Ian Donald
Ian Donald was an English physician who pioneered the diagnostic use of ultrasound in obstetrics, enabling the visual discovery of abnormalities during pregnancy. Donald was born in Cornwall, England, to a Scottish family of physicians. He was educated in Scotland and South Africa before studying medicine at the University of London in 1930, and became the third generation of doctors in his family. At the start of World War II, Donald was drafted into the Royal Air Force as a medical officer, where he developed an interest in radar and sonar. In 1952, at St Thomas' Hospital, he used what he learned in the RAF to build a respirator for newborn babies with respiratory problems.
In 1952 Donald became a reader at Hammersmith Hospital. He developed a device called the Trip Spirometer, which measured the respiratory efficiency of a neonate. In 1953, he improved its design and made a positive-pressure respirator device that was known as the Puffer. In September 1954, Donald was promoted to Regius Professor of Obstetrics and Gynaecology at the University of Glasgow. While working at the Western Infirmary, he met Tom Brown, an industrial engineer who worked for Kelvin Hughes, which led to a series of collaborations between Western Infirmary clinicians and Kelvin Hughes' engineers. They designed and built a series of instruments that enabled the unborn to be examined with obstetric ultrasound, which allowed Donald to build the world's first obstetric ultrasound machine in 1963: the Diasonograph.
Donald also secured the construction of the Queen Mother's Maternity Hospital that was built next to the Royal Hospital for Children in Glasgow.
Life
Ian Donald was born to John Donald and Helen née Barrow Wilson in 1910. His father was a general practitioner who came from a Paisley medical family, his grandfather also a GP, and his mother a concert pianist. Donald was the eldest of four children; his siblings were Margaret, Malcolm, and Alison Munro, who later became a leading headmistress.Donald attended Warriston School in Moffat, and he attended Fettes College, Edinburgh, for secondary education. However, Donald never completed his education in Scotland, as the family moved to South Africa due to his father's poor health. Donald continued his secondary education at Diocesan College in Rondebosch, where he studied the classics, music, philosophy, and languages. In 1927, Donald's mother and two of his siblings contracted diphtheria and his mother died of a myocardial infarction. Three months later, Donald's father died. Maud Grant, the housekeeper, was provided with a trust fund to care for the children. In the same year, Donald was awarded a Bachelor of Arts in arts and music at the University of Cape Town graduating with first-class honours.
In 1930, the family moved back to London and Donald matriculated at the University of London to study medicine at the St Thomas's Hospital Medical School. In 1937 he achieved a Bachelor of Medicine, Bachelor of Surgery at St Thomas, becoming the third generation of doctors in Donald's family.
At the end of his graduate education, Donald married Alix Mathilde de Chazal Richards, a farmer's daughter from the Orange Free State. Donald retired on 1 October 1976. He was offered a consultancy at Nuclear Enterprises in Edinburgh, a position he held until 1981. After he fully retired, he moved to Paglesham. Donald died on 19 June 1987. He was survived by his wife, his four daughters and thirteen grandchildren. He is buried in the churchyard at St Peters Church in Paglesham, Essex.
Career
Donald started his postgraduate medical training at the end of the 1930s, and planned to specialise in obstetrics with a position in Obstetrics and Gynaecology at St Thomas. He started his residency in 1939.Donald's medical career was interrupted by World War II, and in May 1942 he was drafted into the Royal Air Force as a medical officer. He was so successful in the role that he was mentioned in dispatches for bravery after he pulled several airmen from a bomber that had crashed and had set on fire while the bombs were in the airframe. In 1946 he was awarded an MBE for bravery. During his time with the RAF, Donald became aware of a variety of techniques involving radar and sonar.
In 1946, Donald completed his war service and returned to work at St Thomas. In 1949, he was appointed as a tutor in the department of obstetrics and gynaecology. By 1949, the National Health Service had been in operation for three years, and instead of the continual search for money for patient care, money now came from government taxes, so the hospital's role changed from a needs-based approach to a focus on research: as part of their remit, each doctor had to conduct a research project.
Negative-pressure respirator
In partnership with Maureen Young, a specialist in perinatal physiology, Donald conducted a study of respiratory disorders in infants. Donald's study included an examination of available medical respirators, and he was not satisfied with the design and efficiency of the current models. As Donald had an interest in mechanical and technological devices from his childhood, he decided to build a new respirator. By 1952, Donald and Young had built a new medical negative-pressure respirator that they demonstrated at a Physiological Society meeting in the Royal Free Hospital.Trip spirometer
Later in 1952, Donald resigned his role at St Thomas's Hospital Medical School to take up a position as a reader at the Institute of Obstetrics and Gynecology at Royal Postgraduate Medical School located in Hammersmith Hospital. At the medical school, Donald continued his research into neonatal breathing disorders. He worked to improve the device that he and Young had built: the servo patient-cycled respirator. Later, he worked with Josephine Lord, a registrar, to build the Trip spirometer, later called the spirometer, whose purpose was to measure the respiratory efficiency of a newborn. As well as being a diagnostic device, Donald used it to make a quantitative determination of normal respiration with the goal of determining the physiology and pathology of neonatal pulmonary disease.Puffer
In 1953, Donald published a review of best practices in neonatal resuscitation. While at the school, Donald worked on a third device: a positive-pressure respirator. Donald found that the negative-pressure device he had built with Young was not ideal, as it was complicated to set up, difficult to use, and required more than one person to operate; the servo respirator seemed to be ideally suited to the long-term treatment of babies with breathing difficulties. His rationale for creating a new device was based on the idea that a respirator that could be used with a mask applied to a child in a cot or incubator was needed. He built a positive-pressure respirator that was later known in Hammersmith Hospital as the Puffer. It sent a stream of oxygen mixture onto the baby's face and the device could be applied to an ailing infant in under a minute. After treating several infants, colleagues asked him to convert the device to treat adults, which he did with successful outcomes. The device was noticed by the British Oxygen Company, who wanted to commercially develop the positive-pressure respirator.In May 1954, Donald delivered the Blair-Bell Lecture at the Royal College of Obstetricians and Gynaecologists. He spoke about atelectasis neonatorum and how his respirator could improve managing the condition. In the same period he met John J. Wild in London, who had discussed the use of ultrasound with him. Wild had used pulse-echo ultrasound to visualize abnormal tissue in the human breast. In September 1954, Donald was appointed by Hector Hetherington to Regius Professor of Midwifery. Hetherington had to confirm the position with the Secretary of State for Scotland, as it was a government appointment and Donald was proud of his commission that was signed personally by the Queen. Although Donald was impressed by Hetherington, he made it a condition of his employment that Hetherington had to promise to build a new maternity hospital in Glasgow, which was done.
Obstetric ultrasound
Whilst Donald was Professor of Regius Midwifery at Glasgow University, he first explored the use of obstetric ultrasound in the 1950s in a collaboration with John MacVicar, a registrar and obstetrician in the Department of Obstetrics and Gynaecology at the Western Infirmary, and Tom Brown, an industrial engineer who worked for Kelvin & Hughes Scientific Instrument Company, developed the first contact compound sector scanner, and wrote an article in The Lancet: "Investigation of Abdominal Masses by Pulsed Ultrasound". The article contained the first published ultrasound image of a fetus.The development of Donald's interest in ultrasound started when one of his patients introduced her husband to him. The patient's husband was the director of the boiler fabrication company Babcock and Wilcox, and he offered a tour of the plant to Donald, who accepted. The Renfrew company was a large user of industrial ultrasound that was used to check for crack and flaws in welds. Donald's purpose in making the visit to Renfrew on 21 July 1955 was to determine if the industrial detecting equipment could be used to differentiate types of tissue. He arrived at the plant with a number of fibroids and a large ovarian cyst taken from gynaecology patients. When Donald met Bernard Donnelly, an employee in the research department of the boilermaker, Donald asked him to demonstrate the device's use by taking an ultrasound image of the bone of his thumb. Donald experimented with the tissue samples along with a huge steak the company had provided for a control, and determined that ultrasound could be used to scan biological material. He stated:
All I wanted to know, quite simply, was whether these various masses differed in their ultrasonic echo characteristics. The results were beyond my wildest dreams and even with the primitive apparatus of those days clearly showed that a cyst produced echoes only at depth from the near and far walls, whereas a solid tumour progressively attenuated echoes at increasing depths of penetration.When he returned to the hospital, Donald's goal was to find an ultrasound machine that he could continue to experiment with. He obtained a Kelvin Hughes Mark lIb supersonic flaw detector from William Valentine Mayneord at the Royal Cancer Hospital. While Mayneord had been experimenting with the machine in an attempt to image the brain, he had been unsuccessful in his efforts; Donald hoped he could replicate and improve upon his previous success. However, he found that when using the machine it could not produce echoes from less than 8 cm from the face of the transducer, making it almost useless for obstetric diagnostics. Donald experimented with balloons and condoms filled with water to widen the gap with little success. He was assisted by John Lenihan, a professor of clinical physics, who helped him form images, but the Mark IIb was insufficient for the task and the images produced were of very poor quality.