In August 1979, heart surgeon Terence English, who has died aged 93, was about to perform a heart transplant at Papworth Hospital in Cambridgeshire. If things don't go according to plan, the operation will not only be tragic for the patient, but also the end of his vision for the Papworth Heart Transplant Program. Reflecting on Papworth 40 years later, he said: “My back was against the wall. I had a chance and I was going to take it.”
Heart transplantation is the only lifeline for people with end-stage heart failure, and its success has long been a goal of cardiac surgeons. Christian Barnard South Africa performed the first human-to-human heart transplant in 1967, and between 1968 and 1969 Donald Ross performed three operations in the UK, but the longest patient survived was 107 days. This was considered a false dawn, and in 1973 the UK's Chief Medical Officer placed a moratorium on the procedure.
Having trained under Ross at the Royal Brompton Hospital in London, English decided that a heart transplant operation should not be postponed indefinitely. He came to Papworth as a consultant cardiac surgeon in 1973 and worked there as director of cardiology until 1995. He traveled to California several times in the 1970s to study with Donald Shumway, a world leader in heart transplantation. He was also very encouraged in 1976 when the concept of brain death was officially recognized in the UK – a move that improved the prospects for transplant surgery, since a donated organ from a person who was brain dead but with an intact circulation was more likely to be healthy and suitable for transplantation.
English and his team at Papworth reviewed the protocols, collected data, and in 1978 approached the Department of Health's transplant advisory group for permission to perform heart transplantation. They were refused. However, English found Pauline Burnet sympathetic. She was chairman of the Cambridge Health Authority and agreed to fund two heart transplant cases at Papworth.
In January 1979, the first of these cases failed. The patient, Charles McHugh, suffered cardiac arrest during preparation for surgery and died from subsequent brain damage. However, in August 1979, English's second operation was successful. Keith Castle, a gregarious 52-year-old builder from London, lived for almost six years and proved to be an outstanding ambassador for Papworth and heart transplant surgery in general.
The public, many doctors (including some of English's colleagues at Papworth) and the media were hostile to heart transplantation for many years, viewing it as a vanity project for surgeons. But photographs of Castle living life to the fullest began to capture public opinion. The National Heart Research Foundation agreed to fund six more heart transplants at Papworth, and the program gradually expanded. By the end of 1989, English had performed 342 heart transplants, and in 2004 he was pleased to see hundreds of former patients return to Papworth for the program's 25th anniversary.
He was knighted for services to medicine and surgery in 1991 and became President of the Royal College of Surgeons (1989–92), President of the British Medical Association (1995–96) and Master of St Catharine's College, Cambridge (1993–2000).
But high-status establishment positions were not enough for English. At 70 he was passionate on how to make a difference in conflict zones such as Palestine and Pakistan, becoming a trustee of the Leonard Cheshire Center for Conflict Reconstruction and charity International disaster and emergency assistance with long-term support (Ideals). He was also a patron of the Palestine Medical Aid organization. In the last decade of his life, English also supported the Dignity in Death movement, wanting to legalize physician-assisted death.
He was born in Pietermaritzburg, South Africa. His father, Arthur, a mining engineer, died when he was still a child, and his mother, Mavis (nee Lund), a nurse, moved the family to Johannesburg, where Terence grew up with his older sister Elizabeth.
He went to Hilton College in Natal and then worked as a diamond driller in rural Southern Rhodesia (now Zimbabwe) and completed a degree in civil engineering back in Johannesburg at the University of the Witwatersrand. He completed his degree in 1954, but a £2,000 family bequest changed his life. Influenced by his uncle Max Lund, a surgeon, he decided to use his inheritance to go to London to study medicine at Guy's Hospital.
He initially had doubts about the course and although he enjoyed being captain of Guy's rugby team, he decided to quit and go to Canada to work in the mining industry. But after he changed his mind, he successfully appealed to the Dean of Guy's to return to his course, and he qualified as a doctor in 1962.
English has had a lifelong passion for cars: as a medical student he spent his £175 savings on a 1930s Rolls-Royce “to add to the enjoyment of life”. In retirement he enjoyed taking adventure trips to remote parts of the world, climbing Mount Kilimanjaro on his 70th birthday and driving from London to Cape Town and through India and China in his Toyota Land Cruiser. He maintained his brave spirit throughout his life, joining his son's family for a Christmas swim in the sea in Cornwall when he was 85.
In 1963 he married South African nurse Anne Dicey and they had four children. They divorced in 2000, and in 2002 he married Judith Milne, headmaster of St Hilda's College, Oxford.
He is survived by Judith, his children, Catherine, Arthur, Mary and William, eight grandchildren and a sister, Elizabeth.
