Milton, Gerard

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Scourge of the sun led to a lifetime’s work

Dr Gerald Milton (MS ’89, MD ’93) 1924 - 2007

If any disease could be tagged to Australia as a special medical challenge, it would most likely be melanoma, the scourge of a fair-skinned people populating a land meant for the dark-skinned.

Gerald White Milton, born in another sunlit place, Calcutta, of a British father and Australian mother, became the distinguished surgeon and academic who took up the challenge. Becoming president of the Surgical Research Society of Australasia in 1963, Milton turned his attention to melanoma, the prevalent problem attracting little research. Milton saw an opportunity to establish first-class treatment in Australia, which had the highest incidence of melanoma in the world.

"He said: 'Let us set up a clinic,"' recalls Bill McCarthy, Emeritus Professor of Surgery at the University of Sydney

That happened in 1966. The melanoma clinic operated at Sydney Hospital and began the first formal collection of information from patients, using a written proforma designed by Milton and Cecil Lewis, a professor in surgery from Perth. As patient referrals increased, it became necessary to offer chemotherapy and palliative care. The first domiciliary nursing service was established for patients with advanced disease.

After schooling in England and Switzerland, Milton had graduated in 1947 from the University of Adelaide as a bachelor of medicine and bachelor of surgery, taking out two academic prizes. In 1951 he was awarded fellowship of the Royal College of Surgeons and two years later became a fellow of the Royal Australasian College of Surgeons. In 1955 he became a Sir David Wilkie surgical research scholar at the University of Edinburgh and, two years later, a senior lecturer in surgery at the University of Sydney.

Milton was inspired by Sir John Lowenthal, who was professor of surgery at Sydney and later dean of the faculty of medicine. Lowenthal was keen to develop clinical schools at Sydney's teaching hospitals and arranged for Milton, then specialising in gastroenterology, to go to St Vincent's. Milton's ambition was always to be a scientist and academic.

McCarthy joined the the melanoma clinic in 1968 and promoted the extension of the unit's work to include community awareness and education. In 1972 the unit joined the World Health Organisation melanoma group and began to take part in international clinical trials. Milton joined the organising committee for the international cancer conference in Sydney on melanoma and skin cancer. He also represented the clinic at the World Health Organisation melanoma study group.

As patient numbers increased, Milton recruited Alan Coates, a medical oncologist interested in immunology and an expert statistician who worked on clinical trials and went on to become head of the Australian Cancer Society. Milton also picked up Peter Hersey, an immunologist, to help with immune work and try to develop a vaccine against melanoma.

A move in 1983 to the larger Royal Prince Alfred Hospital enabled the clinic, now known as the Sydney Melanoma Unit, to expand. Hersey was assigned to the University of Newcastle, where he built one of the world's leading tumour and immunology laboratories. Another branch of the unit was established at Westmead Hospital.

Milton went on researching, lecturing and writing. A very good clinician, he was a stickler for punctuality and would not tolerate people being improperly dressed, unshaven, or walking around with their hands in their pockets. When a junior colleague came to a meeting five minutes late, saying he lived in Lane Cove and had been held up in traffic, Milton gave him a withering look and said: "Where do you think I come from?" He, too, lived in Lane Cove.

Milton was the keynote speaker at the World Health Organisation International melanoma meeting in Yugoslavia. In 1990 he became Professor Emeritus in Surgery at the University of Sydney and an Officer of the Order of Australia.

In 1994 Milton was awarded an honorary MD at the University of Sydney and an award for excellence in surgery from the Royal Australasian College of Surgeons. He continued to work to the end, holding pigmented lesion clinics in Canberra, Wollongong and Goulburn and travelling throughout the eastern states as a senior examiner for the Australian Medical Council for Foreign Practitioners.

Milton, who died at 83, had homes in the southern highlands and in Darlinghurst but was particularly fond of his weekender at Towlers Bay, on Pittwater, where he entertained enthusiastically, ate, drank, laughed, told jokes and played snooker.

He is survived by his widow, Julia, his first wife, Janet, sons John and Christopher, daughter Claire, and grandchildren.

This is an edited version of the obituary that appeared in The Sydney Morning Herald on 9 May 2007.