Obituary - Colonel James McEwan

One of the great unsung British heroes in the field of chronic pain management is my ex-Army boss and mentor, the late Colonel James (‘Jimmy’) McEwan. He took me under his wing shortly after I was appointed Consultant Anaesthetist in the Royal Army Medical Corps in 1979 and encouraged me to become actively involved in the specialty of chronic pain therapy as it used to be called in those far-off days!

Jimmy, based at the then Queen Elizabeth Military Hospital in Woolwich, S.E. London, founded the first chronic pain relief clinic for the Armed Forces in the mid-seventies and was also involved in teaching John Wedley, Consultant Anaesthetist who then ran the Pain Clinic at Guy’s Hospital. He was close friends and often co-operated with John Lloyd, Sam Lipton, and Mark Mehta who all occupy a special place inthe pantheon of our early British chronic pain heroes.

It was Jimmy who insisted that I join the Intractable Pain Society, which I did in 1980. I remember those early IPS meetings very fondly, especially the joint meetings held with the Dutch Pain Society, which Jimmy and I used to attend on a regular basis. It was then that we both formed a lasting friendship with the late Dr. Menno Sluijter, another ‘great’ in pain management. Jimmy encouraged me to carry out research on the use of radio frequency in lumbar facet joint pain and to present my results to the British Back Pain Society.

I distinctly recall the both of us, in the early eighties, implanting a ‘home-made’ spinal cord stimulator, constructed to Jimmy’s specifications, by our medical physics department, before the technique became widely accepted. He pioneered the use of thermography for chronic pain diagnosis and taught many young consultants the techniques of the then in vogue, trans-sphenoidal pituitary alcohol injection, of cervical cordotomy, various radio frequency procedures, cryotherapy, acupuncture as well as the safe use of neurolytic agents. Those were the days where any consultant could receive paperwork-free, hands-on teaching, from any experienced colleague in any hospital he or she cared to visit.

He was actively involved in the development of the early RF machines and in the testing and perfecting of TENS machines for various companies. He delivered a seminal presentation on TENS at the very first IPS meeting I attended in Oxford, which earned him a standing ovation. He was also a pioneer in the computerisation of pain relief records and indeed taught me how to use a computer in those far off days of green screens, blinking cursors, and floppy discs! I remember him also being very involved, together with a biochemist whose name now escapes me, in attempting to locate blood markers as an indication of the measurement of pain. He always preferred intervention treatment as opposed to filling patients with strong opioids. When it came to musculoskeletal pain, he advocated a system of close cooperation with both the orthopaedic and physiotherapy departments. He was always full of energy and brimming with ideas. With Jimmy, there was never a dull moment!

The Chronic Pain Clinic at the Queen Elizabeth Military Hospital rapidly acquired both a national and international reputation with doctors coming from all over the world to be taught by Jimmy. We had a very large civilian patient intake as many patients preferred to be treated in a military rather than in an NHS hospital.

He was very interested in the psychology of pain and taught all to respect this concept but always to remember that it was not the be-all and end-all of pain management. We had several ex-FEPOWs (Far Eastern Prisoners of War) as our patients. They had suffered heavily at the hands of the Japanese in WW2 and many still carried the physical and psychological scars of their ordeals with somatised chronic pain problems. It was not easy to get them to talk, but Jimmy managed to persuade them to open up to him. He was a very compassionate humanbeing and instilled this sense of compassion into all the many doctors he taught.

He was also an excellent Consultant Anaesthetist, who eventually became the Head of Anaesthetics in the British Army. (Consultant Advisor in anaesthetics to the DGAMS). He was, for a time, a co-opted member representing the Armed Forces on the Council of the Association of Anaesthetists, which he had joined as a member in 1973.

Due to an unfortunate falling-out with the powers that be, he was denied the well-earned rank (and pension) of Brigadier, then customary for the position of Consultant Advisor in anaesthetics. He left the RAMC in 1986 on reaching the compulsory retiring age of 60 years, handing the running of the Pain Clinic over to me. Jimmy then promptly went off to the  British Military Hospital in Hong Kong as a civilian practitioner to continue his work in both anaesthesia and chronic pain management! He returned to the United Kingdom and finally retired from clinical practice in 1990. Together with his wife he moved back to Scotland, settling in Fife, in 2006.

Born in Glasgow on 5 January 1927, he qualified in Medicine from the University of Glasgow in 1949. After completing his national service, he received a regular commission in the RAMC in 1962 and obtained the FFARCS in 1973. He was an accomplished organist, a member of the Order of St. John, an active member of the Church of Scotland and very devoted to his wife, Dorothy, whom he married in 1953, and to his two daughters, Joan and Gillian, both of whom became nurses in the NHS.

When, in 1994, John Wedley and I jointly published our book ‘Handbook of clinical techniques in the management of chronic pain’, we dedicated it to Jimmy, with these words . . .

‘To Colonel J. McEwan, who taught us both so much during
the early years of our careers in the field of pain relief therapy,
we dedicate this book’.

We both received a letter of thanks from him for this dedication.

He passed away on 24 December 2012, in Scotland at the age of 85. His wife predeceased him by just under a year.

Our specialty owes him a great deal. Those of us lucky enough to be taught by him will never forget him.

Dr Charles A Gauci Lt. Colonel RAMC (Retd)