I have arranged to meet up with Professor Shafi Ahmed at his London Club. The receptionist appears momentarily befuddled when I tell her who I’m here to meet – at least until a colleague whispers helpfully into her ear…

‘Oh, you mean Shafi. He’s by the table near the window’. We greet each other with a simple handshake. No academic or professional formality here and no long introductions. We have in fact been friends for over 20 years – veterans of surgical training on the London circuit and postgraduate research at Bart’s and the London School of Medicine. Despite this, I’m still not entirely sure what he actually, does.

I have in fact been tracking Shafi on social media for the last few days – from Malaysia to Abu Dhabi to Amsterdam where he has just delivered the prestigious Spinoza Lecture and received a Chair at the Amsterdam University Medical Centre. It’s pretty much a normal working week for him. Despite this he’s relaxed and pleased to talk about his eclectic clinical and media interests.

Shafi Ahmed was originally appointed as Consultant Colorectal Surgeon at the Royal London Hospital in Whitechapel. As Clinical Lead, he was instrumental in establishing the laparoscopic colorectal service before being appointed as Cancer Lead. He was very much the pioneer for minimally invasive surgery of his time. Before his appointment, he had declined far more ‘lucrative’ postings in favour of his East London home. And to this day, it remains the visual back-drop and view from his apartment in Stratford – a daily reminder of the community in which he grew up and the community which he continues to serve.

For Shafi, surgery always was and will always remain, more about community service than career. Displaced as a child during the turmoil which unfolded following the partition of India and escaping with his family moments before his village was raised to the ground in the then East Pakistan (now Bangladesh) he arrived in the United Kingdom at the age of four with little more than what he was wearing. It is telling that there is only a single surviving photo of him before this time. Some of his early experiences in London were clearly sobering.

A reflection of a time when racism was open and commonplace and went unchallenged. Has this left a lasting legacy? He shrugs his shoulders. It’s not something he dwells upon but it has clearly been a driver behind his desire to break down establishment barriers. Whatever the past, suffice to say, there is no silver spoon here. But the circumstances have clearly proven to be a strong incentive for his family to succeed (his sister is a High Court Judge) and the same motivation appears to be apparent in the next generation (his son has followed him into Medicine and is currently studying at Manchester University).

He arrived in the United Kingdom at the age of four, with little more than what he was wearing.

University teaching roles had made Shafi aware of the somewhat jaundiced experiences of undergraduates during their surgical attachments and so he sought to enhance their participation in theatre. Traditionally, hands-on experiences in surgical theatres has been likened to a surgical scrum - with precious few being able to glean any meaningful view of surgical procedures. The answer? Google glass technology. In 2014 in what subsequently became a landmark event, Shafi undertook a right-sided hemicolectomy whilst wearing Google glass technology. Not only did students on attachment to the surgical firm benefit from better views and contemporaneous commentary but the procedure was also watched live by 14,000 people from 118 different countries. Pandora’s box had well and truly been opened.

In 2016 Shafi used a virtual reality platform (which provided a 360-degree view of the operating theatre) to allow a more ‘immersive’ experience during a laparoscopic anterior resection and which allowed the viewer to more fully appreciate the multiple roles and personnel involved in the delivery of an operation. This time there were 55,00 viewers from 114 different countries. In 2017, he utilized the ‘snapchat’ platform to record a hernia repair, breaking down components of the operation into modular ‘bite-sized’ segments to help with teaching. Shafi subsequently took control of the NHS ‘Twitter’ platform which allowed him to transmit live surgery clips with corresponding commentary made by a colleague. This time the viewers numbered over 1 million. Soon after, Shafi also appeared in the BAFTA nominated Channel 5 production which involved the live filming of a laparoscopic right hemi-colectomy – this time bringing ‘live’ surgery into the mainstream. This and other events were eventually picked up by ‘Time’ magazine which shared these innovations with its global audience of 56 million.

What has been his fascination with technology? As far as timelines are concerned he freely admits he is closer to the abacus than the play station generation. For Shafi however, this has never been a case of ‘boys and their toys’. Technology that breaks down established barriers and glass ceilings. Technology that democratises education and challenges the established order. Technology that reveals Medicine to those who wish to learn and understand. He is unapologetic to those who have denounced the live-streaming of surgical operations as both prurient and theatrical. In his mind these events have simply removed, once and for all, the soft-focus lens placed by the media on the reality of surgery. What if there are complications per-operatively? His view is somewhat sanguine. All surgeons live with the dread of operative complications and suffer the agony of failing to match the increasingly unrealistic expectations promoted by television dramas and glossy magazines. This is real. This is uncut and raw; and the public, have a right to know about the reality of surgical intervention. For Shafi, this is a very visual and visceral form of surgical consent.

With the realization that technology had a crucial role to play in enhancing medical education he co-founded the company Medical RealitiesTM. It offers a number of digital solutions to healthcare training from simulation to patient consultation engines, from patient avatars to digital anatomy. And whilst he remains its Chief Medical Officer, Shaffi has increasingly taken on a number of consultancy roles, one of which involves being advisor to the Abu Dhabi government. He is a regular headline speaker at TEDx events speaking largely on subjects related to connectivity and is also a driving force behind the Giant Health meetings. More recently he was appointed as the Vodafone Ambassador for Connected Health with an aim to enhance connectivity between clinician. One of its aims is to bring to fruition the reality of 5G theatres (to allow tele-proctoring and tele-mentoring). He has a huge social media following on a variety of platforms including Twitter, Instagram and LinkedIn.

All these commitments have necessarily impacted on the time available for clinical work. That said, Shafi continues to have a regular clinical practice at the Royal London Hospital and he is responsible for the hugely successful ‘Barts-X’ module in the undergraduate medical curriculum. It teaches undergraduates about technology and innovation and boasts an international faculty. The module provides students with mentors who help them develop their ideas and in a conclusion to the module students pitch their ideas to a ‘Dragon’s Den’ style panel of venture capitalists. The blueprint has now been replicated at Imperial College in London because of the demand driven by students themselves. In addition to these University affiliations (he holds visiting Professorships at Imperial, UCL and Amsterdam) he also holds Chairs at Bradford and Bolton Universities. With his regular clinical duties reduced it has allowed him to spend greater periods of time undertaking humanitarian work (he is a regular visitor to Gaza to help surgical colleagues develop the surgical service there).

I ask Shafi about his time as an elected member of Council at the Royal College Surgeons of England. He clearly found the role engaging and especially his role in developing the International Surgical Training Program which provided international medical graduates an opportunity to develop skills which can and will benefit local communities on their return home. So why did he resign before the end of his term? He gives me a rueful smile. Clearly somethings were difficult to change. ‘Plus, ca change’ he says (and if you know, you know). When another four white privately educated, men were elected to the most senior roles at the Royal College of Surgeons of England, Shafi tweeted ‘this is 2020, not 1920’. It touched a nerve. In the social media storm that ensued the establishment found it difficult to control the traditional narrative which questioned the ability of the College to embrace the ethnic and gender diversity of its Members and Fellow. It resulted in a grass roots review by Baroness Kennedy and wide-ranging reforms and to which Shafi contributed.

‘Plus, ca change’ he says …and if you know, you know.

So, what does he do in his spare time? Does he have any? Well, he’s currently and diligently putting in the hours as he works towards his Private Pilot’s Licence (PPL). He is a keen sportsman and avid follower of Formula 1 motor-racing, cricket and football. The question seems to have unsettled him slightly. Shafi has glanced at his watch a couple of times now and I’m aware he may have other commitments. Has he got a meeting to attend? Another transatlantic flight? In fact, he’s supposed to be on his way to his brother’s place to watch West Ham play at home and he’s currently running a little late. For someone with an inherently instinctual ability to predict global changes in technological innovation in the field of Surgery his view that West Ham stand even a remote chance of winning this evening borders on the delusional. You don’t need Google glass to predict that. And I tell him so!

Before he leaves I ask him one last question – one from a long-standing friend. Tell me something that no one else knows about you. His answer? He has previously been nominated for a Nobel Peace Prize. He asks me not to mention it in my article - but knows me well enough to realise that I’m going to write about it anyway.

Consultant Orthopaedic Surgeon Dame Clare Marx CBE DL MBBS PRCS, served as President of the Royal College of Surgeons of England from July 2014 until July 2017.

She was also the first woman to be President of the British Orthopaedic Association and subsequently Chair of the General Medical Council until she stood down in July 2021, following her diagnosis.

One of her greatest achievements as president of the Royal College of Surgeons of England was overseeing the redevelopment of its building in Lincoln’s Inn Fields.

It re-opened in July 2021 after being transformed from a sprawling warren of corridors, re-built in the aftermath of a Second World War bomb, to the current, state-of-the-art training centre, fit for future generations of surgeons and dental professionals.

Paying tribute to Dame Clare, Professor Neil Mortensen, President of The Royal College of Surgeons of England, said: “This is heartbreaking news for all of us who had the privilege to know and work with Clare.

“She was a wonderful person, a talented surgeon and a role model for so many in the profession.

“She was committed to improving standards in surgery for the benefit of patients and led the update of one of the College’s core standards documents – Good Surgical Practice, republished in 2014.

“She would often make a point of reminding colleagues that the key to raising standards for patients was for surgical teams to ask themselves whether they would be happy for themselves, or a family member, to be treated in that way.

“Clare led a remarkable life and she was a remarkable person.”

Andrew Reed, Chief Executive of The Royal College of Surgeons of England, said: “Clare was a true one-off.

“The first woman to become President of The Royal College of Surgeons of England, she was a clear-sighted reformer whose passion was for quality, standards and ultimately patients – everything else took second place.

“The magnificent renovation of our College building will stand as her legacy, but the fact that she has left behind such widespread feelings of respect, admiration, friendship and loss speaks louder than all else.”

Dame Clare studied Medicine at University College London, qualifying in 1977.

She chose to specialise in trauma and orthopaedic surgery at a time when there were few women surgeons.

She held NHS consultant and wider leadership roles, first at St Charles and St Mary’s Paddington, and then at Ipswich Hospital NHS Trust, where she worked as an orthopaedic surgeon for 27 years.

She was appointed clinical director of Ipswich Hospital’s combined A&E, Trauma & Orthopaedics, and Rheumatology directorates in 1993.

Dame Clare was elected to the Royal College of Surgeons of England Council in 2009, made Chair of RCS England’s Invited Review Mechanism in 2011, and elected as President in 2014.

Prior to that, she had been elected to the British Orthopaedic Association (BOA) Council and became President of the BOA for 2008-09.

She was made a Dame in 2018. She was awarded a CBE in 2007 for services to medicine, and she was appointed deputy lieutenant of Suffolk in 2008.

In July 2021, she announced her resignation from the GMC after she was diagnosed with incurable pancreatic cancer.

In a public letter she said: “Since receiving this news, I’ve been reminded once again of the importance and power of kindness in everything we do as doctors.”

In April 2022, in a moving and uplifting interview on BBC Radio 3’s Private Passions, Dame Clare talked candidly about her parents, her pioneering medical career, her love for her husband, Andrew; the shock of her diagnosis, and the music that sustained her during her treatment.

Reflecting on how the influence of her father had helped her approach to her diagnosis, she added poignantly: “You only look back to learn…you must look forward for the future…and that is certainly a good lesson for me at the moment.”

Dame Clare also spoke of her desire to disseminate information about pancreatic cancer and the need to get people into treatment earlier.

She said: “If it’s caught really early then surgery can be curative… and wouldn’t it be just for a surgeon to say that, but surgery does still cure many cancers.”

She worked closely with Pancreatic Cancer UK to make changes for pancreatic cancer patients.

Tamzin Cuming, Chair of the Women in Surgery Forum at The Royal College of Surgeons of England and a consultant colorectal surgeon, said: “Clare was a role model and inspiration to all surgeons. It feels particularly sad to lose the only female president the RCS England has had to date, when her gracious and insightful presence did so much to encourage women into the specialty.”

Karen Smith, Director of Strategy, Training and Workforce at The Royal College of Surgeons of England, said: “We are all so sad to hear about Clare’s passing. She broke many a glass ceiling without fanfare.

“She challenged, without being challenging, expressed great insight, and made a huge impression at the College and in the profession. I will also remember her sense of humour and fun. Clare was always approachable, greatly respected and she will be sorely missed.”

Ralph Tomlinson, Director of Research and Quality Improvement at The Royal College of Surgeons of England, said: “Clare was an inspirational person who had a profound impact on the people she cared for and the profession she cared so deeply about.

“She was a pleasure to work with and a privilege to know. Her achievements speak for themselves – I will remember her for the way she was able to show humanity and kindness and the leadership example that she set.”

Jane Corfield, a Lay Reviewer for the College’s Invited Review Mechanism, said: “Clare was such a special and significant figure at the College and an unparalleled example, particularly to countless young women.

“My own daughter, now a Trauma and Orthopaedic Consultant, benefitted from the years of watching her leadership and receiving wisdom and encouragement; and feels the loss of such a shining star.

“I started working with the College back in 1998, and have many memories of her work, and of course her achievement as the first woman President of the RCS England.

“I feel privileged to have witnessed her great contribution. I would like to send my condolences to all at the College, and my thoughts and prayers are with her family and loved ones.”

Dame Clare Marx CBE DL MBBS PRCS, surgeon, was born on 15 March 1954 and she died on 27 November 2022, aged 68. She is survived by her husband, Andrew Fane.