James Keith Ross was a leading cardiac surgeon, and one of the team that performed the first cardiac transplant in Britain. He was born in London on 9 May 1927. His father, Sir James Paterson Ross, was later to become professor of surgery at St Bartholomew’s Hospital, Surgeon to the Royal Household and President of the College. His mother, Marjorie Burton Townsend, had been a surgical ward sister at Bart’s. Keith was profoundly influenced by his maternal grandfather, Frederick William Townsend, who taught him to work in wood, a practical education in hand-eye coordination, which laid the foundation of his exceptional surgical skill. Another influence was his godfather, Sir Thomas Dunhill, who, whilst recuperating from a hernia repair, gave Keith a trout rod and insisted on demonstrating it whilst in his pyjamas in the middle of Harley Street. Keith attended the Hall School, Hampstead, and then St Paul’s, where he was the senior scholar. He went on to Middlesex Hospital medical school, where he won the Asher scholarship in anatomy and the Lyell medal in surgery. Qualifying in 1950, he became house surgeon to Thomas Holmes Sellors, won the Hallet prize in the primary FRCS and then did his National Service in the Royal Naval Reserve, mostly at sea. On returning to the Middlesex, he passed the FRCS in 1956 and began a training in cardiothoracic surgery at the Brompton Hospital and as a Fulbright scholar with Frank Gerbode in San Francisco, where his research into the fate of grafts in the heart led to a thesis for his masters in surgery and a Hunterian professorship. He was promoted to senior registrar in 1961 at the Middlesex and Harefield hospitals, and to part-time consultant at Harefield in 1964, and later at the Central Middlesex and Middlesex hospitals. In 1967, he gave up these posts, which involved a good deal of stressful travelling, to join Donald Ross at the National Heart Hospital. He was by now at the top of the tree, recognised both in Britain and abroad. His personal series of 100 consecutive homograft aortic valve replacements with only two hospital deaths was, at the time, unrivalled. It was with surprise that his contemporaries learned that he had moved to Southampton, though those who knew him better understood that he felt he was needed there, and it was his duty to go. Arriving in Southampton in 1972, he was joined the following year by James Monro, who had just returned from a year with Barrett-Boyes in New Zealand, and brought expertise in paediatric cardiac surgery. Together they built up a first rate team, accepting only the highest standards and insisting on a strict audit, both of the short-term results and of quality of life after cardiac surgery. The reputation of the department attracted young surgeons from abroad, in particular from Boston, to work in his unit and to support this he organised a cardiac surgical fellowship. Once the unit was well established, he started a second open heart programme at King Edward VII Hospital, Midhurst. He was postgraduate dean and then President of the Society of Cardiothoracic Surgeons. He was elected to the Council of the College in 1986. He was awarded a fellowship in 1989 and the Bruce medal of the Royal College of Surgeons of Edinburgh. He succeeded his father to the baronetcy in 1980. Keith was a man of great personal charm, with a high sense of duty, fortified by a solid faith. He was perhaps at his happiest whilst fishing, be it on a Highland salmon river or on the Test. He was also a keen sailor and woodworker, and a talented artist – painting took up much of his time once he had retired. Twice he had pictures accepted for the Royal Academy summer exhibition and, to his glee, sold them both. In 1956, he married Jacqueline Annella Clarke, a Middlesex Hospital nurse. They had four children – a son, Andrew Charles Paterson, an officer in the Royal Marines who succeeds him as third baronet, and three daughters (Susan Wendy, Janet Mary and Anne Townsend). There are eight grandchildren. In 2000, he underwent an operation by his old team to replace his aortic valve. Ironically, it was a procedure he had pioneered. He made an excellent recovery, but nearly a year later developed a dissecting aneursym of the aortic arch: this too was treated with initial success, but he died suddenly on 18 February 2003 in his old hospital.