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Biographical entry Kliman, Murray Rex (1924 - 2011)

BA Saskatchewan 1944; MD Toronto 1946; FRCS 1951; FRCSC 1955; FACS 1958.

Born
31 January 1924
Regina, Saskatchewan, Canada
Died
22 February 2011
Occupation
General surgeon and Paediatric surgeon

Details

Murray Kliman was professor of surgery at the University of British Columbia, Vancouver, Canada. Born on 31 January 1924, he was brought up in Regina, Saskatchewan, where his father, Jacob James Kliman, was in the clothing business. He described his mother, Rose Ann Kliman née Segal, as a 'suffragette', a leader of social change who was the first woman in Saskatchewan to have a driver's licence.

A precocious student, Kliman graduated from high school by the age of 15 and was accepted at the University of Saskatchewan, where he completed his undergraduate education. For clinical training, Kliman went to Toronto. After graduating at the age of 21 (just old enough to sign prescriptions), he went to Regina for an internship at the Grey Nuns' Hospital. There he met his future wife, Beatrice, the only Jewish nurse in the hospital. He considered going into psychiatry, but became more interested in surgery and was appointed as a senior intern. He was then offered a job in the cancer clinic, but Beatrice encouraged him to get experience in general practice.

Kliman began a small-town practice in Mankota, south of Moose Jaw. There he made an immediate impression by his diagnosis and treatment of a local matriarch who had been bedridden for several months. Noting her extreme anaemia, he made some blood smears, which he sent to Regina. Within a few days he got a phone call to say that these were the best pernicious anaemia slides they had seen in years. The local pharmacist had some liver extract and, after daily injections, the good lady was walking downtown in her hat and gloves within three weeks.

There had been plans for a local hospital, but these had stalled, so Kliman's mother decided that something had to be done. She visited Tommy Douglas, the premier of Saskatchewan, which led to a grant of $20,000, enough for a 20-bed institution.

It was now possible for women in the Mankota area to have their babies close to home, and there were 400 deliveries in just over two years. The first caesarean section was done with a textbook open on a music stand. Mrs Kliman warned her husband of the risk of injury to the baby when he cut into the uterus (she had seen many more caesareans that he had). He was chagrined to observe a fine linear scratch on the baby's back when he examined it after delivery.

Kliman then received a call from Saskatoon, where they were looking for an anatomy instructor (he had excelled in anatomy as a student). The Klimans agreed that it was time to go back to the city - by now they had their first child, who would soon need a good school. The new job offered $2,200 per annum, less than his salary in practice. He enjoyed teaching, and they managed for a while. However, the family was growing. Despite an increment received with his promotion to assistant professor, the Klimans concluded that a career in surgery might offer better rewards. Influenced by his British father-in-law, he decided to go to England for further training and surgical qualification.

With some help from an exchange scholarship, the family arrived in Britain and Kliman went to the Royal College, where he got good advice from Sir Francis Fraser, who was in charge of Commonwealth physician education. Kliman passed a course in preparation for the primary fellowship exams and then prepared for the final exams of the Royal College of Surgeons. He attended lectures, rounds and outpatient clinics. He observed surgery in leading institutions, assisting on occasion and he passed the final after a year.

Kliman was keen to work with Denis Brown, pioneer in the treatment of club foot, whose lectures he had heard in Toronto, and he was appointed to attend at Brown's clinics at Great Ormond Street Children's Hospital. After a time, it was evident that he needed more general surgical experience. Denis Brown phoned Ian Aird at Hammersmith Hospital to say, 'There is a young chap from Canada here who needs some general surgery. When shall I send him over?' He soon became a registrar and then clinical assistant to Aird.

After four years in England, it was time to go home. Kliman was tempted to stay, but the family wanted the grandchildren to grow up in Canada. He intended to specialise in pediatric surgery. He was able to get on to the staff at the expanding University Hospital in Saskatoon, but it was made clear that his work would be in general surgery. Saskatoon seemed like a small town.

Kliman had links with Vancouver, where his brother was a lawyer and the family made a swift decision to move west. In due course he went to the health centre for children in Vancouver General Hospital. There was little work at first, so he asked Jack McCreary if there were any jobs in the outpatient area. A foot clinic was planned (with a grant from the Savage Shoe Company), and with his experience under Denis Brown, this seemed an ideal fit.

Kliman was a superb teacher of residents and medical students on the wards of the health centre and the Children's Hospital. Always friendly, he would come to the nursing desk and join in discussions about the patients, offering a beautifully systematic tabulation of relevant factors in diagnosis and management.

Kliman was elected to the board of the British Columbia Medical Association (BCMA) in 1970 and, apart from one year during which he was a vice-delegate, he remained on the board for the next 28 years. He served as a member of most, and chair of many, committees. On the income tax committee, he arranged lectures on tax matters for physicians. On the negotiating committee, he consistently fought for better remuneration for lower-paid physicians, and he was principal contributor to a fee settlement with the Workers' Compensation Board. He liked to open negotiations by saying, 'Tell us what you want and what you can give us in return. We will tell you what we want and what we can give you in return.' While on the economics committee, he again proposed a pension fund, but this would take another ten years to materialise.

Kliman was honoured with both the silver medal of service of the BCMA and the Cam Coady award. He was invited to give the Osler lecture in 1980.

Murray Kliman passed away on 5 February 2011, aged 87. Of modest height and demeanour, but possessed of a formidable intellect, Kliman was a pioneer in paediatric surgery, a gifted teacher, and a delightful colleague. He made an exceptional contribution to the affairs of the BCMA, including participating in negotiations with government and other agencies on behalf of the profession of which he is a proud member. His family, patients, students and colleagues have much to thank him for.

Gary Redekop

The Royal College of Surgeons of England