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Francis Geoffrey Smiddy

Former senior surgeon Leeds General Infirmary, prolific author, and long time examiner for the court of examiners of the Royal College of Surgeons (England) (b Kendal 1922; q Leeds 1944), d Saturday 8 March 2003.

Francis Geoffrey Smiddy was a role model for a generation of medical students and young surgeons in Yorkshire. He was a pioneering surgeon who will be remembered as an inspirational teacher, a prolific author of surgical texts, a wit and raconteur, and a gentleman.

Smiddy—Geoff to his friends and FGS to undergraduates and surgical trainees—was born in Kendal in 1922. His was not an easy childhood. His father left the family home shortly after he was born and his mother must have had very difficult times making ends meet.

He entered Leeds Medical School in 1939, where he excelled, winning the Brotherton Senior Award, being elected president of the university union, and serving on the medical school council. He qualified in 1944 and his first surgical post was as house surgeon to Mr George Armitage, whom he regarded as his surgical mentor. He joined the Royal Army Medical Corps in 1945 and served three years in India. This period left an indelible mark on the rest of his life, not just because of the experiences gained while working in Indian hospitals but also because he contracted a rheumatic endocarditis, which damaged his aortic valve. Thirty years later he required aortic valve replacement.

On return from India he held a number of posts in Leeds Infirmary, including surgical registrar, senior registrar, and surgical tutor. In 1957 he accepted a research fellowship at Harvard Medical School and worked under the direction of Jacob Fine, a pioneer in the care of the critically ill. Here he produced some of the earliest research into the significance of enteric bacteria as a cause of mortality in haemorrhagic shock. Arguably this work laid the groundwork for our present understanding of the gut origin of sepsis hypothesis, which is now generally accepted as being an important mechanism in the development of the systemic inflammatory response in patients with multi-organ failure. This work resulted in him being awarded a ChM in 1960. After his return from America he worked as senior lecturer to Professor J C Goligher and in 1961 was appointed consultant surgeon at Leeds General Infirmary as well as to Seacroft Hospital and Clayton Hospitals (Pinderfields, Wakefield).

Smiddy’s commitment to teaching and training was limitless. He was one of the last "general" surgeons and, par excellence, a clinical teacher. Countless undergraduates and junior surgical trainees will remember vividly his bedside teachings, primarily because his intense enthusiasm for medicine in general and surgery in particular was infectious. Many were intimidated by his depth and range of knowledge and also, it has to be said, by his ebullient and extrovert style. He shunned formal tutorials and didactic lectures and was dismissive of modern educational techniques. Although many undergraduates and juniors will rue to this day their apparent inability to demonstrate the physical signs of illness or indeed the interpretation of these findings, the majority would agree that they rarely forgot their teachings under this master of clinical surgery.

He was elected to the court of examiners for the Royal College of Surgeons of England in 1967. During this time he examined for the fellowship in many remote parts of the world and became recognised as a fine ambassador for the College of Surgeons. In 1969 he was made the first regional adviser for surgery in Yorkshire and in 1978 was appointed examiner in pathology for the primary fellowship examination. By his own admission it was this extensive experience in examining that was the major stimulus to him deciding to write surgical textbooks. Smiddy’s first book, entitled the Medical Management of the Surgical Patient, was published in 1975. In this he quotes from his illustrious Leeds predecessor Lord Moynihan, "A surgeon is a physician condemned to the practice of surgery," and goes on to comment upon what he perceived as being a lack of balance in the judgment of young surgeons in the management of medical complications in surgical patients. His view was that surgical training was too narrow and that young surgeons should be competent to deal with the majority of medical problems encountered by surgical patients. This text sold many thousands of copies running to three editions, was translated into Spanish, Italian, German, and Romanian, and remained in print until 1995. In 1977 he produced the first of his Tutorials in Surgery. These were directed at the young surgeon about to embark on higher examinations. In the preface Smiddy comments that in his experience as an examiner, candidates frequently fail not as a consequence of lack of knowledge but through an inability to express themselves adequately on paper or in speech when exploring surgical topics. It was, he said, as an attempt to help repair this defect that these books were written. The numbers sold are a testimony to their success. His other books included a dictionary of pathology, Multiple Choice Questions inGeneral Pathology, Pocket Examiner in Pathology, and a total of four Tutorials, all covering a wide range of surgical topics.

Smiddy retired in 1987 but remained an active figure in local surgical circles. He was a regular attender at weekly surgical meetings and a staunch supporter of the Leeds Regional Surgical club.

After retirement this workaholic surgeon was very active in the local community. He was a keen golfer at Alwoodley for many years and a past captain of the club. He was an enthusiastic, albeit not always successful, bridge player in Bramhope bridge club. He was a governor of Leeds Grammar School and a student of needlework, silversmithing, computing, and, apart from anything else, continued at every opportunity to travel as he had done all his life.

Geoff Smiddy was a man who always accepted responsibility for his own fate and was never one to blame others for misfortune. He achieved enormous success despite humble origins. He will be remembered with great affection and enduring respect by his professional colleagues and by countless patients who benefited from his ministrations. He inspired many with his teaching and a generation of surgeons will be forever grateful to him. He suffered the ignominy of his final illness with great stoicism, and gratefully appreciated the high standards of medical care at St Gemma’s Hospice, Leeds.

His wife, Penny, whom he married in 1951, and two children, Paul and Clare, survive him. They have four grandchildren.
[ John MacFie ]