Paul Rex Balfour Kitchen FRACS
28 December 1942 - 27 December 2011
Mr Paul R.B.Kitchen, FRACS, died on 27 December, 2011 at 69
years of age, three months after diagnosis of a malignant brain
He had been in practice as a General and Breast Surgeon in
Melbourne since 1976, and from 1986 as Senior Lecturer in the
Melbourne University Department of Surgery at St. Vincent's
Hospital. He graduated in Medicine with honours in 1966 from
Melbourne University, followed by residency and surgical training
at Royal Melbourne Hospital, obtaining FRACS in 1971.
In 1972 he was given the task of developing the Intensive Care
Unit at RMH, including design, equipment, protocols of treatment,
staffing, and training program, and was the first medical
supervisor of this unit.
In June 1972, with his wife Merrill and family, he moved to
Scotland to the Aberdeen Royal Infirmary as Registrar in the
Professorial Surgical Unit, then in 1973 was Senior Surgical
Registrar at Inverness for twelve months.
For two years, from late 1973-1975 he worked as Consultant
Surgeon at the Nazareth Hospital, Israel, which had been
established by the Edinburgh Medical Missionary Society in 1861.
This included a period of surgical work at Al Ahli Arab Hospital in
Gaza. He developed an interest in the historical geography of
Israel, and acquired proficiency in Arabic to communicate with the
patients and staff of the hospital.
On returning to Melbourne in late 1975 he was appointed as
Assistant Surgeon at RMH, and helped establish the Breast Clinic.
He commenced private surgical practice at Diamond Valley Community
Hospital with friend and colleague Mr. Bill Ramsay. In the
following years he made several visits to Nazareth to do surgical
locums, enjoyed travelling to Europe, USA and UK including visits
to centres of renowned surgeons in Breast Cancer - Milan (Veronesi,
Bonnadonna), Pittsburgh (B Fisher), Edinburgh (P.Forrest),
Guildford (P.Boulter), Nottingham (R.Blamey).
From 1981 to 1985 he was Assistant Surgeon at Queen Victoria
Medical Centre, and helped set up the Breast Clinic.
In 1986, at the invitation of Professor Richard Bennett, he
transferred to St. Vincent's Hospital University Department of
Surgery, and helped set up the Breast Clinic, starting a database
for all new patients, which has been used for many research
projects and reports.
Paul was a foundation member of the Adjuvant Trials'
Subcommittee and the Breast Study Committee of the Victorian
Co-operative Oncology Group, Anti-Cancer Council of Victoria, which
involved initiating collaborative clinical trials in the major
Melbourne hospitals and other world centres. He was St. Vincent's
Hospital representative on the Anti-Cancer Council, and Surgeon to
the Breast Screen Program at SVH. He also served 9 years as Surgeon
to the Breast Unit at Peter MacCallum Cancer Institute. From 1988
to 2007 he was joint co-ordinator for the Biennial Breast Cancer
Update Seminars at St Vincent's Hospital, and usually contributed
two excellent papers on aspects of Breast Cancer to those
He was an enthusiastic teacher for medical students and was
twice voted by them as the prize winner for excellence in teaching
In 1985 he visited Dr. George Karydakis in Athens, to discuss
his approach to Pilonidal Sinus surgery, having met him and seen
him operate in London in 1973. Paul had published an article on
this operation in ANZJS in 1981, and was accumulating an extensive
practice in PNS surgery, including difficult and recurrent cases
referred from other surgeons. In 1996 his article in the British
Journal of Surgery described his experience with a very low
recurrence rate. In 2005 he produced a DVD of the modified
operation. His 'Perspectives' article in ANZJS Jan/Feb. 2009
provided a review of more recent modifications of the operation. By
the end of 2009 he had treated 497 patients, with 23% of these
being referred with recurrent PNS after treatment elsewhere.
His publications and research interests in Breast Cancer were
numerous, including cytology, adjuvant therapy, prognostic markers,
hormone receptor assay, small invasive cancers, survey of early
breast cancer management, breast screening, ductal carcinoma in
situ, tubular carcinoma, excision margins, and extensive in situ
He presented papers, and posters, at RACS conferences, and other
Breast Cancer meetings.
At the end of 2007 he retired from the Senior Medical Staff of
SVH after 21 years, but continued with teaching medical students
regularly, and as surgeon in the Breast Clinic.
He ceased private practice November 2009 after 34 years based in
Greensborough, providing general surgical services to the people of
the north-eastern suburbs of Melbourne.
In 1980 Paul and Merrill started a group in Melbourne to support
the work of the Nazareth Hospital and named it 'Friends of
Nazareth'. With Paul as Chairman, this attracted many people,
including those of Arabic/Palestinian background.
Paul and Merrill organised and led 9 work parties of volunteers,
usually 30-38 people, to Northern Israel from 1987 to 2009, to
assist with painting and maintenance of the Nazareth Hospital, and
the Mar Elias Educational Institutions at Ibillin. Paul also did
surgical work in the hospital to provide respite or holiday for
their surgeons. The teams also visited other significant sites in
Israel, with Paul and Merrill giving informative commentaries on
the Biblical history and geography. In total 257 people went on
these teams, all appreciating Paul's leadership, planning, energy,
enthusiasm, humour and his strong Christian faith.
Paul had a great talent for music, playing piano and organ, and
was regularly involved as organist for church services in
Melbourne, and on occasions training and leading choirs. He was
also involved in leadership roles in church and the Christian
In 1991 Paul began part-time study in Theology and in April 2003
graduated as Master of Arts through Melbourne College of Divinity.
His Thesis was titled 'Experiential Learning and Reflective
Practice in Medicine and Ministry'.
In 2009 he developed an interest in Archeology and became a
council member of the Australian Institute of Archeology. He was
doing research for a Ph.D. on 'Medicine and Surgery in First
Century Palestine', and constructed bronze models of Roman surgical
instruments, with an article explaining these.
In May 2010 he gave lectures to Doctors in Tonga on Breast
Cancer management, and a talk to the Tongan Breast Cancer
Paul was highly respected by his colleagues, a skilled and
dedicated surgeon, loving and much loved husband, father and
grandfather, a great example and leader motivated by his Christian
faith, admired and appreciated by many patients, associates and
Paul is survived by his wife Merrill, son Tim, daughters Fiona,
Lisa and eight grandchildren, and his four brothers and sister.
Graham Kitchen FRACS