“A Twist in the Tale” of a Surgeon and his Patient: An Australian First in Seizure Localization

Abstract

In 1894 at St. Vincent's Hospital Melbourne, George Adlington Syme removed a meningioma from a patient with symptomatic focal epilepsy. The operation stands as the first surgery based on seizure localization in Australia. It is also the country's first documented successful resection of an intracranial meningioma. It followed William Macewen's landmark cerebral localization case on the boy John McKinley by 18 years and Victor Horsley's first epilepsy case on Hughlings Jackson's patient James B. by a mere 8 years. Syme's patient, Constable John G., survived the operation by some 23 years, dying from a gunshot wound to the head in 1917. Newly discovered inquest papers reveal that the coroner's judgment that the death was accidental completely fails to address the more credible scenario of suicide. The story makes for a fascinating epilogue to an important landmark in Australia's neurosurgical history.

Keywords:

• Seizure localization
• Australian neurosurgery
• George Adlington Syme

Sincere thanks go to Ms. Barbara Cytowicz for her help with the search of the archives at St. Vincent's Hospital Melbourne and The Royal Australasian College of Surgeons for details concerning the life and surgical career of the late George Adlington Syme; to The Victorian Heritage Trust, The Victorian Police Historical Museum, and The Public Record Office Victoria for references to the late Constable John G. and the presumed inquest held upon his death; to Dr. David Wells, Dr. David Ranson, and Dr. Malcolm Dodd of the Victorian Institute of Forensic Medicine; and to Sergeant Ray Vincent, Mr. David Sandground, Mr. Paul Milani, Dr. Peter Bladin, Mr. Keith Henderson, and Professor Mervyn Eadie for their valuable historical insights.

Notes

First Australian Imperial Force Personnel Dossiers (1914–1920): National Archives of Australia, Series Number B2455, Barcode 8096820.

Proceedings of Inquest Held Ppon the Body of John G. at Melbourne Morgue (1917). The Public Record Office Victoria, Feb. 1, File 102.

Record of Conduct and Service (1883–1917): Victorian Police Historical Museum. Series Number 3409 Constable John G: 114–117.

Syme GA (1893–1904): Case Book. St Vincent's Hospital Melbourne Archives, 13/11/1893 –15/06/1896: 58–65, 114–116, 118.