George Weir Johnston was a consultant general surgeon at the Royal Victoria Hospital, Belfast. He was born into a farming family near Ballymena in County Antrim, Northern Ireland, the youngest of five sons of Thomas Johnston and Jeannie Johnston née Weir. Whatever aspirations he may have had to be a farmer were dispelled when his local family doctor visited – the young George noticed the GP’s stylish car and promptly announced his intention of becoming a doctor. He was four at the time. After his years at Ballymena Academy, he won a scholarship to study medicine at Queen’s University in 1950, picking up many prizes and qualifying with honours at the top of his class in 1956. Still contemplating a career as a GP, he gained experience in obstetrics and paediatrics and then worked in the USA, in a small hospital in Middletown, Connecticut. On his first night on call there, he delivered a baby by breech extraction. This was a routine procedure for him, but by American standards it represented an alarming degree of autonomy for a first-year resident. During his year in the US, he decided to switch to a career in surgery and, on returning to Belfast, became a surgical house officer and later a registrar in the professorial unit at the Royal Victoria Hospital, gaining his FRCS in 1962. Harold Rodgers was an influential mentor, and George became involved in Rodgers’ work on portal hypertension. In those days, before flexible endoscopy or any acid reducing therapy, gastrointestinal bleeding was the surgeon’s problem and the high prevalence of alcoholism in the surrounding community made bleeding oesophageal varices almost a daily emergency. George’s MCh thesis on the causes and treatment of hepatic encephalopathy was completed in 1965 and awarded a research prize, all without the dedicated research time so common these days. He continued to work as a clinical registrar while still caring for his dogs and monkeys, though research on animals was something he never felt at ease with – a legacy of his early years on the farm. He then spent a year at St Bartholomew’s Hospital as an assistant to Sir Clifford Naunton Morgan, and the influence of Harold Rodgers and Sir Clifford remained with him throughout his career. As a consultant to the Royal Victoria Hospital, he joined Terence Kennedy in creating a truly research-oriented NHS ward and over the next 25 years published many studies on portal hypertension, but also wrote on surgery for duodenal ulcer, hiatal hernia, achalasia, rectal cancer and inflammatory bowel disease. The unit was responsible for several randomised controlled trials, with clinical outcomes assessed by an independent clinician, Anne Spencer. George was also at the forefront of the surgical response to the civil violence that was tearing Northern Ireland apart in those years. He was a James IV travelling fellow to the USA and Canada in 1977, and named a Hunterian professor in 1980. Not one to seek honours and office, he served in the background as the regional adviser for the Royal College of Surgeons, and on the council of the Association of Surgeons of Great Britain and Ireland. Many honours nevertheless came his way, notably an OBE in 1994 for services to medicine, and he was made an honorary professor by Queen’s University in 1990. His 1973 paper on injection of oesophageal varices is probably his most enduring legacy and did more than any other to transform the otherwise depressing treatment of this dangerous condition, but at the time he was perhaps best known for introducing stapled oesophageal transection for varices, initially using the Russian SPTU stapling gun, which he personally brought back from Russia. Importing ‘guns’ from Russia to Belfast in the 1970s raised some eyebrows when it became known. He was certainly the world’s best-known exponent and developer of the technique, but in his writings he was always careful to give credit to Vankemmel in Lille for the first early report. His priorities for treating varices were epitomised in his famous aphorism ‘inject, transect, select, reject’, which we all learned. George’s amazing productivity – over 100 papers and 36 book chapters, several films and invited lectures in most major cities in the UK and Ireland, as well as all over Europe, America, Africa, the Middle East, Hong Kong, Japan, Australia and New Zealand – all coexisted with a very busy clinical NHS schedule and a brisk private practice. He was regarded as the go-to person for many complex cases on medical wards, even when there was no obvious surgery required. Everything about him was quick. He walked quickly, talked quickly – sometimes his rapid-fire delivery could seem brusque – operated quickly, and thought quickly, and his astute observational sense often provided immediate and intuitive diagnoses. He wasted no time. His Monday operating list ended at 12.30 and by 1pm he was on the first tee for a quick round of nine holes played with his friend Des Hall, a GP. His ward rounds on Saturdays and Sundays with Sister Cherry were often over by the time the house officer appeared on the scene. His devotion to and empathy for his many alcoholic patients was all the more remarkable in view of his own lifelong principle of total abstinence, partly a consequence of his conservative Protestant culture, but reinforced by his daily experience of the destructive effects of alcohol on his patients and their families. With the words, ‘not even a wine gum!’ he would warn many a patient about abstaining from drink, the twinkle in his eye revealing both his realism and his empathy. George took a great interest in teaching and stimulating his registrars, not only how to operate, but also to write. He had a passion for asking questions, looking for better solutions or better insights. From his early days as a senior house officer in the fracture clinic until his retirement he was motivated to write. He stimulated both clinical and experimental studies in his juniors and took every opportunity to acknowledge their work when he was presenting or teaching. As a teacher of operative surgery, his deftness and rapidity in dissection and suturing was so virtuosic that it sometimes seemed magical. Many consultants look back at their time with him as the most pivotal period of their training. Many of us owe a lot to his wise and insightful career advice. He was of short stature, but was nevertheless looked up to wherever he was. He was commonly known as ‘Wee George’ – a term of affection and respect bordering upon awe, generally used in his absence – but his authoritative wisdom and readiness to engage made him automatically the person instinctively looked to for guidance. As a speaker, he had a great sense of timing; his strong Antrim accent was never a barrier to clarity of communication. Two key factors motivated his life and work – the first was a lifelong Christian faith that he had made his own even as a boy, and which gave purpose to his life. He was a church elder and an important source of wisdom and mentorship for many in the church he was part of for over 50 years. His faith fuelled his compassionate attitude and ethical conduct. For all his quickness, he was a warmly human man with a disarming sense of humour and a sensitivity to distress, not just in his patients, but in his nursing and clerical colleagues. He was quietly and unobtrusively very generous with his money. The other profound focus of his life was his wife and family. He briefly met a student nurse, Elaine Hutton, at a nurse’s Christmas party and was captivated by her. With typical tenacity, he managed to find out who she was and where she worked and began a courtship that blossomed into a romance and a wonderfully heartwarming married life. They had four children, two of whom followed him into medicine. Throughout his life he made a lot of effort to be home and engage with his family, and the progress and cohesion of his family was a source of joy and happiness to him. His final illness was mercifully brief, and his passing was peaceful and confident. He was survived by Elaine and sons Brian, Paul and Colin, daughter Heather and 13 grandchildren. When he died on 27 November 2020, two days after his 88th birthday, lockdown during the Covid pandemic was still in force and it was sad that his marvellous life and career could not be memorialised in the usual way. In-person attendance at his funeral was limited to his immediate family members, but the service was widely watched online.