Dickens, David Robert Vernon (Bob)

  • Qualifications MBBS FRACS FAOrthA 

    24/10/1938 - 28/2/2020

    Background and early life

    Bob Dickens was born in Balldale in southern New South Wales, close to the Victorian border. His family ran a 2000-acre farm. As a country lad he rode a horse to school in his early years. His family moved to Melbourne when he was about nine and he rapidly adjusted to city life, gaining a scholarship to Melbourne Grammar School before continuing to Melbourne University to study medicine and graduating MB BS in 1962.

    He was a resident at the Royal Melbourne Hospital and then gained his fellowship with the Royal Australasian College of Surgeons (1967). That year Bob volunteered for service in Vietnam, where on one memorable occasion, he saved a Viet Cong soldier’s father, which probably contributed significantly to his own survival! In the following year he moved to the Royal Children’s Hospital as the first registrar in paediatric orthopaedics. He then embarked on orthopaedic post-graduate training in the UK with fellowships at the Royal National Orthopaedic Hospital in London, The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry in Shropshire, close to the Welsh Border, and in the USA at Pittsburgh, where he  was involved in basic research, which aroused his subsequent enthusiasm for obtaining access to laboratory research at The Royal Children’s Hospital. Bob may have been the first Australian orthopaedic surgeon to embark on fellowships in both the UK and the USA, a pathway which pre Covid19 had become more popular. The Dickens' children were born during these travels and times were not always easy for the young family, on the road. Bob’s experiences convinced him of the value of international contacts for the fledgling department at RCH. He used these extensive contacts widely and wisely, for the good of the Orthopaedic Department at RCH, especially during his years as Director and head of Department.

    Career at RCH

    He returned to the RCH in 1972, to join Prof Peter Williams AO, Mr Malcolm Menelaus and Mr William Doig, a team who put the hospital at the forefront of paediatric orthopaedics worldwide, especially in the area of surgery for scoliosis. He was not only a gifted surgeon but also an excellent clinician and his many friends and colleagues around Australia and elsewhere frequently sought his advice on matters of diagnosis and treatment for orthopaedic problems.

    He was instrumental in arranging for Ian Torode to join the team in 1983 and together they introduced innovations in spinal instrumentation ­­– a major benefit in the care of patients needing spinal surgery for scoliosis. Bob invited a leading French Orthopaedic/Spinal surgeon, Jean Dubousset to visit Melbourne and other centres in Australia. This was a seminal moment in the development of scoliosis surgery in Australia because it introduced revolutionary new instrumentation and techniques, before the rest of the world had appreciated these advances. The contacts between Melbourne and Paris have remained to this day, under the leadership of Michael Johnson. Jean Doubousset revisited RCH in 2019 with Bob in attendance, for the Wednesday Orthopaedic conference meeting.His involvement with the scoliosis clinic persisted long after retirement, when his encyclopaedic memory of rare conditions was much valued by colleagues and new trainees, in whom he continued to take an interest.

    Director of Orthopaedics at RCH

    Bob was the Director of Orthopaedics at RCH from 1988-95. He brought a fine intellect and a passion for looking after children, along with a lively sense of humour to the role. He was not always in agreement with the hospital administration but tried to avoid open confrontation and his style was deliberately understated. He was a man of few words, who tried to avoid “the limelight”. His preference was to work behind the scenes, where he was extremely effective. He was a fine team player and always a gentleman.

    Bob made his own significant contribution to the department by ensuring the financial basis for the inaugural Professor of Orthopaedics at RCH.  The first in this role was William “Bill” Cole who went on to a stellar International career in research: basic and clinical. One of Bob’s proudest moments came later with the establishment of the Hugh Williamson Gait laboratory and the replacement of Bill Cole with Professor Kerr Graham in 1994.

    Bob’s kindness to the Graham family, in making the transition from the UK to Melbourne was outstanding. He worked behind the scenes on visas, college recognition and most especially on the complex matter of the funding and establishment of the Hugh Williamson Gait Laboratory. When the Grahams arrived in Melbourne in 1994, they were picked up at the airport, accommodation had been arranged, a car was provided on loan and much was done to facilitate settling in to life in Melbourne.

    Bob’s kindness to visiting fellows was legendary and warmly remembered by many. Perhaps this reflected to some degree the difficulties experienced during “life on the road” by the young Dickens family. At his Festschrift, a remarkable number of previous fellows, travelled from the USA and UK to honour Bob at the time of his retirement. Many stories were told of Bob’s kindness and tireless support for fellows from overseas. His Festschrift was also notable for the number of previous patients who attended to honour “Dr Bob” as he was fondly known.

    Bob Dickens had a lifelong commitment to supporting children with disabilities and their families. This was driven both by moral values and by a sense of justice, as also by lived experience as a parent. 

    After retirement and Medical Indemnity Insurance work

    An eye problem led to early retirement from surgery, but he maintained a clinical and medico-legal practice. In 1976, he became involved in the medical indemnity industry when he was appointed to the council of The Medical Defence Association of Victoria. He was appointed President and Chief Executive in 1990 and retired in 2000. His concerns for his medical colleagues in medico-legal matters encouraged him, with others, to establish the Medical Indemnity Protection Society in Victoria Initially being involved in the claims area. He was subsequently appointed to the board of MIPS in 2002.

    Even after the onset of his eye problems, a not inconsiderable handicap for a surgeon, his experience and abilities were freely offered in support of his colleagues. On one occasion, a little girl with a developmental dislocation of the hip had had an open reduction and despite a revision operation, the hip remained dislocated and we were at a loss as to what to do next. Bob offered his help and scrubbed in for a second revision procedure. Throughout the procedure the educated Dickens' right index finger was at work feeling for the obstruction to reduction that other team members had missed. Finally, he found the block, “cut here, he advised” the hip went into joint and stayed in joint. As we later unscrubbed, he drily observed “some operations are better done with the median nerve than the optic nerve”. 

    At a case conference, some years after he had retired, he famously commented on the MRI image of the foot of a patient with a chronic infection or possible tumour, correctly identifying the Palm Thorn which was the cause of many months of pain and was easily removed to relieve the symptoms.

    In 2004, with Dinah Reddihough, Bruce Bonyhady and others, he helped to develop a vision for RCH to become a leader in developmental disability research, and soon the organisation “SOLVE@RCH” was born. Since then, more than $15 million has been raised through philanthropy to fund three chairs at Melbourne University including the “Apex Chair in Developmental Medicine” and the “Lorenzo and Pamela Galli Chair in Developmental Medicine” as well as numerous fellowships. The NHMRC has invested $5 million in two centres for research excellence in cerebral palsy and this funding has helped to support a team of more than 70 researchers and clinicians. 

    Bob’s support for the establishment of the Gait Laboratory in 1994 has led to a world class facility at RCH, The Hugh Williamson Gait Laboratory. There are now a group of similar laboratories throughout Australia (three in Melbourne alone) and New Zealand, all in some way related to Bob’s pioneering spirit. Bob's exceptional commitment to developmental disability research, and his ongoing support of the team undertaking this work, was unwavering and continued until the end of his life. 

    Family life

    Family life with wife Sue and their three children – David, Georgi and Adam – was imbued with Bob’s trademark enthusiasm and commitment. Family holidays, centred around camping, fishing and sailing, were frequent and more recently Bob’s passion for family extended to his five cherished grandchildren.

    He was also a keen skier who organised skiing trips in New Zealand with colleagues and was involved with the Children’s Hospital Ski Club and with the establishment of the second lodge at Mount Buller where he skied on many occasions, as he also did at Mount Hotham, with friends and colleagues as well as with family. 

    Bob’s final years were spent with Pamela and they enjoyed a loving and supportive partnership together during this time. Bob suffered a significant period of illness with courage and dignity but continued to be energetic and active. He attended a Medical School alumni reunion in 2019 and continued to apply his intellect and wisdom to the design of future paediatric orthopaedic research, even in his final days. His last weeks were spent in discussions about the future of the Chair in Orthopaedics, arranging support and funding and urging his colleagues to adopt a wider vision for the future. His will be a lasting legacy.

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    Jim Wilkinson; Michael Johnson; Glenn Bowes; Kerr Graham; Dinah Reddihough; Geoffrey Klug 
                                  Using information from multiple sources.