Dr Bill Frankland: Penicillin, the pollen count and perspectives on medicine

September 2019

Dr Bill Frankland is 107 years old. He was born three weeks before the Titanic sank.

He was taught by and worked with Sir Alexander Fleming, the father of penicillin. During World War II, he was a prisoner of war in Japanese-occupied Singapore, returning to St Mary's Hospital to become a specialist in the field of allergy and one of the first supporters of the 'hygiene theory' – the thesis that increased cleanliness is responsible for the rise in allergy sufferers.

I am meeting Bill for the first time. I am struck by his intelligence and curiosity. There are several academic papers on his desk and he keeps up with research on fungal moulds (three of his friends died from fungal infections). He quizzes me on my kids, my childhood. The continuing theme of our conversation is the disruptive, overriding influence of Chance in Life, especially a long life.

Your twin brother lived until he was 83. Actuarially speaking, that's ten years longer than the average innings for the era. And yet you have outlived him by almost 25 years. Why?

It's just by chance. There were so many times when I might have died. I was very premature, a twin, only 3lb 1oz – and mortality rates were high in those days. During WWII, on the toss of a coin, I stayed at Tanglin Military Hospital instead of going to the Alexandra Military Hospital nearby, where two months later nearly all were brutally killed by the advancing Japanese. During my days as a prisoner of war, Allied officers were often lined up by the Japanese officers to be bashed.

On one particular occasion, I was knocked unconscious – I then slowly got up and staggered with both fists closed and looked as though I was about to hit the Japanese officer. The Japanese private was about to bayonet me to death, but for some reason, his officer stopped him. Half a minute later, I regained full consciousness. On release from captivity, being flown from Singapore to Rangoon in the monsoon rains, one out of three of the Dakotas transporting ex-POWs failed to navigate the mountains and crashed en route, killing the pilot and passengers. It just so happened that my plane was OK.

What were your earliest childhood memories?

I grew up in Dacre near Ullswater, in Cumbria. My earliest memory is of my third birthday, when I and my twin brother were invited to a special celebration by the canon of our church. I ate too much cake and was sick! Five years ago I visited the very same house and identified the very same area on the carpet where the incident occurred (thankfully unmarked).I spent a lot of my childhood going on long cycle rides in the Lake District and climbing up mountains.

Why did you decide to become a doctor?

I had an incompetent doctor who misdiagnosed us as children, which meant we had to have our tonsils removed. Actually, we had bovine tuberculosis. I decided if I became a doctor, I would treat patients more humanely. Then when I was sixteen, I read The Story of San Michele by the Swedish physician Axel Munthe, who described the rabies outbreak in Paris, as well as treating patients all over Europe, including royalty. His description of illnesses, rather like detective mysteries, sparked my curiosity. I decided I would like to be a doctor.

You chose allergy as your specialism, despite having had no prior experience. In these days, when the perceived wisdom is to specialise as soon as possible, why did you do this?

On returning to St Mary's after WWII, we were able to apply for a job of our choice at the teaching hospital. I chose what I knew from having treated prisoners in Singapore, dermatology, but I did not like it. A part-time job came up in the Allergy department. I did not know anything about the area, other than being a hay fever sufferer. I took the job, liked it, and never looked back.

Of all the people you've worked with, who would you consider exceptional? What made them great?

Alexander Fleming, of course. I was taught by him when I joined St Mary's for clinical training. I also worked with Fleming in the Allergy department from 1953 onwards, as his clinical assistant.

When I was put in charge of the experimental ward, I met him every morning at 10am for the last two years of his life, ostensibly to talk about patients on the ward, but Fleming wasn't interested. He was a bacteriologist to his core. We talked a lot about medicine and research generally, and this was when I heard the story of penicillin's discovery in 1928.

Fleming told me that one day, bacterial strains would become resistant to penicillin, predicting this 70-80 years before it became a reality. At the time, I did not really know what he was talking about.

Also, Howard Florey and Ernst Chain, who were instrumental in producing penicillin and making it a usable drug. Together with Fleming, they shared the Nobel Prize for Medicine in 1945. They were exceptionally clever, insightful and they loved the work that they did. Florey had the leadership skills and ability to nurture difficult men like Chain, recognising that it was important "to have him on board".

Can you tell us a little more about Fleming and penicillin?

Fleming was appointed Assistant Director of the Department of Inoculation in 1921. This was not without some controversy; John Freeman, who eventually became my boss, had expected the role would be given to him upon the retirement of Sir Almroth Wright.

In 1928, Fleming was studying the bacterium staphylococcus aureus, observing colonies in petri dishes under a microscope. The lid of each petri dish had to be removed before it was examined, which momentarily exposed the dish and its contents to contamination from the atmosphere. Once examined, the lid was replaced.

Fleming often kept used petri dishes for a few weeks before disposing of them, and this particular batch remained there until his return from holiday. On his homecoming, Fleming and his assistant Pryce found one petri dish on which an area was entirely clear of bacteria near to a mould. Fleming made a subculture of this; the substance was isolated, identified and is now known to us as Penicillium chrysogenum.

It seems that the fungus which contaminated Fleming's petri dish did not blow in from the air outside. The Allergy department resided one floor below, where John Freeman (who had been a contender for Fleming's job) was researching the question of whether fungal spores could cause rhinitis and asthma. The window to Fleming's lab was never open, but his door was never closed.

What was your proudest professional moment?

Although being known for having introduced the pollen count to the public, my claim to fame is introducing double blind controlled treatment trials in allergic diseases in 1954. I am also proud of my work in heading up the Allergy Clinic at St Mary's, which was the busiest in the whole of the UK. In 1965, we treated over 6,000 patients with seasonal hay fever.

What do you think will become the most significant field of research?

Cancer. We will keep looking into why people get cancer, how they get cancer, and ways to stop cancerous cells from proliferating. I have avoided using the word 'cure' deliberately. But I think we will find a way to desensitise those cells. There will be more and more drugs and radiotherapy to deal with cancer.

Boris Johnson is saying he wants to make the UK number one for biosciences. What do you think it will take to achieve this?

Money – to go into research.

In research, inspiration is important. Where do you get your best ideas? Alone? In the bath? Brainstorming with others?

I liked to surround myself with bright people. I loved hiring intelligent Jewish doctors – at the time they were fleeing from Hitler's Germany. Germany's loss was our gain.

Are you still interested in medicine, and what is your daily life like now?

I keep up with research: I am fascinated with fungal moulds. I notice Moses has described in Leviticus Chapter 14 how a priest is to cleanse a house to destroy fungal infestation. They are dangerous. They kill crops and trees. They cause asthma.

I have written five medical papers since I turned 100 and people still ask for opinions on allergy. I was an expert witness on allergy and have given evidence in court, successfully defending two people being tried for murder.

Outings are limited by decreased mobility. However, I managed to get to a church service held by the Drapers' Livery Company a few weeks ago, and I went out with ex-work colleagues for lunch last week. Family come and visit me.

What would you say to those who are thinking of taking up a career in science?

Think about becoming a medical student and a doctor. It is a wonderful career! I have thoroughly enjoyed everything. No two days are the same. I feel I have helped so many people.

We have talked a lot about your medical days. From a wider perspective, do you have any insight that you wish to impart to us?

This is something that relates more to my POW experiences and is a piece of advice that my father gave to me – so I shall pass it on to you. My father was a vicar. I remember him telling me off when I was a child, for saying that I hated my twin brother. He said, "You must not go on hating people. It does you harm but it does not do them any harm".

For more on Bill's life and experiences, see his biography, From Hell Island to Hay Fever: The Life of Dr Bill Frankland, by Paul Watkins (published by Brown Dog Books, 2018, ISBN 1785452657).

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Cheng Bray

Cheng is a senior professional support lawyer in our London office.

"Fleming told me that one day, bacterial strains would become resistant to penicillin, predicting this 70-80 years before it became a reality."