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Biographical entry Todd, Sir Ian Pelham (1921 - 2015)

KBE 1989; MRCS LRCP 1944; MD Toronto 1945; DCH 1947; FRCS 1949; MS 1956; Hon FCSSA 1987; Hon FRACS 1988; Hon FACS 1988; Hon FRCSCan 1989; Hon FRCPSGlas 1989; FCPS (Bangladesh) 1990.

  • Image of Todd, Sir Ian Pelham
Born
23 March 1921
London
Died
21 April 2015
Norton St Philip, Bath
Occupation
Colorectal surgeon

Details

Sir Ian Todd was one of the most distinguished colorectal surgeons of his generation. Internationally-known for his teaching and superlative operative technique, he became a reluctant president of the Royal College of Surgeons of England. He was the founder of stoma care nursing in the United Kingdom.

Ian came from a strong medical background. Both his grandfathers were general practitioners and his father, Alan Herapath Todd, was a consultant orthopaedic surgeon and a fellow of the Royal College of Surgeons. His mother, Constance Alice Payne (née Edwards), was a nurse and his brother, Peter, became a consultant physician. Three uncles were also doctors and one of his aunts a nurse. Perhaps it is not surprising that he chose medicine as a career. He was educated initially at Norman Court in Potters Bar and then Sherborne (from 1935 to 1938), proceeding to St Bartholomew's Hospital Medical College in 1939, where he had a chequered time. With the threat of London being bombed, the medical students were evacuated to Queen's College, Cambridge in 1940 and a year later, in 1941, Ian relocated to Toronto University Medical School with a Rockefeller studentship. While in Canada he was an officer cadet in the Royal Canadian Army Medical Corps. He returned to the UK in 1944 to qualify with the conjoint MRCS LRCP, gaining a Toronto MD in 1945.

National Service as a major in the RAMC followed and on demobilisation he was at various times a house surgeon and anatomy demonstrator at Barts, a resident surgical officer at Great Ormond Street Hospital for Sick Children, a registrar at Barts and at St Helier Hospital, Carshalton. After gaining his final FRCS in 1949 he was appointed chief assistant at Barts, during which time he was awarded the Luther Holden research scholarship and was developing his abiding interest in coloproctology. In 1954 he gave a Hunterian lecture at the Royal College of Surgeons titled 'The role of elective surgery in diverticulitis of the colon' (Ann R Coll Surg Eng. 1955 Feb;16[2]:118-34). In 1954, also, he was resident surgical officer at St Mark's Hospital, at the end of which post he was appointed to a small number of consultant sessions at the same hospital. This was the beginning of his lifetime's association with St Mark's. In 1955 he returned to Toronto for a year on a Wellcome research fellowship, during which time he won the Lister prize in surgery and gained a Toronto MS.

On his return to the UK, he took additional consultant sessions at Bromley Hospital for two years before, in 1958, being appointed a consultant back at his alma mater St Bartholomew's, the same year of his Arris and Gale lecture titled 'Physiology of rectal sensation and its relationship to disease'. Between 1958 to 1961 he was also a consultant at Enfield War Memorial Hospital.

There followed a stellar consultant career as his reputation grew, being a first class clinical opinion and an excellent technical surgeon. He published regularly and gave numerous postgraduate lectures, which led in 1970 to his election as president of the section of proctology of the Royal Society of Medicine and his appointment as a civilian consultant (proctology) to the Royal Navy (from 1970 to 1986). In 1972 he was invited to join the staff of King Edward VII's Hospital for Officers, London, where he remained a consultant until his retirement. He served as an examiner in surgery in London, Cambridge and Bangladesh, and in 1975 was elected to the Council of the Royal College of Surgeons, serving for 12 years.

During his training and early consultant years he became concerned at the many problems associated with intestinal stomas and the generally poor standard of stoma care and advice available for patients. In 1972, with the aid of a ward sister at St Mark's, Barbara Saunders, he set up the first specialist training course for nurses in the management of stoma problems, which ultimately led to the recognition of the stoma care nurse. The three-week course for four carefully selected nurses required agreement and funding by the DHSS, who were initially reluctant, but it proved a notable success and other courses were soon set up elsewhere in the UK and subsequently abroad. A few years later, in 1978, he published a textbook Intestinal stomas (Heinemann) aimed not only at surgeons but also stoma care nurses and patients. Stomatherapy soon became an essential service in all large hospitals.

Ian's international recognition was by now beginning to grow both in the USA and also in developing countries, especially rural India, where he was a regular visitor, enjoying teaching both undergraduates and postgraduates. This commitment to the developing world was maintained throughout his professional life. He said that he found ward rounds in primitive hospitals most rewarding, with the students clamouring to be taught and where he also learned a lot about himself, about local diseases and about how to manage on a shoestring.

In 1979 he gave the Howard H Frykman memorial lecture in Minneapolis titled 'Surgical experience with megacolon and megarectum', the first of several named lectures in the USA. He was elected an honorary fellow of the American Society of Colon and Rectal Surgeons. Many more named lectures were to follow in years to come in countries the world over, including in 1985 the Zachary Cope lecture of the College titled 'Surgical approaches to the rectum'. Just as his lectures increased in number so did his visiting professorships and honorary memberships of world-wide colorectal societies, including those based in France, Greece, India, Belgium, Malaysia, Brazil and other South American countries. By the time of his retirement in 1989 he was arguably the widest-known UK coloproctologist throughout the world.

His election as president of the Royal College of Surgeons 1986 was not something that he desired, indeed the very contrary, for he was not at ease in medico-surgical politics nor did he relish attending the many committees which the presidency inevitably demanded. He could be called the reluctant president. However, his colleagues on Council who elected him recognised his international stature, his notable qualities of integrity and sincerity, and believed that in a time of potential change both in surgical training and also in the wider NHS, a steady hand on the tiller was needed. In this, their judgment proved entirely correct. Throughout his three-year term he proved to be an exemplary president, firm in his dealings with Government and handling domestic problems with great diplomacy, especially with the Court of Examiners. It was the time when major changes in the College examination structure were being explored; abolition of the primary FRCS in favour of a multiple choice examination and the award of the final FRCS in a specific specialty at the end of the appropriate specialist training. Initially there was much opposition to these proposed changes, but not only did they come to pass but intercollegiate agreement was also obtained. This was no mean feat. He was appointed KBE in 1989, before he completed his term as president, showing the respect in which he was held.

Other offices included president of the Medical Society of London (from 1984 to 1985), vice-president of the Imperial Cancer Research Fund (from 1986 to 1989), vice-president of the International Federation of Surgical Colleges (from 1990 to 1993), president of the British Colostomy Association (1991 to 1995), president of the London division of the Ileostomy Association, governor of St Bartholomew's Hospital Medical College and vice-president of the Friends of Vellore Christian Medical College and Hospital.

Throughout his life, Ian was wonderfully supported by his wife Jean Audrey Ann (née Noble), a nurse, whom he married in 1946. They had close on 70 years together. They had five children Neil, Jocelyn, Jane, Caroline and Stewart. Outside of surgery, he was keen skier and tennis player in his younger days, and in later life he enjoyed gardening and carpentry. Music was always a great love. He first attended a performance at Glyndebourne in 1938 very soon after it opened as an opera house, but his love of live opera and classical music concerts transferred to CDs when he retired to the country.

Ian was of gentle, quiet personality with a very deep Christian belief. Despite his fame and many honours, he said that contact with patients was what he found most satisfying in his career. He was revered by his junior staff for his teaching and lack of pomposity, and admired by his contemporaries for his superlative surgical technique.

He died after several episodes of ill health on 21 April 2015 aged 94.

Sir Barry Jackson

The Royal College of Surgeons of England