Emanuel M. Papper, M.D., Ph.D.

Trip to Kuwait, England and Wales

By Dr. & Mrs. Papper

May 25, 1981 - June 9, 1981

Pat and I left on British Airways non-stop to London on Monday, May 25th. This was the day after a very pleasant commencement, the last one that I am to officiate, which was completed very happily with a party in honor of Neil Rosenkranz given by his father, Saul, in his honor, on the Sunday night the 24th of May. Pat and I had a very pleasant time at the party and got our things together leisurely on the Monday, after talking with all of the kids on either Sunday or Monday prior to departing.

The flight was a long and comfortable one to London where we arrived only a few minutes late. The Kuwaiti Airliner, which was a 747 as was the British Airways aircraft, took off exactly on time for Kuwait with an intermediary stop in Paris. Lino Morris joined us in London and this particular flight, while comfortable, was very long, and by that time we had really had enough of flying. We were quite tired on arrival in a very hot Kuwait, although the airport, which is a marble palace of great beauty, was thoroughly air conditioned. We were met by the Minister of Public Health-Public Relations officer and brought to the hotel, Meridien, where we saw Rafael and Aurorita Penalver and Abdul Islami. From there promptly to bed, where we slept very heavily and with only minor interruptions for about 12 hours. On awaking, we felt quite refreshed.

Shortly after awaking, Pat and I had lunch with Steve Spourenones who is a regional manager for Abbott Laboratories for this area. He is delightful and a very able person, multilingual and very intelli­gent. I shall do what I can in a tactful and thoroughly ethical way to be of help in any way I can to Abbott's international interests in this area.

Everything is closed because of the heat until 4 p.m. which is rapidly approaching, at which time the Pappers and Penalvers expect to go sightseeing. We will then have dinner this evening with them and with Dr. Ray Casterline, who is the president of the Educational Council for Foreign Medical Graduates. Our important reasons for being in Kuwait are the ceremonial closing activities for the 1st Course, which has been run here under Dr. Penalver's direction since early January.

After 4:00, our drivers picked us up and we went sightseeing. The things that we looked at were the famous Twin Towers built by a Yugoslav company some years ago. It is higher than the Eiffel Tower and has become the recognizable hallmark of Kuwait, just as the Eiffel Tower is of Paris. We took a look at the national museum which is in gross disrepair and has a few artifacts in it, some suggesting that there was Greek influence in this part of the world, and the scholars of the Middle East believe that it is possible that Alexander the Great actually conquered the northern tip of the Arabian Peninsula. We then went to visit the Souk, a very old and typically Middle Eastern bazaar where all kinds of shops in huge numbers are found. The various kinds of shops tend to congregate according to the goods they sell, e.g., the goldsmiths are all together, the jewelers are­ together, the clothing salesmen are together and so on. There is also one woman's Souk where all of the shops are owned by women, who are completely veiled in the classic traditional costume where only the eyes are seen. I took a photograph of one of them and thought I would have my head handed to me, at least with a verbal assault.

It was extremely hot, approximately 114° F. toward evening, and all of us suffered appropriately, as one can imagine, from this de­gree of heat. We had the usual confusion about drivers picking us up and waited nearly an hour instead of the usual 5 minutes for them to find us. Finally, all turned out well and we returned to the hotel, bathed and went to dinner with the three Penalvers, two Pappers, two Casterlines and Abdul Islami, who is a surgeon and runs the only other important program of its kind in the United States in Intensive Refresher Continuing Medical Education that Rafael Penalver runs with us. Islami is a very interesting person. He is originally from Iran, is multilingual in Asiatic languages, and has had a varie­gated career, including a stentorian voice of America, the practice of clinical surgery, and a very large and important program preparing foreign medical graduates, whether they be foreigners or Americans, but studying outside of the continental United States for efforts at the ECFMG and VQE examinations. We went to bed a bit late but had a good night's sleep.

Thursday, May 28, 1981

We had an appointment with His Excellency, Dr. Rahman Al-Awadi, Minister of Public Health, who views himself as my "brother". Present at the meeting, besides the minister, were Dr. Nail Al Naqueb, the Under Secretary, who is a surgeon and whom we have known for some time and all of the important people in leadership roles in the Ministry of Public Health and in the section devoted to higher and continuing medical education. In our group were Rafael Penalver, Lino Morris and myself.

We exchanged views about the 1st Course, and the Kuwaiti people were extremely complimentary about the quality of the Course and were very happy with the results thus far. They pointed out that there were some problems, usually technical and mechanical, and we were much in agreement with them. We also pointed out that there were some matters that needed rectification from their point of view, and they were in quick and ready agreement. All total, it was a very amicable and pleasant meeting where all of the essentials were not subject to controversy and rapid agreement came. It was decided to make some modifications but to continue the program for the next several years at least. Details will be worked upon after Pat and I have left Kuwait by Rafael Penalver and the people in charge of their Higher Continuing Medical Education Program. Rafael and I shall be meeting in Miami on return of both of us, which is approxi­mately the middle of June, for comparison notes and preparation of the next program.

From the minister's office, which is most elegantly furnished in a building about to be torn down, we went to the Sheridan Hotel Grand Ballroom where the final ceremonial exercises of the closing of the 1st Course were to be held. All of the students were there, and all of them who had begun the Course had finished it with no exception. This is viewed by the minister as a remarkable achievement in itself. In addition to the students and to the groups of people that I mentioned, there were also representatives from the faculty of medicine of Kuwait Univer­sity and other people in government and medical positions of impor­tance. Happily for us, His Excellency, the American Ambassador to the United States, Mr. Francois Dickman and Mrs. Dickman, were also present. A delightful lunch was served consisting almost entirely of typical Lebanese type of cuisine which is very popular in Kuwait. There was much happiness among the students. A great deal of picture taking took place and much pleasant talk.

The Minister of Public Health is a very interesting, intelligent and influential individual. He is currently the president of the World Health Organization, in addition to his other duties, and comes from one of the prominent and important and wealthy families of Kuwait. He has concluded a good many agreements of exchange or contract purchase of physician help from many nationalities in the world. The American Ambassador thought that the number of nations with whom contracts had been signed was 108, but this seems excessively large. As so desperately short of medical attention as Kuwait is, they bring contract physicians from surprising parts of the world where medical shortages exist also. The only explanation I can think of for the availability of such people, e.g., Chinese physicians, is the importance of bringing hard currency back from Kuwait to the Peoples Republic of China, as an example. There are also physicians from the Soviet Union and from other places in the communist block. Many expatriate British Commonwealth physicians serve for varying periods of time, some several years in duration, and there is a thin scatter of American academic and managerial types as well. For instance, the professor of physiology at Kuwait University is an American from Oklahoma whose name is McBroom, educated at the University of Oklahoma and originally from South Dakota.

After the lunch Rafael Penalver, Lino Morris and I conducted our usual debriefing sessions to analyze what we thought we heard and thought and were very much pleased at our agreement that much progress had taken place and that things were going well.

We had an early dinner tonight in preparation for leaving for London tomorrow on Friday the 29th of May. We were disappointed in a miscommunication of some sort, that we could not understand, in that the brother-in-law of the minister who is a surgeon, Dr. Salad Sabri, had made arrangements to bring us to his home to show us what is reputed to be one of the most beautiful collection of carpets in this part of the world. Somehow we never made connections and felt most embarrassed about it, although it was no fault of ours. We did talk to him on the telephone and have vague hopes of one day seeing the famed collection. A possibility, but not a probability.

Mrs. Papper

Manny's story, as usual, is accurate, scientific and interest­ing. He certainly verbalizes very well. However, he does not deal with the Kuwaiti people and really what makes them tick. It's rather pathetic and it's actually amazing to me that those few who are in the leadership role have quite a bit of intelligence and are hard workers, however, anyone else underneath them tend to do abso­lutely nothing. 80% of the people in this country are the workers and they are, of course, all foreigners. The Kuwaitis themselves, other than those few leaders that I mentioned, do nothing but sit on their behinds and watch the "foreigners” work. Filipinos, Japanese, Chinese, Poles, mostly Orientals, that need money desperately are here and are working.

I was amazed to learn that you could not buy anything in Kuwait because the people are not creative and do not produce nor have they produced in the past. Consequently, those things that you can buy, actually the foreigners can buy, are things made in other countries. There is a Chinese store downtown, very well done, Communist China that is, where you buy very beautiful embroidered silk shirts and many other things that you would guess that a Chinese store would have. Actually the prices are very reasonable because there are no taxes in Kuwait.

In the hotel that we are staying, which is beautifully done and is called the Meridien, there is a shopping center downstairs that is absolutely magnificent with all the imported goods which are sold, French, Italian and so forth. The prices, for this type of thing, are very reasonable but, of course, very high actually.

Rafael's wife, Aurorita, their daughter, Aurordita and myself were busy looking around, talking to people and shopping and browsing when we could. We were fascinated over Oriental carpets, consequent­ly we were hoping that someone would take us to see some. We did see some in the outdoor market they call the Souk. However, the carpets, the few that were well done, were extremely expensive and others were just machine made which did not interest us at all. Now the expensive ones, of course, were not made in Kuwait; they were made mainly in Iran and Turkey . An Iranian doctor took us to this market because he had some knowledge of Oriental carpets and it was an amusing and interesting experience.

When Manny says that the weather is quite hot and that the temperature reaches 114° F., you have no idea how extremely hot it really is. All of us at one time or another felt faint due to the heat. It is excruciatingly hot, and there we see the women with their black robes over their dresses, and they did not seem to suffer from the heat at all, and the men, who wear the white robes, nastashas, seem to be quite cool even though we who were dressed in very light clothes were excruciatingly hot.

At the luncheon I was seated next to the Minister of Health and I found him quite charming and intelligent and he seemed to be interested in me. His wife is a pediatrician and a very hard work­ing woman. His sister is dean of the law school and quite a feminist and very vocal in Kuwait. Now this was an absolute dicho­tomy for me, because with very few women present, certainly she was not there, and the way they treat women in this country, I wonder what is going to happen to his sister. However, I expressed a great interest in meeting her and he said next time we came to Kuwait , God forbid, he would be sure to have me meet his wife and sister.

Dr. Papper

Friday, May 29, 1981, we arose at a moderate hour; finished packing for the flight to London. We were driven to the airport during a mild sandstorm, which was very interesting to see as was the sandstorm during the previous night. The weather is so hot that all construction work has to be performed at night, and that was the case all of the night of the 28th of May into the morning of the 29th.

We said good-bye to the Penalver family and went on to the airport with Dr. Abdul Islami who runs the same kind of program that Dr. Penalver does at St. Darnabas Hospital in New Jersey. He is a surgeon and very energetic, very vigorous and a good friend of Rafael and they may often work together. Dr. and Mrs. Ray Casterline - he is the president of the ECFMG - also left on the same flight and were escorted by a member of the Division of Continuing Higher Medical Education in Kuwait. Unfortunately, Ray Casterline was ill with fever, abdominal discomfort and diarrhea. He seemed to fair poorly all through the flight, which was long but quite com­fortable and pleasant. The service was extremely good and the senior steward was the same person we had had on Kuwaiti Airlines going from London to Kuwait on Tuesday night the 26th of May.

I had a very good, long talk with Islami and I do hope there will be some possibility of helping in the collaboration between him and Rafael on a broader scale. I also explored the possibility of developing a new medical school to help satisfy Laci Tauber's aspirations in this regard, and there is a glimmer but not much hope of doing something of significance, but we shall try anyway and it was agreed we would communicate with each other when we both return to see what could be done.

We landed in London Heathrow and were met by Michael and Sally Rosen and were delivered to the Sheridan Heathrow Hotel which is like all of the hotels around that airport - decrepit and uncomfortable. However, we spent the night there and slept reasonably well.

Saturday, the 30th of May

Michael and Sally Rosen picked us up after having spent the night with their son, Timothy, in London and we started the first day of our leisurely visit through the southwest English country­side. Michael Rosen is a very old friend and he is prominent in British anesthesia in the Faculty of Anaesthetists of the Royal College of Surgeon's of England, The Association of Anaesthetists of Great Britain and Ireland, and has contributed much that is use­ful in both clinical research and in the organizational activities in our specialty. He is originally of Scottish ancestry and after a term of service with the Royal Army Medical Corp in Egypt, decided on a career in anesthesia and got started at New Castle with the late Gar Pask, and from there went to Cardiff in Wales with my dear and old friend, Bill Mushin. We see the Rosens quite often at international meetings but this, I think, is the first time in quite a while that we have seen each other in Britain.

We drove to Bath from Heathrow Airport and spent some time looking around there. Bath is a very popular tourist resort for the British and also for Europeans, but apparently not so popular for Americans. It is an old Roman town and the Romans built imported baths in this area because of a natural hot spring. This is, of course, how the name Bath arose. There is a very interesting excavation of a Roman bath and most of it is clear enough to see quite well. We saw the famous "pump room" and toured the bath.

We also visited a part of Bath called the Royal Crescent, which is a group of houses dating back to the early 18th century but built along quite classical Greco-Roman architectural designs. These houses were used by the rich and well born to take a bath in the waters for a variety of ailments. However, there apparently was much gambling, drinking and carousing in addition to taking the waters. In short, it was a spa for the aristocrats of that period.

From Bath we drove into Devon and had the famous Devon cream tea which is a clotted cream added to a sandwich called a scone which is very much like a biscuit. This we did in a town famous for lace-making called Honiton. We drove from there to a very beautiful 12 room manor house, now a hotel run by a man named Boswell, who is a descendent of the famous biographer of Johnson. The place is very beautiful, the food was excellent, and we had good talk, and a good evening and as another diarist might have said "and thence to bed''.

Sunday, May 31, 1981

This is the last official day in which I am vice President for Medical Affairs and Dean of the School of Medicine of the University of Miami. At midnight my term of office in this res­pect expires and I return to the specialty of Anesthesiology as a part-time Professor of Anesthesiology in the School of Medicine of the University of Miami. The department is directed by Dr. Brian Craythorne. Dr. Craythorne and I are the best of friends and I look forward happily to this new association, the newest role of which begins on the lst of June in a small town called St. Mawes in the duchey of Cornwall.

This morning the Rosens and we left Devon after a very good night's sleep, for me at least, at a hotel called Combe House, although there was a very heavy rain, lightning and thunderstorm which flooded all the areas, including washing away some of the roads. We got up leisurely, had a good and typical British break­fast, walked around the gardens a bit and then took off slowly for Plymouth. Plymouth is in Devon and it is on the southwestern coast of England on the Atlantic Ocean. It has a beautiful and well pro­tected harbor and is a favorite place of retirement for Britains from the north of England, Scotland and other places where the climate is less agreeable. Although there is much rain in this part of Britain, the climate is really quite comfortable and there is a wide range of temperate-zone foliage, mixed with an occasional subtropical plant like a magnolia tree or some species of palm trees. Our major reason, of course, for wanting to look at Plymouth is to see the rock, where the pilgrims who left on the Mayflower in 1620 for the unknown vicissitudes of the new world in order to have freedom of conscience and religion, whatever it seemed to have meant in those days. This was also the place where Sir Francis Drake watched for the approach of the Spanish Armada in 1588, and apparently the armada was destroyed by the stormy seas and high winds and Drake and the British fleet never had to put to sea.

When Mr. Walter Annenberg was United States Ambassador to the Court of St. James, he lead a celebration of the 350th anniversary of the Mayflower sailing and a memento and monument to that effect exist alongside of the one commemorating the departure of pilgrims for the colony of Massachusetts. In this part of Devon and further west in Cornwall there are many towns whose names were used in Massachusetts, e.g., Truro, Chatham, Plymouth and really many others.

This being Sunday, it was difficult to have the typical Devon pastiche, which is a kind of dough having minced meat in the center of it. All the kinds of pubs and other places that serve it were closed. There is a version of this dish in Cornwall that we shall try tomorrow. We then continued to drive south and west from the Plymouth area after sightseeing and crossed the Tamer River into Cornwall. Cornwall is separated by this river from Devon for all of its places of contiguity, except for about five miles, and we crossed a pleasant bridge over the river to go from Devon to Cornwall, and then drove on to this lovely town on the "Cornish Riviera" to arrive at a very pleasant and beautiful house converted into a hotel, apparently rather well known for Britain and to some extent to the United States, called Tresanton, to a very pleasant and spotless room. It is too small to suit Pat since there are larger ones, but somehow or other we will make do and be alright. An hour's rest before dinner.

We did something we haven't done in awhile, i.e., blew a fuse by attempting to power a hair dryer in an outlet designed for electric shavers. As one might expect from previous experience, we tried to power the hair dryer in the slot for the electric razor. The fuse of this old and poorly wired hotel blew quickly and, a rather interesting phenomenon, in that all of the overhead lights seemed to have been gone and the rest of it intact. Add-on wiring always has its interests. The village electrician had to come and repair it. These are shades of our almost causing an international incident with the same procedure in Leningrad some three years ago or so.

We had many very pleasant meals and simple at the hotel, and I have now been eating the local fish along both the Devon and the Cornish coast and have been enjoying them. Prior to dinner, there are drinks in a small Victorian styled or possibly Edwardian draw­ing room and the dining room overlooks the Atlantic Ocean on this part of the Cornish coast. There has been a tanker or some other freighter sitting off the coast since we arrived, and it's apparently anchored there. There is no harbor in St. Mawes except for pleasure boats, mostly sailing and some power boats. The big commercial harbor probably is somewhere else, and I may learn where that is.

Monday morning, June 1, 1981

After a very pleasant and full British breakfast we took a short walk in the village of St. Mawes and it began to rain some. We then drove down to another part of the Cornish Atlantic coast, which is part of the Cornish Riviera, to a small and very old town called Mevigassey. Its streets are very narrow and shops are quaint and almost nobody is here except the locals and some small scattering of British tourists. We saw no continental Europeans nor Americans. We had the native Cornish dish for lunch which is called pastiche, and it really is a chopped meat, chopped potato dish encased by a dough which was originally used many years ago by the Pinminors of Cornwall. It has now become a typical delicacy. We met some of the local people in two different pubs, all of whom seem friendly and of what the British would call "the lower classes''.

It began to rain pretty hard and we left this harbor to come back to St. Mawes, had tea and then a short nap. We had our usual pleasant evening meal at the hotel with the Rosens and then after dinner had a very pleasant conversation with an 85 year old retired physician who was in St. Mawes on holiday with his daughter. He was widowed and obviously quite lonely, but remarkably spirited and intell­igent. He told us some of the events that took place with the form­ing of the national service and the role played by Lord Moron, a friend of Winston Churchill's. Lord Moron was known as "Corkscrew Charlie" because of his devious methods, at least as the medical profession viewed them at the time. Then to bed to travel to Cardiff the next day.

Tuesday, June 2, 1981

We took off for Cardiff by driving from Cornwall through the center of southwest England, driving eastward in a northerly direc­tion. It was a fairly long drive but our stops were reasonably frequent, and we had lunch at a charming small town near the famous Dartmoor Prison on the way. Talk was pleasant and as usual Michael Rosen and I talked almost non-stop about a whole variety of matters, both dealing with anesthesia and other things.

In leaving England we crossed the Bristol Channel from Bristol to Wales, and Cardiff was a little bit south of the end of the bridge, and we arrived at the Rosen house approximately 4:30 or so in the afternoon. We then had tea, this time with some of the clotted cream brought from Devon or Cornwall, I have forgotten which. We had dinner with the family and met Mandy Kirby, who is the middle Rosen child and is a medical student at the Welsh National University School of Medicine. Also, we met Mark Rosen, the youngest of the three children. They are absolute delights, very bright, very pleasant, and wonderfully good company. Both of them are as attrac­tive and as extroverted as their parents and all total it was a most delightful evening.

On Wednesday morning we drove around Cardiff and saw some of the sights in this really not so very old town, although there was a Roman city here in Roman times. We had a most pleasant and agreeable lunch and then returned to the Rosen household for a short rest.

That afternoon on Wednesday, June 3, 1981, I lectured to approximately 50 people on a highly personalized view of medical education in the United States. I attempted largely to draw the strings of background of English and Scottish influences on American medicine, followed by Austro-German influences at the end of the 19th century, and then the major change that took place with the Flexner Report. It was a relatively boiler plate kind of talk, but seemed to be very well received by the audience. In turn, I was given a goblet to celebrate the 50th anniversary of the Welsh National University School of Medicine by the Provost, the chief executive officer of the medical school, a surgeon named Albert Duthie.

It was a most pleasant experience and we left the medical school, changed clothes and went to Bill and Betty Mushin's house for dinner. Present were the Rosens, ourselves, the Duthies (Maureen Duthie is a physician also) and, of course, our hosts, the Mushins. Their house is a very modest British one, but has an extraordinary collection of wonderful antique furniture as well as silver. The meal was cooked by Betty and some of the meal was from their large and home-grown vegetable garden. A very pleasant and agreeable evening. Much of the discussion was comparisons of British and American medical practices, education, and science as well as some personal things. Provost Duthie is an extraordinary individual, very bright, and they feel fortunate, and they are, to have him here to lead their distinguished school of medicine. We got to sleep at a relatively early hour.

The Mushins picked us up in the morning about 9:45 and we drove north into the Welsh hills and saw some of the very beauti­ful country characterized in the famous book "How Green was My Valley''. We also saw something of the shopping center of Cardiff, and I purchased a pair of corduroy trousers at Marks and Spencer, the extraordinary department store of the United Kingdom now spread­ing into continental Europe. We ate fish and chips at a very old pub, indeed, at a small town in Wales just north of the first mountain which is called Caerphilly Mountain.

On our return to Cardiff or on the way out, I am not sure which, we saw an absolutely beautiful Cardiff castle which goes back to Norman times in the 11th century and has been modified and restored and has a particular mark of the distinguished architect Burgess. Money was obviously no object in restoring it and it is one of the most incredible places. It was presented to the town of Cardiff by the Third Earl of Butte, a scion of an enormous wealthy Scottish family who made much of their money by the device of marrying heiresses, plus a very great wealth in coal.

We then had a lovely dinner at the Rosens where several of their good friends, both medical and otherwise, including Mike and Ann Vickers - he be the successor to Bill Mushin to the Chair in Anesthesia at Cardiff. Some of their non-medical friends, a Lillian and Michael Bogod, were also there and extraordinarily bright and delightful people. A very happy evening and short.

The Mushins picked us up again and we did a little shopping and bought a silver toaster with an appropriate hallmark for Pat. The toaster is actually a small storage for toast that has already been made; it does not produce anything but it does hold the toast. We then had lunch at the Mushins, all of it again made by Betty and very delightful.

In the afternoon, Bill drove me over to see Ronnie Marks who had some of his dermatological training with Harvey Blank in our institution. He is now the Professor of Dermatology in Cardiff and is highly regarded. This is another important trainee produced from our distinguished Department of Dermatology under the very able leadership of Harvey Blank. We talked mostly, as one might imagine, about what is new in British research and knowledge about scleroderma, because of my constant looking everywhere I go in the hopes that we can find new knowledge and help for Barbara. Ronnie Marks had some suggestions which I will, of course, check out with Barbara's physicians on our return, but essentially not anything of major importance that was new and different from what Ray Jaffe and Gerry Rodnan had been doing and thinking about. Tonight will be a quiet evening at home with the Rosen family before we go on to London tomorrow.

We had a very lovely dinner at the Rosen house with Sally and Michael and with Mandy and Mark. It had some traditionalism of the Friday night dinner, in that a Kiddush of short duration, but very pleasant and beautiful, was pronounced by Michael. We had a pleasant discussion during the evening and then to bed.

Saturday, June 6, 1981

We had a leisurely breakfast in the morning and then took the train from Cardiff to London - a very pleasant and rapid ride of approximately two hours. We were met at Paddington Station by Timothy, Rosen's eldest son, and went to the Churchill Hotel to check in. The Rosens stayed with Timothy in a flat which they have bought for him and use from time to time when they come to London. Lunch was most agreeable and Pat and Sally went to have their hair done after lunch.

Michael and I did some short looking around in London and then spent an hour or so at the Royal Academy of Arts to see the summer exhibition of young and promising British artists. It was a beautiful show and I was sorely tempted to buy a picture by Hepplewhite and another by Carol Weight. They were too expensive and besides Pat was not with me to judge.

On Saturday night all four of us had dinner at a very interest­ing place that one would not come across easily called Leith 's, and we got to know Timothy Rosen better. The Rosen children are remarkably different from each other, all very talented and a remarkably good family, happily oriented toward their parents and a very loving family, indeed. We went to sleep relatively early for us, not quite midnight.

Sunday, June 7, 1981

We relaxed all morning and had brunch approximately noon. The Rosens picked us up in black tie and long dress and we were dressed the same way to go to the opera at Glyndebourne. It was a train ride from Victoria Station to a place called Lewis. Then a short bus ride to the concert area. It is an environment and circumstance which, I guess, could happen only in Britain. Everybody dressed in formal attire and all in the country. The opera was Rossini's “The Barber of Seville" and very happily and well done. A unique feature of this opera presentation is the fact that after the first act a very beautiful and pre-ordered, but nonetheless elaborate and quickly but pleasantly served dinner, takes place for 75 minutes.

After having a wonderful time, both at dinner and the opera, we dashed to the reversal of the travel situation and barely made the train at Lewis back to London . There was in a long taxi queue, but it did not last long and we were promptly back in the hotel shortly before midnight.

Pat and I went to Mark and Spencer's store, which is a remarkable establishment in itself, and then went on to meet Sally and Michael and Mark Rosen who had come up from Cardiff to do some pre-American trip shopping. We met at Fortnum and Mason, a store which is unique and most interesting, where all of them had coffee and a continental type breakfast, except for me, since I had sufficient food before we left.

After this interlude we went to Savile Row where I went to Michael's tailor, a firm called Maurice Sedwell, to have my first made to measure suit - I also bought a blazer - all of which will have one sitting before we depart for home and will be delivered when we next return to Britain in March for the admission into the Honorary Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons of England in March. After the tailor selection and fitting we walked down New Bond Street to look at the shops and then had lunch at a very pleasant place near the American Embassy.

On the way back from lunch to the hotel, I noticed an extremely long line of people at the American Embassy, presumably trying to apply for a visa of one kind or another. Most of the people look like they were Asiatic or Africans. These unfortunate people have trouble even in an enlightened country like the United Kingdom , let alone the United States. Tonight we go to see Noel Coward's “Present Laughter” with Jayne and Charles Wrightsman, who just arrived in London for their summer residence in this extraordinary city. I went back to the hotel and Pat, Sally and Michael and Mark all went shopping in different directions.

After a short rest at the hotel, I received the first fitting for my new experience of a suit and blazer made on Savile Row by Mr. Maurice Sedwell. The suit will be finished on my return to London in March to be inducted into the Honorary Fellowship of the Faculty of Anaesthe­tists of the Royal College of Surgeons of England. The British expect the Princess Alexandra to attend. She is also an Honorary Fellow. The fitting was quite an experience, all new to me. When Pat returned we dressed modestly for the evening.

The Wrightsman chauffeur picked us up in Charlie's Mercedes, one of seven that he owns, with their British chauffeur named Squeire. We then went to their Flat in St. James Place which is absolutely exquisite. It is not, however, as beautiful in the works of art as the apartment in New York or the house in Palm Beach, but the view of St. James Park is incredible. To get there we drove down the Mall and saw all the preparations for the state visit of the King of Saudi Arabia to the Queen. Talk was delightful and it was very obvious that Jayne and the Rosens get along beautifully which was a great delight to me. We had some champagne before dinner and then the usual delightful Wrightsman dinner, but relatively modest in size because of the early hour.

We then went to see Noel Coward's “Present Laughter”, a play which was in the typical vein for Coward. He wrote most of his plays for him to star in and this was no exception. They are all witty, almost brittle drawing room farces, and this also was in that vein. However, it had a particular poignant quality in that it was ready to go into rehearsal in 1939 just on the eve of the WWII for Britain. The play never did go on the boards until it was decided that it would be good for morale to have a "normal" upper class British society comedy during WWII. It was therefore produced in 1942 somewhat after the major affects of the Battle of Britain, but it did help, as did most of these entertainment things, improve British morale. It was an absolutely delightful play about an aging actor who runs into all sorts of complications, social, professional, marital, sexual, and the like. One of the strange parts of it is that Pat and I met, of all people, Ernst Ladermann, recently divorced from Peggy Gordon, who for some reason felt he had to explain that he was there for the 100th anniversary of his fraternity - details unknown to me. We were then driven back to the Churchill Hotel with chauffeured car and the Wrightsmans went home. And so to bed.

Pat and I finished our packing and of all the nice things, received a telephone call from Jayne Wrightsman to wish us well and to tell us how pleasant the evening was for them. It certainly was for us. She also pointed out how much she liked the Rosens. We then went to Heathrow, got on our airplane and were delayed for one hour with loading problems, but possibly a slow down since Britain seems to be on the verge of general strike. The government are holding firm against the civil servants, but nobody is very optimistic at this time. The flight was a little over 9 hours in the air and relatively comfortable. There were no problems of importance.

We got through customs fairly quickly and easily and went home by taxi. A huge amount of mail awaiting us, and because of the change in time and our disorientation in time and space, I was able to get through much of it and Pat, some of hers. It is hard to realize that I have no important responsibilities for the first time in a very long time, indeed. It will be interest­ing to see how well and how quickly I adjust, but that I intend to do. Many telephone calls were made at night and the following morning.

©2003-2004 University of Miami Leonard M. Miller School of Medicine.
All Rights Reserved.