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Biographical entry Mitchell, John Phillimore (1917 - 2015)

CBE 1982; TD; MB BS London 1942; MRCS LRCP 1942; FRCS Edin 1948; FRCS 1949; MS 1955.

Born
8 June 1917
Redruth, Cornwall
Died
16 October 2015
Occupation
Urological surgeon

Details

John Mitchell (or 'J P M' as he was invariably known to colleagues) was appointed as the first consultant urologist in Bristol in 1952 and from that time he worked tirelessly to transform urology into the specialty that it became in his lifetime, with well-trained and equipped staff.

John was born in Redruth, Cornwall, on 8 June 1919 and always remained fiercely proud of his Cornish roots. His childhood was a time of freedom and adventure, spent mainly at the seaside, where he discovered the thrill of diving through the waves, which formed the foundation for his lifelong pleasure of swimming. The family moved to London when his father, Edward John Mitchell, a tax inspector, was placed in charge of Colonial and Dominion Income Tax, and then to Cheltenham. His mother, Elsie Matilda Mitchell née Phillimore, was an actuarial clerk. John was awarded a scholarship at Cheltenham College and then progressed to train at the Middlesex Hospital, winning the Asher prize for anatomy and gaining a scholarship.

On qualifying in 1942, he was appointed as a house surgeon to Lord Alfred Webb-Johnson and Sir Eric Riches, eminent general surgeons with large urological practices. Urology was not a specialty and in his biographical notes John described the primitive state of urology as the Cinderella of surgery. The urological ward could be located by the smell. Prostate surgery was hazardous, all the patients developed infections and spent weeks recovering. Patients with spinal cord injuries died from sepsis. This experience would have made a very deep impression on John, acting as a catalyst for his remarkably inventive mind. John was always seeking new scientific developments to improve patient care and the prospect of less invasive techniques using endoscopic techniques rather than the open surgery would have sparked his imagination.

After that initial baptism of fire, John entered the Army, joining the RAMC 2nd Independent Parachute Brigade to serve in North Africa, Italy, France, Greece, Palestine and Germany; he was mentioned in despatches for outstanding work in the field. After the war John was posted to Iserlohn in Germany, where he met Barbara Helen Browne (also known as Jill). They married in 1949 and shared 60 years together until her death in July 2009. They had two daughters, one qualified and practised as a general practitioner in Bristol, and the other trained as a nurse and specialised in IVF work.

On his return from the Army, John moved to Manchester, where he and Jill lived in a flat below the great Sir John Barbirolli, conductor of the Hallé Orchestra. Sir John and his wife taught music there to students, but John never allowed that to disturb him. Starting again as a house surgeon his career steadily advanced and he became a senior registrar at Salford Royal Hospital under Denis Poole-Wilson and then under Wilfred Adams in Bristol, both general surgeons with a major interest in urology who were pioneering new endoscopic procedures. Poole-Wilson was using the cold-punch, whilst Wilfred Adams had visited Joseph F McCarthy to learn how to use the resectoscope.

John's appointment as a consultant urologist in Bristol in 1952 opened the opportunity for him to exercise his natural flair for innovation combined with fastidious attention to detail. Systematically he modified and, when necessary, designed new equipment for urological surgery; examples included leg stirrups for the operating table to avoid the acute flexion of the hips and pelvis used to expose the perineum in the classical lithotomy position and the rotator cuff on the McCarthy resectoscope, which maintained continuous irrigation through the resectoscope sheath without the need to rotate the sheath itself. He emphasised the need for meticulous cleaning and sterilisation of endoscopic equipment, designing equipment to achieve this. With his colleagues Ashton Miller, Norman Slade, Bill Gillespie and Keith Linton, he promoted closed catheter drainage of the bladder to reduce the risk of urinary infections, which had been considered an inevitable feature of prostatic surgery. Such was his concern about the use of surgical diathermy in urology, he wrote a handbook on the subject with Geoffrey Lumb, one of his senior registrars (A handbook of surgical diathermy Bristol, Wright, 1966).

The introduction of fibreoptic telescopes in the early 1970s designed by Harold Hopkins at Reading University revolutionised endoscopy and, for the first time, enabled trainees to watch transurethral surgery being performed through a side-arm. John was at the centre of this revolutionary period in endoscopic urology and the advantages of minimally invasive surgery rapidly spread to other branches of medical practice, heralding the birth of keyhole surgery.

John was not only an outstanding innovator, but an influential teacher and facilitator too. His contributions to teaching through lectures, publications in international journals and books were prodigious. At the Royal College of Surgeons, he became a member of the Court of Examiners and delivered a lecture on the subject of haemostasis in transurethral surgery both for the Jacksonian prize and medal in 1971 and, two years later, for his Hunterian lecture. In 1974 Bristol University appointed him as their first professor of urology and then followed the presidency of the section of urology at the Royal Society of Medicine, the award of the St Peter's medal of the British Association of Urological Surgeons, before he became president of that Association and finally president of the International Society of Endoscopic Surgery.

John's contributions to urology and to surgery nationally and internationally were legion. John's final honour of CBE in 1982 reflected his life's achievement in establishing urology as a surgical specialty. At the time of his death, there were well over 900 urologists in the UK.

John was not just a technician but a fine clinician, kind and considerate to patients, students, staff and colleagues, giving guidance and generous support to their personal endeavours. Widely read, he had an insatiable appetite for learning with an encyclopaedic knowledge on a wide range of topics, which made him an entertaining companion able to converse on plants, stamps, maps and music.

Retirement enabled him to explore his wide range of interests. He became president both of the local National Trust group and the Bristol Medico-Legal Society, a founder chairman of Bristol University Botanical Gardens and a member of the National Association of Decorative and Fine Arts Societies (NADFAS). He was a keen and skilled gardener, and an enthusiastic plant collector, always insistent that he possessed two specimens of each plant (in case one died). Every new purchase would be documented and labelled. His garden was regularly opened as part of the National Gardens Scheme.

Links with Cornwall were retained by purchasing three tiny cottages in Treligga near Delabole on the north Cornish coast, where he and his family enjoyed sailing and surfing. Family life was influenced by his love of music, which included playing the piano and leading the family in song. The careers of his five grandchildren reflected John's wide range of interests by including a medical practitioner, a language teacher, an actor musician, a research director and a recruitment consultant for sport. His later years became handicapped by loss of hearing and sight, but his impish sense of humour accompanied by a quiet chuckle of laughter were never impaired. He died on 16 October 2015 at the age of 96. In his biographical notes John wrote: 'Professional life is a treadmill which gathers momentum - nothing one can do will slow it down.'

Roger Fenely

The Royal College of Surgeons of England