James Armstrong came from a staunchly medical Belfast family but spent very little of his life in his native province. His father John was a surgeon and sometime Member of Council of the RCS Ireland; his mother Maria, née Rowan, was a doctor, as were three of his brothers and his sister. James was born on 3 June 1910 in Ballymena, County Antrim. He was Educated at Dungannon School and at Queen's University, Belfast, where he qualified in 1933. His father introduced him to basic surgery, teaching him to exploit his ambidexterity and to operate with equal facility with either hand. After his house jobs he left for London, where he took a number of Junior surgical appointments in smaller hospitals and was inspired by Dickson Wright's operative skill. At Charing Cross Hospital he was orthopaedic registrar with David Trevor, confirming his inclination towards that specialty. After gaining his FRCS in 1938 he was for a time surgical registrar to the Metropolitan Hospital, but having already joined the RAF Volunteer Reserve he was called up soon after the outbreak of war. Much of his war service was at RAF Ely, where as a surgical specialist he developed his orthopaedics and on the treatment of fractures by bone grafting. He rose to the rank of wing commander. His first consultant post was at the Royal Waterloo, followed by appointments at the Manor House, the Metropolitan and Lambeth Hospitals. The last named was later taken over by St Thomas's, with which the staff was integrated. His particular expertise was in the management of the prolapsed intervertebral disc by laminectomy. His book *Lumbar disc lesions* was first published in 1952 and went through three editions; he co-authored *Injury in sport* with W E Tucker. As a sportsman he excelled, playing both cricket and rugby for his university and golf for his County (handicap 2); salmon and trout fishing increasingly occupied his later years. His wife commented that he always selected his house surgeons from among the more sporting types on the grounds that they might be more intelligent and would work harder so that they could have time off. This worked well enough (apart from the odd 'patching up' that had to be done on Monday mornings) until a yachtsman was stranded on the other side of the world and was away for longer than anyone had anticipated! He was a very private person who could seem austere, declining to take part in any committee work or social activities, but to those who knew him well he was a warm and loyal friend and could be immensely entertaining as a raconteur. He was married twice but had no children. After the dissolution of his first marriage he took good care to teach the lady who was to become his second wife, Patricia Timpson, to be both keen and competent on the golf course and the river before he married her. He died on 16 August 1996 after a long illness.