Miller, Sir Ian Douglas

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MB 1924 MD 1979 Sir Ian (Douglas) Miller is credited with being Australia’s first neurosurgeon, performing the first operation for a brain tumour in 1933. He was one of the founders of the Neurosurgical Society of Australasia.

Douglas, the son of a GP, was born in Melbourne in the first year of the last century. He finished his schooling at Xavier College, which he felt had provided him with a good classical foundation, and went to Sydney to study Medicine in 1919. During his university years, he met Alexander MacCormick while he was in the famous Sydney surgeon’s private hospital for the removal of a cyst in his back. While he was recovering, Douglas asked MacCormick if he could come into theatre to watch him, and was delighted to be allowed. He had been observing for many days when MacCormick asked him whether he would like to assist, to which he eagerly agreed. These early experiences were what instilled in Douglas the desire to do surgery when he graduated.

He had spent a year as Resident at St Vincent’s Hospital, when MacCormick generously asked him if he wanted to be his Junior Assistant. Douglas fondly recalls:

Yeah, yeah, 75 pounds a year! So, for that I used to roll up in the early mornings, always started at half past seven, and I lived… across the other side of the harbour, so I had to leave home very early. And we’d work through, always had, every morning he’d have a list of operations. We’d work through those. And drive from one private hospital to another. He had a chauffeur who used to carry the bags in, and the theatre sister always came, and his first assistant, who at the time was Benjamin Edye. And we all went in the car from one hospital to another, and jumped out, and the chauffeur ran in with the bag, and then the theatre sister would go in and set up everything, and then MacCormick and his team would come in, do the operations, clear out. And everything would be put back in the bag, and off we’d go to the next one. It’s very hard to believe these days! While he was assisting MacCormick, Douglas was also demonstrating in the Department of Anatomy, having to dash off after morning surgery to get to the dissecting room in time.

In 1927, Douglas travelled to England, working as a ship’s doctor for a pound a day. Once there, he was a student at Middlesex University, also doing relief work at Hackney Infirmary, where he gained a great deal of technical experience. His ultimate goal was to pass the FRCS exam, notoriously difficult to pass in those days. He failed his first attempt but passed the second time round. He recalls the whole experience with equanimity, “I came to the conclusion it was a good thing to have failed because I learnt more than I would otherwise have learnt. And then got through.”

Having obtained this qualification, he returned to Australia to do general surgery at St Vincent’s. Brain surgery was all but non-existent in those days, and something Douglas became involved in quite coincidentally in 1933: he was treating a Russian man who had become blind and, having examined him and taken X-rays and so on, Douglas came to the conclusion that his patient had a tumour in his pituitary gland. As there was nobody in Sydney who could, or would, tackle this problem, he decided to team up with the newly appointed Professor of Surgery, Harold Dew. After practicing on dead bodies in the dissecting room and mortuaries, they felt ready to operate on the man. The case was successful and word spread quickly, so that soon they were inundated with neurosurgical problems about which they knew nothing. Consequently, in 1934, Dew arranged for Douglas to go to England to work with Hugh Caims at the London Hospital, where together with Caims, he developed the beginnings of real neurosurgery.

In 1939, he married an Australian woman in Surrey. However, with the onset of World War II, he was sent to Egypt to be in charge of a general surgical clearing place in the Western Desert, and then to an Australian hospital in Nazareth, where he was in charge of surgery. After his success there, he was appointed to Head of the Centre for Head Injuries in Cairo.

Returning to Australia after the War, he devoted himself exclusively to developing neurosurgery at St Vincent’s Hospital and in Sydney, helped by the many ground-breaking advancements in anaesthesia, instrumentation and lighting that were being made at the time, and which contributed greatly to the development and success of neurosurgery.

Douglas quickly became a leading figure in the Royal Australasian College of Surgeons, becoming President from 1957 to 1959. In that role, he was also fast becoming an important diplomat in medical circles. He travelled to various countries in South-East Asia, both as an ambassador and as a teacher educating the local hospital staff in neurosurgery, an area of medicine in which they were completely undeveloped.

Douglas recalls a surprising response on his trip to China in 1957:

I went… with a special group invited to China – this was very shortly after the Communist Revolution – and 20 Australian specialists were invited for a month. And we went up to China, and handed in our passports of course…some of the chaps got very nervous after this! But they, they looked after us like royalty. It was wonderful, really.[1]
… I remember there was a neurosurgeon in… Peking it was then called, and he seemed to be the only neurosurgeon in Peking for… God knows how many million people! And I said to him, “I’m very interested in what you do about head injuries.” “Oh,” he said, “we don’t have them.” I said, “How do you mean you don’t have head injuries?” He said, “Chairman Mao says we are not to have head injuries.” Finish conversation. [1]

Sir Douglas retired from St Vincent’s Hospital in 1960 but remained Chair of their Board of Directors until 1973.

Citation: Mellor, Lise (2008) Miller, Sir Ian Douglas. 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.