Fillers A memorable trainer

Dr John Annear

BMJ 2002; 324 doi: (Published 11 May 2002) Cite this as: BMJ 2002;324:1152
  1. Daniel C Riordan, specialist registrar in psychiatry
  1. St George's Hospital, London

    Dr Annear was a sage-like, enigmatic, paternalistic, “old school” eccentric whose outpatients clinics stretched into the very late evening. Patients would wait to see him for their appointments, often bringing soup or tea and bedding down until it was their turn. This was not some outback post in the Third World, this was inner city London. Although, the length of outpatients clinics and the fluidity in boundaries were frustrating at times, they were a place of great learning, not in the formal sense but in the artistic practice of medicine. I learnt to listen. The patient's narrative was paramount, and, by example, I too learnt to listen actively. Patients commented after ward rounds that they felt somebody had heard and respected their account.

    Formal supervision took place while on home visits in a clapped out old camper van, which often broke down and was full of old papers and rubbish. A huge bag of Mars bars and full bodied Coke was stashed behind the passenger seat. This was the staple diet of many a trainee, fearful as the camper van sped along a busy main road at full throttle at 20 mph. I was inspired to read and take on new ideas. My trainer had been through several major changes in the NHS and mental health services. Ideas came and went, but he was still able to explore and encourage trainees to read and learn. This infamous van was a place where essentialist and social constructionist accounts of mental illness and the human condition were explored. One session centred on a critique of second wave feminism stimulated by a particular clinical problem. It was an unorthodox yet inspirational introduction to psychiatry.

    This six month placement was often frustrating, often surreal, but remains a treasured memory.


    • We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

    View Abstract

    Sign in

    Log in through your institution

    Free trial

    Register for a free trial to to receive unlimited access to all content on for 14 days.
    Sign up for a free trial