Norman M. Dott

1968, Toronto

Of Scottish-Huguenot descent, Norman McOmish Dott, our distinguished guest of honor in 1968, was born in Edinburgh in 1897. His story is a romantic one; grandson and son of famous art dealers, he intended to become an engineer, but, while he was still an apprentice, a motorcycle accident caused a serious hip injury necessitating a prolonged period in the hospital. Our guest was a fascinated patient and was so intrigued by hospital activities that he decided, upon recovery, to become a medical student, and, in 1919, he graduated M.B, Ch.B. from the University of Edinburgh. He had volunteered for military service but was turned down on medical grounds. This was an added challenge and an incentive to overcome his own disability and to help the afflicted, and, indeed, in World War II he was to establish the famous Brain Injury Unit in Bangour Hospital near Edinburgh and to be appointed consultant neurosurgeon to the Army in Scotland.

After qualifying, he underwent a period of training in general surgery and gained the fellowship of the Royal College of Surgeons of Edinburgh in 1923. During this period he was also actively engaged in original experimental physiological work on gastric secretion and on the thyroid and pituitary glands, and for his notable work on the pituitary gland he was awarded a Rockefeller Travelling Fellowship which enabled him to study in Boston under Harvey Cushing during 1923 and 1924. He was greatly impressed by the developing specialty of neurological surgery and returned to Edinburgh very enthusiastic and determined to introduce and develop this specialty. There were, however, many hurdles to be overcome and many challenges to be met, and indeed one may quote R. L. Stevenson's words, "Am I no a bonny fighter?"

He made important contributions to general and pediatric surgery, and he began to practice neurosurgery privately, because this specialty was not yet accepted in the Edinburgh hospitals. He was an indefatigable campaigner with a remarkable independence of thought and of action, and he was always very ably supported and encouraged by his charming wife, Peggy. Meticulous in all that he did, he showed, without affectation, great originality and expertise in diagnosis and in the operating room and had great sympathy for the sick and a real regard for their anxious families. Loyal service from his juniors and associates was expected and received, and, although always courteous, helpful, and a good listener, he was a strict disciplinarian who never spared himself and expected the same very high standards from his assistants. With tremendous drive, enterprise, and perspicacity, he developed the most comprehensive department of surgical neurology in the United Kingdom and, by his clinical teaching and precept, attracted doctors, nurses, and others from every part of the world to come to study and train in Edinburgh. Many of these are now very distinguished specialists in the United Kingdom and in all parts of the world.

Norman Dott had a remarkable breadth of interest in the entire field of medicine and made a great number of outstanding original contributions, in particular to surgical neurology, but also to many allied specialties and to medicine as a whole, from the clinical, administrative, teaching, and research points of view. He helped to develop anesthesia in Edinburgh from 1918 to 1920, and introduced intratracheal techniques. He made original important contributions concerning the embryology of the bowel. In 1929, using sodium iodide, he was the first person in the United Kingdom to demonstrate an arteriovenous malformation of the brain by angiography. In March 1932, using Thorotrast,* he performed the first angiogram in the United Kingdom to show a saccular intracranial aneurysm. His first vertebral angiogram was done in 1946 to demonstrate an arteriovenous malformation on a posterior cerebral artery. Another very important achievement was the 1931 operation in which he treated an aneurysm on the proximal part of a middle cerebral artery in a patient by wrapping the lesion with crushed muscle. Amongst other original clinical research activities were studies on congenital dislocation of the hip, cleft palate, cerebrospinal fluid circulation and its pathology, brain displacements and related cerebral ischemia, spinal cord compression, facial pain, the treatment of facial paralysis by extrapetrous nerve graft, and the use of hypothermia in cerebral surgery. He invented many instruments and pieces of surgical apparatus, from bowel clamps to operating tables, and designed operating theatres.

In 1947, he was appointed to the first chair of neurological surgery in the University of Edinburgh, and, on reaching the age of 65 years, when regulation required him to retire from the National Health Service and the University, he was appointed emeritus professor. He became a member of the Society of British Neurological Surgeons in 1926 and was president from 1938 to 1945. From 1955 to 1967 he was vice president of the Royal College of Surgeons of Edinburgh, and from 1966 he was the representative of that College on the General Medical Council in the United Kingdom. He rapidly gained an international reputation and has been honored by medical societies and many other scientific and learned bodies throughout the world, including the Society of Neurological Surgeons, the American Association of Neurological Surgeons (the former Harvey Cushing Society), and he was appointed a member of the Editorial Advisory Board of the Journal of Neurosurgery in 1968. In 1936, he was elected to Fellowship of the Royal Society of Edinburgh and in 1968 was made an honorary fellow of that Society. For his important work in surgical neurology for H. M. Forces in the 1939 to 1944 War, he was awarded the high honor of Commander of the Most Noble Order of the British Empire (C. B. E.). In 1960, he was elected president of the Scottish Association of Occupational Therapists and, in 1966, president of the Scottish Society of the History of Medicine. He was made an honorary member of the American Neurological Association in 1965, and in 1966 was elected honorary president of the World Federation of Neurosurgical Societies. Other distinctions included the Syme Surgical Fellowship, the Liston Memorial Jubilee Prize for advances in neurological surgery, and the Sir Victor Horsley Memorial Award and Lectureship.

His was indeed a great success story, and he served his specialty, his medical school, and his country with notable distinction. A particular feature was his great humanity, which was shown in many ways, for example, by helping everal European medical refugees who were involved in the holocaust of the 1930s, and by his intense interest in the rehabilitation and resettlement of his patients, and by most assiduous follow-up studies. One of the honors that he must have particularly cherished was that given in 1962 when he was made a Freeman of his native city of Edinburgh. Characteristically, in his address on that occasion, he referred to the great cooperation that he had always received from his patients and to their unfaltering courage and their implicit faith in him. It is interesting that the photo-portrait included in this book' was taken by one of his old patients, a lady on whom he operated in 1929 for a pituitary adenoma.

In his retirement, Norman Dott was very active in many fields, among them medical administration, medical education, and medical charitable activities, particularly in the spheres of epilepsy, paraplegia, spina bifida, and cancer. He served on several important scientific and government bodies and was always in demand as a lecturer.

Even so, he still made time for other interests which he retained all his life, in particular, fishing, especially in fast-flowing Scottish streams, and in world travel, music, and photography. He spent time with his wife, daughter and son-in-law, and his three granddaughters.

Thus we had a remarkable man, the doyen of British neurosurgeons, a man who became a legend in his own lifetime.

"May health and peace, in mutual rays, shine on the evening o' his days." - Robert Burns

Norman Dott died in April 1974.

*Thorotrast, thorium dioxide, Fellows--Testagar Division, Fellows Medical Mfg. Co., Inc., Detroit, Mich.