Died: January 21, 2022.
DEREK Doyle, who has died aged 90, was a doctor and internationally renowned expert in palliative care who co-founded Scotland’s first hospice, St Columba’s, in Edinburgh.
The one-time missionary was highly influential in developing palliative care medicine and spreading its influence. He was the first President of the Association of Palliative Medicine of Great Britain and Ireland, and a founding member of the International Association of Hospice and Palliative Care.
He and his wife Bethia became Church of Scotland missionaries in the 1960s and he spent 10 years providing medical care in deprived parts of South Africa during what he termed the days of “extreme, bitter apartheid”.
But it is his contribution to the development of better end-of-life care for which he came to prominence, a field in which he remained influential long after his retirement.
Born in Bury north of Manchester, to John, a civil servant, and his wife Gladys, he moved with his family first to Glasgow and then to Edinburgh, where he attended George Watson’s College. His ambition as a teenager was to become a naval architect, influenced by witnessing shipbuilding in Glasgow, but in the event chose medicine, put off by the maths involved in naval architecture, and inspired by his faith to take up a profession where he felt he could do good.
He studied at the University of Edinburgh Medical School, explaining in a later interview with the Royal College of Physicians of Edinburgh that he came into his own as a trainee doctor at the end of third year, when he finally got to spend time with patients. “I just loved being with people; that was a terribly important thing to me,” he observed.
He qualified in 1955 and married Bethia Robb, a primary school teacher, in 1956. His first job was at Leith Hospital (a general hospital which closed in 1987), where he gained experience in surgery. His skills in eye surgery procedures such as cataract removal proved to be a highly useful skill in rural South Africa.
The couple went to South Africa in 1957 and Dr Doyle worked was a missionary surgeon in Kwa-Zulu-Natal before moving to a Transkei hospital as medical superintendent. The Church of Scotland wanted him to go urgently because of staff shortages, and he did so, but said later he was “not professionally prepared at all for what I had to do in Africa”.
The area the couple arrived in was marked by continual intertribal conflicts. He performed 105 post-mortems in his first year, all on war victims. The medical facilities were primitive and there had been no surgery on offer at all for the previous four years. He said it was “very frightening”, doing as many as 240 procedures he had never done before.
In Transkei, he found himself in charge of developing a 150-bed hospital, which was well equipped and had a “super staff”. Here, though, he also saw apartheid up close, treating patients whose backs were criss-crossed with wounds from being beaten, witnessing police brutality and being followed everywhere he went. He replaced overseas staff at the hospital where possible with local African people.
Bethia for her part was barred from teaching local children under apartheid laws.
The couple started a family while in South Africa. They returned to Edinburgh in 1966 and lived in Corstorphine where Dr Doyle worked as a GP and at Corstorphine Hospital. There he got to know Ann Weatherall, the matron, who had a keen interest in palliative care.
The UK’s first hospice, St Christopher’s in London, had been established in 1967 and the two saw the need for something similar in Scotland. They started fundraising and in 1977, St Columba’s Hospice opened in Trinity, north Edinburgh, with views across the Forth. Dr Doyle was its first medical director and stayed in post until his retirement in 1995.
A passionate advocate for palliative care, he poured his energies into raising awareness of the new specialism, developing undergraduate teaching resources as well as targeting qualified doctors with continuing professional development. He was Scotland’s first consultant in palliative care and helped ensure that it was recognised as a specialism, the UK becoming the first country in the world to establish a career path in it. In 1987, he was awarded an OBE.
Dr Doyle’s influence was not confined to his own country. He was the first chair of the European committee for medical education and training in palliative care and founded the Journal of Palliative Medicine. He received the American Academy of Hospice and Palliative Medicine´s Lifetime Achievement Award in 2005 and was bestowed with Lifetime Membership of the International Association of Hospice and Palliative Care in 2009.
A prolific writer, he had dozens of publications to his name, including his memoir, The Platform Ticket: Memories and Musings of a Hospice Doctor, published in 1999 (the title references a comment made to Dr Doyle that he was on the platform as people departed). He brought to it his insights and experiences, including of families reconciled as time was running out. It “exudes hope and love”, wrote one reviewer, arguing that it should be a priority read for all health care professionals.
He held fellowships of several Royal Colleges and was a visiting professor to five universities.
He and his wife had four children, Barbara, Elizabeth, Alan and Peter, and five grandchildren. Bethia died in 2015. Dr Doyle later married Ann Walker, a long-time friend and fellow member of St Anne’s Church. She died in 2018.
Dr Doyle was active in the church and had a strong interest in history. In retirement, he continued providing valued counsel as honorary president of the Scottish Partnership for Palliative Care.
“To me, palliative medicine is companionship with people on the last, final very lonely journey of life,” he once reflected, “when quite frankly they don’t want anything said, they just want somebody there who cares, somebody that’s not interested in their own esteem or importance, but just wants to share his or her companionship with somebody else on life’s road.”