Lives of the fellows

William Alexander Gillespie

b.9 March 1912 d.13 August 2003
MB BCh BAO Dublin(1936) MRCPI(1938) DPH(1938) MD(1942) FRCPI(1957) FRCPath(1963) MRCP(1964) FRCP(1971)

William, or 'Bill', Gillespie enjoyed a long career as a clinical microbiologist, essentially oscillating between Dublin and Bristol. As professor of clinical bacteriology in Bristol, he - modestly, but with persistence and determination - investigated the pressing problems of hospital infection that he encountered. While the subjects of this research might sometimes seem unglamorous the results made a very great contribution to patient well-being.

He was born and educated in Dublin and qualified in medicine at Trinity College in 1936, having acquired several prizes. Soon afterwards he spent four years as a clinical assistant at the Adelaide Hospital, Dublin, spending a year on secondment to the Lister Institute in London. In 1939 he married Marjorie Booth, who was a fellow research worker at Trinity. He obtained his MD, on a haematological topic, in 1942.

After working in the Emergency Medical Service he joined the RAMC and served (with the rank of major, as a specialist pathologist) in the UK, France and Italy, and was involved with the MRC investigations of wound infections and the first use of (benzyl)penicillin. Later, when this agent had been introduced to civilian practice, he investigated its application in the prevention of relapse in rheumatic fever.

After the war he moved to Bristol as lecturer in clinical pathology and he was soon appointed consultant to the United Bristol Hospitals. In 1961, he was given a personal chair of clinical bacteriology by the University. He made sure that the teaching in microbiology received by medical undergraduates was clinically relevant and interesting, while at the same time inculcating fundamental principles. He organised groups of microbiology and clinical medical staff, clinical scientists, nurses and laboratory technicians to carry out research on the prevailing hospital infections. The contribution of the team members was always recognised, and this at a time when the other professions involved were not so organised and prestigious as they are today. Many people testify to the encouragement that William Gillespie gave them in finding research interests to pursue, and also to the kindness that he and Marjorie showed to them and to their families. They remember the hospitality at the Gillespies' north Bristol house, with its glorious garden.

In William Gillespie's research, maintained until his final retirement from practice in 1989, three interlinked strands can be discerned. His name is closely associated with the establishment of the importance of closed urinary drainage from indwelling catheters, after relief of retention, or after urological and gynaecological surgery. At that time 'open' drainage was universal (into a bucket at one Bristol hospital, into a Winchester at another - with identical, very high infection rates). He and his colleagues in the laboratory and the wards showed that most infection could be prevented by closed drainage into bottles, and later into bags. In typical fashion, this success brought into prominence the smaller number of infections established by the passage of bacteria between the urethra and the catheter, and he continued to seek remedies for this, with chlorhexidine wash-outs and applications, and effective methods for stable anchorage of catheters. Other aspects of urinary infection caught his interest, such as the 'urethral syndrome' and the occurrence of Staphylococcus saprophyticus urinary infection, almost exclusively in young women.

His establishment in Bristol coincided with the appearance of outbreaks of infection by multi-resistant strains of Staphylococcus aureus (often resistant to penicillin, tetracycline and chloramphenicol, in the limited range of available antibiotics). Groups investigated epidemiology and prevention, and demonstrated the importance of staff as carriers and of pressure sores and the umbilicus in neonates, as well as bedding as reservoirs. As well as, once again, deploying chlorhexidine (and topical antibiotic preparations) to sites of colonisation, the teams showed the importance of rigorous attention to multiple sources and means of transmission.

In this, there was a need to develop effective methods of sterilisation, for a variety of equipment, often delicate and heat sensitive. Today a central sterile supply department is taken for granted in a hospital, but arguably the first of these was set up in a glass-roofed shed in a rubbish yard at Bristol Royal Infirmary! William Gillespie was also involved in the founding of the important Central Sterilising Club in 1960, and he was an early chairman of this society.

As the time approached (in 1977) for his retirement from his Bristol posts, he began to be incommunicado for periods in the Italian language laboratory. He then spent a year in Florence, teaching English at the British Institute. But the call of microbiology and Dublin came again and he spent four years in his old haunts - as consultant at the Adelaide and honorary professor at Trinity, investigating, among other topics, antibiotic prophylaxis of septicaemia after operation in the presence of infected urine. Even then his energy and curiosity were not exhausted and he returned to the Bristol department to continue teaching and research part time until 1989.

After his 'final' retirement he maintained his academic interests, but was able to give more time to his enthusiasms for Italian (solving Italian crosswords), archaeology and the history of medicine. He remained mentally acute in these fields until a matter of weeks before his death, from complications after a fall. His wife, Marjorie, and their two children, John and Geraldine (the latter also in medicine) survive him.

David Speller

(Volume XI, page 219)

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