Address given by the Archbishop of Canterbury, St Paul's Cathedral

'The past is a foreign country,' wrote the novelist L. P. Hartley. 'They do things differently there.' Well, anyone looking back over the history of surgery can be forgiven for breathing a heartfelt and grateful 'amen.'

Consider this story. In 1873 the Victorian man of letters W. E. Henley travelled hundreds of painful miles from Margate to Edinburgh to put himself at the mercy of his last hope -- Joseph Lister, Chief Surgeon at the Old Infirmary. Five years earlier, Henley's left leg had been amputated below the knee as a result of tubercular arthritis. Now his right leg was threatened as well.

As Henley's biographer puts it: 'The surgeons hovered near, anxious to use their knives.' Such was medical knowledge at the time that doctors had little to prescribe against infection other than salt water and sea air. But Lister was developing his antiseptic system and Henley was fortunate. 'It was a desperate business', Henley wrote later, 'but Lister saved my foot.'

Seventy years before that act of advanced medicine -- as it indeed was at the time -- the Royal College of Surgeons was born from the Company of Surgeons, which itself had developed out of the Company of Barber-Surgeons and London's motley schools of surgery, which ranged from the dubious to the dedicated. Barber-Surgeons! It certainly gives one pause, to realise that removing a sideburn and amputating a leg could once have been viewed as parallel skills.

I don't know whether you rate Archbishops as dubious or dedicated, but the fact remains that for centuries the Archbishop of Canterbury was the principal medical licensing authority in England. The Library at Lambeth Palace holds the records of thousands of licenses for practice in medicine, surgery and midwifery granted between 1536 and 1775. Unusually for the time, the Archbishop of Canterbury extended his license to women and as early as 1613 women were practising as surgeons in this land. You may be relieved to hear that it is not a power that I have sought to exercise -- for men or women…

Of course, this combination of medical science and religious authority could cause conflict at times. Sir James Simpson, who developed the use of chloroform, was told that it was sinful to take away the pangs of childbirth, because did not God say to Eve in the Book of Genesis, 'In sorrow thou shalt bring forth children'? But Sir James was up to the challenge. He answered his critics by quoting from the same passage of scripture that God put Adam into a deep sleep before extracting his rib -- the 'first example,' he said, 'of surgical anaesthesia on record.' It was an inspired riposte for which millions have been deeply grateful.

Gratitude and celebration are very much the focus for our presence here this evening. Gratitude for the remarkable advances in medical science over the last two hundred years. Celebration of all that the Royal College of Surgeons has contributed and made possible since its foundation. As Archbishop of Canterbury I am honoured to salute you and your members, past and present.

There are perhaps two aspects to our celebration. First, we celebrate what has changed: we now take for granted surgical sophistication of a kind the founders of the College could hardly have imagined. As a result, so many more lives can be saved, and the quality of life can be transformed.

But, second, we also celebrate what has remained the same. As in the past, surgeons today require remarkable qualities: among them, a cool head, a steely nerve and extraordinary dexterity. As Henry Bockenham of Norwich remarked way back in 1650: 'A surgeon's brains are to be looked for in his fingers' ends.'

The science of surgery may change but many of the key attributes of the surgeon do not. That is why we celebrate and honour above all the moral vision that has always shaped the best medical practice. It is expressed in many different ways. In the dedication of years of training to heal the hurt of others. In the selfless and exhausting hours spent in actually caring for the sick. In the compassion shown for those who are vulnerable and in need. In short, in a commitment to live life for other people, rather than simply for oneself.

Central to today's celebration is the remarkable figure of Sir Astley Paston Cooper, who in many ways exemplifies the skills and virtues of the surgeon. Cooper was the fourth son of a country parson, but initially his father did not have a high regard for him and indeed called him a 'sad rogue'. But rogue he certainly was not. At the age of 16 he was determined to become a surgeon, and studied intensely at Guy's Hospital to achieve his goal. Cooper's workload as a surgeon was legendary. He rarely returned home before midnight and then he would usually wake his laboratory assistant at four or five o'clock in the morning. He used to say that a 'day spent without dissections was a day lost!' He has been described as 'the father of vascular surgery', and his techniques and inventions decisively pushed medical knowledge forward. His pre-eminence was recognised by the Royal College of Surgeons, who elected him President not once but twice. Despite his great achievements, however, Cooper remained a modest and humble man.

Now, dedication and skill like that don't just happen. They are no accident. They arise from a vision, a vision worth working for. In short, Sir Astley saw his work as a vocation -- not just a job, but a call to service.

There are many reasons, therefore, why it is natural and fitting that in this great church we celebrate the vocation of the surgeon. It is a vocation in which you can take justified pride, and one that I hope will continue to attract and inspire generations to come. We must do all we can to encourage those with the necessary talents and skills to devote themselves to medicine and the other caring professions. At moments like this, in the wake of yesterday's train derailment in Hertfordshire, that message is a specially persuasive one. We grieve for the victims and those bereaved in this terrible tragedy-they are in our thoughts and prayers. So too is everyone involved in tending and caring for those in need of help and treatment. Let us pay grateful tribute to the professionalism, skill and selfless devotion so calmly displayed-from the rescue teams at the scene-to the surgeons, doctors, nurses and medical staff in the hospitals. You have made us more aware than ever of the debt we all owe you.

In a society where self-gratification and the cult of the individual are all too prevalent, we must challenge and encourage our young people with the message that true fulfilment and self-worth come from the service of others. Yes, you may be able to earn more elsewhere, and sometimes for less effort than in many of the caring professions, but the rewards of true service are beyond such calculations. It is a message which governments and political parties, and we as voters and taxpayers, need to share and promote for the common good.

And it is precisely because the vocation of the surgeon that we celebrate here is such a great calling that it is so painful when there is a falling short. I am not talking now about the inevitable but still heart-breaking cases in which, for all the committed deployment of the surgeon's skill, the outcome is unfavourable. Sadly that is always possible. After all, surgeons work in the most demanding and pressurised situations imaginable. They operate at the frontiers of human existence, at the boundaries between life and death and at the limits of what humans know and what they can achieve.

That is part of the reason we honour and admire them -- even hold them in awe. But that makes the gift of humility all the more vital. And there have been well-publicised occasions in recent times when it seems to have been lacking.

At such times, public confidence can drain away and professional morale can plummet.

There is no doubt that patients need surgeons, but surgeons undoubtedly need the trust and confidence of those they seek to serve.

Recent events have made that painfully, crystal clear. But they also provide an opportunity to consolidate that essential contract between public, practitioner and patient on a more secure basis.

How can that be done? Clearly full public confidence must be a priority -- and one that the Royal College is already playing an important role in meeting. Openness and accountability are important. It must be recognised that we live in a society where people are no longer prepared to doff their cap towards authority in any walk of life - including, I may say, my own! Respect has to be earned and in many ways that is quite right. Anything that smacks of arrogance or high-handedness is unlikely to be productive.

The challenge facing this great College, I suggest, is to move into the future with a proper and stabilising sense of pride and confidence in its great and distinguished history, allied to a commitment to adapt and revitalise that tradition in the face of new demands and expectations.

It is a challenge to which I am sure you are equal, as you have indeed been equal to so many challenges over the last 200 years.

For many surgeons down the centuries and still today, their vocation has been rooted in a profound, often religious, vision of human life. This vision is expressed so beautifully in the readings we have heard this evening. It is a vision of the nature and purpose of human life that fosters a sense of humility before God, as the source of life and the giver of all human endowments. It is a vision that also inspires the kind of compassion towards the sufferings of one's neighbour immortalised in the story of the Good Samaritan.

Humility and compassion are two of the hallmarks of great healers. And wherever they exist we give thanks for them. They are glorious signs of the presence in this world of the God who in his healing love embraces the sufferings of humanity -- and who invites us to be the channels through whom that love is extended.

For those of us who are Christians there is a recognition that in serving others our work is patterned on Christ's loving care for others, on the humility to care for our neighbour in distress. Not for nothing did T. S. Eliot turn to surgery as a metaphor for God's deep involvement with humanity:

The wounded surgeon plies the steel
That questions the distempered part;
Beneath the bleeding hands we feel
The sharp compassion of the healer's art
Resolving the enigma of the fever chart.

Of course the human healer's art continues to develop thanks to rapid advances in medical research and technology. As it does so, profound moral and ethical questions have to be confronted about how we use what we know, especially when it affects our understanding of the fundamentals of human existence -- our beginning and our end. Surgeons of course cannot escape such dilemmas or their consequences. The case of the twins Mary and Jodie is evidence enough of that. In all of these issues -- from embryo research to the treatment of patients in a death-like state -- the same virtues of humility and compassion must be our constant guide. For they can surely help us plot a course between what we can do and what we should do, and they can help us use aright the extraordinary gifts God has bestowed upon us.

Then, finally, there will be a need for humility in the face of death itself. However far our skills develop in prolonging and improving the quality of human life, death still circumscribes us all and may appear to frustrate all our work. Death consigns us to futility unless we have reason to believe that it is not the ultimate word on our human story. And that for Christians is central to our faith. Indeed, this great Cathedral is a standing witness to the enduring qualities of faith in a Risen Lord who reassured his followers: 'In my Father's house are many mansions.' That faith has undergirded the lives and work of many thousands of doctors and surgeons. It speaks of values that transcend us and give us hope. It speaks of that eternal life which gives meaning to today.

And so, as we look forward, we must nourish the well-springs of hope. Not a naïve and shallow optimism based on human pride and human expectation. But a profound, joyous and transcendent hope which shapes our vision for the future. A hope which, combined with its sisters compassion and humility, so clearly inspired the pioneers of your great profession, your noble calling and vocation.

It is not for nothing, then, that this anniversary celebration is taking place on the day on which we honour St Luke, the beloved physician, the Patron Saint of surgeons, doctors and nurses. For Luke epitomises these great virtues which continue to stand the test of time. Thus Paul Wigmore's hymn, specially composed for today, sets before us the grandeur of your vocation and challenges your noble College to reach forward in hope:

Compassion our guide
And healing our aim,
Our God at our side
Our work in his name.