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Observations BMJ Confidential

Iain Chalmers: Guilty, obsessional, and frustrated

BMJ 2013; 347 doi: (Published 30 October 2013) Cite this as: BMJ 2013;347:f6152

In the latest in its series asking the movers and shakers of the medical world about work, life, and less serious matters, the BMJ spoke to a pioneer of evidence based medicine


Iain Chalmers is one of the founders of the Cochrane Collaboration, named after Archie Cochrane, who first dreamt of collecting and publishing critical reviews of knowledge from randomised controlled trials. Chalmers became director of the UK Cochrane Centre in 1992 and convened the meeting at which the international Cochrane Collaboration was inaugurated in 1993. Since 2003 he has been coordinator of the James Lind Initiative, which has used a variety of approaches to promote better research for better healthcare. Chalmers always refuses invitations to speak or write about evidence based medicine because, he says, “as a clinician who has not practised clinically since 1973 I don’t think my opinions on this important topic should have any credibility.”

What was your earliest ambition?

To be a doctor, so it was a relief when I scraped into medical school, helped by nepotism. A wake-up call came when I failed my second MBBS physiology exam after having too much of a good time in swinging 60s London.

Who has been your biggest inspiration?

Archie Cochrane. His book Effectiveness and Efficiency showed me how evaluative research could help me to make sense of conflicting opinions among clinical “authorities” while also emphasising the importance of the less tangible aspects of good care.

What was the worst mistake in your career?

I’m spoilt for choice. The fact that some of my Palestinian child patients with measles suffered and probably died from bacterial superinfection because I had withheld antibiotics (as I had been instructed to at medical school) must rate as one of the worst.

What was your best career move?

It’s a toss-up: either a decision to work in a Palestinian refugee camp in Gaza for a couple of years or to accept the invitation to establish the National Perinatal Epidemiology Unit. My inexperience and naiveté on both occasions had some very negative consequences for me and for others, but I learnt a lot of hard and useful lessons.

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

Kenneth Robinson was the best, for introducing sound financial incentives to attract bright medical graduates to take up careers in general practice. There are several candidates for the worst.

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

I will never be able to thank my wife, Jan, enough for supporting me and putting up with my foibles.

To whom would you most like to apologise?

As just one of uncountable numbers of apologies due, I would like to apologise to the person who I implied (when aged about 12) had scratched a 10 inch LP of Tchaikovsky’s 1812 Overture when, in fact, I had scratched it.

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

I would give it to Ben Goldacre to help him continue to promote bullshit detection and to lobby for research to meet the shared needs of patients and clinicians.

Where are or were you happiest?

In Oxford, at home and at work.

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

Tim Berners-Lee’s invention of the web. It’s fantastic.

Do you support doctor assisted suicide?

Yes, and it should not be restricted to terminally ill people who ask for this help but also be available to those “of sound mind” who ask for assistance because they are experiencing otherwise unrelievable suffering.

What book should every doctor read?

Archie Cochrane’s Effectiveness and Efficiency is still an important (and short) read.

What music would you like people to hear at a get together after your death?

I suppose I need to be consistent with the answer I gave when the BMJ asked this question previously (BMJ 2000;321:1577, doi:10.1136/bmj.321.7276.1577): Richard Strauss’s Metamorphosen and Mendelssohn’s Octet—although our drummer son has agreed to organise a rock gig in addition.

What is your guiltiest pleasure?

Eating more than I should.

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

Some programmes continue to match the standard of Civilisation, but if I didn’t watch so much crap on television I wouldn’t have so many piles of important unread books.

What is your most treasured possession?

Happiness, most of the time.

What personal ambition do you still have?

To witness the further development of effective, trustworthy, easy to use, up to date information systems that help patients and clinicians make evidence informed decisions about healthcare and to participate in controlled trials that answer important uncertainties.

Summarise your personality in three words

Guilty, obsessional, and frustrated.

Where does alcohol fit into your life?

Champagne deserves its special reputation, but I wouldn’t find it difficult to live without alcohol.

What is your pet hate?

The perverse effects of filthy lucre in medicine.

What would be on the menu for your last supper?

Shepherd’s pie, followed by crusty bread and Caerphilly or Wensleydale cheese, with a nice red wine, and then a stoned fresh mango or two to end with.

Have you any regrets about becoming a doctor?

No, although I think I would have enjoyed studying social anthropology and seeing where it would have led me.


Cite this as: BMJ 2013;347:f6152

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