BBC sounds, music, radio, podcasts Hello, I'm Lauren Laverne, and this is the Desert Island Discs podcast. Every week I ask my guests to choose the eight tracks book and luxury they'd want to take with them if they were castaway to a desert island. For rights reasons, the music is shorter than the original broadcast. I hope you enjoy listening. My castaway this week is Professor Avril Mansfield, she was the first woman in the UK to become a professor of surgery and enjoyed a distinguished career as one of our leading vascular surgeons now in her 80s.

She knew what she wanted to do from the age of eight when she found a book about surgery in her local library. It's lucky that she was clear about her future. Her teachers predictions were wildly off the mark. One school report predicted Avril will never learn to sew. Her trailblazing career in the NHS has seen many firsts in the operating theatre. She pioneered surgeries in the field of stroke prevention. Two in particular are now available throughout the UK and have saved many thousands of lives, though she remains down to earth about her job, which she describes as a lot like plumbing.

She's also philosophical about her status as a woman in a profession where they're outnumbered eight to one by men, she says. Female surgeons were rare throughout much of my career, but I found that if you're doing a job and you're doing it well, people are not concerned whether you're a man or a woman. Professor Avril Mansfield, welcome to Desert Island Discs. Thank you so much.

So I've really only used part of your quote about vascular surgery being a lot like plumbing. I think we need more detail on that. How exactly?

Well, if a pipe in your plumbing at home becomes blocked, you can either unblock it or you can put a new bit of piping in. Or if that pipe is leaking, there are only one option is to put a new bit in. And it's exactly the same in the human body.

What was the appeal of surgery in particular for you? You set your heart on at such a young age?

In truth, I probably had an inkling for surgery before that because my much loved toy as a child was a panda and that panda had its appendix removed numerous times and put back in again. But nonetheless, it was the about that time that I read about some of the history of surgery and was completely fascinated by the fact that people would, for example, open the chest for the first time, not really knowing that the patient could survive having their chest opened.

It took a lot of courage. And so I was really keen from that age on to be part of that and to see it developing.

I mean, it is perhaps the most visceral of medical skills. You're wielding a knife with a huge amount of precision and delicacy, and that means that it's not for everyone. But how does it feel what you're actually doing it?

Well, you start small. I think people imagine that you plunge into a difficult aortic operation on day one, and of course, you don't. So you start with just a little tiny sister, a lump or a bump or a toenail or something of that sort, something fairly small. And you work up to the more important major life threatening conditions and you never lose when you start a major operation. That moment of reflection, of thinking about what is going to happen next.

But you then start in a job of work and you do it with skill and with precision and skill. You've learned precision that you've gained over the years and you really have nothing then to fear and you simply get on with the job.

Something else that takes skill and precision is music. And you are a musician yourself, a pianist and a cello player. What role did music play during your working life?

It was extremely important throughout my life and remained so never more so than in this period of lockdown. But at the very beginning, playing the piano was something that I did every day. And when I was going off to university, I was at a girls school in Blackpool and I'd never been away from home before. And my piano teacher said to me, You're going to be lonely when you go to your university in Liverpool. And if you are, find a piano and sit down and play and you'll have friends.

And I took her advice. I remember it was the evening of my second day in the Hall of Residence and I was quite lonesome. I couldn't really met anybody very much. And I found a piano and I sat and played.

And sure enough, by the end of that evening, I had a group of friends around me.

Well, on that note, I think we'd better draw a few friends around us. Now, let's hear some music overall. It's your first disc. What is it and why they chosen this?

My first one is Shostakovich, and it's the walls from his second suite. And it is a very lovely piece of music, I suppose. I came to Shostakovich on reading his life story and the traumas that he went through in his life and for his art. And this is not a dark piece at all. It's a very happy piece. It would make me on my desert island feel like dancing, I think. And it is indeed a waltz.

Part of what's number two from Shostakovich's Suite for Variety Stage Orchestra, performed by the Radio Symphony Orchestra of Berlin, conducted by Steven Sloan. Avril Mansfield, you were born in Blackpool in 1937, just before the outbreak of the Second World War. Your parents had met at Blackpool Pleasure Beach and your father was a welder. I think he might have been there fixing the Ferris wheel.

Certainly that's the story. My parents moved to Blackpool because both of them were looking for work and they ended up working on the Pleasure Beach, as it was called. And I think you're probably right. He was probably fixing one of the bits of machinery there. But yes, he worked in appalling circumstances out in the open. He was a wonderful man. I really was extremely fond of my father.

And what about your mother? She wanted to be a teacher. I think she would have loved to have been a teacher. She was told that she wasn't strong enough to continue with education. The fact that she lived to 84 in robust health until then, it it's kind of beneath the knowledge of those days.

But she was certainly made to leave school. I think she worked in sales in a department store until I came along. And then from then on, I don't think I ever worked.

So both of your parents had come from large working class families. You were an only child, so they were able to give you all of their focus.

I think that is the situation. They certainly have been unable to pursue any career choices of their own and were determined that whatever career choice I was to make I was capable of that was probably the main focus I would be able to do so.

That ambition crystallised when you were eight, you told your parents, but they told you not to refer to that ambition outside the home.

The fact that you wanted to be a surgeon, why they really did feel that it was above our station, I suppose is the only way I can express it. I once want some school prize and it was in the local paper and the headline was Avril Wants to Nurse. And I knew perfectly well that my mother had told them that I wanted to nurse. And I was so cross about it because I said, I don't want to nurse, I want to be a doctor.

The NHS was born 11 years after you. So the changing medical landscape must have been the background to your childhood in some ways. Were you aware of it?

Very, very aware of it. My best friend at school was Alistair.

He was the son of the local GP and we would never trouble the GP for anything that wasn't really important. And we could see the queue outside and we would never go to the GP surgery until the queue had disappeared inside because we didn't want to have to stand out in the cold and the rain. And my parents had a lot of people did in those days, pots on the mantelpiece with the money for the various things. And one of those pots was for the doctor.

And I do remember when the health service came in the joy that they would no longer need that little pot.

It's time for your second discover Mansfield. What are we going to hear? Well, we're going to hear something by Donald Swan and Michael Flanders. A transport of delight is the one that I have chosen during lockdown. Possibly the most inspired birthday gift that I got was from my friend in Australia who sent me my very first Lego kit for a London transport double decker bus, which I absolutely loved. It was like going back to being a surgeon again. It had 2000 pieces in it and I really became addicted to this thing.

So that London transport bus sits now in my lounge and I'm very proud of it. And so this piece just fits.

That's got anything to show more than my mind. There is not anything to show.

Like cabbies try to ask me before they overtakes my sticks before. I mean, I doubt it breaks them. Chuckle Taxi drivers going to be mad at us behind that one. I got the numbers like we collected six. We started in London transport. These are all part of me, but an absolute joy.

A Transport of Delight by Michael Flanders and Donald Swan. So after attending primary school in Blackpool, after you pass through eleven plus and went to the Collegiate High School for Girls, now, by then you'd already started doing science experiments at home. What kind of thing.

Yes, it was much easier in those days. You could go along to the chemist shop and buy the bits and pieces you wanted, a Bunsen burner and a glass dish to do the experiments in. And I used to do them in the back kitchen and make some appalling smells. And no doubt some of them were quite dangerous, but fortunately nothing ever blew up. But as you've heard, I had a very bad report about my sewing.

And yes, you never learned to sew exactly enough to. It turned out not to be the case, and if there's something really that I wanted to so I could say, okay, but delving into things with my hands and doing things was always something that I enjoyed and possibly got that from my father because he was a great DIY man and we did plays and he would always do the scenery or the construction of sets clearly. He loved to do things with his hands and his daughter took after him.

So you were a budding scientist. How much encouragement did you get for those ambitions at school?

Not as much as I would have wanted and not as much as I hope happens today. I do hope it's better than it was then. It was girls really were meant to do the art. But of course, I had to do the sciences. I had no choice about it. I knew what I wanted to become. And there were science teachers at school and they did their very best. But my mother was very good and actually bought the syllabus so we could look through it together and make sure that I had read something about all the topics that were meant to be covered in my essay level exam.

So I owe a great deal to her.

At what point did you start to say it was OK to tell people what you actually wanted to do?

I think by the time I'd done what was then O levels, I think she realized that I did seriously have the potential to become a doctor and therefore was OK to start saying, yes, you can apply to medical school. And she was perfectly happy about it.

It's time for some more music. Disc three. What is it and why are you taking it to the island?

Well, we're now moving into the time when I was a student, my uncle had given me an electric gramophone to take to university with me, which was a wonderful gift. We've had a wind up gramophone at home and nothing at that stage to play on it. And I can remember my very first 45 record of Sibelius when I went to university. And then I began to realize that there were composers and there was music and there was orchestral music in particular that I absolutely loved.

And I've chosen Brahms, his second piano concerto, and in particular one bit of it where the cello comes into its own, because it's a combination of the two instruments that I have spent my time trying to play. And one occasion I received a proposal of marriage to this cello solo.

So it's a very romantic piece of music, a very lovely piece of music and one that I could delve into.

Did you say, yes, I'm not going to tell you that. Listen to the music and you'll decide what I said.

Part of the third movement of Brahms Piano Concerto number two in B Flat with Elaine Grimmel and the Vienna Philharmonic conducted by Andris Nelsons Avril Mansfield, and you played piano a lot while studying medicine at Liverpool University, almost to the detriment of your studies. I think you said so. It was clearly very important to you. What did playing give you?

It was difficult, really, when I first went to university because it was such a new world for me and I was pretty unprepared for it. So the comfortable world was that which I had previously inhabited with the piano. And because I did so much of it, it did perhaps take me away from my studies initially. I have to say that didn't go on forever, but I failed an exam and here I was in the career of my dreams. And here I was failing an important exam.

And it was such a wake up call to me. I didn't fail from then on, I can promise you. And so I think perhaps the music was too much of a refuge for me initially from the the cut and thrust of being a medical student, which was quite tough to begin with.

So it was tough. Which aspects were overwhelming? What was going on? Was it the course? Was it the culture living on your own?

It was all of those things. But the first thing I remember going to a lecture and I couldn't understand what the topic was, so I couldn't really go and look it up because I couldn't spell it. I didn't know what it was. And then the next thing happens, you go into the dissecting room and and it's quite overwhelming when you first go in there. And again, I was shocked at my own response to that because I was a little scientist and yet to be faced with all these human bodies exposed for dissection, which was a very important part of the course, but I still struggled to cope with it.

But I had to get there really, because in those days we had to get through this part of the course first before we could move on to the thing that you'd really gone to university to learn about. And that was the care of patients.

It's time to make some room for the music. What are we going to hear next and why have you chosen it?

Well, it's part of my career. I think everybody went to the state. We used to call it BGA, you know, another diploma on your list of diplomas which stood for being to America and was a more established person when I came back in the world of medicine. But I was on the Queen Elizabeth. We all went by sea in those days and we met the tail end of a hurricane going across. So it was extremely rough and down to dinner that evening, just three people turned up and the captain of a whaling factory ship, myself and Peter Maxwell Davies, and I became Max's friend for the whole of his life.

I went to several of his first performances and watched his career develop. At one point, he said he was going to write an opera about the operating theatre with me in it, but I don't remember he ever did. But at least I can have a piece of his music and this particular recording, I think he is playing it.

It's farewell to Stromness. Your friend, the composer, Peter Maxwell Davies, playing his own composition farewell to Stromness Arthur Mansfield and a man who even a hurricane couldn't put off his dinner while he was still in Liverpool at Broad Grain Hospital, you'd seen your first aortic aneurysm surgery and that had a huge impact on you.

Now you describe yourself as entranced, which it's not the word that everyone would use. But what captivated you?

Well, here is this person with a life threatening condition very much on the edge of disaster with some brand new operation that had really only just arrived in the north of England. Certainly, it's a ballooning of the aorta in the back of the abdomen, the aortic aneurysm. And if it gets too big, it will burst and the patient will die unless they can get to surgery very quickly. Indeed, in those days, you had to open up the abdomen and put a clamp on the aorta and replace the aorta with a tube of Dacron.

Today, quite a number of them can be done through an incision in the groin. But in those days it was a massive operation. And to watch it being done with skill and expertise, I just felt that that was so wonderful to watch. I just wanted to go along and do that by 1966.

Then you were back from the U.S. and back abroad green and this time as a registrar actually doing some surgery at all. Or nearly all your peers were men. Did you feel different?

I want to be a surgeon first and foremost. It didn't have to be vascular, but that was clearly the developing specialty that took my particular interest. And I was perfectly comfortable with the fact that there weren't other women doing that training at the same time. And I had a wonderful Australian registrar at the very beginning of my career who was prepared to let me do some simple procedures with his assistants and to pass judgment at the end and say, you'll be fine, you can do it.

Go for it, girl, you're fine. And that was really important to have somebody who could just watch and make sure that you were competent and capable of doing it.

So your colleagues were hugely supportive. What about the patients? What did they make of you? They must have occasionally walked into your office and been surprised that there was a woman sitting there.

If you've got all afternoon, I'll tell you some lovely stories about people coming in and being shocked that I've got all the time in the world.

I'll give you one brief story. And that was a man who came in who had an aortic aneurysm. And I sat and talked to him, took his history. By this time, I was a professor of surgery and I wrote all this down. I then said, would you mind taking your clothes off and popping on the couch so I can examine you? So he stripped naked, lay on the couch. I examined him from top to toe. He never said a word.

And then I said, Right, you can put your clothes on again. And at that point, he said to me, And when am I going to meet Professor Mansfield?

Which I thought it was amazing that somebody would actually stripped naked to some woman that he didn't know who it was and let her examine them from head to toe. But there we are. You do need to retain a sense of humor in this thing. Otherwise all is lost.

It's time to hear some more music. Avril, what's next for us today? This is desk number five.

This is Mozart and Chamber Music. By this time, I was in Liverpool and interested in getting together a small group of musicians to play chamber music. Not easy when you're all medic's all on call, but I learned to love chamber music and still do. And it's one of the things that gives me great happiness now to play with other musicians. And this particular one is a piano quartet by Mozart in G Minor.

And part of the first movement of Mozart's piano quartet, No one in G minor with Daniel Barenboim on piano, can Sultani on cello, Michael Barenboim on violin and Yulia Dannica on viola. Avril Mansfield, he became a consultant in 1972, age 35. And you were working across two of Liverpool's teaching hospitals, the David Lewis Northen and the Royal Southern. So doing general surgery and taking vascular procedures as and when they arose. How did vascular surgery then compare to what it is today?

There are two areas where there are three areas that have changed. Of course, the minimally invasive aspect of doing the operations. It was happening when I was still working, but it's developed a great deal sense. But the things that really stand out is first and foremost imaging. We now get wonderful images of everything that's going on inside the patient, which simply didn't exist when I started doing vascular surgery. And the other thing is anesthesia and intensive care, the care with which that patient is managed, both during and particularly after an operation, the safety of the patient very largely rests in the hands of the anaesthetist.

And I often think they're the one person that nobody talks about. They are really important people. And when that first aneurysm was done that had such an impression upon me, there wasn't a thing called an intensive care unit. So that patient had to go back to the ward and be cared for. My normal ward nurses who of course, had never seen such a patient in their lives before.

So inevitably some of them were not going to get as good care as they would today.

I think the popular conception of a surgeon, the idea that we have is as someone who is the star of the show, but you seem to be painting a very different picture, one that's much more complex and interconnected and really about teamwork.

Absolutely. We are not prima donnas. We shouldn't be prima donnas. We are a member of a team. I always think that perhaps we can allow ourselves to call ourselves the conductor of the orchestra, because if you are the surgeon, then you do have the direction of travel, of an operation in your hands.

You are the person who leads. But having said that, you cannot have a successful operation on your own. You do need that team and you need to carry the team with you. And that, I think, is part of the fun of it, really. It's part of the pleasure of it that you work with another group of people that you enjoy working with.

So after your first marriage ended at the end of the 70s and after that you met Jacques under rather dramatic circumstances.

Tell me how he came into your life.

Yes, we were both on a bus going skiing. I didn't know him at that stage. And I was sitting at the back of the bus and it was a very snowy winter and the ice was almost overhanging the bus and at one point broke the window of the bus and nobody was injured. No harm was done. But the silence that had been in the bus was suddenly melted by this this accident. And then this man appeared saying, I think this calls for a drop of the duty where his famous words, who is this man?

I said to my neighbour, and the rest is history, whisky together. And as I've said many times before, we simply ski together. No hanky panky, as we used to say. But eventually we realised that we needed to be together.

It's time for some music desk number six. What have we got and why are you taking this with you?

Well, Gabrielle Forras, Pavulon is just one of those pieces that I have always loved. I've always thought I would want to have it wherever I was. I've played in it. So I know the music well and it's just there so that I can enjoy it.

Part of forays, Pavane, performed by the city of Birmingham Symphony Chorus with the BBC Philharmonic conducted by Yann Pascale hotelier Avril Mansfield. In 1993, you were appointed professor of vascular surgery at St Mary's Hospital in London. So the first female professor of surgery in the UK. And it was a promotion that that slightly took you away from what you love day to day. How did you manage to transition into that new role?

I had a lot to learn. I'd had an academic job. I'd done research all through my career. So that wasn't new to me. But running a department was and worrying about finances. That was perhaps the biggest problem for me to begin with, which was working out how to keep finances secure. Because you have employees and money doesn't grow on trees, as we all know, and you have to make sure that you're producing the research and the income to support that research.

So it was quite a hard time. And there were moments when I wondered why, what Magnus had made me accept this new job.

And what did you say to you when you'd get home from very long, difficult days?

Well, but this time he was beginning to think about retirement. And then eventually, for the last 10 years of my working life, he was retired. And I can remember him saying, I guess Fridays must be as bad for you as they were for me. I'll cook on Fridays. In the end, he did the weekdays and I did the holidays, holidays and weekends, which was a very equitable distribution of the work.

It's time for our 7th desk today. Oh, dear. Yes, this is my Mamma Mia record. I was taken to see Mamma Mia by the grandchildren when we were all up together in the Lake District and they all wanted to see Mamma Mia! And I wasn't very keen, but I went with them because I like to go to things with them and came out singing. I mean, what's not to love? What's not to love is one of the.

Dancing queen from the soundtrack to the film Mamma Mia! Performed by Christine Baranski. Julie Walters and Meryl Streep.

So Avril Mansfield, like many others, you've been dealing with the challenges of lockdown, courtesy of your husband, Jack. You have six wonderful grandchildren and your stepchildren to what's been the most difficult aspects of lockdown.

Not having a hug from any of my grandchildren has been the worst thing. I mean, I haven't had a hug in months and hugs are very, very important, I think, in life. So, yes, that's hard because my Jack, as I'm sure you realize, died almost seven years ago now. So there's nobody every day. And when I see the grandchildren, they are very careful with me and obey the rules and don't give me a big hug.

I look forward to that very much.

And looking at the pandemic and the effect that it's had on the organization that you've worked for. What's your assessment of the challenge posed to the profession and future?

I think we have a lot to catch up with. They've done a magnificent job looking after this epidemic and we may have yet more hard times for the health service to come. But of course, the fall guy of this has been people who've been waiting for surgery and there are a lot of them. And this is really tough on them and tough on those who would be providing the service they want to do the job. And just as I want to operate on people and get them better, they want to do it and they're prevented from doing it because of the overwhelming response that was needed to this virus.

And everybody who's had to make use of the National Health Service because of personal health reasons, they're the first people to praise it and to realize that it is a very important gem in our country's life.

It's almost time to send you to the island of Mansfield. But before we do, one more desk from you, please. And I'm having a romantic final piece by my favorite composer, Schubert, a man, unfortunately, who had a very short life but somehow managed to produce a vast amount of music. I once went into a music shop in Vienna and asked if I could have a look at some piano music by Schubert. And they practically gave me a whole room full of it so much.

And the songs that he's written are wonderful and romantic. And I used to play these on the piano. And Jack, my husband, he was a very nice tenor voice, would sing them.

So this is a very romantic ending of my choices, always being more and more.

Most need to healthy, he calls me. First of all, first of all, you know, soon there's great interest for this expenditure side show.

First of all, we need to avoid. Part of Shubert's Danjean performed by Peter Schreier with Andras Schiff on piano, So it's time to send you to your island, Aphro Mansfield.

We know you've got a delicate hand for surgery. How handy are you? How well will you get on on the island?

I think I'll probably muddle through much more of a destructive gardener than a constructive one, but I guess I'll have to learn.

We'll give you the books to take with you the Bible, the complete works of Shakespeare and a selection of your own. What will that be? I think I'm going to have the biggest, fattest book of poetry that you can find for me.

Oh, lovely. It'll be enormous. Good. You can also have a luxury item to provide pleasure or sensory stimulation. What would you like?

What I really like is to have Jack with me. But you won't give me that. So that's what I'll have, if I may, is a piano. If a grand piano is allowed, then I will think of my father saying you should always have a piano, you can play it, you can eat off it and you can sleep under it, which would be lovely.

It's evergreen advice and the piano is very much going with you. And finally, if you had to save just one of the eight discs that you've shared with us today, which would it be?

Is the Brahms Piano Concerto, please.

Professor Avril Mansfield, thank you so much for sharing your Desert Island Discs with us. Thank you. I so enjoyed my conversation with Avril, and I hope she enjoys many happy hours playing her piano on the island, the Desert Island Discs back catalog includes many people from the medical profession, including cardiologist Jane Somervell, microbiologist Professor Peter Piot, professor of fertility Robert Winston and Dr. David Not. You can listen to all those editions on BBC Sounds next week. My guest will be former Olympic cyclist and cycling and walking commissioner for Greater Manchester, Chris Boardman.

Do you join us then? A new podcast from BBC Radio for Children of the Stones Village is the sort of place people get murdered. It and old TV shows a village surrounded by an ancient stone circle. The Stones are first in a village with an impossible secret.

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