Obituary: Bernard Nolan ChM, FRCSEd, FRCSEng, surgeon

Born: 17 August, 1926, in Eccles, Lancashire. Died: 18 October, 2013, in Edinburgh, aged 87
Bernard Nolan: Master surgeon who took part in the  first kidney transplantation in the British IslesBernard Nolan: Master surgeon who took part in the  first kidney transplantation in the British Isles
Bernard Nolan: Master surgeon who took part in the first kidney transplantation in the British Isles

Since its foundation in 1726 the Edinburgh University Medical Faculty has attracted students from furth of Scotland, many of whom, as doctors worldwide, have made major contributions to the enhancement of its illustrious reputation.

The list of those English-born Edinburgh medical graduates whose clinical and scientific achievements have brought honour to their alma mater is a long one and there could be no worthier addition to it than the name of Bernard Nolan, whose death on 18 October has profoundly saddened his many friends and erstwhile colleagues, and left all of them with an acute sense of impoverishment.

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Born in Eccles, Lancashire, in 1926, he entered the Edinburgh University Medical Faculty in October 1944. He rapidly adapted to student life in Edinburgh and happily absorbed Scottish university traditions and mores while remaining a proud and loyal Lancastrian.

From the beginning, in spite of wartime prosperity, his good humour, his extrovert cheerfulness and his enthusiastic optimism – to say nothing of his good looks – made a strong impression on his fellow students.

Inevitably, when the Second World War ended, the class of 1944 became, to some extent, divided between ex-members of the Armed Forces newly returned from war service and the younger generation coming straight from school to university, but Bernard Nolan’s warm personality and good sense helped to bridge that gap, as did his keen membership of the University Air Squadron and his equally keen rugby-playing membership of the University Athletic Club.

He participated fully in undergraduate social life and was prominent in University Union activities, all of which helped to make him one of the most popular students of his year, without prejudice to his academic activities.

As a student he had developed a special interest in surgery and after graduating MB ChB in July 1949 he worked until October 1950 in the Royal Infirmary as House Surgeon to Professor Walter Mercer (later Sir Walter), first in the orthopaedic unit and then in general surgery wards 11 and 12.

Professor Mercer’s renowned operative versatility impressed him greatly and confirmed him in his determination to pursue a career in surgery.

There followed a year spent as Surgical Senior House Officer at the Cumberland Infirmary, Carlisle, after which he was called up for National Service in the RAMC.

He spent the next two years as a junior surgeon in military hospitals in the Suez Canal Zone and in Libya, and was demobilised with the rank of Captain, following which he returned to Edinburgh as was appointed Surgical Registrar, first at the Deaconess Hospital and later at the Royal Hospital for Sick Children.

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In May 1955 he became a Fellow of the Royal College of Surgeons of Edinburgh and it was while studying for the Fellowship examination that he met in the university anatomy department a young medical student, Margaret (Peggy) Coleman, who three years later was to become his wife.

At the start of the 1956 Suez Crisis he was recalled to the army and, having become FRCSEd, he was upgraded to Surgical Specialist status with the rank of Major. But the crisis was short-lived and on his return to Edinburgh at the end of 1956 he was appointed Registrar in the Surgical Outpatients Department of the Royal Infirmary.

In May 1957 he became a Fellow of the Royal College of Surgeons of England by examination and the very next day he met for the first time Michael Woodruff (later Sir Michael Woodruff), the newly appointed Professor of Surgical Science in Edinburgh University.

He discussed with Professor Woodruff his ideas for a research project relating to the formation of kidney stones, and was given facilities for this in the Wilkie Surgical Laboratory, following which he moved as Register to Professor Woodruff’s surgical wards at the Royal Infirmary.

Promotion to Senior Registrar came in February 1959, four months after the most important event of his life – his marriage to Peggy Coleman (now a qualified doctor), whose love and devotion were the foundations of his happiness thereafter and the inspiration of his constant pursuit of professional excellence.

In May 1959 Bernard Nolan was appointed Lecturer in Professor Woodruff’s university department with integral involvement in its transplantation research programme and membership of the Edinburgh-based Medical Research Council Group on Transplantation.

Eighteen months later, on 30 October, 1960, he assisted Professor Woodruff to carry out the first ever kidney transplantation in the British Isles and bore a large part of the responsibility for the pre- and post-operative care of both the donor and recipient, who were identical twins. The recipient, who had end-stage kidney failure, did not require immuno-suppression and enjoyed ten years of reasonably good health before dying of unrelated causes.

The total success of the first British kidney transplantation strongly encouraged productive research in the field which, together with improved methods of immuno-suppression, progressively extended the scope of transplantation in the treatment of renal failure.

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During the next two years Bernard Nolan’s transplantation experience increased steadily and in 1962 he was awarded a Postgraduate Fellowship at the Harvard University Medical School, where he worked with Dr Joseph Murray, the acknowledged “father of transplant surgery”.

Later that year he was appointed Senior Lecturer in Surgery at Edinburgh University with Consultant status in the Royal Infirmary. In 1965 he transferred to the NHS as Consultant General Surgeon but in close association with Professor Woodruff continued to run the Edinburgh transplant service.

Three years later the university awarded him its Master of Surgery (ChM) degree for his thesis on kidney transplantation, but the satisfaction afforded by this academic honour was blighted by an outbreak of hepatitis in the Transplant Unit which caused suspension of activities.

The tragic deaths of two members of its staff cast a dark shadow which might have had serious psychological effects, and there is no doubt that Bernard Nolan’s calm, steadfast leadership did much to sustain the unit’s morale.

In 1978, with the retirement of Sir Michael Woodruff, the Transplant Unit moved to the Western General Hospital under the direction of Sir Michael’s successor, Professor Geoffrey Chisolm. As an NHS consultant surgeon, Bernard Nolan increasingly became committed to vascular surgery and pressed strongly for the establishment of a surgical unit devoted to this speciality.

This was achieved in 1982 when the Edinburgh Specialist Vascular Surgery Service was set up in the Royal Infirmary, with Bernard as its “chief”, and over the next nine years he and two other dedicated vascular surgeons, Sandy Jenkins and Vaughan Ruckley, provided an emergency service 24/7, which produced results unsurpassed anywhere in the world.

He retired in 1989, and he and Peggy were able to give full indulgence to their love of foreign travel. They voyaged on cruises to many exciting destinations, including some seldom visited by British tourists, but their fascinating and delightful peregrinations were cruelly curtailed by the effects of a serious road accident sustained by Bernard while walking in the street not far from their home. Recovery was difficult and prolonged but in 2009 he was able to participate fully in the 60th anniversary reunion of the 1949 Edinburgh medical graduates.

Bernard and Peggy had high hopes of being able to resume their travels to faraway places but he developed signs of pulmonary fibrosis, which progressed inexorably and in the last years of his life he became totally disabled by respiratory insufficiency.

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Thanks to Peggy’s loving and devoted care he was able to remain at home, although bed-ridden, and he remained fully conscious, rational and communicative until near the end. He bore his affliction with the utmost fortitude over the months of increasing weakness and no-one who saw him during this time will forget his calm, dignified serenity in the face of death.

Bernard Nolan was a surgeon of high distinction and a perfectionist whose clinical and operative expertise saved the lives of many desperately ill people. His professional life was governed by his deep concern for the overall well-being of his patients, who to him were always far more than “cases”. This is clearly demonstrated in press photographs taken to mark the 50th anniversary of the first British kidney transplantation, in which Bernard is shown with Linda Phillips, aged 53, to whom when she was nine years old he transplanted one of her mother’s kidneys.

An Englishman through and through, Bernard lived happily in Edinburgh, where many citizens were proud to regard him as an honorary Scot whose achievements brought honour to his adopted country.

All who knew him – patients, colleagues, students and his host of friends – mourn his passing and send their deepest sympathy to Peggy, his sons Geoffrey and Johnny and his grandchildren.

They also salute the memory of a great master surgeon, a highly respected medical scientist, an inspiring teacher, a compassionate doctor and a kind, gentle, honourable man.