Professor John Gillingham succeeded Norman Dott as the second Forbes Professor of surgical neurology at the University of Edinburgh in 1963 a position that he held until he retired from clinical practice in 1980 a year before his sixty fifth birthday so that he might take up full time the duties of the President of the Royal College of Surgeons of Edinburgh. During his clinical life his principle interests were the management and prevention of head injury flowing from his war time experiences in north Africa and Italy, the development and understanding of stereotaxis and its application to functional neurosurgery and intracranial vascular surgery and the management of aneurysmal subarachnoid haemorrhage, as President of the Edinburgh College he continued his other great interest that of a surgical educator. In both these roles as surgical pioneer and educator he was helped by his real understanding of the values of life and a lively sense of humour indeed he will be remembered as much for his irrepressible smile and glint in his eye as his huge contribution to neurosurgery.
Born on the 15th March 1916 in Dorchester he attended Hardye's School and then graduated from St. Bartholomew's Hospital Medical School, the University of London in 1939. While at Medical School he won the gold medal in gynaecology which lead him to have to decide whether to follow a career in neurosurgery or gynaecology. Apparently this decision was decided on the spin of a coin – heads neurosurgery, tails gynaecology. Fortunately for neurosurgery the coin landed heads up. Following his house jobs he joined the Royal Army Medical Corps and was appointed to the Oxford Military Hospital at St. Hugh's College where he managed head injuries under Colonel Hugh Cairns and Group Captain Symonds. After eighteen months in Cairns' field surgical unit experiencing general military surgery as well as head injury management he served in North Africa and the Eastern Italian campaign. Later in life he had thought to publish his memories and many photographs of this time but sadly the photographs were destroyed when their house was flooded in 2006. The pace of wartime work lead to an enormous experience of which he kept meticulous notes of the patient's injury and operative procedures. His interest in head injury and its prevention was to continue into his peace time working and he became a leading campaigner for the introduction of seat belt legislation and was the recipient of the Clarke Foundation Award for services to road safety in 1979.
Following the war he returned to Oxford under Sir Hugh Cairns. In 1945 he married Judy Irene Jude the wedding being organised by Cairns to minimise disruption to his busy clinical service. A return to St. Bartholomew's for further training with Sir James Paterson Ross and Mr. John O'Connell lead to his appointment as Consultant Neurosurgeon in Edinburgh the unit at that time being in Bangour General Hospital in West Lothian sixteen miles to the west of Edinburgh and ward 20 (under the clock tower) in the Edinburgh Royal Infirmary in Lauriston Place. The elective Department of Surgical Neurology at the Western General Hospital was opened in 1960 a building designed for the holistic provision of care for neurosurgical patients and one of the neurosurgical theatres being specially equipped for stereotactic surgery. To enable consultation between the two units with the help of Scottish Television he installed, possibly one of the first telemedicine links, between the treatment room in ward 20 at the Royal Infirmary and his office on the ground floor corridor of the Department of Surgical Neurology at the Western General Hospital.
With Dott he learnt and developed his interest in the management of aneurysms, describing the importance of the sentinel bleed and its recognition in the potential to prevent recurrent haemorrhage, issues of vasospasm and its relevance to the timing of surgery. Much of this in an era before CT scanning and with direct carotid puncture rather than transfemoral catheter angiography.
Guiot had visited Edinburgh from Paris to learn about aneurysms and through this visit Gillingham was invited to Paris to see Guiot operate, a subfrontal freehand pallidotomy. Subsequently he adapted Guiot's stereotactic method to an occipitoparietal approach. The Gillingham-Guiot stereotactic frame was progressively refined to include a motor drive of the targeting electrode and cellular recording to improve the accuracy of the therapeutic lesion. His 1960 publication showed that 88% of operated patients had tremor/rigidity abolished or significantly reduced without complication. Later a ten year follow up of a second cohort of operated patients showed consistent relief of tremor and rigidity but a decline in the effect on bradykinesia. The operation was a two stage procedure both being performed under local anaesthetic. The first was the placement of three rows of five metal balls frontal, post coronal and occipital from which by means of a straight plain AP Xray the exact midline could be determined for placement of the frame and a ventricular catheter was placed for myodil ventriculography to define the third ventricle and from this the coordinates for the lesion. Some days later the second stage was performed with the help of the neurophysiologists and physiotherapists in addition to the regular theatre team. Finally the target was marked with a metal ball for radiological confirmation of the lesion. Because of his surgical reputation he had the additional responsibilities of being selected to treat many influential and well known people at home and abroad.
He was an enthusiastic teacher of medical students, neurosurgical trainees and general practitioners. He encouraged trainees to take on research and to attend the European Training Courses on which he was an active teacher. He was internationally recognised and invited to visit and lecture overseas. As a consequence the unit attracted overseas trainees who added to the overall training and breadth of knowledge within the department. His concern for the young extended to offering accommodation in his home to a young trainee in difficulty and an overseas trainee with very limited financial support. Many in the Department will remember being included in the summer parties in Ravelston. As President of the Edinburgh College he introduced the specialty surgical fellowships not without some resistance orthopaedics being the first and neurosurgery second. For the College he had the foresight to develop Hill Square and negotiated the funding for the King Khalid Symposium Hall. He had been elected to the Fellowship of the College in 1955 and a Fellow of the Royal Society of Edinburgh in 1970. He had been awarded an MBE for Military service and CBE following his Presidency in 1982. He was widely recognised in the United Kingdom and overseas with the award of Honorary Fellowships of Colleges and Institutions. The most recent of these was the Medal of the Society of British Neurological Surgeons at Magdelen College, Oxford in May 2009 at which he spoke eloquently and with his customary good humour from his wheelchair.
Following his presidency he became Professor of Neurosurgery King Saud University Saudi Arabia. He remained active into his ninth decade establishing new contacts in Oxford and editing for the European Journal of Stereotactic Surgery.
Family time although at a premium was hugely important. The house at Portling on the Solway Firth and later at Javea on the Mediterranean Coast of Spain, his love of sailing his beloved Nantucket Clipper, “Persephone” gave opportunities to enjoy time with his family and regenerate his energy. He is survived by his wife Judy, three of his four sons (tragically Jeremy and Anni his wife, both GPs, were killed in an avalanche while skiing) eleven grand children and two great grand children.
James Steers