Whārangi 1: Biography
Barratt-Boyes, Brian Gerald
1924–2006
Doctor, cardiac surgeon
I tuhia tēnei haurongo e Jill Wrapson, ā, i tāngia tuatahitia ki Ngā Tāngata Taumata Rau i te 2011.
Early life and training
Brian Gerald Boyes was born in Wellington on 13 January 1924, the second of three children of Edna Myrtle Barratt and her husband, Gerald Cave Boyes. Gerald Boyes was an accountant at the Avery Motor Company. He later contracted tuberculosis, and died in 1944.
Brian attended Johnsonville Primary School, and then Wellington College between 1937 and 1940. At high school he won the E. E. Martin Prize for Mathematics, the S. Eichelbaum Prize for Literature and the Sir Alexander Grey Memorial Cup. In 1941 he enrolled for a medical intermediate year at Victoria University College, Wellington, before studying medicine at the University of Otago in Dunedin from 1942. While at Otago, following the wishes of his mother, Brian changed his surname by deed poll to Barratt-Boyes.
Music and religion played important parts in Brian Barratt-Boyes’s early life. He was a soloist in his local Anglican church choir and a member of a Wellington choir directed by conductor and music teacher Harold Temple White. A talented pianist, Brian also enjoyed carpentry, and his skill with his hands may have played a part in his later success as a surgeon. It was through his church connections that he found accommodation for his university years in Dunedin, giving help with Sunday services in recompense for board and lodging, and later becoming a lay preacher.
Barratt-Boyes graduated MB, ChB (Bachelor of Medicine and Bachelor of Surgery) in 1946, and later qualified ChM, Master of Surgery, in 1962. After gaining his first qualification he was appointed demonstrator in anatomy at Otago Medical School. Subsequently he spent a year as house surgeon at Wellington Hospital.
On 9 November 1949 at Dunedin Barratt-Boyes married Norma Margaret Thomson, a physiotherapist and former student in his anatomy classes at Otago. They were to have five sons.
Barratt-Boyes’s next appointment was as registrar at Palmerston North Hospital, in 1950. He became a fellow of the Royal Australasian College of Surgeons in 1952, at a time when the majority of New Zealand doctors gained the qualification while undertaking postgraduate training overseas.
David Mitchell was Palmerston North Hospital’s senior surgeon, and it was through his connections with the prestigious Mayo Clinic in the United States that Barratt-Boyes obtained his first overseas fellowship in cardiothoracic surgery, from 1953 to 1955. While working under Mayo surgeon John Kirklin, Barratt-Boyes became interested in heart-lung bypass machines. In 1956, he spent a year in Bristol, England, on a Nuffield Travelling Scholarship, where he had the opportunity to further develop the British-designed Melrose bypass machine.
Open-heart surgery
Douglas Robb, surgeon-in-charge at Auckland’s Green Lane Hospital, recruited Brian Barratt-Boyes back to New Zealand as senior cardiothoracic surgeon in 1957, to set up open-heart surgery. By this time Green Lane had been designated the sole cardiac surgical centre in New Zealand. Barratt-Boyes remained at Green Lane for the rest of his career, despite numerous offers from overseas, taking on the mantle of surgeon-in-charge when Robb retired in 1964.
At Green Lane, Barratt-Boyes’ considerable experimental work in the surgical laboratory made cardio-pulmonary surgery on a stationary heart possible for the first time in New Zealand, using a bypass machine. In 1957 a Melrose heart-lung machine had been imported from Britain at a cost of £3,000, paid for by the Auckland Hospital Board after urging by Barratt-Boyes. When the machine arrived at Green Lane it was missing a number of parts. With the ingenuity of Sid Yarrow, a Green Lane laboratory technician, and the skill of Alfred Melville of the Auckland Industrial Development Laboratory, the necessary parts were manufactured and modified, overcoming technical problems experienced during testing.
Barratt-Boyes’s first ‘hole-in-the-heart’, or ventricular septal defect, operation was on 10-year-old Helen Arnold, on 3 September 1958. So-called ‘blue babies’ – children with congenital heart defects – were given the chance of living normal, healthy lives as the result of this surgery.
Resourcefulness also played a large part in the construction of an external pacemaker, built by Yarrow at Barratt-Boyes’s request, to enable the heart to be re-started after bypass surgery. The first permanent pacemaker in New Zealand was implanted in 1961.
Barratt-Boyes continued his ground-breaking work in heart surgery by pioneering homograft (human donor) heart-valve replacements in New Zealand in 1962, virtually simultaneously with (but independently of) London surgeon Donald Ross. Barratt-Boyes had overcome the problems inherent in inserting heart valves, after inspiration gained while taking a bath one day. His continued experimentation with homograft, rather than artificial valves, which were prone to problems, led to his long-term international achievement in this field.
Barratt-Boyes’s first homograft operation was on Marilyn Hollingsworth, who many years later remembered him as having a ‘very quiet, unassuming personality with a lot of dignity’.1 His patients were not limited to New Zealand, his success also attracting people from all walks of life from overseas. One patient, Gordon McShean, wrote a book, Operation New Zealand: my search for a new heart, about his homograft valve replacement by Barratt-Boyes.
In 1969 Barratt-Boyes furthered Green Lane’s status, this time as an international centre for newborn babies with congenital heart disease. By using the technique of deep hypothermia, originally introduced in Japan but perfected by Barratt-Boyes, he was able to perform open-heart surgery on neonates. Prior to this, only palliative operations had been performed on small babies, in the hope of keeping them alive until they were able to withstand major surgery.
Public influence
Green Lane’s standing as an international cardiac centre of repute was enhanced in 1965 when Brian Barratt-Boyes organised a conference of overseas cardiac surgeons in Auckland. John Kirklin, his former mentor from the Mayo Clinic, was guest of honour. Amongst attendees was a then unknown young heart surgeon, Christiaan Barnard of Cape Town, South Africa, who was to perform the world’s first heart transplant in 1967.
Green Lane became a showcase for further conferences, including one in 1972 which resulted in the publication of Heart disease in infancy: diagnosis and surgical treatment. Barratt-Boyes was a superb teacher and attracted many visiting overseas surgeons and trainees, who were able to use their skills and knowledge to save lives in their own countries.
In demand as a guest speaker, Barratt-Boyes regularly travelled overseas. He turned down many well-paid international offers, but in conjunction with his work at Green Lane, he consolidated his position in Auckland by taking up private practice in Remuera at the Mater Misericordiae Hospital.
Barratt-Boyes became an outspoken lobbyist for improvements in public hospitals. The ability to improve and prolong the lives of New Zealanders suffering from heart disease was hindered by a lack of staffing and funding. He famously claimed people were dying on the surgical waiting list and that there was an urgent need for speedier assessment and treatment of cases.
Barratt-Boyes wrote works based on the detailed data he had meticulously kept over the years. His publications ranged from academic journal articles to the seminal and monumental Cardiac surgery (1986), co-authored with former mentor John Kirklin. Although he retired in 1989, Barratt-Boyes continued to contribute substantially to the literature, particularly on valve replacements.
Described by one patient as ‘a gaunt, grave, but good-looking man’2, Barratt-Boyes was regarded by his peers as dedicated and single-minded. He inspired great loyalty from his staff, which he reciprocated.
Recognition and later life
Recognition of Barratt-Boyes’s service to the world of cardiac surgery was evidenced by the many awards and honours he received from within New Zealand and overseas. He was knighted in 1971, having been made a CBE in 1966. Barratt-Boyes was the first person to be awarded an honorary professorship of the University of Auckland. In 1968 he received the Lions International Special Humanitarian Award, the only such award made in New Zealand, and in 1995 became one of the few living New Zealanders to feature on a postage stamp.
Honorary fellowships included that of the American College of Surgeons (1977), the Royal College of Surgeons (1985) and the American College of Cardiology (1989). Barratt-Boyes was also appointed an honorary member of the Indian Association of Cardiovascular Thoracic Surgeons. Other awards included a Sir Arthur Sims Commonwealth Travelling Professorship (1982), a DSc awarded by Colorado University (1985), the René Leriche prize of the Société Internationale de Chirurgie (1987) and the Royal Australasian College of Surgeons Award for Excellence in Surgery (1994). In 2005 he was awarded the Mayo Clinic Distinguished Alumni Award. He was president of the Cardiac Society of Australia and New Zealand from 1986 to 1988.
A private person, Barratt-Boyes spent his limited spare time at his farm, Green Hills, at Waiwera, north of Auckland. In 1982 he met Australian lawyer Sara Rose Monester while on a trip to Sydney. His first marriage was dissolved in 1986, and on 11 April 1986 at Green Hills he married Monester, with whom he retired to his farm, and later to Auckland’s North Shore.
Ironically, Barratt-Boyes suffered from heart disease himself. He battled to give up smoking, but in 1974 he underwent a double bypass operation by Green Lane colleague Alan Kerr. Kerr operated again 10 years later, replacing the original grafts and repairing another coronary artery. Barratt-Boyes died at Cleveland, Ohio, US, on 8 March 2006 of complications following a final cardiac operation. He was survived by his second wife, Sara, and his former wife, Norma, and their five children. A legendary figure in the world of cardiac surgery, his influence spanned the globe. He was, according to one of his patients, ‘a great surgeon, a great doctor and a compassionate man’.3