Browse Fellows

Google

www Lives

Biographical entry Macarthur, Angus MacLeod (1921 - 2012)

MRCS 1943; FRCS 1948; MB BS London 1946; LRCP 1943.

Born
3 January 1921
Southampton
Died
22 October 2012
Occupation
Cardiothoracic surgeon and Thoracic surgeon

Details

Angus Macarthur was a consultant cardiothoracic surgeon at King's College Hospital, London. His life and career spanned vast changes in everyday life, the delivery of healthcare and the practice of surgery.

He was born in Southampton on 3 January 1921. His father, Murdoch Macleod Macarthur, was brought up on Lewis in a seafaring community. He went to Glasgow and studied medicine for a year, but left to study marine engineering. He married Marion MacLeod Wyper, a staff nurse from Glasgow Royal Infirmary, and served in the Royal Navy during the First World War. Angus' older brother, Alastair, was born in 1917 and, after studying medicine at St Mary's in London, became a GP on the south coast.

In 1923 the family emigrated to Southern Rhodesia to seek a more settled home life. Young Angus nearly did not complete the journey: he was scrambling halfway through an external porthole when his seven-year-old brother pulled him back. On reaching Southern Rhodesia, Angus attended Salisbury Catholic School. In 1929 his mother, who was much troubled with malaria, returned to England with the boys. Between 1930 and 1934 they attended Belmont School in Streatham, London, before returning to Southern Rhodesia. From 1934 to 1937, Angus attended the Prince Edward School in Salisbury, where he passed the matriculation exam. He returned to London and took his first MB exam at King's College.

At the outbreak of the Second World War, Angus volunteered for the Royal Navy, but was told to complete his medical training. He initially went to Glasgow, but then joined King's College Hospital during the Blitz. He passed the conjoint examination in 1943 and served for six months at King's College Hospital as a house surgeon to Rear-Admiral Cecil Wakeley, whose surgical career extended back to the First World War.

Angus then enrolled in the Royal Naval Volunteer Reserve (RNVR), serving two years as a surgeon lieutenant in a convoy destroyer, which included duties on the North Sea convoys to Russia. On one occasion he attended a seaman in a merchant ship who had caught his arm in a winch. The destroyer drew alongside, and he and his sick berth attendant were transferred by whaler across to the merchant ship, which was continuing in convoy. He anaesthetised the unfortunate seaman, amputated his arm, transfused one pint of blood and transferred him back to the destroyer, where the seaman continued his recovery.

Angus was demobilised in 1946 and took his MB BS immediately. He continued his house appointments with six months of orthopaedic surgery, followed by a position as a registrar at the regional thoracic surgery unit, both at Horton Hospital in Epsom. This was a large wartime Emergency Medical Service hospital using the site of a London County asylum. In February 1948 he was appointed as a senior registrar at the Postgraduate Medical School of London at Hammersmith Hospital. He recalled his most influential trainers being Norman Barrett, Russell (Later Lord) Brock and Sir Clement Price Thomas.

In January 1950, he was appointed as a consultant thoracic surgeon to the regional unit, south west region, based at St Helier Hospital, Carshalton. From 1950 to 1952 he held the Dorothy Temple Cross travelling scholarship from the Medical Research Council to attend the cardiothoracic unit at Ann Arbor Hospital in Michigan, USA, and other leading American cardiac centres.

Back at home, he sometimes travelled widely to incidents of major trauma. On one occasion he was summoned from St Helier Hospital to Eastbourne, some 40 miles away, following a railway accident. A steam train had run into another train at the station and one passenger had suffered a crushing injury with a left haemothorax, rupture of the diaphragm and avulsion of the spleen, which was floating in the chest cavity. The patient recovered following prompt control of the bleeding and a massive blood transfusion.

In 1953 he was invited to Waterford, Ireland, for three months to start thoracic surgery in a new hospital.

Routine thoracic surgery in those days often involved dealing with complications of longstanding tuberculosis. His first case as a consultant was one such example. A patient with a calcified tuberculous empyema developed massive haemoptysis. An emergency right pleuropneumonectomy was performed. The patient recovered and wrote to Angus two weeks later whilst convalescing in hospital expressing gratitude, not only for his recovery but also for the calm manner in which the operation was explained to him.

Angus' work as a peripatetic thoracic surgeon to the south west region continued until 1962, when he was appointed as a consultant thoracic surgeon to King's College Hospital to join Bill Cleland, who had taken part in the first studies of cardiopulmonary bypass at the Hammersmith Hospital in the 1950s. Angus noted in his application that he had experience in all branches of thoracic surgery excepting cardiopulmonary bypass.

At that time open cardiothoracic operations at King's consisted mainly of procedures to correct atrial-septal defects using profound hypothermia. The operations were performed on Mondays, with post-operative recovery taking place in a small side ward over several days, with a registrar staying in the ward until the patient was stabilised. Initial results were sometimes disappointing but, with the development of a perfusion service, Angus' experience in open heart surgery grew and he took on extra sessions at the Brook Hospital at Shooter's Hill to accommodate an increasing supply of patients from two busy cardiac centres.

Naturally he continued with his general thoracic practice, and was much admired for his immaculate and delicate technique, enabling him to perform a transthoracic oesophagectomy, for example, in 90 minutes without any appearance of haste, without blood transfusion and with the patient being able to start mobilising on the following day.

In 1971 he led a team which carried out an early lung transplant, in a man with terminal pulmonary failure due to cryptogenic fibrosing alveolitis ('Lung transplantation in a patient with fibrosing alveolitis' BMJ 1971 3 391). The operation was carried out with the help of extra-corporeal oxygenation and was followed by immune-suppression. There was a dramatic improvement in pulmonary function and the patient mobilised to the point of being discharged. Sadly, however, the patient died suddenly eight weeks after the operation following a severe haemoptysis from a bronchopulmonary fistula secondary to infection. The conclusion was that further operations of this sort must await more sophisticated techniques of immunological suppression and dedicated funding.

The increase in workload following the further development of the cardiology services at King's and the large increase in the surgical treatment for coronary artery disease led to the appointment of another full-time cardiothoracic surgeon. In 1979 Angus was invited to assist starting cardio-thoracic surgery in a new unit in Kuwait.

At King's in those days all the cardiothoracic operations were still carried out in one small operating theatre with no air conditioning, which opened directly on to another theatre on the main corridors of the original King's College Hospital, built in 1903. Very soon it was working to full capacity, and it was frustrating when managerial constraints were placed on the number of operations undertaken. On one occasion, in 1980, Angus felt obliged to comment in a letter to the Times on the serious implications to patients on the waiting list when the number of proposed operations in the last financial quarter were reduced by 75%. Eventually these problems were overcome with new facilities and he continued an active surgical career until his retirement in 1983.

Angus was an athletic man who rowed for London University until the onset of the war. He was a lifelong enthusiastic swimmer and enjoyed sailing in Germany before demobilisation. He walked a great deal in Scotland, France and Switzerland. Later he took up long-distance cross country walking, on one occasion walking 100 miles in 48 hours.

He was a quiet, private man. In 1947 he married Hilary Claire Parton, also a doctor. They had two children - Janet MacLeod and Duncan MacLeod. After he married he moved with his wife into a new house at Epsom, where they lived for 65 years until his death. Angus and his wife enjoyed the arts and regularly visited central London for concerts and exhibitions. In later life, when he had become house-bound, he took up knitting blankets for charity, which he said satisfied his Scots instinct to re-use old wool and continued to keep his hands busy.

He regarded himself as fortunate that, by chance, he was 'taken up' into thoracic surgery 'a specialty not widely practised nor fully understood', for which there was a huge demand due to widespread tuberculous disease and, when this demand reduced with the arrival of chemotherapy, it was replaced with the new challenge of cardiac surgery, which kept him active until his retirement.

He wished to be remembered for teaching a series of general surgical registrars, for it was not until later in his career that he was involved in a structured thoracic training programme. Many of these registrars became general surgical consultants and valued their experience in the management of chest trauma, including stab wounds of the heart and oesophagus, which were not uncommon in the local area. Some of them changed course and went on to a career in cardiothoracic surgery.

His assistants remember him as a true gentleman, always calm, polite and supportive. As a surgeon he was skilled, unhurried and careful. As a mentor he was greatly valued. He will be remembered with affection by all. He died on 22 October 2012 at the age of 91.

John Keates

Sources used to compile this entry: [The Times 9 January 1980; information from Hilary Macarthur, Alastair Macarthur, Paget Davies, John Wright, Hedley Berry].

The Royal College of Surgeons of England