|Professor John Gillingham|
|Thursday, 01 April 2010|
Professor John Gillingham came as a consultant neurosurgeon to Edinburgh in 1950 and then in 1963 succeeded Norman Dott to be the second holder of the Forbes Chair of Surgical Neurology at the University of Edinburgh.
Throughout his clinical life he maintained a strong interest in College affairs and was elected to the Fellowship of the RCSEd in 1953. Earlier, by examination, he had become a Fellow of the Royal College of Surgeons of England.
It is interesting to note that two influential figures in his earlier surgical life had held senior office in the surgical Colleges. Sir James Patterson Ross, with whom he trained at St. Bartholomew’s Hospital in London before coming to Edinburgh, was President of the English College, and Professor Norman Dott, with whom he came to work in Edinburgh in 1950, was Vice President of the Edinburgh College between 1958-62. Gillingham was elected to the Edinburgh College Council in 1972, becoming Vice President from 1976-79 and then President in 1979.
As President of the Edinburgh College he made significant contributions. Not without some resistance, he introduced the specialty surgical fellowships: orthopaedics being the first and neurosurgery second.
The first few years of the Edinburgh Neurosurgical Fellowship exam were perhaps notable for the fact that examiners outnumbered the candidates, but progressively the value of the specialty examinations was realised and became an Intercollegiate Examination, the office for which is still housed in Hill Square behind the College. For the benefit of the College, he had the foresight to develop Hill Square, acquiring the south side and developing the King Khalid Symposium Hall.
He also was influential in establishing the Jules Thorn Historical Museum and indeed encouraged the neurosurgical trainees in his department to become involved through the Henry Wade Fellowships. He received the award of CBE following his Presidency in 1982, having already been awarded an MBE for his Military service. He was made a Fellow of the Royal Society of Edinburgh in 1970.
He was an enthusiastic teacher at all levels. Medical students, postgraduates, neurosurgical trainees and general practitioners all benefited from and enjoyed his lectures and less formal teaching on the wards and in theatre. Trainees were encouraged to undertake research, to be involved in projects and to attend the European Training Courses on which he was a regular teacher.
He was much in demand as a speaker within the UK and overseas. As a consequence, his department attracted many overseas trainees which contributed to the wider education of all within the unit. He had a particular concern for the young; on one occasion putting up in his own home a young house officer who was in difficulties and on another occasion providing accommodation for an overseas trainee with severe financial constraints, thus allowing him to complete his time in Edinburgh.
Many will recall being included at the summer parties at his Ravelston home. He enjoyed a tremendous sense of humour which was evident through his irrepressible smile and twinkle in his eye.
Born in Dorchester on 15 March 1916, he attended Hardye’s School before going on to St. Bartholomew’s Medical School at the University of London from where he graduated in 1939. Here he had won the Gold Medal in gynaecology which created a dilemma; should gynaecology or neurosurgery be his career? This decision was to be made on the toss of a coin: heads neurosurgery, tails gynaecology. Fortunately for neurosurgery it landed heads up.
Having completed his house jobs, he joined the Royal Army Medical Corps and was appointed to the Oxford Military Hospital under the direction of Colonel Hugh Cairns and Group Captain Symonds. Following an 18-month posting in Cairn’s Field Hospital where he gained experience in general military surgery as well in the management of head injury, he was to serve in North Africa and the Italian campaigns.
He gained an enormous experience operating on over 4000 patients before the age of 28. He kept meticulous records of the injuries suffered and the operative procedures. He had hoped to publish his many photographs of this time but sadly they were severely damaged when his house was flooded in 2006. He was a first-rate clinician with a real understanding of the value of life – knowledge that he attributed in part to his war time experience.
After the war he returned to Oxford to work with Sir Hugh Cairns. Here he met Irene ‘Judy’ Jude who he married in 1945, the wedding being organised by Cairns to minimise disruption to the neurosurgical service. A return to St. Bartholomew’s for further training with Sir James Paterson Ross and Mr John O’Connell lead to his appointment as Consultant Neurosurgeon in Edinburgh.
Before the opening of the Department of Surgical Neurology in 1960, neurosurgery in Edinburgh was housed in wards at Bangour Hospital, a First World War EMS Hospital in West Lothian some 16 miles to the west of Edinburgh and in ward 20 (immediately below the clock tower) of the Royal Infirmary at Lauriston Place. The new building at the Western General Hospital in north Edinburgh was designed for a holistic approach to surgical neurology and one of the twin operating theatres (which were, and still are, unique in their design) was specially equipped for his stereotaxic operations.
Head injuries and other neurological trauma continued to be managed at the Royal Infirmary and Gillingham installed possibly one of the first telemedicine links with the help of Scottish Television between the treatment room in ward 20 and his office on the ground floor of the new Department of Surgical Neurology at the Western General Hospital.
An immensely capable general neurosurgeon, he had three principal neurosurgical interests. The first, stemming from his war time experience, was head injury, and particularly its prevention. Campaigning for the introduction of seatbelt legislation, his work being recognised with the Clarke Foundation Award for services to road safety in 1979. The second was his neurovascular surgical interest developed through working with Dott in Edinburgh, who had been the first surgeon to operate directly on an intracranial aneurysm, Gillingham’s contribution was to the understanding of the significance of the sentinel bleed and with prompt treatment its potential to prevent the risk of a second haemorrhage which often had dire consequences.
He also had an interest in cerebral vasospasm and its relevance to the timing of aneurysm surgery. It is of interest that this work was done by direct carotid and vertebral puncture for angiography and before the advent of CT scanning.
His third interest was that of the development and application of stereotactic surgery which was an indirect consequence of Dott’s expertise with aneurysms. Guiot from Paris had visited Edinburgh and subsequently invited Gillingham back to Paris to see him operate, a free hand pallidotomy via a subfrontal craniotomy. Subsequently he adapted Guiot’s stereotactic procedure to an occiptoparietal approach. He developed the Gillingham- Guiot stereotactic frame over time to include a motor drive of the targeting electrode and cellular recording to improve accuracy of lesion making.
Publications in 1960 and later showed impressive results and sustained improvement particularly with tremor and rigidity but less so with the bradykinetic component of Parkinson’s disease. His work attracted international attention and there is a photograph of him performing a second stage stereotactic operation in a National Geographic magazine in 1976.
His reputation lead to him being selected to treat many influential people at home and abroad.
He retired from clinical practice in 1980 a year before his sixty fifth birthday to take up the duties of the Presidency of the College.
Following his presidency he became Professor of Neurosurgery at King Saud University, Saudi Arabia. He remained active into his ninth decade, establishing new contacts in Oxford and editing for the European Journal of Stereotactic Surgery. His contributions to neurosurgery and medical education were recognised by the award of numerous fellowships of colleges and institutions. The most recent of these was the Medal of the Society of British Neurological Surgeons at Magdelen College, Oxford, in May 2009 at which he spoke eloquently and with his customary good humour from his wheelchair.
Family time, although at a premium, was hugely important. The house at Portling on the Solway Firth and later at Javea on the Mediterranean Coast of Spain and his love of sailing his Nantucket Clipper, ‘Persephone’ gave opportunities to enjoy time with his family and regenerate his energy. He is survived by his wife Judy, three of his four sons (tragically, one of his sons, Jeremy, and his wife Anni, both GPs, were killed in an avalanche while skiing) eleven grandchildren and two great grandchildren.
James Steers FRCSEd