Clive Butler was born in Flaxton, near York, on 8 April 1904, the only son of William Barber Butler and Edith Eastmond, a nursing sister. They had both trained at the London Hospital and had helped to care for the Elephant Man after he had been rescued by Sir Frederick Treves. His father subsequently became a general practitioner surgeon in Hereford and sent Clive to Shrewsbury. He followed his father to the London Hospital in 1923, qualified in 1928, did several junior jobs, and became registrar to Russell John Howard from 1933 to 1935. He was then offered the position of surgeon on the *Queen Mary* on her maiden voyage and continued in this position for seven months, during which time he crossed the Atlantic more than 30 times and made many interesting friends, among them Sir Clifford Naunton Morgan, who was very helpful to Butler in later years when he developed an interest in colorectal surgery. In 1936 the brilliant young thoracic surgeon H P Nelson died from septicaemia after pricking a finger during an operation. Clive Butler was summoned back to the London to fill the gap, and was appointed assistant surgeon the following year. As the most junior surgeon he was put in change of the septic block, which was then crowded with cases of osteomyelitis. His predecessor in that post, Charles Donald, had introduced the Winnet Orr management of osteomyelitis, immobilising the affected limb in a Thomas splint reinforced with plaster and refraining from changing the dressings, maggots or no. But Butler arrived at a turning point in surgery; Domagk discovered the antibacterial effects of prontosil rubrum in 1935 and in 1937 Fuller had found that its effects were due to a metabolite, sulphanilamide. Within a short time Butler had gained huge experience in the use of sulphanilamide, but staphylococcal infections, especially osteomyelitis, continued to baffle him. He was able to show that drilling gave better results than guttering, and together with Frank Valentine, developed a method of monitoring bacteriaemia by counting the colonies in blood cultures. Nevertheless in his Hunterian lecture of 1940, which was based on 500 cases of acute osteomyelitis, the mortality was 25 per cent, rising to 80 per cent in children under a year old. Then in 1944 a limited supply of penicillin was made available to him. The next 21 patients all survived, and soon he could show that it was safe to perform a secondary suture within ten days, instead of months in a stinking plaster. At the end of the second world war, he accompanied Alexander Fleming and Christie to Copenhagen to describe the new techniques. Throughout the war Butler had been kept busy as an EMS surgeon, and in 1945 was formally appointed to the Harold Wood Hospital. By 1948, he had extended his interests to a much wider field of general surgery, notably colorectal surgery, where he had much help from Naunton Morgan, and parotid tumours, where he was one of the first to use a nerve stimulator and to use radium as an adjunct. He was a popular teacher, examined for the MB at home and in Nigeria, and in both the primary and final Fellowship, ultimately becoming Chairman of the Court. He was President of the section of proctology of the Royal Society of Medicine. He retired in 1969, but retained his active interest as curator of the museum at the London Hospital Medical College, where the relics of the Elephant Man were preserved. Shyness made Clive Butler seem a little gloomy and aloof to those who did not know him, but he was in fact a very sensitive and friendly person. He married Nancy Harrison of Minneapolis in 1939, by whom he had two sons, Bruce and Douglas, and a daughter, Anne, none of them entering medicine. The marriage ended in an amicable divorce in 1957. He died on 25 January 1999.