ACNR - Neurovoices

In this episode of ACNR’s Neurovoices podcast, Co-Editor-in-Chief Dr Ann Donnelly speaks to consultant neurologist and author Dr Orlando Swayne about his book, How to Use a Fork: Stories of Mending the Broken Brain.

Drawing on the experiences of people recovering from stroke and other acquired brain injuries, the book combines patient stories with the science of neuroplasticity and the practical realities of neurorehabilitation. Orlando explains why recovery does not necessarily stop after six months, how intensive multidisciplinary rehabilitation can help people rebuild skills and independence, and why access to appropriate services remains so uneven.

The conversation also explores the importance of skilled therapists alongside new technology, the neurologist’s role within the rehabilitation team, and the value of understanding complex cognitive problems such as neglect, inattention and apraxia. Orlando discusses the ethical challenges of writing about patients, his transition from clinical to more lyrical writing, and why neurologists often make such compelling storytellers.

This episode offers a thoughtful and hopeful exploration of what neurorehabilitation can make possible - and why the “neuro” should remain at its heart.

Dr Orlando Swayne, MA (Cantab), MB BS, MRCP (Neurol), PhD

Orlando Swayne is a consultant neurologist who works primarily in the neurorehabilitation of acquired brain injury, including stroke, but who also has a wide general neurology practice. He is a consultant neurologist at the National Hospital for Neurology and Neurosurgery (NHNN), where he is lead neurologist for the Neurorehabilitation Unit, and is a member of the Department of Brain Repair and Rehabilitation at the UCL Institute of Neurology. He also works at Northwick Park Hospital and the Wellington Hospital.

He has published widely on the control of movement by the brain and the role of brain plasticity in recovery following stroke.

His book, How to Use a Fork, brings together the science of brain plasticity with deeply human stories of survival, adaptation and recovery.

• • Orlando Swayne’s UCLH profile
  • Orlando Swayne’s ACNR author profile

Key Discussion Points / Timestamps:

00:00 – Introduction: Ann Donnelly introduces Orlando Swayne and How to Use a Fork.

01:55 – Why write this book? The privilege of getting to know patients during prolonged inpatient rehabilitation and following their recovery journeys.

04:30 – The rehabilitation gap: Increasing scientific understanding of recovery contrasted with patchy and declining access to rehabilitation, particularly in the community.

07:30 – Technology versus the fundamentals of rehabilitation: Why robotics and other innovations can be valuable but cannot replace skilled therapists and multidisciplinary care.

10:00 – Explaining a complex specialty: Using patient stories to communicate the medical, cognitive, psychological, family and social dimensions of neurological recovery.

11:26 – Writing about patients ethically: Consent, confidentiality and the use of composite characters based on several clinical experiences.

12:56 – Reconnecting with former patients: What Orlando learnt from meeting people years later—and why recovery does not simply stop at six months.

15:31 – From clinical letters to lyrical writing: What can be lost when patients’ stories are reduced to bullet points, and the influence of neurologist-writers such as Oliver Sacks.

17:48 – Why neurologists make good writers: The importance of close observation and noticing movement, speech, behaviour and the whole person.

19:40 – Writing How to Use a Fork: Orlando’s six-month break from clinical work, his disciplined writing routine and the benefits of stepping off the medical treadmill.

21:51 – Teaching through stories and metaphors: Making complicated neuroscience understandable, accessible and memorable.

23:13 – Neurorehabilitation in medical training: Why every neurologist needs to understand chronic neurodisability, regardless of subspecialty.

26:35 – Keeping the “neuro” in neurorehabilitation: The essential contribution of neurology, rehabilitation medicine, neuropsychiatry and the wider multidisciplinary team.

28:22 – The art and science of recovery: Supporting diagnosis, prognosis and clinical coordination while recognising the central contribution of therapists.

30:52 – Why choose neurorehabilitation? The fulfilment that comes from working closely with patients, families and an expert multidisciplinary team.

31:39 – Closing thoughts.

Resources & Links:

• How to Use a Fork: Stories of Mending the Broken Brain by Orlando Swayne – book information and purchasing options
• How to Use a Fork - Stories of Mending the Broken Brain | ACNR book review
• ACNR’s Neurovoices podcast
• Explore ACNR’s open-access content
• Join the ACNR online community

If you enjoyed this episode, follow ACNR’s Neurovoices podcast and share it with colleagues.

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The UK faces a major neurology workforce challenge. But how do we develop the clinical and academic leaders needed to build services for the future?

In this episode of Neurovoices, ACNR Publisher Rachael Hansford speaks with Neil Robertson, President of the Association of British Neurologists, about the workforce pressures facing UK neurology and how ABN clinical fellowships aim to support the next generation of leaders.

The ABN workforce report highlights the scale of the challenge facing neurology services. The UK currently has around 1.6 whole-time equivalent consultant neurologists per 100,000 population, far below the European average. But the issue is not simply one of numbers: modern neurology services are increasingly complex, multidisciplinary, and shaped by rapidly advancing therapies.

In this conversation, Professor Robertson explains why reliable workforce data has been difficult to obtain, why counting whole-time equivalents rather than headcount is critical for service planning, and how the ABN hopes improved data will support stronger business cases for neurology services across the UK.

The discussion also explores wider issues affecting the specialty, including:

• increasing consultant workload and changing working patterns
• the growing importance of multidisciplinary teams in neurological care
• the decline in academic neurology and higher research degrees
• the challenge of fitting subspecialisation into a shortened training curriculum

Against this backdrop, ABN clinical fellowships are designed to identify and support talented clinicians early in their careers, helping to develop the academic, clinical and leadership skills needed to shape the future of neurology.

As Professor Robertson notes, some of the most successful neurological services have been built by individual clinicians who combine patient advocacy with system leadership. These fellowships aim to nurture exactly those future “enthusiologists” - clinicians who will champion better neurological services for patients in the years ahead.

Host: Rachael Hansford

Guests: Dr Amy Ross Russell and Dr Rhian Raftopoulos

Length: Approx. 41 minutes

In this follow-up to their 2020 article for ACNR, Dr Amy Ross Russell (Southampton and Queen Square) and Dr Rhian Raftopoulos (King’s College Hospital) reflect on their experiences of working less than full time (LTFT) through training and into consultancy. They revisit the personal, professional, and systemic changes that have shaped flexible working in neurology – and offer practical insights for anyone considering or navigating LTFT working.

Topics include the rise in LTFT working, gender disparities, rota challenges, work-life boundaries, email overload, and the emotional tension of wearing dual hats as clinician and parent. Both clinicians share honest advice, useful statistics, and compassionate perspectives on building a sustainable career in neurology.

Dr Amy Ross Russell is a new consultant neurologist in Southampton and at Queen Square, London, with a strong interest in supporting flexible working.

Dr Rhian Raftopoulos is a consultant neurologist at King’s College Hospital, London, specialising in neuroinflammatory disorders. She has worked less than full time since 2017.

00:00 – Introductions and background to the episode

01:41 – Has LTFT working increased since 2018?

03:59 – Is flexible working still gender-skewed?

04:43 – Reasons for going LTFT and expectations at the time

07:00 – Policy changes: no longer needing a reason to go LTFT

07:46 – Key challenges of LTFT training and consultancy

12:20 – Did LTFT really help work-life balance?

14:03 – Specialty differences and the male perspective

17:00 – Role of partners and importance of reliable childcare

21:06 – Changing perceptions: how colleagues view LTFT now

26:01 – Has consultancy made flexible working easier?

29:02 – Practical advice for choosing working patterns

31:39 – Consultant responsibilities and workload realities

31:47 – Final advice for trainees: know your rights, be kind to yourself

36:40 – Would they choose LTFT again? (spoiler: yes!)

37:00 – Has it changed how they mentor?

39:33 – The future of medical work: toward flexibility for all

• Original 2020 ACNR article: “Working less than full time”
• ABN workforce census (2020)
• BMA: Flexible Training Guidance
• Join the ACNR forums to discuss this episode

Host & Producer: Rachael Hansford

Podcast by: ACNR – Advancing Clinical Neuroscience & Rehabilitation

Visit: www.acnr.co.uk

Host: Rachael Hansford, ACNR Publisher

Guest: Professor Guy Leschziner

Episode Length: Approximately 29 minutes

Publication Date: 7 July 2025

Professor Guy Leschziner, a leading figure in sleep medicine, discusses the evolving landscape of sleep-related disorders. Despite increased awareness and research linking sleep to various neurological conditions, there remains a lack of comprehensive training in this field for medical professionals. Leschziner highlights the importance of proper diagnosis and judicious referrals to sleep clinics, emphasizing that excessive daytime sleepiness can often indicate an underlying issue beyond insomnia. He notes the positive trend of growing interest and multidisciplinary involvement in sleep medicine, while also advocating for a more holistic approach to patient care within the current healthcare system constraints.

This podcast provides valuable insights for neurologists, sleep medicine practitioners, and healthcare professionals interested in understanding the current landscape and future directions of sleep medicine.

Professor Guy Leschziner is a Professor of Neurology and Sleep Medicine at Guy's and St. Thomas' Hospital, working between the Department of Neurology and the Sleep Disorder Centre. He is a recognised expert in sleep medicine and author of multiple books on the subject, including "The Nocturnal Brain" and his latest work "Seven Deadly Sins: The Biology of Being Human."

• [00:01-00:30] Introduction and Professor Leschziner's role at Guy's and St. Thomas'

• [00:30-01:25] ABN conference talk on managing sleep disorders for general neurologists
• [01:37-02:33] Lack of sleep medicine training in medical education historically
• [02:17] Growing research appreciation for sleep's importance in neurological health

• [02:45-03:38] Diagnostic approaches for different sleep disorders (insomnia, narcolepsy, parasomnias)
• [03:45-05:52] When GPs should refer patients to sleep clinics
• [04:29] Key warning sign: "If somebody is excessively sleepy during the day"

• [06:13-08:47] Changes in neurological awareness of sleep medicine over recent years
• [07:23] Sleep medicine now recognised as multidisciplinary field
• [10:23-11:03] Coverage of sleep topics in medical conferences

• [08:55-10:14] Professor Leschziner's path into sleep medicine

• [11:03-12:45] Holistic patient evaluation and the need for adequate consultation time
• [12:56-14:20] Patient collaboration in research and public engagement

• [14:31-16:15] Changes in consultation models (remote vs. face-to-face)
• [16:24-17:58] Increased referrals for post-viral fatigue and Long COVID-related sleep disturbances

• [18:13-19:47] Genetic determinants of sleep patterns and disorders
• [18:32] Genetics influence chronotype, sleep requirements, and disease risk
• [19:00] Gene-environment interactions in sleep disorders

• [19:47-21:46] Benefits and limitations of sleep tracking devices
• [20:12] Caution against sleep trackers for insomnia patients
• [21:09] Value of objective sleep data in longitudinal research studies

• [22:06-23:45] Closed-loop auditory stimulation and sleep architecture manipulation
• [23:08-24:26] Revolutionary new treatments for narcolepsy using hypocretin/orexin agonists
• [24:14-24:18] Timeline: "Within the next three to five years"

• [24:41-28:11] Comprehensive overview of sleep clinic diagnostic approach
• [25:02] Three main categories: insomnia, hypersomnia, and parasomnias
• [27:33] Various diagnostic tests including MSLT (Multiple Sleep Latency Test)

• [28:21-29:04] New book: "Seven Deadly Sins: The Biology of Being Human"
• [28:25] Explores neuroscience of behaviour and free will through patient stories

• "Sleep intersects with pretty much every aspect of neurology" - [11:03]
• "We are slaves to our genes, but we're also slaves to our environment" - [19:32]
• "We are very poor witnesses to our own sleep" - [21:20]

1. Training Gap: Significant lack of sleep medicine education in medical training despite its importance
2. Referral Criteria: Excessive daytime sleepiness is a key indicator that distinguishes other sleep disorders from insomnia
3. Multidisciplinary Growth: Sleep medicine has evolved from respiratory-physician-only field to multidisciplinary specialty
4. Technology Caution: Sleep trackers can be counterproductive for insomnia patients
5. Future Treatments: Hypocretin/orexin agonists may revolutionize narcolepsy treatment within 3-5 years

• ABN (Association of British Neurologists) Sleep Specialist Interest Group
• ACNR Sleep Series articles (since 2016), edited by Kirsty Anderson
• Professor Leschziner's books: "The Nocturnal Brain" and "Seven Deadly Sins"

ACNR (Advances in Clinical Neuroscience & Rehabilitation)

• Website: ACNR.co.uk
• Online Community: forums.acnr.co.uk
• Social Media: Follow @ACNR on LinkedIn, X, Facebook, Instagram

Duration: 15 minutes

 Guests: Richard Davenport (Outgoing President, ABN) and Neil Robertson (Incoming President, ABN)

 Host: Rachael Hansford, ACNR

 Recorded at: ABN Annual Conference, Liverpool, May 2025

In this handover conversation, recorded live at the ABN’s 2025 Annual Conference in Liverpool, outgoing president Richard Davenport sits down with incoming president Neil Robertson to reflect on a turbulent but transformative few years for the Association of British Neurologists.

Together, they discuss:

• The unexpected financial and staffing challenges tackled during Richard’s term
• The role of the ABN office and the impact of appointing a new Executive Director
• Membership growth and the importance of understanding why 30% of UK neurologists remain outside the organisation
• Securing a long-awaited agreement with official journal Practical Neurology
• The evolving structure of the ABN, and how it can better support its officers and members
• The importance of protecting and promoting academic neurology in the UK

Neil also outlines his priorities as President – from clearer governance and council roles to making ABN membership more accessible, relevant and rewarding.

Whether you're an ABN member or simply interested in the leadership of professional medical organisations, this episode offers a candid and collegial look behind the scenes.

👉 Join the conversation: Continue the discussion with your peers in our online forum at https://forums.acnr.co.uk 

Download the transcript 

In this interview, Sri Kodali speaks to Dr Gordon Plant about his career and what retirement looks like for him. Find a transcript here.

Guest Information

Dr Gordon Terence Plant MA MD FRCP FRCOphth trained in Neurology at the National Hospital, Queen Square, London, in Vision Science supported by the Wellcome Trust in Cambridge and as an MRC Travelling Fellow at the Smith Kettlewell Institute in San Francisco, where he attended clinics with Bill Hoyt. He was appointed consultant to The National, St Thomas’ and Moorfields in 1991. He is a passionate believer in the need for physicians specialising in eye disorders and as Training Programme Director initiated the first Medical Ophthalmology rotation in London.

He retired from clinical practice in 2020 but remains active in research and teaching.

Key Discussion Points:

Early Influences and Scientific Curiosity (1:00-2:00)

• • Dr Plant's initial interest in science, sparked by a love for biology and animals in primary school.
  • The surprising ambition to be a part-time tap dancer!
  • The decision to pursue medical sciences at Cambridge, driven by practical financial considerations rather than purely altruistic motives.

Navigating Physiology and Finding Vision (2:00-4:00)

• • Initial interest in physiology, but disillusionment with animal work.
  • The pivotal connection between physiology and psychology at Cambridge, leading to an interest in human studies and vision science.
  • Key figures like Horace Barlow, Colin Blakemore, and John Robson and their influence on Dr Plant's path.

Combining Neurology, Ophthalmology, and Research (4:00-6:00)

• • Training in neurology while maintaining a focus on vision.
  • Volunteering at Moorfields Eye Hospital to gain experience in ophthalmology.
  • Research on optic neuritis, utilising visual evoked potentials and the then-new pattern ERG.

Overcoming Training Hurdles (6:00-8:00)

• • Challenges in navigating the non-linear training system of the time.
  • Persistence in pursuing opportunities despite setbacks and being "forgotten" after time away.
  • The importance of mentors like Ross Russell in solidifying the decision to combine neurology and vision.

Mentorship and Inspiration (8:00-10:00)

• • The influence of Ross Russell's teaching and approach to problem-solving.
  • Early exposure to fascinating eye cases during an SHO position, reinforcing the potential of combining neurology and vision.
  • Contrasting the surgical focus of ophthalmology at the time with the appeal of a neurological approach.

Early Research Experiences (10:00-11:00)

• • Animal research experience during medical school, contrasting with later preference for human studies.
  • The significance of seizing opportunities and creating one's own path in vision science.

Patient-Led Research and Career Progression (11:00-13:00)

• • The transition from training to consultant and the initial desire to work in America.
  • Securing a research fellowship at the Smith-Kettlewell Institute in San Francisco.

A Transformative Year in San Francisco (13:00-16:00)

• • The stark contrast between the research environment in a private institute versus a university department.
  • The "can-do" attitude and collaborative spirit at the Smith-Kettlewell Institute.
  • Research on motion perception and the challenges of finding patients with specific deficits.

Consultant Life and Continued Research (16:00-17:00)

Interview with Emily Linnemann, Executive Director of the ABN

Host: Rachael Hansford, ACNR Publisher
Guest: Emily Linnemann, Executive Director of the Association of British Neurologists (ABN)

Episode Overview:

In this short interview recorded at the ABN conference in Edinburgh at the end of May, Rachael Hansford interviews Emily Linnemann. Emily has recently taken on the role of Executive Director at the Association of British

Join us for a conversation that explores the future of the ABN, the importance of community, and the impact of climate change on neurological health.