Robert Alan Smith
BDS (SYD.), MB, BS (SYD.), FRCS (ENG.), FRACS
Plastic and Reconstructive Surgeon
2 August 1937 - 2 May 2017
Robert (Bob) Smith, Plastic and Reconstructive Surgeon, inventor of Solugel and raconteur extraordinaire, was born on 2 August 1937 in Mittagong, New South Wales, to parents Clare Smith and Robert Frederick Smith. He is "R.A. Smith" to his hospitals, "Boss" to his family and "Algy" to his close friends.
He went to a Catholic primary school in Mittagong and later to Chevalier College in the NSW Southern Highlands near Bowral. Bob attended St. John's College within Sydney University studying Dentistry and graduated Bachelor of Dental Surgery in 1959. He then paid his own way through Medicine at Sydney University by doing dentistry part-time by day and playing the piano in pubs at night, graduating as Bachelor of Medicine and Bachelor of Surgery in1963, with Junior and Senior Residency at Sydney Hospital through 1964-65.
Bob married Beverley in 1965 and together they raised their two sons Nick (now an Orthopaedic Surgeon) and Ted (Ear Nose and Throat surgeon), who have extended the family with four grandchildren each.
Bob travelled to England and was appointed Registrar in General Surgery at West Kent General Hospital (1967-68) and later as Senior Houseman and Registrar at Nuffield Burns Unit, Stoke Mandeville Hospital, Buckinghamshire, from 1968-71. He obtained Fellowship of the Royal College of Surgeons, England in 1971.
It was at Stoke Mandeville that his inquisitive mind turned to solving the problem of getting topical burn medications, specifically gentamicin at the time, past a barrier (which we now recognise as biofilm) and into deeper tissues. In Bob's typical joie de vivre fashion, he set up his experiments at the local watering hole, consisting of soaking onions in a variety of liquid ingredients and a dye. After some weeks, the publican asked him to come and see one particular onion - the dye had penetrated through all the layers of the onion. The ingredient in that jar was propylene glycol (still used as a vehicle in many creams and lotions) and the seed of Solugel was born. Subsequent dramatic clinical results and sequential reductions in gentamicin content led to the realisation that the propylene glycol itself was imparting most of the wound-healing effect.
On returning to Australia, Bob Smith was Senior Registrar in Plastic and Reconstructive Surgery at Royal Prince Alfred Hospital in 1972. He was awarded Fellowship of the Australasian College of Surgeons by examination. Shortly afterwards he was appointed Honorary Plastic Surgeon (and later Visiting Medical Officer) at Liverpool District Hospital and at Bowral Hospital (1973), with further appointments at Soldiers' War Memorial Hospital North Ryde, St. Margaret's Hospital Surry Hills and various private hospitals including Bigge Street, Idaho and Buena Vista, with rooms in Liverpool and Paddington.
Major trauma was commonplace in South-West Sydney prior to the introduction of compulsory seatbelts. Bob Smith's extensive experience in handling the large trauma load arriving at Liverpool Hospital honed his skills to a fine art, in all fields of Plastic Surgery. Noticing almost invisible closure of the columella after trauma, Bob was an early adopter of the open rhinoplasty technique after 1972. All other cosmetic surgery aspects of his practice also flourished, through a very low complication rate based on his remarkable dexterity and knowledge of healing. Many trainees (including the writer) have benefitted greatly from his generosity in teaching.
At Liverpool, Bob teamed up with hospital Chief Pharmacist Maxine Goodman to make "Romax Gel". His unorthodox but very successful treatment of burns using the propylene glycol-based Romax became legendary in the South-West of Sydney. Patients with 70 per cent full-thickness burns treated with postage-stamp grafts healed surprisingly quickly and with remarkably less scar formation, which continued until the commencement of the three dedicated Burns Units elsewhere in Sydney.
Like many new treatments, change can be slow and Bob's direct no-nonsense approach sometimes sat uncomfortably with the establishment - even dating back to his diplomatic criticism that his bosses in England weren't washing their hands before touching inpatients.
Eventually one of Bob's anaesthetists convinced him to patent the effective gel, which was freely supplied to those who wanted it. A large pharmaceutical company, competing with an imitation product, offered him a seven-figure sum to take it off the supply chain - which he refused, knowing that other available treatments were less effective and the gel had almost no tissue toxicity. Eventually another company, Johnson & Johnson, acquired the patent - with Bob insisting in the contract that the gel be sold at a low price. Solugel (its current name) continues to be sold unchanged, in many countries throughout the world.
Bob Smith was a kind and compassionate man. The unmatched loyalty of his office staff, including that of his career-long practice nurse Judy Rusbourne, stems in part from his typical generosity in spirit (and financially) in times of personal need. But he was better known as a larrikin, who could blast off a string of profanities on the Royal Sydney Golf Course - and yet smoothly dis-arm the surprised passing lady golfers just as quickly, and whose colourful stories at his numerous dinner parties were matched only by his quick wit and discerning taste in wine. He was both a gourmet and culinary genius, to the extent that the Sydney Good Food Guide (of One-to-Three-Hat fame) offered to retain Bob as a restaurant reviewer - an offer he (probably reluctantly) declined.
No friend declined a dinner invitation from Algy - a nickname bestowed on Bob during his college days with room-mate and pilot friend Richard Loneragan (likening Bob to 'Algernon' in the World War 1 & 2 Biggles Flying Ace books). Bob was also in the Australian Army Reserve, assigned to the Intelligence Division after being commended for bending the rules a bit.
Bob Smith was still attracting referrals and discharging happy patients in 2012 at age 75, when he finally retired from surgery. In January 2016, the diagnosis of oesophageal carcinoma and subsequent radiotherapy and chemotherapy was met with Bob's stoicism and very little complaint. His wife Beverley had gone through years of her own protracted difficulties, of great distress to Bob, who loved her unconditionally right up until his passing peacefully on 2 May 2017. Bob Smith's trainees, as well as Beverley, his admiring sons Nick and Ted, his grandchildren and numerous others are very much richer for the privilege of knowing him.
This obituary was kindly provided by Dr Russell Aldred FRACS - Trainee and admiring colleague.