Paul Brian Counsell moved to Bermuda as a consultant surgeon in 1958 and for several years was the only general surgeon there. Isolated in Bermuda, he carried out general surgery in the widest sense, performing abdominal surgery, orthopaedics, genito-urinary surgery, and an occasional Caesarean section or hysterectomy when requested by a GP obstetrician, or a craniotomy for a head injury following a road accident. A keen tennis player, he suffered from orthostatic hypotension in his later years, which brought on many syncopal attacks. On 20 July 2001, feeling a syncopal attack coming on, he knelt by the side of the bed, and fell forwards, face down. He was asphyxiated in the bedclothes.