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Biographical entry McDonald, Hugh Alexander (1914 - 2009)

MRCS 1937; FRCS 1944; LRCP 1937; FRCS Edin 1941.

Born
29 May 1914
London, UK
Died
28 March 2009
Great Yarmouth, UK
Occupation
General surgeon

Details

Hugh McDonald was the first consultant general surgeon with the FRCS appointed to Great Yarmouth Hospital, Norfolk, who did not also engage in general practice. He was born in London on 29 May 1914 and went to Guy's Hospital after schooling at Bishop's Stortford. House appointments at St Andrew's Hospital, Bow, followed qualification and he later worked as a resident surgical officer to the women and the children's part of St Mary Hospital, Plaistow. He then had a spell in general practice in the London area, before applying for surgical postings with the Emergency Medical Service.

The Great Yarmouth appointment was advertised as: 'Resident surgical officer with a salary of £750 per annum and with residential emoluments'. The hospital management committee stipulated that he should deal with all surgical cases including orthopaedics and gynaecology, but on the understanding that the GPs performing these tasks would retire by degrees. Complex orthopaedic patients were to be referred to the Norfolk and Norwich Hospital, where the all-powerful 'Tommy' Brittain ruled the specialty. As the title 'resident surgical officer' did not quite 'fit the bill', he was called 'surgeon to the Great Yarmouth Hospital'. McDonald's request in 1946 that his title be changed to 'honorary consultant surgeon' was turned down and he had to recognise that local general practitioners used the hospital as a 'club' for coffee and a chat! Obtaining beds and the use of outpatient facilities proved an uphill struggle for many years.

In 1948 he was given full status of 'consulting surgeon' and was allowed to see private patients, admitting them to the small number of beds allocated in Great Yarmouth when the NHS was introduced.

McDonald practised every surgical specialty except otolaryngology and ophthalmology. Some specialties were covered by Norwich consultants in those early days, including complex gynaecology and obstetrics. McDonald, however, was experienced in both and was able to guide the hands of the first full-time gynaecologist appointed to the 'coast' with great sensitivity.

Norfolk's 'cottage hospitals' had many GP surgeons of good quality who operated with the help of GP anaesthetists. From the 1940s and for 25 years, family doctors routinely visited their patients in hospital, checking their progress and helping with surgery whenever possible. McDonald replaced four GP-surgeons who had done all cold and emergency cases that did not require transferring some 20 miles to Norwich. On one occasion a GP referred and assisted with the surgery on a fit young male with peritonitis after being knocked off his bicycle. Theatre staff were intrigued to see peas floating in the peritoneal fluid, but the patient made a good recovery.

A year or so after his appointment, McDonald raised a few eyebrows by his early mobilisation of patients after surgery. A local GP's daughter had an emergency appendicectomy, and recalled: 'He was quite young and up-to-date. In those days it was normal for post-operative patients to be bed-bound for a fortnight and to take a long convalescence. He had me out of bed two days after the operation and walking on the third day. I was discharged within a week and was swimming in a fortnight!'

Hugh McDonald excelled in all forms of gastric surgery necessary in those days in duodenal and gastric ulcers. In his hands total gastrectomy was a safe procedure. To add to this huge workload he performed post-mortems at the hospital well into the 1970s, including those for HM Coroner. The only trained pathologist was based in Norwich and journalists reporting on 'coroner's court' cases in the local press nicknamed him 'Mac the knife'.

The decline of the fishing industry in Yarmouth led to widespread poverty and many people became seriously ill or died after eating putrescent fish. In his work as a pathologist, McDonald found that 'toxic' oesophageal rupture was caused by decaying fish, mainly mackerel. This inspired him to resort to open oesophageal removal and not oesophagoscopy to evacuate the 'debris' from the friable 'tube', and with considerable success.

Fascinated by human anatomy as a student, McDonald 'drew much and wrote little' when answering questions in anatomy examinations. He retained an excellent knowledge of relevant clinical anatomy throughout his career.

He was a gifted pianist and artist, and Hugh McDonald confessed that, had he not entered medicine, he would have liked to have become an orchestra conductor. Many of his paintings were exhibited in shops along Gorleston High Street and sold well. In retirement his hairstyle became a little 'Bohemian', to say the least

He married first Bettina Symons, by whom he had two daughters and a son. His daughter Sarah McCoy trained in catering, is married and has two daughters. The second, Dinah Greaney, has a son, and McDonald's only son works in the entertainment world in Dubai and is married with three children. Bettina died of cancer at 48 and Hugh later married Vera Taylor, who predeceased him.

Hugh McDonald died on 28 March 2009 in the James Paget Hospital (which replaced both Great Yarmouth and Lowestoft hospitals in 1981), of cardiac problems one year after he had undergone a successful hip replacement.

N Alan Green

Sources used to compile this entry: [Information from: Sarah McCoy, Hugh A Evans and A W McKenzie; Eastern Daily Press 10 April 2009; The Guardian 3 July 2009; BMJ 2009 339 2992; History of medicine in Great Yarmouth: hospitals and doctors, Paul P Davies (2003, private publication)].

The Royal College of Surgeons of England