William Stephen Wren: William Stephen Wren, who has died aged 77, was the father of children's anaesthesia in Ireland and hundreds of adults today owe their survival to his skills and commitment.
Bill taught scores of trainee anaesthetists, now scattered all over Ireland and the rest of the world, how to care for critically ill infants and children so that the real number of those who owe their lives to the work of this admirable professional is in the thousands. He died in Dublin on August 11th.
He was born in Dún Laoghaire (he was very proud of being from the borough) on July 21st, 1929, the younger son of Tom Wren, an engineer, and Josephine Wren, née Barry, a member of the distinguished Cork tea merchant and political family. He attended the Christian Brothers school in Dún Laoghaire and then went on to UCD. He graduated with an MB from UCD in 1952.
In the 1950s, almost every young Irish doctor went to England on qualification. There were no jobs and no future at home. He worked firstly in Dover and then began anaesthetic training in London working at the Whittington Hospital, Archway, north London, a huge, understaffed, under- resourced London County Council hospital, to which the locals had given the uncompromising nickname "Feet First".
He worked at Whipps Cross Hospital but his appointment to the Royal Postgraduate Medical School at the Hammersmith Hospital really sealed his decision to pursue a career in anaesthesia. The Hammersmith was the top rung on the training ladder of the time. He took the diploma in anaesthesia (London) in 1954.
In 1956 he returned to Ireland as consultant anaesthetist to Sligo General Hospital. Within a year he was appointed to the newly opened Our Lady's Hospital for Sick Children, Crumlin, Dublin, where he was to spend the next 37 years (1957-1994).
At that time there were no dedicated children's anaesthetists in the country. There were many reasons for this but it was perceived that the field of children's surgery was really limited and likewise children's anaesthesia. There was also the issue of income.
Much of the argument for a new speciality was to ensure better care for the newly born but at the time consultants were almost entirely dependent on private practice. As one hard-headed jaundiced, obstetrician said: "When they have paid the accoucheur they haven't got a sous left".
Bill Wren was a superb anaesthetist. Early on he gave up to 2,500 anaesthetics per annum when the recommended quota was 800. He was on his own then - there are now nine consultant anaesthetists at Our Lady's. He set up an attractive training scheme, which drew in really good applicants, and almost all rotated through his own department. Organising training programmes required a lot of work and tact and there was no payment of any kind for the effort involved.
There was no academic infrastructure. Perhaps it was here that Bill Wren was at his pro bono best and the programmes are perhaps his most visible monuments. He then turned to research and was involved in several useful, durable trials of newer anaesthetic agents. Two publishers offered him contracts to write books on paediatric anaesthesia but he said he could not find the time.
He was deeply involved in the setting up of the faculty of anaesthetists (founded 1959) and at 44 he was easily the youngest dean when elected for 1973-1976. He was made an honorary fellow of the Royal College of Anaesthetists London in 1976. Later the section of anaesthetics in the Royal Academy of Medicine in Ireland set up a unique biennial lecture in his name.
Intensive care may well have been the biggest advance in medical practice in the latter half of the 20th century and Bill Wren created the country's first unit for children at Our Lady's. Long, complex operations became safe. Open-heart surgery in children using surface cooling began in the 1960s and heart-lung bypass in the early 1970s.
This placed a huge burden on the anaesthetic services to which he responded with his customary professionalism.
In the 1980s the Department of Health recruited him as medical adviser. It was a unique appointment recognising the man himself and the central role of anaesthesia and intensive care in modern medicine.
Handsome, of medium height, the word elegant is the one that repeatedly comes to mind. Immaculately turned out, he always seemed to have just had a haircut. This elegance was transferred to his practice where he made much that was difficult look simple.
He had a great choice of words and an attractive speaking voice. At times there was a touch of the grandee in his manner but he had a genuine sense of humour, a quality that is not as widespread in Ireland as is frequently claimed.
He epitomised one of his favourite quotations from Hemingway who defined courage as "grace under pressure". Earlier he had been a competitive swimmer.
The cheroots struck back and when a small cell cancer of the lung was discovered in the spring it had already spread elsewhere.
He was a great family man. In 1955 he married his college sweetheart Dr Maev Wren née McGrath, daughter of Dr Donnie McGrath, a Dublin graduate who was an anaesthetist in Kent, and Isabelle Teulon.
This was a wonderful, loving partnership. They had five children, all university graduates, Frances, Maev Ann, Kevin, Johanna and Anne.
Bill Wren changed things greatly for the better in a significant sector of Irish medicine. In our conservative society his was a big achievement. Ireland was lucky to have him.
Bill Wren, consultant anaesthetist: born July 21st, 1929; died August 11th, 2006.