Lives of the fellows

Desmond Alan Dill Montgomery

b.6 June 1916 d.7 July 2003
CBE(1981) MBE(1942) MB BCh BAO Belfast(1940) MD(1946) MRCP(1948) FRCP(1964) MRCPI(1974) FRCPI(1975) DSc NUI(1980) FRCOG(1981)

A junior doctor in his first year after qualification would not expect to be left to staff and equip 1,000 emergency beds in various empty barracks in a strange city in India while his superiors withdrew to the cooler hill station for the summer: Staff Captain Montgomery, newly arrived with the RAMC in Lucknow, was left in that position in April 1942.

Some inkling of the problems involved in the evacuation by rail of military casualties from Burma had reached the high command, but the established custom of GHQ moving to the hills continued. Throughout that hot summer he spent many days and nights in Lucknow railway station, where the broad gauge line from Calcutta and the narrow gauge line from Bengal coverage. With a small team of a few officers he evolved a reception and distribution scheme for the trains and their sick, wounded, tired and demoralised military passengers. Some were kept in Lucknow, others dispatched all over India. Ambulances had to be provided, and food prepared for both British and Indian troops – regardless of religion or caste. Somehow by improvisation and very hard work he managed, and as a very young army doctor was awarded the MBE (military).

Montgomery was born in China, where his father was a medical missionary. His grandfather was the Rev Dr Henry Montgomery, well known as the founder of the Shankhill Road Mission and its pioneering social work. He grew up in Belfast and was educated at Campbell College and Queen’s University, where he graduated with first class honours and several medals in 1940. After only six months as a house physician he married his fellow student, Susan Holland. They had only a brief honeymoon before he was commissioned in the RAMC and posted to India.

After the Second World War he returned to clinical medicine as registrar in the Royal Victoria Hospital with W W D Thomson [Munk’s Roll, Vol.V, p.413]. Following posts at Hammersmith and the National Heart Hospital in London, and after obtaining his membership of the College and his MD (with a gold medal), he was appointed consultant physician at the Royal Victoria Hospital in 1951. These were the early days of the National Health Service, but he maintained his academic interests and began a series of clinical research papers on endocrine disease, particularly Cushing’s syndrome. He remained in a health service appointment throughout his life, but continued to emphasise the importance of research in this environment.

In 1958 he became physician in charge of the recently opened Sir George E Clarke metabolic unit, the gift of a Belfast shipyard magnate. This was probably the first endocrine and diabetes centre in the UK, with beds, outpatients and research facilities in one building. He immediately abolished the pre-existing waiting list and ran the unit subsequently on a direct admission basis. He built up an interdisciplinary team with specialist nurses, social workers and chiropodists, and developed close links with ophthalmology, neuro- and vascular surgery.

He was an early advocate of evidence-based medicine and produced his own guidelines for patient management, which were much appreciated by junior staff and patients alike. He also became an obstetric physician and developed one of the first joint diabetic antenatal clinics. This pioneering approach was recognised by the unusual award of the fellowship of the Royal College of Obstetricians and Gynaecologists to a practising physician.

In 1959, while at a meeting in Cardiff of the Association of Physicians of Great Britain and Ireland, he travelled in the same train as Ivo Drury from Dublin and realised that both had a major interest in endocrinology. When parting at Liverpool he remarked that it was pity they only met at meetings in England, which reflected the absurdity of the situation where physicians in Belfast and Dublin hardly knew each other. Drury subsequently wrote that too many people were blowing up bridges and he would like to try building a bridge if Desmond would help at the other end. Jointly they agreed to discuss the formation of a physician’s club with the aim of promoting friendship among physicians in Ireland and the advancement of clinical medicine. The first meeting was in Dublin in 1960 when the northern members “graciously suggested that the club be named after Sir Dominic Corrigan” (who first described the “collapsing” pulse of aortic valve incompetence). Subsequent annual meetings have been held alternately north and south to the present day and the initial aim of breaking down barriers has been achieved as much in members’ houses as in the lecture room.

He was a founder signatory of the British Geriatrics Society when at the Hammersmith Hospital in 1947, and was presented with a gold medal at their 50th anniversary meeting in 1997. (He modestly said he just happened to be there when others were setting up the society.) He was also the first president of the Irish Endocrine Society from 1976 to 1978, and presented a handsome presidential chain with the arms of the four provinces of Ireland surrounding a steroid ring; this society remains active, with an annual meeting held in different parts of Ireland and several postgraduate functions.

He collaborated closely with chemical biochemistry and published many papers on endocrinology and diabetes. His book with R B Welbourn on clinical endocrinology for physicians and surgeons established a new cross-disciplinary approach to the specialty. He lectured on the international circuit for the British Council in Russia and India, but was always more at home with the written word. In his later career he became chairman of many important administrative medical committees in Northern Ireland and, following retirement, was chairman of the Northern Ireland Council for Postgraduate Medical Education. Appointed CBE in 1981, he also served on the General Medical Council and the Senate of Queen’s University. He was greatly respected as a leader of the profession for his high ethical standards and wise advice.

Growing up as a presbyterian, he was a lifelong member, and subsequently elder and clerk of session of Fisherwick Church, Belfast. He succeeded his father-in-law as president of the Belfast City Mission, and was a trustee of the Presbyterian Church in Ireland.

In later life, with increasing frailty, he spent much time looking over the north Atlantic from his cottage at Ballycastle, County Antrim. He was brave in the expression of his liberal principles and had not been afraid to walk up and down the Falls Road in a peaceful demonstration outside the hospital at a time of acute sectarian tension. His prospective optimism was encapsulated in an address to the Ulster Medical Society, commenting on the divisions and sectional interests in the profession and urging us as men and women of integrity, vision and dedication to hand on a society worthy of those who will follow us. He leaves his wife Susan, and two children.

David Hadden
Richard Clarke

[The Independent, 7 Aug 2003]

(Volume XI, page 400)

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