Lives of the fellows

William Paton Cleland

b.30 May 1912 d.29 March 2005
MB BS Adelaide(1934) MRCP(1939) FRCS(1946) FRCP(1966)

Willam Paton Cleland was an Australian doctor who trained initially in chest medicine and surgery in Britain and then became a leading pioneer of open heart surgery in the late fifties. He trained young surgeons from abroad who later became leaders in their own countries. Outside the operating theatre he was very active in promoting his specialty by teaching, writing and lecturing, and was the first director of surgery at the Institute for Diseases of the Chest in London.

Cleland was born in Sydney and educated in Adelaide, where he graduated in 1934. He was the son of Dora Isobel Paton and John Burton Cleland. His father (later Sir John Cleland CBE) was professor of pathology at the University of Adelaide, whose untiring work for the natural environment was commemorated in the naming of the Cleland Conservation Park in the Adelaide Hills. Cleland was proud of his ancestry and he became the 26th head of an ancient Scottish family, which traces its history back to a cousin of William Wallace.

After house jobs at the Royal Adelaide Hospital Cleland went to Britain at the age of 27 to specialise in chest medicine at the Brompton Hospital for Diseases of the Chest, London, and he gained the MRCP in 1939, being elected one of the few surgical Fellows in 1966. But he was told by Tudor Edwards and others that he would make a good surgeon and so he became the resident surgical officer at the Brompton. His mother did not approve, commenting: "Bill was never any good at carpentry".

During the war he served in the Emergency Medical Service at the Horton Hospital, Epsom, where there were naval and civilian patients, both those with pulmonary disease and with wartime injuries. He removed bomb fragments from the heart and the lungs in addition to treating pulmonary tuberculosis and gained his FRCS in 1946. He later became civilian consultant in thoracic surgery to the Royal Navy.

He then obtained consultant appointments as thoracic surgeon to King's College Hospital, the Brompton Hospital and to Hammersmith Hospital at the Postgraduate Medical School of London. This latter appointment was to prove the highlight of his surgical career.

Cardiac surgery developed rapidly after 1945 when the first 'blue baby' operation was done in America, but they were all done with an intact beating heart and there was an urgent need to be able to open the heart and fully correct the defects. For this a heart lung machine was needed and at Hammersmith Hospital Dennis Melrose invented a pump oxygenator in 1952. Having seen the apparatus, Bakulev from Moscow was keen to buy one and to start open heart surgery in the Soviet Union. He invited Melrose to bring the Hammersmith team, with Cleland and Hugh Bentall as the surgeons and Arthur Hollman as the cardiologist, to visit Moscow in May 1959. The Russian doctors selected four patients with congenital heart disease for surgery. Two of them were very blue children with the tetralogy of Fallot, a condition which the team had never before operated on. But all four operations were successful. This was the first time that a foreign medical team had actually worked in the Soviet Union, as distinct from just being shown round, and they returned on the inaugural flight of the Tupolev 104.

He was an unhurried, unflappable and meticulous surgeon, and the operating theatre was always calm when Bill was operating. Many surgeons and physicians from Britain and abroad came to Hammersmith to learn these new techniques and Cleland lectured and did heart operations in Europe and the Middle East. For his work in their countries he was made a Commander of the Order of Falcon of Iceland and a Commander of the Order of the Lion of Finland. In 1958 he was one of the first surgeons in the world to operate on the newly recognised condition of obstructive hypertrophic cardiomyopathy.

In 1968 an article from Cleland and his colleagues in The Lancet on 'A decade of open heart surgery' gave details of 1,200 operations which showed the safety of using extra corporeal circulation, and he wrote a definitive paper in Thorax in 1983 on 'The evolution of cardiac surgery in the United Kingdom'. He wrote chapters on heart surgery for several textbooks and also on surgery of the lung, which he continued to practice. In fact his paper in The Lancet in 1963 comparing surgery with radiotherapy remains one of the very few randomised trials in lung cancer surgery.

Bill Cleland was a strongly built man with a soft Australian accent. He was a warm-hearted man, always a pleasure to be with, and a person one felt instinctively could be completely trusted and reliable. He was an extremely hard worker, being on the staff of three hospitals and consulting and operating at others.

In 1940 he married Norah Goodhart and they had a very happy married life, although his wife died ten years before him. Outside London they lived in a 18th century mill house near Andover in Hampshire with a trout stream running through the property. He was an outstanding angler, fishing being his main hobby, and the salmon of the River Spey, Lapland and Iceland were magnets for him. At home he was a keen gardener and beekeeper and he usually won top prizes in the annual village show at Goodworth Clatford, where he was much loved for his modesty, wisdom and wit. Second only to fishing was his great love of opera, with Angela Georgiu his favourite diva. He had a daughter and two sons who are a teacher, a professor of demography and a consultant neurologist.

In his nineties he was physically frail but as alert as ever and he died in his 93rd year comfortably and peacefully at home in his own bed after only a short illness. A lifelong friend remarked, "How typical of Bill to have arranged his death so well".

Arthur Hollman

[The Independent 9 May 2005; The Guardian 21 May 2005;,2005,330,1212]

(Volume XII, page web)

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