Edward N Armitage

A true Yorkshireman, but of the gentlest kind, Edward Armitage made significant contributions to the study and practice of regional anaesthesia. His work with children was of particular importance to him, and to others, because his paediatric caudal dosage schedule (based on the meticulous observation of well over 1,000 children) was, and indeed still is, used widely. He was a pioneer also of the use (in both adults and children) of continuous epidural block after major surgery, emphasizing throughout his career the importance of pain prevention, rather than relief. His work in these two areas, undertaken as early as the 1970s, was of sufficient importance for him to be one of the invited speakers at the very first meeting of the European Society of Regional Anaesthesia in Edinburgh in 1982. Thereafter he was a strong supporter of the Society’s meetings, both at home and throughout Europe, where he was also widely respected.

Born in Huddersfield in 1935 to a non-medical family, Edward was educated at Oundle School, studying only classics until the age of 15, but thereafter encompassing quite easily the switch to the sciences needed for medicine. However, that early classical schooling was to benefit his approach to both presentation and publication throughout his life. His interests as an undergraduate (at UCH where he qualified in 1960) are said to have been typical of the time (driving fast cars, drinking beer and chasing nurses), but music, especially playing his beloved piano, was already an important part of his life. His early anaesthetic training was also at UCH, where a major influence was the late Massey Dawkins, one of that small number of clinicians in the UK who kept the faith with regional anaesthesia after the adverse publicity generated by major complications led to its near abandonment in the early 1950s.

Edward next went as a registrar to Great Ormond Street Hospital (recognizing there that regional anaesthesia could offer much to children) before going to Seattle to work with the late John Bonica and round off his ‘regional’ training. On his return to the UK he moved to Brighton where he was to spend the rest of his career, initially as a senior registrar, but appointed to a consultant post in 1973. His early major contribution was to the development of a paediatric day surgery service which included an anaesthetic assessment clinic, a feature innovative enough to attract a film crew from the BBC. Fortunately, the producer recognized the need for a second ‘take’ of the scene showing auscultation of a child’s chest, but this time with the stethoscope in the good doctor’s ears! Thereafter, his major emphasis was on the work on regional anaesthesia noted above.

The inaugural ESRA meeting was where he and Tony Wildsmith originally met, this leading in an editorial collaboration lasting a quarter of a century and producing three editions of Principles & Practice of Regional Anaesthesia, the first regional anaesthesia text to be produced in the UK for over 20 years. His contributions were to every component to the book, bringing the high standards which informed his clinical work, and insisting that both text and illustrations were clear, accurate and based firmly on good scientific evidence (as opposed to being ‘evidenced based’, a phrase he detested). However, this publication was not the only contribution made in his later career. He collected a unique series of patients with ‘cleft’ larynx and, of huge importance, worked tirelessly (and successfully) to persuade the Association of Paediatric Anaesthetists that it should open both its meetings and membership to clinicians working in ‘non-teaching’ centres.

In retirement, he continued to take an interest in developments in regional anaesthesia, but held to his long expressed view that those who were no longer ‘doing’ should soon stop writing and lecturing. He kept busy with his growing number of grandchildren, a beautifully restored drop-head coupe Railton car of pre-war vintage, study of the history of our specialty, and a keep fit schedule which included an early morning ‘skinny-dip’ in an unheated pool! A penchant for writing long narrative poems in the style of William McGonagall amused him and his friends, but music continued to be a passion, and he was a skilled organist. While modest about his professional achievements he never missed an opportunity to claim to have been the only anaesthetist to have played the organ in the presence of Royalty. However, he was shrewdly aware of the significance of his work, and was justly proud of being made an honorary member of the Association of Paediatric Anaesthetists, full recognition of his persuasion of that group to broaden its remit.

His final illness, self diagnosed, was borne with fortitude and dignity, and managed in the way he chose to the very end. Every day was looked upon as a blessing and an opportunity to pursue his interests. The church in Ditchling, Sussex was packed for his ‘celebratory’ service, and might have been filled again by those who were unable to be there, but this was not surprising. To quote: “He was such a lovely man.”

Acknowledgment: As well as our own knowledge of the man, we have drawn on the addresses given at the funeral by Roger Richmond and Geoffrey Hatcher.

Tony Wildsmith
Barrie Fischer