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Biographical entry Milstein, Benjamin Bethel (1918 - 2013)

MRCS 1942; FRCS 1947; MB BS London 1942; LRCP 1942.

30 September 1918
22 April 2013
Cardiothoracic surgeon


Ben Milstein was a consultant thoracic and cardiovascular surgeon at Papworth Hospital, Cambridge. He was one of the unsung heroes of cardiothoracic surgery. He was born in Dublin on 30 September 1918, the first son of orthodox Jewish immigrant parents, Hershel and Rebecca Milstein. The family later moved to Hampstead, where Hershel worked as a tailor. Ben attended St Marylebone Grammar School and won an open scholarship to University College Hospital (UCH), London, where he qualified in 1942, and abandoned all his Jewish beliefs.

After resident appointments at UCH, he joined the Army and served from 1942 to 1946. He was a medical officer to various artillery units and was mentioned in despatches in 1945. Following his demobilisation, he returned to UCH, gaining early experience of thoracic surgery under R S Pilcher. He also trained with Oswald Tubbs at the Brompton Hospital, and was a senior registrar to Sir (later Lord) Russell Brock at Guy's Hospital.

He was appointed as a consultant surgeon at the Brook Hospital and Preston Hall Sanatorium, before his appointment as a cardiothoracic surgeon at Papworth Hospital, Cambridge, in 1957, where tuberculosis surgery was performed, with virtually no cardiac surgery. Ben built this unit up into one of the most prestigious cardiothoracic units in England. In 1958 he performed the first open-heart surgery at Papworth, the repair of an atrial septal defect under hypothermia, and the following year carried out an operation using an artificial heart-lung machine.

In 1969 Ben, in association with Roy Calne, investigated the possibility of cardiac transplantation in animals, but the work was abandoned due to lack of funding. Three years later Terence English was appointed as a locum, and Milstein wanted their working relationship to be one of cooperation rather than the competition, which occurred in many other cardiothoracic units. With Milstein's support and in face of strong opposition English campaigned to develop a heart transplant service at Papworth, and in 1979 the first successful human transplantation in England was carried out at Papworth. Milstein later ruefully said that English ended up with a knighthood while he remained Mr Milstein!

In 1956 Ben gave a Hunterian lecture on cardiac arrest and resuscitation; a year later he was given a Jacksonian prize for his work on the pathology and treatment of aneurysms. In 1963 his book Cardiac arrest and resuscitation (London, Lloyd-Luke Medical Books) was published. He was editor of Thorax from 1978 to 1983, and president of the Thoracic Society in 1980.

He was a founder member of Pete's Club, where cardiothoracic surgeons discussed their work. The only rule was that no case should throw credit on the presenter: only errors of judgement were discussed. As a consequence, the members learnt a tremendous amount at these meetings. Ben presented many times, though his subsequent treatment of these cases always demonstrated his surgical skill!

His surgical career spanned the entire development of cardiac surgery, from early closed operations on the mitral and aortic valves, to open-heart surgery for the repair of damaged valves and closure of congenital septal defects. In addition, he maintained an active interest in lung surgery. At Papworth he was known for his wise counsel and forthright attitude, as well as his devotion to his work. He was thought by some to be difficult, but this was due to his emphasis on a high standard of work. A Cambridge general practitioner who developed a lifelong friendship with Ben described him as a free thinker and an iconoclast all his life. He was a brilliant conversationalist and knowledgeable on a very large range of subjects.

After retirement he devoted much time to the restoration of antique furniture, the manufacture of violins, his garden, painting and his passion for music, often irritating his family by playing Radio Three very loudly in his house and car.

He married Margaret Hargreaves in 1941, whom he had met at medical school over a shared cadaver. She later became a chest physician. They had three daughters, Susan, Diana and Anne. After Margaret died in 1994 he was ably supported by his partner Judith Chivers. He died on 22 April 2013, aged 94.

Raymond Hurt

Sources used to compile this entry: [The Guardian 4 June 2013, BMJ 2013 346 3862].

The Royal College of Surgeons of England