Archibald McIndoe

Archibald McIndoe. 1900-1960.

Image from Queen Victoria NHS
Foundation Trust.

Archibald McIndoe

No Ordinary Surgeon

Motivated by a desire to be more than just an ordinary doctor, Archibald Hector McIndoe pursued greatness and became much more than an ordinary surgeon. Appointed plastic surgeon to the Royal Air Force in the midst of World War II, McIndoe brought plastic surgery to the forefront of burns treatment and became a pioneer of what is more commonly known today as ‘therapeutic community’. As noted by one of his patients; “McIndoe, as well as being a great surgeon, was also a great psychologist”.

Following a successful career at the Mayo Clinic (USA), Archibald McIndoe went on to form a partnership with the 20th Century’s founding father of plastic surgery — fellow New Zealander Sir Harold Gillies. On the eve of World War II and following Gillies recommendation, McIndoe was made plastic surgeon to the Royal Air Force. This appointment presented him with a number of challenges, not least the medical profession’s use of outdated treatments. In the process of meeting these challenges he brought plastic surgery to the forefront of burns treatment and became a pioneer of what is more commonly known today as ‘therapeutic community’. McIndoe’s brand of therapeutic community saw him dispense with the usual hospital rules in order to meet the psychological needs of his badly deformed patients. He employed staff specifically for this purpose, and mobilised the resources of an entire community.

More than just an Ordinary Doctor

Archibald Hector McIndoe was born in Dunedin, New Zealand, on the 4th of May 1900. His father John McIndoe was a printer and his mother Mabel an amateur painter. His older brother was also a printer and it was thought that Archibald would similarly take up printing. But Archie, as he was then known, loathed the idea of following in his father’s footsteps. Quick witted and academically astute, he had much greater ambitions. His friends were of a similar ilk, so when they applied to enter Otago University Medical School, Archie naturally followed. For Archibald McIndoe, matriculation into medical school turned out to be a mere formality. Indeed, McIndoe graduated in 1923 having been awarded the Junior Medicine Prize, the Senior Clinical Surgery Medal, a Bachelor of Medicine, and a Bachelor of Chemistry. After graduating he made no secret of his desire to be more than just “an ordinary doctor”. The thought of general practice dismayed him and he considered hospital work out of the question.

Otago University

McIndoe did end up doing hospital work but not for long. Soon after starting an internship at Waikato Hospital, he received a letter from Otago Medical School stating that he had been recommended for a scholarship at the Mayo Clinic in Rochester Minnesota (USA). Founded by William and Charles Mayo, the clinic had a reputation for producing some of the world’s best surgeons. This was the opportunity McIndoe had been hoping for; to further his career overseas and to avoid being, as he put it, “a doctor who just settled down to bring other people’s children into the world”.

Quick, Charming & Socially Adept

McIndoe arrived at the Mayo Clinic on New Year’s Day 1925. Although his first two years were spent studying pathology and working in the clinic’s mortuary, he still found time to publish four papers on cancer and bile duct surgery. By 1927 his efforts had won him an MSc in Pathology and that same year he was made assistant surgeon to Donald Balfour. Balfour, the clinic’s chief surgeon, soon noticed the quickness of McIndoe’s clinical judgements and the smooth precision of his cutting and sewing. Under his supervision McIndoe began specialising in stomach surgery and was soon handling several cases a day. A person close to McIndoe wrote;”He was the quickest man to open and shut a stomach that I ever saw”. Indeed, McIndoe was very quick even by today’s standards, and this quickness would later become a feature of his work as a plastic surgeon.

The New Clinic. Rochester, Minn.

But it was not just McIndoe’s quickness that set him apart from the other young surgeons. Everybody who came into contact with McIndoe liked him. The Mayo brothers considered him to be “one of their bright young men” and Balfour had taken him under his wing. A fellow student Walter Alvarez also recalls McIndoe’s natural charm and social skills; “Sometimes when in my home and in a jovial mood, he and one of his Australian friends would take off their shoes, pull their trousers up to their knees and dance for us a Maori haka… He was the sort of man who made his mark and stood out from the crowd.”

By 1929 McIndoe had completed an MSc in surgery, published several papers and was destined for a partnership at the Mayo Clinic. However, it was a major discovery that really set him apart from the other young surgeons and it was this discovery that ultimately changed the course of his career. While working under Balfour, McIndoe discovered that the liver had two blood supplies. He theorised that when operating on the liver, one supply could be shut down and the other kept open. The first time he tried this operation his elderly patient died, but he was soon exonerated when it was found that the patient’s death was due to an unrelated illness.

With Balfour’s encouragement, McIndoe continued to experiment and was eventually successful. In fact, McIndoe was so successful that he was asked to demonstrate his operation (later known as “McIndoe’s operation”) to a convention of surgeons in Chicago. Attending the convention was an English surgeon by the name of Lord Moynihan, a man that McIndoe would later refer to as an “old English bastard”. Moynihan, the doyen of British surgery, was impressed by McIndoe’s skills. Taking the young surgeon aside, he said; “you should come to England” and offered him a professorship in surgery at London University. Despite the Mayo brothers protesting vehemently, Moynihan’s offer was too good to refuse and in November 1929, the ambitious young New Zealander left the security of the Mayo Clinic and sailed for greener pastures.

The Damp Streets of London

But McIndoe had been misled by Moynihan. There was no professorship in surgery at London University. Furthermore, when he called on Moynihan at his London residence, the great English surgeon denied that he had ever offered him a position. Showing him to the door, he stated rather indifferently; “Something good will turn up”.

McIndoe was beside himself. He had nowhere to go. He had severed his ties with the Mayo Clinic and his American qualifications were of no use to him in England. For the next few hours he walked the damp streets of London and eventually ended up at the zoo. Recalling what seemed like a nightmare, he wrote; “I thought the animals should be paying to see me. There wasn’t an animal in the whole zoo that wasn’t a bigger freak than me!” It was at this point that he pulled a piece of paper from his pocket. It was a letter from his mother. She had developed a passion for genealogy, and having heard that her son was going to England, she had written to him insisting that he look up a distant cousin from New Zealand — a plastic surgeon by the name of Harold Gillies.

The Damp Streets of London, 1920s

The Greatest Partnership in 20th Century Surgery

Gillies — born in Dunedin in 1882, educated in Wanganui and Cambridge — is possibly the greatest figure in New Zealand medical history. He was the first person to apply plastic surgery techniques to the horrific types of injuries that the battlegrounds of WW1 were producing. Gillies single-handedly created Britain’s first plastic surgery unit at Aldershot Hospital during World War I and is generally regarded as the man who “invented plastic surgery”. When McIndoe was greeted by Gillies at his Queen Ann Street practice, he would not have known then that this famous figure was about to become his mentor and one of the greatest medical partnerships was about to commence.

Gillies and McIndoe, the greatest partnership in 20th Century surgery

Touched by McIndoe’s “tale of woe”, Gillies was more than happy to help out his cousin and using his influence, he got McIndoe a temporary position at St Bartholomew’s Hospital (London). McIndoe stayed in this position for less than a year, obtained his British qualifications — at typical breakneck speed, and was subsequently made a member of the Royal College of Surgeons. Using his influence again, Gillies put McIndoe forward for another position, this time as lecturer at the Hospital for Tropical Diseases. McIndoe was successful but he soon became disgruntled with this position; “teaching students was a chore and a bore” he said, and furthermore, there was no outlet for his considerable talents. It was therefore a godsend when Gillies offered to take him on as his partner at his new Harley Street practice, thus beginning what has been described as “one of the greatest partnerships in twentieth century surgery”.

From 1931 to 1939 the two New Zealanders did hundreds of operations together. They also devised new techniques and pioneered what is more commonly known today as cosmetic surgery. Face-lifts were a specialty but Gillies also pioneered a breast reduction technique which McIndoe helped perfect. In 1938 they published their first joint paper on this technique and that same year McIndoe rocked the medical fraternity when he published his own paper entitled; “An Operation for the Cure of Congenital Absence of the Vagina”. Pioneered by McIndoe, this operation was later perfected and unabashedly named “McIndoe’s Vagina”.

During the early years it was Gillies who did most of the work. However, by 1938, Gillies was forced to concede that “the tail was beginning to wag the dog”. By Gillies’ own estimate, McIndoe had become; “a first-class plastic surgeon”, and was now receiving more referrals than the older man. As had been the case at the Mayo clinic, his popularity was due in large part to his natural charm and social skills. Indeed, this charm is reflected in the following poem which was published at the time in a book entitled “The Plastic Surgeon; Its Habits, Diet and Behaviour” (1938);

“The kindest man I ever knew
Was A H McIndoe
His eye was mild, his heart was tender,
Of damaged faces he was mender.
Alas, his quite peculiar charm
Became a source of some alarm.
For patients far from getting bored
Refused to own that they were cured,
And when he told them to get up
Would promptly ask him out to sup,
Or murmur in his burning ear
‘Okay we’ll go together, dear!’
Till strained relations vowed to stew
Th’insinuating McIndoe.
Weeping to see them mope and suffer
He thought ‘I really must be gruffer’.
And so he thought to steel his mind
In theatres of a different kind …
No more he holds the fevered hand,
But pokes them in the belly-band;
Tears off their dressings and their skins
And parks his forceps on their shins.
You’d fancy this would make them sore?
They only worship him the more,
And Harley Street is one long queue
Of fans in wait for McIndoe.

Gillies could not match McIndoe’s charisma. Nor could he match his cousin’s quickness; “His cousin could accomplish with a few bold scalpel strokes what would take the older man an hour to think about.” But it was Gillies who had taught McIndoe the art of plastic surgery, and as noted by one observer; “Gillies, more than any other single influence, was the man that made the McIndoe who became known during and after the war.”

Indeed, following the outbreak of World War 2, Gillies recommended that McIndoe succeed him as Plastic Surgeon to the Royal Air Force. Unaware that this position would ultimately thrust him into the forefront of plastic work, McIndoe accepted but with one proviso; that he remain a civilian rather than become a commissioned officer. The Royal Air Force pressed the issue for more than a year but McIndoe stood his ground and in April 1939 it finally yielded to his request, giving him the title of “Civilian Consultant”. His rejection of a commission would turn out to be a brilliant slight of hand, enabling him to eventually challenge the military and its outdated medical practices.

A Burning Issue

Upon being made Civilian Consultant, McIndoe set up a plastic surgery unit in an old country cottage at Queen Victoria Hospital, East Grinstead. In the months that followed, it became clear that Queen Victoria Hospital would deal with the bulk of British air casualties. However, these casualties were like nothing seen before. Most of them were young men, some as young as 17, burnt beyond recognition after being trapped in the cockpits of their fighter planes. Often described as “faceless”, the severity of their burns could not be overstated. Ben Bunions, who was brought to McIndoe in 1940 recalls the horror of seeing his first badly burnt airman; “I’d never seen anything like it before. He came towards me, propelling his wheelchair and, as he got closer, I saw that his hands were badly burned and his feet as well. And his ears and his nose. His whole face. It was terrible.”

Although McIndoe was able to make these men new faces, he knew that they would never look normal again. Furthermore, these men were highly educated and career oriented. He might have seen some aspect of himself in them and being only too aware of his own struggle to succeed, he wondered how these young men would cope; “How were they going to work? To eat? How were they going to attract a pretty girl? How were they going to manage courtship, making love”. These questions began to consume McIndoe.

The old Queen Victoria Hospital © Queen Victoria Hospital NHS Foundation Trust

A Saline Solution

Nevertheless, as McIndoe began to treat these young men, a clear and effective strategy emerged. As noted by Peter Williams, this strategy was essentially “two-pronged”;

“He [McIndoe] would, on the one hand, reconstruct a patient physically. The process was slow, with each operation producing a marginal improvement. On the other hand he was preparing the patient for a life in which some degree of disability or disfigurement was an inescapable fact. The treatment finished when the patient himself decided that he was happy to try to cope with life with what he had.”

Reconstructing the patient physically, however, presented a major challenge. There had only been small advances in general surgery between the two world wars and the methods being used to treat badly burnt people were somewhat primitive. Of greatest concern to McIndoe was the medical professions use of tannic acid. McIndoe had good reason to believe that this treatment was doing more harm than good and his suspicions were confirmed when a young fighter pilot by the name Richard Hillary arrived at Queen Victoria Hospital.

Hillary was destined to become a legend but when he was wheeled into McIndoe’s surgery, he was completely covered in tannic acid. The acid had coagulated thus immobilising his fingers and toes. His eyelids had also stiffened and it looked as if he would be permanently blind. Fortunately, McIndoe’s nurses were successful in removing the solution with lukewarm brine and the young pilot was eventually able to see again. But McIndoe was shocked by what he had seen! Laying down his scalpel he began writing letters, firstly to his superiors in London and then to the War Wounds Committee demanding that tannic acid no longer be used as a treatment.

The challenge facing McIndoe was to find a suitable replacement. At the time, a number of badly burnt airmen had come to him via the Atlantic. These young men appeared to be in better shape than those who had ended up on dry land. The salt water, it seemed, had in some way benefited them. They appeared to be in less pain, their burns were cleaner and it was easier for the surgeon to graft on new skin. Ingeniously, the New Zealander translated these observations into an idea; ‘the saline bath’. Patients, he reasoned, could be lowered by stretcher into a salty solution and receive the same soothing benefits afforded to them by the ocean.

To the Forefront of Burns Treatment

McIndoe’s original conception of the saline bath had to undergo some major modifications before it was of any use. For example, it was discovered that the saline solution needed to be slightly higher in temperature than blood heat. In other words, considerably warmer than the English Channel! Furthermore, the salinity of the water had to be kept at a constant level, a phenomenon that does not occur naturally in the waters around Britain. In sum, McIndoe’s prototype was nothing like the Atlantic Ocean but it was nonetheless a success and within a few months saline had completely replaced tannic acid as a treatment.

Airman being treated in one of McIndoe’s Saline Baths © Queen Victoria Hospital NHS Foundation Trust

McIndoe’s saline bath literally placed the plastic surgeon at the forefront of burns treatment. Prior to its introduction, the burns victim was the sole responsibility of the general surgeon. The plastic surgeon was only called in to cover or remove ugly scars after the tissue had healed. Incidentally, although saline has been replaced by more effective solutions, it is a legacy of McIndoe’s brilliance that the bath or ‘burns tank’ is still being used as a treatment.

While the saline bath made McIndoe’s job easier, making the patient a new face proved to be a long and arduous task. Some of his patients required more than 70 operations over a period of several months’ – sometimes years. During that time numerous skin grafts were undertaken, noses replaced, eyelids reformed, and facial features (chins and cheek bones) re-established. However, it soon became apparent to McIndoe that the physical pain of having to undergo one operation after the next was no more gruelling than the mental anguish that each patient had to endure. In a somewhat sombre note, McIndoe wrote;

“The impact of disfiguring injuries upon the young adult mentality is usually severe. They are usually unprepared mentally for the blow [of disfigurement], so that for a period they may be psychically lost, depressed, morose, pessimistic, and thoroughly out of tune with their surroundings.”

Burnt airmen of Ward III undergoing face and nose reconstructions © Queen Victoria Hospital NHS Foundation Trust

Pioneer of the World’s First Therapeutic “Community of People”

Initially, it had not been McIndoe’s intention to address his patients’ mental state but his antipodean manner soon turned out to be the perfect antidote. The shift from cold, clinical professionalism to mate-ship and egalitarianism came naturally and as such, he had no qualms about supplying his patients with beer, joining them for a drink, or having them sit in on operations. Even getting their opinion on what they thought should be done was not below him. Ward III, McIndoe’s maxillofacial unit, was laid back and literally devoid of a single rule. In the words of patient Alan Morgan; “It resembled a big comfortable hotel. It was mad; everybody was doing their own thing. There was a big barrel of beer at the end of the ward and you could help yourself”.

McIndoe’s patients were allowed to watch operations © Queen Victoria Hospital NHS Foundation Trust

Indeed, McIndoe’s patients were free to do whatever they wanted as long as their behaviour did not interfere with the well-being of others. In addition to generating an atmosphere of camaraderie and mutual responsibility, this laissez faire approach helped to counteract the despair of disfigurement. As noted by patient Bill Simpson, they all felt like brothers in misfortune; “A community of people who all, and were all suffering in the same way [and hence] cheerfulness invaded the consciousness of even the most unreceptive patients”.

As a “community of people”, McIndoe’s patients became more responsible for themselves and one another. Australian fighter pilot Geoffrey Page recalls that;

“If someone was incredibly ill, you didn’t disturb them. It was an unwritten law that you left him alone and if the ward sister or nurse said, ‘look he’s having a hard time’, we tiptoed around. But the moment he was alright, we’d pour beer over him. That was part of the rehabilitation process.” Meetings were regularly convened to ensure that they had their say on issues affecting them and McIndoe would keep them up to date on their own and each other’s progress. A group of long-term patients would act as guides or escorts for new patients; “wheeling nervous first-timers on their trolleys into theatre to give them courage”. E. H. Mayhew has noted that; “the spirit of Ward III became a therapeutic agent in itself.”

It would be some time before a similar “community of people” were established in a hospital outside of East Grinstead. An almost identical regime would later be formalized at nearby Belmont and Northfield hospitals to help returned servicemen recover from the psychological effects of war. Army psychiatrist Tom Main would later coin the phrase “therapeutic community” to describe it, while he and Maxwell Jones would largely be credited with starting it – more than three years after the establishment of Ward III

From Ward III to the East Grinstead Community

Perhaps the hardest task confronting the New Zealander was getting his patients out of Ward III and back into the community. They were, after all, extremely disfigured and the thought of showing one’s face in public was a daunting prospect but McIndoe had a plan. In a move reminiscent of a modern day social worker, he ventured into the East Grinstead community, his first port of call being the local pub. Here he began talking to people about the work going on at Queen Victoria Hospital and the condition of his patients; “They must not be treated or even looked at as abnormal”. “Talk to them” he said and “take them into your homes”.

The New Zealand born maestro was on a mission to mobilise the resources of an entire community; to literally move his brand of therapeutic community into the streets of East Grinstead and the hearts of its people. The scope of this mission was breathtaking to say the least and as E H Mayhew has pointed out, it was McIndoe himself who;

“Addressed local worthies, hosted seminars and lectures at the hospital [for the towns people], and arranged concerts and sporting events in the grounds. He prevailed upon the ladies of the larger houses in the town to visit the ward and its patients, to provide fresh flowers on a weekly basis, and to act as ambassadors for East Grinstead’s population at large.”

Of course, the sheer scale of McIndoe’s work meant that he could not do everything himself. So he employed people who were able to take on more than just one role. Orderlies for example would not only wheel patients around ward III but accompany them to pubs, clubs and restaurants. Nurses would not only dispense medicine but encourage locals to open up their homes. Physical Education Trainer, Edward Blacksell took on the role of “welfare officer” advising the men on social and financial matters. He was also instrumental in helping set up community workshops.
Workshops were set up to assist with future employment and local businesses were encouraged to help teach McIndoe’s patients new skills. As noted by one observer, many of McIndoe’s patients were involved in high-tech manufacturing, including the manufacture of aircraft instruments. Most of these jobs had a therapeutic value, for example, by helping patients rediscover how to use their badly mutilated limbs. Often undertaken between operations, this approach to helping the patient cope with their disability was not unlike modern-day occupational therapy. Nonetheless, according to E.H Mayhew; “the last piece of the burn treatment infrastructure” was not the East Grinstead community but the now famous ‘Guinea Pig Club’.

The Guinea Pig Club: The Unique Spirit of the Patient Community

Plaque outside the Guinea Pig Pub, named in honour of the club (c) Queen Victoria Hospital NHS Foundation Trust

As “the last piece of the burn treatment infrastructure”, the Guinea Pig Club formalised the relationship between McIndoe and his patients. The club was not McIndoe’s idea but he strongly endorsed it and in 1943, he became its first president. It was originally called the “Maxillonians Club” after McIndoe’s maxillofacial unit but this name did not last long. A patient who was being wheeled into surgery, yet again, shouted out jokingly; “We’re nothing but a plastic surgeons guinea pigs.” The term “Guinea Pig” quickly gained traction and less than a year after the club had been formed, its name was changed accordingly.

As membership grew and as each airman left East Grinstead, “happy to try to cope with life with what he had”, the club became more than just a name. Regular get-togethers were organised to ensure that the “spirit of Ward III” continued; a welfare fund was set up to help out needy members; and the club assisted the men in finding employment. Indeed, the club protected the dignity of the burnt airmen by ensuring that their “other face” was not compromised, as they began to seek their place in society again. According to founding member Tom Cleave;

“The biggest single achievement of the Guinea Pig Club is to have helped every member to save his face. His “other” face, that is, in a psychological sense, so that he could securely take his place once more in society.”

A Guinea Pig reunion, with the ever sociable McIndoe at the piano © Queen Victoria Hospital NHS Foundation Trust

Over the years, the Guinea Pig Club has been the subject of numerous books plays and documentaries. The club’s history, its members and their antics have been well documented. However, the Guinea Pig Club was more than just a support club for badly burnt airmen. It was, as E.H Mayhew has so astutely put it; “an attempt to institutionalise the unique spirit of the patient community”; to ensure that this spirit would continue over time, in the absence of McIndoe and outside of East Grinstead.

The “unique spirit” of Ward III did continue over time and well beyond the confines of East Grinstead. Membership continued for than 60 years across 19 countries and 5 continents. Amazingly, McIndoe’s Guinea Pigs gathered for the last time in October 2007 by which time worldwide membership had dwindled from over 600 to just 96. Nonetheless, the Guinea Pig Club had served its purpose by enabling the burnt airman to “take his place once more in society” and this was never more evident than the success that he forged for himself after leaving East Grinstead.

The Guinea Pig Pub, East Grinstead © Queen Victoria Hospital NHS Foundation Trust

In one way or another, all of McIndoe’s ‘Pigs’ were successful just by virtue of the fact that they were able to face the world again and live normal lives. However, some stood out more than others. Noel Newman, whose hands had been badly damaged, went on to pursue a career in community medicine and eventually became Deputy Medical Officer of Health. A badly disfigured Bertram Smith returned to Queen Victoria Hospital but this time as a fully qualified surgeon and ended up being trained by McIndoe in the art of plastic surgery. RAF cameraman Jimmy Wright pursued a career in film production, despite being totally blind and went on to produce a string of successful television documentaries. Others, such as Richard Hillary and Geoffrey Page went on to became World War II aces, while Tony Hodgkinson ended up flying Vampire jets as the world’s only legless test pilot.

The Last Guinea Pig Reunion 2007 © Queen Victoria Hospital NHS Foundation Trust

There were many other Guinea Pigs, too, who left an indelible mark on the world and their stories have been well documented. But their success, confidence and will to succeed, is owed entirely to the effort and courage of one man. That man was known as the “Chief Guinea Pig”. He was also known as “The Boss”, “The Maestro” and “God”. He not only rebuilt their faces but also their lives. New Zealander Archibald McIndoe took his unique treatment plan from the theatre to the ward and from the ward to the community. He was instrumental in institutionalising the “unique spirit of the patient community”, thus making his guinea pig stock outstanding members of their own societies.

The legless Colin Hodgkinson being lifted into the cockpit of a Vampire Jet

Fame & Fortune

By 1946 Ward III was winding down and the burnt airmen were returning home. The New Zealander who had dreamed of being “more than just an ordinary doctor” had become more than just an ordinary surgeon; he had become the world’s leading plastic surgeon and his star was shinning brighter than ever. Indeed, McIndoe made the front page of several publications including TIME magazine’s September 1948 edition under the heading; “The Man Who Makes Faces.” His appearance in TIME coincided with a lecture tour of the United States and a visit to the Mayo clinic where, 19 years earlier, he had begun making a name for himself as a stomach surgeon. By this time he was ‘Sir Archibald McIndoe’, having been awarded a knighthood in 1947 “for his remarkable work on restoring the minds and bodies of the burnt young pilots of World War II”.

With fame came new opportunities and now that the war was over, McIndoe made no secret of his desire to make money. Turning his attention to cosmetic surgery, he opened his Harley Street practice to patients of a different kind; wealthy actors, models, princes and princesses who were seeking to look increasingly more beautiful. His clients included Kay Kendall and Ava Gardner (actresses), the Duchess of Windsor, and the granddaughter of Queen Victoria. He could even claim an Indian prince; the “Maharajah of Rajpipla”.

Actress Ava Gardner

By the late 1940s, “he was earning money by the fistful” but this success had come at a great price. As consultant plastic surgeon to the Royal Air Force, he had worked 15-hour days, 7 days a week, without a break for more than 6 years. He had gained little in the way of financial reward and his marriage had suffered miserably. The burden of responsibility had been great and as noted by his biographer, Hugh McLeave, this burden became even greater after the war;

“Long hours of operating at the Clinic, at East Grinstead and at several other hospitals filled his day. His nights were often mortgaged to work on behalf of the Guinea Pig Club, his rehabilitation schemes, his committee work, or meeting people who might help with money or support.”

Sir Archibald McIndoe © Queen Victoria Hospital NHS Foundation Trust

Tired and overworked, McIndoe purchased a farm in East Africa where he began taking lengthy breaks in order to convalesce but his work-load did not decrease, and the physiological effects of stress were becoming increasingly more apparent. Exploratory surgery for stomach cancer was followed by the removal of his gall bladder and in 1958, a rigorous examination revealed a “diaphragmatic hernia” and mild angina. Two years later, he sailed with his wife to Spain where a delicate operation on one of his eyes was carried out in order to save his sight. The man who had expended so much energy in pursuing his dream of being “more than just an ordinary doctor” was now feeling the ill-effects of a life lived at pace, and on the flight back from Spain he suffered a mild heart attack. Although he was able to walk off the plane without any apparent difficulty, a picture taken at the time shows him looking much older than his 58 years.

On the 12th of April 1960, less than 6 months after returning from Spain, McIndoe died in his sleep. Sadly, he never made it back to his native New Zealand but for him, the most symbolic part of that nation had been living nearby since 1945. His mother had decided to settle in England and McIndoe had arranged for her to live in a cottage on St. Johns Road (East Grinstead) which they named “Aotearoa” — McIndoe’s reverence for his mother and his country were never in doubt. After her death in 1951 he wrote; “she knew me as no other woman has ever done. I shall miss her more than I can say.” Indeed, it had been the hand of fate delivered in a letter from his mother on that damp day back in 1937 which had been so instrumental in establishing him as one of the world’s greatest plastic surgeons.

“All patients were people”

A tribute to McIndoe, his life and person is offered by Guinea Pig Russell Davis. In summarising the essential traits and principles that made McIndoe who he was, Davis stated;

“I believe that McIndoe’s greatest quality was that of courage. And it was displayed in so many ways. The fact that he left the assured success of the Mayo Clinic as and when he did displayed courage. The fact that he successfully went against the trends of the times and refused a commission in the RAF showed courage. McIndoe believed that continuous care should extend, directly or indirectly, from the moment of injury, to the point at which the injured person re-entered society — and beyond. And so, whatever he had done before, from the time that he came to East Grinstead, he pursued these objectives quite without thought of the consequences to himself. He spearheaded the efforts to make society — at least some society — aware of patients as individuals. While McIndoe foresaw that there might be individual problems, in some ways he never understood some of those problems. For to him, all patients were people and he never differentiated between people.”

Related posts

‘The Guinea Pig Club’ film in the works on Kiwi plastic surgeon Sir Archibald McIndoe – March 2016

‘McIndoe Sculpture Unveiled’ April 2013


Books and Written References:

McLeave, Hugh (1961). McIndoe: Plastic Surgeon. Frederick Muller Ltd, London

Mosley, Leonard (1962). Faces from the Fire. Weidenfeld And Nicolson, London

Williams, Peter; Harrison, Ted (1979). McIndoe’s Army, The injured airmen who faced the world. Pelham Books, London

Mayhew, E. R (2004).The Reconstruction of Warriors: Archibald McIndoe, the Royal Air Force and the Guinea Pig Club. Greenhill Books, London

Manning, Nick (1991). Maxwell Jones and the Therapeutic Community Movement: A Sociological View. The International Journal for Therapeutic and Supportive Organisations, 1999, Volume 12: Numbers 2 and 3, pp.83-97

Pound, Reginald (1964). Gillies; Surgeon Extraordinary. Michael Joseph Ltd, London. Whitcombe & Tombs, New Zealand

Pines, Malcolm (1999). Forgotten pioneers: The unwritten history of the therapeutic community movement. The International Journal for the Therapeutic and Supportive Organizations, 1999, Volume 20: Number 1.

Internet References:

Nichol, Brian (2000) Bion and Foulkes at Northfield: The Early Development of Group Psychotherapy in Britain, The Business Coach Institute

Campling, Haigh, Douglas (1997). Canadian Society of Plastic Surgeons – ‘Tribute to our founders’. The Canadian Journal of Plastic Surgery, 1997, Volume 5, Number 1.



Tags: Archibald McIndoe (Sir)  burns treatment  Doctor  Plastic surgery  Surgeon  

  • Armando Chan - 1:52 am on August 13th, 2022
    Great information shared.. really enjoyed reading this post thank you author for sharing this post .. appreciated
  • Joyce Evelyn Gillam nee Hampson - 3:48 pm on November 22nd, 2015
    I am 87 years old but have always been interested in Archibald Mc Indoe mainly because of his Plastic Surgery. Having just read his life story - below - I think he was a wonderful man and fully accepted that not only was the burns or injuries important but so was the mind. I have only had one Plastic Surgery done and that was only because my nose had been broken 3 times and was affecting my sinuses. First broken nose happened in Birmingham General Hospital in UK, this was after a test had been done and blood taken. Next thing I knew was being on a trolley being wheeled to the X Ray Department. I was offered Plastic Surgery because I should not have been left alone, I being so young and scared said No, perhaps he may have been the one to operate as I think he was visiting the Hospital at the time.
  • Julia O'Neale - 8:00 pm on October 24th, 2013
    I was badly burnt aged 11 months old in 1947. in ESSEX England this great man saved my life in the Great Ormand street hospital .Little did I know that I would many years later become a Kiwi. On reading your article I remembered the saline baths which were part of my skin grafts in later years and the wonderful attitude to life he left me with a truly great man
  • Craig - 5:30 pm on September 20th, 2001
    "Your list of New Zealand heroes is impressive, and I would like to add three more names; Harold Gillies',CBE, FRCS (1882-1960), Archibald McIndoe M.B, ChB, F.R.C.S (1900-1960), and William Alban Phillips, PhD (1914-1975). These are three New Zealanders that have left their marks on the world. Gillies for example is considered the founding father of modern plastic surgery. Although his specialty was facial plastic and reconstructive surgery, Gillies' interests included microvascular surgery, and the reattachment of amputated limbs. His maxim of "never throw away anything until you are sure you do not require it" is followed in all fields of plastic surgery to this day. McIndoe was the cousin of Harold Gillies and was also a pioneering plastic surgeon who worked primarily with WWII burns victims, particularly fighter pilots. It was McIndoe who made the connection between the recovery rate of burns victims who had fallen into the sea and the concept of saline baths for burns victims. Prior to that an oil solution was used on their burns. Finally, William Alban Phillips' area of expertise was economics. He is best known for his infamous 'Phillips Curve' which models a trade-off between inflation and unemployment. You will not find any modern economic text that does not have a section on the Phillips Curve. Needless to say, Phillip's model has influenced the economic policy of countless governments throughout the world, yet few New Zealanders have ever heard of him." Craig Wellington, New Zealand
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Sydney Smith

Sydney Smith

“A New Zealander, he came to the famous Chair of Edinburgh, took ‘time off’ to organize a medico-legal system and Institute in Egypt then returned to Edinburgh to add to his…

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