Derek Wylie made many outstanding contributions to anaesthesia, medical education and prevention of medical negligence, but in spite of these he is probably best remembered for his great personal charm, kindness and integrity. He was fun to be with, whether in the operating theatre or medical school bar, and was a friend to everyone regardless of rank. He detested pomposity and provided guidance through example. Many years after he 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.
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. He qualified in 1943.
He initially intended to become a physician and held junior appointments as casualty officer, house physician and resident anaesthetist, during which time he obtained his diploma in anaesthetics (then the only anaesthetic qualification) and his membership of the Royal College of Physicians. He joined the RAFVR in 1946 and served as a physician in England, Palestine and Aden before demobilization in 1948. He married Margaret (née Toms) in 1945 and they had two daughters and two sons.
In 1946 the senior anaesthetist at St Thomas’s wrote 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. He was offered the job. Such a career change presented a difficult decision but he joined the staff of St Thomas’s in 1947.
At the inception of the NHS, anaesthesia was still in its infancy and yet now it is the largest hospital medical specialty, extending beyond the operating theatre to pre- and post-operative care, intensive care, pain relief and maternity wards. He played a major part in this development which allowed so many surgical advances to proceed in parallel. In 1953 he wrote The practical management of pain in labour (London, Lloyd-Luke [Medical Books] Ltd). With his friend and colleague H C Churchill-Davidson he carried out clinical research on themselves, including the effect of muscle relaxants, and they produced A practice of anaesthesia (London, Lloyd-Luke [Medical Books] Ltd, second edition, 1966), which became a best-selling textbook.
By 1972 he 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 Derek Wylie, to investigate the causes of deaths associated with anaesthesia. This was probably the first national investigation of its kind and was the direct forerunner of the current National Confidential Enquiry into Perioperative Deaths, which is now carried out by both anaesthetists and surgeons.
He was president of the anaesthetic section of the Royal Society of Medicine in 1963 and an honorary treasurer of the Society from 1964 to 1970. He was elected to the board of the Faculty of Anaesthetics (now the Royal College of Anaesthetists) in 1960 and was dean from 1967 to 1969. He was president of the Association of Anaesthetists of Great Britain and Ireland from 1980 to 1982, and during that period was president of the 6th European Congress of Anaesthesiologists held in London.
He served on many committees at St Thomas’s and, in 1974, 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 on a quarterly basis.
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 organized 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. He told me that being agnostic he had no fear of death or nothingness and we agreed that since we shared the same philosophy, should this prove to be wrong, we would probably go to the same place and meet up again sometime. I hope we do.
R A F Linton
[Brit.med.J., 1998,317,1392; The Independent 21 Nov 1998; The Times 29 Oct 1998]