Interview available here: https://bit.ly/2xaS6e2

Summary:

Dr Roy Robertson (RR) and Dr Carol Sutherland (CS) discuss their experiences providing treatment for patients living with the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). At the beginning of the HIV epidemic of the 1980s, both Robertson and Sutherland were based in Muirhouse, working in a general practice surgery with many young drug users who were affected by HIV. Dr Roy Robertson was the first medical professional to link HIV infection and the sharing of needles in 1987, in a report published with The British Medical Journal. At the time of the interview, he was a Professor of Addiction Medicine at The University of Edinburgh; a general paractioner in Muirhouse, Edinburgh, and the organiser of The Muirhouse Medical Group.

At the time of interview, Dr Carol Sutherland was a Clinical Psychologist for NHS Lothian. Graduating from The University of Edinburgh in 1985, she began working at the doctor’s surgery in Muirhouse from 1986 until 1989 as a Research Associate for The Edinburgh Drug Addiction Study.

This interview was conducted by Dr Louise Williams (LW), LHSA Archivist.

Detailed timings:

0:23 – Name and occupation of both interviewees.

1:40 – RR discusses when he was first interested in addiction medicine.

3:26 – RR states that young people who were ill were predominantly intravenous drug users (IDUs).

3:40 – RR discusses the historical context behind the increase of popularity in heroin in western Europe.

4:15 – RR describes the vast increase of IDUs in Edinburgh from the 1970s to 1980s.

4:42 – RR states that there were no services for treating sick IDUs in the 1970s and 1980s, describes the public response to the first instance of HIV.

5:59 – CS describes the lack of public appetite for initiatives such as needle exchange.

6:33 – CS describes how international scholars were interested in how heroin use in Edinburgh and Glasgow differed.

7:26 – CS discusses how HIV affected families, communities and young people.

8:35 – RR describes difficulty of finding medical facilities to treat HIV-positive drug users.

9:10 – RR describes how IDUs infected with HIV became patients in Muirhouse surgery.

9:53 – CS and RR discuss the role of the CDPS and Dr Judy Greenwood.

10:12 – CS discusses the role of Dr Ray Brettle and Dr Alison Richardson in introducing treatment for IDUs.

10:26 – CS describes an increase in NHS funding in an attempt to solve the HIV epidemic.

11:36 – RR describes how Dr Ray Brettle created a new hospital ward with a variety of medical professionals to help those infected with HIV.

12:10 – RR compares working towards HIV treatment to working in medicine in a developing country.

12:29 - CS describes how her generation had never experienced an outbreak of an unknown disease.

12:55 – CS describes UK Department of Health and Social Security campaigns around HIV.

13:18 – Both CS and RR describe the large media presence at Muirhouse surgery.

14:44 – RR describes the role of Andrew Moss (San Francisco epidemiologist) in working with the British Government.

15:20 – RR discusses Moss’ co-operation with Brian McClelland and Rob Kivell in recommending needle exchanges and the provision of methadone. Discusses concern of the Lord Advocate and the Crown Office.

16:42 – RR details his visit to New York with Andrew Moss and the large numbers of people dying in the city. Concerned that this would happen to his patients in Edinburgh.

17:43 – RR and CS discuss the debate about the length of the incubation period for those infected with HIV.

18:38 – RR discusses how there was often a feeling of national tragedy and catastrophe at International AIDS conferences. CS discusses how this predated the impact of HIV and AIDS across Africa, meaning the discussion was largely focused on the Western perspective.

19:01 – CS describes the discrimination towards the homosexual community during this time, and the difficulty in finding scientific presentations at conferences. Discusses the large interest in the topic and how Edinburgh, though a small player, ended up being a key player in discussing the progression of the disease.

19:53 – RR discusses how the Washington AIDS conference made the medical community realise that a large number of people in Africa could be infected with HIV, though even then they vastly underestimated this number. Discusses how in America, it was believed that only a few homosexuals were HIV positive when in fact, over half a million people were.

20:40 – RR describes the introduction of antiretroviral drugs in 1996. Discusses how the Muirhouse surgery participated in the trial of AZT and how this inspired a feeling of hope that this would help solve the issue.

21:05 – CS describes the large number of deaths prior to the introduction of retroviral drugs. States that there were so many funerals each day that they often struggled to bury so many young people.

21:36 – CS discusses the controversy involving the ethics of the Wellcome Foundation and AZT drugs.

21:48 – CS describes how she went to do clinical training and then worked in the Genitourinary Medicine department at The Royal Infirmary of Edinburgh. Also discusses her job working with patients infected with HIV in Nottingham and how this experience differed from her Edinburgh work.

22:50 – LW asks both RR and CS to discuss their first experience seeing a patient they believed was infected with HIV.

23:07 - RR describes the role of George Bath, John Peutherer, and Philip Wellsby in diagnosing patients at the Royal Infirmary of Edinburgh with HIV [then known as HTLV3 ] for the first time.

that many of his patients were HIV+ in late 1985. Describes how they did not what the disease was, the severity of the disease, and the significance of the epidemic.

25:26 – RR describes his 1986 article for the British Medical Journal (BMJ) written with Ken Roberts, Philip Wellsby, and Ray Brettle and a preceding ITN interview that portrayed patients in a negative light.

27:24 – RR discusses the effect of HIV on heterosexuals.

27:56 – CS describes the perceptions of HIV posiive gay men and HIV positive drug users.

28:10 – CS describes the first HIV positive patient she encountered, and the attitudes held by her friends and family towards her job.

28:50 – CS describes anxieties of medical professionals working in the HIV field.

29:07 – CS compares the experience of GPs to medical specialists treating HIV positive patients. Explains distinctiveness of the field.

29:39 – RR discusses the anxiety felt about HIV. Discusses the anxiety felt by the police and the experience of people infected with HIV in prison.

30:44 – RR describes a study by Gerry Friedland about household context of HIV and its massive impact in informing people of how HIV could be spread.

31:31 – Both RR and CS discuss how AIDS changed the way that blood is now stored. Individual staff member identified.

32:29 – Both RR and CS discuss the large amount of young people who died of heroin overdoses during the 1980s.

33:17 – RR describes the reluctance to do post-mortems on IDUs and HIV positive patients.

33:40 – RR describes the first suspected and documented cases of individuals dying from AIDS-related illness.

34:46 – CS and RR describe the different impact of HIV in the east of Scotland compared to the west.

35:05 - RR and CS describe the vulnerability of HIV positive individuals and how they could often be exploited.

36:36 – RR discusses the significance of Scottish AIDS Monitor in recognising the needs of homosexuals and IDUs. Both CS and RR discuss the public objection towards the initial proposal to build Milestone House (an AIDS hospice) in Torphichen.

37:58 – RR and CS describe how the hospice was overwhelmed with a large number of HIV+ young people who were reluctant to leave due to their lack of resources.

38:42 – CS describes flexibility and blurred boundaries in HIV care in the early days of the epidemic. RR discusses absence of alternatives provided by medical and social agencies.

39:14 – CS and RR describe stigma towards IDUs and the impact of NHS cuts have at time of the interview.

40:32 – RR discusses the number of medical professionals approaching his Muirhouse surgery for training and research purposes.

41:15 – CS describes meeting the American Surgeon General, C. Everett Coop. RR describes meeting the Director of Social Work in Soweto with Ray Brettle. Both CS and RR describe the funding granted for meetings by the Scottish Office.

42:43 –CS’ attendance at international conferences. Discusses the presentation given by Sue Davidson on maternal transmission of HIV.

44:55 – CS and RR describe the debate among medical professionals about immunity and infection.

45:58 – CS describes her experience working at Chalmers Hospital and the difficulties in working with patients that were similar in age to her. CS describes how she chose not to continue working in HIV-related clinical work after working in Nottingham for several years.

49:26 – RR describes the importance of government funding. CS discusses how the outbreak of Ebola reminded her of her own experiences working with people infected with HIV.

50:27 – CS and RR describe what was learned during the HIV epidemic. RR discusses how little was learned about IDUs and HIV because of the stigma that they face and the limited response towards the large numbers of drug-related deaths at the time of interview.

51:20 – RR describes public misunderstandings about resources used for the treatment of drug users.

52:00 - CS discusses the lack of financial resources for mental health and how this affects those suffering with addiction at the time of interview. RR discusses the multiple factors that mean IDUs receive little support.

53:58 – CS describes her experience working for the Obesity Services and the need for more preventative measures for obesity and addiction to be put in place.

54:49 – RR discusses the limited response to the HIV outbreak in Glasgow at the time of interview.

56:42 – CS discusses the news coverage surrounding the drug “Spice” and “ChemSex parties” at the time of interview and how the advancement of technology affects the transmission of HIV.

57:07 – RR describes the necessity for a response to the HIV epidemic in Edinburgh during the 1980s and 1990s and how people in the UK often do not realise the large numbers of people infected worldwide.

58:34 – LW asks for CS and RR to discuss The Edinburgh Drug Addiction Study.

58:44 – RR describes the origins of The Edinburgh Drug Addiction Study and how it became a long-lasting [rolling?] programme. RR discusses the value of The Edinburgh Drug Addiction Study because of its cohort.

01:00:22 – CS describes meeting with IDUs and hearing their life stories. CS discusses the humour and strong characters that she encountered and their desire to tell their story.

01:02:43 – RR describes how rewarding the experience working with the Study cohort has been.

01:03:57 – CS discusses the challenges of working with young people infected with HIV.

01:04:39 – RR describes how IDUs often depended on their services because of the lack of other support available to them.

01:05:56 – CS discusses the impact that IDUs had on the Muirhouse Doctor’s Practice.

01:06:54 – CS describes her experience working in an impoverished community.

01:07:40 – RR describes the conditions where patients were previously treated and the reactions towards prescribing methadone in Muirhouse.

01:09:13 – RR discusses the other drugs prescribed to IDUs and how the understanding towards dosage changed over time.

01:10:14 – LW asks if there were concerns about a market for methadone.

01:10:37 – CS discusses the availability of drugs like dihydrocodeine.

01:11:05 – RR describes the inevitably of the trading of prescription drugs and the larger sense of understanding and acceptance towards drug addiction.

01:12:46 – CS describes the varied drug use of the homosexual population in London and how this is more accepted due to their social class.

01:13:29 – LW asks about categorisation of HIV positive individuals due to method of infection.

01:13:54 – CS and RR discuss how technology has impacted on relationships.

01:14:27 – RR discuss the impact of class on access to drugs.

01:15:01 – CS asks RR if he has encountered anyone abusing fentanyl. RR discusses how some patients use fentanyl due to availability and the concerns over fentanyl in Canada at the time of interview.

01:15:48 – RR describes the assumptions held towards doctors that prescribe drugs to those struggling with addiction.

01:16:33 – CS discusses the unrealistic view towards curing addiction.

01:17:17 – RR discusses the follow up study he carried out with John MacLeod and the tragic lives of drug users struggling with addiction.

01:18:06 – RR describes the unhelpful approach of the media and the press in portraying the work done to help those with drug addiction issues in the Muirhouse clinic.

Duration (h:mm:ss): 1:19:38

Format: .WAV file

Date of interview: 26 September 2017

Copyright: LHSA