Abstract
Bruce Lindsay Taylor was an excellent and resourceful clinician, and a consummate problem-solver. His practice was founded on a vast clinical knowledge, outstanding practical and communication skills, timeliness of action, empathy for patients and their families, fairness and, above all, extreme kindness.
Bruce was born on 14 April 1955 at Broughty Ferry, Dundee, Scotland to Stanley Lindsay and Hilda May Taylor (nee Lindley), brother to Isla and Lindsay. After education at Perth Junior Academy and Brechin High School, he studied medicine at the Universities of St Andrews and Manchester between 1973 and 1979.
On graduating, Bruce undertook House Officer posts at Manchester Royal Infirmary and Bury General Hospital. Initially, he planned a surgical career, passing part 1 of the Fellowship of the Royal College of Surgeons (FRCS) examination in April 1981 whilst working in Bristol as Anatomy Demonstrator and Senior House Officer (SHO) in Orthopaedics and Accident & Emergency. However, following a chance discussion with the Professor of Anaesthesia there, his career focus changed, and he began anaesthetic training as SHO at Gloucestershire Royal Hospital in October 1981. He completed specialist training in Anaesthesia and Intensive Care in Southampton, Cambridge, Bristol and Exeter between 1982 and 1989, gaining Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons (FFARCS, later FRCA) in 1984. He then accepted the opportunity to work in Australia for 15 months as Registrar in Anaesthetics in Brisbane and Medical Practitioner to the Flying Surgeon Service at its Queensland Longreach base. In the latter role, he rapidly developed significant versatility and confidence, anaesthetising patients from the very extremes of life in isolated locations and high ambient temperatures, sometimes with the aircraft pilot acting as anaesthetic assistant! During this time, Bruce gained his pilot’s licence.
Prior to 1992, structured Intensive Care Medicine (ICM) training in the UK was poorly developed and, whilst in Australia, Bruce recognised the benefits of the Australasian ICM training system. Consequently, he returned to Australia in February 1989 to undertake additional specialist training in ICM, working for 12 months as a Senior Registrar in Intensive Care at the Royal Children’s Hospital, Melbourne and, later, for 6 months as Locum Staff Specialist in Intensive Care in Brisbane. In 1990, he was awarded Fellowship of the Australia & New Zealand College of Anaesthetists (FANZCA) and Fellowship of the Joint Faculty of Intensive Care Medicine (FJFICM), subsequently becoming a Foundation Member of the newly formed Australia & New Zealand College of Intensive Care Medicine (FCICM). Bruce would later use his experience of the Australian ICM training system to benefit the UK’s own ICM training programme, in his role as a member of both the Board of the UK Faculty of Intensive Care Medicine (2005–2009) and the UK Intercollegiate Board for Training in Paediatric Intensive Care Medicine (2005–2013). Bruce was eventually awarded Fellowship of the UK Faculty of Intensive Care Medicine (FICM) at its creation in 2011.
In June 1990, Bruce was persuaded to return from Australia to a UK consultant post by a long-term friend who was developing intensive care services in Portsmouth. Initially, Bruce was responsible for the management of patients in the intensive care unit (ICU) at St Mary’s Hospital, Portsmouth and for others requiring mechanical ventilation on the Wessex Renal and Transplant Unit. Inevitably, he also offered his paediatric intensive care expertise to the paediatric department in the hospital. As a result, several critically ill children were admitted to the St Mary’s ICU rather than being transferred to Southampton, which had no dedicated regional general paediatric ICU at the time, or further afield. The ICU service in Portsmouth became recognised for its expertise in caring for very sick children and was often referred critically ill children from surrounding hospitals. This necessitated the development of a reliable, high quality transfer system in which a fully equipped transfer team was despatched from Portsmouth by ambulance and/or HM Coastguard helicopter to stabilise and transfer the children. Bruce’s passion for ensuring excellent intensive care services for children led to him being invited to serve on national groups working to structure paediatric intensive care services around the UK. Locally, he worked closely with staff at Southampton General Hospital to develop the regional paediatric ICU (PICU) service there. Eventually, Portsmouth’s two ICUs no longer admitted the youngest and sickest children but acted in a supportive way to Southampton’s PICU service to ensure safe and effective care, thereby emphasising Bruce’s perpetual belief that a patient’s best interests, rather than local medical politics, were paramount. Bruce’s efforts were rewarded with Honorary Consultant status in the Southampton PICU.
Bruce’s approach to all intensive care, whether for adults or children, was to always do the simple things well, attend to the details and, above all, ensure patients were safe. His philosophy, hard work, dedication and genuine willingness to help were an inspiration to all who worked alongside him. Whilst he openly acknowledged the limitations of intensive care support and was not afraid to remove treatment when it appeared ineffective, he often fought to continue treatment when other hospital staff felt that all reasonable measures had been implemented. Because of Bruce’s tenacity and persuasive advocacy, several patients who would otherwise have died are alive and well today.
Bruce was a motivating and enthusiastic teacher. In the ICU and operating theatre, he was keen to pass on knowledge, skills and practical tips to anyone who would listen. In the classroom, he taught on numerous courses, including those covering the principles of Adult and Paediatric Intensive Care Nursing. He became the Director of the Wessex Advanced Paediatric Life Support Course (APLS) and developed two multi-professional courses – Paediatric Emergency and Resuscitation Seminars (PEARS) and Surgical Paediatric Emergency & Resuscitation Seminars (SPEARS) – to teach non-paediatric staff the basics of caring for sick children. From an early age, Bruce had shown great practical prowess for repairing items, especially cars, employing the motto that ‘nothing existed that couldn’t be fixed. . . . . . . . .eventually’. He put these talents to good use on several courses to construct unique task-specific mannikins, where none existed. Bruce was also a trainer on the Royal College of Surgeons Care of the Critically Ill Surgical Patient (CCrISP) course and Examiner in Critical Care & Applied Physiology at the Royal College of Surgeons.
In March 2005, Bruce raised awareness that the UK Department of Health’s draft influenza pandemic contingency plan predicted over 50,000 UK deaths, yet crucially contained no mention of ICU requirements or the impact of a pandemic on critical care services. Consequently, he was invited to Chair the UK Department of Health’s Critical Care Contingency Planning Group considering strategies for managing emergencies where the number of patients significantly exceeded normal critical care capacity. During the H1N1 Swine Flu outbreak in 2009, he gave a presentation to the Science and Technology Committee at the House of Lords in which he ‘. . .expressed with some force his concern about provision for critical care in the event of a pandemic and also about the ethical guidance given to healthcare workers to assist them when presented with difficult choices arising from scarcity of intensive care unit resources. . .’ Bruce’s concerns proved prescient 11 years later during the SARS-Cov-2 pandemic, yet he would never know how his persistence in raising these issues had helped the UK in its response to the COVID pandemic (vide infra).
Bruce was a humble Scotsman, who failed to recognise the magnitude of his influence on medicine. He often felt an imposter on committees, even those he chaired, and expressed surprise that he could hold his own with those he regarded as superior intellects. Nevertheless, Bruce held several major positions in the UK Intensive Care Society – Council member; Chair of the ICS Standards, Safety & Quality Committee; Editor of the Journal of the ICS; ICS Honorary Secretary and ICS President. In 2012, Bruce’s contributions to medicine were recognised with the award of a NHS Consultants’ Clinical Excellence Gold Award, Honorary Fellowship of The Royal College of Physicians and Honorary Membership of the Intensive Care Society.
Bruce came from a musical family; he played violin, guitar and, maybe inevitably for someone who spent time in Australia, didgeridoo. He played bass guitar in the band EMD – ‘Emergency Manoeuvres in the Dark’ – and relished writing material for and participating in hospital revues, his tour de force being a rewrite of the lyrics of Paul Simon’s ‘The Sound of Silence’ as ‘The Sound of Suction’.
Bruce met Claire Rogers, an ICU nurse at the Royal Devon and Exeter Hospital, in 1986. They married in 1994 and had two sons, Alex and Christopher and a daughter, Lily. Cruelly, much of the family’s life, especially the children’s upbringing and memories of their father, was scarred by his development of the symptoms of frontotemporal dementia, finally diagnosed in 2012 as Semantic Variant Primary Progressive Aphasia. Eventually, this robbed Bruce of many of the essential components of his personality – his dry, witty humour, eloquence, originality and ability to comprehend. After many years of slow deterioration, Bruce died of pneumonia at St Magnus Hospital, Haslemere on 22 January 2024.
Obituary provided by friend and colleague, Gary B Smith.