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Desmond Gareth Julian: cardiologist who revolutionised acute coronary care

BMJ 2020; 368 doi: (Published 17 March 2020) Cite this as: BMJ 2020;368:m1093
  1. Marika Davies
  1. Perth, Australia
  1. marikadavies{at}

As a junior doctor in 1956, Desmond Julian was advised against pursuing a career in cardiology. The main focus of the specialty at the time was on congenital and rheumatic heart disease, and he was warned that “all the mitrals have been operated on.” Fortunately, he did not follow this advice: he loved the specialty of cardiology, which he said “used all of the senses,” and his interest was further developed while he was working as a cardiology fellow in Boston, USA.

Changing practice

In the 1950s and early ’60s the practice of cardiology was very different. Patients who had had a myocardial infarction (MI) were admitted to general wards throughout the hospital—often in beds as far as possible from the busy nurses’ station—and were treated with morphine and rest. A cardiac arrest was treated using a defibrillator the size of a refrigerator, which had to be fetched from wherever it was in the hospital.

Working as a cardiology registrar at the Edinburgh Royal Infirmary, Julian was impressed by a film about treating cardiac arrest by an open chest …

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