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Biographical entry Sweetnam, Sir David Rodney (1927 - 2013)

CBE 1990; KCVO 1992; BA Cambridge 1947; MB BChir 1950; MRCS 1950; FRCS 1955; Hon FRCSI 1997; Hon FRCPSG 1997; Hon FCSSA 1998; Hon FDS RCS 1998; Hon FACS 1998; FRCS Edin 1999; Hon FRCP 2013.

  • Image of Sweetnam, Sir David Rodney
Born
5 February 1927
London
Died
17 May 2013
Occupation
Orthopaedic surgeon

Details

Sir Rodney Sweetnam was undoubtedly the doyen of orthopaedic surgery of his generation. He had many talents. Foremost, he was a natural surgeon, gifted with great operative dexterity. He was also a pioneer in the research and management of bone tumours, and, thirdly, was an outstanding committee chairman and strategist. His sprightly manner and careful but resolute decision making were balanced by a warm and sensitive personality, and a youthful sense of humour.

Sir Rodney Sweetnam was elected president of the Royal College of Surgeons of England in 1995, only the second orthopaedic surgeon after Sir Harry Platt to have achieved this position. He became a leading light in the organisation of the British Orthopaedic Association (BOA) and in the management of the British Journal of Bone and Joint Surgery, as well as being orthopaedic surgeon to HM the Queen, civilian consultant to the Army and consultant adviser to the Department of Health.

Sir Rodney was born into a medical family. His father, William, a graduate of Trinity College, Dublin, was a well-respected general practitioner in Wimbledon. His mother, Irene née Black, was a medical student prior to her marriage. Although he was named David Rodney Sweetnam at birth, his mother was told on his first day at nursery school that there were too many 'Davids' and thereafter he became 'Rodney'.

He was educated at Pembroke House Preparatory School and Clayesmore School, Dorset, where he evidently enjoyed his schooldays, as judged by his recent reminiscences in their school magazine (although he commented elsewhere that he did not excel at school). Towards the end of the Second World War he recalled a Lancaster bomber crash landing in the school field. He and a group of prefects ran to see if they could help the airmen trapped in the burning wreckage, but, whilst the others ran to the flames, he was more cautious. He wrote that he then realised that he was not a brave man (he failed to mention that years later he received a bravery award from the Metropolitan Police for saving the lives of two officers trapped in a crashed fire-ravaged patrol car). It would seem that wartime school teaching was not always of the highest standard, and Rodney's father coached him in the study of Latin, then a necessary prerequisite for Oxbridge entry. He had little interest in sport either at school or later in life, but always enjoyed exercise, especially brisk walking. He was company sergeant major of the school cadet corps.

Rodney entered Peterhouse, Cambridge, in 1945 as a titular scholar (later to be made an honorary fellow in 2003). He remarked that for the first time he started to take his studies seriously and, as a consequence, he took a first in the natural sciences tripos, gaining his BA in 1947. He attended the Middlesex Hospital Medical School, London, for his clinical course, qualifying MB BChir in 1950. He then completed two years National Service as a surgeon lieutenant in the Royal Navy, where he served on the battleship and flagship HMS Vanguard, regretting that he just missed its Royal tour to South Africa, but not regretting that he managed to stay outside the Korean War zone!

Rodney gained his FRCS diploma in 1955 and embarked on his specialty training in orthopaedics. He worked under many of the great orthopaedic surgeons of the day, including Philip Wiles and Philip Newman at the Middlesex, Sir Reginald Watson-Jones and (Sir) Henry Osmond-Clarke at the London and Sir Herbert Seddon at the Royal National Orthopaedic Hospital. Rodney was appointed as a consultant at the Middlesex Hospital in 1960, aged 32, replacing Philip Wiles, who in his time had carried out the world's first total hip replacement (in 1938) and had worked alongside Sir Gordon Gordon-Taylor in his management of bone tumours.

With Philip Newman, Rodney Sweetnam created a very happy and efficient orthopaedic unit. He was one of the very few consultants to run a Saturday morning fracture clinic, which he kept up until his retirement. Following on from Philip Wiles, Rodney continued to develop a major interest in bone tumours. Working with Sir Stanford Cade, the pioneering radiologist and radiotherapist, he demonstrated in a series of adolescent lower limb bone sarcomas that local radiotherapy followed six months later by amputation, providing the patient was free of detectable metastases, led to a similar if not slightly better survival rate (then only 20%). Thereby, untimely amputation compounding a tragic terminal illness in an adolescent was largely avoided. This study was awarded the Jacksonian prize in 1966 and he presented his work as Hunterian Professor in 1967.

The subsequent development of massive replacement prostheses with John Scales from Stanmore enabled radical tumour excision to be achieved with limb salvage, even in cases of hemipelvectomy, thereby avoiding the mutilation of Gordon-Taylor's hindquarter amputation. This technique was probably Rodney's most notable achievement and one which, combined with steadily improving chemotherapy regimens, vastly improved both life expectancy and quality. He wrote some pivotal papers on this work and gave the Gordon-Taylor, Stanford Cade, Bradshaw and Robert Jones lectures. In the generality of orthopaedics he wrote three small but useful and well-received text-books, two written with Philip Wiles (Essentials of orthopaedics fourth edition, London, J & A Churchill, 1965 and Fractures, dislocations and sprains London, J & A Churchill, 1969) and one written with Sean Hughes (Basis and practice of orthopaedics Heinemann Medical, 1980).

Rodney chaired the MRC working party on bone sarcoma from 1980 to 1985. Earlier, he was appointed chairman of the Department of Health's advisory group on orthopaedic implants (1973 to 1981). Interestingly, his committee recommended that all new joint and other implants should be subject to a trial period of surveillance before general release to orthopaedic surgeons. However, the Department of Health took no further action. Rodney later commented that had the Department implemented this, many implant failures might have been avoided, such as the 1998 3M Capital hip fiasco (when a hip implant failed and tracing patients proved difficult). He subsequently became a consultant adviser in orthopaedic surgery to the Department of Health (from 1981 to 1990).

Rodney joined the council of management of the British edition of the Journal of Bone and Joint Surgery (now the Bone and Joint Journal) in 1975, becoming secretary/treasurer later that year. He held this position for 17 years in partnership with David Evans of the Westminster Hospital as chairman. During this period the journal achieved world status. Rodney then took over the chairmanship on David Evan's retirement in 1992. Under Rodney's shrewd leadership and with adequate funds in reserve the council of the Journal of Bone and Joint Surgery made the bold decision to withdraw from its inadequate offices at the Royal College of Surgeons and become independent by purchasing freehold premises in Buckingham Street, a decision fully justified with time.

Rodney also had a close relationship with the British Orthopaedic Association, serving as secretary from 1972 to 1973 (when he was also secretary to the orthopaedic section of the Royal Society of Medicine) and as BOA president in 1985 to 1986. He was awarded an honorary fellowship of the BOA in 1998. He was elected to the council of the Royal College of Surgeons of England in 1985, becoming vice president from 1992 to 1994 and president from 1995 to 1998. Contrary to his views about the journal, he came to the opinion that the BOA, representing the largest surgical sub-specialty, should remain firmly within the RCS as an influential body.

Apart from being on the consultant staff of the Middlesex Hospital from 1960 to 1992 (where he was chairman of the medical advisory committee to the board of governors from 1971 to 1972), Rodney also served on the staff of King Edward VII Hospital, London, from 1964 to 1997. He was an honorary consultant to the Royal National Orthopaedic Hospital, consultant to the Royal Hospital Chelsea and an honorary civil consultant to the Army. He was president of the Combined Services Orthopaedic Society from 1983 to 1986.

Among his many other distinctions, Rodney was appointed orthopaedic surgeon to HM The Queen and the Royal Household in 1982, a post he held for ten years, with a commitment to ensure that he was almost always available if needed. Reputedly, when the Queen phoned him he always stood to answer. During an early visit to Buckingham Palace, some junior members of the Household secreted several valuable ornaments into his Gladstone bag, which fortunately he noticed just in time before leaving the Royal suite. He was made a CBE in 1990 and was knighted in 1992.

Outside medicine, Rodney served as a trustee of the Smith and Nephew (charitable) Foundation and of the Newman Foundation. He was director and vice chairman of the Permanent Insurance Company, and director of the Medical Sickness Annuity and Life Assurance Society.

Rodney came to love 'The Middlesex Hospital' dearly (he always insisted on a capital 'T' for 'the'). For him and many other colleagues it embodied the highest standards of teaching and clinical practice in a disciplined, yet friendly atmosphere within its multi-specialty setting. He epitomised this ethos and viewed orthopaedics as best developed within a multi-specialty context. The many past trainees, nurses and physiotherapists who worked with him at the Middlesex will always remember the many orthopaedic department alumni or 'snowball' gatherings, in which Rodney was the central figure, reflecting the affection and admiration with which he was regarded.

Rodney was part of a close knit family. His lovely wife Pat was a nursing sister at the Middlesex and his daughter Sarah also trained in nursing there. David, his son, qualified at the Middlesex, following him into orthopaedic surgery. He described his happy domestic life as 'a perfect marriage to the daughter of a surgeon, a daughter who became a Middlesex Hospital nurse like her mother and a son who became an orthopaedic surgeon like his father!' Rodney enjoyed working in the garden, but was more interested in scaling trees with a chain saw than tending to weeds and flower beds; he personally dug the hole for the swimming pool in his garden. In Who's who he described himself as a 'garden labourer' in deference to Pat's horticultural talents. Her declining mental health in his last few years, for which he gave her considerable support, greatly saddened him, second only to which was the closure of the Middlesex.

His life is an extraordinary record of accomplishment. Rodney was tireless. He was nearly always first in the consultant car park at the Middlesex, having commuted down the M1. Visiting his private patients first, he then digested The Times in the consultants' sitting room or King Edward VII's library, being ready for his NHS commitment by 8.00-8.15am. Patients were bemused to see him on the ward before they were properly awake.

Although not interested in sport, he enjoyed exercise and remained slim and spare throughout his life. He walked extremely fast for long distances. Ward rounds were conducted at speed, those attending being strewn behind him as he ran up five flights of stairs. His perambulations six times each day around Lincoln's Inn Fields when president were legendary.

Rodney had a quick and intuitive intellect. He saw through humbug with alacrity. He was a brilliant chairman, keen to make decisions and avoid being side-tracked. Besides being a very deft and skilful surgeon, he was an incomparable mentor, giving time to teach and counsel his junior colleagues, sharing a life-long interest in their careers and supporting all those who were conscientious and worked hard. His many hand-written letters offering congratulation or commiseration have become valued mementoes.

Rodney had his bête noires, a major one being those smelling strongly of garlic. Many remember that it was an unwise orthopaedic registrar indeed who would risk turning up to assist Sir Rodney having eaten garlic the night before. Rapid departure from the theatre was assured. A note tacked to the back of the presidential dinner chair at the Royal College of Surgeons read simply: 'No garlic'. He also despised tardiness in any form. Yet these strong dislikes were tempered by a ready sense of humour, with a gift for swift repartee and a broad knowledge of all that went on in the world.

Sir Rodney Sweetnam died on 17 May 2013, aged 86, and was survived by his wife Pat and his son and daughter.

Michael Edgar

'From the painting by John Weston RP.'

Sources used to compile this entry: [The Times 12 June 2013].

The Royal College of Surgeons of England