ANZCA Bulletin June 2011 - Australian and New Zealand College of ...

Against opposition from some less
enlightened surgeons and some nurses,
she established a recovery room on a
shabby closed in veranda of the old 4G
theatres.
She soon demonstrated the value
of one-to-one nursing supervision and
on-the-spot anaesthetist support.
In 1960 with characteristic vision
and tenacity of purpose, she opened
the respiratory unit, a forerunner of
the modern intensive care unit. Here,
patients with tetanus, poliomyelitis,
chest injuries, drug overdose and
myasthenia gravis were ventilated
achieving world-class results.
There were no facilities for estimation
of blood gases, no pulse oximeters – the
outcome the result of Ruth’s constant
observation, meticulous attention to
detail and her fantastic clinical acumen
– and simple Radcliffe ventilators.
It was Ruth who developed the
concept of a cardiac arrest team at
Royal Brisbane Hospital but the
anaesthetic department could not
keep up with the demands because of
theatre responsibilities so the emergency
department undertook the role.
It was the good fortune of the Prince
Charles Hospital that Ruth was appointed
its first director of anaesthetics in
1963. Initially the commitment was to
thoracic surgery but with the arrival
of Dr Mark O’Brien in 1967, the cardiac
unit developed rapidly. Ruth became
the perfusionist with an ongoing
commitment to anaesthetics.
Intensive care was undertaken in
the postoperative ward with input from
the cardiac surgeons as well as Ruth
and her colleagues. It is significant that
they had the awesome responsibility for
paediatric patients without the luxury of
a developed paediatric infrastructure
and paediatric equipment.
She contributed in no small way to
the very high regard in which the Prince
Charles Hospital’s cardiothoracic unit is
held nationally and internationally.
During her directorship, Ruth was
responsible for the training of 250
specialist anaesthetists. I was privileged
to be one of her initial trainees in 1953.
Her professional colleagues at the
three hospitals speak with admiration of
the respect she earned from medical and
nursing staff, patients and their carers.
Her balanced, non-confrontational
arguments were revealed when it was
stated that Queensland was training too
many anaesthetists; she quickly rebutted
that heresy.
She knew how to manage “cranky”
surgeons. She told them to “get on
with the surgery for which they were
trained” – and gave them a score on
her “grizzle graph”!
Never a “women’s libber”, Ruth
avoided involvement in industrial
matters but was an active member of
the committee that worked to achieve
secure employment for married
women employed in government
and semi-government positions. The
positions held by married women were
classified as temporary with no rights
to superannuation and their jobs were
advertised each year. If a male or a single
woman with the same qualifications
were available, the incumbent lost
her job.
Ruth’s friends can look back on
a life of service to medicine and the
community, recognised appropriately by
admission as a Member of the Order of
the British Empire in 1987.
What of Ruth’s other interests
apart from the superb clinical care
of individual patients She took over
the lectures to medical students
previously given by a surgeon and a
physician – at least the physician had
trained in anaesthetics in Edinburgh!
Her commitment to teaching students
the principles of the care of the
unconscious patient and the importance
of pre-operative assessment rather
than just anaesthetic techniques was
revolutionary.
Her contributions to the formal
preparation of registrars for the
examinations for both the primary and
the final fellowship were marked by their
diversity but always integrated basic
science with clinical care.
She always emphasised the
maintenance of standards yet the
importance of never putting at risk,
justice to the trainee whom she assessed
perceptively – illustrated when she
recognised the innate ability of Wally
Biggs as she organised the crash course
to prepare him for his role as anaesthetist
to the Flying Surgeon.
She encouraged general practitioner
anaesthetists to accept placements in the
department so they could update their
anaesthetic skills.
Ruth had remarkable technical skills
not only in the day-to-day maintenance
of anaesthetic machines, ventilators and
monitors. I remember being mesmerised
when as a registrar she told me that she
had installed a hot water system at home
at the weekend. So it was no surprise
when I heard that she had taught a
young neighbour how to do a grease and
oil change on his truck, confirmed when
he attended her funeral service – not
the usual entry on the CV of a director
of anaesthesia!
Ruth appreciated the need for an
organisation to represent the views
of the whole profession. She joined
the British Medical Association as a
student member in 1945, attained full
membership in 1947 and was delighted
to receive honorary life membership of
British Medical Association/Australian
Medical Association in 1997.
Equally she was proud to be a 50-
year member of the Australian Society
of Anaesthetists and of the Medical
Women’s Society.
Ruth’s major interest outside of
medicine was her cats.
With her colleague, the late Dr
Dorothy Bowman, she established
the Merlin line of Uki Russian blue
cats – and these lordly creatures won
numerous awards over many years and
had pride of place in her home.
There were delightful messages on
attractive wall plaques letting visitors
know who was most important:
“This house is for the comfort of our
CATS. Visitors must take second place.
“If you love cats, you will understand,
if not, what are you doing here
“People who don’t like cats were
probably mice in an earlier life.”
Ruth loved the Australian fauna and
flora – as she sat on her front veranda
doing a cryptic crossword or reading the
paper, she found joy in hearing the songs
of the native birds in the trees she had
planted – not a rose, camellia or azalea
in Ruth’s garden – just the native trees
she had nurtured.
Sadly, her last years were marred by a
debilitating illness. She elected to remain
in the home her parents had bought for
her when she was six. This was made
possible by the selfless support of her
dedicated neighbour. Home visits by
her general practitioner and geriatrician
supported by personal carers and
Karuna Home Nursing Service ensured
her comfort and dignity.
So as we reflect on Ruth’s life, her
medical practice and service to the
community over 64 years, we salute a
gifted, dedicated clinician, a wonderful
teacher, an innovator, a researcher and
a loyal friend.
She exemplified her school’s motto –
“non nobis solum” – “not for ourselves
alone” – and the philosophy of the
school’s patron, St Hilda of Whitby:
“Leadership through excellence”.
Professor Tess Cramond
ANZCA Bulletin June 2011 107