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Biographical entry Savage, Paul Thwaites (1916 - 2013)

MRCS LRCP 1939; MB BS London 1939; FRCS 1947.

Born
28 January 1916
Cambridge
Died
17 November 2013
Occupation
General surgeon

Details

Paul Savage was a consultant general surgeon at the Whittington Hospital, London. He was born, with his twin sister, on 28 January 1916 in Cambridge, the second son of Sir Edward Graham Savage, the chief education officer of the London County Council, and May Savage née Thwaites, who was a nurse at Bolingbroke Hospital in south London until her marriage in 1911.

From 1925 until 1928 Paul was educated at Manchester Grammar School, after which he transferred to Dauntsey's School. He studied medicine at the London Hospital Medical School from 1933, qualifying in August 1939, shortly before the outbreak of the Second World War. After a short period in general practice, he joined the Royal Army Medical Corps (RAMC) in 1940, serving for four years and achieving the rank of captain. He was the section commander in the 9th and 14th Light Field Ambulances in Iraq, Syria and the Western Desert, being wounded in the battle of Alam el Halfa. He then served in the No 1 General Hospital in the Canal Zone and subsequently aboard the leaky hospital ship SS Peran at the Anzio landings and evacuating casualties up the coast. He moved to the General Hospital in Syracuse. Finally, he served as a graded surgeon with a field surgical unit in France, Holland and Germany.

After this extensive and eventful RAMC service, he returned to the London Hospital from 1947 to 1950 as a first assistant to George Neligan and Hermon Taylor, and as a lecturer in the surgical unit under Victor Dix and Samuel Richardson. He acquired the fellowship of the Royal College of Surgeons in 1947, completed his training at the West Middlesex Hospital as a senior registrar to John Scolefield from 1951 to 1952, and was then appointed as a consultant surgeon at the Whittington Hospital in north London. He retired in 1982.

During the period of rapid development of surgical techniques, he rose to the challenge, introducing many new techniques and procedures as diverse as flexible gastroscopy and transurethral prostatectomy. The orthodox treatment of obstructing colonic lesions at this time with a three-stage procedure - de-functioning colostomy, resection and anastomosis, completed by closing the colostomy. Paul promoted immediate resection and anastomosis after decompressing the bowel, publishing his results in the British Journal of Surgery ('The management of acute intestinal obstruction: a critical review of 179 personal cases' Br J Surg. 1960 May;47:643-54). He also invented a metal suction tube for the intra-operative decompression of obstructed bowel. With his tongue firmly in his cheek, Sir Alan Parks labelled it a 'dangerous instrument', but many of us found it a valuable help, provided it was wielded carefully. The Whittington Hospital was allied to University College Hospital and served as a rotation training hospital for trainee surgeons. Paul served as a senior lecturer in surgery from 1978 until 1982, and was a dedicated teacher to his trainees, many of whom now occupy consultant posts throughout the country. After formal retirement he worked as a locum until 1987.

As a true general surgeon in a busy municipal hospital for 31 years, he dealt with all the surgical conditions within the abdomen, but had special interests in gastrointestinal surgery, urology, breast and thyroid. He did not engage in private practice because of his commitment to the National Health Service. He cared for his patients meticulously, kept full notes, photographing specimens after dissecting them in his office. He mapped the tumour spread, lymphatic extension and submitted up to 50 potted biopsy samples after each resection. It was by analysis of his carefully documented series of patients that he was able to justify his approach to the management of large bowel obstruction and demonstrate that the excellent results he obtained justified the adoption of this technique. Principally, however, he used the data he collected to monitor his own performance and to assess whether a surgical technique he tried was good or bad.

Paul was a stalwart supporter of the Royal Society of Medicine, rarely missing meetings of the colorectal and urology section, and continued to attend these meetings into his nineties. He was president of the section of coloproctology for the 1977 to 1978 session.

Paul met his future wife, Anne Stutchbury, at the United Hospitals Sailing Club. She qualified a year after him from the Royal Free Hospital and then entered general practice. They were married in Westminster in 1950. Anne survived Paul. Their three children are John, Adrian (who was a consultant surgeon in Dudley) and Christopher.

Paul pursued an active sporting life, playing rugby for his school at Dauntsey's and for the London Hospital team. He skied from the age of 17 up to the year 2000, and was a member of the Ski Club of Great Britain and the Army Ski Club. He enjoyed walking, skating, swimming, gardening and photography. His great love, though, was sailing. He was a keen off-shore sailor and a member of the Crouch Yacht Club, the United Hospitals Sailing Club and the Cruising Association. He owned a Stella Sloop and sailed her single-handed until the age of 85.

The Whittington was one of the London County Council hospitals which, in common with the Middlesex county hospitals, produced many outstanding practical surgeons who were ideal teachers of young hopefuls. At this time many young men from Australia, New Zealand, Canada, South Africa and other Commonwealth countries came to Britain to train. It was difficult for them to secure appointments in the 'teaching' hospitals. Talented municipal surgeons were identified and gained reputations, their names passed round by word of mouth. They were identified by the length of queues of trainees hoping to work with them.

Occasionally Paul was criticised for not delegating responsibility to his trainees. Those who knew him could recognise why this was so: everything he did he performed assiduously, thoughtfully, obeying the maxim 'get in right first time'. I believe he could not bear to watch any procedure performed casually, sloppily, clumsily. Those who had watched him perform absorbed, often unconsciously, the standard he set and would naturally copy it when allowed to operate alone. Trainees for whom he had acquired trust were released to allow them freedom to act. It is rather frowned upon to say so, but here was a master surgeon.

He died on 17 November 2013, aged 97.

R M Kirk
Adrian Savage
Michael Madigan
John Cochrane

The Royal College of Surgeons of England