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Biographical entry Walt, Alexander (1923 - 1996)

MRCS and FRCS 1956; MB ChB Cape Town 1948; MS Minnesota 1956; FRCS Canada 1955; FACS 1962; Hon FCS (SA) 1988; FRCS Edinburgh 1993.

Cape Town, South Africa
29 February 1996
General surgeon and Trauma surgeon


Alec Walt was born in Cape Town in 1923, the son of Isaac Walt, a wholesale grocer who had emigrated to South Africa from Lithuania to escape the pogrom. When only two and a half years of age, his mother, Lea, née Garb, and two sisters were killed in a train crash, but his father was determined that all three sons be educated - and all three became doctors. At Grey High School in Port Elizabeth he distinguished himself as a sportsman and formed a lifelong friendship with Bill (later Sir Raymond) Hoffenberg. Together they entered the University of Cape Town as medical students in 1940, but an acute sense of patriotism led them to volunteer for service with the army medical corps - which was approved only at the third attempt. They served for three and a half years with the 6th SA Armoured Division and 5th US Army in Egypt and Greece, and throughout the whole of the Italian campaign, during which time they spent many hours planning how to fail trivial army examinations so that they could remain together as privates in the same unit. It was service with a surgical team in the field which instilled a long-abiding interest in trauma and served him well in later years during his time in Detroit. He played rugby for the Mediterranean forces, and was disappointed that circumstances did not allow him to accept a place in the army team in London where he hoped to see his brother after a 25 year absence. With army planning at the time, he also missed the appointment for an interview for a possible Rhodes scholarship.

On demobilisation in 1945, Alec Walt returned to medical school, graduating in 1948 and serving his internship in Groote Schuur Hospital. In 1947 he married Irene Lapping, with whom he had been close friends since boyhood, and they went abroad for his surgical training, firstly to attend the basic science course for the primary fellowship of the College, and then to undertake residency training at the Mayo Clinic. While there he qualified FRCS Canada in 1955 and MS Minnesota in 1956. Returning to England as surgical registrar at St Martin's Hospital, Bath, he took his final FRCS in 1956 before returning to Groote Schuur with his wife and three children - John Richard, born in 1952, Steven David, born in 1954, and Lindsay Jane, born in 1955 - as an assistant surgeon and lecturer. However, he became increasingly concerned that his family should not be brought up in the political climate of South Africa and in 1961 left a flourishing practice to return to the United States and an appointment with the Veterans Hospital in Detroit. His abilities were clearly recognised, for in 1965 he was appointed Chief of Surgery at Detroit General (later Receiving) Hospital, and the following year Chairman of Surgery and Penerthy Professor of Surgery of the Wayne State University School of Medicine, from which he retired in 1988. He was assistant and, from 1968 to 1970, associate dean of the medical school.

As Professor of Surgery, Alec Walt gained recognition as a superb teacher and distinguished academic. He was designated 'clinical teacher of the year' on no fewer than three occasions and in 1984 received the Lawrence M Weiner award of the Alumni Association for outstanding achievements as a non-alumnus. On his retirement in 1988, he was a visiting fellow in Oxford with his old friend Bill Hoffenberg, then President of Wolfson College and also of the Royal College of Physicians. He was elected to the Academy of Scholars and was designated Distinguished Professor of Surgery of Wayne State University.

Alec Walt's avid thirst for knowledge made him an active and prolific clinical investigator, his 165 published papers and reviews concentrating on the surgery of trauma and of hepatobiliary disease which, along with breast cancer, were his prime interests. His army experience, which endowed him with unusual skills in the organisation of trauma services, stood him in good stead during the Detroit riots in 1967, when his paper on the anatomy of a civil disturbance and its impact on disaster planning was a classic. On four occasions he took surgical trauma teams for training in Colombia, whose government presented him with the Jorge Bejarano medal in 1981. Principal author of the first paper describing the prognostic value of oestrogen receptors in breast cancer, he was an active participant in therapeutic trials in this disease and latterly became a strong proponent of the need for multidisciplinary care. His final contribution to Detroit surgery was his development of the Comprehensive Breast Center in the Barbara Ann Karmanos Cancer Institute, now named the Alexander J Walt Center.

Alec Walt had a distinctive clarity of writing and speaking which led to his appointment to the editorial boards of several medical journals, including the Archives of surgery and the Journal of trauma. He was in great demand as a lecturer, honouring numerous prestigious national and international commitments. He was Hunterian Professor at the Royal College of Surgeons in 1969 and Moynihan Lecturer in 1988, and in 1995 gave a keynote address at the 75th Anniversary Meeting of the Association of Surgeons of Great Britain and Ireland. He held leadership positions in many North American surgical organisations, including the Presidency of the American Association for the Surgery of Trauma, the American Board of Medical Specialties and was Vice-President of the American Surgical Association. He was elected an honorary Fellow of the College of Surgeons of South Africa in 1989, and of the Royal Colleges of Surgeons of Edinburgh and Australasia in 1993 and 1995 respectively.

A keen contributor to the affairs of the American College of Surgeons, Alec Walt served as a Regent from 1984 to 1993 and as Chairman of the Board of Regents from 1991 to 1993. He was elected 75th President in 1994, an office to which he immediately brought great panache. Unfortunately, during his presidential year he developed a massive recurrence of a bladder cancer, first treated twelve years previously. With typical courage he elected to have chemotherapy 'spaced' so that he could preside over the Annual Clinical Meeting, at which his successor was to be inaugurated.

The attributes which contributed to Alec Walt's great distinction as an academic surgeon were a keen intelligence, capacity for hard work, absolute integrity, a deep concern for all people, particularly the young, and, greatest of all, a deep and sincere humility. He did not suffer fools gladly and had no hesitation in attacking the uncritical, unscientific or badly presented paper with a characteristic irony; but he would always have a kind congratulatory word for those who had given of their best. A top sportsman - champion hurdler at school, captain of cricket and an athletic Blue at university - he led by example, not dictate. Realising a boyhood dream of climbing to 17,000 feet in Nepal with one of his sons and his daughter at the age of 62 while recovering from treatment of his bladder cancer, he took with him Tennyson's Ulysses, a favourite poem, passages from which he would loudly declaim. He was devoted to his wife Irene, his three children, his son-in-law and his 20 month old granddaughter Eve Lenora, all of whom gave him the love and respect which nourished him throughout his professional life, and supported him during his final illness. Alec described his mother as a 'homemaker', and his wife had been no less. From the earliest days of his marriage Irene provided a home with an ever-open door, a kindness which endeared her to impoverished and hungry British fellows at the Mayo Clinic, of which I was one.

Vivid personal memories of Alec Walt are firstly early days together in Rochester, Minnesota when, as the deluded captain of the first and only Mayo Clinic cricket team which lost their match in Chicago he chastised us for our dismal performance and undisciplined behaviour on the previous night; later, when as visiting professor to his department in Detroit, joint discussions with his students revealed the depth of his feelings for the inequalities of care for women with breast cancer which, later on at midnight in the emergency room, was extended to all of those others whom society had deprived; then at the Asian Association of Surgeons when, as President of the American College of Surgeons he gave a masterly address on surgical training, during which his deep sense of responsibility for the future of young surgeons was only too evident; and finally, on the beach in Bali, when we shared our feelings of good fortune to have had a job in life which had provided us both with such great fulfilment, pleasure, and even fun. Shortly before his death he advised his son John to 'work hard, be honest, and the rest will take care of itself' - advice which is exemplified by the life he led.

He died on 29 February 1996 aged 72, survived by his wife Irene and his children - John, a lawyer, Steven, a professor of law, and Lindsay Jane, a sculptress.

Sources used to compile this entry: [Contributed by Sir A Patrick Forrest with assistance from Mrs Irene Walt; J RCSEd 1997 42 142-3].

The Royal College of Surgeons of England