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In the years before he began his work on diagnostic ultrasound, Ian Donald developed a characteristic approach to clinical work, and to the professional and social role of the obstetrician, that would be formative in his relationship to the new technology. In this chapter, we explore his maturing as a clinician and a researcher, with particular attention to his first innovative use of diagnostic imaging and his enthusiasm for applying technology to clinical concerns . It was his prior commitment to the clinico-anatomical method, acquired at St. Thomas’s, that provided the focus for his earliest imaging research. We also explore the background to his appointment to the Regius Chair of Midwifery at the University of Glasgow and describe the medical environment he encountered on taking up this post. The character of the Royal Postgraduate Medical School at the Hammersmith Hospital, where Donald began his readership in 1952, was distinctly different from that of the Medical School at St. Thomas’s Hospital. Far from being a venerable voluntary foundation, the Hammersmith Hospital had opened in 1905 as a Poor Law infirmary. It was taken over as a municipal hospital by London County Council in 1930, then incorporated into the National Health Service in 1948. The Postgraduate Medical School was established in 1935, in response to concerns about the quality of postgraduate medical education in London. The aim of its founders was that the school should be a “university centre with whole-time academic staffing and with research opportunities for the staff.”1 The first professor of medicine at the Postgraduate School was Francis Fraser. Since 1921, Fraser had been professor of medicine at St. Bartholomew’s Hospital. But Barts, like St. Thomas’s, was not a congenial environment for the scientifically minded physician, and Fraser eagerly grasped the opportunity for a fresh start at the Hammersmith. He set about recruiting like-minded Chapter Four Ian Donald before Ultrasound II Hammersmith and Glasgow Ian Donald before Ultrasound II 73 colleagues and cultivating a strong institutional commitment to research. In 1938, John McMichael joined Fraser’s department, quickly securing an international reputation in cardiovascular physiology. McMichael’s style of investigation , which employed the controversial technique of atrial catheterization, was interventionist and technically sophisticated—as was that of his colleague Sheila Sherlock, who developed liver biopsy techniques that helped elucidate the pathology of hepatitis.2 In the years following the war, the Postgraduate School made a large number of new appointments. In 1947, Ian Aird was recruited from Edinburgh to become professor of surgery, and John McClure Browne became professor of obstetrics and gynecology. McClure Browne developed techniques for studying placental function and localization, while Aird emerged as one of the most innovative surgeons in Britain.3 In the Department of Medicine, Guy Scadding , Peter Sharpey-Schaffer, and John Crofton undertook original and important work in respiratory and cardiovascular medicine. Thus, by 1952, when Donald joined the staff, the Postgraduate School had established its preeminence within British clinical research. Nevertheless, it must have required a degree of moral courage for Donald to leave his post at St. Thomas’s, where he certainly had career prospects, to move to the Hammersmith. Despite the growing international reputation of the Postgraduate School, a prejudice remained among the elite circles of London medicine against the school’s style of work. As John Crofton, who moved from St. Thomas’s to the Hammersmith in 1947, recalled, “At the stage I went to the Postgraduate School, the teaching hospital thought it was terrible. These were places where they put needles in the liver and catheters in the heart! You don’t go to a place like that. There was a sort of ambivalence, which of course gradually changed as such distinguished work came out.”4 Donald must have been aware, however, that to reach the heights of his profession in the changing climate of British medicine after the Second World War, he would need to consolidate his reputation as a researcher. At St. Thomas ’s in the 1950s, an active involvement in research was still rare among senior clinicians. By contrast, every member of staff at the Postgraduate School had his or her own research project.5 Moreover, given that Donald’s major interest at St. Thomas’s had been neonatal respiratory problems, the attractions of the Hammersmith, which was now a major center for applied respiratory physiology and related clinical research, must have been considerable. In the 1950s, the Postgraduate School was also one of the few academic...

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