Lives of the fellows

Keith Douglas Fairley

b.25 July 1898 d.19 December 1977
MB BS Melb(1920) MD(1922) MRCP Lond(1924) FRCP(1935) FRACP(1938)

Keith Fairley was born in Victoria, Australia, the son of James Fairley, a bank manager.

He was educated at Melbourne Church of England Grammar School, where he obtained his colours for tennis and athletics. At school he was quiet but cheerful but above all he showed a dogged determination to achieve his goal: to be a successful scholar. This pattern of life continued over the years. He excelled at his studies and in 1915 was awarded the Henry Berthon and Warden’s scholarship to enter Trinity College, University of Melbourne.

At the University he studied medicine and met with early success, obtaining the exhibition in physics and first class honours in biology, chemistry and anatomy. His success as a scholar continued during his medical course, which ended at the Melbourne Hospital in 1920 with the exhibition in medicine and the Jamieson prize in clinical medicine.

Keith was appointed house physician and then registrar at the Melbourne Hospital, where he set the pattern of his future medical life: a life dedicated to the care of his patients and to medical research. He was confronted immediately with a medical emergency, to treat severely ill patients suffering from the panepidemic of influenza, which was raging in Melbourne. His patients were housed in a huge Worth’s Circus tent, as the hospitals were overcrowded. He recalled that some deaths occurred in the younger patients who refused to rest — ‘toxic myocarditis’.

Returning to the Melbourne Hospital, he worked in the wards and in the neighbouring laboratories of the Walter and Eliza Hall Research Institute under the Director, Charles Kellaway.

In the Institute he joined his brother Neil Hamilton Fairley, Charles Kellaway, Harold Dew and Fanny Williams in a study of hydatid disease which was infecting workers on the sheep stations in Victoria. From 1923 to 1933 this team carried out splendid researches into the diagnosis and management of the disease, and were greatly aided by the hydatid complement fixation test improved by Neil Fairley. In 1923 and 1930 Keith Fairley and Williams reported the value of this test in detecting a recurrence after operation. Based on these researches, Dew (later Sir Harold Dew, Professor of Surgery, Sydney University) wrote in 1928 his fine Australian classic, Hydatid Disease: Its Pathology, Diagnosis and Treatment.

The brother, later Sir Neil Hamilton Fairley, left the Institute to become director of a tropical diseases institute in India, and later was appointed consulting physician to the School of Tropical Medicine, London. During World War II he was consulting physician to the Australian Imperial Forces. His doctor son Gordon inherited his father’s great ability, but tragedy came - he was killed by a terrorist bomb in London.

Keith and Neil Fairley’s two other brothers were doctors. James died in World War I; Ronald died in 1974 after a most rewarding life as a general practitioner in the country town of Corowa, New South Wales.

In 1923 Keith Fairley worked with FM Burnet (later Sir Macfarlane Burnet) on the treatment of typhoid fever with intravenous typhoid vaccine. Fairley reported that, if given in the early stages of the illness, there was a pronounced reaction followed by improvement. However this method was not used by others owing to the reactions.

In the Institute, Burnet studied the antibody response to the typhoid infection and to typhoid vaccines given prophylactically. He was impressed with the potentialities of these studies and in 1971 he wrote, ‘In all probability it was this interest in Keith Fairley’s work that mapped out the general course of my own research, which started with two papers on the antibody response in typhoid fever’.

In 1924 Keith went to London to work for his MRCP examination. During his successful studies he took time off to play tennis with his medical colleagues, James Officer Brown (later Sir James, a leader in thoracic surgery in Australia) and Eccles MacKay, a surgeon. They were fine players and enjoyed representing the Cumberland Lawn Tennis Club. Fairley and MacKay visited Leonard Plews at Buxton, to play tennis, and fell in love with his two charming daughters - Fairley married Eileen at Buxton, and later MacKay married Vivienne who played a distinguished role in the Australian Red Cross during World War II. Eileen took a keen interest in ballet and fostered it in Melbourne.

Keith and Eileen Fairley had two sons and two daughters. Their doctor son Kenneth FRCP, married Priscilla Kincaid-Smith FRCP, in London: later in Australia they became famous for their researches in kidney diseases. A second son, Ian, had a successful career as a restaurateur in Melbourne and Greece, but to the family’s great sorrow he died in Sri Lanka from septicaemia.

Keith Fairley was proud of his membership of the College and felt greatly honoured by being promoted to Fellow in 1935. He played a leading role in the establishment of the Royal Australasian College of Physicians, being elected Fellow in 1958 and vice president in 1959.

During his association with Kellaway, Fairley studied lead poisoning. The incidence of chronic nephritis in Queensland children was high and was attributed to lead ingestion, first noted in 1892 by Gibson and his colleagues. In 1929 Nye described the lead painted Queensland houses, and the hand soiling of the children playing on the painted verandas. In an excellent review in 1958, DA Henderson stated that in 1934 the Queensland Government asked the Hall Institute to report on the problem. Fairley was appointed and, after exhaustive enquiry, supported his Queensland colleagues in recommending prohibition of lead paint on the surfaces exposed to children. This was adopted and the incidence of chronic nephritis fell. Fairley continued his interest in lead poisoning, and was appointed medical adviser to the Mobil Oil Company. For many years he recommended safeguards for those associated with lead-containing fortified petrol.

In later years Fairley studied thyroid disease and the indications for surgical treatment. He was concerned by the occasional postoperative complications and welcomed the coming of carbimazole and I131 treatments. He and his colleagues soon established the advantages of I131 in the treatment of diffuse toxic goitre, as it avoided some of the dangers of operation. They accepted the problem of determining the optimum dosage. Douglas Hicks, pathologist at the Royal Melbourne Hospital (‘Royal’ after 1935), recalled, ‘In later years, when I reviewed with Keith Fairley the pathology of his thyroid cases, he revealed a deep understanding of the fundamental processes involved and displayed qualities of mind on a plane well beyond his peers’.

He was a fine lecturer at the University of Melbourne and tutor at Trinity College. In 1927 he was appointed physician to the outpatients department of the Melbourne Hospital and in 1943 was promoted to inpatients. He enjoyed his teaching on his ward rounds — his orderly mind and erudition stood him in good stead. His meticulous bedside examinations were a memorable lesson to all who accompanied him, young and old. His method of teaching was time consuming and lacked some of the sparkle and gaiety of his more flamboyant colleagues — but he gained immeasurably from this thoroughness and from his warm and generous personality.

Tennis continued to fill his leisure hours. He was a fine player, obtaining his blue at the University and later representing the State of Victoria, when he contested some of the ‘greats’ - O’Hara Wood, Wertheim, Clemenger and Fitts. In later years he continued to play with his less skilled medical colleagues, who cherished his company but feared his aggressive service.

Advancing years and some rheumatic discomfort reduced his activity, but he continued to treat his loyal and grateful patients, and to enjoy the affection of his family and friends. He passed away with confidence and courage, having served his profession and his country well.

Sir Ian Wood

(Volume VII, page 183)

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