Edgar Samuel John King 1900-1966
This memoir was originally published in Records of the Australian Academy of Science, vol.1, no.2, 1967.
Edgar Samuel John King was born at Mosgiel, New Zealand, on June 10 1900 and migrated to Australia with his parents while still a boy. He received his primary education in Queensland, New South Wales and Victoria, and his secondary education at Melbourne High School. The cost of his education was largely met by scholarships obtained at competitive examinations. In 1918 he entered the first year of the medical course in the University of Melbourne and thus commenced the long and fruitful association with medicine and Melbourne which only terminated with his death on 31 January 1966. He never knew the leisure of retirement, consenting, at the request of the University, to continue in the Chair of Pathology after the retiring age in order to assist over an awkward period and knowing full well that he was harbouring a mortal illness. His determination to die in action, as it were, was one of the characteristics of this remarkable man.
His election to Fellowship of the Academy in 1954 was a well-deserved tribute to one whose contributions to scientific knowledge were made not only in the laboratory, as is customary, but also in the wards and operating theatres of hospitals. His reputation for thorough diagnostic investigation and painstaking attention to operative detail was outstanding. More importantly, however, we constantly find, in his approach and in his writings, an aim to use all observations derived from the clinical study of patients and of operations as a basis for extending and unifying knowledge. It was this attitude which made him outstanding, for surgery is a field where technical details may easily absorb energy and attention so that none remains for the more intellectual problems with which it abounds. Inspection of a list of his writings reveals the wealth of his experience, the range of his interests and the intensity with which he carried on his investigations; it also demonstrates how valuable the study of clinical material by an informed and enquiring mind can be. His life's passion was asking why and how and for him surgery provided a practical outlet for this preoccupation.
Professor King's principal contribution to medical science was the application of general biological principles to the study of pathology with particular reference to ovarian tumours, certain chronic diseases of the gall bladder and tumours of bone and synovial membranes. Original contributions were also made to the histology and pathology of synovial linings of joints and tendon sheaths, pilonidal sinus, branchial cysts, varicose veins and cysts of the thyroid gland. During the period 1930 to 1945, he devoted considerable attention to surgical technique with pioneering efforts resulting in operations for the removal of the oesophagus for cancer, decortication of the heart for constrictive pericarditis, and removal of the thymus gland. The successful elaboration of these surgical procedures was necessarily preceded by extensive experimental work.
Edgar King graduated in medicine from the University of Melbourne in 1923 after an undergraduate course which, though at honours standard, provided no hint of the quality of the man or of the talents that were to emerge at a later date. He was appointed to the resident medical staff of the Alfred Hospital in 1924 and in 1925 served as the last House Surgeon to Hamilton Russell. The latter had been the last House Surgeon to Lord Lister and had brought to Australia the latter's meticulous attention to detail and his scientific approach to surgical problems. Russell carried on this tradition at the Alfred Hospital and his own contributions to surgical science were considerable. It is clear that King was greatly influenced by his surgical master and that this influence played a major part in shaping his subsequent career.
After a short term as Acting Superintendent at the Alfred Hospital he proceeded, with the MD degree (1926), to London for postgraduate work. After obtaining the Fellowship of the Royal College of Surgeons of England in 1927 he returned to Melbourne in 1928 to embark on a surgical career.
Though attached to the visiting surgical staff of the Alfred Hospital his most important and cherished position at this time was that of Stewart Lecturer in Pathology in the University of Melbourne. On 21 December 1931 he was appointed Surgeon to Out-Patients at the Melbourne Hospital, being successful in the face of considerable competition because this highly prized post was the blue riband surgical appointment in Melbourne. The appointment was also unique in that King had not had any previous association with the Melbourne and, at the time, he occupied only a junior surgical position at the Alfred. But his remarkable qualities were now emerging and all the pointers to an outstanding career in surgery were abundantly evident.
The thirties saw a period of tremendous energy and a dedication to his work that was unbelievable. This was his great decade of productive activity and achievement in surgery. He was a methodical and tireless worker and his efforts to achieve his ideals were unremitting. He worked long hours in an honorary capacity not only at the Melbourne but at a number of other hospitals. He established a large private practice but had no idea of money and if he remembered to send an account it was always ridiculously small. In the Department of Pathology he served with distinction as Lecturer and Senior Lecturer (1928-1938) and as Acting Professor in 1934. His crowded days and nights were spent teaching, operating and investigating. Despite long hours in the operating theatre, lecture room and laboratory he would still be available in the early hours of the morning for his emergency calls and operations at the Melbourne, and as a student I can well remember what a provocative, exciting and stimulating instructor he could be on these occasions. In all quarters his enthusiasm was infectious, he was a brilliant and inspiring teacher and a great stimulus to medical students. During this period he attained the MS (1930) and DSc (1933) degrees and the Fellowship of the Royal Australasian College of Surgeons (1930).
Now a serious investigator he published more than 50 papers on diverse subjects in pathology and surgery, won the Jacksonian Prize of the Royal College of Surgeons, England, three times (1931, 1933, 1938), the Alvarenga Prize of the College of Physicians of Philadelphia (1931), and the coveted Syme Prize of the University of Melbourne (1931).
He was a quick and skilful surgeon partly, at least, because of careful advance planning. His extensive knowledge of pathology encouraged him to question accepted doctrines and to look for ways of improving surgical results. In this sense he was, more than most of his contemporaries, an experimentalist. The material handicaps to experimental surgery in Australia in the 1930s were immense, for full-time salaried appointments did not exist in any branch of medicine. Thus King was forced to do his research work at night and in occasional hours stolen from a busy day of private and public hospital surgical practice which often started in the early hours of the morning. His appointment in the Department of Pathology at the University of Melbourne provided basic facilities for pathological research although it was necessary to supplement the animal supply by breeding the guinea-pigs at home. It was a formidable undertaking to produce such a volume of outstanding work in two disciplines under such conditions, but King succeeded in doing it. Although he was undoubtedly an academic, he was a surgeon as well as a pathologist but the vindication of pathological principles was the logical end result. Wider opportunities would certainly have taken him to a chair of surgery. He pioneered the surgery of the heart and oesophagus in this country and quickly established an international reputation in this field. He was the first Australian to report successful oesophagectomies for carcinoma. These operations were done under endotracheal ether anaesthesia and had to be completed within an hour if the patient were to have any chance of survival. There were no antibiotics and a blood transfusion of one pint was considered adequate. It is a miracle that surgery of this sort and under these conditions could be successful, and only a surgeon of King's ability could have made it so.
At this time he developed a slight weakness of the eye muscles which made it necessary to look a little sideways to avoid diplopia. Anyone who did not know this would be startled to see him driving urgently down the road he was always in a hurry apparently looking out the side window all the time. His refusal to be affected in the slightest by this small physical disability foreshadowed his courageous refusal to be discouraged by much greater disabilities in later years.
The outbreak of World War II in 1939 saw King at the height of his surgical and scientific career, bristling with ideas as he galloped through life. He immediately enlisted as a surgical specialist and for the whole duration he devoted his immense drive and ability to his military duties. He commanded a team which brought skilled surgery close to the firing line. However, incapable of idleness, he found the long periods of inaction which were a feature of this war unbearable. Characteristically, he used these intervals to prepare for publication material previously accumulated as well as new observations on the surgery of war wounds. During the seven years of war service, an additional ten papers and a book, Surgery of the Heart, were published.
After service in the Middle East, where his surgical skill enabled him to render major services to the casualties who came under his care, he returned to Australia to solve difficult organisational problems at the 115th Australian Military Hospital at Heidelberg, Victoria. This task completed to his and others' satisfaction, he again sought a field posting and served in North Queensland, Bougainville and New Guinea.
Edgar King therefore seemed destined to be among the most eminent figures in surgery in post-war years. Fate, however, decided differently. By 1945, the progress of the illness which was to over-shadow the rest of his life could no longer be ignored. Perhaps he had neglected it for too long already, on the ground that victory was the first condition of survival. He spent 1946, the year of his discharge from the Army, in hospital with severe pulmonary tuberculosis, and an internationally known surgical career ended at its peak.
A return to surgical practice was out of the question and his reaction to the new situation was a characteristically positive one. He decided to return to pathology. He was appointed Pathologist to the Royal Melbourne Hospital in 1947. His period of service at this hospital was a fruitful and happy one. He adjusted to the restrictions imposed by his medical advisers but could not remain idle for the post carried interesting teaching responsibilities and challenging research opportunities which he was eager to exploit.
King's reputation as an investigator, teacher, and administrator made him the obvious choice for the Chair of Pathology in the University of Melbourne when it became vacant in 1951 and he served with great distinction in that position until his death. He knew the importance of research not only for the advancement of knowledge but also for the illumination of pathological teaching, and his ideal of what a University pathology department should be was clear and unchanging. He immediately set about reorganising and expanding the department with the object of meeting the pressing demands of under-graduate and graduate instruction and of again bringing the Department to the forefront as a research centre, for the war years had been an obstacle to progress.
The task was not an easy one under the conditions in which State Universities operated throughout the 1950s. Student numbers were high and budgets could no longer meet the rising costs of modern University standards. King set about the task with characteristic vigour and by the end of his first decade in the chair he was justified in reviewing the results with considerable satisfaction. Well-planned renovations and alterations within the existing building had greatly increased space and improved efficiency. The unique heritage of irreplaceable museum specimens was remounted, supplemented, and made accessible for study by the introduction of a system of adequate illumination. Later, the animal house, the optical and photographic laboratory, the general laboratories and the workshop were re-equipped. Finally, it became possible to develop a laboratory of electron microscopy, the value of which to pathology King had long foreseen. The teaching and research staff more than doubled, and the annual budget increased from about $A6000 to $A90,000. Most of this increase came from donations and research grants. Professor King was himself a generous donor, his personal contributions from consultant fees exceeding $A70,000. The fruits of this progressive policy included a continuous flow of scientific contributions from members of the staff, and an increasingly high reputation for the Department. All this was achieved in an old building against the frustrating administrative delays and financial restrictions of the 1950s. Yet he maintained throughout a steady pressure of enthusiasm which greatly eased the difficulties.
Though steeped in classical pathology, a measure of his flexibility was the manner in which his interests in later years shifted to experimental and chemical pathology. Thus he came to combine, in an effective and productive way, an extensive knowledge of morbid anatomy and the capacity to select, plan and conduct critical experiments. His broad, well-informed biological and comparative approach to all pathological problems must be stressed. His writings, as did his conversation, reveal how his mind preserved this flexibility and enabled him to keep abreast of the great advances in cancer research and experimental pathology. He was, however, always available to discuss clinical problems with clinicians and to give them the benefit of his experience. This, and his reputation as a histopathologist, meant that he was greatly in demand as a consultant. His income from this work was considerable but, generously, it was all ploughed back into the Department.
His keen intellect, critical judgment, immense capacity for work and progressive outlook were a great attraction to the younger generation, and, from the time he took the Chair, King had no difficulty in gathering an enthusiastic staff, comprising both clinicians and pathologists, which soon became a busy and productive group. He gave every help and encouragement the department could afford to young workers. He spared no effort in encouraging and supervising those who undertook a PhD project because of the training, value and incentive inherent in working for this qualification. The younger graduate who was fortunate enough to get a place on the staff was well aware that he had an unrivalled opportunity to advance his career. At the same time King had no sympathy for slackness and, as a perfectionist, he could be demanding. The author of a paper who had not thoroughly prepared his material could expect trouble from his incisive mind and the lesson would be hammered home in an unforgettable manner. But none would deny his fairness and justice in awkward situations, even when his opinion was unfavourable.
A stream of research was soon flowing from the department and its success as a graduate school is shown by the record of 19 doctorates of philosophy in 15 years. And in all this Professor King was not only the Professor of Pathology but the driving force and inspiration behind the whole department. His endeavours and achievement over the concluding years of his life are all the more remarkable when it is recalled that for so much of the time he was battling against his own personal medical problems.
Professor King did not consider that a university department should channel all its research into one particular line of investigation. He was therefore prepared to allow those who wished to pursue their own interests to do so, if he considered that satisfactory work would be produced. In practice, a considerable degree of voluntary collaboration developed around a few main lines of research, which maintained a surprising continuity, although the scope and complexity of the problems which could be undertaken progressively increased.
In spite of this diversity of interests, the department under Professor King's guidance was not fragmented; each member knew of, discussed and learned from the work of the others, and thus maintained a breadth of interest which was reflected in his teaching.
In December 1965, in anticipation of his forthcoming retirement, his students, past and present, combined to present him with a volume of papers written for the occasion as a tribute of their affection and respect.
During these post-war years, Edgar King was awarded many honours and distinctions reflecting the esteem in which he was held by his colleagues. He was admitted a Fellow of the Royal Australasian College of Physicians (1949) and of the Australian Academy of Science (1954), and in 1956 became a Foundation Member of the College of Pathologists of Australia. He was the Edward Stirling Lecturer (Adelaide) in 1948 and the Bancroft Memorial Lecturer (Brisbane) in 1950.
Edgar King worked outside the University in many fields for he always found the time to meet other professional obligations. His profound knowledge, his ability to get quickly to the heart of a problem and his grasp of financial matters made him an invaluable committee man. His judgments were always to the point. Indeed his actions were always reasoned and objective and were never governed by prejudice or animosity he was always completely fair even when at times it went very much against his own feelings. His hallmark was his absolute honesty and integrity. These outstanding qualities made him a trusted adviser on many medical and government committees and his help was constantly sought in difficult situations. As a result his life became full of committee responsibilities in these post-war years.
Professor King played an important part in promoting support of medical research in Australia as a member of the National Health and Medical Research Council of Australia (1956-1964) and its Medical Research Advisory (1956-1964) and Radio Isotopes (1952-1966) Committees, and the Advisory Council of the Life Insurance Medical Research Fund of Australia and New Zealand (1957-1966). He greatly influenced the development of the Victorian Anti-Cancer Council's support for cancer research, first as a member of the medical and scientific committee from 1951, and subsequently as a member of the Executive Committee which he joined in 1960 and of which he became Chairman in 1963. He was a member of the Walter and Eliza Hall Institute Board from 1951 to 1966 and of the Research Advisory Committee of the Baker Institute of Medical Research from 1952 to 1963. He was the medical member of the Commonwealth Serum Laboratories Commission from its creation in 1961 and served on the National Radiation Advisory Committee from 1959 to 1966. He served on the Council of the Royal Australasian College of Surgeons from 1950 to 1958, was Honorary Treasurer of the College from 1951 to 1958, Chairman, Board of Examiners for the Primary Fellowship from 1948 to 1958, and Chairman of the Editorial Committee of the College Journal from 1950 to 1958. He was also active in the affairs of the Postgraduate Federation of Medicine (Vice-President, 1954-1963 and President in 1957) and of the Melbourne Medical Postgraduate Committee (Vice-Chairman, 1956-1963). His public services to Australia were recognised by Her Majesty the Queen in 1965 when he was created a Companion of the Most Distinguished Order of St. Michael and St. George.
Professor King's career was unique in the achievement of distinction in several fields: surgery, pathology, administration (both military and civil), scientific investigation and academic life. He brought to each facet of his life's work a characteristic combination of qualities: an adventurous zeal and capacity for hard work, a determination to overcome all difficulties even at the cost of personal sacrifice, a logical and analytical approach, an original and widely-informed mind, sound judgment, an all-round ability in practical as well as in theoretical matters, and an honesty of purpose in which personal considerations had no place. Perhaps it was this quality of integrity, as much as his scholarship and achievements, which evoked such a deep and permanent sense of loyalty and admiration in his students, associates and contemporaries. He was a splendid colleague in every way and for all his accomplishments he remained a modest and friendly man.
His death means more than a loss to Pathology for he had been everywhere regarded with affectionate respect in medical, lay and scientific circles. He has left an inspiring record of what one man with a remarkable combination of professional and personal excellences can accomplish.
In 1930 Professor King married Leonora Shaw. She survives him with four daughters.
Sydney Sunderland,CMG, Professor of Experimental Neurology and Dean of the Faculty of Medicine, University of Melbourne. Foundation Fellow of the Academy, and Secretary, Biological Sciences (1955-1958).