OBITUARY

Professor FJ Gillingham PRCSEd, CBE, FRSE

Professor John Gillingham succeeded Norman Dott

as the second Forbes Professor of surgical neurology

at the University of Edinburgh in 1963 a position that

he held until he retired from clinical practice in 1980

a year before his sixty fifth birthday so that he might

take up full time the duties of the President of the

Royal College of Surgeons of Edinburgh. During his

clinical life his principle interests were the manage-

ment and prevention of head injury flowing from his

war time experiences in north Africa and Italy, the

development and understanding of stereotaxis and

its application to functional neurosurgery and in-

tracranial vascular surgery and the management of

aneurysmal subarachnoid haemorrhage, as President

of the Edinburgh College he continued his other

great interest that of a surgical educator. In both

these roles as surgical pioneer and educator he was

helped by his real understanding of the values of

life and a lively sense of humour indeed he will be

remembered as much for his irrepressible smile

and glint in his eye as his huge contribution to

neurosurgery.

Born on the 15th March 1916 in Dorchester he

attended Hardye’s School and then graduated from

St. Bartholomew’s Hospital Medical School, the

University of London in 1939. While at Medical

School he won the gold medal in gynaecology which

lead him to have to decide whether to follow a career

in neurosurgery or gynaecology. Apparently this

decision was decided on the spin of a coin – heads

neurosurgery, tails gynaecology. Fortunately for

neurosurgery the coin landed heads up. Following

his house jobs he joined the Royal Army Medical

Corps and was appointed to the Oxford Military

Hospital at St. Hugh’s College where he managed

head injuries under Colonel Hugh Cairns and

Group Captain Symonds. After eighteen months

in Cairns’ field surgical unit experiencing general

military surgery as well as head injury management

he served in North Africa and the Eastern Italian

campaign. Later in life he had thought to publish his

memories and many photographs of this time but

sadly the photographs were destroyed when their

house was flooded in 2006. The pace of wartime

work lead to an enormous experience of which he

kept meticulous notes of the patient’s injury and

operative procedures. His interest in head injury and

its prevention was to continue into his peace time

working and he became a leading campaigner for

the introduction of seat belt legislation and was

the recipient of the Clarke Foundation Award for

services to road safety in 1979.

Following the war he returned to Oxford under Sir

Hugh Cairns. In 1945 he married Judy Irene Jude the

wedding being organised by Cairns to minimise

disruption to his busy clinical service. A return to St.

Bartholomew’s for further training with Sir James

Paterson Ross and Mr. John O’Connell lead to his

appointment as Consultant Neurosurgeon in Edin-

burgh the unit at that time being in Bangour General

Hospital in West Lothian sixteen miles to the west of

Edinburgh and ward 20 (under the clock tower) in

the Edinburgh Royal Infirmary in Lauriston Place.

The elective Department of Surgical Neurology at

the Western General Hospital was opened in 1960 a

building designed for the holistic provision of care for

neurosurgical patients and one of the neurosurgical

theatres being specially equipped for stereotactic

surgery. To enable consultation between the two

units with the help of Scottish Television he installed,

possibly one of the first telemedicine links, between

the treatment room in ward 20 at the Royal Infirmary

and his office on the ground floor corridor of the

Department of Surgical Neurology at the Western

General Hospital.

With Dott he learnt and developed his interest

in the management of aneurysms, describing the

importance of the sentinel bleed and its recognition

in the potential to prevent recurrent haemorrhage,

issues of vasospasm and its relevance to the timing

of surgery. Much of this in an era before CT scann-

ing and with direct carotid puncture rather than

transfemoral catheter angiography.

Guiot had visited Edinburgh from Paris to learn

about aneurysms and through this visit Gillingham

was invited to Paris to see Guiot operate, a subfron-

tal freehand pallidotomy. Subsequently he adapted

Guiot’s stereotactic method to an occipitoparietal

approach. The Gillingham-Guiot stereotactic frame

was progressively refined to include a motor drive

of the targeting electrode and cellular recording to

improve the accuracy of the therapeutic lesion.

His 1960 publication showed that 88% of operated

patients had tremor/rigidity abolished or significantly

British Journal of Neurosurgery, April 2010; 24(2): 106–107

ISSN 0268-8697 print/ISSN 1360-046X online ª The Neurosurgical Foundation

DOI: 10.3109/02688691003680408

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reduced without complication. Later a ten year

follow up of a second cohort of operated patients

showed consistent relief of tremor and rigidity but a

decline in the effect on bradykinesia. The operation

was a two stage procedure both being performed

under local anaesthetic. The first was the placement

of three rows of five metal balls frontal, post coronal

and occipital from which by means of a straight plain

AP Xray the exact midline could be determined for

placement of the frame and a ventricular catheter

was placed for myodil ventriculography to define the

third ventricle and from this the coordinates for

the lesion. Some days later the second stage was

performed with the help of the neurophysiologists

and physiotherapists in addition to the regular theatre

team. Finally the target was marked with a metal ball

for radiological confirmation of the lesion. Because of

his surgical reputation he had the additional respon-

sibilities of being selected to treat many influential

and well known people at home and abroad.

He was an enthusiastic teacher of medical stu-

dents, neurosurgical trainees and general practi-

tioners. He encouraged trainees to take on research

and to attend the European Training Courses on

which he was an active teacher. He was internation-

ally recognised and invited to visit and lecture

overseas. As a consequence the unit attracted over-

seas trainees who added to the overall training and

breadth of knowledge within the department. His

concern for the young extended to offering accom-

modation in his home to a young trainee in difficulty

and an overseas trainee with very limited financial

support. Many in the Department will remember

being included in the summer parties in Ravelston.

As President of the Edinburgh College he introduced

the specialty surgical fellowships not without some

resistance orthopaedics being the first and neurosur-

gery second. For the College he had the foresight to

develop Hill Square and negotiated the funding for

the King Khalid Symposium Hall. He had been

elected to the Fellowship of the College in 1955 and

a Fellow of the Royal Society of Edinburgh in 1970.

He had been awarded an MBE for Military service

and CBE following his Presidency in 1982. He was

widely recognised in the United Kingdom and

overseas with the award of Honorary Fellowships of

Colleges and Institutions. The most recent of these

was the Medal of the Society of British Neurological

Surgeons at Magdelen College, Oxford in May 2009

at which he spoke eloquently and with his customary

good humour from his wheelchair.

Following his presidency he became Professor of

Neurosurgery King Saud University Saudi Arabia.

He remained active into his ninth decade establishing

new contacts in Oxford and editing for the European

Journal of Stereotactic Surgery.

Family time although at a premium was hugely

important. The house at Portling on the Solway Firth

and later at Javea on the Mediterranean Coast of

Spain, his love of sailing his beloved Nantucket

Clipper, ‘‘Persephone’’ gave opportunities to enjoy

time with his family and regenerate his energy. He is

survived by his wife Judy, three of his four sons

(tragically Jeremy and Anni his wife, both GPs, were

killed in an avalanche while skiing) eleven grand

children and two great grand children.

JAMES STEERS

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