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Bruce N. Bailey, 29 February 1928–29 April 2001
British Journal of Plastic Surgery (2001 ), 54, 550-551 9 2001 The British Association of Plastic Surgeons doi: 10.1054/bjps.2001.3669
BRITISH
JOURNAL
OF
PLASTIC
SURGERY
OBITUARY
Bruce N. Bailey, 29 February 1928-29 April 2001 Bruce Bailey's many friends will be sad to learn that he died in April. He was born in Yorkshire and educated at Bradford Grammar School. Following his training at The London Hospital he did his National Service as a medical officer in the Parachute Regiment and continued in the Army for another two years, subsequently becoming a Senior Surgical Specialist at Millbank. His plastic surgical training was at Stoke Mandeville Hospital, where he worked with J. P. Reidy, one of Kilner's disciples. He was a Consultant there from 1963 to 1990 when he retired early from the NHS because of ill health. These stark details reveal little of the man himself. Like all those of his generation, he was a general plastic surgeon throughout much of his career, and his experience of basic surgical and biological principles served him well all his professional life. He had a major interest in bums and spent a year at the Shriners unit in Galveston, Texas. Although he was very happy to tum his hand to all aspects of plastic surgery, he realised at an early stage that sub-specialisation was necessary and, even before consultant expansion made this easier, he passed on responsibility for cleft surgery and head and neck cancer to his colleague Sanu Desai. They were the only two consultants in a busy unit for many years. He was then able to concentrate on his main interests bums, flap reconstruction and hand surgery. He saw the possibilities of new surgical techniques and was always keen to apply them where he saw a potential benefit. This approach helped many patients and pushed forward the boundaries, but his enthusiasm to use new untried techniques occasionally led him into difficulties. He would have been very frustrated to be working in the controlled post-Bristol surgical environment of today. There are several examples of his willingness to adopt new methods and challenge accepted conventions. He saw the value of neonatal cleft lip repair and the open-palm technique for Dupuytren's contracture, both procedures proposed by McCash but not widely practised. He was an advocate of the use of hand bags in the treatment of bums and, although this technique bore little resemblance to that used by Bunyan in wartime, eponymous credit was frequently misdirected. He wrote an excellent monograph on bedsores in 1967, which still has a place today and which led to the assumption that he treated patients from the paraplegia unit at the hospital. This was far from the truth as Bruce had a different approach, particularly in the young chronically disabled victim. He favoured aggressive surgery, but this was only done when the wound was 'healthy' and the patient's healing capacity ready for a major operation. This same approach was predominant in the burns unit,
where he favoured early excision and grafting of large deep bums and was quick to see the potential of tangential excision for deep dermal injuries. His fascination for reconstructive surgery found its place in the treatment of trauma and cancer, and those who knew him at the time will always recall his enthusiasm to embrace microsurgical free tissue transfer. Although he was brought up at a time when tube pedicles and cross-leg flaps were the accepted techniques, he was critical of their limitations and quickly recognised that 'free flaps' were the answer to many difficult problems. Those who worked at Stoke Mandeville around then were privileged to see the transition from traditional flap reconstruction to challenging microsurgical methods. The subsequent re-assessment of skin circulation brought about many exciting change.s and, because of Bruce's willingness to move away from conventional methods of reconstruction, Stoke Mandeville became one of the leading microsurgical units of the 1970s. Around this time he started going to India to operate, and became a visiting surgeon at the Gujarat Cancer Institute. As a result, several young Indian doctors came to work in Aylesbury and joined the large group of young 550
Obituary local trainees whose careers benefited from time spent learning from Bruce and his colleagues. Hand surgery was arguably his main love. He applied his skills to the treatment of major injuries and congenital hand deformities with his usual enthusiasm. He was one of the first to use Buck Gramko's pollicisation technique, after inviting the Hamburg unit's Senior Registrar over to demonstrate the operation. He recognised that patients with rheumatoid hand deformities could benefit from early treatment, and knew that they were not being referred for surgery. The Combined Hand Clinics that he set up with thoughtful rheumatologists helped dispel their pessimism about the value of surgery when patients retumed postoperatively. Before Swanson's finger joints became available, he introduced his dermal arthroplasty for the treatment of metacarpophalangeal deformity, and this helped many patients with rheumatoid disease. He was a perfectionist and his desire to achieve the best extended outside the hospital. Many sporting pursuits gave him pleasure but took their toll, and he sustained numerous injuries while parachuting, playing rugby, climbing or rally driving. As a consequence, he needed surgery on endless damaged bones and joints, and eventually had to channel his energy into his other lesshazardous interests. Many a trainee turned out to play squash early on a Sunday morning because that was when there was time to spare! When he and his family lived in the country he had short-lived, often disastrous, ventures into growing mushrooms, producing eggs and keeping bees. He developed a severe allergy to their stings but still tended the hives dressed in a full wet suit and net hat, with his forbearing
551 wife ready to administer a syringe of Piriton when he was inevitably stung. Many trainees wondered why he persisted when he appeared on Monday morning looking like the Michelin man! He played bridge with his supportive wife, Jean, loved music and was an accomplished pianist. He read extensively and his photographic skills extended beyond the hospital. His large collection of clinical slides will be remembered from the inspirational lectures he gave at home and abroad. He was a regular contributor to meetings of the bum, hand and plastic surgery societies and always encouraged trainees to participate. They, like many of his patients, will remember his kindness and good humour. Unfortunately, he was not a great committee man, unless it was strictly necessary, and never held office in the BAPS. It was a cruel turn of fate that such an active man should develop Parkinson's disease when he was still very involved in his work. Although he was uncomplaining, it must have been frustrating to be so restricted. It is also ironic that, after treating numerous patients for skin cancer, he should die from an aggressive melanoma, and it was typical of a man who never made a fuss that few friends knew that he had terminal disease. Like the hopeful subject of Roger McGough's poem 'Let me die a young man's death', it is sad that Bruce died as he did. Those who knew him well can easily imagine him falling off a mountain or crashing a rally car at the age of 80. It was not to be, and he will be missed for many reasons, not least of which was his zest for life. PHILIP J. SYKES
BRITISH
JOURNAL
OF
PLASTIC
SURGERY
OBITUARY
Bruce N. Bailey, 29 February 1928-29 April 2001 Bruce Bailey's many friends will be sad to learn that he died in April. He was born in Yorkshire and educated at Bradford Grammar School. Following his training at The London Hospital he did his National Service as a medical officer in the Parachute Regiment and continued in the Army for another two years, subsequently becoming a Senior Surgical Specialist at Millbank. His plastic surgical training was at Stoke Mandeville Hospital, where he worked with J. P. Reidy, one of Kilner's disciples. He was a Consultant there from 1963 to 1990 when he retired early from the NHS because of ill health. These stark details reveal little of the man himself. Like all those of his generation, he was a general plastic surgeon throughout much of his career, and his experience of basic surgical and biological principles served him well all his professional life. He had a major interest in bums and spent a year at the Shriners unit in Galveston, Texas. Although he was very happy to tum his hand to all aspects of plastic surgery, he realised at an early stage that sub-specialisation was necessary and, even before consultant expansion made this easier, he passed on responsibility for cleft surgery and head and neck cancer to his colleague Sanu Desai. They were the only two consultants in a busy unit for many years. He was then able to concentrate on his main interests bums, flap reconstruction and hand surgery. He saw the possibilities of new surgical techniques and was always keen to apply them where he saw a potential benefit. This approach helped many patients and pushed forward the boundaries, but his enthusiasm to use new untried techniques occasionally led him into difficulties. He would have been very frustrated to be working in the controlled post-Bristol surgical environment of today. There are several examples of his willingness to adopt new methods and challenge accepted conventions. He saw the value of neonatal cleft lip repair and the open-palm technique for Dupuytren's contracture, both procedures proposed by McCash but not widely practised. He was an advocate of the use of hand bags in the treatment of bums and, although this technique bore little resemblance to that used by Bunyan in wartime, eponymous credit was frequently misdirected. He wrote an excellent monograph on bedsores in 1967, which still has a place today and which led to the assumption that he treated patients from the paraplegia unit at the hospital. This was far from the truth as Bruce had a different approach, particularly in the young chronically disabled victim. He favoured aggressive surgery, but this was only done when the wound was 'healthy' and the patient's healing capacity ready for a major operation. This same approach was predominant in the burns unit,
where he favoured early excision and grafting of large deep bums and was quick to see the potential of tangential excision for deep dermal injuries. His fascination for reconstructive surgery found its place in the treatment of trauma and cancer, and those who knew him at the time will always recall his enthusiasm to embrace microsurgical free tissue transfer. Although he was brought up at a time when tube pedicles and cross-leg flaps were the accepted techniques, he was critical of their limitations and quickly recognised that 'free flaps' were the answer to many difficult problems. Those who worked at Stoke Mandeville around then were privileged to see the transition from traditional flap reconstruction to challenging microsurgical methods. The subsequent re-assessment of skin circulation brought about many exciting change.s and, because of Bruce's willingness to move away from conventional methods of reconstruction, Stoke Mandeville became one of the leading microsurgical units of the 1970s. Around this time he started going to India to operate, and became a visiting surgeon at the Gujarat Cancer Institute. As a result, several young Indian doctors came to work in Aylesbury and joined the large group of young 550
Obituary local trainees whose careers benefited from time spent learning from Bruce and his colleagues. Hand surgery was arguably his main love. He applied his skills to the treatment of major injuries and congenital hand deformities with his usual enthusiasm. He was one of the first to use Buck Gramko's pollicisation technique, after inviting the Hamburg unit's Senior Registrar over to demonstrate the operation. He recognised that patients with rheumatoid hand deformities could benefit from early treatment, and knew that they were not being referred for surgery. The Combined Hand Clinics that he set up with thoughtful rheumatologists helped dispel their pessimism about the value of surgery when patients retumed postoperatively. Before Swanson's finger joints became available, he introduced his dermal arthroplasty for the treatment of metacarpophalangeal deformity, and this helped many patients with rheumatoid disease. He was a perfectionist and his desire to achieve the best extended outside the hospital. Many sporting pursuits gave him pleasure but took their toll, and he sustained numerous injuries while parachuting, playing rugby, climbing or rally driving. As a consequence, he needed surgery on endless damaged bones and joints, and eventually had to channel his energy into his other lesshazardous interests. Many a trainee turned out to play squash early on a Sunday morning because that was when there was time to spare! When he and his family lived in the country he had short-lived, often disastrous, ventures into growing mushrooms, producing eggs and keeping bees. He developed a severe allergy to their stings but still tended the hives dressed in a full wet suit and net hat, with his forbearing
551 wife ready to administer a syringe of Piriton when he was inevitably stung. Many trainees wondered why he persisted when he appeared on Monday morning looking like the Michelin man! He played bridge with his supportive wife, Jean, loved music and was an accomplished pianist. He read extensively and his photographic skills extended beyond the hospital. His large collection of clinical slides will be remembered from the inspirational lectures he gave at home and abroad. He was a regular contributor to meetings of the bum, hand and plastic surgery societies and always encouraged trainees to participate. They, like many of his patients, will remember his kindness and good humour. Unfortunately, he was not a great committee man, unless it was strictly necessary, and never held office in the BAPS. It was a cruel turn of fate that such an active man should develop Parkinson's disease when he was still very involved in his work. Although he was uncomplaining, it must have been frustrating to be so restricted. It is also ironic that, after treating numerous patients for skin cancer, he should die from an aggressive melanoma, and it was typical of a man who never made a fuss that few friends knew that he had terminal disease. Like the hopeful subject of Roger McGough's poem 'Let me die a young man's death', it is sad that Bruce died as he did. Those who knew him well can easily imagine him falling off a mountain or crashing a rally car at the age of 80. It was not to be, and he will be missed for many reasons, not least of which was his zest for life. PHILIP J. SYKES