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Biographical entry McEwan, Lena Elizabeth (1927 - 2011)

MB BS Adelaide 1949; FRCS 1954; FRACS 1958

Born
11 August 1927
South Australia, Australia
Died
4 October 2011
Occupation
Plastic surgeon

Details

Lena McEwan was the first woman to specialize in plastic surgery in Australia, and did so with much distinction. She was born on 11 August 1927 in South Australia. Her parents were recent immigrants from Glasgow, and when Lena and her mother conversed in demotic Glaswegian, they became totally incomprehensible to those not familiar with this language. She was educated in St Peter's Collegiate Girls School and in the University of Adelaide, where she graduated MB BS in 1949. She was a brilliant student. After a year as a resident medical officer in the Royal Adelaide Hospital and a year in general practise, she went to England for surgical training and secured positions as registrar in two great teaching hospitals, the Birmingham Accident Hospital and the now Royal London Hospital. She took the FRCS (Eng) diploma in 1954, and then returned to Adelaide, where she worked as Senior Surgical Registrar in the Royal Adelaide Hospital. This was a very responsible post, especially demanding in emergency surgery. Lena coped with the work with effortless ease, showing great skill in delegation; on one busy night, she directed a bemused neurosurgeon to remove a difficult retrocaecal appendix.

Lena took the FRACS diploma in May 1958. She obtained a position as Honorary Clinical Assistant in the surgical staff of the Royal Adelaide Hospital, but after a year in this capacity she decided to move to Melbourne.

Her English experience had included plastic work, and she came under the influence of B K (later Sir Benjamin) Rank, then the leading Australian plastic surgeon. In 1960-61, she was appointed as his associate at the Royal Melbourne Hospital (RMH), where she later became his second assistant after John Hueston. She also obtained an appointment as assistant plastic surgeon under George Gunter at Prince Henry's Hospital (1963-5), and an honorary appointment as plastic surgeon on the staff of the Queen Victoria Memorial Hospital, (1961-82), later the Queen Victoria Medical Centre (QVMC), and at the Peter MacCallum Cancer Hospital (PMCH), where B K Rank took over as head of unit after retiring from the RMH. She remained at the PMCH until her retirement in 1992.

Lena made notable contributions in widely different fields. In 1962, she published a paper on repair of injuries of the median and ulnar nerves. She studied the outcomes in patients treated in the Royal Melbourne and Royal Children's Hospitals; most had undergone primary nerve suture and were later assessed by quantified neurological tests of motor, sensory and sudomotor functions. Her study showed the good results of early operation by expert plastic surgeons, especially in children. Her elegant paper attracted much attention at a time when many surgeons favoured secondary(delayed) repair; it was later repeatedly quoted by Sydney Sunderland. After fifty years, the paper reads as a definitive contribution in a controversial field, and as a very mature assessment by one still a trainee. Lena also published a perceptive study of hand function and its restoration by surgery; this too reads very well today.

At the QVMC, Lena collaborated with William Walters in the care of persons suffering from transsexualism due to underlying gender dysphoria. An interdisciplinary team was established in 1976, to treat selected individuals by gender reassignment. In most cases, this required reshaping male genitals to conform with a psychological conviction of female identity. In 1986, the members of the team published a book describing their work; in this, Lena was the leading author of a section describing the technique of male-to-female genital reassignment.

She is remembered for her high surgical competence in these demanding operations, and for her compassionate care for the patients; she was never judgemental in her attitude to patients whose experience of transsexualism had affected their lifestyles. She also showed moral courage in undertaking what was then a controversial branch of plastic surgery.

Lena became head of the Skin Unit in the PMCH in 1982 in succession to B K Rank. She was much interested in the management of skin cancers, and she coauthored with D R Marshall and B K Rank in a study of malignant melanomas. This confirmed the value of wide surgical excision, but also showed that massive excision of very small lesions did not improve the outcomes. It was well received at an international congress of plastic surgeons.

Lena was a good teacher, and taught many future plastic surgeons at the PMCH, where she had a rotating trainee registrarship. She was also much interested in the needs of undergraduates, and was Senior Resident Tutor in University College where she later became Vice Principal. She was instrumental in the foundation of a scholarship at University College, and made generous donations to education there and in Adelaide.

She was vivacious and companionable, and made many friends. She had sharp wits, and sometimes a sharp tongue. Once at a meeting, she memorably summed up the many questions of a self promoting colleague with a devastating phrase from ornithology: "male display." After her graduation, she must have had to struggle to establish herself as a woman in plastic surgery, and it has been suggested that she encountered male opposition. If this was so, she did not become embittered. In 1967, when she was president of the Victorian Medical Women's Society, she gave an address on the economic value and the problems of women in the Australian medical workforce. This reads as a tranquil and balanced assessment, tinged with gentle irony and making very constructive suggestions.

After her retirement, she moved to Torquay Vic, where together with her friends Dame Joyce Daws DBE and Dr June Pash she developed a long-standing interest in botany, notably in growing proteas. She did this very well. She died after a short illness on 4 October 2011, from ovarian cancer, and was widely mourned.

D R Marshall
D A Simpson
W A W Walters

Sources used to compile this entry: [Republished by kind permission of the President and Council of The Royal Australasian College of Surgeons from In Memoriam (https://www.surgeons.org/member-services/in-memoriam/)].

The Royal College of Surgeons of England