Harold Gillies

I’m not sure where I first heard about Harold Gillies.  It may have been through a podcast, or maybe in a book I was reading since we’re in the midst of the World War One centenary.  I don’t really know.  But, I remembered him because what he did really stuck with me.  And it turns out he kept doing cool stuff after the First World War!

sir-harold-gilliesHarold Delf Gillies was born on June 17, 1882 in Dunedin, New Zealand, the youngest of Robert and Emily Gillies’ eight children.  Robert was a Member of Parliament and a businessman, but died when Harold was only four.  Because of his positions, though, Robert left his family well taken care of.  Harold followed his brothers to prep school in England, and then to Wanganui College back in New Zealand.  Harold was a skilled artist and throughout school, he was also good at sports, including cricket, golf, and rowing.  After Wanganui, Harold went to Caius College at Cambridge, back in England, and won ribbons for rowing, “despite a stiff elbow sustained sliding down the banisters at home as a child” (1).

At Cambridge Harold studied medicine and became a fellow of the Royal College of Surgeons in 1910, specializing in ear, nose, and throat surgery.  When the First World War broke out, Harold decided to join the Red Cross rather than waiting to be drafted.  In 1915 he joined the Royal Army Medical Corps and went to Wimereux in France.  In France Harold met Charles Auguste Valadier, a French dentist, and Bob Roberts, an American dental surgeon.  Roberts lent Harold a German book about jaw and mouth surgery.  Valadier “was not allowed to operate unsupervised but was attempting to develop jaw repair work” (2).  Valadier was trying early skin grafts on his patients.

We have to go off on a little bit of a tangent here for a minute and talk about skin grafts and early facial surgeries.  In India, they had been doing a sort of rhinoplasty for centuries, using “crescent shaped flaps of skin … drawn from patients’ foreheads and fashioned into substitute noses” (3).  In the nineteenth century, the French and the Germans “had developed a technique whereby skin could be transferred from one part of the body to another,” “’but appearance was of secondary importance’” (4).  This is probably what was in the book Roberts lent Harold.  Harold saw all this and wanted to make the person look normal, or even better than they looked before.

Harold left Wimereux for Paris to try and meet Hippolyte Morestin, a renowned surgeon.  Morestin had also done similar surgeries, having removed a tumor on a face and covering it with jaw skin from the patient (5).  After meeting Morestin, Harold returned to England to try and convince “the army’s chief surgeon, [William] Arbuthnot-Lane, that a facial injury ward should be established at the Cambridge Military Hospital, Aldershot” (6).  This ward was quickly outgrown and a new hospital just for this purpose was opened at Sidcup, becoming Queen Mary’s Hospital later on.

Harold’s artistic abilities played into how he viewed himself as a surgeon, and surgeons in general.  As mentioned earlier, Harold wanted to make his patients look at least as good as they did before their injuries.  He saw facial reconstructive surgeons as a type of artist and plastic surgery as “a strange new art” (7).  In order to have the results he wanted, Harold came up with a number of new techniques for facial surgeries.

First, Harold made sure to visualize how he wanted the person to look in the end.  He took the time to make drawings on paper, worked with wax, or even made plaster models of his patients.  Secondly, Harold made sure his teams included anyone he could possibly need.  He understood the importance of having a dental surgeon on hand since so much of the facial structure is related to the mouth and jaw.  Thirdly, “because surgery on damaged faces was impossible when a mask was used to anaesthetise the patient, he encouraged anaesthetists to develop alternative techniques, such as using a tube in the trachea” (8).  Harold was also one of the first, if not the first, to document the entire process.  Henry Tonks, a surgeon and painter, helped Harold document both “pre- and post-facial reconstruction cases” (9).

nxotnujqgbkhtwhrz9odAfter the Somme (1916), Harold and his team at Aldershot helped over two thousand men with jaw and facial mutilations (10).  Despite everything he did during World War One, and his fame now for his advancements, “his work during the First World War went largely unnoticed” (11).  Harold was recognized by other countries for his work before he was recognized in England.

In the early 1920s Harold went to Copenhagen “to treat a number of Danish naval officers and men who had been severely burned in an accident” (12) when a Royal Danish Navy ship exploded.  The Danish government decorated Harold for his services.  Finally, in June 1930, Harold was knighted for his services to England; Arbuthnot-Lane said “Better late than never” (13).

After World War One, Harold opened a private practice for surgery, gave lectures, taught, and promoted his new techniques.  In 1920 his first book, Plastic Surgery of the Face, was published.  (He would also co-author 1957’s The Principles and Art of Plastic Surgery.)  In 1930, Harold invited his cousin, Archibald McIndoe, to join his practice; McIndoe became well-known for plastic surgery as well, making new advances during the Second World War.  In 1938, Harold and his practice began correcting breast abnormalities, going back to Harold’s wanting to make people look as good or better than they had been.

During World War Two, Harold was called on to be a consultant for the Minister of Health, the Royal Air Force, and the Admiralty; he helped organize plastic surgery units across the country, and trained many Commonwealth doctors in plastic surgery.  After the war, in 1946, Harold was “elected foundation president of the British Association of Plastic Surgeons; he later became honorary president of the International Society of Plastic Surgeons” (14).  In 1948, Norway decorated Harold for his work during World War Two.  He was also made an “honorary fellow of the Royal Australasian College of Surgeons, of the American College of Surgeons and of the Royal Society of Medicine, London” (15).

In 1946, Harold and a colleague performed “one of the first sex reassignment surgery from female to male on Michael Dillon” (16).  In 1951, they performed a male to female sex reassignment surgery; their way of performing this surgery became standard for the next forty years.

Going back a bit, for his personal life, on November 9, 1911, Harold married Kathleen Margaret Jackson in London.  They had four children.  Their oldest son, John, became a RAF pilot during World War Two and spent much of the war as a POW.  Their youngest son, Michael, also became a doctor.  Harold had been good at sports while he was in school, but continued on, becoming a champion golfer.  He also continued with his art, exhibiting at Foyale’s Art Gallery in London in 1948.

In May 1957, Kathleen died, and in November of that year, Harold married Marjorie Ethel Clayton, who had been his surgical assistant.  In August 1960, while operating on the leg of an 18-year-old girl, Harold suffered a “slight cerebral thrombosis” (17).  On September 10, 1960, Harold died at The London Clinic in Marylebone.  Despite his fame and having earned around £30,000 a year between the wars, he only left £21,161 upon his death.  To finish I’m going to quote at length from Sir Heneage Ogilvie, a renowned British surgeon, who wrote in 1962:

“During my life I have only known three surgeons who were undoubtedly first-class.  They were Geoffery Jeferson, Harold Gillies and Russell Brock.  Apart from Arbuthnot Lane, who was before my time, they are the only men in Europe or America who have taken a branch of surgery and by their own effort, by their leadership, their research and craftsmanship, have left it far higher than they found it.  To say that of Gillies is an understatement: he invented plastic surgery.  There was no plastic surgery before he came.  Everything since then, no matter whose name be attached to it, was started by Gillies, perfected by him and handed on by him to lesser men, who have often claimed it as their own” (18).

1, 2, 5, 6, 13, 16, 17 – Harold Gillies

10, 11, 12 – Harold Delf Gillies

8, 14, 15 – Rex Wright-St Clair, “Gillies, Harold Delf,” Te Ara, The Encyclopedia of New Zealand.

3, 4, 7, 9, 18 – CJ Williams, “Harold Gillies: Aesthetic Reconstructor,” NZEDGE, June 26, 2002.

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