Donald Dundas Moir

Abstract

Born 19 June 1929 Died 13 August 2017 Dr Donald Moir was born in Kendal, England, a fact which he acknowledged but about which he was reticent, as a consequence of his love of Scotland and particularly the Scottish mountains. His parents returned to Scotland when Donald was four-years-old. He attended Hillhead High School and undertook his medical training at Glasgow University, graduating in 1952. His initial anaesthetic training was undertaken at Stobhill Hospital in Glasgow, with his close colleague and friend Donald Campbell – later ‘Sir Donald’. He completed his anaesthetic training, obtaining the anaesthetic Fellowship, and in 1961 moved to Cleveland, Ohio, USA, to study under Professor R.A. Hingson, who had established a 24-hour service for caudal epidural pain relief in labour. On his return, Donald was appointed as the first consultant anaesthetist to the newly opened Queen Mother's Hospital, Glasgow. The obstetric team at the new hospital was young, enthusiastic and led by the charismatic Professor Ian Donald, who was the first person to establish the value of ultrasound in obstetrics and to embrace other new techniques, among them the epidural service offered by Donald Moir. A “24/7” epidural service was established, one of the first in the United Kingdom (UK). Initially epidural analgesia was only offered to patients with a specific indication, frequently hypertension during labour, but its value in the treatment of pain soon became apparent. This benefit, allied with its apparent safety and few significant fetal and maternal side effects, resulted in the technique rapidly gaining favour: its use spreading widely. In 1969 Donald gained an MD with his thesis on epidural analgesia. These were exciting times and the first small meeting of what was to become the Obstetric Anaesthetists’ Association was held in Glasgow in 1969; attendees included, amongst others, Selwyn Crawford, Bruce Scott, Mike Tunstall and Donald Moir. Donald’s second major and profound contribution involved general anaesthesia. By the late 1960s, reports of extremely unpleasant episodes of awareness during anaesthesia for caesarean section were being published. At this time a technique of 50% inspired oxygen in nitrous oxide, with muscle relaxant but without an inhalational volatile anaesthetic, was being used, as it was thought that the inhaled anaesthetic drugs caused uterine relaxation and hence increased bleeding. Donald demonstrated that the concomitant addition of 0.5% halothane appeared to eliminate awareness and was not associated with increased blood loss. This approach was widely adopted as the standard general anaesthetic technique in the UK and elsewhere. In 1976 Donald wrote a well-received textbook: “Obstetric Anaesthesia and Analgesia”. It was intended primarily for Fellowship examination candidates, but a shorter book was available for midwives. His continued research showed that intravenous oxytocin, compared with ergometrine, reduced the incidence of vomiting in conscious patients, and was not associated with increased blood loss. The main thrust of later research was to define the place of epidural analgesia and the effects of differing concentrations of local anaesthetic solutions, for both pain relief and operative delivery in obstetric anaesthetic practice. For many years Donald was the anaesthetic representative for the Confidential Enquiry into Maternal Deaths, which highlighted the problems associated with obstetric general anaesthesia. He was instrumental in developing local anaesthetic techniques and encouraging the move away from general anaesthesia. Throughout his life Donald was a keen golfer and sought, but did not always find, relaxation in the game. In 1988 he retired and moved to the location of his family roots, in Perthshire. There he studied at the Open University, gaining a BA (Hons) in English and History. While not a ‘Munro bagger’, he climbed more than half the Munros in Scotland, as well as enthusiastically tending a large garden. He is survived by his wife of fifty years, Heather, and his sons Neil and Ian.