b.1 January 1909 d.20 November 2005
AO MB BS Adelaide(1933) FRACP(1952) FRCP
Until the mid-20th century, to diagnose a child with leukaemia was to pronounce a death sentence. There was no known cure, and medical opinion was that to attempt one simply prolonged the child's suffering. Most children died within weeks. Today, most children diagnosed with leukaemia in Australia are completely cured. But it took years of relentless toil, of trial and error with many casualties, to produce this revolution in outcomes.
John Colebatch, who has died in Melbourne, aged 96, pioneered the use in Australia of drugs to treat, and ultimately to cure, leukaemia in children. He, and the talented team that grew around him, made the Royal Children's Hospital one of the world's leading centres for paediatric haematology, saving the lives of hundreds of children, and turning certain cancers from implacable killers into treatable diseases.
An ambitious, driven, hard-driving man, he held to his conviction - through years of slow progress and disapproval from colleagues - that certain malignant diseases in children could be cured. He was backed by a handful of influential supporters, and slowly his patients' progress proved him right.
His perfectionism on the job made him a challenge to work with. When he retired from the Royal Women's Hospital in 1959 to focus on haematology, the nurses presented him with a banner reading: ‘A paediatrician is a man with little patients’. He hung it in his study at home.
His fascination with leukaemia began in 1938, when he was a dapper, earnest, prodigiously hard-working postgraduate in London. Just as his friend Benny (later Sir Benjamin) Rank apprenticed himself to learn the new science of plastic surgery, so Colebatch threw himself into studying the new discipline of haematology (blood diseases) on top of his training in general paediatrics.
But while Rank's new skills soon became highly valued with the outbreak of war, Colebatch endured many years of frustration, doubts and strong opposition before events vindicated him. Returning to Melbourne in 1939, he found no interest in paediatric haematology, and in any case he, too, soon went off to war. For five years his patients were convalescing soldiers.
In 1946 he returned to the Royal Children's as an honorary general paediatrician. Two years later his life changed when, from Boston, Sydney Farber reported trials of a drug that caused leukaemia to go into temporary remission. While the drug was highly toxic and no patients survived long, Colebatch persuaded the hospital to allow him to carry out the world's first controlled trial of the chemical substance.
To him, the results were encouraging: patients on the drug survived 21 weeks on average, twice as long as those left untreated. But to colleagues, he was just prolonging the suffering of doomed children. The advent of new and better drugs did not alter their view. A compromise was reached: doctors who endorsed his work could refer cancer patients to Colebatch; those who opposed it could ignore him. Most did. Even in 1956, only one in four of the hospital's cancer patients were sent his way.
But gradually the resistance faded. By 1960 the average patient survived more than a year, and the team saw its first patients go into permanent remission. Parents of cancer victims were supportive, as was the hospital's medical director, Vernon Collins. And in 1958 the Anti-Cancer Council (now Cancer Council Victoria) intervened to help fund the work, appointing Colebatch its Kilpatrick Research Fellow.
Peter Campbell, who joined the Children's Hospital around that time, recalls it as ‘a very exciting place to be. Everybody was young, ambitious, enthusiastic, and wanting to learn as much as they could. Gifted individuals like John built up around them teams of experienced and enthusiastic people. We all worked terribly hard; hours didn’t matter.
The dissension, however, did. Henry Ekert, his colleague and successor, recalls Colebatch as being ‘on the outer, and (having) a very tough time combining his clinical work with research into the treatment of leukaemia. If not for his obsessive drive, I don't believe that the prospects for (those) children, which were regarded as hopeless, would have improved as far or as fast as they did’.
But the tide was turning. In 1963, Colebatch chaired the first national controlled trial, with all 12 paediatric hospitals collaborating in a five-year trial of different drugs and treatments. Their results attracted worldwide attention, overturning accepted global knowledge in two important respects. By the end of the 1960s, one in three patients with acute lymphocytic leukaemia went into remission for at least five years, and most of them were cured.
In 1967 the hospital set up a Haematology Research Clinic. In 1971 the Australian Medical Association awarded him its triennial prize for ‘his outstanding work on leukaemia in childhood’. In 1974 he reached the hospital's retiring age and went to work for the Anti-Cancer Council, setting up a national clinical trial of breast cancer treatments to establish whether, and when, to use less traumatic treatments than total mastectomy.
At 72 he finally gave up full-time work, though he retained his private practice until his mid-80s. Increasingly his relentless energy was thrown into a wide range of community activities. Two stand out: the Australian-Asian Association, where as Victorian chairman, he ran programs to help Asian students settle in Melbourne; and the Studley Park Association, where as president he campaigned to preserve the historic Willsmere hospital building and the Abbotsford convent on the Yarra. He also used his medical expertise to successfully challenge the old SEC's plans to run high-voltage transmission lines down Merri Creek and the Yarra.
His most personal campaign, however, was for Betty, his wife of 52 years, who almost single-handedly raised their four children while he was preoccupied with the treatment of children with malignant diseases. When she became a victim of Alzheimer’s disease and had to go into a nursing home, John visited her almost every day for twelve years, using all his physical and mental resources to keep her flame burning.
He is survived by his daughter, Anne Caldwell, his sons, Tony, Hal and Tim, 12 grandchildren and five great-grandchildren.
The author, Tim Colebatch, The Age’s economics editor, is the son of John Colebatch.
[Reproduced, with permission, from the Royal Australasian College of Physicians’ College Roll]
(Volume XII, page web)
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