Friday, 17 February 2017

Transcript of Jim Al-Khalili’s interview with Professor Sir Simon Wessely | The Life Scientific, BBC Radio 4 | 13 February 2017


Jim Al-khalili’s subject in his ‘The Life Scientific’ programme on BBC Radio 4 on Monday, February 13, was Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, who has had a professional interest in ME/CFS since early in his career. We thought you might want to read the conversation – a transcript of which has been circulating on the internet for the last 24 hours or so. We’ve not had a chance yet to check the text against the actual BBC iPLayer recording at http://ift.tt/2kFeSDg but will do so shortly.

featured image copyPresenter Jim Al-Khalili:

My guest today is a psychiatrist who has spent his whole career arguing that mental and physical health are inseparable, and that the Cinderella status of mental health funding is a national disgrace. His current role as President of The Royal College of Psychiatrists has given him a platform to bang the drum for parity of funding, the need to reduce stigma of mental illness and better training for doctors. Professor of Psychological Medicine at The Institute of Psychiatry, Psychology and Neuroscience, part of King’s College in London, Sir Simon Wessely has always been fascinated by the puzzling symptoms and syndromes which can’t easily be explained. So it’s perhaps inevitable that he’d find himself at the centre of research, trying to understand that distressing and debilitating condition chronic fatigue syndrome or “CFS”. Then as soldiers who served in the first Gulf War returned home complaining of strange symptoms, his research antennae began twitching again, because many of these symptoms sounded remarkably similar to those he’d seen in his “CFS” patients. And so began a long period of ground-breaking research into military health. Simon Wessely, welcome to The Life Scientific.

Simon Wessely: Hello.

Jim Al-Khalili: Now last month the Secretary of State for Health, Jeremy Hunt, quoted you as saying that we had some of the best mental health care in the world. I’m assuming you really wouldn’t want that to convey the message that everything’s fine.

Simon Wessely: No, certainly not, and I mean I said that in the context of returning from a trip to Sierra Leone, where they have an absolutely abysmal service. And it is true that in global context and even in the European context, we do have good services, but that doesn’t mean they’re remotely good enough.

Jim Al-Khalili: What difference has it meant for you being President of The Royal College of Psychiatrists? By which I mean, what powers has it given you to make a difference when it comes to mental health care?

Simon Wessely: Oh power, I wish we had power, that’d be great. No, it’s been great, and I’ve really enjoyed it, partly because this was an opportunity to really do something for the general image that we have, erm, to help recruitment and to help the understanding of mental disorders, and I thought, you know, I’d reached that stage of my career where it seemed like the right thing to do, plus you know a lot of the people I’d trained had got much better at research than me now and they want me out of the way, and who can blame them.


“THE ULTIMATE POWER COUPLE…”

Jim Al-Khalili: Well, um, speaking of power, I also gather you’re in the record books because you’re one half of the first couple to ever lead two Royal Colleges. Your wife, Clare Gerada, has also been President of The Royal College of GPs. It does make you the ultimate power couple, doesn’t it? [Simon Wessely laughs.] How was it that one of your sons described the relationship?

Simon Wessely: My God, you’ve done your homework! Yes, they said it was about competition, and they’re completely wrong of course, though I have to say that everyone in the audience seemed to laugh and agree with them, but I don’t know where that came from.

Jim Al-Khalili: You don’t recognise it?

Simon Wessely: No, I don’t recognise it. Quite how they’ve turned out as well as they have, I have to say is sometimes beyond me.

Jim Al-Khalili: So what sort of conversations have the two of you had about your big vision of how you can change health care for the better?

Simon Wessley: Oh, I don’t think we do have those kind of conversations; it’s much more practical about getting on or not getting on with politicians, media, it’s that kind of stuff really rather than the big vision. Actually she’s been a great help because she’s been there and knows what it’s like and can give advice. At times of course she’s a back seat President as you would imagine and … I would say it’s my turn now, um, but actually it’s been very helpful, and she’s still a force in the household and a force in the land [chuckles].


ARMCHAIR DIAGNOSES AND PRESIDENT TRUMP

Jim Al-Khalili:

You mentioned how to get on with politicians and I have to ask you this because I think it’s quite topical, armchair diagnoses and the US President Donald Trump. Does it concern you when you hear people including doctors diagnosing Donald Trump with a mental health condition?

Simon Wessely: I think it does, yes. I watched this happen and I can see that a lot of people think that demagoguery, misogyny, intolerance or whatever else you might associate with the President is a form of mental illness, and I don’t think it is, I think they’re completely separate, we know a lot about mental health and mental disorders, and I know more about those other subjects than you do so I think it’s not a good precedent that we set. It brings us into disrepute, and it’s not as if Mr Trump is going to say, “You know what, I think I do have a narcissistic personality disorder, I’m going to step down.” [Both chuckle.] I don’t really see that happening.

Jim Al-Khalili: Yes.

Simon Wessely: I need to be treated. Exactly, yes. [More chuckles.]


“THE ESSENTIAL RESILIENCE OF NORMAL PEOPLE”

Jim Al-Khalili: It might surprise many listeners that, for somebody who works with people who suffer great distress from mental illness, in fact you’ve always believed very strongly in human resilience, haven’t you?

Simon Wessely: Yes, that’s true, and um a general theme of the research we’ve done over many years is, to put it at its simplest, people are a bit tougher than we think. And by the “we”, I mean all sorts of people, so we’ve done work and …Second World War, and how everybody assumes that when the war came, the civilian population would completely panic, disappear into the forests, nobody would go to work and we’d lose the war. Now, all that turned out not to be true.

But what’s interesting is how very little has changed in the view of what we could loosely call the authorities, the local authorities, modern politicians etcetera. Frightened of the public, they think we’ll run scared, and don’t actually appreciate the essential resilience of normal people, and all of our research has spoken to that theme.

Jim Al-Khalili: Um, and what about sort of individual traumatic events that would affect maybe a smaller group of people directly?

Simon Wessely:

Yes, I mean if you take for example the London bombs, say, in the 7/7 I think we call it now in the rather unpleasant phraseology I don’t really like, but anyway. What happened there was that we did immediate population studies on how ordinary Londoners were coping with it. Obviously people were upset, which is not a mental health problem, but they didn’t need professional help, they didn’t want professional help, and they coped with this in the way that we always do, drawing on our own resources, talking to our families, friends, vicar, doctor or whatever, at a time and place of our choosing. Those people who had been directly affected, we showed that kind of intervention, you know, within 24 hours which is known as debriefing which as you saw, trained counsellor or whatever it was, and you know better out than in, how was it for you etcetera, which sounds perfectly good, but actually in randomised controlled trials was shown to make people worse, so they got to have more mental health problems if they’d received that intervention. So now the policy is, we wait a bit, and if people are still distressed 10 – 12 weeks later, then yes, we will offer help because we then know treatments that we have work. And that’s been quite a big change to the way in which we appreciate trauma. Most people will cope, through normal social networks. A minority will not, will develop actual disorders, for which we can help.

Jim Al-Khalili: Would you say that therefore that grief, after sad events, is a normal thing?

Simon Wessely:

Absolutely, I mean where I think you’re going towards is that psychiatrists are sometimes involved of being in a kind of plot of global domination, based on the American Diagnostic & Statistical Manual which is the kind of bible of psychiatric disorders which gets bigger and bigger every year, we get more and more disorders. Actually this time it got a little bit smaller but that was only because they’d printed it on thinner paper. And they create new diagnoses constantly: coffee drinking disorder, answering back your parents disorder, excessive love of guns, actually I made that one up actually, yes that’s not in it [both chuckle], the one they should have in it isn’t in it, and, um, there’s a certain amount of truth in that, but the real truth is that actually we are very concerned at not doing that. We cannot cope with the disorders we have, and we do think there are such things as shy children. We do think there are some quirky bookish kids; I was probably one myself; this is just the normal part of development of personality and should not be treated or pathologised. So we are the ones who are very very keen on maintaining the boundaries and not extending them, but there are those drives in society as well but it’s not psychiatry that’s pushing that.

Jim Al-Khalili: Well, we’re going to come back to your work in a moment in psychiatry, but I want to take you back to your childhood.

Tell me about your father, Rudolf – Rudy, who was born in Prague before World War 2.


“DAD WAS ON NICK WINTON’S KINDERTRANSPORT TO ENGLAND”

Simon Wessely:

Yes, true. Yes, my Dad came from central Europe. He was actually born in Vienna and then brought up in Prague as most central Europeans were, and in 1939 his parents, as the Nazis had now taken over Prague, er put him on a train, a Kindertransport train, and he came to England, rescued by a man called Nick Winton, who now is very well known but wasn’t then, and so came here when he was 12 and would never see his parents again. Served in the Navy briefly during the war, and saw action. Went back at the end of the war, realised that he was the only survivor of his family, came back to Britain and settled in Yorkshire. And so yes, he had a, huh, difficult past, um, that’s absolutely right, one of many.

Jim Al-Khalili: When did he learn what had happened to his family?

Simon Wessely: He lost contact with them in 1942 when they were deported to Theriesen[stadt]?, the ghetto Theresien[stadt]?, and in fact they were murdered in Auschwitz a year later, but during that time when he had no contact with them. When he went back I’ll say one thing, they kept very good records, and for him it was relatively easy to establish the fates of certainly his mother, and cousins; it took us a long time to find out what had happened to his father.

Jim Al-Khalili: I gather there’s a nice story about him with the man who took him in, Nick Winton, much later in life?

Simon Wessely:

Yes. My Dad, when he retired from teaching, worked for an old people’s charity called the Abbeyfield, and he was on the national committee. And so once every three or four months I think he went down to London and he would sit next to this fellow called Winton because they were both Ws, who picked up my Dad’s accent (my father always had an accent. I couldn’t hear it but everyone else could), and said, “Really, you know, where’s your accent from?” So, came from Prague as a kid. And Nick said, “I was in Prague before the war.”

“What were you doing?” And he said, “Well, it’s a very strange story really. I was arrange these Jewish children.” My father didn’t believe him, simply didn’t believe him. He rang me up and said, “I don’t know why he’s told me this story.” So, “Ask him.” So the next time they met, Dad said, “I was quite disturbed by what you said.” “Why?”

“That’s how I got here, and I don’t know how it happened, but I remember coming.” And anyway, and then Nick produced the file, and there was a sheet with my father’s picture, the fake Nazi visa, the correct British visa, and his address in Prague. And that was the first of those children – I call them children, but my Dad was already in his 60s, he had found, that Nick had ever met, and Nick then expressed the view that … to meet more and everything then took off.

And er my father was always in touch with Nick until my father’s death, um, because they were both actually quite shy people, and Nick was also very shy, very moral, very strong, a magnificent man. I mean, what can one say? Yeah.

Jim Al-Khalili: Hmm. Well, it’s obviously still moving for you to this day.

Simon Wessely: Yes, yes it is. If you watched the Esther Rantzen programme, which everyone has seen that slight? programme, my father is the only man Nick knows, so my father was in the green room out of sight, but you can see me right at the back ? everyone else, and I – if anyone else listening to this programme who hasn’t seen that clip and sees it now, I can promise you, you will cry. It is impossible not to cry. It’s just the most moving thing I have ever seen.

Jim Al-Khalili: Incredible. And your mother, Wendy, how did your parents meet?

Simon Wessely: Well, yeah, Mum came from Doncaster, and, um, was very different to my Dad in all sorts of ways. They were a most unlikely couple actually. They met teaching in Sheffield. Mum did maths and music. She was a professional musician around Sheffield; teacher.

Jim Al-Khalili: I believe one of your heroes was the late great psychiatrist and broadcaster, late also of this parish as presenter of Radio 4’s “In the psychiatrist’s chair”, Dr Anthony Clare. Now, I’m not going to stray into these territories, it’s too much of a jump for a theoretical physicist, but if you’ll allow me, I’m going to have a go and ask you this question: how did you make sense of your father’s experience?

Simon Wessely:

Well, it wasn’t that difficult. It wasn’t a big thing, in the sense I was always aware of it, and there were certain things in the family, for example when “The World at War” series was on, and I was obsessed with history, I still am, but the episode on the camps we weren’t allowed to watch. And the other thing was very ?, I remember when I was 12 we had a school trip to Spain. And my Dad just said, “You can’t go.” “Why?” He said “We don’t go to Spain. Decent people don’t go to Spain while General Franco’s there.” And I had a tantrum and said, “I’m not going to have any friends. You’re ruining my life” etcetera and my father you know was a very shy quiet man but he simply said, “We don’t go to Spain.” And I didn’t go. So there was things like that, but I can’t say it had any traumatic effect on me; it didn’t; but it was always there, and I remember the first time we went back to Czechoslovakia was in 1968, August 1968. For those who know your history, that was when the Russians invaded, and um –

Jim Al-Khalili: Bad timing…

Simon Wessely: Yes [laughs], although as a kid it was so exciting, I mean for adults it was terrifying…

Jim Al-Khalili: Yes.

Simon Wessely: And I remember seeing the only time I saw my father cry, was when we went to the Jewish memorial in the synagogue, and there were his parents’ names, and that was the only time that I actually saw my father break down. And it was, you know, just, I mean it was distressing, but understandable.

Jim Al-Khalili: But he tried to shield you from … from…

Simon Wessely: It’s I … I … you’re doing too much of an Anthony Clare there. You’re reading more into it than there was. It was a thing that we knew about, I knew about, I was interested in, but it wasn’t the dominant influence on my childhood. I had a very very normal, very happy childhood actually. You know, you’re looking for trauma where there isn’t any.

Jim Al-Khalili: OK, fine. [Both chuckle.] But you say you were interested in lots of things, you had a deep love of history. What was the trigger then, firstly for your decision to study medicine, then to go on into psychiatry?

Simon Wessely: Medicine I genuinely cannot remember. I was 15 at school, and you have to decide what you’re going to do, and for some reason I decided I wanted to do medicine. I was much better on the arts subjects than the science, sorry, Jim, but that was true, and so I end up going to medical school. How I did psychiatry is a bit clearer. It was in fact the person you’ve just mentioned. It was reading Anthony Clare’s Psychiatry in Dissent. Clare was a brilliant journalist and um I was hooked.


WHY WAS THE MAUDSLEY SUCH A PERFECT FIT?

Jim Al-Khalili: Why then would you say was the Maudsley such a perfect fit for you?

Simon Wessely:

Because it was relatively small in those days. There was no real difference between the consultants and the academics, and it took me a long time to work out which was which because they were all very good doctors, very well read, very interesting people, some of them very difficult, some of them very nice, but the biggest thing was the people that I was with. And that that group, we all started together, and we’ve stuck together over 35 years, something awful really, but it was my colleagues, and I do often say to students, “It’s all very well having mentors and all that kind of stuff, but the people who really matter are the people you meet on that first day in the new job, and I still think that’s one of the reasons why I most like psychiatry. I like my colleagues.

Jim Al-Khalili: And at the beginning, you didn’t really see yourself doing medical research?

Simon Wessely: No, not at all. But you couldn’t keep that going at the Maudsley, you really couldn’t. The research culture was very strong.


CHRONIC FATIGUE SYNDROME ENTERS THE CONVERSATION

And as I got a bit older I had a stroke of luck that I went to Queens Square, The National Hospital for Neurology and that was in this fantastic hospital, surrounded by neurologists, so there were only three psychiatrists, and that’s when I really started to get interested in research, and that’s where I got interested in “chronic fatigue syndrome”.

And because these patients were being seen there. I have to be honest, and say nobody really liked them.

Jim Al-Khalili: Tell me about some of these patients, that you saw at Queens Square.

Simon Wessely: Well, there were people being referred (Queens Square is the home of neurology), and, at that time, it was felt that this might be a mysterious muscle disease, there was a headline in one newspaper and of course Queens Square is the best place on earth to deal with mysterious muscle diseases. They rapidly concluded it wasn’t a muscle disease and then didn’t really want to have anything to do with the patients to be honest with you. So they started – this happens a lot when people don’t know what to do – they do ask psychiatrists to get involved. So I started getting involved, and I was the only one, and I just got more and more fascinated.

Jim Al-Khalili: Because this was the 1980s, and “chronic fatigue syndrome”, “CFS” wasn’t a new condition, but at the time I remember it being misleadingly dubbed “Yuppie ‘flu”, and yet it was a very, a real debilitating disease.

Simon Wessely: Yes. It re-appeared. It had disappeared for many years and then come back as the illnesses do, under a different guise and really in the early 80s, and it had only just started to hit the press. But at this time, it was really seen as something quite mysterious.

Jim Al-Khalili: You’ve said that “chronic fatigue syndrome” lives in an ambiguous territory between medicine and psychiatry. What was known at the time that you started serious research into the condition?

Simon Wessely: Well, really very little. It had not been an area where much of medicine or academic medicine feared to tread. I think that’s a reasonably fair comment. And certainly there had been no systematic epidemiological studies, very little looking at exactly what was the, the mechanisms of fatigue, and absolutely nothing on treatment, nothing at all. So the literature was terribly small, and um some of it really referred to completely different conditions.

Jim Al-Khalili: So how far have we come? What was it that you and your colleagues did manage to …?

Simon Wessely:

Well on the positive side, we showed, and I think subsequent research has confirmed, that this is certainly finally a central disorder, not a peripheral disorder. We showed it wasn’t linked to common viral infections, but other colleagues showed that it was linked to things like EBV, yeah, Epstein-Barr virus, glandular fever, which we confirmed. We showed that it had a different neuro-endocrine signature to depressive disorders. I originally thought it was a variation of depression but er we changed our minds as the data changed and we felt that actually that was important but not the same. We showed the social class gradient–it wasn’t yuppie flu, and then we started to think about how can we improve treatments, which wasn’t difficult because there wasn’t any.

Jim Al-Khalili: So why was the research you were doing Simon so unpopular with a vociferous minority who really turned you into a hate figure?

Simon Wessely: Well not just me, there is a few of us come under that heading. But I think that it’s to do with, for some people, the very existence of psychiatry was almost an affront to them. That the fact that we unashamedly did what we did and that we were also showing that some of the treatments that were used that were not entirely biologically based were helping. I think some people just simply couldn’t bear because they felt that it was denigrating them. That it was in some ways saying that they weren’t genuinely ill and they felt that any association with psychiatry was close to intolerable. Too painful and they would simply rather we weren’t there.


“THE BACKLASH – HOW BAD DID IT GET?”

Jim Al-Khalili: And is this reaction, the backlash, how bad did it get?

Simon Wessely: Well – it’s difficult to talk about really because it’s been there for a long time, and it’s not just me by the way, it’s happened to lots of people in this area. But it’s a constant presence.

Umm, you know we talk to the same people that my friends who do animal work talk to and we get the same advice and information and take, you know, some of the same precautions they do. That’s…

Jim Al-Khalili: But you’ve personally been threatened?

Simon Wessely: Yes I have. That’s not actually the biggest deal. It’s more the organized attempts at, um, interfering with your science, your research, your career actually. And all sorts of pressure. It’s like being stalked I think. It’s, it very much feels very similar to that. But again I have to say the fact I’m here, Jim, suggests that, um, it’s not been that effective. Um, but it’s not been that pleasant either.

Jim Al-Khalili: And at its worst you decided, well you tell me, what did you do?

Simon Wessely: Well some years ago, coming back from a meeting in America with another colleague of mine and both of us just took the decision I think it’s time to move on and I felt that I was not really in a good position to help take the subject forward and I just took a conscious decision it’s time to move on, and it was the right decision to take.

Jim Al-Khalili: You didn’t stop seeing patients?

Simon Wessely: Oh, no patients I kept seeing all the time. It’s like you know A J Cronin’s “Adventures in Two Worlds.” It’s two worlds.

There’s the world of the clinic, but there’s this other world of politics and er internet and some things like that which is pretty unpleasant at times.

Jim Al-Khalili: And, and looking back you know 25 years ago, do you think now or wish that you’d done anything differently?


“THE YOUTHFUL ME COULD HAVE HANDLED IT A BIT MORE SENSIBLY”

Simon Wessely:

I think the youthful me possibly could have handled it a bit more sensibly. I think that’s probably true. And I certainly underestimated the depth of hostility that was out there to psychiatry. And by the time I’d realized that, some of the things had been said.

But equally I don’t think it would have made much difference. There are some people out there who continue over the years to make things up. To distort and tell lies about you and that would have happened anyway to be honest Jim in this field. It happened to others as well.

Jim Al-Khalili: Well, in fact Simon Wessely by this point, you’re talking about just after the first Gulf war, this whole new area of interest was opening up for you. Gulf War Syndrome. So what drew you to that in particular?

Simon Wessely:

Well it was that I’d trained in epidemiology. Along come these stories. Cinically they sound terribly similar to my patients but they were very, very different people, and it was also clear that the Ministry of Defence was making a dog’s breakfast of the research, well, they weren’t doing any, and what they really needed was an epidemiological approach. You had to know what were the experiences of the whole deployment compared to those in the military who had not deployed. It seemed obvious at the time, but we ended up in fact having to go to the Americans to get the money. The British Government, um, the then Minister of Defence er refused to give it, saying, I had an interview with him, and he said er, “In my experience research always makes things worse.” [They both chuckle.] So we went to the Americans, got the money, and I came back and then started the studies and that was the beginning of it.

Jim Al-Khalili: I do remember reports at the time that there was a real fear that these returning troops had been affected by either depleted uranium, or vaccinations for anthrax, all sorts of terrible scenarios.

Simon Wessely:

Yes. The first thing we showed was that something had happened, and so we unequivocally showed that something had gone wrong and that those who had gone to the Gulf had more symptoms than they should. The pattern of the symptoms was the same as the normal population, the controls, so this wasn’t a new syndrome, but they had twice as many symptoms as people who hadn’t been to the Gulf. So clearly something happened that could only be due to going to the Gulf. That was the starting point. Then there were all these villains that you mentioned, and we were able to show that it wasn’t due to most of those. So we ended up thinking this could either be a form of conditioned anxiety disorder, because the threat of chemical weapons was, this is the first Gulf War now, we’re not talking about Iraq, we’re talking about the first Gulf War, they were around big time and were lethal big time and were very very scary. And/or a interaction with a reaction to the multiple vaccines programme. And we couldn’t really get it much further, so we’d eliminated a lot of things, and then of course Iraq starts in 2003. This time, the MoD had learnt from the mismanagement of Gulf War Syndrome, and we were asked to do the study that should have been done over 10 years previously.
Record-keeping was good, and, right from the start, we were in there doing the same big study again, and we gave the same questions in the same order on the same coloured paper, so it was just absolutely a repetition. And this time, there was no Iraq War syndrome. That was the definitive proof, because we’d used all the same possible toxins again, and this time there was no repeat of Gulf War Syndrome.

Jim Al-Khalili: So was there a big difference between the first Gulf war and the second?

Simon Wessely: Yes, there was a big difference.

Jim Al-Khalili: So what was the …?

Simon Wessely: Well, we’ll never know for sure, but I think it was a combination of things, and the biggest thing was the information mismanagement. A lot of things were said that weren’t true. For years rumours were allowed to spread. Every time someone got cancer it was blamed on Gulf War illness. Every time someone had a birth defect, and so on and so forth. So there was this information vacuum, and rumours fill an information vacuum, and that is what had happened. And mixed in, possibly, with unknown things that we s, we’ll never know.

Jim Al-Khalili: So what you’re saying is that, essentially, there was a high probability that people were frightened, that there was paranoia, and I guess almost like a contagion that, that can spread?

Simon Wessely:

Well certainly we know that knowing someone that had Gulf War Syndrome, was a risk factor for developing it, but I think there’s big unknowns there, not that I, I don’t want to quote another American politician, not in favour at the moment, but, there were, and I think it’s one of those areas that we will never really know. And there’s been a long history of post war syndromes, the change, going right back to shell shock, going back to effort syndrome, going back to the Crimea, and these things are not new. The message loud and clear was you need to do research. You need to do that health surveillance, you need to be able to spot difficulties when they appear, or alternatively to offer reassurance when they don’t. And that was the big message.


WHAT’S IT LIKE DOING RESEARCH FOR THE MILITARY?

Jim Al-Khalili: And you’ve been to Iraq, you’ve been to Afghanistan. What’s it like doing research for the military?

Simon Wessely:

Well, I recommend to everyone because I’m privileged that I have been out to those places as you’ve said, and no matter who you are, once you are on their territory, you are useless. You are a waste of space, you’re a danger to yourself, you’re a danger to them, and they don’t half tell you. They call you Sir because they have to, but it’s dripping with contempt in every syllable. You have a minder whose job is to keep you alive, from doing ridiculously stupid things, and so I thoroughly recommend it to everyone. It’s very good for the soul. You realise your essential insignificance and how useless you are, in their world. Also, the other thing I like, is when we do our research, you know Jim, and we all know, you find something but it’s years before it makes any impact.

Simon Wessely:

I mentioned Chronic Fatigue Syndrome. It was years and years before we made any impact on policy. But we’ve had instances we showed early on that the reservists in Iraq had a greater risk of mental health problems. We published it in The Lancet, it warned the MoD what we were going to say, and that afternoon the Secretary of State stood up and announced a new reservists mental health programme. So it had an impact in 12 hours. You don’t normally get that. And that’s incredibly satisfying in any scientific career, where you can see real tangible evidence of the impact that you make on the health and wellbeing of the armed forces past and present.

Jim Al-Khalili: What is it then about psychiatry that for you, that matches your personality, that ticks your boxes? Is it a sense of the history, of the feel that plays a role, as well as you know just doing the research and gathering the evidence?

Simon Wessely:

I think psychiatry does appeal to me because the essence of psychiatry is that it’s a mixture of the biological (which is vitally important, particularly at the moment where we are really investing in neuroscience at the moment as we should, but that will never be the complete answer, and we’re not neurologists. It’s the psychological which is clearly important. We’re interested in the products of what the brain does, the mind, but we’re not just psychologists. And we’re interested in the social. How society and how we are as groups hence my, you, my liking of the army. How that can make us ill but get us better. And we’re always going to be all three and if you take any one of those away I don’t know what you’ve got but it’s not psychiatry and it will always appeal to people who like any one of those three but also can combine them together and show equal respect to the physical, psychological and social.

Jim Al-Khalili: Simon Wessely, thank you very much for sharing your life scientific.

Simon Wessely: Thank you very much, Jim.



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