Smith, Edward Durham AO

  • Durham Smith

    Date and place of birth

    27th of May 1922, Sunderland, UK. 

    Durham's parents and ancestry were Australian dating back to migration from UK in 1853, but in 1922, his parents went to England where his father undertook further studies in theology (he was an Anglican minister) at Durham University - Durham was an accident somewhere along the way! The name “Durham” derives from this association. The family came back to Australia when he was just a few months old.

    Academic qualifications


    Training and career

    Durham's training years were distinctly messy! He started medicine in 1941, but was interrupted by war service (Army), and subsequently graduated with an MB BS (Melb.) in 1948.  Durham completed an RMO year at The Alfred Hospital in 1949, destined for general practice, but his progress was further interrupted when he was struck down with tuberculosis for the next 3 years. During his recovery, after the first year, Durham worked as a medical officer in sanatoria, and with much spare time, he attended MD lectures and a medical clinic at the Alfred Hospital. He completed his MD by thesis later on. Paediatric surgery was, however, the aim, as he had been stimulated by his time as an RMO at the Alfred paediatric ward.  By 1953, having recovered from TB, Durham undertook a year at the Anatomy School and returned to the Alfred as surgical registrar, completing FRACS in general surgery in 1956. With no opening at The Royal Children's Hospital, Durham started training in neurosurgery at the Alfred in 1956, as assistant neurosurgeon with Hugh Trumble and Keith Bradley for the year. By luck, in that year the Alfred decided to upgrade the paediatric service (with the impending arrival of Monash students), and offered to train a surgeon committed to paediatric surgery. Durham was appointed, and in 1957 was seconded to the RCH for the next 3 years as assistant surgeon to Douglas Stephens’ unit, part-time surgical registrar, and assistant neurosurgeon to Mr R.S. Hooper, as well as servicing the paediatric ward at the Alfred, and some general surgery. It was a bit busy! The arrangement also included a fellowship in GOS and other UK Centres, and Harvard Children’s and other US Centres in 1959. On return, a decision had to be made between a career as a paediatric neurosurgeon or as a general paediatric surgeon, but in view of the Alfred commitment, Durham chose the latter.

    For the next five years, Durham continued to run the paediatric surgical service at the Alfred (with John Solomon), and with an increasing involvement at the RCH in the Stephens unit, including surgical research sessions in the RCH Research Foundation. In 1965 he was appointed as a full surgical consultant at the RCH, and after nine years as paediatric surgeon at the Alfred, retired from this position. Apart from the clinical work as a staff surgeon at RCH in the Stephens unit, Durham continued to maintain 2 -5 sessions a week in research as surgical research fellow at the RCH under Douglas Stephens for the next 10 years. He was also a consultant with Stephens for neonates at the Royal Women’s Hospital for 10 years from 1960, (where they also had access to autopsy material for congenital anomalies), and at the Mercy Maternity Hospital from 1971 until retirement. Durham was chairman of the RCH Medical Staff Association in 1979 and retired from his position as consultant surgeon at the RCH at the end of 1986.

    All of the paediatric general surgeons at RCH needed to continue being fairly “general” to earn a living and Durham remained on the rostered call at the RCH for any surgical admissions, including neonates, until he retired. However all three general units began to concentrate on specialised areas from the middle 1960’s. Russell Howard’s unit (with Nate Myers, Helen Noblett and Max Kent) specialised in thoracic lesions, Murray Clarke’s unit (with Peter Jones and John Solomon) focused on burns, and Douglas Stephens’ unit (with Robert Fowler and Durham) handled the genito-urinary, cloacal, and ano-rectal anomalies. In 1961 they started the first Co-ordinated Clinic in Australia for spina bifida involving several disciplines, and Durham managed the urinary aspects. His research was in spina bifida (spinal cord pathology, and urinary control mechanisms), hypospadias (with a new procedure), and ano-rectal anomalies, (clinical decisions, pathological anatomy, diagnosis and management, including new operative techniques and an International Classification developed at RCH at the international conference in 1970). 

    Career highlights and research

    Durham states that any career highlights in clinical surgery or research were totally dependent on the work of others, especially Douglas Stephens for constantly encouraging, stimulating, goading and making opportunities; most of the original ideas came from him, but other colleagues, especially Robert Fowler and Justin Kelly, also had creative minds. Durham comments that he had very few original ideas, and his contributions were only in two areas.  First, in the collation, analysis and systemizing of data into a coherent whole, in articles and books. A book on spina bifida, published in 1965, won the Simpson-Smith Prize at the University of London in 1959, and two books on ano-rectal anomalies co-authored with Stephens (1971 and 1988) became standard international reference texts. Durham was also a co-author with Stephens and editor of his monumental text on congenital anomalies of the kidney, urinary and genital tracts (1996), revised by John Hutson in 2002. Secondly, Durham tried to refine and simplify the operative techniques in a number of the classic lesions of urology (hypospadias, partial nephrectomy, ureteric reflux, ileal conduits, ureterocoeles, etc and ano-rectal anomalies).  In 1975 Nate Myers and Durham separated the Priestley siamese twins who had very complicated urinary and bowel problems. Both boys became champion badminton players in adult life!

    Honours, awards and appointments

    From the early 1970s Durham became increasingly involved at the Royal Australasian College of Surgeons, a body which is primarily responsible for the training of surgeons, the award of the FRACS, and for the development and maintenance of surgical standards. In summary, after election to the Victorian State Committee in 1972, he became an examiner for the FRACS Diploma in Paediatric Surgery (for 11 years), and eventually chairman of the Court of all Examiners. He served on the central Council of the College from 1978 until 1989 and was on various committees, Vice-president, and President of the College 1987-89.  The latter appointment is very demanding and precipitated retirement from clinical surgery a little earlier than planned. Following the presidency he was appointed to the inaugural position as Executive Director for Surgical Affairs of the College for three years.

    It is customary to list Honours and Awards. Durham likes to remember the privilege of a life in clinical surgery for children, which he loved, and that is, he feels, his best award; but the obligatory list includes an AO (1991);  Honorary Fellowships of FRCS(Eng), FRCS(Edin), FRCPS(Glas), FRCS (Ire), FCS(SthAf), FCS (Jap); Honorary Membership of the British Association of Paediatric Surgeons (and Denis Browne Gold Medal), the American Paediatric Surgical Association, and the paediatric surgical associations of South Africa and Japan. He was President of the Australian Association of Paediatric Surgeons and of the Pacific Association of Paediatric Surgeons; Vice-president of the World Federation of Paediatric Surgical Associations; winner of the RCH Gold Medal in 1988, and secretary and president of RCH Medical Alumni.

    Outside medicine

    Beyond surgery, Durham has lived a blessed life of 67 years with Dorothy (2015), a graduate of music, and their four sons; and a life-long interest in history, current affairs, the broader aspects of science, and ethics/theology (the latter formalised into a book, 2006, and 2nd edition 2011, Search for Understanding –The Fullness of Life? Wishful Hope or a Real Possibility. It is a liberal view to re-define the central tenets of traditional Christian orthodoxy, their relevance to contemporary society, and perhaps to move beyond them). Durham also enjoys sport (tennis, water skiing, now golf), computers, travel and music, which he says are all part of the mix.