Hamilton D’Arcy SutherlandThis address was delivered at the fifth Foundation Day Ceremony held at Royal Adelaide Hospital on 13 July, 1983.
Sir Francis Drake, in his dispatches to Queen Elizabeth I, following his raid on Cadiz on 17 May, 1587, stated:
There must be a beginning to any great matter, but the continuing of the same to the end until it be thoroughly finished, yields the true glory.
Hopefully, there will never be a factual end to this great matter, that is the hospital and its purpose. Even though there has to be an end to our service to the hospital, if we have done our work to the best of our ability, and have continued to believe in what the hospital stands for, we will have contributed to ‘the true glory’ of carrying the hospital into the future.
I entered medicine by the decree of the school headmaster fifty one years ago and when I leave the Institute of Medical and Veterinary Science next week I do so with the awesome realisation that I have been a miniscule part of this campus for more than a third of its history.
History should always form a part of our lives because, in all circumstances the best decisions are made from a knowledge of it, if not in detail at least with an awareness of its impact on the matters of today.
In this regard we must be both proud and grateful to James Estcourt Hughes’ contribution to the life and future of the Hospital by his chronicling of its history for posterity. The activity of Ron Hooper and the Heritage and History Committee is of increasing importance and will, I hope, be a permanent activity.
South Australia spent its early years under the blight of extreme financial stringency so that it should not put the British Government to any expense. This hospital likewise, started in an atmosphere of professional disputes, administrative wrangling and financial turmoil.
It is a fact of society that all organisations, like organisms, must continually adjust to their environment or perish and one of these adjustments is by the generation of strong leadership.
The Adelaide Hospital, in its travails over the years, has generated many wise leaders and one of the earliest, strongest, and most timely, was Dr William Wyatt, who came to South Australia at thirty-two years of age in 1837 in the colony’s second year. He was thirty-six when the hospital was founded, and he lived to be aged eighty-one.
He demonstrated his rare versatility in that he was a founder and governor of St Peter’s College, was on the boards of the South Australian Institute, the Botanic Gardens, the library, the museum, the art gallery, and he was the coroner and the commissioner and inspector of schools.
Dr Wyatt led the hospital as chairman of the board for eighteen years and as a practising doctor ‘had the honour of having sawn off the first leg needing amputating in South Australia’.
And so we came down through the great names of the past like Edward Stirling, Joseph Verco, Simpson Newland, de Crespigny, the Hones, Ivan Jose and Leonard Lindon through the wartime generation to the Lendons, McEachern, Sleeman and Colin Rankin, all of whom played major roles in the fashioning of the hospital as we know it today.
The unfairness of history is to those who have played a vital role in the same progress, but, hidden in the system they get overlooked by history but we should not forget the collective contributions they have made.
Today’s people are too close to us and too numerous to mention but their contribution is even greater because the hospital has never worked harder and better than it is doing today to preserve its standards and its future. When this present era is passed, history will surely remember many of them.
From those deeper in the system I would like to remember, in this little bit of history, all of those I worked with but especially Sisters Tossel and Carr, Betty Scott Young, John Stace, Audrey Simpson, Peter Hetzel, John Waddy, Neil Pressley, Val Gurr and Veronica Cummings, without any one of whom cardiothoracic surgery in my time would have been a lesser thing.
Enough of people for the time, because I would now like to pay a tribute to a small building which had great significance in the development of the hospital as well as having a nostalgic memory for me, the ‘Old No 1 Theatre’.
The hospital’s first operating theatre, which also served as a chapel, the dual purpose being more than a coincidence in those days, was built in 1856, eleven years before Lister published his work on antiseptic surgery. Operations were understandably few at that time but by 1888 both surgery and anaesthesia had advanced, thus creating the need for further operating facilities and approval was granted for a major addition to the hospital in the form of a new operating theatre complex, as it is said, ‘with surgeons’, students’, waiting and anaesthetic rooms provided with all the necessary appliances and fittings’. Also, as part of the complex, were two six bed post operative wards, a nurses’ station and isolation rooms ‘for (as it said) the receiving of patients after operations until they are fit to remove to the general wards’.
Dr William Gardner, who was one of the hospital’s first four honorary surgeons, the first dean of the faculty and first lecturer in surgery at the university and prominent in the planning of the building, was, by general consent, invited to perform the first operation at its official opening in 1891. So was born an operating theatre complex which was decades ahead of its time and which continued to serve the hospital well as a general theatre until general surgery moved to the McEwin Building in 1946.
It was in Old No 1 as a fourth-year student in 1935 that I came over faint at the sight of a cholecystectomy incision being made by Santo Messent and had to leave the theatre in shame and where later that year I assisted at my first operation. It was an appendicectomy performed by Paddy Funder, who, when it was all over, came across to me with a pair of artery forceps and said, in the way registrars have of speaking to fourth-year students, ‘If you are ever going to be a doctor you might as well learn to put these things on and take them off properly’.
Time passed and in 1946, Dr Rollison gave me as surgical superintendent, the job of transferring general surgery from Old No 1 to the McEwin Theatres which we did over a single weekend. Then, as it happened, I performed the first operation on the new general surgical floor; an emergency the night before routine operating commenced. Another vivid memory I have of Old No 1 as a student was the blood transfusion procedure of the day. For this, the two sides of the theatre were booked hence it was usually at night, the recipient on one side and the donor, usually a relative laboriously grouped and matched during the day, in the other. The donor blood was run into an open glass jar containing citrate and stirred with a glass rod as it flowed. A second ‘team’ was waiting in the other theatre ready to give the blood by the simple method of straining it through a sheet of gauze into a glass funnel connected by red rubber tubing to the needle of the patient.
In 1949, after my thoracic surgical training in England, which incidentally was largely surgery for tuberculosis at that time, we were able to rejuvenate Old No 1 for thoracic surgery and to start on the backlog of cases immediately.
Over the next ten years, the new surgical speciality gradually progressed from tuberculosis to non-tuberculosis work as tuberculosis came under control and routine thoracic and cardiac surgery became more established culminating in the first open-heart procedure in the same theatre at the end of 1960.
The theatre, by then seventy years old and with only minor additions, was ideal for open heart surgery because of its sheer size and the availability of ample space for pump preparation and cleaning equipment storage and all the other requirements of an open heart programme. Most important of all, working in virtual isolation allowed us to build on and cement the team spirit we had been developing from our tuberculous beginnings and which always stood us in good stead.
When cardiothoracic surgery moved to the East Wing and Old No 1 was pulled down as part of the rebuilding programme, I managed to salvage some brass door handles from the old theatre and have them built into my own furniture in memory of my thirty year span in Old No 1 and the last thirty years of the theatre’s existence.
I cherish the thought that some human hand must have touched those same brass door handles at least twice for every operation that was ever performed in Old No 1 in its seventy five year history, because, they were on the sliding doors giving access and egress from the operating tables themselves.
How much more would I have liked to have seen preserved those wonderfully old silky ceramic floor tiles so tenderly scrubbed and mopped by seemingly endless generations if nurses and on which the careers of so many of South Australian surgeons were built and on which the surgical history of this hospital was made from the time of Lister to the present day.
Now let me close as I began with Francis Drake and with the conviction which I hope we all share, that the true glory in a hospital is not merely with its foundations, but in the continuing of its work for the care and welfare of patients until it be thoroughly finished.