In January 1973, a new Consultant in General Medicine with an interest in Gastroenterology (as it was then termed for his field was not regarded as a speciality), took up his post at Doncaster Gate Hospital, Rotherham; an unusual choice for someone trained in academic centres in India and the UK, and who was expected to remain in that environment.
His reason for this change in direction surprised his teachers and was unclear even to him, as it was instinctive. He later realised this reflected his yearning for independence and to be able to ‘do his own thing’, ie devote himself fully to clinical work and to develop research (he had no interest in private practice - which surprised and confused his colleagues and employers). His reason for choosing Rotherham as his base was equally unclear. That there was a vacancy for a physician helped, but he sensed opportunities which later were to be fulfilled through the combination of wonderful, supportive patients, a hospital management which at that time was amazed that anyone would undertake research at so small a place so encouraged him, and his wife, Gouri, the rock of the family. Initial finance was £23 – the remnant of a small gift received to support his earlier work in Sheffield – augmented by much scavenging, the kindness of strangers, goodwill and sheer good fortune.
It was customary for incoming consultants to produce a wish-list of equipment and facilities with which to produce the results expected of him or her. It was also customary for the wish-list to be pruned by employers, and limited to the first item! At this time, a range of endoscopy equipment had just become available in the UK so this is what our hero requested and, much to his surprise, received in full. The then Chair of the Appointments Committee, Jack (later Sir Jack) Layden later explained that “we wanted to keep you here lad”!
A breakthrough in peptic ulcer disease research
Armed with this equipment and spurred on by a long-standing fascination with peptic ulcer disease, which was particularly common in Rotherham, Dr Karna Dev Bardhan (KDB) began his research. In the mid-1970’s, the H2RAs emerged; these were the first drugs that could effectively suppress stomach acid secretion so had the potential to heal peptic ulcer. The research team at Smith Kline & French who pioneered this development, became aware of the increasingly strong research interest at Rotherham and a link was formed. The very first clinical trial proved that cimetidine, the test drug, was extraordinarily effective in rapidly relieving symptoms and healing the ulcer, and the follow-up studies demonstrated ulcer recurrence could be greatly reduced with a small nightly dose. Rotherham’s industries at that time were principally coal and steel, demanding heavy physical work and a fit workforce; but ulcer disease often prevented the victim from working.
This medical advance led to fewer deaths from ulcer complications, a rapidly diminishing need for surgery and to speedy return to work. These studies brought in small amounts of funds from the pharmaceutical industry. As was then the practice. such grants were made to the investigator as a personal payment, to be used as he or she saw fit. Gouri, however, urged KDB to use them for wider benefit. This led him to strengthen clinical gastroenterology, establish a patient database, ensure systematic follow-up of all his patients and develop the facility for their direct self-referral if problems arose. The residue was still sufficient to start investigating the regulation of acid secretion, leading to the first PhD.
From these beginnings, there emerged a model of clinical practice and research, “from bedside to bench and back to bedside”, a “virtuous cycle” linking fundamental science, translational medicine and clinical research. As peptic ulcer started to wane, reflux disease, another acid-related problem, emerged which needed even stronger therapy for its control. This led to early studies with the proton pump inhibitors (PPI) which proved very effective. As is the nature of research, each advance leads to other opportunities requiring different skills. Thus issues identified at Rotherham were investigated through ‘fundamental science’ by forming collaborations with various university departments in Sheffield and led to further joint PhDs. These collaborations were essentially on an ad hoc basis but the increasing volume of joint research now required a formal structure.
The creation of BRET
The Bardhan Research & Education Trust of Rotherham Ltd, which became known as BRET, was therefore created, incorporated as a company limited by guarantee on 13 April, 1988, and entered on the Register of Charities on 21 December, 1989. BRET now began to support a wider range of research, both at Rotherham and the University of Sheffield but later expanding to other centres, covering PhDs, MDs and post - doctoral Fellowships, as well as support at an ealier stage, BMedSci and MSc.
Image: The Bardhan Lecture award
In the early 1990’s, BRET’s viability came under question due to the activities of a former Trustee and Director, but, with the formation of a new, stronger and committed board, the recovery began. The very nature of BRET allowed Trustees to stay closely in touch with Fellows, a major strength. From discussions, they recognised the need for ‘blue skies’ thinking and to risk supporting such projects (where other funding sources were reluctant). Some projects failed, but not for the want of trying. Most succeeded, judged not only by the breakthroughs but also in the personal development of the researchers, many of whom in later years went on to great prominence. To date, over 50 scientists have been awarded in excess of £2 million. In parallel, educational grants have been awarded at the University of Sheffield, making it possible for high-calibre overseas science students to undertake Masters studies in Bio-medical Science.
Dr Bardhan's retirement
KDB retired from active clinical work in March 2011 but continued full-time, with ongoing research and teaching the medical students at Rotherham. The changes in the direction of research and NHS environments now require direction from younger and stronger hands.
The Trustees invited KDB to develop 'memoirs', reflecting his life in Rotherham and how gasteroenterology came to flourish - and why. Professor Bardhan completed his memoirs and the book ‘an improbable journey in medicine’ is now available on Amazon: An Improbable Journey in Medicine: A Story of Courage and Enterprise
“The Trustees believe that medicine is best served when led by research, supported by science and sustained always by compassion. The Trust’s aim is to promote research and education in medicine in general and in the field of gastrointestinal disease. The Trust seeks to encourage men and women of any age, particularly those not based in academic centres, to pursue research or educational activity. The principal requirement and qualification of the candidate is to have the necessary drive, determination and ability to develop good ideas.”
KBD presentation
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