Looking both ways: the Jamieson Memorial Lecture, 2006.

The Jamieson Memorial Lecture, delivered annually to the Neurosurgical Society of Australasia, commemorates the life and work of a leading Australasian neurosurgeon, Dr Kenneth Grant Jamieson (1925-1976), of Melbourne and Brisbane. He was the first specialist neurosurgeon to be appointed to the Brisbane General Hospital, the Brisbane Children's Hospital and the newly established Princess Alexandra Hospital in Queensland, jointly in 1956. He went on to serve as President of the Neurosurgical Society of Australasia (1971-1973) and as a Councillor of the Royal Australasian College of Surgeons from 1971 until his death. His pioneering research to study the sociophysical interplay of factors leading not only to head and spinal injury but to those causing all life-threatening trauma gave weight (from 1961) to advocacy for the introduction of breathalyser surveillance and to the compulsory wearing of seat belts in cars. In international perspective, Kenneth Jamieson was a pioneering 'accidentologist'. He was one of the first clinicians to address seriously the extraordinary burden of mortality from road trauma. He was a role model for those clinicians who came to see their professional and ethical duties extending to preventive and public health domains, both within and beyond the aegis of their chosen specialties. He saw a need for integration between the many bodies teaching resuscitation and life-support skills; at the 1975 Annual Scientific Meeting of the Royal Australasian College of Surgeons, he moved the motion to establish the Australian Resuscitation Council. The vigour and outreach of the Australian Resuscitation Council today remain one of his memorials. In the clinical sphere, his research centred on the early drainage of extradural haematomata and from 1962 on the operative treatment of aneurysms of the vertebral and basilar arteries. He was a dominant and leading advocate for clinical teaching in neurosurgery, particularly for more formal and sophisticated clinical teaching, improved training and higher standards of neurosurgical nursing. In a humorous but profound after-dinner speech, delivered to the Neurosurgical Society of Australasia (NSA) in 1973, Kenneth Jamieson acknowledged the 'importance of hindsight' as a desirable attribute for all neurosurgeons. The 2006 Jamieson Memorial Lecture takes this theme, extending it by using the metonymic symbolism of the NSA, whose emblem features two lizards, vertebrates with prominent postpineal midline parietal eyes. 'Looking both ways' stresses the desirability of all doctors to develop their knowledge of the history of their specialty in order that perspective might be enhanced. In this theme of 'looking back', the author draws particularly upon the contributions of three other Australians in the progression of neurosurgery: Lord Florey, Brigadier Sir Hugh Cairns and Dr Dorothy Russell. In 'looking forward', the author gives several examples of futurists who have striven to advance the causes not only of neurosurgery but of other cognate medical disciplines. Effective futurists are those who do not simply prognosticate, but combine prophecy with a will to modify the future, and who in so doing hold optimistic views for the future. Such an approach needs special attributes if pioneering advocacy for improvement is to be both directed and ultimately successful. The attributes needed to be a medical historian-futurist are summarized in the themes of (i) perspective; (ii) courageous resilience and optimism; (iii) evangelistic enthusiasm; and (iv) the skills of creativity that are needed for innovation. One audit of history suggests that much can be achieved if such qualities are possessed or can be developed by those who also 'look both ways'.