Intended for healthcare professionals

Observations BMJ Confidential

Chris and Xand van Tulleken: Sibling revelry

BMJ 2018; 363 doi: (Published 03 October 2018) Cite this as: BMJ 2018;363:k3954


The van Tulleken twins, 40, appear regularly on television, either separately or together, in a wide range of programmes ranging from silly/serious to seriously silly. Both went to King’s College School in Wimbledon and then Oxford University, and both studied tropical medicine. Chris did a molecular biology PhD at the Towers Lab at University College London and is now an infectious diseases registrar at University College Hospital. Xand got a Fulbright scholarship to Harvard, did a masters of public health, and now teaches and writes in London. Together they present the children’s programme Operation Ouch and travelled the world to make Medicine Men Go Wild, an examination of tribal medicine. A double gift to television producers, they contrive to make the best of the medium.

What was your earliest ambition?

Xand: Becoming doctors was our first serious ambition that we thought might be achievable. We wanted to see as much of the world as possible to try to understand it and, in some naive way, make it a better place. Medicine seemed like something that might help us do that.

Chris: Xand also wanted to be the lead singer of Guns N’ Roses, and I’m still very supportive of this.

What was your best career move?

Xand: I did the diploma in tropical medicine at Liverpool and then travelled to Darfur with Doctors of the World. The clinical work was extremely challenging, but it also forced me to look more at the determinants of health and at complicity in abuse. Much of what I now write about and teach comes from that job.

Chris: Entering a ski race to the North Pole in my first year as an SHO. Bizarrely, it took me into tropical medicine, and it’s why I have a media career.

What was the worst mistake in your career?

Chris: I’ve had lots of failures in science, medicine, and television, but I’m happy where I am.

Xand: A patient I didn’t say goodbye to, who was being treated for lymphoma. I was the haematology SHO and had spent a lot of time with her. She became increasingly distressed as her treatment regimen began to fail. When I rotated to another job one of her nurses tracked me down and said that she’d been asking to speak to me all night. I said that I’d go and say hi, but I didn’t. I was terrified of talking to her about death or seeing her family.

How is your work-life balance?

Xand: Earlier this year I signed up for six pottery lessons. I missed one and was late for the rest, and it still felt wildly self indulgent.

Chris: It’s hard to find balance when you work with your brother, best friend, and clone. Work and life become the same. My wife is helping me to gradually understand that doing nothing is still doing something.

How do you keep fit and healthy?

Xand: I cook almost all of my meals and eat lots of vegetables. I spend two hours a week at the gym, and I cycle everywhere I can.

Chris: I mainly eat plants. And I do something physical every day, even if it’s just 10 press-ups, because something is infinitely more than nothing.

What single change would you like to see made to the NHS?

Xand: More funding. We have a severe lack of beds, equipment, and staff across a vast range of services. It has some wasteful inefficiencies, but trying to make a profoundly underfunded service efficient is far more wasteful.

Chris: I’d reduce reliance on the private sector. The interests of the private healthcare industry in the UK, and globally, are often contradictory to the long term health and financial security of the population.

What do you wish that you had known when you were younger?

How subtle the influence of private corporate interests can be: those free pharma lunches turn out not to be free after all. Companies’ ability to distort truth is reasonably easy to understand (although we spent little time on it in medical school), but their ability to shape narratives, guidelines, and policy so that their interests are concealed or seem aligned with those of patients is far harder to detect and to push against. It’s been fun trying to make television about this subject.

Do doctors get paid enough?

Chris: I’d like to see working conditions improve more than pay. The UK has many doctors whose jobs I simply couldn’t be paid enough to do.

Xand: Any concerns about doctors’ pay are dwarfed by the dismal salaries of other healthcare workers, who are desperately undervalued and underpaid and have fewer options to earn more if they choose.

To whom would you most like to apologise?

We both apologise constantly, even for things we haven’t done. We’re trying to stop it.

What do you usually wear to work?

We’re twins, so we’ve been colour coded since we were small (Chris is blue, Xand is green), and this applies to everything we wear on Operation Ouch: usually scrubs but also tutus, sequinned leotards, and chefs’ aprons.

Which living doctor do you most admire, and why?

Doctors who are members of crisis affected populations and are working in those crises. They have none of the comforts or glamour of expatriate aid workers; they face violence or, at best, the hopelessness of life in a refugee camp; and yet we’ve met many who bring a cheer and courage to their work that’s hard to muster in far easier circumstances.

What is the worst job you have done?

Chris: A surgical job in Cambridge where I worked only nights while teaching anatomy. It was like commuting to Australia every two weeks. I was exhausted and unsafe.

Xand: A summer job in the Harrods pet accessories department. I sat in a windowless room and put price tags on thousands of dog and cat collars.

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

Xand: In humanitarian responses, inclusion of the affected population in decisions about the care and services they receive, particularly using unconditional cash transfers to allow them to entirely determine how they help themselves. We’re a long way from where we should be, but it’s radically different from when I began working in humanitarian medicine 20 years ago.

Chris: Effective treatment and prevention of HIV.

What new technology or development are you most looking forward to?

Xand: A sincere desire to help distant strangers seems more important than any technology in humanitarian crises. My son assures me that he’ll invent teleportation. He lives over 4000 miles away in Calgary, and I yearn for a teleporter.

Chris: A working printer. Anywhere.

What book should every doctor read?

Xand: The Seductions of Quantification, by Sally Merry.

Chris: Anything by Margaret McCartney.

What is your guiltiest pleasure?

Szechuan food from Barshu Restaurant in Soho. In vast quantities. We eat together, each of us watching television on our phones.

Where are or when were you happiest?

Chris: In general, now—in east London with my wife, Dinah, and my daughter, Lyra.

Xand: Wherever my friends and family are.

What television programmes do you like?

Chris: Hey Duggee. It’s a third parent to my 14 month old.

Xand: Anything with spies in it.

What personal ambition do you still have?

Xand: Neither of us has a five year plan. We try to make interesting choices and work hard at them. We’d both love to keep doing what we do now but to do it better and reach more people.

Chris: What he said.

Summarise your personality in three words

Chris on Xand: Funny, foody, and fancy.

Xand on Chris: Like the Terminator.

What is your pet hate?

Xand: People who force you to choose between cats and dogs.

Chris: Medical arrogance.

What would be on the menu for your last supper?

Szechuan food (see above).

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

Xand: Not a dirge. Maybe “Welcome to the Jungle” by Guns N’ Roses.

Chris: The Cremation of Sam McGee, a poem by Robert Service. It’s been good company on many expeditions in the Arctic.

Is the thought of retirement a dream or a nightmare?

An impossibility.

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

If we were just doctors/academics we’d probably dream of presenting children’s television . . . luckily, we get to do that too.

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