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Biographical entry Macintosh, Sir Robert Reynolds (1897 - 1989)

Kt1955; MRCS 1924; Hon FRCS 1989; Hon FFARCS 1968; FRCS Edinburgh 1927; DM Oxford 1937; DA 1939; FFARCS 1948; MD (Hon Causa) Buenos Aires 1950; Hon FFARACS 1950; MD (Hon Causa) Aix-Marseilles 1952 Hon DSc University of Wales 1962; Hon FFARCSI 1964.

Born
17 October 1897
Timaru, New Zealand
Died
23 August 1989
Occupation
Anaesthetist

Details

Robert Reynolds Macintosh was born in Timaru, New Zealand, on 17 October 1897 the son of Charles N Macintosh, a surveyor who had been a member of the first rugby football team representing New Zealand abroad in 1893, and his wife Beatrice, née Thompson. He was educated at Waitaki Boys' High School and in 1916 volunteered for war service, initially taking a commission in the Royal Scots Fusiliers and later transferring to the Royal Flying Corps. He was mentioned in despatches but towards the end of the war he was shot down over France and taken prisoner. Although he made a number of attempts to escape none of these was successful and he was not repatriated until the end of the war.

He entered Guy's Hospital Medical School and qualified in 1924. His early house appointments included one in Montevideo where he perfected his Spanish and initially he intended to be a surgeon. He passed the FRCS Edinburgh three years after qualification but found that his skills in anaesthesia were too much in demand and he settled in London, where in conjunction with W S McConnell he developed a group practice in private anaesthetics largely concerned with dental work. At this stage in his life he and other consultants from Guy's used to play golf at Huntercombe where they frequently dined with Lord Nuffield and his wife. They were able to give him informal advice on a number of Lord Nuffield's proposed benefactions to medicine. He had on one occasion anaesthetised Lord Nuffield who had unpleasant recollections of previous anaesthetics and who found an intravenous barbiturate induction a pleasant surprise.

Lord Nuffield originally proposed to found chairs in medicine, surgery and obstetrics and gynaecology, but when Macintosh commented light-heartedly that anaesthesia was not included, Lord Nuffield took up the point and proposed to endow a chair of anaesthesia. The University said that there was inadequate academic status in anaesthesia to justify a chair but Lord Nuffield insisted on its creation making his other lavish donations conditional on this development. He increased his benefaction to £2 million and the University fell in with his suggestion. Macintosh took up the chair in February 1937 with two main ambitions; firstly to make anaesthesia more safe and secondly to enable anaesthesia to extend the limits of surgery.

Macintosh embarked on his academic appointments with great enthusiasm as he loved teaching, although he was not a great speaker and was not always comfortable when lecturing or presenting papers. Within two years he enlisted the support of Dr Kurt Mendelssohn and Dr H G Epstein from the Oxford University physics department and with their help created the Oxford Vaporiser which would deliver a known concentration of ether. Two prototypes had been developed by 1941 and thereafter production was started at the Morris motor works in Cowley. By the end of the war over four thousand had been supplied to service and civilian hospitals and a modification of this vaporiser was used in the Falklands campaign of 1982. His new department also advised Lord Nuffield on the development of a tank ventilator for patients with poliomyelitis.

During the war he was consultant in anaesthesia to the Royal Navy and the Royal Air Force holding the rank of Air Commodore. He continued to run the department of anaesthesia at the Radcliffe Infirmary. The war research undertaken in his department included assessment of various methods of artificial ventilation, the provision of respirable atmosphere in submarines, the design of life-jackets and the determination of the maximum altitude at which airmen could bale out without oxygen. He ran regular short courses to train young doctors in the skills and techniques of anaesthesia and persuaded the hospital to provide nurses to assist the anaesthetist. He developed the laryngoscope blade which bears his name and in conjunction with Freda Bannister wrote a standard textbook of anaesthesia. At the end of the war he was awarded the Order of Liberty by Norway.

Macintosh believed that most anaesthetic deaths were caused by the incompetence of anaesthetists and did much to debunk the then fashionable concept of attributing many of them to "status thymo-lymphaticus". Dr William Mushin joined his department in 1943 and together they undertook an investigation into anaesthetic deaths. In 1949 he persuaded the Association of Anaesthetists to appoint a committee to investigate deaths associated with anaesthesia and this was the precursor of the detailed audit system established later.

After the war the anaesthetic department was not given the promised accommodation and many developments were hampered. He continued to receive many invitations to travel abroad where his achievements were recognised by numerous honorary degrees and diplomas. Throughout his life he taught simple but safe methods of anaesthesia which were appropriate even in under-developed countries.

He was created a knight in 1955 and retired from his chair in 1965 but maintained his interest in the specialty of anaesthesia, attending meetings up to the age of 90. He was made an honorary Fellow of Pembroke College, Oxford, in 1965 and of the Royal Society of Medicine in 1966. The award of an honorary FRCS in 1989 gave him especial pleasure. He enjoyed swimming and a good game of tennis. In 1925 he married Rosa Marjorie Henderson and her death in 1956 left him desolate. In 1962 he married Dorothy Ann Manning who survived him and to whom he attributed the happiness of his retirement years. He died on 23 August 1989 aged 91.

Sources used to compile this entry: [Anaesthesia 1989, 44, 951; Lancet 1989, 2, 816 with portrait; Brit med J 1989, 299, 851 with portrait].

The Royal College of Surgeons of England