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I will remember you: Malcolm Needs 

Pat Letendre interviews our TM colleagues - past & present:

It's my pleasure, indeed an honour, to write a series of blogs for CSTM to celebrate the careers of transfusion professionals who came before and made a difference. Some names you may recognize, some you may not. But rest assured they all made a difference and we are the better for it. 

Each blog begins with a brief background on the person's career, followed by musings on their career and my comments throughout. Although all participants enjoyed their careers and love the transfusion profession, they speak honestly about both the ups and downs. Perhaps their reflections will resonate with your experiences.

I will remember you: Malcolm Needs 

This blog features Malcolm Needs, a UK biomedical scientist. Yes, the CSTM 'I will remember you' series has branched out to include a transfusion professional from across the pond. I'm delighted that Malcolm has generously provided his reminiscences of a long career. As you know, we need to create a record of transfusion medicine life and realities, the kind not found in published research and textbooks.  

I first 'met' Malcolm about 2009, in a manner of speaking, on an American blood bank forum, BloodBankTalk, which has undergone name changes over the years and is now part of PathLabTalk. Today there's even both a UK and USA blood bank section (Further Reading).

The word generous is one of the key words that defines Malcolm Needs. That stood out right away on 'BloodBankTalk'. Who was this guy, I wondered, who would help U.S. blood bank technologists with so many issues and who now has more than 6000 entries on the forum? And it wasn't just that he replied, it was the quality: concise, clear, sound explanations and commentary. Clearly, this British bloke was an expert, one with extensive experience and a great educator too.

Since then I've had the pleasure to get to know Malcolm better, albeit still at a distance. When asked, he once shared with me an excellent Powerpoint presentation he'd created on a topic of interest. Upon joining TraQ, of course, he sent positive feedback. Same on Twitter. 

BACKGROUND 

Before you can appreciate how Malcolm  made a difference and understand his musings, you should know a few of his experiences. I encourage you to consider your career compared to his in the UK and how you may muse on transfusion medicine. 

In brief, Malcolm began his career at the Blood Group Reference Laboratory, London and later began working in hospital transfusion services where he gained incredible experience, being involved in providing blood for transfusion after several tragedies: three IRA bombings and two train crashes, in total involving dozens dead and hundreds injured. 

He then worked briefly at the International Blood Group Reference Laboratory in Bristol before joining the Red Cell Immunohaematology (RCI) Department of the UK's national blood supplier, the National Health Service Blood and Transplant (NHSBT), Tooting Centre, soon becoming the Reference Service Manager, a position he held until July 31, 2014.

His career was capped with a newly created post within the Red Cell Immunohaematology Dept. at NHSBT: Reference Service Manager – Training, a national post he held until retirement 31 Oct.  2016.
For a few of Malcolm's many contributions to the UK transfusion community and beyond, see what I have struggled to make a short resume

In his musings below, included are [photos] Malcolm supplied featuring some of the transfusion pioneers he's met.

MALCOLM'S MUSINGS

How did you make a difference?
One of the great loves of my professional life is having had the opportunity to GIVE BACK just some of the enormous help that I have received by way of training and education.

I fondly remember that, when I started  as a callow youth of some 18 years at the Blood Group Reference Laboratory (BGRL) back in the early 1970s when it was in London, and when I knew nothing about blood groups, blood group serology or blood transfusion, I was taken under the wings of a number of simply fantastic people who would spend hours trying to get facts through my fairly solid cranium. 

To name a few, they included  To give an example of the help I was given, I used to have a cup of coffee at the end of the day (for no reason other than I wanted to miss the worst of the rush-hour), and Ken Goldsmith used to also come into the coffee room at about the same time. There was I, just out of school, sitting in the same room as a world-famous physician and scientist, and he would spend a minimum of an hour explaining something like the structure of the ABO antigens, by using the analogy of a British Rail shunting yard.

Across the car park was the MRC Blood Group Unit, run by Drs. Rob Race and Ruth Sanger. Included in their staff, amongst others, were In short, what I am saying is that I could not have been luckier, and all of these people, every single one of them, spent time with me, teaching me the basics and, eventually, the more complex aspects of blood group serology.

I have also been incredibly lucky in that I was able to meet many of the world’s “greats” in terms of blood transfusion, as they visited either one or both of these establishments, and, to name just a few, these luminaries included  Some start to a professional life for a lad just out of school!

BOTTOM LINE
Unless I had no morals and no conscience, I had no alternative than to pass on to others what I had been taught myself. Initially, this was not easy, as I had lost my father to cancer when I was about 14, had been to a single sex school (the only contact I had with these strange things called “females” were my relatives), was achingly shy and suffered from a form of agoraphobia, which meant that simply talking to a stranger, let alone lecturing to a room full of strangers, was agony. 

Very early on, however, I was given a good piece of advice. This was that, as I was talking to students of my own age, few of whom were working in my particular branch of pathology, none of them would know whether or not I was talking sense! This took a huge amount of pressure off my shoulders and, as the old saying goes, I never looked back.

From these humble beginnings, I have since regularly lectured on many university courses, on courses for people undertaking the examination for Membership of the Royal College of Pathology, at symposia/congresses/courses, both within the UK and abroad in the Peoples’ Republic of China, Switzerland, Providence and Las Vegas.

What was the most fun?
As a blood group serology “nerd”, I am particularly pleased (and proud) of being either the primary author or a co-author of several abstracts and posters describing
  • Novel D variants;
  • Novel RHCE allele leading to a D - - phenotype;
  • DOLG, a novel high prevalence antigen within the Dombrock Blood Group System.
I was also a co-author of a paper published in Nature Genetics in 2013 entitled, “SMIM1 underlies the Vel blood group and influences red blood cell traits.”, which was one of the three papers published simultaneously and led to Vel being elevated to a full Blood Group System.

 Also equally pleased of having served twice as a member of the National Council of the British Blood Transfusion Society, being sometime Editor of their Newsletter, and Chairing several of their sub-committees.

For the Institute of Biomedical Science, I have served on their Special Advisory Panel for Transfusion Science, and have served as their Chief Examiner in Transfusion Science between 2012 to 2017, their representative on the Medicines and Healthcare Products Regulatory Authority (MHRA) Haemovigilance Expert Panel, their representative on the British Standards in Haematology Transfusion Task Force and their representative on the UK Transfusion Laboratory Collaborative.

I've contributed a chapter entitled, “Human erythrocyte antigens or blood groups.” in the book Fundamentals of Biomedical Sciences, Transfusion and Transplantation Science, edited by Robin Knight, 1st edition, Oxford University Press 2013. It is hoped that the 2nd edition will be published in late 2017, this time edited by Professor Neil Avent, to which I am contributing two chapters, entitled, “Compatibility testing and adverse effects.” and, “Immune-mediated red cell destruction.”Going back to being a blood group serology nerd, I would be remiss if I didn't mention a very special moment in my career (see below in Pat's Musings). 

BOTTOM LINE
The thing that I am most proud and pleased to have done in my career, however, is to have made friends with so many people who have a real love and respect for the work we do, some of whom I have never actually met, and only know from such sites as PathLabTalk (but I still feel like I really know them, as they are so generous with their knowledge and time).
 

Malcolm throughout the years

        

PAT'S MUSINGS

As you can see, Malcolm was one lucky bloke  to have worked among many of transfusion medicine's greats. Let's face it, the 1970s were probably the Golden Age of blood group serology and in many ways UK's scientists ruled. Some came to the USA (Garattty, Issitt, Judd - all with the qualification FIBMS) to be known informally as the 'UK mafia'. 

Malcolm  also had the invaluable experience of working in UK hospital transfusion services when mass casualties occurred. Not events you want but, when they happen, they provide a test of fire.
Malcolm also related a very special moment in his career, one to which anyone who loves immunohematology can relate. It's been given a page of its own as I suspect blood group serologists will love it but other readers' eyes may glaze over. I can relate because twice in my career working as a medical laboratory technologist on the bench I found what we thought was the first ever example of...only to find others had made the discovery just before us. Still, they were special moments, indeed. 

I smiled at Malcolm noting that he was 'achingly shy' and talking to a stranger, let alone lecturing to a room full of strangers, was agony. Being shy and introverted myself that resonated. I recall in high school hating it when the teacher would go down a row asking questions of each student in turn. As my time came, all I could hear was my wildly beating heart and I knew my face was flushed. Today I recognize that as a panic attack associated with glossophobia. Yes, there's even a name for it and it's apparently one of the most common phobias. 

The panic attacks were one reason I initially became a high school teacher, because I knew that degree of fear had to be overcome. Malcolm made good use of advice that, when talking to non-specialists his own age, none would know whether or not he was talking sense. For me, one word did the trick. In my third career as a medical laboratory science educator (after teacher and med lab tech), whenever I went into a classroom or spoke at conferences, I would take a deep breath, let it out slowly, and say, 'Showtime!' (sometimes even aloud).

TM professional, consider this. In January 2015 I got an e-mail request from Dr. Eric Hoy, a fellow I know who taught at the University of Texas Southwestern Medical Center in Dallas. He wrote in part: 
'While I was at UT, I stumbled upon an online group of blood bankers from the UK.  As I recall, one of the frequent posters was a chap named Malcolm Needs, and I learned a great deal from him. Unfortunately, when I retired from UT, my email connection was cut off about 30 milliseconds after my retirement took effect, and I lost all of my contacts. Are you aware of this list, and can you provide a link so that I can re-subscribe?  I may be retired from UT, but I still direct my laboratory, and I still love Immunology and Immunohematology.'
Seems that quality and generosity are recognized worldwide and Malcolm exemplifies both.

Stay tuned for a second blog in which Malcolm muses on the transfusion 'notables' he has known over the years. In yet a third blog, he will discuss regrets and concerns.

Comments are most welcome. Please add to the record of what it was (or is) like to work as a transfusion professional in the UK. Or maybe you'd care to comment on the joy of blood group serology? Or the joy of public speaking? 

Further Reading

Comments

Comments
Pat Letendre
So good to see Imelda Bromilow comment on Malcolm's blog. I contacted Imelda (who I've never met) a few years ago about a Canadian mentoring project that never got off the ground and she graciously consented.

For those who may not know, a brief bio:
-----------------------------
Prior to becoming the Scientific Support Manager at DiaMed GmbH in Switzerland in 1995, Imelda was employed as Clinical Scientist at the Mersey and North Wales Blood Transfusion Centre. She was responsible for all aspects of immunohaematology and related services to regional hospitals.

Imelda gained teaching experience at 3 universities for students undertaking professional Biomedical Science examinations and/or BSc and MSc courses in Biomedical Sciences. She was also involved in teaching medical students at Liverpool University and Senior Registrar grade medics undertaking the Royal College of Pathology examinations.

Imelda then worked for DiaMed for 15 years, during which time she was responsible for managing the Customer Service Laboratory. She organised and lectured on International Transfusion Science Courses in Switzerland and was a guest speaker at conferences and User Group Meetings throughout the world as well as organising training at different levels as requested.

She was recognized by the ISBT and received an award for outstanding contribution to education in Transfusion Science and Medicine
http://www.isbtweb.org/fileadmin/user_upload/Awards_and_fellowships/2016/ISBT_Award_winners_2016.pdf

Imelda is a founding member of the BBTS. She has many publications
https://www.ncbi.nlm.nih.gov/pubmed/?term=bromilow+I%5Bau%5D
and is the co-author with Geoff Daniels of 'Essential Guide to Blood Groups'.
http://ca.wiley.com/WileyCDA/WileyTitle/productCd-0470750324.html
--------------------
Imelda, We are so glad you survived Legionnaires disease and I would like to invite you to share your experiences over a long career in both the public and private sectors. If you would consider it, please contact webmaster@transfusion.ca who will let me know. You have unique experiences that deserve recording to document our transfusion medicine history. But if it's too much right now, no problem. Many thanks for considering it.

Cheers, Pat
2/1/2017 8:19:16 PM

Imelda Bromilow
Yes, I too have never known a 'shy or retiring' Malcolm!! I was however, happy to see that you have instigated this to recognise colleagues who have made valuable contributions to our blood group passions!
I,too was extremely lucky to have some of the 'greats' who unstingingly helped me, many of those mentioned by Malcolm but also people such as George Garratty and George Bird, who are sadly no longer with us, plus others who I am blessed to count as friends such as Martin Olsson and Jill Storry to mention but a couple. Like Malcolm, my passion has included education and I held many courses in Switzerland and throughout the world. I was honoured to receive an award from the ISBT for my work in education, which was a real thrill.Professor John Barbara picked it up on my behalf as I was busy teaching in Costa Rica at the time.
I am no longer active in our profession because I contracted Legionnaires disease in 2015, spent almost 3 months in a medically induced coma, but can reiterate here how important transfusion is....I was given many blood and platelet transfusion whilst comatose but have no doubt that they helped to save my life! I have looked at transfusion from both sides now, to coin a phrase from a song, as you often do!
2/1/2017 4:06:31 AM

Pat Letendre
About Malcolm's comments on public speaking & the joy of "spreading the word", this truly resonates. Letting others know about TM 'goodies' is a passion since I left Canada's blood supplier & was hired by Med Lab Sci, University of Alberta in Edmonton ~39 yrs ago. It's why I love Twitter as a medium that can spread the news, whether the good, bad, or ugly.
1/19/2017 6:55:33 PM

Pat Letendre
About Malcolm/s comment on the 'joy of blood group serology', I think the key factor is more experience with working on difficult serological problems.

And in Canada folks in transfusion services labs may be generalists who rotate through transfusion service, hematology, and chemisty labs, perhaps even micro labs. Specialist transfusion lab workers are increasingly rare.
1/19/2017 6:46:54 PM

Malcolm Needs
As for public speaking, the joy there is "spreading the word" (for want of a better way of putting it) to delegates or those attending degree courses, who may not be "up-to-date" with the latest discoveries or whatever. Again, this would not necessarily be the fault of those listening to the lecture.

I was in the privileged position of
a) Having access to most Journals as a matter of course (a perk of working in Reference);
b) Being expected to read appropriate papers and text books;
c) To have met an awful lot of the "transfusion greats", and so being able to chat to them on a friendly basis.

The people "forced" to listen to me lecturing may not have had these privileges, and may certainly not have had the time at work (or at home) to catch up on such reading. And here, I must offer thanks to my wife Dee and son Harry, who have both put up with me being almost "out of the loop" at home on occasions, when I am concentrating on boning up on a particular subject prior to delivering a lecture.
1/19/2017 5:12:11 PM

Malcolm Needs
Pat asked for comments on the joy of blood group serology.
I think that, to me, the joy of blood group serology is (in most cases) being able to sort out a problem for my fellow blood transfusion workers in the hospital laboratory in a timely fashion for them and their patient (hopefully in such a fashion that the patient never actually knows that there has been a problem in the first place).

This is not to say, "Hey, aren't I great? I sorted out a problem you couldn't!" It has to be stressed that those Biomedical Scientists working in the hospital laboratories go through exactly the same examination process as do we, and so have exactly the same qualifications as do we. The only differences are that we have access to far more in terms of antisera (particularly very rare antisera) and red cells (particularly very rare red cells) and, possibly other reagents (such as dithiothreitol and such things as recombinant red cell proteins) and more experience working with rare antigens/antibodies.
1/19/2017 5:07:13 PM

Malcolm Robinson
Fascinating tale: imagining Our Lord Malcolm as shy and retiring does take a great amount of effort. His presentations are epic; Look forward to reading more about our shy and retired Oracle, that is Malcolm Needs.
1/16/2017 1:04:22 PM

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