Surgical engineering


This week’s blog by Project Archivist Louise looks at some medical make-do-and-mend!
The case notes of Norman Dott not only contain the stories of ground-breaking surgeries, but also house vivid accounts of the relationship between doctor and patient. Sometimes, correspondence between patients (whether private or hospital cases) and Dott and his team outnumbers accounts of medical treatment!

I’m currently cataloguing the cases that Dott treated just following the Second World War, when he was still splitting his time between Bangour Emergency Medical Service Hospital in Broxburn and the Royal Infirmary of Edinburgh. Although many aspects of the hardships of conflict were over, shortages of everyday necessities were still very much a reality, and not just in the case of filling the kitchen cupboards.

One gentleman who was treated by Dott for a brain tumour decided to extend his gratitude to the Edinburgh neurosurgical team in an extremely practical way. Using his business connections, he managed to procure lengths of stainless steel from which to manufacture (in Dott’s words) “the nice little machine we use to hold the brain out of the way when we are dealing with tumours difficult of access.”

Dott's specifications for the stainless steel rods (LHB1 CC/24/PR2.4831)
 
The rods (precisely specified by Dott) were then assembled into the surgical apparatus by the “excellent anaesthetist and engineer, Dr Maxwell-Brown.” Maxwell-Brown, like Dott, was well known for his mechanical flair having (like Dott almost did) served an engineering apprenticeship – he fitted up a workshop at Bangour during the Second World War to supply prototypes and to fashion surgical equipment that could not otherwise be procured during shortages (a hobby that continued throughout his life). Maxwell-Brown was particularly known on the Edinburgh wards for his self-retaining brain retractor, and maybe it is for this apparatus that the steel rods were sent by the generous patient. As Dott stated on Maxwell-Brown’s retirement in 1954, “most of our really difficult and outstanding operating is done with the help of instruments he designed and made, and could not be done without them.”