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The People’s Hospital Tales from the surgeon's table

Chapter Five

Gaining status – Melbourne University establishes the first Professor of Surgery

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The first Department of Surgery staff in 1993. Ms Lien Wright (left), administration assistant, Ms Meron Pitcher, senior lecturer and research team members Dr Wayne Phillips, Dr Simon Green and Ms Sahar Bassal with Professor Bob Thomas, chairman of the Division of Surgery.

Western Health archives

The first university chair of surgery was established at the hospital in 1993 when Bob Thomas was appointed as a professor and given the task of setting up a Department of Surgery affiliated to Melbourne University.

Before taking on the job, Professor Thomas was a surgeon at the Royal Melbourne and Epworth Hospitals, while also working as a cancer researcher in Melbourne University’s department of surgery at the Royal Melbourne.

Professor Bob Thomas, the hospital’s first professor of surgery.

Professor Bob Thomas, the hospital’s first professor of surgery.

David Johns

He said Vernon Marshall, then Professor of Surgery at Monash University and Professor David Penington, Melbourne University’s Vice-Chancellor and former Dean of Medicine, were highly influential in persuading the Department of Health about the potential benefits of establishing university research departments in medicine and surgery at Footscray.

“There was a feeling among the decision-makers that as a general rule, if you have a research program going in a hospital you usually get better care and outcomes for patients, “ Professor Thomas said. For example if you have a group of patients in a clinical trial, they usually do better than patients who are not in a clinical trial.”

Research departments attracted surgeons who wanted to combine their clinical practice with research.

“You get a group of people who have an interest in life above and beyond their immediate clinical practice,” Professor Thomas said. “That’s good for the quality of care for the patients. It’s good for young trainees because their progress is often predicated on their research efforts as well as their clinical efforts.

“Incorporating young people into research projects acts as a cauldron for new ideas, for innovation.”

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The shock of the wild West

Moving from the Royal Melbourne to Footscray in 1993 proved to be an unsettling experience for Professor Thomas:

“At that time people from the Royal Melbourne rarely looked to the west. They looked to the east, they all practiced in the east. Vernon Marshall was one of the rare exceptions. He was always at Footscray and he was at the Royal Melbourne as the deputy head of the department of surgery (before his appointment to Monash University).

So when I arrived it was a terrible shock because we’d never looked west from the Royal Melbourne. I hardly knew where Footscray Hospital was, even though I was in my 50s.

I arrived out there and I wasn’t given a room, I found a room to use. It was a tiny room next to where they kept the feed for the rats, which were used for the research done in Professor Yeoman’s medical department.

I had this sack of smelly feed next to me and nothing else. Not a thing. Nobody had the slightest interest in giving me anything. They said, ‘Well there you are!’ That was my first shock.

The second shock was the remarkable difference between the Royal Melbourne’s patients and Footscray’s. Out in the west the patients were much more aggressive, there was a lot of crime.

In the first week I was there they dropped a guy in to casualty who’d been stabbed 37 times in a telephone booth in some sort of drug deal. Amazingly he’d survived and he came into casualty. His assailants came into the casualty department to try to finish him off. For a gentle little man from the Royal Melbourne, this was quite a shock. This was happening only 5kms out from the Royal Melbourne across the Maribyrnong.

At Footscray I saw cases that I’d never seen before. Many patients in the west were at least 10 years older than their chronological age because of smoking and because they had such hard lives. That made for bad results in surgery.

It was almost like the Wild West, so different from the genteel, intellectual environment of the Royal Melbourne. Everything was different.”

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Starting from scratch

Soon after arriving at Footscray, Professor Thomas realised he “had to get out of my little hole in the cupboard” and find more suitable accommodation.

He discovered an unused section of the hospital – the former pathology block - and asked the hospital’s administrative leaders for permission to turn the entire area into the new department of surgery. “It was much better than the area Neville (Yeomans) had for his department of medicine,” Professor Thomas said. “He’d had the old nurses home converted into his department but it was small.”

The old pathology block was a rabbit warren of small rooms. Professor Thomas wanted to knock out most of the internal walls to create big, open offices and laboratory areas. His plan was based on advice received from his former boss Professor Maurice Ewing, Melbourne University’s first professor of surgery.

Professor Ewing worked in a small, oddly shaped office in the university’s clinical sciences block. Surveying his cramped office, Professor Ewing told his younger protégée: ‘Bob, if I’d had my time over again, I would have knocked down that wall to make a bigger office.’

The first Department of Surgery staff in 1993.

The first Department of Surgery staff in 1993. Ms Lien Wright (left), administration assistant, Ms Meron Pitcher, senior lecturer and research team members Dr Wayne Phillips, Dr Simon Green and Ms Sahar Bassal with Professor Bob Thomas, chairman of the Division of Surgery.

Western Health archives

Footscray Hospital approved Professor Thomas’s renovation plans and converted the pathology block into a suite of large offices and research laboratories. Meanwhile he recruited the department’s first small team of researchers and teachers.

He persuaded Melbourne University to give him a full-time research scientist, Dr Wayne Phillips, who came from the Royal Melbourne’s department of medicine.

Meron Pitcher was appointed as a senior lecturer and surgeon to be involved in clinical activities as well as teaching and research. Her specialist training in breast cancer led her to establish a breast cancer clinic at Sunshine Hospital.

Ms Lien Wright, the department’s administrative assistant, Dr Phillips, Dr Simon Green, and Ms Sahar Bassal formed the nucleus of the research team working in the department’s laboratories.

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Establishing a frozen tissue bank – one of Victoria’s first

Professor Thomas’s clinical interests in cancer led the laboratory team to focus on the disease.

They developed a cancer program that combined the cancer departments of Footscray and the Royal Melbourne.

“I wasn’t a laboratory scientist, I was a clinical researcher,” Professor Thomas said. “So we started doing things like collecting tissues, supported by the Ludwig Institute, which gave us a refrigerator. We took samples of bits of cancers and looked at them for genetic mutations.

“It was one of the first frozen tissue banks in a large public hospital in Victoria.

“My main issue was to get my department up and running so that it could flourish. We had PhD students, and we took registrars from the Royal Melbourne and the Alfred and rotated them through Footscray.

“Meron Pitcher was really good at the stuff I wasn’t good at, such as dealing with registrars.”

Professor Thomas’s background as a surgeon helped build trust and acceptance between the hospital’s surgeons and the newly formed department.

“Most of them knew me as a surgeon, not just as a crazy academic scientist who was not interested in clinical work,” Professor Thomas said. “We set up meeting rooms where surgeons could come and start to discuss cases.”

As chair of the division of surgery, Professor Thomas was responsible for overseeing the research department, the surgeons on staff and relationship with Melbourne University. It was a delicate task because the bruising battle over university affiliation was still fresh in people’s memories.

Students watching a surgeon operate at Footscray in 1994.

Students watching a surgeon operate at Footscray in 1994.

Western Health archives

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Healing old wounds

Ms Pitcher said Professor Thomas’s personal charm and reputation as an outstanding clinician were crucial in healing the split between surgeons who supported Monash’s bid for affiliation and those who backed Melbourne’s bid.

“There were some people here who had quite a few connections to the Royal Melbourne and there were others who had connections with Prince Henry’s,” Ms Pitcher said.

“It was a bit of a Monash versus Melbourne University situation. Bob transcended that because he was one of those people who could give the big picture view. He wasn’t just a gun surgeon. He could look at the big picture and ask how do we make a difference across the board and improve the whole system.

“I suspect he was deliberately sought by the hospital to get on and do that. They wanted someone who could take the hospital from being a local community hospital to a true teaching hospital. They saw Bob as someone who had the vision and ability to do that.

“Because he was interested in systems improvement, he could get the administrators on board, and he could deal with other clinicians and bureaucrats.

“He’d had a lot to do with the Cancer Council. Cancer is a very multi-disciplinary clinical area and it also involves consumers. Bob recognised the importance of consumers in making change at policy level.”

By 1998 the hospital’s academic quarters were humming with activity. University staff were involved in a mixture of clinical and laboratory research. The Department of Surgery’s research included the study of molecular and cellular study of gastrointestinal tumours. Tissues from the frozen tissue bank enabled researchers to study the role of enzymes that transmit signals from a cell’s exterior to its interior and the role of specific genetic regulators in bowel cancer.

Professor Thomas’s colleagues in the Department of Medicine intensified their research into digestive health, taking part in international studies investigating trefoil peptides and the role of stomach acid in reducing the risk of stomach and duodenal ulcers.

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