Donald Gordon Macleish
Donald Gordon "Scotty" Macleish AO
Vascular Surgeon
5 December 1928 - 22 May 2016
I first met Scotty when I was an intern in the Casualty Department in my first week at the Royal Melbourne Hospital in 1958. Scotty was the senior surgical registrar. Three of us new graduates had each seen the same patient and managed him poorly. Scotty took us all aside and explained what we should be doing. He did not tell us off. He just quietly explained how we should look at the total management of a patient, and not just the immediate problem.
One of our duties at that time was to go to the operating theatre in the middle of the night and harvest arteries from recently deceased car accident victims. Scotty was in charge of the artery tissue bank. He was responsible for the collection and storage of these specimens. Thus in 1958 he already had an involvement with vascular surgery.
He read about the bypass surgery being performed by Michael De Bakey in Houston, Texas. He thought "this is unbelievable- I must go and see for myself". So off he went to Houston.
When he returned to Australia Scotty was appointed as a junior consultant to the unit of Eric Hughes Jones. A patient presented with a severely ischaemic leg (i.e. one with very poor blood supply) and an arterial X-ray showed a blocked artery in the thigh, just like he had seen in Houston. He discussed this with Eric and went ahead and performed a bypass operation. I quote Scotty's own words, which I heard again last week in a film I have of Scotty:- "When Eric saw the pink foot and felt a strong pulse, his face lit up. That's when I knew this was the surgery I was going to pursue".
During the 1960s Scotty was elected to the Victorian State Committee of the College He eventually became chairman of that committee.
I also wish to pay tribute to Scotty's commitment to overseas training of surgeons in developing countries. In 1970, five fellows of the College were appointed to a teaching assignment in Singapore as part of the Colombo Plan. Scotty and I went for a month each.
Following a meeting with Thai surgeons in Thailand when Scotty was President the Weary Dunlop/Boonpong scholarship was established for young Thai surgeons to come to Australia. Scotty became chairman of the committee to oversee this project and remained committed to it for many years. There are several Thai surgeons now in senior positions in Thailand who owe their start to this scholarship.
During his time on Council Scotty became interested in the development of surgery in Papua New Guinea. He made visits to PNG during his time on Council and after his retirement from President. He made eight visits in all, a substantial commitment to the development of academic surgery in that country.
Scotty's contribution to overseas training went for 20 years.
For the 50th anniversary meeting of the College in Melbourne in 1977, Scotty was appointed the convenor to arrange the program for the Vascular Section and I was appointed his assistant. Scotty managed to persuade De Bakey to come to the meeting as the vascular surgery showcase speaker. De Bakey was probably the world's best known surgeon at that time. What a coup! A suitable program was arranged around five key lectures De Bakey would give. Unfortunately about eight days before the meeting Scotty had a phone call from De Bakey. He could not come. His infant son had been admitted to ICU with a life-threatening illness. We rearranged the program and despite the absence of De Bakey the program was a huge success - thanks to Scotty.
In 1975 Scotty was elected to the College Council. Dick Bennett was elected at the same time. What a wealth of talent they were! They formed a close friendship and worked very well together for years. They played tennis and golf together also.
In 1980 I became secretary of the Victorian State Committee. Scotty, as a Councillor attended all meetings. I learned about his facility with words first hand. The secretary compiles the minutes and each month Scotty carefully read and corrected those minutes. His corrections were always spot on and I developed a high regard for his use of words.
From 1979-1983 Scotty was the Censor-in-Chief on Council in charge of surgical training and examinations. He became Vice President in 1983 and finally was elected as President in 1985.
Scotty's predecessor as President was Mervyn Smith. The general view of Council at that time was that the College should stay strictly out of politics. Mervyn Smith was the voice of that view. The Association of Surgeons was formed and spoke out strongly against this. In fact for the first time in the history of the College a group of fellows moved a censure motion against the President. Council voted on this and supported the President - after all he was just the spokesman for Council's views.
My reason for talking about this is that as Scotty succeeded Mervyn Smith, it was his job to calm the troubled waters. Scotty had a very firm view of the College direction. He was not dictatorial but he was a leader. He patiently listened to the views of others and then developed a way forward. It was obvious that contact with government could not be avoided when issues of registrar training positions and the number of hospital surgical beds were concerned. Negotiations with government are inevitable. Since Scotty's time discussions with government have become more and more frequent and the need for a group like the Association of Surgeons just disappeared.
The official portrait of Scotty as College President was painted by Judy Casab (who won the Archibald prize twice). When I first saw it I did not like it at all. I now realise why. It depicts Scotty as a dour scot, but those who knew him well will attest to his sense of humour.
I mentioned earlier Scotty's use of words. In 1984 he gave a lecture titled "The Tyranny of Words". I will quote just one example from this. Biliary Colic. Scotty described that Sir Walter Scott had it. For non-medical people the term means severe pain in the gallbladder. Scotty pointed out that colic refers to the colon and has a characteristic intermittency. Scotty said that, just as Sir Walter Scott described, the pain is not intermittent. Most biliary pain comes from gallstones. When we say that someone has biliary colic, we mean that a stone is jammed in the outlet of the gallbladder, not in the bile duct and therefore the pain is not biliary. Thus the condition should be described as "gallbladder pain". Generations of students have learned about biliary colic, and no doubt will continue to do so.
Scotty was fascinated by history, particularly by Scottish history. I quote directly from Scotty's paper:-
"The origin of distilling is lost in antiquity. Whisky is something which, in the 5th Century A.D. the Irish gave to the Scots, who have been refining it ever since. The pot-still was, in the early days, quite illegal, and had to be mobile. The customs and excise men from the south could not match the ingenuity of the whisky distillers and "smugglers" in the highlands.
The Cardow distillery was founded by John Cumming, a forebear of Johnnie Walker. Cumming was greatly assisted by his wife Ellen, who kept a boarding house in Knochando where she put up any visiting customs and excise men. Quickly making them feel at home, she raised a red flag, which was a sign for the pot-stills to be hidden. It was this sort of thing which made the authorities give in, and whisky distilling was licenced in 1823."
I think the highlight of Scotty's College Presidency was the installation of HRH Prince Charles as College patron on 4 November 1985. There was a special ceremony at Government House attended by the then members of the College Council Executive and Past Presidents.
John Royle OAM FRACS, 25 June 2016
With thanks to Geoff Down, Elizabeth Milford and Dick Bennett
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