Obituary: Prof Cairns Aitken, psychiatrist who played a major role in the creation of Edinburgh Royal Infirmary

Cairns Aitken died in Edinburgh Royal Infirmary, the hospital that he had a major role in the creation of while serving as chair of its Trust from 1993 to 1997. He had enjoyed a distinguished career, holding many prominent roles in management within Edinburgh’s universities and its health service, and was Emeritus Professor of Rehabilitation Studies at the University of Edinburgh.

Born in 1933, he was an only child. Together his parents ran a hotel in Dunoon and his father was a qualified accountant. While he was a medical student at Glasgow University his mother died of severe asthma. The stress and worry caused when she had severe breathless attack had a profound effect on him, influencing his career choice and clinical outlook.

Early exposure to psychiatry came from a chance meeting with a fellow medical student who told him about free lodgings if you helped as a student at the Gartnavel Royal Mental Hospital. For two years, he enjoyed free digs, waitress service meals and an introduction to the fascinating challenges of a traditional psychiatric hospital of the time.

After qualifying in Medicine in 1957, he went as an exchange Fellow to McGill University, Montreal. Before embarking, he took the wise precaution of becoming engaged to Audrey, whom he wed in 1959 as soon as he returned from Canada. It was the start of a happy marriage that lasted to his death.

He obtained a commission in the RAF (1959-1962) and joined the Institute of Aviation Medicine in Farnborough, allowing him to travel widely and develop his clinical and research interest in treating flying phobias. During this time Cairns had the fascinating experience of visiting Nasa in its very early days and was part of a delegation to Washington to hear the astronaut John Glenn give his report to President John F Kennedy and the US people on his return from space.

After completing his specialist training in Psychiatry at the Maudsley Hospital in London, in 1966 he was headhunted to return to Scotland. He took a position at Edinburgh University as a lecturer, then senior lecturer and consultant, at the Department of Psychiatry at the Royal Edinburgh Hospital, where he continued his research into asthma and psychosomatic medicine. He edited the Journal of Psychosomatic Research from 1979-1986, was President of the Society for Research in Rehabilitation from 1981-1983 and President of the International College of Psychosomatic Medicine from 1989-1994.

In 1974, when he was appointed Professor of Rehabilitation Studies in Edinburgh, he was able to make the bio-psycho-social approach to healthcare which he had advocated for so long became practical reality. This new chair was designed for someone who combined an interest in disability with an understanding of the interplay of biological, psychological and social factors in motivating or frustrating recovery. He recognised the importance of the team, including not only nurses and medical staff but also psychologists and therapists, as well as the patients and their families, in providing the environment for effective rehabilitation.

Cairns’ other significant appointments included being Chairman of the BBC Scottish Medical Advisory Board from 1984-1987 and a member of the General Medical Council from 1991-1996.

He was appointed to the Human Genetics Advisory Commission in 1996, which had been created to report on issues arising from new developments in human genetics and their consequences. During his membership the commission advised on ways to build public confidence in the new genetics in relation to public health, insurance, patents and employment.

In addition to all this clinical and academic work he became chairman of the Council of Napier College and helped steer it from being a local college to becoming a national polytechnic and from there, the renowned university it is today. The transition was an enormous achievement, taking hours of painstaking negotiations. In 1990 he was, fittingly, made a Fellow of Napier University.

Many would have felt such achievements were sufficient but Cairns then threw himself into a series of challenging projects. After serving as Vice Dean and Dean of the Faculty of Medicine at the University of Edinburgh from 1988 to 1991, he went on to become Vice Principal of the university with responsibility for Planning and Budgeting, at what was an exceptionally challenging time, playing a major part in a turnaround which formed the foundations of the university as it is today.

It was while he was a director of Lothian Health Board from 1991 to 1993 that he took up the most challenging and controversial task of his career, as Chair of the Royal infirmary Trust, during the move from its historic city centre site to form the new hospital at Little France.

Cairns recognised the importance of clinicians’ involvement in management at a time when many were wary of the inevitable conflicts and disputes that this entailed. He was always one to march towards the sounds of gunfire and not shrink from difficult or unpopular decisions. A friend who knew him well said that in resolving a difficult problem he would identify a goal and then form a project team of skilled experts who worked together to overcome obstacles and succeed.

After so many years of public service he was awarded a CBE in 1998. Among his other honours was the Order of Merit of the Polish Republic in recognition of the important and continuing links between Edinburgh and Polish medical schools.

Alongside his successful career, Cairns was a family man, receiving loving support from his wife, Audrey. In retirement they had fun travelling the world, from Botswana to Ecuador, as well as spending enjoyable holidays with family and friends in Tuscany.

Cairns also pursued many enthusiasms in his beloved Scottish homeland as “projects”: for example, visiting and documenting all its inhabited islands, tracing the journeys of Bonnie Prince Charlie and visiting all the hydroelectric schemes. All of these adventures were approached with energy and the rigour of a scientist, with meticulous reports and photographic records. He was a skilled photographer and many of his photographs are in the SCRAN collection, which is available to the public as an educational archive.

In his approach to his post-retirement projects one detected the passionate and meticulous way in which Cairns set himself objectives and approached challenges throughout his career. He was very fortunate in having a family who provided love, support and infinite tolerance. He was devoted to his wife Audrey, and their three children: Robin, Gail and Shona, who died tragically of a bone tumour while a student at St Andrews University. He was also very proud of his two grandsons: Callum and Fraser, whom he was thrilled to see win places at Cambridge and the grand old university in Edinburgh to which he had devoted most of his career, in the city that he loved so much.

Dr Bruce Ritson  & Robin Aitken