Lance Bromley was a consultant cardiothoracic surgeon at St Mary's Hospital, London. He was born on 16 February 1920 to Lancelot Bromley, a surgeon at Guy's Hospital, and Dora Ridgway Bromley née Lee of Dewsbury, Yorkshire. Educated at St Paul's School, Lance Bromley obtained his 1st MB examination there and went up to Caius College, Cambridge, in 1938 to read medicine. On obtaining his 2nd MB, he was offered a place for his clinical training at St Mary's by the dean, Charles Wilson (Later Lord Moran). The Blitz on London in the early 1940s forced the medical school to evacuate its students to Harefield Hospital near Uxbridge in northwest London, an Emergency Medical Services hospital in the grounds of a sanatorium for patients with tuberculosis. The students were taught medicine by George Pickering and surgery by David Levi. Lance, like many medical students, was much more interested in meeting real patients, although he admitted to being rather nervous and hesitant to begin with. It was an excellent beginning to clinical training and he was to see a variety of medical and surgical conditions, many of which were in a very advanced stage. With the cessation of enemy bombing the medical school returned to Paddington. During this time he left the wards for three months - going back to anatomy and physiology and taking the primary examination of the Royal College of Surgeons of England. Sport was not neglected and he was selected to play rugby for the Barbarians from 1940 to 1943. Around this time Lance was a demonstrator of anatomy and student clinical assistant in the neurology department, working with Wilfred Harris, who was an expert in treating trigeminal neuralgia by needling through the front of the face into the ganglion. Qualifying in December 1943, Lance was appointed as a house surgeon to the senior surgeon at St Mary's R M Handfield-Jones, who was to become his 'father figure' and mentor. As the war with Germany continued, Bromley joined the Royal Army Medical Corps in December that year and was sent by troopship to India. While house surgeon to Thomas Field at the 40th West African General Hospital he was responsible for the care of West African troops fighting the Japanese with General Slim's 14th Army in Burma. There were many medical conditions, but filariasis and yaws were common conditions and a number of soldiers were suffering from schistosomiasis requiring cystocopy for diagnosis and follow up. Back in London with the rank of captain, Lance passed the final FRCS examination and obtained an ex-service registrar post in general surgery at St Mary's soon, moving up to senior registrar. The first year was spent with R M Handfield-Jones, A E Porritt and John Simpson, an ENT surgeon; and the second with Arthur Dickson Wright. Lance recalled these being the two happiest and most interesting years of his life. The work was varied, with many acute conditions. Dickson Wright was a master technician who would tackle any surgical problem. Unfortunately he had no idea of time: arriving an hour or so late for his afternoon session only to mumble something and disappear, returning at 10.30pm with never a word to the waiting team. In the summer of 1949 Lance's surgical appointment ended and he spent three months as a supernumerary registrar on the medical unit. Donald Brooks, a physician at St Mary's and the Brompton, urged him to apply for the resident surgical officer post at that hospital. Appointed in 1949, he worked with Clement Price Thomas, Bill Cleland and Norman Barrett. Pulmonary tuberculosis was still a common condition, with streptomycin just beginning to be introduced. Thoracic surgeons performed thoracoplasties and segmental lung resections. Adhesion section done via a thoracoscope was a common technique to induce a complete pneumothorax. Lung cancer was especially common, and resection was the only hope of cure at that time. Cigarette smoke was just being recognised as a cause, but little was done to discourage it. Price Thomas, having chain-smoked throughout his life, including during outpatient sessions, was to develop lung cancer himself. On completion of the Brompton attachment, Lance was appointed extra senior registrar at the Royal Postgraduate Medical School at the Hammersmith Hospital working with Bill Cleland, Hugh Bentall and Denis Melrose, who was developing a heart lung machine. While still at the Hammersmith Lance became a senior lecturer to the surgical unit at St Mary's under Charles Rob. In 1952 he met a physiotherapist, Rosemary Anne Holbrook, at a party and they soon married. Shortly before taking up his consultant appointment Lance and Anne, with baby Christina, spent 10 months in the United States on an American Association for Thoracic Surgery travelling scholarship. Based at Harvard in the laboratories of Francis D Moore, whose vision of surgical teaching included physics, physiology, biochemistry, nutrition and metabolism, Lance saw at first hand the developments in cardiothoracic surgery which were to influence his subsequent approach to the specialty. While at Harvard Anne and Lance befriended H A F Dudley, who had a research post there, but who had left his wife and children behind in Edinburgh. Later Lance was to play a large part in encouraging Hugh Dudley, who by then had been 'transported' to Australia, to accept the offer of the chair in surgery at St Mary's. In 1953 Lance was appointed as a consultant thoracic surgeon to St Mary's Hospital. These were exciting years, with the rapid development of cardiac surgery and he still had a part-time appointment at the Hammersmith, where cardiopulmonary bypass was being developed. The same year he was also appointed as a consultant general surgeon at Teddington Hospital for one half day a week, alternating an outpatients' clinic with an operating session. This rewarding appointment, away from the stresses of cardiothoracic surgery, continued until his retirement. In the early 1950s the traditional work of the thoracic surgeon, pulmonary, pleural and oesophageal, was steadily expanding into the fields of cardiac surgery. Closed procedures such as valvotomy were soon augmented by more complex operations with the introduction of cardiopulmonary bypass. Cardiac and thoracic surgery was not an easy undertaking in those early days; patients were often very high risk and even 'too late' for salvage. Procedures now considered routine were pioneering operations. Each operation required different surgical skills and an understanding of varying physiological changes. One needed to be both a master of surgical technique and an expert in peri- and post-operative management. Initially Lance performed his own cardiac catheterisations until Edwin Besterman joined him as a consultant cardiologist, when they were able to form a joint cardiology surgical ward, with a happy and efficient nursing team and their own mini ITU. Before each operating session there would be a full team meeting at which every clinical detail and investigation result was considered with great care. At the end of each operation he would dictate a full description of the findings and procedure, often illustrated with a sketch, which was typed up immediately by his secretary. Lance was a very sound surgeon and a very calm one - never known to raise his voice. He appreciated his staff and always thanked the nurses and perfusionists after an operating session. St Mary's was fortunate at that time to have two pioneering peripheral vascular surgeons on the staff, H H G Eastcott and Ian Kenyon, and together they performed a number of ground-breaking procedures. At the suggestion of Dickson Wright, Lance developed a link with medical services in Gibraltar and, with Edwin Besterman's connections in Malta, they made regular trips to these countries to see outpatients, perform bronchoscopies and arrange for complicated surgical cases to go to St Mary's for operations under health agreements between the UK and Gibraltar and Malta. With rheumatic fever common in those countries, there was no shortage of patients with mitral stenosis. Although Lance never showed any outward signs of the pressure of his work, the inevitable failures affected him. He cared deeply for his patients and if one did not survive surgery he would often take the next day off for reflection; and in later years he would dream of his 'failures'. He was soon invited to join the London Society of Thoracic Surgeons, where the 'second generation' of thoracic surgeons (the first generation included Clement Price Thomas, Russell Brock and Thomas Holmes Sellors), who had had their training in London, would meet once a year 'to report to each other their two most dreadful mistakes in the previous year'. Meetings started with a topic review or presentation of surgical outcomes followed, after lunch, by the presentation of individual surgeon's 'Charlies'. The meeting was always followed by a good dinner. The Charlies Club met from 1952 to 1992 and the final minute recorded: 'When the Charlies were first set up it was thought by some of us that we might, as years went by, become pompous and thus unable to think of any mistakes we may have made. Happily this did not happen and from the first to the last clinical meeting the essential spirit of the Club prevailed and there was no lack of ghastly errors to report' (Royal College of Surgeons of England Archives. MS0148. London Society of Thoracic Surgeons. Minutes of Meetings of The Charlies Club. 1952-1992). With an increasingly busy professional life, Lance and Anne moved from Roehampton to Hyde Park Crescent, a short walk from the hospital. Now with three daughters and a larger house, there was always extra room for visitors, and lonely trainees from the Antipodes were often to be found lodging in the attic. Lance was a family man and loved the evening meal with all the family in their basement kitchen. Family and friends joined together in a meal that would last for hours - with Lance fast asleep at the end of the table by the conclusion of the evening! For most of Lance's consultant career he was supported only by senior registrars rotating through general or vascular surgery. In the 1970s surgery for coronary artery disease was developing rapidly as coronary angiography became readily available under the direction of consultant radiologist David Sutton. Now in his 50s, Lance was not happy with undertaking the fine suturing of artery and vein grafts, and delegated this task to a number of able general senior registrars who worked as his first assistant. In 1976 Stuart Lennox, on the staff of the Brompton Hospital, became a part-time consultant at Mary's. Having been 'solo' for so many years, Lance was able to slow down at last. Lance enjoyed teaching and for several years was an examiner for the London final MB BS examination. Although he published a number of papers, he admitted to never being an academic and usually had to get up early to complete a paper to meet a deadline. Lance found his year as chairman of the medical committee interesting and challenging. Working with the house governor, Alan Powditch, and the matron, Miss Douglas, he dealt with the personalities and idiosyncrasies of his colleagues with charm and efficiency. Lance loved sailing and often said he would have liked to have been a yacht builder. Initially crewing for friends, he was able eventually to afford his own yacht and became a member of the Royal Ocean Yacht Club. Anne would usually accompany him (although she was easily seasick) and many of his friends and trainees were invited to join them on their Nicholson 32 *Murmur* sailing out of Newhaven or Gosport. On his retirement in 1980 at the age of 60, Lance became director of Medical and Health Services in Gibraltar for three years - where he could keep his last Nicholson boat *Sunmaid of Sussex*. In retirement he had time to take up golf again with renewed vigour and enthusiasm, and enjoyed gardening at their cottage at Barcombe. An early pioneering cardiothoracic surgeon who developed the speciality single-handed in his hospital, Lance Bromley is remembered with affection by his colleagues as a man of great integrity, by his many surgical trainees as a teacher, mentor and friend who showed his concern and interest in their careers, and by his patients for his kindness, gentleness and surgical skill. He was devoted to his wife Anne and their three daughters Tina, Louise and Rachel. He died on 25 April 2013, aged 93.