Author: Dr Peter F. Burke FRCS(Eng) FRACS DHMS, Specialty Editor-Surgical History: ANZ Journal of Surgery

The RACS Herbert Moran Memorial Lecture in medical history has conditions, which stipulate simply the subject, ‘be of medical historical interest.’

Herbert Michael ‘Paddy’ Moran was an extraordinary Australian surgeon. From his birth in 1885, until his death in 1945, as a result of metastatic melanoma—his life whether as pioneer captain of the Wallabies rugby team, successful Macquarie Street Sydney specialist, Italophile, linguist, scholar, Catholic, and patriot—rewards study.

Primary sources of information about Dr Moran can be found in three major published works.

In 1939 he wrote Viewless Winds: Being the Recollections and Digressions of an Australian Surgeon. The Sunday Times of London called it ' ... a fine addition to the field of medical autobiography. Every man’s life has a plot and a pattern, but not neat ones, and the most interesting people who come our way most often soon depart and are seen no more. This is the charm and magic of autobiography. In this Dr Moran excels’.

Having graduated from the Sydney Medical School, in 1908 he captained the first Australian rugby team to tour the United Kingdom, the ‘Wallabies’, but after eight matches and significant injuries, he left the team, moving to Edinburgh to undertake studies leading to the FRCSEd.

From 1910-1915, Dr Moran established his first practice in an industrial suburb of Sydney, as he saw an opportunity for doing much surgery there. After two years, he became so busy that he had to take an assistant and was appointed to the honorary surgical staff of Saint Vincent’s Hospital.

He regularly visited an old Scottish lady, too poor to pay for medical advice. Late one afternoon she told him, “Doctor dear since you were last here, I took a guinea from my savings and went over to Macquarie Street and saw a really good doctor. And he says just the same as you"!

This led Dr Moran to reflect, ”A great truth dawned on me, as sooner or later, it dawns on most men: the doctor who treats for nothing has his services valued at his own price.”

Following the declaration of WWI, Dr Moran decided to offer his services and sold his practice. To avoid barracks in Australia, he sailed direct to England where he enlisted in the Royal Army Medical Corps.

Here he became acquainted with the “gnawing boredom of war”, until word came through that in Gallipoli, his fellow countrymen had had their baptism of blood.

Dr Moran saw action at Suvla and Imbros, transporting injured to Mudros: a ship that had been used for 30 years in the cattle trade was transformed into ”the travesty of a hospital ship.”

With no room at Mudros, the ship was sent to Malta with nearly 1100 on board; with totally inadequate sanitary arrangements, typhoid fever and dysentery resulted. Dr Moran was felled by amoebic dysentery and after recovering “they marked me down for Mesopotamia in order to complete my intestinal education".

Invalided out again, this time with chronic dysentery, he returned to Australia, to find himself in the throes of a “miserable sectarian brawl”: in one corner William Hughes the federal prime minister, in the other, the Catholic archbishop of Melbourne Dr Mannix, who, at that stage had been in Australia for just three years. The issue, conscription.

Mannix opposed conscription and split the Catholic body into two hostile layers. Thanks to the Archbishop a system of boycott against Catholic workmen and tradesmen was set up throughout the whole Commonwealth: ‘no Catholics need apply’.

Dr Moran writes, “about this time my own health was bad. The dysentery contracted during the war had been so constantly recurring that I had seriously considered retiring permanently from medical practice.”

In November 1921 he decided to spend a year abroad. In the years immediately following the war he had become increasingly aware of the importance of cancer both as a social and a medical problem.

Following studies in France, England, and the United States, Dr Moran became the first medical practitioner in Australia to use radium needles or radium tubes in the treatment of cancer.

For most practising surgeons, the new movement was a heresy: “The more resentful called us innovators, ’burners’‘ and spoke of the method as ‘pin-cushion therapy’.

”In later years, I formed the first society in Australia for the study of medical history and literature, gathering a small group of men with rich and learned talents, including, Leslie Cowlishaw, who knew all about medical incunabula.

”There is always a prejudice against medical men who write anything but strictly medical articles. A strong feeling exists that literary exercises are the last infirmity of an idle old practitioner,” Dr Moran wrote.

Beyond the hill lies China: Scenes from a Medical Life in Australia was published in 1945. Begun in Rome 1939 and completed in Colchester, East Anglia in 1943, Dr Moran described this work as “a narrative” as it traced the career of a rather shy and timid fictional medical student, John Challis, at the University of Sydney. The book provides unflinching accounts of his medical practice, until his death in the London Blitz. He thus used an authorial ploy to interpose his overview.

The publication's title refers to the incorrect geographical assumptions made by convicts who were transported from the northern hemisphere and had no understanding of their geographical surrounds. For some the mistaken belief that they were not so distant from China and the east, led to their wish of escaping there. Dr Moran wrote, ’But not all the convicts had submitted.’ He remembered the story of those, convicts who moved by a fierce nostalgia, had burst their bounds. Beyond the Hill, across the Bay, lay China! Men whispered the news, their hearts excited. China! The freedom and romance of Cathay.

Dr Moran does not shy away from describing authentically a life in general practice with all its ramifications, right up until the death of Dr Challis.

‘In a darkened street … he did not hear the premonitory whine: the world was far, too far, away. He had been beyond the sensation of any blast. Upon a London Street, bespattered by a crimson dust he lay, and life hurt him no more’.

In My Fashion, An Autobiography of the last Ten Years, was completed over three months in 1945, just before Dr Moran’s death in Cambridge. He noted, “however misguided, I have done this, my third book, as a duty, where I wrote my two previous books as a pleasure.”

In 1930 Mussolini had received Dr Moran to express thanks for initiating the teaching of Italian at Sydney University. Now in 1935, in the Great Hall of the Città Universitaria of Rome, an excited crowd was waiting impatiently, to be addressed by Mussolini.

All the universities of the world had been invited to send representatives, ”I was representing both the University of Sydney and the RACS, dressed in the gold-faced gown of the Australasian College.”

”Mussolini spoke for no more than a quarter of an hour but in that short period he had poured into his speech the maximum possible content of passion and provoked the maximum possible reaction amongst his listeners.

”In the first days of February 1945, I observed that a pigmented mole which I had had, for at least ten years, upon the skin of my upper abdomen, was breaking down. The shape of this mole was irregular. It was flat, hairless, and in size about that of my thumbnail. To my knowledge it had never been injured or suffered unusual friction.”

Incomplete excisional biopsy confirmed aggressive malignant melanoma.

Dr Moran wrote, ‘there was nothing to do but to carry on’.

References.

This paper based on the 48th Herbert Moran Memorial Lecture, Of Medicine: The Splendour and the Misery. Peter F Burke, 5 May 2023, RACS ASC Adelaide.

Viewless Winds, Being the Recollections and Digressions of an Australian Surgeon. London, Peter Davies; 1939.

Beyond the Hill lies China. Scenes from a Medical Life in Australia. London: Peter Davies. Sydney: Dymock’s Book Arcade Ltd. 1945
In My Fashion. An Autobiography of the last Ten Years. London: Peter Davies. Sydney: Dymock’s Book Arcade Ltd. 1946

Figures.
1.    Herbert Michael ‘Paddy’ Moran.
2.    Radical Radium Needling of Breast.