way. It was a book about ESP, such as telepathy, by Stamford Research Institute (SRI).  As, by that time I had already experienced telepathy with the children, I was already sold on the idea.  In any case SRI was very reputable organisation, and - as I read the book - I realised that their work had been very well founded. This didn't stop it being dismissed by all the many critics of such sciences. One of the more ridiculous observations is that 70 percent of people report that they have had such ESP experiences, including 70 percent of scientists, but scientists as a group refuse to accept the concept -- and do precious little research work on it.  Against this general trend, the SRI work was excellent.  It was particularly good at handling clairvoyance or distance seeing.

They had people (psychics and others) who were put in controlled conditions and asked to describe a position on the map many miles away.  These targets were chosen at random and the clairvoyants had no way of knowing what was there in practice. Even so, these people were able to get quite accurate pictures of the places that they were asked describe.  One of the more interesting cases was where they were given position in the middle of the forest and described a whole collection of buildings there.  When the map was consulted, no buildings were shown there, but when it was visited on the ground it was discovered it was a highly secret American intelligence base!

The nice thing about this book was that it explained how you could do your own test; to see whether you could also see at a distance.  In this way, 30,000 or more feet above the Atlantic with several hours to kill and nothing else to do, I thought this would be a great location in which to test my ESP.  Accordingly I started to draw a picture of what I thought the place I was going to, the Meadowlands Hilton, would look like.  I didn't know anything about this and I hadn't being told anything about it in advance.  I suspect almost nobody I knew would have even heard of the location.

I drew a very strange picture. The hotel, that was what I assumed it was, looked like a normal hotel. That said, it seemed to be surrounded by something like a circus tent with some pine trees around it. Behind it, though, was an open stretch of water; with three motorways crossing over each other in the middle of the water.  Even stranger, on the far side there were three high towers, a circular building with a chunk out of it and another building which was like a slab of cheese. Overall there was steam rising everywhere.  I heaved a sigh of disappointment.  Nothing, but nothing, could be that strange!

When I arrived at the Hilton hotel, having negotiated a surprise snowfall which had all the American cars hitting each other -- so much for American preparedness for snow -- I found the hotel was nothing special. It was just a normal Hilton hotel.  Alright, there were a few stunted pine trees planted outside but that was all

The next morning when I went down to breakfast, however, I found that the dining-room was extended beyond the base the building into a sort of conservatory; over which there were brightly coloured blinds - giving the impression of a circus tent.  I was taken aback a bit at this for it did seem to fit in with what I had seen.

The real revelation came when I went back to my room and drew the curtains. The hotel overlooked the water in the swamplands of the Meadowlands, and these stretched into the distance.  Running over this were the three motorways crisscrossing each other - in almost the exact configuration I had imagined. The three towers were there also. They were in fact radio towers.  The circular building, with the section cut out of it, was the baseball stadium and the cheese shaped object was in fact the grandstand of the racecourse.

This was astounding, since it meant that I had seen in considerable detail, from a distance, a picture of the place to which I was going; despite the fantastic nature of that view.

What was even more interesting was the fact that there wasn't any steam, but snow was falling; and this gave exactly the same impression. The problem with this was that the previous day, when I had seen it, snow was not falling.  The implication for me was quite significant. It meant that I had also been able to see into the future. 

I well remember - when I spent an idle afternoon in my vac job at the Strowger Works tossing a coin with Norman Killey. I correctly predicted fifty ‘heads or tails’ on the trot, an ability that surprised even me. It was not particularly useful, since it was unpredictable in its own right and never gave me anything which was useful in terms of picking the winner of the Grand National or anything like that. But the odds against getting such a result were close to infinite! The only time I tested it in terms of a casino, where I was betting on red and black, I did manage to boost my winnings from £10  to £900 before I lost my touch; and lost my stake.  But apart from that I never made money from my ability to see the future.

It was significant really only in one way. That was that it convinced me that, at least, physics, and indeed all the sciences, were wrong in one major respect.  Nothing in physics could predict such phenomena.  There have been a few claims that particles can travel into the future but nothing which would explain how I could see into the future or even see at a distance -- or even undertake telepathy.  I don't know how it is done and it's not terribly useful.  At best the process works at a rate of just a couple of baud a minute.  You can get very simple answers back but not particularly helpful ones.  But that was pretty much the same when people were investigating the early stages of electricity.  It would never have occurred to them that a whole society would, as now, become dependent on electromagnetic phenomena.

The terrible thing is that scientists, and our leaders in general, just dismiss such events as individual daydreams or mirages; or worse still - as the television programmes prove - the work of cheats. For me what remains, therefore, is the enormous question of what forces -- outside any considered by sciences at the moment -- are involved in producing the phenomena.  The sciences dismiss them on the basis that nobody can reproduce the experiments, but then they couldn't reproduce lightning which led to the idea of electricity in older times, and dismissed each individual's experience as a worthless aberration..  One of these days, though, they will realise that there are massive forces at work which they have never even considered.

The opening up of the IBM Biomedical Group  proved to be a real stimulus for my sales techniques. Initially, of course, it was an exploratory venture and for the first few months my role was largely as a researcher. Subsequently, as the group became established, the role was extended to `consultant', where the PR element was still more important than the commercial aspects. Even so, I found that this low-key approach was immensely successful. In truth it made me even more successful than I had been with my hard sell. The picture was consolidated by the fact that, for much of the time, I was up against (head-to-head) just about the best conventional salesman I have ever come across. He was superb. His traditional sales techniques were near perfect. His skills and personality could not have been faulted. Yet, by my anti-salesman approach, I managed to achieve a 90 per cent win rate against even this paragon.

Thus, when I moved on to start my initial sales contacts. Once more I threw myself on the mercy of my potential customers. There really was no way that I could disguise my lack of medical knowledge from a doctor. But, once more, they were only too pleased to talk to me. Over the next few months I rapidly learned not just to talk the language of the trade, but even gained sufficient technical knowledge to be able to lead them into new lines of research. This latter level of expertise is not normally necessary for a sales professional; but my experience showed that, if you can handle the technical requirements, it can be very fruitful.

Ultimately, I probably made three to four times as many customer calls as my colleagues. However, these only took something like 50 per cent more of my resource, and I estimate I achieved as much as three times more repeat business than my colleagues did. In any case, I enjoyed these customer calls most of all. They were rarely stressful; the relationships had already been successfully built. The customers were my friends.

A pride in one's work is essential to be a successful sales professional. In my days of medical sales I did not merely become well versed in my products, I became one of the world's leading authorities on apheresis; the medical process of cell separation. As such, I was listened to by leading medical consultants in the USA and Europe, not just in the UK. Indeed, one of my most memorable, and pleasurable, experiences was walking along the beach at Travemunde, on the Baltic coast near Hamburg, with two of the leading international experts on apheresis. We were at a medical conference there, but our conversation as we walked along the beach was about future developments in the medical treatment of various immunological diseases. The conversation took off into the stratosphere and I was able to participate as an equal. This was the real joy of my role in Biomedical. I personally, by my contributions at times like this, helped save thousands of lives.

To support my Biomedical marketing, I organised several learned symposia. Each lasted a full day with a dozen or more speakers, presenting papers that were at the leading edge of medical research. Identifying who were the most important researchers in the forefront of medicine was no easy task in itself. I brought these speakers in from around the world, flying them from the USA as well as from Europe, at a cost of several thousand pounds in air fares alone. The audience, typically of around 600, had to be housed; and there are relatively few venues capable of handling this number and providing the atmosphere needed. They had to be seated, and had to be able to see and hear what was going on (which required full, professional, lighting/projection and sound teams - with up to half a dozen outside staff just for this). Of course, they also required feeding; and, where the details now counted, this had to be well done. It was a monumental task, and cost the best part of £10,000 each time; together with a number of weeks' work on my part. Again, though, it was a dramatic success, and significantly enhanced my group’s reputation.

At IBM I was never selling in a vacuum. I was always well aware of the shadowy figures who were my competitors. On the other hand, the way I dealt with them was sometimes very idiosyncratic. Thus, in those days at least, those in the (hospital) market were very concerned with their professional image and hated anything commercial! Accordingly, I used to present a picture of myself as an 'anti-salesman', saying for example “I could never be a good salesman, with my ample figure!”, and subtly reinforcing the image of my competitors as smooth (and, by association, untrustworthy) operators. In addition, as a balance to the very professional ('expert consultant') image I presented, I used to include anecdotes about my 'incompetence' as a salesman, typically adding the comment, “I will never make the grade as a real salesman. It's fortunate that in this job I can concentrate on helping customers, and forget about all the sophisticated techniques of selling!” I even used to let slip honest `snippets' about problems with the equipment; very carefully, though, explaining how they had been solved. By implication I suggested that my competitors had similar, or worse, problems which they didn't talk about - probably because they hadn't resolved them. I accompanied these `indiscretions' with the disclaimer: “Of course, if I were a good salesman, the ultimate salesman, I wouldn't tell you this, but I believe that honesty is the best policy.”  

Most of all, though, I deliberately displayed my admiration for the sales skills of the individual salesmen competing against me. As I have already said, my most competitive campaign was reserved for the best salesman who ever lined up against me when I was running the marketing for Biomedical Group. During the social chit-chat, I would confess my admiration (which was genuine) for his sales techniques. I would carefully explain to the prospect exactly how the techniques worked, and suggest that the prospect watch this salesman the next time he called. As a result, that salesman walked into calls where nobody listened to his pitch, but instead watched his techniques. All they saw was his smooth objection handling (“That must have been the 'apparent agreement technique'”) and his closing (“My god, that was a clever 'alternative close'”). Of course, these prospects did not really admire his style; they hated it - it was the epitome of salesmanship (a term of abuse for them)! That salesman must have wondered what was happening: the harder he practised his skills, the more he lost their confidence. I backed up my `admiration' by explaining that he was such a good salesman, much better than me, that: “If I didn't have a machine that was so much better than his, the proverbial better mouse-trap, with his sales skills he would walk all over me!” This was not strictly accurate, since the machines were not too different in basic performance; though I worked hard to create procedures which made our machine much better.

The final benefit of this anti-salesmanship was that it offered a very distinctive trade-mark. Before a prospect can place an order with you, he has to remember you. If you are indistinguishable from the morass of other salesmen, he may have some difficulty matching you to your product. I gained most recognition at an industry conference at Stirling University. I was, foolishly, trying to demonstrate our blood cell washer. I shouldn’t have done so! To load the machine I had to insert a plastic line into a bag of blood, an outdated one we had got from the local blood bank. This was something I was never good at, and that day I exceeded even my worst performance; and I pierced the side of the bag. As the blood started running down my arm, turning my sleeve bright red, I made a dash for the gents toilet. In there I dumped the bag in the sink and tried to empty it completely, by stabbing it with a pair of scissors. Blood was spurting everywhere when one of the doctors entered, to apparently see me stabbing myself in the wrist. It took some explaining.

For some time thereafter not a few of customers used to introduce me to others as “Don’t you remember him? He was the one who got blood everywhere in Stirling!” Never mind, they didn’t forget me. Mind you that night I had to fly to Paris with one shirt sleeve white and one, even after washing most of the blood out of it, a delicate pink!

When IBM Biomedical Group started up in the UK we used the US brochures, which simply showed what the machines looked like and described – very briefly – what they did. Later though, for quite a long period, my main mailing was deliberately designed as a `sleeper'. It was a quarterly medical journal of some international repute. Discreetly, but very clearly, it gave my address and telephone number; so that, when the prospect came to make his decision (which could be any time over a five-year period), this information was instantly available on his bookshelf; and he would contact me before thinking of anyone else. It was a relatively long term investment, which many sales profes­s sales professionals would not consider, but it worked.

This Journal, finally named the ‘Apheresis Bulletin’, was a genuine scientific journal  - which was at the leading edge of plasma exchange.  This was the up-and-coming area where the cell separator was being used.  The idea behind the Journal was that it would give us a degree of authority, whilst at the same time expanding the use of the machine in terms of the markets addressed.  But above all it was intended to sit on shelves in the consultant's office, so that, if he ever needed a cell separator, he only had to go to his book shelves to find our contact details.

It was a very interesting project. I hired Terry Hamblyn, who was the consultant at the Royal Victoria hospital just outside Bournemouth. He was one of the up-and-coming livewires, and was happy to edit the journal. Of course, the fact that we paid him handsomely for this helped. Unusually for academic journals, we paid contributors. Accordingly we were able to go out and get the best contributors.

To manage the academic content, where I was the publication editor covering all the other administrative factors, I hired a top flight editorial board. Indeed it was of incredible quality, with people like John Goldman and Ray Powles, as well as some of the blood transfusion directors.  Even so, the meetings of this editorial board were a hoot. Everyone got on very well with each other, and there was as much laughter as there were serious decisions.  For all of us I am sure it was a very enjoyable experience.

As a footnote, I took some pleasure in publishing, under the IBM name, a paper on priapism. This is the medical state where men get permanent erections.  Moreover, I included several pages of photographs of these.  I think I was probably the only member of IBM who managed to get pornographic photographs into its material.

On the other hand, I also built something of a similar reputation within the company across the UK. At the kick off meeting, where it was traditional that all the key players - usually senior managers - were presented to the audience of many hundreds by a photographic slide - sitting sternly at their desks and looking very earnest - I was shown in bed being attended to by a nurse and seemingly attached to the IBM 2997 machine.  Of course the whole audience broke out in laughter and the managing director even referred to it in his final speech.  It's useful at times to be a celebrity!

We also took stands at the usual range of medical conferences. I eventually decided that this was an unproductive waste of our time, even though we only took a small shell stand and had our own portable stand equipment to furnish the shell. I achieved some prominence, though, by the simple expedient of having very powerful lighting. Indeed, one of the simplest, cheapest and best means of highlighting a rather dreary stand is to use at least twice the amount of lighting that everyone else does. The stand will be a (somewhat hot) pool of light, standing out from competitors, for very little cost.

On the other hand, one IBM group, with which I worked, spent a small fortune on a colour blow-up to cover the whole back wall of their stand at the Royal Show, the largest agricultural show in the UK. It showed a hillside covered with a crop of corn and colourfully dappled with poppies and other wild flowers. It was a beautiful picture. Unfortunately, all that the farmers attending the show could see was a good crop ruined by weeds. Poppies are an expensive mistake for a farmer - and in that case for IBM!

My main way of selling the cell IBM 2997 separator was, though, to invite people to a demonstration of it in use.  Needless to say, this had to be in a hospital where they were actually treating patients, typically for plasmapheresis. In the main I used the Royal Marsden hospital in Sutton; but I also used the Manchester Royal and Glasgow Royal hospitals. 

Indeed, seminars at the Royal Marsden, at Sutton in Surrey, became something of a routine. For each event, I hired a room there since they had excellent facilities for meetings. In this I gave a multi-media introduction to the operations of the machine.  Only then did we go to see the machine actually in operation. Finally we returned to the meeting room, for question-and-answer session – at which Ray Powles, the leading oncologist there, would also address the audience.

My style was very laid-back, and most of the attending sold themselves on the virtues of the machine.  Accordingly my main approach was to seemingly hold people back, for example saying "...don't get too enthusiastic, be as realistic as you can about it".  This only pushed them into being even more enthusiastic -- and incidentally protected me against future problems from them feeling they had been oversold.  Usually I was able to get a commitment from a significant number of the audience before the seminar was ended.  On the other hand, the cash raising procedures were so horrendous that it typically would take another two years before they actually were able to buy the machines.

After the meeting we went down to the restaurant in Sutton which I regularly used for the meal.  As far as they were concerned, I was the last of the big spenders and accordingly the food was always very good.  Not least, the restaurant knew my taste and rang me beforehand to see whether I wanted fresh lobster and strawberries flown in from California (when it was rare for such things); and I usually did! 

Entertaining was something that medical consultants knew of about.  As I went around the country, and took them out for lunch, I gained experience of some of the best restaurants in the UK.  Later on I was able to say, of the up-and-coming chefs, I had tasted their cuisine when they were first starting out.

I must have run three or four dozen such small meetings, but I also decided to back this are with a large-scale symposium which was intended to reach a wider selection of people. Accordingly, I ran a symposium - for UK attendees - at the Royal Society. To hire the main hall at the Royal Society you had to go through a member of the Royal Society -- fortunately John Goldman arranged this for me.  With something like 1,000 attending, it was a major event, with international speakers.  It was very successful in creating awareness amongst haematologists in general.

I then ran a second symposium in the building with the roof gardens in Kensington High Street. After Derry & Toms had closed, the top floor of this had become a conference suite.  In this case the thousand or so consultants attending, as well as coming from the UK, also came from overseas; as did most of the speakers.  Again it was remarkably successful.  It did, however, mean that I had to start to develop skills as an impresario. We had to hire not just the speakers, and pay for them coming from overseas, but also had to hire in all the sound and projection equipment.  It was a major venture, but great fun

The biggest fear I had, when I moved into IBM Biomedical, was that I wouldn't be able to cope with the medical environment. Fortunately, this proved wrong. In fact, as with most jobs I have undertaken, I managed to read myself into medicine in a matter of two to three months. Again as usual, I consolidated my knowledge and experience, by talking to the best experts in the country. This, incidentally, also set a wonderful foundation for my later sales campaigns.  Accordingly, I became a real expert on haematology; and on plasma exchange in particular.  In the case of the latter, I was ultimately to become one of the world's top experts -- whose opinion was sought by many of the leading international consultants. 

Fortunately, I missed another operation in Cambridge.  I was in hotel there, on standby, when they undertook a liver transplant.  For some reason the hotel didn't manage to track me down, even though I was fast asleep in my room. I suppose I should be grateful for that, since in those days the operation was not just relatively unsuccessful but was incredibly messy. The surgeons needed the wellingtons they wore, since they were wading through inches deep blood! The operation took something like sixty pints of blood.

At times the medical experience had its amusing side, though.  For example I found myself, at one teaching hospital, doing the rounds with the consultants and being asked to support their decisions. It was an amazing experience. As usual, the consultants discussed each patient in front of them; assuming that the patients wouldn't understand a word of what was being said - though of course they did. Even so, patients are so trusting in their doctors - foolishly so at times - that I believe if asked to sign for permission to have their head amputated they would!

Incidentally, inside most hospitals I was always thought to be a consultant.  This was partly because I was one of a few people in a suit who moved purposefully through the hospital -- most of the others were visitors who had a lost look about them.  In terms of medical staff, of course, most junior doctors – typically the housemen - wore a white coat, with their stethoscope hung around their neck; they were expected to have to use the stethoscope regularly. Registrars, on the other hand, had their stethoscope stuffed into the pocket of their white coats, since they used them more rarely. Consultants had no white coat, just a suit, since they expected their firm to do all the hands-on work with the patient. Thus was the hierarchy maintained and I - in my expensive suit - was automatically seen as a consultant; and the crowds of nurses and junior doctors parted before me as I made my progress! 

In terms of the hen-pecking order, also remember going into some hospitals with my colleague who was a dentist.  The consultants immediately probed us about who we were, and he proudly described himself to them as a dentist -- from which point they almost totally ignored him, since dentists are seen as failed doctors.

After one doctor's round, when we got back to consultants’ office, I found myself being put behind his desk as the consultant almost cowered in the corner. "Please will you explain what is happening, to the wife of patient" he pleaded. I had already got the impression that her husband, who had to sign a consent form for the operation, was still under the anaesthetic when people had held his hand to make the signature. However, I was happy to explain matters to his wife – who obviously was quite a powerful lady.  Only after she had she left did the consultant tell me that she was the hospital matron!

Once I had begun to consolidate my understanding of pheresis, I moved on to try and develop the usage of this.  Thus I attended various conferences in Europe and the US to learn what were the latest developments. I then spread this knowledge amongst my customers and, in turn, they then worked on various developments.  This was not a matter of developing the machine, but of testing the various plasma exchange procedures -- which was the new aspect I focused on -- on patients with different diseases. 

My commercial interest in this type of procedure arose from the fact that the IBM cell separator was needed to separate out the existing – diseased – plasma so that it could be replaced by fresh plasma provided by the blood transfusion service. At that time there was anecdotal evidence that a number of immunological diseases could be treated by this procedure. Hence, I used to persuade my clinicians to try an ever wider range of patients -- typically in the field of immunology -- to see what benefit their patients might get. I was then able to spread this information around my UK customers and also report it at international meetings.

The first international meeting, however, was in Paris; where our cell separator was first launched in Europe.  The whole of IBM Biomedical Europe was on hand to demonstrate the machine.

It was my first experience of a medical conference. Something like 5000 doctors attended, and it seemed like most came from Australia. It was significant, however, that - although there were 5000 attendees - the conference rooms could hold no more than a thousand. I gained the distinct impression that many of them were actually on a tax deductible holiday.  But it was certainly a beautiful venue for a holiday.

I can't remember much about the actual Congress itself, except that my American colleague Corky Bastian developed an upset stomach and this was made much worse by him taking the prescriptions given him by three consultants at the same time!

On the other hand, this was one meeting where I took my wife and family with me.  We hired a flat in the town of Asniere, on the northern edge of the city, for a couple of weeks. While I was busy they did the sights in Paris. They covered everything; more than I would ever see. The only day we had together was the middle Sunday, when we went down to Fontainebleau to see the chateau there.  En route we stopped and bought a baton of bread, together with some brie and a bottle of cheap wine. We had this as a picnic in the Gorge D'Apremont; a beautiful country area just outside Fontainbleu.  It was a lovely meal, one of the most memorable ever, very simple but delicious.

During our training for the ECG machine which was due later, the week before we were taken to the Saint Petriere hospital; one of the main hospitals in Paris – where Princess Diana later died.  There we were shown the various surgical procedures taking place.  As we were able to watch from the gallery above, we saw a large part of an open-heart operation.  I was expecting it to make me queasy, but it didn't do so -- the part where they put in the device to crack open the chest wall, so that the surgeon get inside, was perhaps what made me most squeamish.  But the surgery had some fascinating moments.  The registrar spent most of the time preparing patient, including opening the chest, but his main job but was to take out the vein from the leg, which often is the most painful part of recovering from the operation.  All this was prepared, and the chest was open with the heart still beating, before the consultant deigned to arrive and spend 20 to 30 minutes attaching the bypass and checking that it was all right; before waltzing out again, leaving the registrar to shut the chest.  I actually found very little of this very squeamish, but I must admit all of us voted against going to a steak house afterwards; having seen the chest incision scarred by diathermy!  In fact by far the worst operation, which I also saw, was a hip replacement.  I think that was probably worse because it looked very much like carving a leg of pork, and this was somehow rather inhuman.

That was the most I ever saw of an operation. It was not, however, the closest I ever got to one.  The Papworth team were interested in using one of our machines in their heart transplant work, so I actually went into theatre with them while they conducted open heart surgery; albeit for a more routine bypass. Accordingly, I was just a matter of a few feet away from the operation that took place. However, as in this case the green sheets hid everything from sight, there was little to see. On the other hand, it was very interesting experience, rounded off by having fish and chips brought in to the consultants office next door!

Incidentally, there was a great amount of controversy about the transplant unit staying at Papworth, which was a small hospital, rather than moving to Addenbrookes, which was the massive regional centre. There were many arguments put forward, but when you were in theatre there the real reason became obvious. All the theatres at Addenbrookes were white tiled cubes, hidden in the bowels of the hospital. At Papworth they were on the top floor, and one side was a wall of glass overlooking beautiful countryside. As they operated, the surgeons had Mozart played over the hi-fi. It was a wonderful place to work. It may not been have efficient, but it sure was effective.

Later I went to various medical congresses in the States.  The most interesting of these was in Dallas.  Driving into Dallas from Dallas/Fort Worth airport I discovered the car was tuned to the classical channel. This was symptomatic of Dallas which actually was very sophisticated city.  It was nothing like the impression given on television.  We stayed at the Hyatt Regency, and I almost suffered from vertigo when I looked over the walkway that led to my bedroom, to look down into the atrium hundreds of feet below

The most interesting aspect of my time there was, though, that one evening the hotel hosted two high school Proms; taking place in the conference rooms in the basement.  It was especially interesting because I went down to observe these with an American colleague, from our development laboratory. He explained what the rituals were all about. It was interesting because one prom was a white group and the other one was black. Both were totally separate, and it seemed almost as if there was a colour bar, but the black group seemed to be having a whale of a time and looked like normal teenagers.

On the other hand the white group looked like something out of ‘Gone With The Wind’.  The boys were there in their white tuxedos and women were in their Scarlet O'Hara ball-gowns.  It was fascinating that they all had white or green ball-dresses except for one who literally had a scarlet one, and – like the heroine of the film - was obviously the one who wanted to stand out.  All came out to have their picture taken with their beau. All the time my colleague was explaining all the details of the rituals being enacted; as they must have been for decades before.  As I said it could well have taken place 100 years before.

Mind you the most eventful part of the Dallas trip was the travel to and from it. I arrived at Newark airport to discover that my flight, by Braniff, was actually from Idlewilde; which detail had been hidden in the small print. I was furious and audibly complained that Braniff was so bad it should go bust. I eventually caught another flight and - after being delayed above Dallas in a cloud-burst which flooded parts of the city - we landed safely.

On arriving in the terminal, however, I heard the announcement that Braniff had actually gone into Chapter 13. My problem was that I was booked on Braniff back to the UK, and Dallas was the hub dominated by Braniff. Accordingly, I spent a great deal of time over the next few days trying to rearrange my flights. I was told that extra flights by other airlines were being arranged, and we would be able to get out within the month! After much ringing around I was able to book a flight to the UK via San Fransisco! In the event I told the Thomas Cook branch in my home office to book me a new flight and sort out the cost later; and I got a flight at almost the same time as planned.

At about this time I started getting more directly involved in research.  Thus, I was working with the Royal Free hospital, who were trying to separate out stem cells.  This research was the philosopher's stone in those days, though it didn't really materialise for another couple of decades; but it is now one of the most significant areas of medical research.  In our case, at the Royal Free, what we were doing was taking the marrow, which had been extracted from the donor's hips, and refining it down -- using the cell washer rather than the cell separator -- to get a very concentrated layer of buffy coat (as the layer of lymphocytes and granulocytes was called).  This was then treated with various reagents to clean it further, and again was concentrated using the machine – to form layers of varying density. The main reason for doing this was trying get rid of the stray white cells which could cause Graft Versus Host (GVH) disease; which was the worst side-effect of a failed bone marrow transplant.  Essentially, when this happened, the patient's body, inside as well as out, turned into sores. It was an awful way to die.

We were quite successful and presented our work at a number conferences, from which it was taken up across the world. I believe it went on to save several thousand lives worldwide and contributed to the more recent developments which are expected to save millions more.

On the other hand I also got interested in using columns of coated beads to treat the plasma we were taking out of patients, since plasma was difficult to get and expensive; and also could cause anaphylactic shock.  I was once at St Thomas's hospital, opposite the Houses of Parliament, where - after a plasma exchange - the patient went into anaphylactic shock.  The worst thing was that we had just removed the catheters from his arms. The main thing, in anaphylactic shock of this type, is to get access into the veins and fill them full of saline or Ringers solution.  In this case the veins completely collapsed and the medical team had no access. It was touch and go for a few minutes, while the crash team desperately tried to revive him. It is something you don't think of, that - without suffering any major injury - you can literally die from shock.

Anyway we were determined to develop the columns which would process the plasma, the beads inside of which were coated with various substances. To do this though I needed to use the best the technology in the world, and I had one of my contacts in the Scottish blood service try to track this down. After couple of months searching the world, he came back to me tell me that the best the technology was actually owned by IBM Instruments Inc -- my sister company!  It shows you how bad are communications lines within companies the size of IBM.  Having said that it was worth the money, several thousand pounds, I spent on finding it.

In terms of our private lives, at the age of nine our children switched to Church Farm School, just across the road.  Church Farm School was a much greater problem.  For one thing, the staff and headmaster were not of the same calibre.  But, more important, the county council was set on playing political games with the future of the school.  Not least, they eventually decided to shut down the school; so that it could be used as a special needs school – and, more cynically, its playing field could be sold off for housing.

This brought me into the spotlight, as I was by then a councillor, and I started to help the parents with their campaign.  I've always enjoyed campaigns of protest, which will be remembered from my time in the anti-apartheid movement. But this was a much more gentle operation.  Thus, for the first week, the children's parents went -- under my direction -- to County Hall in Kingston where (complete with a big selection of placards) they noisily demonstrated outside the County Hall while the education committee was meeting.  Under a considerable amount of persuasion from me, the local press were there in numbers; and it was headline news in all the local papers.

The next demonstration, again timed to coincide with one of the education committee meetings, took the form of a motorcade.  This was all above-board, cleared by the police, and merely consisted of a dozen or so parents' cars draped with posters; which were to go round the one-way system in central Kingston a couple of times.  What the police had not realised, but was part of the plan, was that the cars spread out and moved very slowly.  As a result the ordinary traffic through Kingston, which was already slowing to look at all the banners, was slowed down until there was massive traffic jam.  Thus, instead of whisking through Kingston in a matter of a few minutes, the demonstration held up traffic on the grand scale for more than an hour. I particularly relished seeing a chief inspector forced to take up traffic duty to try and sort out the mess!  Again this made headlines in the local papers.

The greatest coup of all, though, was the following week; when I announced to the papers that, to help deliberations, we would not be demonstrating that week.  This again got front page news – all for an announcement that nothing was going to happen!

Despite all of this, the school was still ultimately scheduled by the education committee for closure.