ONE MIGHT believe that during its 250 years the Faculty of Medicine in Edinburgh had experienced most pressures, but with the establishment of the National Health Service in 1948, the need to plan clinical teaching between two employing authorities - the university and the NHS - introduced new administrative problems.
In 1965, as an experiment, the university appointed an Executive Dean to its Medical Faculty. That the experiment worked was due to the man they chose - Professor Archibald Duncan - who, over a decade became, in the Vice-Principal's words, the 'driving force in Edinburgh medicine', laying the ground work for its present standing as one of the top clinical academic centres in the UK.
British deans do not have the authority to 'hire and fire', but have to influence events by good management and diplomacy; in these Archie Duncan excelled. His load of paper and committee work was massive not only within the faculty, central university and health authorities, but also with national bodies, for he was deeply involved in broader aspects of medical education and the quality and ethics of health care. But he never appeared harassed and was always prepared to stop to listen, whether to staff or students; for he was a natural counsellor, always sensitive more to the needs of others than to his own. And all felt much the better for his counsel. To him, it was more important that a task should be completed than that he should receive the credit. But credit came his way with the conferment of the Honorary Degree of Doctor of Medicine in 1984, a rare honour for a member of faculty.
The foundations of this remarkable character were laid in Darjeeling, where his early years were spent as one of three sons of a Church of Scotland missionary; an upbringing which endowed him with the classless humility which endeared him to all. He came to Edinburgh for his education at Merchiston Castle School, and later its university (graduating in medicine in 1936), where, as he was already tonsured and neither smoked, drank nor played sport, he was regarded by some as rather 'holy', but to those who knew him he was great and amusing company - always in control of his moods, his only show of temper being a twitching of the lip and a few beads of sweat on the cheek. And, as was later proved by his war service as a naval surgeon, his courage and resolute character were not in doubt. He spoke little of the lives he protected during the evacuation of his sinking ship, for which he was awarded the Distinguished Service Cross, nor of the support which he gave to young aviators during his later service with the Fleet Air Arm (Squadron A26) in north Africa, particularly during the retreat from Benghazi. He remained loyal to the senior service, his preferred drink being pink gin (Plymouth, of course), and took great joy in dining with the Royal Naval Medical Club in the Painted Hall in Greenwich.
His early training with Professor RW Johnstone led Duncan to specialise in obstetrics - he became a Fellow of the Royal Colleges of Surgeons, Physicians, and Obstetrics and Gynaecology. Following clinical academic posts in Inverness, Aberdeen and Edinburgh, he was appointed in 1953 to the chair of Obstetrics and Gynaecology at the Welsh National School of Medicine in Cardiff, where he first brought academic influences to bear on that speciality.
Deeply concerned with the excessive perinatal infant mortality in South Wales, he initiated joint conferences and ward rounds with paediatricians and midwives; paediatric appointments in outlying hospitals; a system of 'domino' (domiciliary-in-out) deliveries, allowing the mother and baby skilled hospital care during these critical five to six hours; and the Cardiff Birth Survey; all of which dramatically reduced infant deaths. He insisted that the progress of all patients on his unit was reviewed at twice-weekly meetings of medical and nursing staff, introduced the concept of 'team' as opposed to hierarchical nursing care, and demanded that he be informed should any problem affect one of his patients, irrespective of the hour of day or night.
He was a natural teacher, but no matter how large the class, he always ensured that the patient was properly introduced and brought into the discussion, for he regarded the patient (not the teacher) as the central figure.
Duncan strongly encouraged research (he was then a member of the MRC Clinical Research Board) but he was not a laboratory man. Belief that the further advancement of his speciality rested in laboratory science led him to leave Cardiff for Edinburgh. But he continued to attend meetings of the Welsh Obstetric Society, which he had founded, for many years.
During his student days, Duncan met Barbara Holliday, the flat-mate of his flat-mate's sister. They married in 1939, establishing a lifelong partnership and creating a most hospitable home. No small part of his success in Edinburgh was due to the welcome which they gave to those appointed from elsewhere. The Duncans had no family of their own but they were true parents to many young people from all parts of the world in whose memory their kindness and consideration will long remain.
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