Fred once said, “I studied medicine so I could help others – set a leg or whatever – and it’s given me a great deal of satisfaction”. But setting legs was not what Professor Fred Hollows ended up doing…

Fred had done an eye term at medical school and, as a result, he assisted eye surgeons at Auckland Public Hospital in his first job after graduating.

At the same time, he had a growing interest in practising in Africa – “there seemed to be a crying need for properly run clinics, free of political or church influence” – and someone told him if you were to be useful in Africa you had to know how to take out cataract because there was a lot of cataract blindness.

A great deal to learn

In his second job, at Tauranga Public Hospital, he made a deal with the eye surgeon to see all his eye cases and take notes and assist in the operations. In exchange, Fred took some of the surgeon’s ear, nose and throat cases. By the end of that year, Fred was doing cataracts himself and finding eye medicine more and more interesting. Ophthalmology was a trade he described as not especially prestigious, but “good work”.

He took an ophthalmology job at Wellington, the biggest hospital in the country, and was there to break open the crate when the first retinal camera to be imported into New Zealand arrived. He felt he was in the vanguard of eye work and enjoying it, but there was a lot he didn’t know and no specialist post-graduate training in New Zealand at that time.

To London via the Panama Canal

Fred decided he needed a diploma from the Moorfields Eye Hospital Institute of Ophthalmology in the UK, and it looked like it might be necessary to qualify as a fellow in the specialty after that, so lots of time and money was needed.

He worked as a general practitioner for a year to fund the move, “incredibly hard work  – one weekend off in five – but very interesting,” and also worked as the ship’s doctor on the way over, six weeks via the Panama Canal, “one of the sweetest times of my life”. Once in London and studying he worked at night as a “radio doctor” on call, zipping about London in the snow in a Mini Minor.

Playing in the big league

According to Fred, he didn’t have any particular ambition, just wanted to see if he could “play in the big league”. He shared the diploma prize with another New Zealander and the fellowship was the obvious next step.

Studying for the Fellowship Primary at the Royal College of Surgeons in the early 1960s was the most intellectually expanding period of Fred’s life. The teachers were the people who had set the standards in the subjects and the electron microscope had just come into use. “Fascinating stuff,” said Fred.

He passed the notoriously tough Primary exam first go and got a job in Cardiff in Wales as an ophthalmology registrar in the Royal Infirmary. He was determined to continue his run and sit for the fellowship proper as soon as possible, which he did, and failed, twice. He didn’t know enough. He knuckled down and “worked like a dog” for two years, doing cataracts, squints, retinal detachments, corneal grafts, sat the fellowship again and “had no trouble”.

Fred’s mentor in Wales

The most important influence on Fred in Cardiff was Professor Archie Cochrane, a pioneer of epidemiology. They collaborated on a glaucoma survey in the Welsh valleys and it was that survey which gave Fred an academic reputation.

Fred took to heart Archie’s credo of “no survey without service” and followed this approach when he led the ground breaking trachoma survey of outback Australia in the late 1970s.

Off to Australia

In 1965 Fred moved to Australia to become Associate Professor of Ophthalmology at the University of New South Wales (UNSW) in Sydney.

From 1965 to 1992, he was the head of the ophthalmology department, overseeing the teaching at UNSW and the Prince of Wales and Prince Henry hospitals. In his first year, he set up a small eye unit at the Prince of Wales Hospital and performed the hospital’s first cataract extraction.