Alumni profile - Charles Knowles
The hat I have worn the longest is being a surgeon, followed by my research hat... The other hats I now wear are as a semi-professional musician. I have also been recruited as the lead for colorectal at the new Cleveland Clinic London which will be opening next year behind Buckingham Palace.
After completing your undergraduate clinical training in Medicine at The London Hospital Medical College (Medicine MBBS, 1992), what sparked your interest in undertaking your PhD at Barts and The London in 2000? What was the focus of your PhD research? I hadn’t actually intended to do any research but I was advised by the then Professor of Surgery Norman Williams that I was going to do a year’s research and this was in an era where if the Professor of Surgery advised you to do a year of research, you were doing a year of research! Studying patients with chronic constipation was an ongoing area that our department was involved in with the academic Department of Neurology and I was assigned to that project. It went very well, and I ended up getting a grant to continue that one year into a three-year PhD from the Royal College of Surgeons of England and I’ve basically gone with the flow ever since. I’ve been at Barts on and off ever since I completed my PhD and I have lived in Whitechapel for thirty years, so I am a long-standing resident of the immediate area.
You wear many hats, such as Professor of Surgery and Deputy Director of Research at the School of Medicine and Dentistry and Director of the National Bowel Research Centre. What other roles do you currently juggle and if you had to choose a favourite, what would it be and why? The hat I have worn the longest is being a surgeon, followed by my research hat, the latter in terms of leading my own projects, and more recently, directing research in leadership positions. The other hats I now wear are as a semi-professional musician. I have also been recruited as the lead for colorectal at the new Cleveland Clinic London which will be opening next year behind Buckingham Palace. In addition, I have a son, daughter, two Labradors and a cat!
I am going to rephrase your question as ‘which of these hats would I leave first?’. I’m 52 now and operating is a relatively young man’s game; with everything else that I’m doing, maybe at 55 I will start to think about winding up operating. The problem with operating is that you’ve got to do enough of it to keep your skills up so you can’t just keep reducing it, there comes a point where you have to stop it entirely. Having said that, I will continue to see patients and hopefully offer my wisdom on diagnosis and treatment beyond this point.
How has surgery changed since you first started out in your career? The obvious change in my speciality has been the advent of laparoscopy; this started when I was a medical student and is now well established and used in a large number of abdominal operations. I made a conscious decision a decade ago that I wouldn’t go down the line of being an expert in either laparoscopic or robotic surgery. This was partly because my sub-speciality has a lot of operations that don’t naturally involve laparoscopy but also because everyone else seems to want to do it - there is still a space for people who are experts in operations outside of laparoscopy. I also gave up endoscopy more than five years ago because again, if you don’t do enough of it, you can’t keep your skills up. Research doesn’t have a discreet end point so I won't be able to walk away from any of my current projects any time soon, and I can’t easily hand them over to anyone else.
What are your main research and clinical interests? What projects are you working on now? My clinical interests overlap with my research interests to a large extent; both involve the management of common functional conditions like chronic constipation and faecal incontinence which are very common bowel symptoms amongst the population. I am also an expert on rare diseases that affect the nerves and muscles of the gut; from a therapy perspective, my main research interests are in neuromodulation which uses electricity to treat the nervous system to treat the bowel, and now in cell therapies (regenerative medicine).
An exciting ongoing project is with Oxford University and the University of Antwerp where we are developing a new generation of neurostimulators to use for some of the above conditions. The other major trial that I am part of is the EU-funded study across seven countries in Europe led by University College Hospital and Queen Mary. I am the Clinical Lead for this study and as an Honorary Professor at UCL, with both my UCL and Queen Mary hats on, this is another very exciting study which will develop anchored cells on microparticles to help with the treatment of women with incontinence.
What advice you would give to current students or recent graduates considering their career options? Medical students should take solace in the fact that perhaps uniquely amongst all other graduates, they have a protected career ahead of them in these difficult times. I am confident that medicine and surgery will remain after Covid, people will still get ill and medical professionals will still be needed to treat them. One thing that Covid has highlighted however, is the necessity to have good people going into areas like Public Health and Global Health; my daughter is currently reading Global Health at Queen Mary.
The NHS has received a nationwide boost from the public since the start of Covid but the downside of Covid is the inability to travel so I feel very sorry for the medical students of this year, particularly in relation to their electives and their future opportunities to travel to other parts of the world to study and work what with the combination of Covid and Brexit. I want to let them know that they have my full sympathy.
Back in April we featured you in our Togetherness campaign for your amazing contribution to the fight against COVID-19. Not only did you help recruit more than 200 medical students to work on the frontline in London, you also penned a charity single to acknowledge the bravery of NHS staff and other key workers. How did you discover your love of country music and your talent as a country singer? I have been playing the guitar since I was at school and growing up, I mainly played in rock bands – punk, new wave, all sorts. My country music phase has now ended. The artist formerly known as Charlie Knowles, the country musician recording in LA, has been replaced by the artist Charlie James, a UK singer songwriter. This is not because my country music was met with an unfavourable reception, but because my new manager, Nick Tauber, former producer for Thin Lizzy, Marillion and Toyah Willcox, felt that a departure from country music would benefit authenticity. Nick is right, I don’t drive a truck or ride a horse or even live in Nashville. So, I’ve changed direction and I have now recorded half an album which has an acoustic feel, and might be best described as a British version of Paul Simon. It is lyrically strong and sits somewhere on the border of folk, Americana and rock. The plan is to launch Charlie James as an artist and to try and get a record and publishing deal on this basis.
What inspires your song writing? In general, life experiences (often bad life experiences) are the best thing to write about. One of the advantages of being 52 is that I’ve had many such experiences! Experiences can be amplified or modified - “based on a true story as Hollywood would say” - into a song and these are often the best songs because they are authentic - as Hank Williams said, you get a hit record when people can hear your song and think it is about them. That noted, I have also written some more abstract, David Bowie style ideas! I don’t have an exact formula, but to date, I have written about seventy songs and I usually find the time to write or rehearse most evenings.
How do people react when they find out about your singer-songwriter career given your day job as a Surgeon (amongst many other roles)? I have only ever received a positive response so far. In many ways being a successful singer-songwriter is no different from being a successful Surgeon; there are common skills to both. However, part of the reason to rebrand as Charlie James is to provide some separation between both. I don’t want to be known as the ‘singing surgeon’ from a music credibility point of view.
Coronavirus is having a huge impact on the performing arts. Has your music been affected in any way? Live performances have been the main problem; I was performing gigs almost weekly before Covid, but I haven’t performed a gig since February. However, I’m not going to sit here and moan about my position when I’ve got friends who I’ve played with in bands who are living in hostels and who have no source of income. It’s awful. Fortunately for me, we managed to get recording done and move other aspects of my music forward and I can continue with my song writing, but for those musicians involved in live music, it has been terrible.
Thinking back to live performances, what stands out to you as one of your favourite musical experiences, both as a performing artist and an act you have seen live? As a performer I will never forget playing at Ipanema Beach in Rio de Janeiro in front of thousands of people with a local blues band in 1992. In terms of other peoples’ performances, The Stranglers, Ian Dury and the Blockheads and the Boomtown Rats stand out as memorable performances. My biggest musical regrets were never seeing Queen or Thin Lizzy perform live and only watching Live Aid on the television. My most surprising gig was when I saw rap artist Gil Scott-Heron play at Camden; it wasn’t music that I’d normally listen to, but it was so good I bought a ticket for the following night.
Throughout my music career, another thing I have enjoyed is the variety of people I have been fortunate enough to meet. Once when I was in Chicago me and a friend were having a drink in a music venue and Buddy Guy got up to play and then came and sat at our table afterwards and we had a few beers and chatted. I have had some great moments.
What was so special about your time at Barts and The London as a student? And what has been so special about your time as a member of staff? I was at the London Hospital Medical College as it was back then, and the great thing was that we lived in the community we would serve in the future because the medical school was so well integrated with the Royal London Hospital and the East End. I used to box at one of the clubs on Cable Street, we drank in the local pubs. We had a good time; it was as simple as that. In my last year four of us lived in a decrepit house with an outside toilet and we had a fantastic time, it was so cheap. I feel sorry for students now, they just don’t have that experience and rent is so expensive.
In terms of the hospital, when I qualified, we worked the long days that people worked back then, but we had camaraderie and teamwork with nurses, we knew all the staff on a ward and we all socialised outside of work. I am afraid that too has now gone along with the hospital swimming pool, squash and tennis courts and social club. We are now spread across multiple wards with rotating staff and no one can afford to live near the hospital. The destruction of the team is the single biggest disaster for the NHS in my opinion.
What has been the most memorable highlight in your medical career to date? Probably passing the FRCS exams. The old exam had such a low pass rate, part I was about 20% and parts II about 30%. I am one of the few very lucky people to have got through these exams first time, particularly part one which was the anatomy, physiology, pathology one – it was a nightmare exam, everybody hated it. It was such a relief to get through it first time, we were drunk for a day afterwards!
When I got my chair was another career highlight, otherwise, it is always good when your research paper lands in a journal like The Lancet.
If you could sum up our Barts and The London community in three words what would you say? Inclusive, relaxed and grounded.
Do you keep in touch with any members of your year group? There are a few that work at the London and then a few I have kept in touch with as friends over the years, some who are dispersed as far afield as Australia.
This profile was conducted by Alumni Engagement Officer, Nicole Brownfield. If you would like to get in touch with Charles or engage him in your work, please contact Nicole at firstname.lastname@example.org.