David Wilkie was one of the great, some would ague the greatest, surgeon produced by Edinburgh in the 20th century. By any standards he was a surgical giant – an innovator who created, out of very little, a prestigious department which could vie with the best research facilities outside America. His 14 years as Professor of Surgery in Edinburgh saw surgical thinking transformed from the anecdotal case-report style of the 19th century to the analytical science-based style of the 20th. Yet to those who knew him- colleagues, assistants and students- the overriding memory was of his personal warmth and charm.
David Wilkie (“DPD” to his friends) was born in Kirriemuir, the Angus village immortalised as “Thrums” by J. M. Barrie. They were not contemporaries as children (Barrie was 22 years older) and came from very different backgrounds; Wilkie was the son of a wealthy jute merchant whilst Barrie was the 9th of 10 children, living in a small 3-room cottage. Both achieved eminence in later life and they became friends. When Barrie was appointed Chancellor of Edinburgh University the friendship developed, strengthened no doubt by the bond of common threads in childhood. But there were differences. Barrie never escaped the influence of his formidable mother and part of him always wanted to remain the adored small boy, a part of his character that he drew upon in the creation of Peter Pan. Wilkie on the other hand was blessed with a less complex personality and a kindly nature. His friend and colleague, Henry Wade, wrote “….. never once did I hear him speak a hard or unkind word of anyone”.
From Kirriemuir Wilkie moved to Edinburgh Academy and would speak fondly of his school days there. Graduating from Edinburgh University in 1904 he became a Fellow of the College in 1907 and two years later had obtained two masters degrees. During House appointments in Edinburgh he worked under Sir Harold Stiles and Professor Francis Caird whose influence helped to mould his ideals and ambitions. Thereafter, as an aspiring surgeon, he travelled to three great European Centres – Bonn, Bern and Vienna – before returning as private assistant to Caird. Caird was a disciple of Lister and an advocate for experimental research in surgery. This time with Caird saw Wilkie’s ambition to become a surgical scientist develop further.
His first appointment was as surgeon to Leith Hospital. Leith at that time was a bustling seaport whose prosperous business community helped foster a spirit of civic independence from Edinburgh. The Surgical wing of the Hospital, built as the Queen Victoria Jubilee extension and opened in 1903, had wards built in the new Nightingale style. Wilkie came to a busy and modern surgical with Henry (later Sir Henry) Wade and John Struthers (later President of the College) as his colleagues. His time at Leith introduced him to the pleasures and responsibilities of an independent charge and saw the start of his contributions to the literature. Before long he made his mark on the national scene. The Provincial Surgeons, a surgical club founded by Moynihan and containing many of the foremost surgeons of the day, required a representative from Edinburgh. They chose Wilkie – then only 30-years-old.
After War service as a Naval Surgeon he returned to Edinburgh where his genius as a teacher became increasingly apparent. His students would describe his eloquence, simplicity and clarity of presentation and his ability to make the dullest topic come alive. He joined Sir John Fraser in the Extra-Mural school. In 1923 when Professor Alexis Thomson resigned the Chair of Surgery Edinburgh saw the need for a full-time Chair and a Rockefeller Foundation grant made this possible. Wilkie was appointed to the Chair of Systematic Surgery in Edinburgh in 1924.
In his fourteen year tenure of the Chair, he was to make major contributions to the understanding of a variety of abdominal, particularly acute abdominal, problems. He clarified the natural history of acute appendicitis and of acute cholecystitis. He wrote on peptic ulcer, on intestinal obstruction and on surgery of the spleen and the biliary tree; and he attracted around him a group of young surgeons many of whom went on in turn to become Professors of Surgery. One of them, Sir Charles Illingworth, described how, as House Surgeon under Sir Harold Stiles, he first came under Wilkie’s influence. “In the summer Styles took a long vacation so for three rapturous months in the absence of that formidable master, I basked in the sunshine of Wilkie’s easy charm. Soon afterwards he invited me to be his assistant in private practice, and I can still recall the ecstasy, the heartthrob, the feeling of walking on air which his letter brought.” Wilkie’s tireless energy and his ability to organise allowed him to combine a busy clinical practice in The Royal Infirmary, to head a series of research programmes, to teach and yet to maintain a large private practice. That private practice was inevitably criticised from some quarters. Yet the lucrative proceeds were used for some remarkable acts of philanthropy. Wilkie’s surgical research department flourished to the extent that another floor was added funded by an anonymous donor. It was only after Wilkie’s death that he emerged as that donor. In 1933 he bought the old Roxburgh Cinema in Edinburgh and after reconstruction presented it anonymously to the University settlement. Renovated as Kirk o’Field College it was formally opened by J. M. Barrie offering skills training to unemployed people during the depression.
Wilkie recognised at an early stage the value of experimental research in surgery. He established a major research department next to the Reid School of Music in a building previously used for the teaching of anatomy to female students. This new facility included laboratories, operating theatre, X-ray department, photography department and was adjudged the best equipped outside the USA. Appropriately, after his death it became known as “The Wilkie”
Wilkie’s main legacy to surgery was the establishment of a scientific tradition of discipline and criticism in surgical research and clinical practice. These were attributes which passed to his pupils, who included Illingworth, Wilson and Aird. Hugh Dudley was later to point out that “no fewer than 19 holders of Chairs in the United Kingdom and Australia between 1955 and 1970 passed through the hands of these four men.
The true extent of his philanthropy only became known after his death. He had been the anonymous benefactor who had paid for the extension to the “Wilkie”. Beneficiaries of his considerable estate included the University settlement, the Kirk o’Field College, The University, and the children of Kirriemuir.
Wilkie was to die from gastric cancer whilst only 56. The manner of his passing gives us insights into the helplessness of diagnosing and treating gastric cancer at that time. After a haematemesis and with continuing dyspepsia no fewer than four barium meals failed to show the tumour. It was eventually diagnosed by Wilkie himself feeling the mass in his abdomen as he lent across the operating table.
Perhaps the most fitting epitaph was written by his protégé, Sir Charles Illingworth. “His greatest contribution lay in the influence he exerted amongst his colleagues and assistants. His genius lay in his ability to foster cooperation and inspire enthusiasm.”
