William Leslie Francis Utley

OBE, MB.ChB(NZ), FRCS (Eng) FRACS (born 6 August 1922, died 14 April 2012)Bill graduated from the University of New Zealand in Dunedin in 1945. He married Patricia Gardiner in 1946. After hospital residencies in Christchurch and a short spell in general practice, in 1948 he went to England as a ship's surgeon and began as a house surgeon at the Royal Post-graduate Hospital at Hammersmith. He passed the Fellowship of the Royal College of Surgeons of England and then had a registrar position at All Saints Hospital, London under Terence Millin who popularised the retropubic approach to open prostatectomy, which was safer than the trans-vesical method introduced earlier by Freyer. Bill then was appointed as Urology Registrar at St Peter's Hospital, Covent Garden in 1951-1952. There followed short appointments at St Mark's Hospital for rectal diseases and then 8 months at the Whittington Hospital in London. He returned to Christchurch in 1952 first as a resident surgical officer and senior registrar and then consultant in Urology working in the Urology Department with E R (Steve) Reay and Norman Greenslade. He was involved in some seminal research on the prevalence of vesico-ureteric reflux in neonates and in early childhood and the relationship to its grading severity to the risk for renal scarring. He collaborated with George Rolleston, and Fred Shannon. George Abbott, and Ross Bailey, and later Tom Maling (radiologist) were also involved. Bill's father had spinal vertebral injuries in WWI, and subsequent osteomyelitis, a spinal abscess resulting in tetraplegia. He died soon after when Bill was 2. Perhaps this was one of the triggers that stimulated his interest in spinal urology. Knowledge of the neurological problems in spinal injuries was thin in the1950s and on a sabbatical leave Bill went to the UK to Stoke Mandeville Hospital to learn more and to upskill under the tutelage of Sir Ludwig Guttman. On the return trip he visited Ernst Bors at the Long Beach Spinal Center in Los Angeles California. On return to Christchurch he was convinced that New Zealand needed a dedicated Spinal Unit. He wished to adopt Guttman's philosophy first that patients should be admitted as early as possible after injury to a specialised spinal unit, and secondly that the Unit should make the patient as independent as possible and rehabilitate him/her so that life was worth living. These principles remain the firm basis of the independent living paradigm espoused strongly by Allan Clarke and the Burwood Spinal Unit and its Academy of Independent Living. In 1974 Ludwig Guttmann visited Christchurch and the Ministry of Health, adding weight to Bill's efforts to establish a standalone Unit. He was also involved in establishing the Paraplegic Federation, Parafed, to encourage rehabilitation through sport, and was active in supporting patients to compete in the first Paralympic Games in New Zealand held in Dunedin in 1974. Later he was made an honorary member of Parafed, which continued with Guttman's philosophy by emphasising the importance of sport to the gaining of independence and quality of life. He supported the formation of Kaleidoscope, an organisation to help people spinal patients back into the workforce as another means of restoring patients to independent useful living. He also visited the Spinal Unit in Perth and held fruitful discussions with Sir George Bedbrook, on developing the shape of the new Unit. Allan Bean and later Angelo Anthony did further training in managing those with spinal injuries at the Perth Unit. With advice, persistence and enthusiasm he was the prime mover in establishing a Spinal Unit in Christchurch Hospital initially in 1968 assisted by Bill Liddell Orthopaedic surgeon and J Cunningham, neurologist. Later he succeeded after much lobbying and political persuasion in establishing a purpose-built Spinal Unit at Burwood Hospital, Christchurch in 1979. This unit accepted patients from as early as possible after the injury so rehabilitation could begin straight away. He was the director of the Spinal Unit from 1964 to 1999. At the beginning the Urology Ward had its own operating theatre, purportedly for doing cystoscopies and minor procedures. Major procedures were allowed on a trial basis. The trial lasted 30 years. The theatre staff introduced themselves on the day of the patient's admission and would explain any details. On arrival in the theatre next day for the operation, the patient would be greeted by familiar faces. The same theatre nurses would visit the patient in the ward post-operatively, and many patients appreciated that. It did not last, as there was no staffed Intensive Care Unit close by. Similarly a cystoscopy and minor procedures theatre was incorporated in the new Spinal Unit in 1979. It was not long before even major procedures were undertaken there for a time, before the requirement these be done in the main operating theatre suite was enforced for safe post-op recovery care. He trained many urology registrars over the years, including two from USA: Dale Vermillion (Billings, Montana) and Bob Donohue (Denver, Colorado). Together with Bob he undertook the first kidney transplant in the South Island of New Zealand in 1972. Bill was awarded the OBE in 1972 for services to medicine. He developed a liaison with the Pacific Islands and was instrumental in aiding some Fijians to advance in training as specialist surgeons and one did complete the Urology training for the RACS. Together with the other urologists in Christchurch, in 1981 he assisted in the establishment of a renal transplant program in Riyadh, Saudi Arabia where earlier a Christchurch renal physician Peter Little had established the Kingdom's first unit for managing end-stage renal disease. Bill was far-sighted in introducing a partnership model in specialist private practice in 1978, which has continued successfully in Christchurch ever since. At the time this type of specialist group practice was practically unknown in New Zealand. Bill was a urology examiner for the Royal Australasian College of Surgeons from 1978 to 1982. He was President of the Urological Society of Australasia in 1980. Aside from medicine, Bill was active politically both as an elected member of the Christchurch City Council, and an elected member of the then North Canterbury Hospital Board. While in that capacity he served as the Chair of its Works Committee for 9 years. He also served on the Executive of the St George's Hospital and in 2010 was made a Life Member of the St George's Hospital Society. He farmed a small property on the outskirts of Christchurch and often after a busy operating list he would drive home and get on the tractor do the ploughing and other work as needed. He chaired the New Zealand Murray Grey Beef Cattle Society for 3 years. He had enormous enthusiasm and energy in all he took on. Bill died on 14 April 2012 after a period of illness precipitated by a fall at home. Bill is survived by his wife Pat, daughters Frances and Juliet, sons-in-law Ross and Steve, and daughter-in-law Marie, and their families. Their son John was a general surgeon in Christchurch and had died a few months earlier in 2011. To Pat and the family, we extend our sincere sympathy, and trust that this acknowledgment of his many contributions to Urology and Spinal injury in Christchurch and the rest of New Zealand will help in some way to bear their loss in his passing. Written by Ted Arnold, with assistance from Pat and other colleagues in New Zealand.