Profile: James Drife

Not many people can say that they are a star act at the Edinburgh fringe. Now add being a famous researcher and prominent professor on top of that. Kay Brennan talks to the man who fits the bill

"I nearly fainted at my first delivery," admits the professor of obstetrics and gynaecology, describing his introduction to obstetrics as a medical student at Edinburgh University. "Perhaps because we were called out after spending an evening at the local hostelry."

But the experience didn't discourage him, and he became a senior house officer in obstetrics and gynaecology straight after his preregistration year. "I've no regrets about entering the field so young," he says. "It is such a broad specialty that it gives you experience of the whole range of medicine from psychiatry to surgery."

As a young doctor James formed the Abracadabarets, a stand up comedy act, with some college friends. "The show was very non-medical. We weren't trying to trade on being doctors. It was more a send up of Edinburgh and a parody of popular radio shows at the time," he recalls. They soon gained local celebrity status at the Edinburgh fringe, the free for all relation of the festival, which picks out new talent. "We chose the name as it would mean we'd be top of the bill in the alphabetical listings. It's all about word of mouth at the fringe and our show sold out by the middle of the first week. We've been back five or six times now and intend to take a new show this summer."

James thrives on entertaining. "Making an audience laugh is a huge high, but unfortunately it's a very brief one as the worry of how you are going to follow it up soon takes over," he says. "You're only as good as your next joke." He has never shied away from the spotlight. He recalls: "I joined a band at college called the Unbelievable Brass. I sang and played the maracas, but not being very good at either I was kept strictly under control. They let me stay as I carried the drum kit."

His experience at the fringe prompted a personal view for the BMJ, and he was offered a regular slot as a Soundings columnist for the BMJ. More than 20 years on, James is still regularly broadcasting his controversial opinions in this column. "My articles have caused a few raised eyebrows over the years," he muses. "Ten years ago I wrote about a lecture I had given on breast cancer prevention. I asked the audience why we are so reluctant to suggest removing the breasts when there is a high risk of breast cancer. It caused an uproar in the press. They gave me a real roasting that weekend in the papers. I was branded a chauvinistic swine, and some breast surgeons said they were outraged by my comments. However, I feel that the controversy helped people face up to the issue. Recently, a well conducted trial of prophylactic mastectomy has been published in a leading journal, and I like to think this was partly stimulated by that furore."

His own research has also caused a few headlines. "Journalists used to regard research into the breast as slightly strange. They wondered why I would want to study something so odd, " he says. "One paper on changes in breast volume got the media tremendously excited."

His in-depth knowledge of the breast has made him a popular "expert" to supply quotes for the press. "In 1981, research linking the contraceptive pill with breast cancer caused a huge public scare. I was pressured by the press to give lots of interviews, as I was one of the few people who had done research on how hormones affected the normal breast."

After collecting the necessary material for his doctoral thesis, James moved to Bristol to work with the late Mike Hull, a leading authority in infertility at the time. He then did a year of general surgery so he could obtain his FRCS. "I dropped from being a senior registrar to a surgical senior house officer, which made me realise how hierarchal medicine really is. I found it hard being the junior again, with little relevant surgical experience.

James was soon right at the top of the hierarchy when he was appointed chair of obstetrics and gynaecology at Leeds General Infirmary in 1990. His flamboyant teaching style has proved popular with students over the years and his after dinner speaking talents made him a regular guest at the Leeds medic ball.

It is difficult to see where James gets the time to write material for the Abracadabarets and perform. He is an external examiner for the National University of Malaysia and has been involved with the General Medical Council for six years. Until last year he was also vice-president of the Royal College of Obstetricians and Gynaecologists. But he explains: "My commitments mean I spend many hours on trains and planes, which gives me time to reflect and write about my experiences."

With such a busy schedule, how has his family fitted in? He explains: "My wife is a GP, and her father was a professor, so she thinks our hectic life is normal. It was difficult when our children were growing up as I was often away, but I think they accepted my absence because they knew what I was doing was useful. I don't think they would have been so understanding if I was spending most of my time on the golf course."

James thoroughly recommends his specialty. "There is so much variety in obstetrics and gynaecology. You can be consulting on sexual medicine one day and in the operating theatre the next. I'm afraid that the future generation will not be able to see the width of the subject as things get superspecialised."

He advises being interested in research from an early stage. "Research will help you understand how reliable the evidence is that underpins practice, and will enable you to make up your own mind about how best to treat a patient. We should not be the technicians who are told what to do by other people."

He has no regrets about the path he has chosen. "Like everyone else, I often think it would be nice to have an easier job, but part of my personality is one that always drives for more." In such a successful and varied career what does Professor James Drife still have left to achieve? "I'd like to have a song on Top of the Pops!" he smiles.

The Abracadabarets are appearing at this year's Edinburgh fringe festival. You can catch them at the Royal College of Physicians in Queen Street from the 6-10 August. You can order a copy of their CD "The songs of the Abracadabarets" from 38 Kinellan Road, Edinburgh EH12 6ES.

Kay Brennan, final year medical student, Leeds University
Email: kaybrennan@hotmail.com


studentBMJ 2002;10:259-302 August ISSN 0966-6494