Coll Fisher 1935 - 2008
Coll Fisher was a popular obstetrician who was at the centre of many of the changes in the care of pregnant women for almost 40 years. Concerned about the rising caesarean birth rate - topical again now - early in his career, he deplored the defensive obstetrics engendered by increasing litigation from the 1970s and was critical, always politely and with laconic humour, of colleagues with excessively high caesarean rates.
Writing in the Medical Journal Of Australia in 1990, he advocated no-fault insurance as the solution to the problem of rapidly rising medical indemnity costs for obstetricians - and ultimately for their patients.
Fisher, who has died at 72, was named Cuthbert Collingwood, after the remarkable admiral who was with Nelson at the Battle of Trafalgar in 1805. His father, Ernest Fisher, was a country general practitioner, aged 56 when Coll was born; his mother, Louisa, was 40. The boy boarded at Scots College, where he played rugby with a "golden boot" for the 1st XV and GPS Firsts and was a champion swimmer.
Fisher then enjoyed the freedom of life at Wesley College, making a "gentleman's progress" through medical school at Sydney University. He had followed his older brother, Eric, and sister-in-law, Anne, into medicine and, after graduating in 1962, eventually joined the family practice in West Wyalong.
While still a student at Royal North Shore Hospital he spied a glamorous young physiotherapist, Gillian Adams. His first words to her were to invite her to the hospital ball. They were married in his final year.
After hospital residency and four years as a general practitioner in West Wyalong, Fisher moved to the Royal Hospital for Women in Paddington. Rapidly acquiring the skills and knowledge needed to care for high-risk pregnant women, he chose a career as a staff specialist obstetrician rather than private practice. Under the leadership of John Greenwell, the medical superintendent, Fisher, Ed Bosch and Steve Steigrad formed a strong triumvirate of staff obstetricians.
The revolution in perinatal care was just beginning in 1968. Technological interventions such as intrauterine transfusions for severe Rhesus incompatibility, obstetric ultrasound to detect abnormalities, amniocentesis for the prenatal diagnosis of chromosomal abnormalities and foetal monitoring during labour were introduced.
Fisher was a consummate clinician, often in demand for advice from GPs and consultants. Even at night and weekends he was accessible, minutes away from the hospital at his home in Woollahra.
He encouraged neonatal pediatricians to visit pregnant women and their patients-to-be in the antenatal ward, sometimes perceived as a rather daunting experience at the Royal. He visited nurseries frequently to check on the progress of babies he had delivered. When he emerged perspiring profusely after a morning of intrauterine transfusions or amniocenteses, he made light of the technical difficulties of safely injecting blood into the abdomen of his tiny foetal patients.
After the obstetrician Bill Garrett and the physicist George Kossoff developed grey-scale ultrasound, Fisher became expert in using this revolutionary technology.
The old Royal's hub was the area near the main entrance, where Fisher, gregarious by nature, would often greet colleagues and other staff, then chat about clinical problems, sport, politics or whatever at all hours of the day or night. Like many contemporaries, he felt that the Royal lost its soul when it moved to Randwick, where budgets and bureaucracy seemed to supplant patient care as the main priority.
The Paddington site became his home after the historic hospital was demolished in the 1990s. The Fishers bought a new apartment off the plan and enjoyed views like those from the old labour ward.
Fisher had a pivotal influence on the training and career choices of numerous young obstetricians. Calm in adversity, and known as "cool Coll", he was an ideal role model. Patients and young doctors were fortunate that he didn't become mired in excessive administration, although he was director of obstetrics and of the Foetal Intensive Care Unit at the Royal and served on committees of the NSW Health Department and of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Knowledgeable about rugby and cricket, he had excellent recall of games decades ago. On occasional trips to England, a Lord's Test was high on his agenda. He played tennis regularly, read voraciously and was enthusiastic about movies and opera.
Burdened uncomplainingly since 2005 by chemotherapy for multiple myeloma, and perhaps with an inkling of his fate, he enjoyed Christmas in Canberra with his extended family and, with his son, Robert, the first day of the New Year cricket Test against India. He would have been appalled by the furore that tainted the result.
He collapsed with breathing difficulties at a cinema and died the next day.
Coll Fisher is survived by Gillian, their children, Robert, Jane and Caroline, and their partners, Victoria, Tim and Matthew, four grandchildren, his brother, Eric, and sister, Adrienne.
By permission of the Sydney Morning Herald