Lives of the fellows

Robert Brash (Sir) Wright

b.1 March 1915 d.4 December 1981
OBE(1945) DSO(1946) BSc Glasg(1934) MB ChB(1937) FRCSE(1947) FRFPS(1948) ChM(1952) FRCSG(1962) FRCP*(1971) Hon FRACS(1968) Hon FRCS(1975) LLD Glasg(1981)

The small community of Overtown, near Wishaw in Lanarkshire, lies on the border of the coalmines and steelworks of the industrialized lower Clyde Valley to the west and north, and the rolling slopes of the famous Clyde orchard area with its fruit, vegetable and flower farms to the south and east. Further south still, is the attractive town of Lanark and beyond that the high moors which stretch almost to the borders of Scotland and England. In this setting Hugh Wright and Janet Brash settled down to spend a lifetime as local practitioner and wife. They had three sons and a daughter. Robert Brash Wright was their second son.

Life and practice in Overtown, then as now, are divided between the urban and rural aspects of the community, and to this background Robert Wright often referred in later years. He clearly enjoyed the life it offered, first in the local school and later at the more prestigious Hamilton Academy, an excellent secondary modem school in the county town some five miles away. He was a good pupil and a keen cricketer and rugby football player. As in later life, he had a sturdy stocky build, which must have been useful on the sportsfield.

At the relatively young age of seventeen he was accepted into the medical faculty as an undergraduate in the University of Glasgow in September 1932. He travelled from home by train and bus daily and although taking some interest in University life he was much attached to home affairs. He qualified in 1937 with honours. It might have been expected that he would find an opening as a house officer in a University unit, but his independence of spirit was already well developed and he took a post as a house surgeon in Burnley, where a friend of his father’s had offered him good experience; thereafter he remained in Burnley for a further six months as a house physician in the same Victoria Hospital. By now he knew he wanted to be a surgeon and he obtained a post in a surgical unit in Plymouth in September 1938. Fate stepped in after a very short time when his father had a severe stroke and young Robert was summoned home to hold the family practice together. His knowledge of the district and practice personalities must have been a great support to him in what would nowadays be regarded as an almost impossible burden for so inexperienced a graduate. But other events were soon to take over as 1939 wore on.

By September, Robert was in the RAMC, commissioned as a lieutenant and posted to No 10 Field Ambulance which proceeded to embark for France later in the month. He remained there until May 1940, transferring to No 159 (Welsh) Field Ambulance, and then in August of that year returning to UK where he remained until February 1942, latterly in 219 Field Ambulance. He then embarked for India with No 158 and in July 1942, served three months with the India Military Hospital before rejoining No 158 Field Ambulance, now in the Middle East. He later transferred to No 33(1) Field Ambulance with which he remained until December 1942. He was then appointed as commanding officer to a series of field ambulances, Nos 31 and 10 in the Middle East, and finally until his demobilization in December 1945, he was serving with No 4 Casualty Clearing Station as its CO with the rank of lieutenant colonel.

During 1944 his unit, like many others, was drafted to Italy and took part in the fighting there. On 24 September 1944 he received wounds in his foot and hands from an exploding mine and was for a time in hospital. He used to say that he had parts of Italy under his skin for evermore, which was as close as he ever got to discussing the episode.

His was a distinguished war service, earning him the DSO and military OBE, but he never discussed the details with his colleagues or family. The DSO was awarded for his service with the Indian division in Italy; the military OBE was awarded for his enormous administrative contribution.

The war over, RB, like so many other hopeful young doctors discharged from the services, realized that however great his wartime experience there was much of his chosen specialty yet to be learned. He availed himself of the clinical refresher scheme designed for ex-service men for one year and spent the time in the professorial unit of CFW Illingworth at the Western Infirmary in Glasgow. He took his FRFPS (Glasgow) and FRCS (Edinburgh) in 1948. In Illingworth’s department he came into contact with many wartime colleagues and friends, among them William Sillar, a fellow pupil from Hamilton Academy with a distinguished war record like his own, and later to be a lifetime colleague at the Southern General Hospital. After a year, however, they split up and RB went to work as a junior ‘extradispensary’ surgeon with Murray Newton, an excellent teacher and distinguished thyroid surgeon.

Later he climbed the promotion tree to work with AB Kerr, like himself a war veteran although older in years and, also like Bob, a future president of the Glasgow College. RB’s drive, surgical skill and ability quickly gained him promotion, and his research work led to a ChM with honours. His experience was general, with particular interests in vascular surgery, and in thoracic and thyroid surgery, reflecting the interests of the units in which he worked. His ChM thesis was on the subject of varicose veins and gravitational ulcer. This was his most productive period of original research.

In 1948, with the advent of the NHS, he had been graded as consultant surgeon and shortly thereafter he was given some surgical sessions in a small but prestigious hospital in Govan, founded by the famous Govan shipbuilder William Elder, and called the Elder Cottage Hospital. These sessions were much sought after and usually held by young surgeons thought to have a good future. Normally the tenure was relatively brief and relinquished on obtaining a charge appointment in the parent hospital. As will be related, RB was associated with the Elder Cottage for the rest of his professional life.

In 1946, on his return home, Robert married Helen Tait, a school-time friend whom he originally met on a summer holiday at North Berwick. North Berwick was a favourite holidaying place for the Wright family and many others from the Hamilton and Wishaw areas, where Helen also came from. Indeed, Dr Wright senior used to refer to one spot on the beach as ‘Wishaw Cross’. Their marriage was an entirely happy one, each setting the other off in excellent harmony and yet in many ways being quite different in interest and attitudes. Their family consisted of a son, Hugo, and daughters Margaret and Patricia, and their life was spent in several houses in the village of Bearsden in Dunbartonshire, west of Glasgow. Bob, a lifelong non-smoker and teetotaller, was a most excellent host as was Helen a delightful hostess. They kept up their attachment to North Berwick by acquiring a holiday house there and for many years that was their main holiday spot, until in his last ten years or so of active professional life Helen and Margaret persuaded him to take his vacations in a series of Mediterranean countries.

His outside activities were gardening, walking, and, for a time, golfing. He played cricket at school and later in life it became an absorbing hobby. He would be off on his own to spend days at Lords and Headingly watching Test matches whenever his busy life allowed it. He took a great interest in Rotary, being a member of the Glasgow Rotary Club through which he met a number of non-medical acquaintances and friends. His church, New Kilpatrick in Bearsden, was important to him and he became an elder and took his duties seriously. His was a simple uncomplicated faith and fitted in well with his lifestyle, which was upright, honest and kindly. He was a forthright sort of man whom some thought too dogmatic, but his essential honesty also compelled him to see the point of view opposite to his own. Those who knew him well valued his straightforward approach and kindness.

The remaining loves of RB’s life were his hospital, his college activities and his contribution to medical affairs at all levels.

In the years immediately following the second world war the College (or Faculty as it then was) in Glasgow was seeking a new status and a new role. It was slow to rise to the immediate demands for postgraduate education which the returning service doctors found so necessary for their progress. This vacuum was filled in part by the Medico-Chirurgical Society, an old-standing group representing all disciplines in medicine. Its meetings were popular and well attended and it clearly filled a much felt need. In 1949 RB was appointed honorary secretary and he remained actively associated with the Society throughout his life, becoming president in 1966. His influence was immediately felt and continued when in later years other postgraduate activities, including those of the College, began to compete with the Society. Among other changes, he introduced research reports to the Society in 1962. He remained very attached to the ‘Medico-Chirurg’ and indeed the Society owed much to his efforts and continuing interest. In 1981 he was created an honorary member. It was a major interest in his medical life in the post war years and through it he became known to the Glasgow medical world.

During this time it became obvious that RB Wright was to be one of the significant future figures in Scottish surgery. Some assumed that he would follow an academic career and although his record to date would have made that possible, research did not hold special attractions for him. Teaching, on the other hand, did appeal to him, and he was a superb lecturer and clinical instructor in clear simple language, using every day similes which appealed to his students. He opted for a teaching hospital role, outside the major teaching hospitals as it happened. His remaining hospital work was to be carried out in an ex-poor law institution in Govan, the centre of the then thriving shipbuilding industry.

Robert Wright came to the Southern General Hospital (SGH) in 1954 to replace W Arthur Mackey. The hospital, an ex-local authority building dating from 1870, had been acquired by the NHS in 1948. Before the war, the MOH of Glasgow, Sir Alexander MacGregor, decided to upgrade its medical and surgical services, and Arthur Mackey continued this and developed the number of specialties by encouraging James Levack, who had been the resident surgeon in post since 1936, apart from war service, to enlarge his interests in genitourinary surgery, and by importing another Illingworth protege, William Sillar, to start an accident and orthopaedic service. At the same time, about 1950, surgical undergraduates began to attend the unit regularly for daily teaching. This then was to be Bob’s inheritance - a thriving, developing surgical unit with keen and energetic staff, all about his own age.

It was an appointment half-expected and yet to some surprising. He was only thirty eight and there were other more senior surgeons who might have reasonably expected to get this much sought after post. There were acid remarks from some of Bob’s contemporaries and more especially from those who had suffered slightly — or imagined they had - from his direct and critical method of comment. To some he was ‘opinionated’, which is not easily tolerated by Scots in Scotland, but in the end most had to admit that he was practical, fair and usually correct. Everyone felt he had taken on a large task. It was therefore somewhat surprising when he sought to enlarge it even further.

Near the Southern General Hospital lay the Elder Cottage Hospital, a small but active establishment much loved by the Govan folk who were in the main honest hard workers in shipbuilding or in jobs associated with the shipyards. Elder himself had been a shipbuilder and had shown great kindness to the parish which had made his wealth. The ‘Cottage’, as it was known, had medical and surgical beds and it was a great honour to be appointed either visiting physician or visiting surgeon to ECH. This was reserved for the two most promising young men at the Western and Royal Infirmaries. Alex Imrie (FRCP) had been appointed physician and he was based at the Royal Infirmary. RB Wright had been appointed surgeon in 1948, as has already been recorded. Here he ran the surgical wards and a weekly operating session and clinic. The Cottage had come under the new board of management of Glasgow SW Hospitals, which included the Southern and another of Elder’s beneficences, the David Elder Infirmary. But the Cottage continued its way of life with its own matron and staff as if the NHS had never been born. To RBW it was an ideal place, entirely his own, the medical beds having recently been given over to surgery. Here he could work as long and as hard as he pleased. To his practical mind the sensible thing was to combine this appointment with his new job. This was more easily said than done and to begin with his plan met with opposition. Probably the general practitioners of Govan had some influence in the eventual decision, which was to let Bob keep both appointments. So the Cottage continued to provide patients and doctors with a magnificent service, based almost solely on RBW, until his retirement, having withstood several attempts at closure or change of use. Many a junior surgeon paled at the thought of doing the chiefs enormous clinic when he was absent. Bob merely asked for another cup of tea and got on with the work in his characteristic fashion.

In the Southern the impact of the new man was quickly felt. Robert Wright was somewhat appalled at the bread-and-butter surgical waiting list, and set out to overcome that in his first year. Although he had trained himself to perform mitral valvotomies, it was typical of him that he said quite firmly that he would accept none in his first year until he had established himself with his staff, and in his job, and overcome the list of hernias and varicose veins. It was also typical of him that in a year he was ready to start valvotomies again, and characteristic of his attitude that when open-heart surgery came along he was the first to say that he would not enter that field in his type of unit with its heavy routine load, and that he would therefore abandon cardiac surgery in favour of the big centres.

The unit at the SGH had always been popular with undergraduates; under the new chief its reputation for excellent teaching grew, students being much attracted to RB’s form of instruction. It was simple, crisp and practical, full of homely phrases and analogies, interspersed with flashes of real humour and all delivered in Bob’s direct fashion and Lanarkshire tongue. For some it was too blunt and too direct and penetrating, but students and junior staff loved it. There was no ‘humbug’ about Bob. As a result, there was fierce competition to join his unit as students, house officers, or junior trainees. In a short time he was a member of the board of management. His approach appealed to the lay members if not always to all of his medical colleagues, but his contribution was considerable and he remained a member until the board disappeared in 1974.

Another activity was in postgraduate education. As the first specialty adviser in surgery of the newly formed West of Scotland postgraduate committee, RB set up a scheme of rotation between the city and district hospitals for surgical trainees. This was an immediate and continuing success. Only one of Bob’s determination, however, could have ensured that such an arrangement would survive the built-in prejudice of the central hospital teaching units to become a reality.

This then was the background to his professional life at the time when he became involved in the work of the Royal College of Physicians and Surgeons of Glasgow, an association which was to lead to his becoming successively treasurer, president and representative on the General Medical Council, and to his being known throughout the world of surgical Colleges. Soon he had persuaded the Colleges to reconsider their examination methods and to permit Glasgow to experiment, monitor and report on new examination techniques, with such success that others have followed this example. In later years there were repercussions and RB was accused of ‘going it alone’ in Glasgow. In fact, of course, he acted strictly according to his remit and, when published data showed that the Glasgow examination was performing its function as well as the older systems but even more objectively, he encouraged the College to retain the new system. Others have now copied the Glasgow system either completely or in part.

During his time as president (1968-1970) in Glasgow, the College, which combines physicians and surgeons, was in close debate and negotiation with the London and Edinburgh Colleges of Physicians and exploring the possibilities of a unified examination. Although the MRCP (UK) was to appear in his successor’s period of office, Bob and the president of the Royal College of Physicians of London, Lord Rosenheim, had an immediate understanding of each other’s point of view. This was to develop into a considerable degree of respect and friendship and must have been most helpful in the talks which led to the development of a common MRCP Part 1. Largely because of this, he was elected a fellow, under Bye-law 39(b), of the Royal College of Physicians of London in 1970 and this was, perhaps, the most prized of his many honours.

At home, his presidency was also distinguished by his wish to make the College more widely known to his fellow citizens of Glasgow. With his many connexions, particularly through his membership of Rotary, he set up the friends of the College group and established regular luncheons for distinguished Scottish laymen. He also encouraged local groups to visit the College, entertaining them with interesting and amusing anecdotes about the individuals whose portraits grace the College walls, about the buildings themselves and items of College history.

In 1971 after retiring as president, he was elected as the College representative on the General Medical Council. This also meant that he retained a seat on the College council, so that he was a member of that council from 1966 until his death in 1981. RB took immediately to the General Medical Council. His impact was quickly seen and ‘his interventions in debate were always well timed and carefully assessed and cogently argued’ as Sir John Walton has said, and as one can imagine. What also quickly became clear was his personal integrity, his kindliness and intellectual honesty, not to mention considerable personal energy. He quickly became involved in the work of the overseas committee and, as its first chairman in 1972, he headed visiting deputations to Malta, to South Africa, to Australia and New Zealand. During this time he made many overseas friends and learned much about the educational problems of students in less privileged countries. He became interested in disciplinary matters and was elected deputy chairman of the disciplinary committee under Lord Richardson in 1974. There too he made a strong impression. In this work he realized the importance of health questions in disciplinary cases and was thus well placed to offer good advice in the formation of the new health committee in the restructured Council. Rapidly, Robert Wright became one of the most respected members of Council and it was no surprise when he was knighted in 1976 and in due course succeeded Lord Richardson as president in 1980. He immediately launched into a series of programmes on the registration and training of overseas doctors in the UK; on reviewing the role of the register; and on the Council’s new tasks in relation to postgraduate education. There can be no doubt that he would have had much to offer in his role, so soon and so tragically to be terminated.

RB’s health had always seemed robust. He had occasionally minor problems with his old wounds and an early brush with coronary disease which did not trouble him again until one cold evening walking from Victoria to his favourite Caledonian Club, carrying a suitcase heavy with Council papers, he suddenly experienced angina. Although no infarct was found, he had continuing discomfort. Over a Christmas break he had bypass surgery with immediate success and he seemed well set for the future. But within a year a new and sinister ailment had affected him and he knew exactly what it was. He attended his last Council meeting in that shadow, returning home to have his fears confirmed. Like the courageous fellow he was, he sat down and wrote his letter of resignation to the College. Within six weeks he was no more.

He was a man of medicine, which was his life. Awards of all kinds came his way: honorary fellowships of the English and Australasian surgical colleges and of the London College of Physicians; and the honorary degree of LLD of his own University of Glasgow in 1981. But these told little of the man who was a distinguished surgeon and, more than that, one of the great statesmen of medicine.

GB Shaw

* Elected under the special bye-law which provides for the election to the fellowship of "Persons holding a medical qualification, but not Members of the College, who have distinguished themselves in the practice of medicine, or in the pursuit of Medical or General Science or Literature.."

[Brit.med.J., 1982, 283, 1616; 284, 131, 211; Lancet, 1982, 1, 117; Times, 12 Dec 1981]

(Volume VII, page 621)

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