From Faculty of Medicine Online Museum and Archive
MD honoris causa 1985 MB BS (Otago) FRCS FRCSE
Rowan Nicks, the first founding full-time Cardiothoracic Surgeon was appointed to Royal Prince Alfred Hospital in 1956. Rowan designed the first automatic pacemaker.
Rowan was educated in New Zealand, studied Medicine at Otago Medical School and graduated in 1937. After serving as house surgeon for two years at the Auckland Hospital, he sailed to London as a ship’s surgeon for post-graduate surgical training. He joined a class at the Middlesex Hospital and was appointed Honorary Demonstrator in Anatomy.
On the Declaration of War in 1939 he volunteered to join the British forces, but he was not needed at this time and continued working at the Department of Anatomy. He passed the primary FRCS examination and then joined the Royal Naval Medical Service as a Surgeon Lieutenant and was sent to sea. “It will make a man of you”, said the surgeon captain.
Rowan served throughout the war mainly at sea and in the Mediterranean theatre where he introduced the first Field Surgical Unit in the Royal Navy and the first Casualty Clearing Ships for the landing in Sicily.
After the war, on the recommendation of the Royal Navy, Rowan was appointed the first trainee in cardio-thoracic surgery at the Brompton Hospital, London under Mr Tudor Edwards and his team. In the middle of his training he was asked to apply for an appointment as full-time surgeon to the new cardio-thoracic surgical unit at the Green Lane Hospital, Auckland, New Zealand, his home country. Prior to taking this appointment in 1947, he was given a travelling scholarship to visit cardio-thoracic units in Sweden and Norway and in the United States. After this he returned to New Zealand to pioneer cardiovascular surgery.
With my colleagues I had developed lung and tuberculosis surgery, cardiovascular and oesophageal surgery, and had established a service for congenital and acquired heart disease. We had established an arterial bank and had built up a service for paediatric and cardiothoracic oesophageal surgery with the support and confidence of the Auckland paediatricians. It had been a full program and I departed on the crest of the wave.
In 1956 he moved to Sydney in order to take up a foundation appointment as Cardiothoracic Surgeon at Royal Prince Alfred Hospital. He developed a heart surgery unit at the Hospital which became, and has remained, one of the leading cardiac surgery units in the country. During his time as Head of the unit at Royal Prince Alfred Hospital, many developments and major advances occurred in cardiac surgery. In 1957 he was involved in the first case of open-heart surgery in New South Wales. Shortly after, Rowan received a government research fellowship which enabled him to continue researching and developing safe open-heart surgery techniques at the University of Sydney. It was during this time that pacemaking was developed and not long after, Rowan designed the first automatic pacemaker. He recalls:
Mr Eric Miller, a retired engineer… was suffering from frequent blackouts due to spontaneous intermittent heart block. The electrode I had inserted on to his heart was brought out through the chest wall and connected to a manually-operated external pacemaker which he wore on a belt around his waist and which he turned on like an electric light switch whenever he felt faint. It worked well, but some months later, fearing that his heart might stop during his sleep, he and his wife (she was terrified and could not sleep) came to see me and asked what could be done automatically if his heart stopped when she was not awake to turn the pacemaker on. As a consequence the automatic ‘switch-on’ device was invented.
In 1963, he took a surgical team to Port Moresby where he operated on patients with advanced pulmonary tuberculosis and other chest and heart diseases, and was also involved in the teaching and training of medical students, nurses and physiotherapists. Through this experience Rowan “found an empathy with the New Guinea people and became aware, for the first time, of the vast number of people in the developing Pacific and Asian nations who were looking to Australia for help”.
With the death of his wife Mary in 1969, Rowan decided to travel to India and Africa. He worked in New Delhi, “lecturing to medical students, working in the overflowing wards, mingling with the people hurrying in the streets, bathing, as it were, in the river of life”. Nicks travelled to Kampala, Uganda where he joined the Mulago Hospital at Makerere University.
He returned briefly to Sydney in 1970 but travelled again to India and then Russia in 1971, participating in international congresses. Further travels in the years that followed took Rowan to Iran, the UK, Malaysia, and also to Tanzania.
Rowan retired in 1973. Reflecting on his career he writes:
I regarded myself as an uncomfortable catalyst between the old and the new worlds, between the old tradition of voluntary service and the new complex organisation required by full-time specialties; I believed that medical horizons were limitless and that we should rise to the ideals of our profession.
On going back to India in 1973, he says:
[T]hat flight to Madras began the transformation of my retirement to a new and exhilarating career – teaching and organising life-saving surgery to receptive and dedicated doctors and nursing staffs in India and in the newly emerging nations of Africa, Asia and the Pacific. Working with these fine people has enriched me with friendships and knowledge – knowledge of new cultures, of traditions and wisdom that reach back to the beginning of human history.
Rowan was awarded a Medical Doctorate from the University of Sydney in 1985. John Royle of the Royal Australasian College of Surgeons describes Rowan’s contributions:
Rowan Nicks travelled extensively overseas and this was recognised in September 1995 when he was made an Honorary Fellow of the International Society of Surgery. Rowan saw not only the need to have the very best in Australia and New Zealand, but a duty to help in countries less advanced than our own. He taught in Africa and the legacy of his teaching remains there. The units he established have continued to grow and prosper to bring health to those countries. When Rowan was no longer able to contribute personally so much to underdeveloped countries, he established a fund at the Royal Australasian College of Surgeons to provide scholarships for surgeons from underdeveloped countries to expand their surgical education and training in Australia and New Zealand. ‘Rowan Nicks’ Fellows, under this scheme, have come to our country from Malaysia, Bangladesh, Nigeria, Tanzania, Zimbabwe, and China, and have been trained and gone back to their own countries to help the local population.
In 2001, Rowan Nicks was awarded the Centenary Medal for “service to the community through health”.
At the University of Sydney, Rowan established the Rowan Nicks Russell Drysdale Fellowship in 2005 to support individuals wanting to make a contribution in the area of Australian Indigenous Health and Welfare.
Citation: Mellor, Lise (2008) Nicks, Rowan. Faculty of Medicine Online Museum and Archive, University of Sydney.
An alternate version appears in: Mellor, L. 150 Years, 150 Firsts: The People of the Faculty of Medicine (2006) Sydney, Sydney University Press.