Obituary - Dr Ralph Stephens Vaughan

Ralph was born in Morriston, Swansea growing up with his brother Denzil in a bilingual household in Glais. He attended Middlesex medical school where his desire to succeed academically was matched by his passion for sport; many a tale is told of his exploits in the various rounds of the Hospitals Cup and its related 'aprés rugby' activity! Despite his sporting prowess, Ralph was clearly no academic slouch as witnessed by his appointment as House Physician to the Professor.

Sport remained a large part of Ralph’s life, playing rugby for Glais RFC and London Medical Schools, and later regularly playing squash and swimming at the Sports and Social Club.

Ralph qualified in 1966 and following house officer appointments, set about deciding on a specialty.  A two-week placement in an inner-city South London clinic persuaded him Gynaecology was absolutely not for him and he found his calling in Anaesthetics. One suspects that like most of us, time has dulled his recollection of the exact reason behind such a decision but early contact with some of the doyens of anaesthesia almost certainly influenced him. His first posts were as SHO and later registrar in South-East Essex where he came under the tutelage of Drs J. Alfred Lee and Dick Atkinson in Southend; not a bad early example.

After a few years of sampling the Essex life, Ralph returned to his beloved homeland and joined the department in Cardiff working under Bill Mushin, again not a bad influence for an up-and-coming anaesthetist. He rose through the ranks of senior registrar and lecturer, being appointed consultant in 1973. Under the influence of the Cardiff heavyweights: the two Bills (Mushin and Mapleson), Mike Rosen and John Lunn, Ralph developed his academic, clinical and medico-political skills.

From early in his career, Ralph had involvement with the Association of Anaesthetists, being Honorary Secretary to the then Junior Anaesthetists Group from 1969-72. With his appointment as a Consultant, he continued his links with the Association becoming the guru behind the trade exhibition at the Annual Scientific Meetings. Much of the success of our current relationships with industry is based on Ralph's hard work in making all exhibitors feel important and part of a big family. Sadly, such important behind-the-scenes work seldom receives the recognition it deserves. Election to the Council of the Association allowed Ralph to bring his unique slant onto many important issues. Ralph always held strong views and was not afraid to air them; he was respected by all as a man of principle. His qualities were recognised by his colleagues on Council, and he was elected to the office of Honorary Secretary from 1992-94. His value to the Association was further recognised by his subsequent appointment as Vice President.

Not content with his enthusiastic involvement with the Association, Ralph was elected to the Council of the Royal College where he rose to be Vice President in 1999. During his time on Council, he held several key roles including Chairman of the Examinations Committee. Few people have been so successful in working in the two bodies for the unity of anaesthesia – and I suspect even fewer have served as Vice Presidents of both.

Most of Ralph’s research revolved around practical Airway Management. He stated in an Anaesthesia editorial in 1989 that " ... it is of paramount importance that anaesthetists learn to use a fibreoptic bronchoscope competently”. This summarised many years of research and teaching on the practical management of the difficult airway. The transition from what was a fibreoptic intubation meeting to a broader difficult airway meeting occurred in 1995, stimulated particularly by a chance meeting between Dr Adrian Pearce and Dr Ralph Vaughan on a plane from Edinburgh to London. These two were prominent in the development and running of airway management courses at Guy’s Hospital in London and University Hospital of Wales in Cardiff respectively. Ralph was a founder member of the Difficult Airway Society with Adrian Pearce and also the first Chairman of this Society.

Ralph started the Association seminar on difficult airways; still running today as the longest running Association seminar. His fellow lecturers would try to beat his feedback scores by introducing videos and interactive technology, enthusiasm and educational fads but Ralph’s  seemingly casual, off-the-cuff style always won the day. In recognition of this ability to hold an audience, the Ralph Vaughan Cup was designated by DAS for the best oral presentation by a UK/ Irish Trainee. On the journey home, he would regale his fellow lecturers with entertaining stories, always with a nugget of wisdom.

He inspired and taught on the Cardiff three-day DAME (Difficult Airway Management Education) course. Many current international airway experts refined their airway teaching skills on this course. In addition, he co-authored over 80 peer-reviewed papers and many books. In 2010, he was Awarded the DAS MacEwan Medal in recognition of his enormous contributions.

As a clinical anaesthetist, Ralph had always been able to combine his excellent technical abilities (regional and airway) with compassion for his patients and a trusting relationship with his surgical colleagues. If only all anaesthetists could be so endowed, we would have a much easier job convincing others of our merits; he inspired a generation of colleagues to behave in a similar fashion. Those of us who took over his gynaecology and thoracic lists as he became more involved in medico politics knew that we had a very high quality of care to live up to-not a bad thing.

Ralph’s family were extremely important to him. He met the extraordinary woman (who became his wife) at the age of 16. They were married in 1966 and had two daughters to complete the family.  One daughter later benefitted from the high standard of Ralph’s teaching when during childbirth, the anaesthetist placing her epidural gleefully told her “your dad taught me how to do this”.  Thank goodness he had taught him well.

After an initial retirement that many colleagues felt was premature, he returned to the department in a part-time temporary position. His wisdom for consultants and sheer enthusiasm for teaching trainees was always appreciated.

In retirement, he could enjoy his love of golf.  He held many roles in Radyr Golf Club including Vice Captain in 2010 and Captain in 2011. He would often stop at the bench overlooking the 11th fairway for a drop of “Irish tea” before continuing his round. He loved being on the golf course with old and new friends, particularly at the 19th hole where he enjoyed a very large glass of pinot which he liked to call his weekly prescription. He captained the Swallows and the Vets and organised many social events including, as befitting the passionate Welshman he was, the yearly St David’s day celebrations.

Around the same time, he became involved with and eventually chaired the Radyr and Morganstown Association Community Council.   He made a huge contribution to Radyr life including involvement in starting the first Welsh-speaking nursery.  However, his major contribution should probably be measured in the weight of sausages and burgers cooked and served in many village events where he and his buddies became a well-oiled barbecuing machine; often very well oiled! He was one of the familiar faces behind the hot burger stalls at the Festival events.

Ralph did an enormous amount for anaesthesia locally, nationally and internationally, but it must be the sincerity of his friendship and encouragement that he gave to everyone he met that will be his lasting legacy. Many of his younger colleagues who he mentored, taught, and refereed considered him with great affection as “Uncle Ralph”.

For his family, he was a wonderful loving and supportive husband, father and dadcu who considered they were very blessed to have had him.  His passing has left a huge void in their lives that will never be filled. He leaves his wife of 56 years Marilyn, two daughters and four grandchildren. Throughout his career, Ralph was always supported by his wife Marilyn ‘both in sickness and in health’ and our sympathies go out to her and the whole family. Others of us have lost a dear and caring friend, and anaesthesia has lost one of its gentlemen and strongest supporters.

Dr Mark Stacey

Acknowledgements

Mike Harmer; https://das.uk.com/content/2010-das-medal-drralph-stephens-vaughan

Suzanne Vaughan -eulogy