 RCSEd Council Member and Honorary Librarian
Tony, as Alexander Gunn was always known, was educated at the Edinburgh Academy where he was recognised as a keen and gifted sportsman, particularly in golf, tennis and squash. He entered the medical school of Edinburgh University in October 1945 and graduated MB, Ch.B in 1950.
After several junior hospital posts he served his two years of National Service as the regimental medical officer with the Green Howards in Colchester and Egypt. On his return to civilian life he worked in surgical training posts and became a fellow of the Royal College of Surgeons Edinburgh in 1955.
After further surgical training at the Royal Infirmary and Western General hospitals he was appointed Consultant Surgeon to Bangour General hospital in 1964 and remained in that post until he retired in July, 1988.
In 1966, he was awarded the degree of Ch.M for his thesis on carcinoma of the colon.
Tony was very much involved in research during his time at Bangour. In one study he compared the early removal of the gall bladder with delayed removal in patients with acute cholecystitis, using punch feature cards to analyse the data. But his most important research works were in surgical audit and computer-aided diagnosis. Tony, with others, was a pioneer in the use of surgical audit and showed it to be a valuable tool in the quality of patient care.
Since the late 1940s surgical units in the Lothian Health Board had held Saturday morning meetings in which they took turns to reveal and discuss their clinical management, morbidity, and the mortality of the patients in the unit since their last meeting. However, it proved difficult to compare one unit with another.
In the mid-1970s the Lothian Health Board, with a grant from the Scottish Home and Health Department, established the Lothian Surgical Audit with a small committee of four. Tony, who already had experience of surgical audit at Bangour, was one of the four.
The committee published its report on the First Five Years (1979-1984) in 1985. It proved that clinical care evaluation could be sustained over a long period by surgeons working in a large health authority and that it could produce unexpected benefits.
Computer-aided diagnosis in patients with acute abdominal pain was preceded by a study Tony carried out in the early 1970s before computers were available.
The clinical findings in patients referred to the Accident and Emergency department at Bangour with acute abdominal pain were scrupulously entered onto a structured one-page record by the A&E doctor. The information on the card was later compared with the final diagnosis.
When desktop computers became available, the information on the card was fed into the computer and its response was compared with inputted data, hopefully enhancing the accuracy of diagnosis.
It proved to be useful with Tony’s enthusiasm, hard work and punctilious supervision when others were entering information on to the card, but other hospitals didn’t find it valuable and it ceased to be used at Bangour after Tony retired.
Tony was very much involved in the work of the Royal College of Surgeons, Edinburgh. He was a council member from 1975 to 1985; the honorary librarian from 1985 to 1998 (the 50th person to hold this position, which ceased after Tony’s tenure) and joint founding secretary of the Senior Fellows’ Club from 1991 until 2002. He was appointed the college’s Syme Professor for the year 1987 for his review of some 20,000 patients with abdominal pain and gave the lecture entitled Computer Aided Diagnosis at the college’s autumn meeting in Leicester.
He was also presented with the Farquharson Award in 1966 and the College Medal in 2006 for outstanding contributions to the college and to surgery.
One of Tony’s non-surgical contributions to the college was in 1991 when he led a team that presented a large college exhibition, which was open to the public.
They visited in their thousands, commemorating the life and work of the college architect William Henry Playfair who was, of course, also responsible for many of the other fine buildings in Edinburgh.
A video was made of the exhibition and Tony provided a memorable voiceover for it.
Tony was an excellent teacher of anatomy and surgery, not only to undergraduate medical students but also to medical graduates who came from many countries, particularly India, Pakistan, Egypt, Australia and the UK seeking to pass the primary fellowship examination and, if successful, the second part later. In the 1950s and early 1960s Tony and colleagues organised extramural courses for the primary fellowship. Tony taught anatomy and the colleague physiology and a pathologist soon joined the team.
The lectures were given in the evening and were very successful. The lecturers gave up these courses when they became consultants but continued teaching on courses organised by the college and university.
Tony was one of these people who had the facility for communicating his thoughts, ideas and knowledge clearly both orally and in writing.
He was the author of no fewer than 57 articles and with others of several chapters in surgical textbooks. He was also on the editorial board of the British Journal of Surgery.
Tony was a keen gardener; he was known to put one of his roses in his lapel when leaving home to drive to Bangour – when he arrived he transferred the rose from his lapel to a test tube on his desk.
He and his wife Dorothy moved to Yetholm in 1985 into a house called The Wickets, the name chosen by the previous owners who were mad on cricket, especially Test matches.
Many of us remember the Gunns’ wonderful hospitality and the pleasure of sitting in their beautiful garden with its view of the Cheviot Hills. He was session clerk at the London Road Church of Scotland from 1967 to 1973 and he is still very fondly remembered by many at the church for all that he did with them.
Tony became a member of Bruntsfield Links Golfing Society in 1979 and he was also a member of Minto Golf Club. He retained his golfing abilities, particularly his long drives, until he was forced by illness to give up the game.
Sadly, Tony’s final years were shadowed by illness, but he was always surrounded by loving care. Dorothy and one son predeceased him. He is survived by three daughters and a son and eight grandchildren.
Jack Newsam FRCSEd
First published in The Scotsman on 1 May 2010.
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