Observations BMJ Confidential

John Guillebaud: Passionate, perfectionist, persevering

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g2456 (Published 09 April 2014) Cite this as: BMJ 2014;348:g2456


John Guillebaud’s career has centred on the role of voluntary birth control in preserving environmental sustainability. He was medical director of the Margaret Pyke Centre from 1978 to 2002, and in 1992 he took up a personal chair at University College London with the title professor of family planning and reproductive health. He continues to provide three hour presentations to GPs and practice nurses nationwide, he keeps his textbooks updated, and he is a national and international consultant. He has performed more than 5000 vasectomies and is now collaborating on a novel method of male systemic contraception.

What was your earliest ambition?

To be an engine driver. I was influenced by the mighty behemoth of a Garratt steam locomotive that pulled the train between Nairobi and Kampala on a joyful journey at the end of term, when I was off to Rwanda for the holidays.

Who has been your biggest inspiration?

My biology master, whose teaching inspired me to become the first doctor in our family; and another biologist, my Cambridge tutor Colin Bertram, whose evening lecture on population to the St John’s College Medical Society led me, while still a second year medical student, to choose family planning—the obvious specialty for a doctor concerned about the future of humankind on a finite planet.

What was the worst mistake in your career?

Speaking to a press agency in 1999 about the UK’s abysmal performance in preventing teenage pregnancies, without insisting on an advance view of the text that they would distribute worldwide—including to the Daily Mail! Damage limitation was difficult once I had been comprehensively misrepresented.

What was your best career move?

Joining the staff of the Middlesex Hospital (later to be University College London Hospitals), as a consultant gynaecologist and medical director of the Margaret Pyke Centre for Family Planning.

Bevan or Lansley? Who’s been the best and the worst health secretary in your lifetime?

Lansley was the worst, for what seems the worst of the NHS’s far too frequent “re-disorganisations”; and Bevan the best, although he hoped that his NHS would eventually become less expensive as general health improved. He never foresaw the complete opposite, which has come about through less smoking, longer lives, the arrival of new technologies, and enhanced public expectations.

Who is the person you would most like to thank and why?

My wife and best friend, Gwyn, for her unconditional love and support.

To whom would you most like to apologise?

To everyone’s grandchildren, because of the saying “We have not inherited the Earth from our grandparents; we have borrowed it from our grandchildren”—on which I based my 1994-2044 environmental project www.ecotimecapsule.com, which is ongoing (see www.justgiving/2wheels2kidsgreener).

If you were given £1m what would you spend it on?

Women(!)—by advocacy and actions to promote the proper resourcing of voluntary family planning. It’s a win-win intervention, regardless of eco-issues, through reduced maternal and infant mortality—yet it still gets less than 1% of aid budgets, which is derisory.

Where are or were you happiest?

Probably now, playing with my two grandchildren. My most memorable happy time was sharing (after weeks of beans and rice) a freshly hunted, woodfire roasted “porco do mato” (peccary) with my hosts in the Kamayura village, who were as friendly as they were unfazed by my wearing clothes. This was while I was a medical officer on the Mato Grosso expedition of the Royal Society and Royal Geographical Society in 1967-69.

What single unheralded change has made the most difference in your field in your lifetime?

Post-it notes—an essential requirement for me, the quintessential absent minded professor! Also the arrival of the levonorgestrel releasing intrauterine system (Mirena), which I say “ticks more of the boxes defining an ideal contraceptive” than any other, and yet about which there has been a deafening media silence.

Do you support doctor assisted suicide?

No. I can see no safeguards that could avoid producing more net public harm than exists now, wherever there is optimum palliative care. In terminal care I believe in the proper application of the principle of double effect, where with good communication the provider intends always the beneficial effect of the complete relief of symptoms despite the shortening of a life whose quality has all gone. And I always believe “Thou shalt not kill, but needst not strive officiously to keep alive” (Arthur Clough, 1819-61).

What book should every doctor read?

The Population Explosion (1990) by Paul and Anne Ehrlich. Written decades ago, yet so prescient and environmentally holistic. The title of the first chapter says it all: “Why isn’t everyone as scared as we are?”

What poem, song, or passage of prose would you like mourners at your funeral to hear?

“Faith,” from The Unutterable Beauty—the collected poems of Geoffrey Studdert Kennedy, a padre in the first world war.

What is your guiltiest pleasure?

Those addictive dark chocolate ginger biscuits from Scotland, with coffee from freshly ground Colombian coffee beans.

If you could be invisible for a day what would you do?

Discover first hand what the self interested world elites are really planning behind closed doors to (not) do—especially about climate change.

Clarkson or Clark? Would you rather watch Top Gear or Civilisation?

Clarkson! I need to know what our opponents are up to. Anyway, I enjoy (some of) the antics of this high priest of overconsumption.

What television programmes do you enjoy?

Good dramas, such as Broadchurch and Borgen. Or anything by David Attenborough revealing the incredible beauty, biodiversity, and Gaia-like interdependence of the species that share our home, or at least try to.

What is your most treasured possession?

My green Brompton fold-up bike, which I take almost everywhere. I maintain that, environmentally, bicycles are like contraceptives—although maybe a bit cumbersome in the bedroom.

What personal ambition do you still have?

To stay fit enough to enjoy a full life, including entering the annual Brompton World Championship: a time trial after a Le Mans style start for over 600 entrants, all of whom must wear jackets and ties. Lycra is forbidden!

Summarise your personality in three words

Passionate, perfectionist, persevering.

Where does alcohol fit into your life?

In a beer mug, watching Arsenal or England.

What is your pet hate?

All examples of unthinking BAU (business as usual), whether it’s leaving the lights blazing or making unnecessary car journeys, meaning gluttonous energy use and emission of greenhouse gases as if there were no tomorrow.

If you weren’t in your present role what would you be doing instead?

Probably not an engine driver! Maybe an entrepreneur for the green movement’s five “R”s (refuse, reduce, reuse, repair, recycle)—hopefully with success, generating big bucks, and thus getting media influence as a “celeb.”


Cite this as: BMJ 2014;348:g2456