Charles Rob

MC FRCS
Charles Rob as a 1st Lt. in the Royal Army Medical Corps, Tunisia, 1943.[1]
Born
Charles Granville Rob

(1913-05-04)4 May 1913
Weybridge, England, United Kingdom
Died26 July 2001(2001-07-26) (aged 88)
Berlin, Germany
NationalityBritish
EducationSt John's College, Cambridge
Known for
Medical career
ProfessionSurgeon
FieldTransplant surgeon
Sub-specialtiesVascular surgery
AwardsRené Leriche prize

Charles Granville Rob MC FRCS (4 May 1913 – 26 July 2001) was a British surgeon who pioneered techniques in the repair of damaged blood vessels, particularly the operation to unblock arteries of the neck, known as carotid endarterectomy and of the aorta when treating aortic aneurysms.

After graduating from Cambridge University and St Thomas' Hospital Medical School, Rob operated throughout the Blitz and in the Tunisian Campaign, where he received the Military Cross.

After the Second World War, Rob became the youngest chief of surgery at St. Mary's Hospital, London and he also lead the vascular surgery program at St Mary's Hospital, London where he carried out one of the world's first carotid endarterectomies and a year later performed the UK's first deceased donor human-to-human kidney transplant. His contributions paved the way for St Mary's in becoming a pioneering centre in vascular surgery and transplant surgery.

In 1960, he moved to the United States and continued developing techniques in vascular surgery including vein by-pass grafting.

Early life and education

Charles Rob was born on 4 May 1913 in Weybridge, England. His father was Joseph William Rob, a family physician, who came from the farming and landowning family in Catton near Thirsk, Yorkshire. The Robs traced their ancestry from Loch Lomond, Scotland where they owned a successful cattle droving business, which continued after they settled in Yorkshire in the 1680s. [2][3] and his mother was a descendant of Edward "Grog" Vernon, the British Admiral who introduced diluted rum for Royal Navy sailors in the 18th century.[2][4]

He was educated at Hordle House and Oundle before going on to graduate from St John's College, Cambridge,[2][5] in 1934. During his time there, he once climbed one of the spires of King's College to place an open umbrella on the top.[2] He also joined the university air squadron[2] to train to be a pilot. After receiving a reserve commission as a pilot in the Royal Air Force he transferred to St Thomas's Hospital for his clinical attachment. In 1937, he graduated with an MB from Cambridge University.[3]

He became a member of the Royal College of Surgeons in 1937 and, after two years of surgical training at St Thomas's, he gained his FRCS.[2]

Second World War

At the onset of the Second World War in 1939, Rob was at the Royal Victoria Hospital, Montreal, but shortly returned to St Thomas's hospital to work throughout the Blitz (1940–1941).[2] Here, he met Mary Dorothy Elaine Beazley, who had worked as secretary and secret courier to Royal Air Force officer William Wedgwood Benn, and had subsequently enrolled in the Florence Nightingale School. They married six weeks later and later had two sons and two daughters. Joseph William Rob, Peter James Rob, Caroline Rob Zaleski and Rebecca Rob Podore.[2][6]

He was later made resident assistant surgeon at Hydestile Hospital, close to Godalming[2] and had also operated in bunkered operating rooms at St. Mary's hospital.[6]

He joined the Royal Army Medical Corps in November 1942 and was posted to the 1st Parachute Battalion as a surgical specialist. He took part in the mission to seize the Souk-el-Arba Airfields and the road junction at Béja during the Tunisian Campaign. Here, he performed more than 150 operations after converting the French garrison school into a hospital. He suffered a left tibia and kneecap fracture when a bomb fell, and was reported to have used his own blood to transfuse a wounded person. After 24 days, he had treated over 200 people.[2]

He was awarded the Military Cross for his efforts. After leaving Tunisia he took up command of a field surgical unit in Sicily and Italy and became lieutenant colonel.[2][3]

Surgical career in England

Upon return to London after the Second World War, Rob resumed duties at St Thomas' Hospital and later became professor of surgery at the University of London and St. Mary's Hospital in 1950.[3] During his time as professor of surgery, he was involved in the vascular surgery programme and also became advisor to royalty and Winston Churchill, and in 1959 several times assessed the blood clot in Churchill's little finger.[3][7]

Michael DeBakey performed the first carotid endarterectomy in 1953 and the procedure became better known after Rob and his colleagues performed one in 1954.[8][9] The operation proved to reduce the risk of stroke in patients with significant blocked carotid arteries[10] and he reported to have carried out more than 5000 of these operations in his lifetime.[11] In addition, he introduced using frozen cadaver arterial grafts in the treatment of aortic aneurysms.[2][12] In 1955, he presented his experiences of over 30 abdominal aortic aneurysms to the Royal College of Surgeons.[13]

In 1955, Rob performed the UK's first recorded deceased donor kidney transplant with Hammersmith hospital's surgeon Jim Dempster, at St Mary's Hospital.[14] The recipient had developed acute renal failure following a septic abortion and was considered by Dempster as not ideal for transplant[15] and an unnecessary fatal disaster. However, it instilled an interest in further transplantation developments at St Mary's, which became regarded as pioneers in this field.[16][17]

Surgical career in the United States

In 1960[2] Rob accepted the position of chief of the Department of Surgery at the University of Rochester, Strong Memorial Hospital and moved to the United States.[6] Here, he continued to develop the technique of vein by-pass grafting.[2]

In 1961, after recalling that cloth grafts had been used in the aortas of pigs, he used his nylon shirt to successfully repair an aortic aneurysm in a human.[18] After debriding and resecting the aneurysm, the two open ends of the aorta needed to be rejoined with a graft, but the surgeons found that no graft was available to complete the procedure. To the surprise of his colleagues in theatre, Rob called for the shirt in his locker, cut out a rectangle and stitched it into a tube to be used as a graft, possibly the first use of a synthetic vascular graft in a human. The patient survived and the assistant recalled meeting the patient again eight years later.[18]

After retiring[6] in 1978, he moved to East Carolina University, taking an appointment as professor of surgery. Five years later he joined the Uniformed Services University of the Health Sciences at Bethesda, near Washington DC.[2] He was a past president of the International Society of Cardiovascular Surgery and the North American Chapter of the International Cardiovascular Society.[10] He was awarded the René Leriche prize of the International Society of Surgery.[2] In 1994, he required a carotid endarterectomy himself.[9]

Death and legacy

Rob died of heart disease while visiting relatives[10] on 26 July 2001 in Montpellier, Vt.[3] Apart from his medical innovations, he has been remembered for his saying on the treatment of a gangrenous limb: "The best treatment for the condition is rest. The best way to rest is sleep. The best way to get sleep is to relieve pain, and the best way to relieve pain is to give whiskey."[3][4]

Selected publications

Rob published more than 200 papers. His book publications included:[3]

  • Operative Surgery. 8 vols. Butterworths, London, 1956. (edited with Rodney Smith)

References

  1. ↑ "Vascular trauma: A 40-year experience with extremity vascular emphasis". ResearchGate. Retrieved 28 November 2018.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 "Rob, Charles Granville (1913–2001)". livesonline.rcseng.ac.uk. Retrieved 21 November 2018.
  3. 1 2 3 4 5 6 7 8 Saxon, Wolfgang (29 July 2001). "Dr. Charles Granville Rob, 88, Surgeon Who Aided Churchill". The New York Times. Retrieved 21 November 2018.
  4. 1 2 "Professor Charles Rob". The Daily Telegraph. 15 August 2001. ISSN 0307-1235. Retrieved 21 November 2018.
  5. ↑ Pearson-Chisman, Tom (2017). Remembrance: The biographies of the nineteen boys and men of Hordle House School who gave their lives in the service of their country. Lymington: Walhampton School.
  6. 1 2 3 4 "Mary Dorothy Elaine White Beazley Rob". www.obits.democratandchronicle.com. 3 June 2012. Retrieved 26 November 2018.
  7. ↑ Scadding, John W; Vale, J Allister (July 2019). "Winston Churchill: two mild left hemisphere strokes, finger gangrene and syncope in 1959". Journal of the Royal Society of Medicine. 112 (7): 278–291. doi:10.1177/0141076819843656. PMC 6613274.
  8. ↑ Friedman, Steven G. (2005). A History of Vascular Surgery. Blackwell Futura. p. 10. ISBN 978-1-4051-2522-2.
  9. 1 2 Rich, Norman M. (January 2002). "Charles Granville Rob". Journal of Vascular Surgery. 35 (1): 178–179. doi:10.1067/mva.2002.121119. ISSN 0741-5214.
  10. 1 2 3 Estrada, Louie (29 July 2001). "Surgeon Charles Rob, 88, Dies". The Washington Post. Retrieved 28 November 2018.(subscription required)
  11. ↑ LaMuraglia, Glenn M.; Brewster, David C.; Moncure, Ashby C.; Dorer, David J.; Stoner, Michael C.; Trehan, Samir K.; Drummond, Elizabeth C.; Abbott, William M.; Cambria, Richard P. (September 2004). "Carotid Endarterectomy at the Millennium". Annals of Surgery. 240 (3): 535–546. doi:10.1097/01.sla.0000137142.26925.3c. ISSN 0003-4932. PMC 1356444. PMID 15319725.
  12. ↑ Frederick, John R.; Woo, Y. Joseph (September 2012). "Thoracoabdominal aortic aneurysm". Annals of Cardiothoracic Surgery. 1 (3): 277–285. doi:10.3978/j.issn.2225-319X.2012.09.01. ISSN 2225-319X. PMC 3741772. PMID 23977509.
  13. ↑ Rob, Charles (November 1955). "The Surgery of the Abdominal Aorta and its Major Branches". Annals of the Royal College of Surgeons of England. 17 (5): 307–317. ISSN 0035-8843. PMC 2377934. PMID 13275887.
  14. ↑ "Renal Medicine: History Of". www.renalmed.co.uk. Archived from the original on 12 May 2018. Retrieved 21 November 2018.
  15. ↑ Hopewell, John (2016). "The Early History of the Treatment of Renal Failure by Haemodialysis and Transplantation in the UK" (PDF). British Transplantation Society. Retrieved 27 November 2018.
  16. ↑ England, Royal College of Surgeons of. "Dempster, William James – Biographical entry – Plarr's Lives of the Fellows Online". livesonline.rcseng.ac.uk. Retrieved 27 November 2018.
  17. ↑ Crowther, S. M.; Reynolds, L. A.; Tansey, E. M. (2009). History of Dialysis in the UK: c. 1950–1980. Wellcome Trust Centre. pp. 25. ISBN 978-085484-122-6.
  18. 1 2 Pories, Walter J. (4 August 2015). Menzoian, James O. (ed.). "Historical Vignettes in Vascular Surgery; The shirt off his back". Journal of Vascular Surgery. 62 (5): 1366–1367. doi:10.1016/j.jvs.2015.08.054. PMID 26506277.
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