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John Buckler
“The Leeds-Leipzig Paediatrics link, 1977-89”
Mainly Paediatric:
The association between the Paediatric departments of Leeds University and the Karl Marx University in Leipzig – as part of the overall University link – began in 1977. I was approached by the head of our department in Leeds, Professor Smithells, at an early stage to ask if I would like to be the first of what, I think, had been envisaged as one of a series of such visitors from our department and, despite not speaking a word of German, I gladly accepted. As it happened, apart from a few visits in the company of the Professor himself, I remained the only representative from Leeds, and I continued to make visits every two years or so until the reunification of Germany when the programme stopped. My counterpart in Leipzig was Dr (now Professor) Helmut Willgerodt. He, too, apart from an occasional visit from the head of his department, Professor Wolfgang Braun, was their only representative to come to Leeds, and that with rather less frequency than my visits to Leipzig.

The driving force behind the visits was “collaboration” – a useful euphemistic word! This was the research component of our time together. In fact that was exclusively with Helmut who worked in the same paediatric speciality field as I did, namely Endocrinology and Growth. The first visit was around a conference entitled “Wachstum und Entwicklung” – two words whose meaning I have not forgotten! Helmut and I spent many happy hours together, ploughing through case notes of the patients we had looked after in our respective hospitals, and either comparing the outcome of our regimes of treatment or pooling the data for rare conditions to get a series with larger patient numbers. Progress was, of course, slow, as we only met about once a year, but it seemed worth while, and we were proud to have had published a few articles, notably one in the English Paediatrics Journal Archives of Disease in Childhood entitled “Growth in thyrotoxicosis” – a relatively rare condition in children. The remainder of my time was spent shadowing other consultants on their ward rounds or in their clinics, notably those with Helmut, and attending the numerous department meetings – little of which I understood.

As with any Centre, standards were variable, but my overall impression was very favourable. The staff were knowledgeable and well read and conscientious and hard working. The day was long, starting early about 8 am, though finishing rather earlier than I was wont to in Leeds – about 4-5 pm. The atmosphere was friendly and respectful, and the attitude of junior staff and nurses and other ancillary services was impressive and reminiscent of the “good old days” (may I be forgiven!) in England which, sadly, are gone for ever. I was particularly impressed by the nursing charts on the wards which were completed for every patient in the minutest and almost obsessional detail and kept updated, and with observations that were frequent, reliable and accurate. It was possible on referral to these to know with confidence every detail of a child’s progress and treatment, and they were clear and readable.

I have never come across such ideal monitoring anywhere else – and so unlike much of our current paperwork which, though more bulky and impressive looking, conveys little useful information and is difficult to interpret. In Outpatients, too, in the Leipzig Kinderklinik, documentation was excellent, though much of the basic observations and recording were undertaken by the nurses. I got the impression that most of the staff were of long standing and experience, and certainly did not change frequently. They knew the quirks of the doctors with whom they had worked very closely for many years. (I have known such quality of support in the past in England, but not these days.) On the other hand, there were strange inconsistencies and a sometimes questionable appropriateness of some undertakings. The children with growth disorders had a medical photograph taken at almost every attendance, they had frequent X-Rays which were unnecessary, and I was dubious whether they were interpreted in the best way, and techniques of measurement, though consistent, being taken by the same observer, left quite a lot to be desired.

Resources were clearly deficient and equipment archaic, yet within these limitations the standards were outstanding. Helmut ran the chemical pathology labs, and the methods were extremely outdated, lacking automation (which has of course ultimately arrived with the West). I remember my astonishment – throughout the time of my visits while still the DDR – that blood samples for testing were taken by the consultant in clinic using a needle directly into the vein and letting the blood drip out into a container. There were no sterile syringes. Technically these doctors were highly expert!

Standards of treatment varied, depending on the quality of the medicaments that were available. In my own field with the use of Growth Hormone, the preparation they used was of poor quality and their results very inferior to ours. This proved quite an embarrassment to me when we compared the outcome of our regimes. Yet in some areas with simpler, cheaper forms of treatment such as for thyroid disorders (of which they have a far higher incidence than we do) the quality of outcome was excellent.

Parents and children were treated very politely but they were far less demanding and far more accepting – and the concept of litigation just did not exist: oh what joy! This was, however, associated with certain standards that were accepted without question there, but which would be unacceptable to us – such as restricted visiting and long waiting times. However, the service they received when they saw the doctor seemed to make waiting worthwhile. This was a referral centre so, though many patients were from Leipzig, many also came from a considerable distance.

I like to think that our departments proved to have one of the most effective collaborative associations of this kind – due to a large extent to the extraordinarily cordial relationship that was built up with my counterpart in Leipzig, Helmut Willgerodt (he is due to retire at 65 in 2001). Since the Wall came down, our inter-university link has stopped, but I have been back three times – once to the celebrations of the 100 years of the Kinderklinik, once for Helmut’s 60th birthday celebrations and, most recently, at my own instigation. There is no doubt that the key to my enjoyment and the success of the collaboration has fundamentally depended on the individual personalities whom I have known.

Mainly personal:
On his visits to England Helmut was always obliged to travel by air, but I was able to choose the overland route to the DDR by rail, which was far more interesting and exciting – but rather frightening for an inexperienced traveller who had never before been to Germany and never behind the Iron Curtain. The experiences at the frontier were dramatic indeed. The artificial ostentation of wealth and comfort displayed right up to the border station on the West, where colours were bright, contrasted with the grim greyness and discomfort of the East. With my ignorance of German I developed various ploys to facilitate my entry to the East, such as conspicuously studying my elementary German Grammar book and using the phrase ‘auf Einladung’ which seemed to minimise my cross-examination and, in particular, with regard to the finances! I also learnt that to go from West to East at night by sleeper resulted in a much quicker and gentler transition – and that was the way I invariably chose after the initial visits, arriving in Leipzig at about 9am, tired but tolerably relaxed.

When I visited Leipzig with an invitation to contribute to conferences or a symposium, I was accommodated in a hotel of high standard for the DDR, but for the majority of the early visits I lived in the University Guest house in Beethovenstraße, where I was looked after in a very concerned and comfortable way by Frau Rust, and shared the building with numerous visitors from other countries. I catered for myself in theory and occasionally got my own breakfast, but in practice I had nearly all meals during the day with Helmut in the hospital refectory (with filling, but basic, unvarying food) and was taken out in the evenings – very spoilt. In the later visits I stayed in a guest house behind a courtyard near the Nicolaikirche in the Ritterstraße.

I cannot speak too highly of the way I was always looked after by my Paediatric colleagues. They were friendly, interested and generous. A few spoke fluent English, including Helmut, some none at all, but most a smattering – and a far better smatter than mine! However, over the years I made a little progress, and they always encouraged my efforts and we had some good laughs! I was of course aware of the constraints under which they laboured through the regime, and the great bonuses that accrued for those who were Party Members. However, being naturally naïve, I did not realise that there were those among their number who were informers, and I was saddened when this came to light at the time of Reunification when these individuals disappeared from the scene.

I was offered wonderful hospitality by the English-speakers, including meals at their homes or in restaurants and being taken by car to many places of historical and cultural interest, including Dresden (which I found particularly harrowing from the effects of wartime devastation – a reaction which persisted for me on a very recent re-visit), also Weimar, Erfurt and East Berlin (I never got across to the West !) In view of the obvious poverty overall in the nation, I was surprised by the relatively high standard in which these doctors lived. The food was excellent, and their accommodation adequate and comfortable, though small. This was possibly due to the unrepresentative company that I kept, though doctors were not affluent by our standards, but it was more likely due to the fact of the cheapness (through subsidisation) of essentials such as the basic food and drink requirements, rents and travel within the city and country by public transport. Non-essentials were, of course, extremely expensive. Helmut took me to visit his allotment which is about 30 miles outside Leipzig and quite sizeable, with a building where he and his wife can stay overnight. It is, however, too far for frequent visits, and he has, of course, no garden in town.

The subsequent tragic changes since the Wall came down have been very evident to me in recent years, in terms of unemployment, mistrust, crime, drugs (though still only about one sixth of the incidence in the West) and a great increase in the cost of essentials. On a recent visit I was struck by the great variation in the quality of the buildings. Many have been greatly improved with impressive restoration, and there are attractive new buildings, yet alongside, and sometimes in remarkably close proximity, there are decrepit, dirty, grey, unpainted, crumbling, boarded-up structures – even worse than in the days of the DDR. I was informed that few people now want to rent flats, and many are moving elsewhere due to lack of jobs. And many who do have work prefer to live outside the city with houses and gardens of their own. Prices of property have risen catastrophically and, as a consequence, Helmut cannot afford to live in his previous flat and has had to move to a smaller one. The population of Leipzig has fallen from about 600 000 in 1945 to 490 000 now (about 10 000 per year since Reunification). Before Reunification only old people could go to the West – as I remember so well from my return train journeys from Leipzig. Now it is the young ones who move out and the old ones are staying put. The population mean age is becoming much higher, with a greater proportion of pensioners, and the death-rate exceeds the birth-rate which has fallen. This is bad economically for the city.

I felt sympathetic to the feelings of many of the doctors after Reunification, when the attitude of Western doctors was to treat those from the DDR as if they were ignorant and inefficient, whereas, in my opinion, that was far from the truth. For example, I had been impressed by the establishment of iodine supplementation to foods through the activity of the consultants – as iodine deficiency was common in many areas of the DDR – with pleasing reduction in goitre and hypothyroidism. This practice was stopped with the arrival of the experts from the West, who presumably thought they knew better.

Despite the friendliness of individuals to me, I was always conscious of the restriction within their lifestyle and their fear of the regime. Conversation in public was cautious and limited when it touched on anything potentially with a political connotation. Things eased a little in the safer surroundings of the home, depending on who was present. Helmut found it extremely difficult to relax when he visited us in Leeds and could not believe that he was not being watched – which he probably was, even in Leeds. The Russian military presence was everywhere, and clearly hated by the Germans, though they had to be careful how they expressed it. Helmut had to present a comprehensive report to the authorities when he visited abroad, and he learnt not to be too enthusiastic about his time and research in the UK. By contrast, he had to eulogise and produce a glowing impression of his “collaboration” on the visits he made to Moscow which, he confided to me, were a waste of time, as the Russian standards were abysmal. These visits were almost mandatory – as, I think, were those he made to Czechoslovakia, though these latter were of greater value. Russian was a compulsory second language in schools, but it was clear that most people hated it and avoided its use whenever possible. I was never sure whether the strict adherence to the law in the DDR was merely a reflection of the Germanic culture, or the consequence of subjection! Certainly I found it extremely difficult to wait at pedestrian crossings till the lights went green even when there were no vehicles anywhere in sight!

These visits of mine to Leipzig were highlights in my experience, and a real bonus for which I feel very honoured and privileged.

Der Gebrauch einer Sprache führt zu Einsichten, die für Außenstehende fremdartig und undurchschaubar bleiben. Nur dem Eingeweihten erschließen sich Wortbedeutungen und sprachetymologische Zusammenhänge. Im Schaufenster eines Leipziger Friseurs stand ein Schild mit der Aufschrift:

echtes Klettenöl !
zum Kletten der Haare !

from: Leipzigs langes Leben (Leipzig, 1982)