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Biographical entry Gillingham, Francis John (1916 - 2010)

CBE 1981; MBE 1944; MRCS LRCP 1939; MB BS London 1939; FRCS 1947; FRCS Edin 1957; FRCP Edin 1967; FRS Edin 1970; Hon MD Thessaloniki 1973; Hon FCS Sri Lanka 1980; Hon FRACS 1980; Hon FRCSI 1981; Hon FRCS Glasgow 1982; FRSA 1991.

Born
15 March 1916
Dorchester, Dorset
Died
3 January 2010
Shipton-under-Wychwood
Occupation
Neurosurgeon

Details

John Gillingham was professor of neurosurgery at the University of Edinburgh. He was born in Dorchester, Dorset, on 15 March 1916, the son of John Herbert Gillingham, a businessman, and Lily Gillingham née Eavis. He was educated at the Thomas Hardye School in Dorchester, and then studied medicine at St Bartholomew's Hospital Medical School, where he won prizes in surgery and obstetrics.

After graduation and house posts with Sir James Patterson Ross and Ronald Christie, he joined the Royal Army Medical Corps. He was deployed for 18 months in Sir Hugh Cairns' 'crash course' at Oxford on all aspects of neurological trauma. Gillingham later became commanding officer of the number 4 neurological surgical unit in the Middle East and Italy - the 'nomadic surgeons'. His unit chased after the 8th Army in the desert for some two months during the huge battle of El Alamein and then to Sicily. During this time Gillingham contracted poliomyelitis, which left him with a paralysed jaw. He ate slops for three months, but, in his own words, he eventually 'cheeked' his way back to command the unit.

After the war he became a senior registrar in general surgery and then in neurosurgery at Bart's, and in 1950 he was appointed as a consultant neurosurgeon and a senior lecturer in surgical neurology at the University of Edinburgh. Gillingham spent 12 years working alongside Norman McOmish Dott, one of the great triumvirate of neurosurgeons that also included Cairns in Oxford and Sir Geoffrey Jefferson in Manchester. In 1962 Gillingham became a reader and, in 1963, professor of surgical neurology at Edinburgh.

Gillingham's experiences during the Second World War gave him an understanding of, and a lasting interest in, head injuries. He kept meticulous notes on how bullets entered, traversed and often exited soldiers' brains, and correlated these injuries with any abnormal central nervous system signs or behavioural and emotional aberrations. He later described an area now known as the reticular activating system, noticing that injuries to this part of the brain always resulted in total loss or serious loss of consciousness. Gillingham regarded this area as the seat of the conscious mind, an analogy being the central processing unit of the computer. In recognition of this work he was awarded the medal of the Society of British Neurological Surgeons (in May 2009).

When his colleague in Edinburgh, David Whitteridge, described the use of microelectrodes in distinguishing between grey and white matter, Gillingham immediately saw their usefulness in distinguishing deep brain structures. From these first microelectrode recording studies, fundamental insights were gained which improved the accuracy of locating lesions within the brain, including the observation that spontaneous rhythmical discharge from the thalamus was synchronous with tremor.

However, the main emphasis of his work in Edinburgh was on stereotaxis (or the use of three-dimensional coordinate systems to locate and operate on targets in the body), which he used as an aid to localising brain lesions. He was introduced to stereotactic surgery by Gérard Guiot, who had visited Edinburgh to learn aneurysmal surgery from Dott and Gillingham. Gillingham's wealth of experience in aneurysmal surgery led him to adapt Guiot's stereotactic method. Over the years he refined his procedures, targeting the cerebellum, brain stem and cervical spine to help patients with chronic pain and dystonias. Results from 60 patients with Parkinson's symptoms showed that electrocoagulation of lesions in the globus pallidus, internal capsule and thalamus, either separately or in combination, reduced tremor and rigidity in 88% of cases. In this era predating MRI scans, stereotactic neurosurgery proved to be one of the most important developments in 20th century brain surgery.

Gillingham's interest in the nature of memory and evolution never diminished. One day, discussing Marcel Proust's In remembrance of times past, he remarked that Proust may have had temporal lobe epilepsy. Gillingham pointed out that temporal lobectomy on the left side had to carefully done, lest damage to the superior temporal gyrus caused loss of cognitive memory. He added that the hippocampus, amygdala and the wider functions of the temporal lobe are concerned with memory, both long- and short-term.

Gillingham was elected a fellow of the Royal Society of Edinburgh in 1970. In 1980 he became president of the Royal College of Surgeons of Edinburgh, where he vigorously pursued and established fellowships in surgical sub-specialties. Education was a primary interest, and he supported the use of television and other visual aids.

After he retired from Edinburgh, Gillingham was professor of neurosurgery at the King Khalid University Hospital in Riyadh - at that time a veritable nest of distinguished medicos. Gillingham's services were in demand during the planning of a new medical school and I remember him insisting on a helicopter pad being built. With great gusto, he improved training and skills in the neurosurgery section, which soon began to flourish.

In 1945 Gillingham married Judy (Irene Jude), who was a constant support. Cairns, a brilliant administrator, arranged their wedding locally in Oxford, followed by a reception in his house. After the war they settled in a splendid house overlooking the Forth, where Judy was a sparkling hostess, entertaining guests with tales of their many tours abroad. They had four sons (Jeremy, who predeceased him following a skiing accident, Timothy, Simon and Adam) and many grandchildren.

John Gillingham died on 3 January 2010, at the age of 93. His modesty and kindliness were apparent throughout his life; all who met him admired him. Once, walking through the main corridor of the King Khalid Hospital in the company of a Syrian surgeon, we encountered John, advancing towards us with his entourage. As they passed by, the Syrian doctor lent over and whispered in my ear: 'Do you see that man? I would never tell him so, but I would do anything for him!'

Angus E Stuart

The Royal College of Surgeons of England