Obituary: Derek Wylie

MANY YEARS after Derek Wylie had become a consultant a very junior nurse in the operating theatre said she thought he was so good he should apply for a consultant job. That pleased him. Wylie, for more than 30 years a consultant at St Thomas's Hospital, made many outstanding contributions to anaesthesia, medical education and prevention of medical negligence, but he detested pomposity.

The son of a dental practitioner, he was born in Huddersfield and educated at Uppingham School, Gonville and Caius College, Cambridge, and St Thomas's Hospital Medical School, qualifying in 1943.

Initially intending to become a physician, he held junior appointments as Casualty Officer, House Physician and Resident Anaesthetist during which time he obtained the Diploma in Anaesthesia - then the only anaesthetic qualification - and Membership of the Royal College of Physicians. He joined the RAF Volunteer Reserve in 1945 and served as physician in England, Palestine and Aden before demobilisation in 1947.

In 1946 the senior anaesthetist at St Thomas's had written to him in Palestine to ask whether he would object to being considered for the post of Honorary Anaesthetist. He raised no objection, since it never occurred to him that someone with so little experience could be appointed. However, the Voluntary Teaching Hospitals in those pre-NHS days could make their own rules and he was obviously deemed to have potential. Such a career change presented a difficult decision, but he joined the staff of St Thomas's in 1948.

At the inception of the NHS, anaesthesia was still in its infancy. Now it is the largest hospital medical speciality, extending beyond the operating theatre to pre- and post-operative care, intensive care, pain relief and maternity wards. Wylie played a major part in this development which allowed so many surgical advances to proceed in parallel.

In 1953 his The Practical Management of Pain in Labour appeared in the UK and the United States and was translated into German. With his friend and colleague Harry Churchill-Davidson, Wylie carried out clinical research, including the effect of muscle relaxants on themselves, and they co-wrote the best-selling textbook A Practice of Anaesthesia (1960). It was also published in the US and widely translated.

By 1972 Wylie was becoming heavily involved with national anaesthetic bodies and was developing what became his major interest, medical negligence and its prevention. In the early 1950s the Association of Anaesthetists of Great Britain and Ireland set up a committee of four anaesthetists, including Wylie, to investigate on a voluntary basis the causes of deaths associated with anaesthesia. This was probably the first national investigation of its kind and it was the direct forerunner of the current "National Confidential Enquiry into Perioperative Death" carried out by both anaesthetists and surgeons.

He served on many committees at St Thomas's and in 1974 he was elected Dean of the Medical School. Hugely popular with the students because of his approachability and genuine concern for them, he was no pushover when it came to tough negotiation. After completing his term of office in 1979, he retired from the NHS to devote his time to medical negligence and its prevention. He joined the Council of the Medical Defence Union in 1962 and served as President from 1982 to 1988. During this period he developed his view that the union should play a significant part in the prevention of medical problems that could lead to claims of negligence and with this in mind initiated the union's own journal.

One of his best examples was how to die. Although resection of his oesophageal carcinoma prolonged his life, he knew it was unlikely to have been curative. The time left was for preparation not pity and he organised everything he could with characteristic humour and efficiency. The last time we met he said he expected to die the following day; which he did. I asked if he was worried about dying and he told me that, being agnostic, he had no fear of death or nothingness. We agreed that, since we shared the same philosophy, should we be wrong, we would probably go to the same place and meet up again sometime. I hope we do.

William Derek Wylie, anaesthetist: born Huddersfield 24 October 1918; Consultant Anaesthetist, St Thomas's Hospital 1948-66, Senior Consultant Anaesthetist 1966-79, Dean, St Thomas's Hospital Medical School 1974-79; Consultant Anaesthetist, National Hospital for Nervous Diseases 1950-67; Consultant Anaesthetist, Royal Masonic Hospital 1959-82; Dean, Faculty of Anaesthetists of the Royal College of Surgeons 1967-69; President, Association of Anaesthetists of Great Britain and Ireland 1980-82; married 1945 Margaret Toms (one son, two daughters, and one son deceased); died Uckfield, East Sussex 29 September 1998.

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