BJUI
BJU INTERNATIONAL
{Face to Face}
An interview with
Roger Kirby, MA, MD, FRCS
(Urol), FEBU
EDITOR’S NOTE
‘Face to Face’ is a monthly interview series with
personalities in the urology field. As a successor to BJUI’s
‘Conversations’ feature, ‘Face to Face’ is fashioned after
the highly acclaimed BBC television series of the same
name where former British politician John Freeman
interviewed famous men and women with an insightful
and probing style.
In this edition of ‘Face to Face’, I talk with Professor Roger
Kirby, who is a Consultant Urologist and Director of The
Prostate Centre in London. Open since March 2006, the
Centre is a state-of-the art facility and the only private
centre in the UK devoted exclusively to prostate problems
and the entire spectrum of men’s health. He did his
undergraduate training in Medical Sciences at the
University of Cambridge’s St. John’s College and his
medical degree at the University of London and the
Middlesex Hospital. Later, he returned to the University of
Cambridge to obtain his MD. For 9 years, he served as
Consultant Urologist, Department Head, and Director of
Postgraduate Medical Education at St. George’s Hospital
where he became Professor of Urology in 2001. Professor
Kirby is a prolific author and fundraiser, working tirelessly
for several charities devoted to prostate cancer and other
urological conditions. I recently spoke with him in his
London offices. To listen to the complete interview, please
visit www.bjui.org/.
INTERVIEW
John Fitzpatrick (JF): Well, it is a great pleasure to be
talking today to Professor Roger Kirby. We have known
each other for a very, very long time. Roger, tell us where
you were born and where you went to school.
Roger Kirby: I was born in Buckinghamshire, and went
to school in Berkhamsted, which is a kind of minor public
school, where my elder brother and younger brother
were also at. So, we were the three Kirby bothers
together. All of us played on the school’s rugby team.
Berkhamsted was quite well known for its rugby prowess,
but perhaps not the academically excellent school. But
actually, we had a fantastic time there.
JF: Your elder brother is a doctor. What was it that
motivated you to do medicine?
Kirby: You are right. My elder brother was a doctor, Mike
Kirby, now Professor of General Practice. My father also
was a Professor of Biochemistry. He used to work at the
Chester Beatty on cancer research. In fact, he became a
Fellow of the Royal Society (FRS) on the basis of his work
on the extraction of DNA from mammalian tissues.
Unfortunately, he died rather prematurely from heart
disease at the age of 49 years, when I was aged 16 years
and still at school. So that was a bit of a tragic event for
our family.
But we did not let that get us down. In fact, it only made
me work a bit harder, because before then I used to mess
about a bit in school. After my father died, I realised I
had better start doing some work, because I was going to
have to make some progress all by myself. And that is
pretty much what I did. I think it helped me get into
Cambridge University as a medical student.
JF: To become a FRS is a very rare event in somebody’s
career. Were you inspired by that?
Kirby: Yes, that was a major inspiration. He was a
fantastic, fun-loving guy, actually, a character. Everybody
loved him. He was a great father, researcher, and an
inspiration to us all. Although it was tragic that he died
so young, sometimes an event like that can have a
positive effect. It kind of galvanized us. We still think
about him in the most positive terms. They say that if
you die young, you die a hero. If you live too long, you
become a bit of a silly old fool! So, in some ways,
although he died much too young, he is still an
inspiration to me and Mike.
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JF: How did you enjoy Cambridge?
Kirby: I am not going to tell you exactly all the things I
got into at Cambridge. I was at St. John’s College, which
is famous for its rowing. It was founded by Lady
Margaret Beaufort, the mother of Henry VIII. So, it is a
very historic place and a fantastic place to be a medical
student. We just had so much fun. I went there in 1969
and stayed there until 1972. Those were really good days
at the end of the 60s.
JF: The hospital was in London though, wasn’t it?
Kirby: The clinical medical school in Addenbrooke’s
hospital did not open until the mid-70s. So, we all left
Cambridge, en masse, and came down to London as a big
group. When I went to the Middlesex Hospital, Richard
Turner-Warwick was the famous lead urologist there. He
inspired me to go into urology.
Again, we had a fantastic time because that part of
London on Charlotte Street was where all the advertising
agencies were. There were just non-stop parties, social
events, concerts. In between all those things, I actually
did a little bit of work too and managed to get through
my finals! Sounds a bit boastful but I got a distinction in
surgery at Cambridge in 1975. That is probably what
inspired me to do surgery. I am really pleased now that I
did. Before that, I was thinking about doing cardiology!
JF: When did urology come along?
Kirby: I did my first house job over in Cheltenham
working with a guy called Peter Boreham. He was a
slightly grumpy, but very inspirational guy. So, I just
really liked him and thought urology was kind of a
thinking-man’s surgery. It was more interesting than
general surgery, more of an intellectual challenge. I just
kind of took to it really. From that time on, I decided I
was going to do urology. I have no regrets about that
– some 30 years later!
JF: You then went to various hospitals around the
country, but ended up back in London.
Kirby: Yes, they were Brighton, Wolverhampton, and
Gloucester. Ken Shuttleworth from St. Thomas’ sent me
up to Wolverhampton. He said, ‘Kirby, you’d better get up
to the Midlands. There’s so much work up there. To be a
good technical surgeon, you just have to do lots of cases.
So, I want you to go there’. I was slightly horrified when I
arrived in Wolverhampton, sort of the ‘Black Country’,
thinking I was going to have to live there for a couple of
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FACE TO FACE
years. Actually I had a fantastic time and we did loads of
work.
JF: You became a consultant after you did your senior
registrar training. Then, you went to St. Bartholomew’s.
Kirby: That’s right, St. Bartholomew’s Hospital, the oldest
hospital in England at its original site, founded in 1123
with the famous Henry VIII gate that you go into in
Smithfield. It was a fantastic place. My two colleagues
there were Hugh Whitfield and Bill Hendry. I actually
took John Wickham’s job, so I felt quite proud to be a
replacement for him, although I never learned to be as
good of a surgeon as he was!
JF: Many people ask me where you and I first met. I was
having a conversation with Professor Geoffrey Chisholm,
and suddenly this individual came up and interrupted our
conversation!
Kirby: [Laughs] It was during one of the first meetings I
ever organised on prostate cancer. We invited some
well-known people down, including Chisholm and the
still young and vibrant Professor John Fitzpatrick! I
remember having a conversation with Chisholm, saying
that I never would ever be able to become a professor
because it would mean losing too much money! He
looked especially askance.
JF: Your memory is quite right. However, a few years
later, you moved to St. George’s Hospital.
Kirby: St. Bartholomew’s was under threat of closure.
They wanted to merge it with the London Hospital, which
had a different urology department and different ethos
to ours. St. George’s had a vacant job for Director of
Urology because Bob Shearer had gone to the Royal
Marsden. It was in the southwest of London, near where
I had bought a house in Wimbledon Village. They gave
me a research unit there, where we did some trials. It
was a good move.
JF: One of the things I remember about you in those
days was how you talked about people inspiring you.
However, you have also inspired a lot of young,
up-and-coming urologists to do research. Tell us about
that.
Kirby: It is one of the things I feel most proud about: the
people we have helped get into the specialty. In those
days, you could not really get to be a senior registrar in
urology unless you did some research first. It also helped
with a consultant application later on if you got a higher
degree, such as an MD or an MS. We found money for
17 people to do research; all of them but one ended up
with a higher degree. All of them, even the one who did
not get the higher surgical degree, have all gone on to
be flourishing, successful consultants in urology. In a
way, it is a kind of legacy I left behind for which I feel
quite proud.
JF: You moved into the private sector but not before you
become a professor.
Kirby: I was lucky to get that professorship. It was on
the basis of all the publications, something like 325
papers, I published and the more than 60 books.
Professor John Herman Taylor, quite the famous general
surgeon at St. George’s, was the one who put together
the proposal for a chair in urology. I thank him for doing
that and was lucky to get it! Having spent 25 years in
the NHS, writing all those papers, and becoming a
professor, I just felt like another change in my life. I get
a bit restless after ≈10 years of doing the same thing!
That is when I decided to spend the final decade of my
career in urology establishing and running The Prostate
Centre.
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JF: The Prostate Centre has a really huge patient base
and also has an academic sense about it as well. Would
you agree?
Kirby: We try to make it a centre of excellence outside
the NHS. Quite a bit of writing comes from here.
Although we do not do much research, we write about
the research that others do and use it. As the Centre is
dedicated to men’s health, we use this research to inspire
men to live longer, healthier, and fitter lives by doing
more exercise and eating less food.
JF: One of the things you have helped popularise is
robotic radical prostatectomy. Why are you so attracted
to that as a surgical technique?
Kirby: Again, that was a bit of serendipity and good luck.
I had been across to the Henry Ford Institute in Detroit,
Michigan. From 2002 onward, we were watching the
developments of robotic prostatectomy. I had done
> 1000 open radical prostatectomies using a suprapubic
transverse incision and getting pretty good results. But, it
was difficult to get perfect vision of the nerves.
we all got to the top eventually, including me despite
some mountain sickness. We raised £200 000! That
started us off on a whole series of other interesting treks
in Corsica, Mount Kinabalu in Borneo, and just recently,
an amazing trek north of Annapurna in Nepal. The latter
raised £440 000 for Prostate Action. We have had some
fantastic adventures, John!
JF: Oh, we certainly do. It has added a totally new
dimension to my life, for which I am certainly delighted.
And, I am afraid, Roger, it is all you fault! It has been a
really great pleasure to have a conversation with you,
Roger, today. Thank you for letting us into some aspects
of your life of which others may not be aware. Thank
you very much indeed.
Kirby: Great pleasure, John!
{}
The London Clinic acquired a first generation daVinci®
robot in 2005. I had no choice but to learn how to do
it, as I was already doing all the open ones. Patients
were also asking to have it done in a minimally
invasive way. So it became sort of imperative.
JF: Another big part of your life and work is what
you do for charity. What motivates you? Tell us about
some of your activities.
Kirby: A number of things motivate me to work with
these charities. I get more excited when I receive a
donation of a £1000 or just recently £250 000 for
charity than I do when I get a cheque written up for
me! We set up the Prostate Research Campaign, UK in
1995, which is now called ‘Prostate Action’. It turned
into a flourishing charity that brings in >£2 million a
year. Of course, with your help John, we started the
British Urology Foundation in 1995, now simply called
‘The Urology Foundation’. That is also flourishing as
well, bringing in >£500 000 a year. The monies go
to support research into prostate and other
urological cancers. Both charities also support a
lot of training. We send young surgeons across
to America to learn how to do laparoscopic and
robotic operations. I think we do a lot of good!
JF: You and I have had a lot of fun with this charity
thing. It has added a fitness element into our lives
that is required to climb mountains and do long and
difficult treks to raise money. Do you enjoy that as
well?
Kirby: Oh yes! That goes back to 2000, when I met
an inspirational patient called Andrew Everington.
We refer to him as ‘The Legend’ now. He is a
tough-as-nails 75-year-old Scotsman. When we first
met, I told him he needed his prostate cancer treated.
He said, ‘well, you can, but it will stop me from
running in the 2000 London Marathon.’ So, I came
back with, ‘No, it won’t stop you. In fact, not only will
it not stop you, but I’ll run it with you,’ because I had
always wanted to do it. So, I ran the London Marathon
3 years in a row, then thought, well, I have got to do
something different. That is when you and I were
kicking around this idea of climbing up Mount
Kilimanjaro in Tanzania.
We decided to do that. All 14 of us got to the top
– some sooner than others! Rather annoyingly, you got
up there well ahead of me and most everyone else. But,
FAVOURITE THINGS AND THOUGHTS
UROLOGICAL HEROES:
Richard Turner-Warwick, Ken Shuttleworth, and
John Wickham.
‘Richard was my mentor and a fantastic surgeon,
kind of pleasantly eccentric, always a fantastic
character’.
FAVOURITE AUTHORS:
William Shakespeare.
‘I love Shakespeare! I tend to bore all my friends
and relatives by quoting my favourite passages,
such as the one by Brutus in Julius Caesar (Act 4,
Scene 3):
‘There is a tide in the affairs of men.
Which, taken at the flood, leads on to fortune;
Omitted, all the voyage of their life
Is bound in shallows and in miseries.
On such a full sea are we now afloat,
And we must take the current when it serves,
Or lose our ventures.’
‘The words still make my spine shiver whenever I
listen to Shakespeare. Nothing does it for me like
his works’.
CURRENT READ:
Great Expectations by Charles Dickens.
‘Actually, I am just reading Great Expectations,
partly because my daughter played Estella in the
BBC miniseries. Just is a fantastic book; he is
such a brilliant writer! I said to myself that this
year I would try and read the whole of Dickens’
output. But then my son actually went and
bought me the box set. I think there are ≈40
books in it. So, so far, I have only read one! I have
got 39 more to read before the end of the year. I
do not think I am going to make it!’
MUSICAL INFLUENCES:
Led Zeppelin ‘Stairway to Heaven’, Amy
Winehouse Back to Black.
‘When I turn on “Stairway to Heaven”, it just
sends shivers up my spine, too, because it
reminds me of some of the good-old-days we
had back in the 1970s’.
‘Amy Winehouse was a fantastic little singer
– Back to Black is a very good album’.
‘I am kind of egregious when it comes to musical
tastes. I listen to Classic FM a lot. Some of my
real proper music lover’s sneer at me! I like
Classic FM; it is really good. But, I also listen to
some Rock ‘n’ Roll.
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2012 THE AUTHOR
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