Obituary

500 www.thelancet.com Vol 382 August 10, 2013

Sir David Innes WilliamsFounder of paediatric urology. He was born in London, UK, on June 12, 1919, and died there on May 3, 2013, aged 93 years.

The attractions of joining a branch of medicine acknow-ledged to be making rapid and exciting advances are self-evident. No such description could be applied to urology in the years after World War 2. But this did not deter David Innes Williams from wanting to enter it. In fact, the absence of anything much going on was what drew him to it. As he recalled in an interview he gave 60 years later, “Urology hadn’t really gained anything from the war. Orthopaedics and neurosurgery and plastic surgery had all gained enormously and the people coming back for those specialties were sort of ready to shoot, but in urology there wasn’t anything special at all really, so it was rather interesting.” In 1948 he joined St Peter’s Hospital for Stone, one of the constituent bodies of London’s newly created Institute of Urology. “Most urology was a part of general surgery at that time”, according to Christopher Woodhouse, Emeritus Professor of Adolescent Urology at University College London. “Even for adults there were relatively few individuals who would consider them selves urologists. They were general surgeons with an interest.”

When it came to young patients no-one at all was specialising, a fact brought home to Williams by the failure of staff at St Peter’s to know how to treat one particular child suff ering from urinary retention. Once again it was the absence of anything much going on that attracted Williams. He responded by visiting a surgeon, Thomas Twistington Higgins, at the nearby Great Ormond Street Hospital for Children (GOSH). Higgins had an interest in urology, and Williams managed to get a part-time outpatient job at

GOSH. “It’s a remarkable place”, he later said of the hospital. “You only had to say you were interested in something and the patients came in.” He clearly made an impact; in 1952, at the age of 32, he was made a consultant at GOSH, and the country’s only full time paediatric urologist. So he remained for the next 10 years, a period during which he laid the foundations of what was to become a new subspecialty.

Trained in medicine at Cambridge University, Williams had spent 3 years in hospital practice and a further 3 years in the Royal Army Medical Corps before making the move into paediatric urology. His contributions over the next three decades were numerous. “One of his biggest was simply in classifying the various congenital anomalies of the system”, says Woodhouse. “He worked out how they were related embryologically, and studied their long term outcomes.” David Frank, Editor in Chief of the Journal of Pediatric Urology, was Williams’s fi nal registrar at GOSH. “He was an innovator as a surgeon. Technically very good, he never rushed, and his results were excellent.” Woodhouse agrees. “Surgery previous to his interest in it had been mostly excisional, and for stabilising complex systems. And the outcomes often weren’t good. A lot of patients died or had long-term morbidity. He started the reconstruction of complex anomalies to such an extent that people who wanted to learn about it came from all over the world.” From 1976 to 1978 he served as President of the British Association of Urological Surgeons.

At the age of 60 years Williams surprised everyone by quitting GOSH and his clinical work, and moving into academic administration. “He felt that he’d done everything that was a challenge to him, and that if he continued he’d just be doing the same sort of thing year after year”, says Woodhouse. Another motive might have been that he didn’t entirely relish the consequences of his fame within the profession. As Frank recalls, “He was at his peak when he decided to stop. But he spent a lot of his time trying to hide away because he was constantly surrounded by people trying to see him.” Williams’s fi rst post-clinical job was the directorship of the British Postgraduate Medical Federation, a University of London body set up to oversee its various postgraduate medical institutes, one of which was the Institute of Urology. He also became a Pro-Vice-Chancellor of the University of London and chairman of the council of the Imperial Cancer Research Fund. He was knighted in 1985.

Frank remembers his mentor as a man who was polite, fair, always on time, never rushed, and with a slightly dry sense of humour. “He knew an enormous amount. Nothing ever seemed too diffi cult for him.” Woodhouse speaks of Williams as reserved, but approachable. “He was a precise individual, a man of few words. And extremely supportive of his trainees like me, always very encouraging.” Even now, 30 years after he stopped practising, Williams’s reputation is as high as ever. He leaves two sons.

Geoff Watts

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