Pieter Pretorius

Interviewee: Pieter Pretorius (South Africa-at-Large & Green 1995) [hereafter ‘PP’] 

Moderator:  Akudziwe Mawere (Zimbabwe & Balliol 2023) [hereafter ‘AM’]  

Date of interview: 17 August 2024 

[file begins 00:01] 

AM: Okay. This is Akudziwe Mawere (Zimbabwe & Balliol 2023). I’m here with Dr Pieter Pretorius in Rhodes House for the oral history interview project. So, just to confirm, can you tell me your full name and your constituency? 

PP: Yes. I’m Pieter Michiel Pretorius, and I’m a Rhodes Scholar from South Africa. It’s the South Africa-at-Large constituency, and I came up in 1995. 

AM: Okay. And can you confirm that you consent for me to record this interview? 

PP: Yes, I am happy for the interview to be recorded. 

AM: Thank you. I was so happy to get the opportunity to interview you because you seem like someone who has had a similar journey to me, having studied in South Africa and then having come here and further specialised, which is something that I am hoping to do. So, from this interview process I am going to try and get a mini-autobiography from you of your journey pre-Rhodes Scholarship, during your Rhodes Scholar years, and then post-Rhodes Scholar years. And this interview can be as long or as short as you want it to be. So, can you tell me a bit about your life before the Rhodes Scholarship? 

PP: I was born in a small town in South Africa called Wolmaransstad which is a small farming town in-, it used to be in the Western Transvaal province. It’s now the new provincial dispensation in South Africa: it’s called the North West province. So, it’s south west of Johannesburg, I think about 150 kilometres or so, towards the Botswana border end of the northern part of South Africa if you know the geography in that area. It’s, as I say, a farming town, and I was born in 1969, so, at the height of apartheid.  

So, in that time, of course, it was a segregated society. So, I lived in the white part of this small town and that’s the only part that I really saw. As far as I was concerned, as a small child, that was the world that existed in this, you know, tiny little farming town. And I saw only white children at school. I went to an Afrikaans school. There were only state schools there. In South Africa, bizarrely, although there are many private schools, they are not Afrikaans language, they are English. So, I went to a state school in this little town with lots of farm boys, although we lived in the town itself, and I lived there until I was 12. So, I finished primary school in this town called Wolmaransstad. My parents didn’t go to university. My father was a small businessman. He had a drive-in movie theatre in Wolmaransstad, which is something that I think people of your generation aren’t really familiar with. 

AM: Drive-in movie-? 

PP: Drive-in movie theatre. 

AM: I think I’ve come across it. 

PP: You will see it in old American movies. So, people drive with their cars and park, and there are poles with speakers. You put a speaker in the window of the car and you watch on a big screen. So, you are in the car watching the movie with a lot of other people who turn up in their cars.  

AM: Okay. 

PP: And that was a big part of the, sort of, social scene in this very, very remote area. And, you know, on weekends the farmers would all come for the Saturday night movie and people would have a braai – you know, barbeque. There were barbeque places at the movies. So, that was my dad’s business. He also did a bit of farming. So, he had two farms in the area: one was his family farm where he grew up and later on, he bought another farm. And again, it was cattle and maize that we grew there. The other economic activity in that area is small-scale alluvial diamond mining.  

And it is a very insular, parochial society. So, as I say, I am Afrikaans-speaking, so, I grew up in that culture, which is very insular. I think things have changed now but, in those days, in the days of apartheid, for example, we didn’t have television until 1976, and I think in our house we only got a television in 1980. So, I was already in primary school when I saw a television for the first time. That was also slightly by design. You can imagine the government that runs a system that is very unfair wouldn’t want the people in their own country to see what other countries are like. Not having television doesn’t expose people to normal societies. So again, as I said, when I was a child that seemed entirely normal to me, the way that South African society was organised, because I knew nothing else. And there were no televisions to show me examples of, you know, what normal societies look like.  

So, that was me as a small child. A very happy house. I have three siblings – an older brother, younger brother and sister. Things were fine. We had enough money, you know, more at some times than others, but there was no deprivation or anything like that. So, I’d say I lived a very privileged life in that sense. Everything, in my little cocoon of society, seemed very safe, and so on, and I was unaware of the greater aspect of society, which was everything but. There were serious issues, and potential for, you know, a violent revolution, not least. But I became aware of that only later on.  

So, we left Wolmaransstad. My parents divorced and my mother and me and my siblings moved to a bigger town – still an Afrikaans town – called Potchefstroom, a bit closer to Johannesburg.  

AM: Okay. 

PP: It’s a small Afrikaans university town and I went to high school there. Again, an Afrikaans state school. And this school was called Volkskool which means ‘The school of the nation.’ 

AM: Volkskool? 

PP: Yes. Volk, obviously referring to the Afrikaner volk in that case, nd it had the distinction, which the school seemed proud of it at the time, that one of their alumni at the time was a person called Eugène Terre'Blanche. Now, you may be too young to be aware of this person. He was what we would now call, clearly, a neo-Nazi. So, he was a leader of the Afrikaner Resistance Movement, they called it, an explicitly racist, sort of, faction of the far right that had uniforms and insignia that looked quite like the Nazis. And he presented himself as-, He was often on a horse, often making a salute that looked surprisingly like a Nazi salute. And the school was quite proud of having his person as an alumnus, and he actually came and talked to us. You know, that’s to give you an idea of what society was like.  

Now by that time I had developed a bit of an awareness of the anomaly that South African society was, and I suspect, in retrospect, I had become increasingly, sort of, isolated from my peers because of opinions that differed from the mainstream of that society. And also, certainly because of, I guess, what you might call, sort of, religious scepticism. You know, South African society, particularly Afrikaner society, is very religious – Protestant Christian – and I wasn’t particularly keen on it because a big part of what was used to justify apartheid was religion – in the same way religion was used to justify slavery and all sorts of other things – and it was clearly used to justify apartheid. So, I became more and more disillusioned with it and that created some difficulty with my peers who were all, you know, white Afrikaners like me, and that continued when I went to university in the Free State. 

So, I went to a small medical school in the University of the Free State which is in Bloemfontein: again, an Afrikaans university. And the same, sort of, themes: the social isolation from my peers, because it was essentially everyone Afrikaans-speaking in the university as well. But it was an important, I think, sort of, formative experience of starting to form opinions of my own about what I see around me and what I think about it. And although it could be uncomfortable at the time, it was clearly-, I guess it was a way of opening my eyes to how society worked and what was going on in South Africa. 

AM: Okay. 

PP: And my student years were quite busy. I found medical school very challenging. It was hard work, but I really enjoyed it, and I threw myself into the work. It felt like something important. For one thing, it was a privilege to go to university. As I said, neither of my parents did. And from a young age, they always stressed to all four of us children, the importance of getting an education. Part of that, I realised in retrospect-, my father was very concerned about the political situation in South Africa, the uncertainty of the future, even the possibility of, you know, a violent uprisings, which-, he was surprised that it didn’t happen, because he once explained to me, he said, [10:00] ‘If I was in the situation that the majority of people find themselves in, I would be planting the bombs.’ You know, he said if he was subjected to what black people were subjected to, he would be what white people called a terrorist. The first time he said it I found it jarring from this person who clearly is a conservative Afrikaner, but it was just the ability for him to put himself in other people’s shoes and say, ‘What would I do if I was treated like that?’ And that realisation from him, I think, scared him about the future, because he thought, ‘This is going to happen: there is going to be an uprising and white people are going to get what’s coming to them.’  

So, he saw education as a passport. He said, ‘You may one day need to flee, and the only thing you can take with you is what’s in your head, an education. Nobody can take that away at the border. They can take money, they can take vehicles, they can take possessions, but the one thing that nobody can take away from you is your education.’ So, education was always, in our family, seen as something very important, and it’s the thing that nobody can take away from you, the thing that if you lose everything else, that’s what you start with again, somewhere. And I think that’s a valuable way of thinking. Throughout the world, we’ve seen so many people in situations where their education is the thing that becomes the passport for a new life after some upheaval. 

AM: Yes, even as Nelson Mandela says. 

PP: Yes. And of course, my father turned out to be wrong about the dangers. We had a peaceful transition. You know, it’s one of the, sort of, social miracles of our time that we saw happening. Certainly in my lifetime, I saw that play out. So, that aspect of it never came true. I never needed to make a life with just my education. I had the privilege of getting a good education in Bloemfontein. As I said, I worked quite hard. At school, I worked hard but not very hard, and I did okay, but not very well. 

AM: Is this secondary school? 

PP: Yes. Yes. I managed to get into university, which at that time was much easier than in almost any country now. So, it really was a different time in terms of university admission. With the grades I had at school then, there’d be no chance of getting into a good university now, not even a university like that, which I have to stress is not within the top 1000 medical schools in the world. But when I arrived there, because I didn’t really have people in my family to talk to, to ask, ‘What is it like in university? What are the academic demands? How do you prepare for exams?’ and things like that, I used a, sort of, brute force approach of working just every hour of the day, and working incredibly hard. And when the first exams came around in first year, I did very well – sort of, from being middle of the class, and a bit above at school, I was suddenly right at the top of the class at university. The sense of achievement from that took me by surprise but also became self-reinforcing. I wanted to have that feeling again of having done well. So, then it became a pleasure, working hard, because suddenly I got rewards that I wasn’t used to. Suddenly, I was the guy who did really well in the class. And that continued throughout medical school. I did very well throughout and enjoyed it and felt I was working towards an education that leads towards a fulfilling, important job. So, I really liked that feeling of a long-term project that leads to something positive for myself and the ability to do positive things for other people. 

AM: Was it also six years in med school? 

PP: It’s a six-year course. 

AM: Okay. So, how was it structured from the first to the final year? Because for us it was: the first two years, basic sciences; the third and fourth year, clinical sciences but more based at med school; and then the last two years hospital-based clinical rotations. 

PP: Yes. So, for us it was: the first two years, anatomy and physiology were the important subjects. So, those two subjects you carried through the first two years. In the first year, we also did chemistry and physics, but anatomy and physiology were for the first two years – very good courses, lots of dissection, lots of laboratory time. And then in the third year, it was the preclinical subjects of pharmacology, anatomical pathology, chemical pathology-, I can’t remember what else: a bit of psychology. And then from the fourth to the sixth year – so, the last three years – were hospital-based. So, all the clinical subjects: surgery, paediatrics, gynaecology, obstetrics, orthopaedics, psychiatry and so on. So, the last three years were rotations in the hospitals in the mornings, and in the afternoons, lectures in those subjects. So, that’s the way that it was structured. 

AM: Which hospital were you predominantly based at? 

PP: Yes. So, in Bloemfontein, the teaching hospitals were Universitas Hospital, which is physically attached to the medical school. So, that’s in the main part of Bloemfontein. And there is a very big teaching hospital called Pelonomi Hospital. Traditionally, these were the white hospital – Universitas – and the black hospital, Pelonomi. Of course, during that time, that started to change because this was in the late 1980s, early 1990s, before the first democratic election, but, you know, the time of apartheid was up and things were starting to change in terms of segregation. It was slowly disappearing. But still, at that time, Pelonomi was predominantly a black hospital, and Universitas a white hospital, and we spent our time between the two. 

AM: So, you were a doctor-in-training who grew up in a predominantly white society, and now you were suddenly exposed to these very overt inequalities.  

PP: Yes. 

AM: I’m assuming the inequalities between the two hospitals were very obvious in apartheid. What was that like for you in your training phase? 

PP: Yes, it was very obvious. Of course, as I said having grown up in that society it was totally unsurprising because it was a reflection of the rest of society. So, I wasn’t surprised to get to Pelonomi and see that the facilities weren’t as good. That was really the way the whole society was structured, and intentionally so. You know, if one group of people get to vote and decide the lot of other people, they are likely to favour themselves, and that was clearly what was happening there. But by that time, of course, I was more aware of these differences. and it was also interesting to see, then, the political debate and how, you know, people were working to change that, because that was the time of the release of Mandela, the negotiations between the National Party and the ANC, first in exile, and then the ANC after it was unbanned. And that process of how you structure a society, how you go from that situation to a more normal society, that was fascinating to see, to see that play out in real time. It’s, as I say one of the big social changes of the 20th century, and I was there, I saw these things happening. It was really quite, by then, an exciting time. It still felt dangerous, and clearly, we know from the history of the end of apartheid how bloody that was in places.  

AM: Yes. 

PP: But things could have been a lot worse, and I think it’s a credit to the society that a predominantly peaceful way was found to remake a society. It was exciting to see. 

AM: I’ve got two questions for you. Maybe you can answer them at the same time. So, the first one is, what were some of the dramatic differences between the hospital that served predominantly black patients and the white patients during your med school years? And then secondly, what were some of those dramatic changes you noticed in the post-apartheid era? 

PP: The differences between the hospitals were partly, that Universitas was built in one go in the late 1960s, early 1970s, as a modern hospital for the time, whereas Pelonomi was built piecemeal: it was a small hospital at first and bits and pieces were added to it. So, it wasn’t as well planned. But that’s, sort of, a function of the nature of it growing from a small hospital to a very large hospital. Clearly less money was spent on it. It was just obvious that the estate, the facilities, were not as good. The wards were much bigger, with far fewer-, well, I don’t think there were private rooms, whereas in Universitas there were some private rooms, you know, where a single patient would occupy a room. That wasn’t the case in Pelonomi. It had far larger wards. And it was partly because staffing such a big hospital, you needed to be able-, it’s easier to staff a ward with more patients because fewer nurses can keep an eye on all the patients. But, you know, it had a different vibe to it. 

And the other thing that I noticed – that was one of those quaint observations at the time – is that at the time of handover between nursing shifts [20:00] in Pelonomi, the black nurses, who were predominantly Suthu-speaking in that area sang-, there were some songs they sang at the time of changeover. And, you know, if the students were around, they would all stop and listen and it was just amazing, and a completely different thing that wouldn’t happen in the Universitas hospital where one shift would stop and another one would start. It was like a little ceremony. I don’t know what they sang but it was quite something to see. So, there were cultural differences in just how people went around their daily business. 

AM: I remember at Bara [Chris Hani Baragwanath Hospital, Johannesburg], they used to sing as well. I just thought it was a South African thing in general.  

PP: Yes, I think it is. There is a lot of-, there are sort of interesting harmonies that come out of it. So, some of it is together, and then there would be a call-and-response aspect of songs. A little bit, I think, like the worker songs that you also had in mines in South Africa. ‘Shosholoza’ is an example of the call and response. 

AM: Oh, yes. 

PP: And it has to do with the work and, you know, there are some onomatopoeiac components to it. And, of course, there is a culture of singing in black churches in South Africa, if you are familiar with the music of black churches. There is something quite special about that. 

AM: Okay. And post-apartheid, what changes happened in Pelonomi? 

PP: Well, I’m not sure because I finished medical school in 1993, and that’s two years before the first democratic elections. And I’ve never been back to Pelonomi since then, so I don’t know. But I’ve heard from other people that obviously the whole way that healthcare is provided there has been rationalised by using the different hospitals not anymore for different races but for different types of diseases, different types of care. Depending on, you know, whether you need to go to a TB ward you might go to Pelonomi, whether you are black or white, and they have facilities that deal with certain types of services rather than duplicating each of those on the two sides.  

AM: Okay. 

PP: So, I think they have rationalised the way you use the two facilities to take care of more people better rather than take care of different people differently, if you see what I mean. 

AM: Yes, Definitely a more efficient health model, if you ask me. 

PP: Yes. I mean, it’s so obvious that you can provide more healthcare if you don’t have to duplicate everything just on the basis of skin colour.  

AM: Exactly. So, you finished med school in 1993 and then you came here in 1995. I’m assuming in between you were doing internship? 

PP: Yes. 

AM: How was that? 

PP: I loved it. I got an internship in a hospital called Rob Ferreria Hospital in Nelspruit, which is in the eastern part of the country. It’s now called the Mpumalanga province: it used to be called the Eastern Transvaal. And Nelspruit is now called Mbombela, I believe. It’s a sizeable town, near the border with Mozambique and Swaziland, and on the way to the Kruger National Park, for people who have driven from Johannesburg. So, you go past Nelspruit to get to the Kruger National Park.  

The hospital was very different to, say, the hospitals in England now, because I think we were eight interns there, and there were another five or six doctors who were called medical officers, and none of them were specialists. They were generalists who could do a bit of everything – a bit of surgery, a bit of obstetrics, a bit of anaesthetics, a bit of paediatrics. So, they were real jacks of all trades and very good doctors, and they provided great training for us. But the working situation was very different to what, say, interns or housemen are exposed to here because you really work on your own a lot. At night, if there is caesarean section to be done, one intern will give the anaesthetic, the other one will do the surgery, and you try not to call the medical officers in from home to come and help. Of course, you do if there is a big problem. But most of the surgery and so on at night, you do without help which means our medical training also had to take account of that. So, it was much more hands-on than medical training, say, in the UK. Because here we have the luxury of many more senior doctors and specialists who can do those things but in rural South Africa, the situation was different. So, much more junior people had to step up at a much earlier stage of their career, to take much more responsibility, more difficult clinical decisions, and so on. But it’s a fantastic way of putting yourself in a situation where you have to act because you are what’s there. You know, if you don’t do it, that person suffers, so you very quickly get used to, as a 20-something-year-old, making life and death decisions on your own, and doing your best. It felt like real medicine at the time, you know?  

AM: Yes? 

PP: It was exciting, tiring, very long hours, but it felt like I was really using the training that I had.  

AM: You talked about paging your medical officer. What was your paging system back then? 

PP: Yes, we had pagers, so that’s how we would get hold of them if we needed to. 

AM: Like the ones that you only see on TV now? 

PP: Yes, the ones that bleep, you know, that you carry in your belt and they make a loud bleeping sound and the only thing that comes up on it is a number that they then have to phone. So, if the bleep goes with a number, they then know that they need to phone that number in the hospital and I would then tell them what’s going on. Because that was also before cell phones. 

AM: Yes. Because now, well at least at Bara, the paging system is more cell-phone-based. If someone needs to get in touch with you, just call the phone, and when you are on call everyone is on a WhatsApp group.  

PP: Right. Right. Yes. 

AM: You know what needs to be done when. 

PP: Yes. I mean, it’s fantastic what technology does now to make our lives easier. Those were the old days. 

AM: Now coming onto the Rhodes, what motivated you to apply for the Rhodes Scholarship, to come to Oxford? What was that decision like for you? 

PP: This is going to sound very ignorant to you, because at the time when I was at medical school, I had not heard of the Rhodes Scholarship, I was literally unaware of the existence of it. And that’s partly to do with my background: you know, Afrikaans people from small towns, it’s not something that features in our consciousness at all.  

But at university, towards the end of my time in Bloemfontein, one of the professors that I really admired – a young man called Bruce Middlecote, who was the professor of pathology, he was very involved with the students. He knew who was attending class, who was doing well, who was working hard – he had lot of empathy with the students. And I think he, sort of, identified in me someone who worked really hard and had some ability and wanted to do as well as I could. And he mentioned to me that the Rhodes Scholarship existed. And I think he had a friend who was part of the Rhodes Scholarship administrative team in South Africa, and he mentioned to me that that’s something that I might want to consider applying for if I kept working hard and doing well. And I think he gave me a brochure that he must have got from this woman who worked for the Rhodes Trust in South Africa that explained a bit of what it was about. And, as I said, it was completely new to me. I had no idea that it existed. And I’m pretty sure at the time I thought Oxford University was in London. I mean, I wouldn’t have known that it was a separate city. It was that degree of ignorance which sounds odd now, but of course, that was before the internet. I couldn’t go and Google ‘Rhodes Scholarship,’ ‘Oxford University,’ and things like that.  

AM: Yes. 

PP: So, I knew really almost nothing about it, but I kept the brochure and then, at the time I could apply, after medical school, I must have phoned and asked for the application forms – I imagine it was all on paper – and during my internship, I applied. 

The interview process was a, sort of, a multi-step process. Depending on the constituency that you applied for – and I applied for, as I said, the South Africa-at-Large – we had some preliminary interviews, and I remember it being in Grahamstown, which is a place I had never been to. So, I flew to Port Elizabeth, now called Gqeberha. 

AM: Really? Since when? 

PP: About two years.  

AM: Oh. Interesting.  

PP: Yes, the name has changed. And actually, the name of Grahamstown has also changed, and it’s been named after a Xhosa chief– I can’t remember the name now [Makhanda]. But anyway, you know what I am talking about when I say Grahamstown. It’s a small university town. Rhodes University is in Grahamstown. So, I went there for the interviews, and it was a fascinating process. I met some interesting young people from all over South Africa. And, the interviews were quite intimidating. It was a long table, and I think the chair of that committee was Laurie Ackermann (Cape Province & Worcester 1954). [30:00] He was a judge, and I believe I saw an obituary for him in the latest Rhodes newsletter. I believe he died recently. He was very good at putting everybody at ease. You know, he made it clear that it didn’t matter if you come from a small place, and you don’t know, really, what the Rhodes Scholarships are. They were interested in the sort of people we were and how we saw the world, and what we thought we could get out of a Rhodes Scholarship. 

I was fortunate enough to be selected there to go to the final interviews which were a few months later in Cape Town. And again, I was fascinated by the selection of people there and the people interviewing us. One of the things that stuck in my mind-, there is a woman called Mamphela Ramphele. She is now a, sort of, elder stateswoman of South Africa. She was a politician and also, in the 1970s, she was the partner of Steve Biko, a famous anti-apartheid activist and medical student who was killed after being arrested by the police during an uprising in the 1970s.  

AM: Steve Biko as in Steve Biko Hospital in Pretoria? 

PP: Steve Biko as in Steve Biko Hospital. That’s right. Yes. And he died as a medical student, and she was his partner at the time and she was very impressive. I think her degree was in anthropology. She had a very distinguished academic career and in, sort of, mainstream politics, I think she was crowded out by the more raucous elements in the ANC, and so on,  and she was considered a much more thoughtful person who made, I think, great contributions, mostly behind the scenes. And she was the chair of the selection committee, and again, just a very impressive person to meet in person. I’d heard about her but seeing her in action in person was quite something.  

And I was fortunate enough again, obviously, to be selected there and it really changed my life. You know, suddenly, there was an opportunity that I couldn’t have dreamt of when I was younger: to go to a different country, to go to Oxford University and to experience things that I would never have experienced otherwise. So, it was truly life-changing.  

AM: Okay. So, did you have to write an essay, as we do now? 

PP: Yes. Yes. There was a statement – I guess it’s like a personal statement. I don’t remember much of it, I have to say. And also, we had to have, like, referees, I think five or so, who had to write supporting statements for us. Yes, I think that was how the process worked. But it’s a while ago now. I’m sure there are many details I’ve forgotten. 

AM: But you don’t remember broadly what you wrote about in your personal statement? 

PP: I really don’t remember. I must have it somewhere. I didn’t think to look at it. Yes, it would actually be interesting to go and look. I’m sure it would now strike me as quite naïve, my 20-whatever-year-old, 24-year-old, 23-year-old self. You’ve reminded me of something. I’ll go and see if I can find it because I think that would be interesting, to see what I was thinking at the time. 

AM: If you don’t mind, I would love to read it, because every time I read mine, I just cringe so hard. 

PP: I’m sure I will have the same experience. I don’t know if it exists still, but I will look. 

AM: Okay. What did I write about? I don’t even remember. I’m sure something quite pretentious. But anyway, I’m here, so clearly it impressed someone. 

PP: Yes. It may not impress you now, but it impressed someone. Before I forget, one of the things that I remember from the interview that Mamphela Ramphele-, we were talking about things and of course, at that stage, the political changes going on in South Africa were at the top of everyone’s mind. So, this was in 1994 when the interviews were. She must have asked about my background, knowing that I am an Afrikaner from a conservative place, and I think she could probably sense my excitement about the changes that were happening, and she said, ‘What have you done to make this happen?’ And I thought for a moment. I thought, ‘Nothing, literally nothing. You know, all of this is happening, I have done nothing.’ I thought, ‘What a terrible answer.’ You know, there were people who literally died for this, and someone here, the man she was in love with, died for this. Here is a white medical student: I have not contributed anything to it. So, I made her a promise. I said, ‘I will make a cross on a piece of paper soon, that’s what I will do to change it.’ And she was happy. 

AM: Like the vote? 

PP: Yes.  

AM: Okay. So, elections were 1994. 

PP: The elections were 1994. Yes, that’s right. 

AM: Okay. And the interview must have been 1994. 

PP: Yes. It was before that. So, it was, you know, ‘I’ll do something.’ That is the thing that everybody can do in a democracy, and suddenly we were a democracy. Actually, there was something in 1992, actually – I said I’d vote again. In 1992, we had a referendum in South Africa, and it was a referendum only for white people. And the question was whether you support the continued negotiations. Essentially it was phrased in such a way to make it clear that if you say ‘Yes’ to it, you support the government pursuing negotiations and a path towards a democratic dispensation. So, that was an important step in 1992, when only white people could vote, giving legitimacy to the process, because at that stage the national party government was under a lot of pressure from the right wing about the changes that were happening, and they needed a democratic – well ‘Democratic’ in inverted commas – mandate to keep walking that path towards democracy. And that was one of the things that gave hope in that late stage of apartheid, that the arrow of time was walking toward the direction of progress, that there was support from the white community to continue that. I’d almost forgotten about that. Yes, making a cross on paper started before. 

AM: In 1992. 

PP: Yes, because that was one of the first times I could vote. It felt like a very important moment, that referendum.  

AM: I didn’t know about the referendum. I only knew about the 1994 elections because when we learn history about sub-Saharan Africa that was one of the big moments in history that everyone always talks about. 

PP: Yes, and you can see photographs from that time now, the queues of people, of people queueing to vote. For many people who were 60 or 70 years old, then that’s the first time they could go and vote in a democratic election. Imagine that. Imagine, your whole life, being denied voting, and suddenly you get the chance. 

AM: We take that for granted. 

PP: We take it for granted, and we should, because it should be a basic human right to be able to vote. But many people don’t have it. 

AM: Yes. But the fact that people had to fight – some people had to die – for us to have that right to vote, I just think, ‘Oh, I don’t feel like going out today and standing in a queue to vote.’ 

PP: Yes. Yes. 

AM: The next election, I will think about what you just said. 

PP: Yes. Other people sacrificed for that. It matters. It matters to be informed. It matters to participate in the process. Yes. 

AM: Yes So, when you applied for the Rhodes, what was the applicant pool like? Because I imagine it was still predominantly white. 

PP: It was predominantly white. Now, of course, that’s an artefact of the apartheid system because Rhodes, in his will, he didn’t specify that at all. You know, what’s one of the amazing things about Rhodes’s will: race wasn’t specified. It was for men, but race wasn’t specified. So, his will isn’t racist. It was sexist. 

AM: But one could also argue that he didn’t specify because he had white as a default. 

PP: That may well be the case, of course, but it’s quite lucky that he didn’t, because it saved another change to the law. Because of course, his will had to be changed by an act of the British parliament, I think it was in the 1970s.  

AM: Okay. 

PP: I may be wrong about the date there, but the British parliament changed it to allow women to apply women to apply as well to the Rhodes Scholarships. [40:00] Of course, initially, at the time when he made his will, very few women went to Oxford University. There weren’t female colleges yet, so, you know, as a man of his time he may have thought, ‘University is a place where men go.’ Because at that stage, that was more or less the case.  

But the reason why, even in my time, there were still far fewer black applicants to the Rhodes Scholarship was, of course, the nature of education in South Africa. There were far fewer, percentagewise, black people making it to university, because schooling wasn’t so good and, you know, the education was geared at giving an advantage to white people. That was clearly the case. And that’s changed very rapidly since, of course, and now people can compete on an equal footing, and many more black people have been getting Rhodes Scholarships since then. But at that stage-, I can’t remember the percentage in my year, but it was definitely predominantly white. I don’t know what the percentages are like now, but it would have changed. 

AM: And gender distribution, what was that like? 

PP: That was – again, I should have looked up the numbers – I think it was more or less equal at that stage.  

AM: Okay. That’s good. 

PP: Yes. Certainly, if I try and picture our group, more of the people that I knew and became close to were the women in that year. So, yes, there wasn’t a big disparity if there was one. 

AM: And were you the only medic in the group? 

PP: No, there were two of us, at least two. So, the other one did psychiatry later on. It was a woman called Kezia Lange (South Africa-at-Large & Christ Church 1995) who actually lives in Oxford as well, by pure coincidence, and she’s a psychiatrist here. Yes. 

AM: Are you still in contact with her? 

PP: Yes. Yes, we see each other occasionally at the hospital. 

AM: The JR [John Radcliffe Hospital, Oxford]? I must get in touch with her. 

PP: Yes. It’s another one to interview! 

AM: Yes. Okay, so you get the Rhodes Scholarship. Next step, application to Oxford. Now, we do it online. How did you do it in your day? 

PP: It was a paper process. So, I think I must have asked for an application form. Maybe there was a phone number on the brochure that I had to get to do it. Or are you talking about the application to Oxford? 

AM: To Oxford, yes. 

PP: Sorry. Yes, again, through the Rhodes, we must have been given paper forms. I don’t remember a lot of it. 

AM: Was it all just letter communication? 

PP: It was all letter communication. You had to lick a stamp, lick an envelope, and stick it in the post box. 

AM: Wow. We take technology for granted. I remember when we had the Bon Voyage – because for our year, we had the Bon Voyage with the Southern African scholars – one Rhodes Scholar – he’s a judge. I think his name is David. I don’t remember his name, but he is a judge [possibly Edwin Cameron (South Africa-at-Large & Keble 1976?] – and he was talking about how when he was at Oxford, if you wanted to communicate with people back at home, it was all letters.  

PP: Yes. Yes. 

AM: And if you wanted to communicate with someone from another college here, all letters and stuff, but now it’s all just in our hands. 

PP: Yes. Phoning home was exceptionally expensive when I first came here. So, you phoned home very, very infrequently. Skype didn’t exist. Communication was very different. There was no instant way of contacting people from home unless you could save up the money for a phone call. It was literally many, many pounds for a minute. 

AM: Yes. And when you came here, did you have someone like Mary Eaton [the Registrar of the Rhodes Scholarship? Was Mary around then?  

PP: I don’t think she was. As I say, I wasn’t very involved with Rhodes House. I spent almost no time here. I just got on with things in the college and at work. And there wasn’t at that stage, as far as I can remember, much of a community centred around Rhodes House.  

AM: Oh. 

PP: There may have been, and I wasn’t a part of it, of course. There may be people who made better use of what was here, but I don’t recall coming here very often at all. 

AM: Did you have a welcome day? 

PP: Yes. We had that and we had a photograph taken in the garden. We had a ball once. And as I say, maybe there were events. Of course, it would have been more difficult to organise because there would have had to be letters sent out to everybody. You couldn’t just do it electronically. Email had just come in then, but I can’t remember whether we had emails from Rhodes House very often. Email was brand new and very clunky at the time. And many people arriving here at that time, that was the first time they had an email address, which was their university one. 

AM: What did you apply to when you came to Oxford? 

PP: I applied to do a research degree in pathology. So, I was quite interested in pathology, and it was a project on breast cancer research – so, the genetic aspects of breast cancer, so, a molecular biology project. But when I arrived and, sort of, got into the lab, and so on, I very quickly realised I didn’t like it. The lab was a little bit dysfunctional. The professor clealy had a lot of conflict with other parts of pathology. The department had split and the actual nature of the work was less interesting than reading papers about it: you know, standing in the lab and mixing colourless solutions, putting it in a machine, and then waiting for gels to come out, with stripes on it. It’s very time-consuming. Molecular biology at that stage was more like, you know, alchemy than science, and slow, and the answers were interesting, but getting to the answers was more like cooking or baking. It was a recipe to follow, and I didn’t find that process particularly interesting and it felt a little bit divorced from the clinic for me. And, of course, by then I had practiced in a fast-paced clinical setting, and I felt that I probably needed to move to something a little bit closer to clinical work. 

So, I quickly, within a month or two, looked around for another project, and there was something in radiology which by chance happened to be in breast cancer research, again, but MRI scanning, and I switched to that project which-, again, it wasn’t part of a big group, or big lab. It was essentially a very busy clinician who decided to start supervising research students. But the whole set-up of it wasn’t ideal. It’s not like, maybe, the situation where you have, where there are frequent meetings with PhD supervisors who are actually very familiar with the process, who are true academics themselves. This was different: a busy clinician who occasionally found time to answer an email, but we almost never had face-to-face meetings. So, I felt very out on a limb and didn’t particularly enjoy it very much, but managed to write up an MSc and complete it. But the process, really, I didn’t enjoy it all that much and it wasn’t the way that I think a research project should be structured now with, you know, a student who is, sort of, investing their time in it. But it gave me an opportunity to learn MRI, so I made the most of it. I got the clinical aspects out of it, and it gave me an opportunity, then, to realise that I like that specialty, and of course, having the degree is just a stepping stone towards applying then for a training post in radiology, which I did as soon as I could.  

So, I had an opportunity to either convert to a DPhil, which would have taken an extra year, or to just write up an MSc, and I decided what I would do is apply for registrar jobs and see if I got it. If I got it, I’d write up the MSc quickly and finish. If I didn’t, I’d spend another year, do a DPhil and then apply again. So, it gave me two opportunities to apply for a registrar job, and that’s what I really wanted. What I wanted to get out of it was a registrar job and I was lucky enough to get a job in Oxford. I also applied in South Africa because the plan wasn’t initially to stay in Oxford, but I applied in South Africa as well. And as a, sort of, just, Hail Mary, I applied in Oxford as well, thinking I probably wouldn’t get it, but if I did, then I could stay longer and train here in a department that I knew to be very good. And I was bit surprised, and very happy, when I got it and then I told my supervisor, ‘I’m going to write it up as an MSc, step away from it and start learning the real job I want to do.’ So, that’s what I did. 

AM: So, you applied for registrarship in radiology? Was it directly in neuroradiology? 

PP: No, radiology.  

AM: Okay. 

PP: You have to train in radiology first. [50:00] 

AM: And transition from your South African degree to the UK, for you to practise in the UK, what was that like? 

PP: It was fairly straightforward at that stage. I had to get GMC registration. Again, I can’t remember the exact process, but it wasn’t very hard, and I got GMC registration while I was still a research student, because I did some locums. I needed a bit of extra money, so I started doing locums on weekends just to earn a bit of extra money. Now again, I would suggest you don’t do that, because it’s time-consuming.  

AM: Okay. Did you have to write PLAB? 

PP: No. At that stage I didn’t and there was a weird anomaly where South Africans didn’t have to do the English test even, whereas Australians did. So, people who were native English speakers from another ex-colony had to do an English exam. Whereas someone who wasn’t a native English-speaking person from a different ex-colony didn’t have to.  

AM: Oh, my God. 

PP: It was very strange. And I didn’t have to do any exams. I could just get GMC registration and work, surprisingly. 

AM: Wow. Life was relatively easy for you back then. 

PP: Yes, it was. Yes. Some things were much simpler, despite the lack of internet.  

AM: Yes. I mean, the bureaucratic processes in your case, they seemed to be quite straightforward, and I just wish it were like that now. 

PP: By comparison I think they probably were. 

AM: So, your radiology registrarship, how long was that? 

PP: That was-, And I am trying to just remember now because it’s changed a little bit. I believe it was four years at the time. And then neuroradiology was an additional two years. I really should remember that, but yes, I think that’s the way it worked. 

AM: Is it still the case now? 

PP: It’s changed a little bit now. If you want to do neuroradiology, it’s now three years plus two. Yes, it’s three years plus two. 

AM: So, less time. 

PP: Yes. Unless you want to do interventional neuroradiology, then it’s three plus three.  

AM: Okay.  

PP: But for neuroradiology it is three plus two now. Yes, it’s three plus two for neuroradiology. For interventional neuroradiology, it is three plus three. 

AM: Okay. So, if you just want to be a generic radiologist, it’s three years, you are done? 

PP: No, then it’s four, because it’s three years general and then an extra year. So, everybody does at least four years, and in some subspecialties, there’s an extra year, and in some, an extra two years. So, all the interventional specialties have an extra two years on top of the minimum of four. 

AM: Were there any issues that you faced in your training programme here in the UK that you don’t think you would have faced in South Africa? 

PP: It’s hard to know, because I never trained beyond medical school in South Africa, so I don’t really have something to compare with. The process was well structured. The college exams, I thought, were a good way of making you study in addition to learning on the job. They were challenging but not particularly hard. If you’re used to passing exams, they’re very doable and the process of preparing for them is, you know, the process of acquiring knowledge that you would want to acquire anyway. So, no, I didn’t find it particularly challenging. One thing that I was a little bit worried about is that most people who do radiology in the UK would do either physicians’ exams or the surgical exams first – so MRCP [Membership of the Royal Colleges of Physicians] or FRCR [Fellowship of the Royal College of Radiologists]   – and that was, sort of, an additional thing that most people have to be able to get approved for a training programme, which again-, for a competitive place to be able to get it. And I didn’t have that, which is why I thought I wouldn’t be appointed. But I was hoping, you know, the fact that I would soon have an MSc would make up for that, and it maybe it did. 

AM: And you were a Rhodes Scholar. 

PP: And that, of course. Of course, that opens doors as well. But I was surprised that it didn’t seem to put me at much of a disadvantage, the knowledge that people had from doing MRCP or FRCR, and I think that’s a reflection of South African medical training: that it’s really quite good and quite broad. So, I never felt at a disadvantage that I didn’t have that additional, sort of, post-medical school medical qualification. I don’t know what the situation is now for radiology trainees – how many of them would have done those exams – but I think still a sizeable percentage would do MRCP or FRCR in advance of training in radiology. 

AM: Yes. I’ve heard that specialist training is now very, very competitive: you have to do a DPhil to give yourself a competitive chance for becoming a consultant. 

PP: I think that’s true in some specialties. Radiology, I don’t believe that’s true. In some surgical specialties, where there are bits of training bottlenecks, I think that is true. But in radiology, that’s not the case. I think you can certainly train in radiology without a higher degree.

AM: Good to know. 

PP: Yes, and it’s an expanding specialty. But of course, you are going to have a DPhil in a few years’ time, so it’s an irrelevant point to make to you. 

AM: That’s true. I just have to stick it through. Stay strong. 

PP: You have to stick it through, and, you know, the rewards will come. 

AM: Did you discover any extra-academic parts of yourself when you were in Oxford? Like college, what was that for you? 

PP: I was at Green College – it’s now Green Templeton College – which is a postgraduate college. I picked it not on the basis of knowing very much at all. I mean, I must have just read tiny little bits in a brochure about the different colleges, and I picked it when I hadn’t been to Oxford before. It worked out fine. It was a nice little college. I wasn’t very involved in college life. Maybe going to a college that also has undergraduates would have been quite a different experience, or one of the more traditional colleges, but I don’t know, because I didn’t do that. I’m quite an introvert anyway and I like to work hard, so I spent my time mostly in the Radcliffe Science Library, which is what the building behind us used to be. 

AM: Radcliffe Science Library? Which one is that? 

PP: It’s that building right there. It’s now a new college. I forget what it’s called now. 

AM: Reuben? 

PP: Reuben College: that’s right. Yes. But that used to be the science library, and it used to have all the medical textbooks, and of course, that was, as I said, before the internet really took off, so, if you wanted to read something, you had to go and find the books in there, and I quite enjoyed that. So, yes, again, like in medical school, I worked very hard and I read quite widely. I spent most of my time reading about things that weren’t part of my research, to be honest.  

AM: Like rabbit-holes, or just general interest? 

PP: Exactly. Exactly. This, sort of, rabbit-hole, medical interest, and discovery of the unexpected – you open a textbook and you open it in the wrong place and your eye falls on something and you can’t get up for the next day because it’s fascinating. Yes, so, I spent a lot of time in the library reading. The research was quite clinical: so, it involved scanning patients at the John Radcliffe and analysing, together with people in the engineering department who wrote the software, and so on. But I did the analysis of the breast cancer scans, or scans in patients with breast cancer. And as I say, the important thing about that was not that I got an MSc out of it but that I learnt quite a bit of useful facts about MRI. You know, MRI physics and how things work, how radiologists structure their report and things like that. So, those were things that, sort of, made me realise that radiology is a career that I could go into. As I said before, I was interested in pathology first, and I think part of my personality-, I like diagnostic specialties. I like solving mysteries. I like thinking about probabilities and I like working out what’s going on. You know, take a mystery and try and unravel it, and diagnostic thinking is like that. Radiology and pathology have that in common. 

AM: And internal med. 

PP: And internal medicine, of course, but internal medicine has the therapeutic component to it as well. Whereas I like the diagnostic thinking, and I like to do lots of that every day. So, I deal with a scan, work out what’s going on with this patient, then move to the next scan, whereas my report goes to the clinician, and they then have to figure out what to do about it. And of course, it takes different people to practise medicine and some people are good at that part of it. But I fortunately realised that diagnostic thinking is the thing that excites me, the thing that stimulates me, and that if I worked hard at it, I could become good at it and that’s why I picked radiology. 

AM: Have you watched a YouTube comedian called Dr. Glaucomflecken? Have you seen him? 

PP: No. 

AM: I will show you a video of him afterwards, because he makes fun of specialties and his whole thing with radiologists is that indoors they wear shades.  

PP: Right. 

AM: And they never see the sun for days at a time. And if you want to hide a 100-dollar bill from a radiologist, you put it in a patient. Is that true for your case? 

PP: In my case yes, I have very little personal contact with patients because I essentially [1:00:00] deal with digital images. Well, occasionally I have to talk to patients and so on and, of course, because it’s so infrequent, it’s quite nice for me to do that, and it is nice to be reminded that there is a person at the end of the scans. But most of the time, I spend my time looking at digital images on a set of computer screens. And, you know, medicine has evolved to the point where we need people who look at computer screens all day to help the people who actually are in contact with the patient, and it’s important to figure out which person you are, where on the team your particular talents, your particular personality traits, are best suited. And I was lucky I found, really, the specialty that does suit me. 

AM: Okay. So, what are you working on now, and what’s next for you: clinical-wise, research-wise, career-wise in general, life-wise? 

PP: Right. So, my career as a consultant neuroradiologist, I’m very clinical. I do some research, but my focus is on the clinical work. And within neuroradiology, there is subspecialisation as well. My particular interests are neuro-oncology, so, imaging patients with brain tumours in particular. So, that’s a big part of my work, is looking at scans of patients with brain tumours, making the diagnosis, trying to discern what sort of brain tumour it is, because that informs the surgeons about the type of surgery that needs to be done. And then also, post-surgery, and post-radiotherapy, post-chemotherapy, analysing the scans again, looking at what the response was, trying to work out what complications have occurred, and things like that.  

So, it’s a challenging specialty. Some of the work is complicated and difficult. The judgements are difficult, and that’s what makes it satisfying. It is a hard skill to acquire, a big body of knowledge to acquire, and you work in a big team of very talented people. And there is pressure on everybody in the team not to be the weak link, because you ruin the whole team. If you are not good at the bit of job that you do, other people can’t use their talents properly. You know, the surgeon can’t do the right thing if he’s told the wrong thing by the radiologist, or the pathologist, or if his anaesthetist isn’t up to it. So, the whole team need to function well and that creates a degree of pressure, but healthy pressure. Because the project is about getting the best outcomes for patients, and there is a large team of motivated, talented, skilled, highly educated people, and we all work on this project. And, you know, it feels nice to be a part of something like that. 

AM: And research-wise – okay, we have our project upcoming. 

PP: Yes. So, the research: I am, sort of, a facilitator of other people. There are people who do research as proper academics – that is the focus of their work – people like Natalie, and so on, and I can offer aspects of my neuroradiology skills that help them in their research. And again, that’s mainly neuro-oncology, a bit of neurofibromatosis type 2, again, which is to do with brain tumours. I also work with people in the psychiatry department that work on imaging in psychosis, but also imaging in cognitive impairment. So, there is a number of research projects where I act as the radiology contact and do some analysis of the scans, advise on scanning protocols, advise on the direction that research needs to take to be clinically relevant. So, I enjoy that part of it, but it’s a relatively small part of my job. It’s a small part of my time commitments, but again, it gives me a slightly different focus to the medical work. I learn things that are relevant to the clinical work and, of course, I pick up things from the research that help me in the other parts of my job as well. 

AM: Right. I’m hoping when I finish my DPhil to do more 50/50 if that’s plausible. 

PP: That’s entirely possible. Yes, that’s entirely possible. So, if you find that the research is really something that grips you and that you want to continue with, it’s very possible in medicine to have a career that’s part clinical, part research. And people like you who are going to finish a good PhD should be encouraged to do that. 

AM: Yes. And one last question before we wrap up the interview: how do you think your life would be different if you weren’t a Rhodes Scholar? 

PP: Oh, it’s hard to know the path not taken, isn’t it? Because getting a Rhodes Scholarship is a sliding doors moment and your life changes. I suspect I’d be in South Africa.  

AM: Yes. 

PP: I suspect I’d be, probably a radiologist, or a pathologist. And one of the things that make me glad that I came here is that I think I would probably have had to end up in private practice rather than in the state sector, because the funding in the state sector has become quite problematic. You know, the resources and funding, and so on, is not great and the state sector is really struggling there. And the way that I want to practise medicine, the level that I want to practice at, I suspect I would have become very frustrated and would have had to go into private practice, and I’m not sure I would have enjoyed it that much. I do a bit of private practice here, but my main focus is in the NHS, and, you know, we live in a country here in the UK where there is a health service where any sick person can walk through the doors of a hospital and avail themselves for free, at the point of care anyway. Of course, we pay taxes, but whether you pay taxes or not, you walk through a door and suddenly you have access to one of the best health systems in the world with, you know, thousands of motivated people to take care of you. 

AM: Free of charge. ‘Free of charge’ in quotes. 

PP: Well, free of charge at the time. And if you are not in a position to pay taxes, it literally is free of charge. And to be part of that overall project, where we provide that to a society, it’s an incredible thing to be a part of. You know, we are not blind to the problems, are not blind to the frustrations of working, but as a, sort of, social invention in the country, it’s one of the things that makes Britain the country that it is, to have that free-at-the-point-of-delivery-of-healthcare system, and something that every generation needs to fight for to keep it going and the people working in it, that’s a big part of our lives, is keeping that project on the rails. 

AM: Okay. Thank you so much for your insights and taking the time for me to interview you today. I had so much fun learning about your stories and hearing your answers. I will stop the recording now. 

PP: Thank you. It was great to talk to you. 

[file ends 1:07:48]