Richard John Earlam, who was a consultant general surgeon at the Royal London Hospital, played a crucial role in the introduction of the air ambulance service to London thus contributing to a huge drop in deaths from trauma in the capitol. Born in Liverpool on 26 March 1934 he was the son of Francis Earlam, a general practitioner, and his wife Elsie Noeline née Skippers who was a science teacher. His uncle Laurence was also a GP. Educated at Liverpool College and Uppingham School he went up to Trinity Hall, Cambridge at the age of 18 to study medicine. His tutors at Cambridge, he acknowledged, inspired his enthusiasm for research and he estimated that the 300 hours that he spent there studying embryology were the *basis of future thoughts on an intrauterine volvulus causing aganglionic bowel*. After graduating in 1955 he returned to Liverpool where he was a house surgeon at the Royal Infirmary working with Charles Wells and then spent a year as house physician at the Royal Southern Hospital in 1959. The following year he began his national service in the RAMC doing three months general duty with the Royal Warwickshire Regiment. He was then posted to Hong Kong with the British Military Hospital where he served for 21 months as a junior surgeon. From there he moved to Australia taking a post as a GP in New South Wales in 1962. On his return to the UK in 1963 he worked as an anatomy prosector at the Royal College of Surgeons of England before returning to Liverpool as surgical registrar to the Royal Liverpool Hospitals. While there he was, at various times, influenced by Philip Hawe, James Cosbie Ross, Norman Gibbon and Charles Terence Burgess. His mentors were quick to perceive his enthusiasm for research and it may have been a remark of Hawe’s *Now there is a problem for you to solve, Earlam* that set him off on his studies of disorders of the oesophagus. He moved to the USA in 1966 and became a research assistant at the Mayo Clinic in Rochester working with Charles Code, F Henry Ellis and George Hallenbeck. All three were distinguished figures in the field of gastrointestinal physiology and it was from this experience that Earlam gained his lifelong interest in the subject. While in America he wrote his thesis on the repair of hiatus hernia in dogs and began to study the use of oesophageal manometry. It was this process, used to measure the performance of a valve at the end of the oesophagus, that he was later to introduce at the London Hospital, setting up an oesophageal manometry laboratory and carrying out more than 1000 of such procedures which formed the basis of his work *Clinical tests of oesophageal function* (London, Crosby Lockard Staples, 1976). Before returning to the UK he spent a year researching cardiac surgery in Munich in 1967 at the Universitats Klinik with Rudolf Zenker and Hans Borst on an Alexander von Humboldt scholarship. In 1968 he joined the staff of the London Hospital as a lecturer in surgery and was appointed consultant in 1970. During the 28 years he was to spend at the London he was immensely prolific, writing or co-authoring over 150 papers and several books notably *Trauma care* (Saldatore, 1997) and *ABC of major trauma* (London, BMJ Books, 1991). He also served on many important committees at the hospital and others such as the European Oesophageal Group and the International Society for Digestive Surgery. Undoubtedly his outstanding contribution was the introduction of the London Air Ambulance Service (LAA). During the 1980’s he had been aware of reports issued by the Royal College of Surgeons of England in which it was pointed out that a vast improvement in the treatment of major trauma patients could be achieved if they could access specialist hospital services more speedily. On congested city streets this was often impossible. Aware that the Germans already ran a helicopter emergency medical service and that Cornwall had recently introduced one, Earlam and a colleague, Alastair Wilson lobbied the various bodies involved. Frustratingly they met with opposition on almost every front, from the ambulance service, the coroners, the hospitals and the Department of Health. It was not until 1988 that he managed to persuade Baron Stevens of Ludgate, chairman of Express newspapers, a family friend, to provide funding from the group for an air ambulance and crew for six years. Kenneth Clarke, then minister for health, refused to fund the helipad but Earlam went straight to the Prime Minister, Margaret Thatcher and she backed the scheme. Fortunately the London Hospital was both a multidisciplinary centre and had the facility to build a rooftop helipad. From the time that the service started in 1989 there was a marked improvement in mortality and Alastair Wilson noted that whereas in 1989/99 there were 340 deaths from serious injuries in London there had been 1300 ten years earlier. Today the service covers the whole of the area enclosed by the M25 with a population of eleven million and has played a vital role in many recent incidents such as serious train crashes and terrorist attacks. During the bombings in 2005, for example, the LAA carried out 25 missions and 208 people were treated at the Royal London. In 1998 he retired and was able to enjoy his various enthusiasms which ranged from carpentry, beekeeping, stamp collecting and tennis to walking in the mountains of Bavaria and Switzerland with his family and sailing his beloved Dragon boat. He married Roswitha Teuber in 1969, having met her at a cocktail party when he was working in Munich. When he died on 23 July 2016, aged 82, she survived him along with their two daughters and four grandchildren.