|Year : 2021 | Volume
| Issue : 1 | Page : 91-94
The champion runner who became the forerunner in ophthalmic surgery training
C Biju John
Department of Ophthalmology, Regional Institute of Ophthalmology, Government Medical College, Thiruvananthapuram, Kerala, India
|Date of Submission||07-Feb-2021|
|Date of Acceptance||07-Feb-2021|
|Date of Web Publication||19-Apr-2021|
Dr. C Biju John
Regional Institute of Ophthalmology, Government Medical College, Thiruvananthapuram, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
John C B. The champion runner who became the forerunner in ophthalmic surgery training. Kerala J Ophthalmol 2021;33:91-4
The Oxford Room of the Royal College of Ophthalmologists, London, houses the college museum and historical library. There is a mind-boggling collection of antique surgical and optical instruments and books there which can by themselves chart the history of ophthalmology. A good collection of honorary medals and other honors won by great men who shaped European ophthalmology is another attraction. But among that medal collection is one stand out shining piece of metal that is going to surprise the uninformed viewer as it is something which is hardly expected amidst the academic decorations. It is an Olympic Bronze Medal – The 1924 Paris Olympic Bronze medal to be exact [Figure 1] medal.
|Figure 1: Both sides of the medal (Reproduced with permission from The Moorfields Collection in the archive of the joint Moorfields and Royal College of Ophthalmologist Library)|
Click here to view
| The Making of the Olympian Ophthalmologist|| |
H B Stallard is a familiar name for the ophthalmology resident as his book “Stallard's Eye Surgery” is considered as sort of a bible for the aspiring ophthalmic surgeons. It is highly unlikely that such a book be written again as it was a single author textbook describing almost all the surgical techniques in ophthalmology. Five editions were published from 1946 to 1973 and all the illustrations, perfect in every detail were drawn in pen and ink by the author himself. The book was then revised by Michel Roper Hall, who arranged it in 12 chapters each dealing with one surgical subspecialty. While it was those gifted hands of his, both of which were equally dextrous that earned Stallard a place in the ophthalmic history as a surgeon, writer, and teacher, it was his feet that helped him place an indelible mark in the history books outside ophthalmology. It was only after an intervention from the fate that resulted in a reduction in function of his lower limbs that the upper ones gained an upper hand. What was a loss for Britain's athletics was a gain for world ophthalmology. It requires just one sentence to show how great his achievement in the sports world was. He won the Bronze medal in the 1500 m race in the Paris Olympics representing Great Britain., No other ophthalmologist has won an Olympic medal before him or after him.
Major Hyla Bristow Stallard MBE FRCS who mostly went by the name Henry Stallard was born in Leeds on April 28, 1901, as the eldest of three brothers. He was an excellent athlete and sportsman right from his school days. However, it was from 1919 when he joined the Gonville and Caius College, Cambridge that his athletics career really began to blossom. Henry wanted to become a great middle-distance runner and trained hard for the same. In 1920, his team set a new world record by beating America in the 2 mile Pennsylvania relay. The New York globe headlines read “American Milers must watch Stallard at Antwerp” (Antwerp Olympics). However unfortunately, Stallard had broken his toe in Pennsylvania and so could not be selected for the Olympics that year. In 1922, he graduated and won the Shuter Medical Scholarship to St Bartholomew's Hospital, London. The demanding life of a medical student however did not curb his passion at all. The daytime was entirely devoted to studies and the nights for pursuing his passion. The empty night streets of London became his running tracks. The next 5 years saw Stallard attaining peak athletic proficiency. He became the only athlete in British Amateur Athletics ever to win the mile, the half-mile and the quarter-mile. Naturally, he was chosen to represent Great Britain in the 800 and 1500 m races in the 1924 VIII Olympiad held in Paris. He had even beaten fellow Cambridge runner Douglas Lowe during the trials, who was also selected along with him.
The bittersweet events that unfolded in that Olympics athletics meet and narrated by Hugh Williams are sure to touch the average ophthalmologist's heart., HB Stallard was considered favorite to win the 800 m. However, the schedule of the events was such that he had to run on 5 consecutive days as he was there in two events. This took a toll on Stallard's right foot which became known only in the 800 m finals, when despite being in the forefront initially, he finished in pain as a gallant fourth. The gold medal was won by Douglas Lowe whom he had beaten during the trials [Figure 2]. However, the 1500 m was still there and he was going to compete injury or no injury. Nursing the injury which he thought was minor, he ran the following afternoon for the last 1500 m heats, won, and qualified for the finals scheduled the following day. However, he was in considerable pain and his right foot seemed to be injured badly (a stress fracture and a ruptured ligament as would be discovered later). The team physician examined the foot and said it is better that he withdraws as the foot may not take the stress and might collapse if he runs on that. The team captain also tried his best to dissuade Stallard from running the following day. However, Stallard said adamantly “I am going to run tomorrow even if I never run again” and did exactly that with a bandaged foot. It was the most painful and agonizing race that Stallard ever ran. He came third, just two seconds behind the winner Paavo Nurmi of Finland. He was in terrible pain and collapsed immediately after crossing the finishing line. The unconscious Stallard had to be stretchered off [Figure 3]. The first words of the man who had run the last three races on a fractured metatarsal bone after regaining consciousness were “Sorry Philip for the poor show.” Philip Noel Baker was the Captain of Stallard's team. The Olympic Bronze medal thus won by Stallard shone better than the gold medal, for his countrymen and Stallard was welcomed back in his country as a true hero and carried on shoulders. His courageous running in that Olympic event has been immortalized in the epic film “Chariots of Fire” and the Bronze medal sits proudly in the Royal College of Ophthalmologist's Museum, London. The film itself was a huge commercial success and garnered four Academy Awards. Stallard was portrayed in the film by British actor Daniel Gerroll.
| Early Ophthalmic Career|| |
He got his Medical Degree in 1926 and still continued to run for Britain till 1928 when he was forced to retire due to recurrent stress fractures of both feet. Maybe it was nature's way of telling him that his hands were more blessed than his feet and he had to move on. Stallard was good with his hands and was ambidextrous. This along with his love for surgery probably attracted him to ophthalmic surgery. In the eye department at Barts, he came under the influence of Foster Moore who was conducting research in the conservative management of retinoblastoma by inserting radon seeds at the base of the tumor. By 1929, he was a fellow of the Royal College of Surgeons and was appointed in the Moorfields Eye Hospital as a pathologist and museum curator. He was just 27 years old then. During his work, there he happened to see a lot of retinoblastoma and became interested in improving the management of ocular malignancies. He did extensive research in retinoblastoma and other intraocular malignancies building on his experience with Foster Moore and established the principles of brachytherapy for these tumors. He first used Radium 226 as radioactive applicators and later the Cobalt 60 plaque which he placed on the surface of the eyeball overlying the tumor and could give measured monitored radiotherapy to the tumor., He managed to salvage many eyes through these methods and succeeded in popularizing the use of cobalt 60 episcleral plaques for the treatment of choroidal melanomas.
He had his hands full at this time as along with considerable contributions to his chosen subspecialty – the treatment of ocular malignancies, he also filled the positions of Assistant Editor of the BJO and Secretary of the Ophthalmic Society of the UK (OSUK). In addition to the consultancy in Moorfields and St Bartholomew, he was also in the Staff of Queen Alexandra Hospital for Children, The Radium Institute, and Mount Vernon Hospital. But after being accused of not spending enough time in the clinics by Moorfield colleagues, he resigned from there in 1938.
| The War and the Book|| |
It was the Second World War which helped Stallard reach the pinnacle of his surgical proficiency and paved the way for the ophthalmic world getting Stallard's master piece work. Stallard held a territorial army commission from 1929 onward. So when the war began in 1939, he rejoined full time in the Royal Armed Military Corps. In 1941, he was posted to Cairo to run a 68-bed ophthalmic unit. He had only 4 nurses, 2 orderlies, and 1 trainee ophthalmologist to assist him. He worked there till Rommel's defeat in 1943., During this time, he performed over 600 major surgeries which included war wounds of the eye, eyelids, and orbit and also civilian surgeries such as squint, retinal detachment, glaucoma, and others. He perfected a technique of removing intraocular shrapnel using the surgical giant magnet. He recorded in detail about 100 such cases and published a first of its kind paper on that. He even did six successful appendicectomies which was not surprising as he had qualified as a general surgeon initially.
It was this extensive surgical experience in Cairo that stimulated him to begin his work on his masterpiece book “Eye Surgery” in 1942. Cairo was the place where the Olympian ophthalmologist performed his last athletic world record event. He became the fastest man to climb up and down the “Great Pyramid of Giza”. He did that in 13 min and 23 s and the record is probably going to stay as climbing the pyramid is now forbidden. His passion was surgery and research and he hated administrative work. Due to this reason, he declined promotion above the rank of major and this helped him to focus on his work and passion. He then commanded the British Army Base Ophthalmic Unit in Normandy where he had to work in extreme and exacting conditions. No wonder when in 1944, he was transferred to a hospital in Brussels, he wrote “it was odd to tread on a firm floor and have a bath again.”
After the war, he rejoined Moorfields and St Bartholomews. It was at this time in 1946 that he published his life's work – the first edition of Stallard's Eye Surgery and it became an internationally accepted reference book on that subject. The next five editions which came out in the span of the next 25 years were also edited by Stallard himself. His artistic talents were in full bloom in the book. The over 600 illustrations that he drew in the book in pen and ink were perfect in every detail. His major field of interest during this time was the conservative management with radiotherapy of intraocular malignancies, especially retinoblastoma and choroidal melanoma and occuloplastic surgery. His exquisite surgical technique along with his patient and dedicated teaching skills attracted students and observers from all parts of the world. His athletic stamina was in display in the operation theater, also where marathon sessions were the norm than the exception. He continued his pioneering work in radiation therapy of malignant eye diseases and perfected the use of brachytherapy for retinoblastomas by stitching radioactive cobalt plaques onto the sclera overlying tumors.
Stallard's life partner Gwynneth Page whom he had married in 1932 was his work partner also. She acted as Stallard's secretary in the smooth running of his practice.
The Stallards travelled widely. His lectures and demonstrations took them to North America, India, Africa, and repeatedly across Western Europe.
| Awards and Accolades|| |
For his war time services, he was awarded the Member of the Order of the British Empire in 1942 and was mentioned in dispatches in 1943. He received The Order of the Southern Cross from Brazil for his free services to the underprivileged Brazilian children. He was invited for many prestigious eponymous lectures such as the middle more and the Mckenzie lecture. The prestigious Doyne Memorial Lecture which he gave in 1962 on the conservative management of retinoblastoma was acclaimed world over. He also received a Honorary Doctor of Laws from the University at St Andrews.
| A Brave Athlete Till the End|| |
Henry Stallard was an athlete and fitness freak all his life and tried to continue in the same vein as long as he could. Till his retirement from the National Health Service at 65 years, he used a bicycle to travel from his house to his workplace (Moorfields or St Bartholomew) and always arrived earlier than his colleagues who struggled with their motor cars in the London traffic [Figure 4]. After parking his bike, he would run up four flights of stairs to his office with his house surgeon and registrar panting after him. But then, it was sad that the same fate that broke his lower limb bones and denied him an Olympic gold medal in 1926, struck once again in 1972, this time threatening not only his limbs but also his life. He developed Paget's disease of the pelvic bone and that too complicated with estrogenic sarcoma. But did he also force fate's hand by routinely carrying unshielded radioactive plaques in his hip pocket as he went from hospital to hospital treating intraocular malignancies, before his retirement. The sarcoma was most likely radiation induced. He was at that time elected as the President of the OSUK and 2 days after his brave presidential address in April 1973 (he had received a blood transfusion that very morning) resigned due to deteriorating health. He struggled on in his private practice for 6 more months braving the pain, inconveniences of multiple blood transfusions, and side effects of radiation therapy and finally wrote to his patients that he will have to retire in October. But he did not have to as he died rather suddenly at his home in 21 October 1973. He was 72 years' old. The man who saved the lives and eyes of millions of children worldwide thanks to his pioneering work in retinoblastoma management however did not have any of his own.
I express my immense gratitude to Richard Keeler FRCOphth (Hon) Hon Curator, The Royal College of Ophthalmologists, and Hon Archivist, The Moorfields (Alumni) Association, for his help.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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Williams H. Life of Stallard. Br J Ophthalmol 2010;94:395.
Turell MB. The Olympian ophthalmologist. Br J Ophthalmol 2011;95:752-3.
Bullock JD. Henry B. Stallard MD. The 1924 Paris olympics, and Chariots of Fire. Surv Ophthalmol 2011;56:466-71.
Stannard C, Sauerwein W, Maree G, Lecuona K. Radiotherapy for ocular tumours. Eye (Lond) 2013;27:119-27.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]