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Prof. David Ian Hamilton, FRCS – June 22, 1931–October 6, 2017

Published online by Cambridge University Press:  29 December 2017

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Abstract

Type
Obituary
Copyright
© Cambridge University Press 2017 

David Hamilton was born in Stockton on Tees. His father was brought up as a Quaker and became a civil engineer, specialising in bridge building. David grew up with the teaching that “if a job is worth doing it is worth doing well”, from his father who was a skilled handyman.

At the age of 12, David decided that he wanted to become a surgeon because it would allow him to use the manual skills, learned from his father, with the pursuit of medicine. He was a keen and talented rugby player at school, during National Service in 1949–1951 and during his years as a student at The Middlesex Hospital. He played for the English School’s XV against a French school’s team in April 1949. He was also a regular player of tennis and cricket – being a member of his school first XI for 4 years.

While still at school, he started meeting and “going out with” the daughter of the minister at the Presbyterian Church, which the family attended in London. Their relationship blossomed and lasted for the next 69 years, though he and Myra were not married until he finished his medical student days, at the Middlesex Hospital, in 1957. They would have celebrated their Diamond Wedding in November this year – though Myra pre-deceased David by a few months, in June, 2017.

After graduating and completing his pre-registration year at The Middlesex Hospital, he became an anatomy demonstrator and proceeded to pass the primary FRCS exam at the first attempt before going on to complete the final exam – again at the first attempt – in 1961. His early surgical training included a period of orthopaedic surgery, which he greatly enjoyed, but soon after finishing his FRCS a surgical rotation at The Middlesex saw him doing cardiothoracic surgery with Sir Thomas Holmes Sellors. Sir Thomas tempted him to continue in that area of surgery and he went on to a term at Harefield Hospital, before applying for a senior registrar position in Liverpool, which started in 1965.

Overseas training took him to California where he was a Fellow in Cardiac Surgery at the Presbyterian Medical Center, San Francisco, with Dr Frank Gerbode, between 1966 and 1967. Soon after returning to Liverpool, he was appointed to a newly created full-time post as consultant cardiac surgeon at Broadgreen Hospital in 1968. The team at Broadgreen included Leslie Temple, Ronald Edwards, and John Bickford. In addition to adult cardiothoracic surgical work at Broadgreen, they also ran a surgical unit that had been developed at The Royal Liverpool Children’s Hospital, and it was this work which David became increasingly involved with over the following 20 years, becoming the sole cardiac surgeon at RLCH, Myrtle Street, between 1974 and 1983, when a second surgeon was appointed to assist him there.

His research activities, while in San Francisco, had involved work with tissue valves, and he developed a powerful interest in the use of homograft and heterograft valves. He visited Green Lane Hospital in Auckland in 1969 and was impressed with the work that was being performed by the team there under the direction of Brian (later Sir Brian) Barratt-Boyes with deep hypothermic circulatory arrest. With the senior anaesthetist at RLCH, Dr Gordon Jackson Rees, he developed a technique of “Core Cooling”, which became the standard practice for deep hypothermia in Liverpool and in many other centres, rather than the “surface cooling”, which had been developed in Auckland in the 1960s.

During the early 1970s, he developed a close link with an anatomy lecturer from Manchester University, Dr Robert (Bob) Anderson, who had been spending time in the Institute of Child Health in Liverpool, after completing an MD on the cardiac conduction system. He encouraged Dr Anderson to look at the conducting system in the heart of a patient who had died after repair of an atrioventricular septal defect, having developed heart block. This initiative led Dr Anderson to start studying the conducting system in a range of other cardiac defects and, with other members of the Liverpool team including Dr Robert Arnold, Dr Richard Jones, and Dr Jim Wilkinson, to look in much greater detail at the anatomy of a wide range of abnormalities of the heart. This interest was the foundation of Dr Anderson’s subsequent stellar career, and increasing international fame as a cardiac morphologist, becoming the Professor of Cardiac Morphology at the Brompton Hospital and later at Great Ormond Street.

His time in Liverpool saw the arrival of Prostaglandin as a means of palliation for sick infants with critical CHD and the introduction of two-dimensional echocardiography. Both of these changes brought a huge change to the management and outcomes for affected infants. The introduction of prostaglandin to initial treatment was, he said, the basis of a substantial reduction in his golf handicap, as the need for emergency surgical intervention was greatly reduced!

The success of the team at Myrtle Street over the next decade led to the development of a reputation nationally as one of the premier centres for surgery on CHD in the United Kingdom. Their results were recognised as being among the best in Europe, if not in the world.

He took on many trainees from United Kingdom and from elsewhere in Europe, especially from Poland, where he developed a strong link, travelling thither on many occasions over about 15 years from the late 70s and throughout the 1980s. He became a member of The Polish Association of Paediatrics Surgeons.

In addition, he was a member of the British Association of Paediatrics Surgeons, The British Cardiac Society, and of The Society of Cardiothoracic Surgeons of Great Britain and Ireland, of which he was president in 1993.

In 1986, David was appointed to the Foundation Chair of Cardiac Surgery in Edinburgh. He and Myra moved there in late 1986 and he continued in that position until his retirement in 1993.

His main leisure activities during his later years involved music, which had always been a passion, and golf, which he continued with into retirement. After finishing his period as Professor in Edinburgh, he returned to Merseyside where he and Myra lived in West Kirby, on The Wirral. Soon after this he developed Parkinson’s Disease, which increasingly handicapped him over the years that followed. Despite the impediment of progressive Parkinson’s, he continued with his golfing activities until nearly 80, although increasing health problems eventually led to his requiring care in a nursing home. Sadly, Myra also became incapacitated and joined him in an adjacent room in the same facility, before dying in June, 2017.

David was “A Gentleman” in the best sense of the term. Unassuming and modest by nature, considerate, and supportive of his team, he was a superb example of a thoroughly decent human being. He produced an excellent autobiography entitled “Mission Improbable”, published in 2009 and co-written by his son Alastair. This provides a charming and intimate insight into the man and his life’s work. It was written very much as a memoir for his own family, rather than as a book for an audience beyond close friends and colleagues and his children and grandchildren. It is though a very typical product of a kind and thoughtful man who had no great academic pretensions and was at many times surprised and embarrassed by his own success and the high regard in which he was held by so many colleagues and friends, as well as by his thousands of patients and their families. His account of his many medical and surgical colleagues, over the decades, was always flattering of others and never critical. This was typical of the man who maintained a “blame free” culture within his own department and as far as his influence could go. It was not in his nature to attack or undermine other people in his team – be they trainees, nurses, technologists, physicians, or fellow surgeons. His leadership ensured that the morale of his team was extremely good.

David and Myra leave three surviving sons, one of whom is a General Practitioner. Their first son, Ian, died in 2016 from Melanoma.