Clark, Graeme M

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MB BS 1958 MSurgery 1969 Ph D Med 1970 MD 1989 FRCS (Edinburgh) FRCS (England) FRACS Hon MD (Hanover) Hon MD (Sydney) Hon DSc (Wollongong) Hon DEng (CYC Taiwan) Hon LLD (Monash) Hon FAudSA Hon FRCS (England)

One of our most distinguished alumni in the field of Otolaryngology is Professor Graeme Milbourne Clark, foundation Professor of Otolaryngology at the University of Melbourne and pioneer of the multiple-channel cochlear implant, the ‘bionic ear’.

Professor Graeme Clark pioneered the multiple-channel cochlear implant which has brought hearing and speech understanding to tens of thousands of people with severe-to-profound hearing loss in more than 80 countries.

Graeme Clarke graduated from Medicine at the University of Sydney in 1958 and became Resident Medical Officer at the Royal Prince Alfred Hospital (RPAH), Sydney. In 1960, he also became Lecturer in Anatomy in the Faculty of Medicine. By 1961, he had graduated to being Registrar in Neurosurgery and Otolaryngology at RPAH. He went to London in 1962 and was appointed Senior House Surgeon of the Royal National Ear Nose and Throat Hospital in London. He remained in England for four years, working at Bristol General Hospital and the Royal Victorian Eye and Ear Hospital.

When he returned to Australia, Graeme first went to the Alfred Hospital in Melbourne, where he was the first Assistant Ear, Nose and Throat (ENT) surgeon, later becoming Senior Honorary ENT Surgeon. In 1967, he again lectured at the University of Sydney, this time in physiology. In 1969, he served as a Senior Research Officer of the National Health and Medical Research Council of Australia.

Graeme became the foundation Professor of Otolaryngology at the University of Melbourne in 1970, retiring from that position in 2004, when he was made Honorary Laureate Professorial Fellow at the University and became full-time Director of the Bionic Ear Institute.

Graeme had commenced basic research on electrical stimulation of the auditory nerve fibres at the University of Sydney in 1967. His research showed that multiple-channel (electrode) stimulation rather than a single-channel cochlear implant would be required for the management of a severe-to-profound hearing loss. Since 1970, Graeme has led the research on electrical stimulation of the auditory nerves in the Department of Otolaryngology at the University of Melbourne and the Bionic Ear Institute. This research has demonstrated that a multiple-channel cochlear implant can provide significant understanding of speech for severely-to-profoundly deaf children and adults and enable near normal speech for deaf children through electrical stimulation of the hearing nerves in the cochlea. The research also demonstrated that bilateral and bimodal cochlear implants can enable people with hearing aids and implants to localise sound and hear more effectively in a noisy environment. In a series of studies on experimental animals, he showed that a multiple-channel cochlear implant was safe, with minimal risk of meningitis from middle ear infection, if a fibrous tissue sheath was produced around a single-component multiple-electrode array and this was facilitated with a fascial graft.

It was not previously thought possible to provide speech understanding with a small number of electrodes, as the cochlea (inner ear) is innervated by 10,000 to 20,000 neurons in a complex manner. However, the multiple-channel cochlear implant resulting from the discoveries of Graeme and his co-workers is the first sensori-neural prosthesis to effectively and safely bring electronic technology into a direct physiological relationship with the central nervous system and human consciousness. Graeme also established the surgical and audiological principles that are the basis for its regular clinical use.

A month after Graeme and his team operated on Rod Saunders to implant the University of Melbourne’s first bionic ear, they asked Saunders to return so they could see whether the surgery had worked and how they could help him understand speech. When they tested him with an electric current, all Saunders could hear was the hissing sound frequently experienced by deaf people. Finally, just before the third hearing test, they discovered a fault in the test equipment, which could account for the lack of results.

Below is an excerpt from Sounds of Silence, describing the third appointment with Rod Saunders.

At the second test session I was eager to find out whether Rod could recognise the voicing and rhythm of speech. To test for these skills, we used the computer to play tunes through the implant. The first was the then national anthem, “God Save the Queen”. Our answer came immediately as Rod stood to attention, disconnecting some of his leads as he did so. It was good to have selected a patient with a sense of humour. Then Jo suggested, “Why not test him with Waltzing Matilda?” Rod had no trouble with that one either. He could recognise the songs he knew, but could he hum the tune of a song that had come out after he went deaf? We found that he could, which was very encouraging.[1]

His work to develop the multiple-channel cochlear implant and take it through to commercial reality took 18 years, from 1967 to 1985, and is outlined in the History of the Cochlear Implant. The cochlear implant originally developed by the Melbourne research team and manufactured by the Australian company Cochlear Limited has held up to 80 per cent of the world market over the last 20 years.

In addition to this research, Graeme has played a key role in the development of the Automatic Brainwave Audiometer, the first method for objective accurate measurement of hearing thresholds for low and high frequencies in infants and young children, and the Tickle Talker™, a device enabling deaf children to understand speech through electro-tactile stimulation of the nerves of the fingers.

Graeme was awarded the AC (Companion of the Order of Australia), Australia’s highest civil honour, for services to medicine and to science through innovative research to further the development of cochlear implant technology for worldwide benefit in 2004.

In 2005, he received the Excellence in Surgery Award from the Royal Australasian College of Surgeons which recognises the highest level of surgical achievement by world standards, advanced innovation in the field, continued quality and worth of the innovation, and the highest standard of ethics. He received the A Charles Holland Foundation International Prize for fundamental contributions to the progress of knowledge in audiology/otology, at the XVIII World Congress of the International Federation of Otorhinolaryngological Societies in Rome. He received the Royal College of Surgeons of Edinburgh Medal for outstanding contributions to medicine at the Quincentenary Ceremony for the Presentation of Diplomas.

Graeme also received the Prime Minister’s Prize for Science, Australia’s pre-eminent award for excellence in science, recognising outstanding achievement by Australians in science and technology to promote human welfare in 2004. He was elected a Fellow of the Royal Society for his contribution to science, both in fundamental research resulting in greater understanding, and in leading and directing scientific and technological progress in industry and research establishments. He was elected an Honorary Fellow of The Royal College of Surgeons of England, awarded for outstanding achievement in medicine. He was elected a Fellow of the Australian Acoustical Society for notable contribution to the science and practice of acoustics, and received the Doctorate of Laws honoris causa from Monash University, its highest honour.

In 2003, Graeme was elected an Honorary Fellow of the Royal Society of Medicine in London for exceptional distinction, with recipients drawn from across the world and from a wide range of endeavours, particularly in the medical sciences. He received the Doctorate of Engineering honoris causa from Chung Yuan Christian University in Taiwan.

In 2002, Graeme was elected an Honorary Member of the American Otological Society. He received the Doctorate of Science honoris causa from the University of Wollongong, Australia. In 1998, he was elected Fellow of both the Australian Academy of Science and the Australian Academy of Technological Sciences and Engineering.

Graeme has received Honorary Doctorate of Medicine degrees from the University of Sydney and the Medizinische Hochschule, Hanover along with many other awards and prizes.

Citation: Mellor, Lise (2008) Clark, Graeme M. Faculty of Medicine Online Museum and Archive, University of Sydney.

An alternate version appears in: Mellor, L. 150 Years, 150 Firsts: The People of the Faculty of Medicine (2006) Sydney, Sydney University Press.