William WAUGH1922–1998

William WAUGH

1922–1998

William Waugh was born on February 17, 1922 in Dover, where his father was a general practi- tioner. Both of his parents came from Ulster, but he was brought up in England and educated at Eastbourne College and Pembroke College, Cambridge, although this was during the Second he was elected founder president of the Old Oswestrians Club and delivered the Gold Medal lecture in 1970. He faithfully supported the hospital League of Friends from its inception in 1961, and his radio appeal for funds in 1964 will be remembered as a masterpiece of oratory and cajolery. He retired from the active staff in 1967 but continued to visit us as an emeritus consult- ant until the end.

Sir Reginald was, above all, essentially

“human” and like all great men was an alchemy of strength and weakness—a perfectionist and a romantic. Throughout his career he never lost the art of joining with youth in fun and games. How greatly he treasured those relaxing musical evenings with his junior colleagues, and his brand of “Oswestry billiards” is now world famous.

So passes a gallant gentleman and friend. It is hard to imagine Oswestry without R.W.-J. In 1940 he wrote to Hugh Owen Thomas and Sir Robert Jones: “They whose work cannot die, whose influence lives after them, whose disciples perpetuate and multiply their gifts to humanity, are truly immortal.” This can truly be said of himself.

World War when students were few. He won an entrance scholarship to King’s College Hospital in London, where he did the clinical part of his medical studies, graduating in 1945 and being awarded the Legg prize in surgery. He sub- sequently worked as resident medical officer and senior house officer at the same hospital.

In 1947 he married Janet McDowell, whose father was professor of physiology at King’s College. They had two daughters.

His surgical career can be divided into three phases. The first was the period of training. He was a surgical registrar at King’s College Hospi- tal and then, for 2 years, a surgical specialist in the Royal Air Force, which included 9 months in Aden. After this he took up orthopedic surgery, returning to work at King’s and then in Toronto.

He obtained his MChir (Cantab) in 1952 and 3 years later moved to Oxford as first assistant to Professor Trueta, where he struck up a lifetime friendship with Jimmy Scott, who was later to become one of the senior orthopedic surgeons in Edinburgh. Connections established in these posts reappeared later. He arranged for orthopedic trainees in the Royal Air Force to spend 2 years at Harlow Wood Orthopaedic Hospital, and later at Nottingham. Mr. Buxton, his chief at Kings’

College Hospital, “was involved in the creation of an orthopaedic and rehabilitation service in war-shattered Greece. He arranged for Greek orthopedic surgeons to come to King’s and other centres for postgraduate training.” William main- tained this link and many Greek surgeons trained at Harlow Wood Orthopedic Hospital and in Nottingham and Derby. His work in the academic department of orthopedics at Oxford established his credentials to set up such a unit himself 20 years later.

In 1957 he was appointed consultant orthope- dic surgeon at Harlow Wood Orthopaedic Hospital in Nottinghamshire. It had been opened in 1929 through the initiative of Alan Malkin, who became president of the British Orthopedic Association in 1948–1949, by which time Harlow Wood had established a considerable reputation.

This was carried forward by William Waugh and his senior colleague Peter Jackson and they became close friends. He said that Jackson had the better clinical brain, but that he (William) was the better writer. They collaborated closely on numerous publications, especially on surgery of the knee and foot. Together they edited a book on Surgery of the Knee Joint, published by Chapman and Hall. William was an outstanding teacher; his

Who’s Who in Orthopedics

lectures appeared informal and even casual, but were carefully prepared. He played an active part in the postgraduate courses at Harlow Wood, which had been started by Peter Jackson. At that time these were the only such courses and were therefore attended at least once by most trainees from all parts of the country.

When William was appointed to the editorial board of The Journal of Bone and Joint Surgery in 1970, he felt that he had reached the summit of his orthopedic career. In this he was wrong; there was much more to come. When he and Peter Jackson were over 50 years old they took up knee replacement, a challenge shirked by some of their contemporaries, and became leading authorities in this field.

In 1965 the Pickering Committee recom- mended that a new medical school should be established in Nottingham, the first in the UK in this century. The first students entered in 1970. At that time, Harlow Wood was completely separate from orthopedics in Nottingham, although its out- patient clinics, staffed by consultants and regis- trars from Harlow Wood and originally held in a building belonging to the old Cripples’ Guild, had been relocated to the Nottingham General Hospi- tal. Jackson and Waugh saw that the balance was changing and in 1970, on the retirement of Noel Birkett, then the senior orthopedic and trauma surgeon in Nottingham, they began trauma ses- sions in the city.

With the establishment of the medical school, several new consultant posts in orthopedic surgery were created and those appointed feared that they might find themselves in conflict with the older and established consultants. The reverse was true; Waugh and Jackson welcomed them and built up a happy and united team. A new medical school and university hospital were built and for- mally opened in 1977 by the Queen, who named the whole complex “The Queen’s Medical Centre.”

It was decided to establish a Chair of Orthope- dic and Trauma Surgery in Nottingham and William was appointed. He recalled that “I was invited finally, and accepted with some reserva- tion. I chose the date of April 1, 1977 to start, which somehow seemed appropriate”. He was then aged 55 and later described the years that followed as “a long and difficult period for me.”

Nevertheless, he achieved a great deal.

His first step was to design an undergraduate course, which involved attachment to the depart- ments of orthopedics, rheumatology and accident

& emergency for 8 weeks, with a clinical and viva examination at the end. This proved to be one of the best undergraduate courses in orthopedics in the country.

His research activities focused on the outcomes of osteotomy of the tibia and of total knee replace- ment. With Marjorie Tew, a statistician, he carried out a long-term review of all the knee replace- ments performed in his unit. Later, they intro- duced the concept of survivorship analysis for knee replacements, now accepted as one of the best ways of measuring the success of joint replacements generally.

In addition to these heavy clinical and aca- demic commitments, William was a great sup- porter of the British Orthopedic Association, serving on the executive council and as vice pres- ident in 1984. He was a member of the editorial board of the British volume of The Journal of Bone and Joint Surgery and was president of the orthopedic section of the Royal Society of Medi- cine in 1980–1981.

A division of orthopedic and accident surgery had been set up in the Department of Surgery, headed by Professor Jack Hardcastle. Before his retirement, on the advice of orthopedic surgeons throughout the country, William obtained agreement from the University of Nottingham to establish orthopedic and accident surgery as an independent department within the medical school.

He had always intended to retire before the age of 65 years and did so in 1984, when Angus Wallace, who had been a lecturer in the depart- ment, succeeded him. The Waughs then moved to the home that they had purchased some years earlier in Wadenhoe, a village in Northampton- shire, and for a few years he taught some sessions in the Department of Anatomy in Leicester Uni- versity. He enjoyed his retirement enormously and had time for his interests in gardening, pho- tography and architectural history.

He did not rest on his laurels, but blossomed in a new career as a medical historian. His taste for writing on subjects other than surgery itself had been whetted by an invitation to revise the book The Whiskies of Scotland, which had been written by his father-in-law but was then out-of-date. The new edition was published in 1986. It was fol- lowed in 1987 by a 200-page book on The Devel- opment of Orthopedics in the Nottingham Area, including Derby, Leicester and Mansfield. This was published by Nottingham University and we have quoted from it above. He next embarked on

Who’s Who in Orthopedics

Who’s Who in Orthopedics a biography of Sir John Charnley, whom he had

known well. It was hard to write an interesting biography of a doctor whose life consisted of encounters with many different people. In this case, however, the development of the hip replacement provided a strong theme for the book, which is subtitled The Man and the Hip. It is an illuminating study of the struggles required to achieve this huge advance in surgery. It was published by Springer-Verlag in 1990.

His last book was A History of the British Orthopedic Association, which he was invited to write to mark its 75th anniversary. This was an even more difficult subject to organize, but William managed it very successfully, dividing it into periods, in each of which he outlined the progress of the Association and then gave pen- portraits of the successive presidents who were, of course, the leading orthopedic surgeons of their time. It is thus a history, not just of the Associa- tion, but of British orthopedics. It was published in 1993 by the British Orthopaedic Association.

In recognition of this work, William was made an honorary fellow of the British Orthopaedic Association, a distinction once described by a former president as “far more exclusive than the Presidency.”

Even after this he continued to edit papers for the journal International Orthopedics until he developed a cerebral lymphoma in 1998. After an illness lasting 2 months, he died on May 21 at the age of 76 years.

Most of us would be proud to establish a rep- utation either as a distinguished orthopedic surgeon, a professor, or a successful author. To have been all three in turn is remarkable. His col- leagues, however, will remember him best for his kindly encouragement and wise advice, which were invaluable to us. He had a stock of useful aphorisms. One of these emerged from a survey, which tried to define the characteristics of the orthopedic surgeon and concluded that he is “a reliable gentleman.” William Waugh exemplified this.

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Bernhard Georg WEBER (Hardy)

1927–2002

Shortly after his 75th birthday, quite unexpect- edly, our dear friend, teacher, and honorary trustee of the AO Foundation, Prof. Bernhard G.

Weber, died of heart failure.

Right up to the very end of his life, he was working intensively for patients and in the field of patient-oriented science. As late as the eve of his departure, he was still working on a book dealing with his own AO philosophy, as well as his presentation as the “John Border” memorial lecturer at the Orthopedic Trauma Association in Toronto, in October 2002.

Having completed his medical studies in his home city of Basel, he built up his knowledge in the posts of house physician, seagoing medical officer on an ocean liner and hospital assistant. He adopted his very own idiosyncratic approach to resolving a personal dilemma as to whether he should choose medicine or architecture, therefore, during his period at the Zürich Balgrist Hospital, he recognized in orthopedics the way in which medicine, engineering and craftsmanship, includ- ing the artistic side of our occupation (hobby), all fuse together.

When, in 1959, Maurice E. Müller took up his

post in St. Gallen as head of the first orthopedics

and trauma clinic in Switzerland, Hardy Weber

followed him, taking up the post of Oberarzt; or

senior surgeon. At that time, St. Gallen was a