Remembering Professor Douglas ‘Doug’ Baird, AM

Doug Baird was too young to die. I know that it is seemly to accept the irreversible fact of death. But in Doug’s case it is especially unacceptable. Sweet was his nature and notable his achievements. But his best years lay ahead. It is by the tragedy of his death that we, his family, friends and colleagues come together today to reflect upon his achievements. We honour and celebrate his life. But, inside, I rail against fate’s cruelty. And most of you will do so with me.

I first met Douglas Baird when we were both under-graduates of this University. As often happened, his outstanding intellectual gifts also propelled him into student politics. Formidable indeed, in those days, was the power of organised under-graduate medicine. I sat with Douglas on the Board of the Sydney University Union. True to his egalitarian ideals and the upbringing by his mother he played a leading role in the amalgamation of the Union and the Women’s Union. In the heady debates of student affairs and the tough factional deals common in those far-off days, we forged a friendship that endured through the decades which followed.

His First Class Honours B Sc (Med) and MB BS never went to his head. Yet he was proud of them. And he was deeply hurt when the University first awarded, and then withdrew, the University Medal from him allegedly for a miscalculation. When serving as Fellow of the Senate elected by the Under-graduates, I became his advocate in that cause, as well as his friend. It was to no avail. But that misfortune never warped Doug Baird’s view of the University. He loved this place. It is entirely fitting that we should meet here to remember him. This was a centrepoint of his life, this Great Hall.

After under-graduate days we kept in touch through a would-be “secret society” of ex-student politicians. For me, Douglas Baird never seemed to change. True, the advent of Phillipa and his children, joys of his life, expanded his personal zone from that provided by his loving parents. True his professional accomplishments enlarged his considerable intellectual life. True also his country honoured him for his services to medicine in Australia and overseas. But his basic simplicity of character and loving-kindness remained steadfastly the same, enduring all.

The Sydney University Medical Journal for 1967 describes him when he was President of the Sydney University Medical Society. The anonymous reviewer in that Journal captured some of the paradoxes of his life. He was “forceful but not inflexible”. A man of peace, he nevertheless worked in Vietnam with the Prince Alfred team at the time the review was written. And after surgery, he gave English lessons to local doctors and nurses. The reviewer commented:

“It is characteristic of Doug Baird to fill his time so completely. It is also characteristic of him to undertake something requiring such zeal.”

Ahead of his time, Douglas Baird was noted, even then, as a frequent traveller to Singapore, New Guinea and Vietnam as part of the development of his medical career. Later he was to add India, Malaysia and other lands of our region. He once told me that the heroic surgery into which he was suddenly thrust at an early age, in Vietnam refined, under almost unendurable pressure, his surgical skills which were to become legendary.

That commentator of nearly thirty years ago recorded that he played bad golf and worse squash and tennis. Wise was Doug Baird to turn to creative gardening. Even at the end, he and Phillipa were planning a new garden together.

The writer of 1967 observed that it had been said of him:

“It wouldn’t be Doug without a panic”.

I read that assessment with initial surprise. But then the memories of our youthful endeavours together came flooding back: his urgent interventions in meetings and his sheer determination, persistence and insistence. His panics were, I suspect, very strictly controlled. When action was needed, this was a most resourceful and talented professional man: swift of action and with a steely determination.

I want to speak here for the thousands and thousands of patients of Douglas Baird. When my mother suffered a heart attack a decade ago I contacted him. Within hours he had seen her, reassured her and within days he had operated upon her. I will never forget how, in the middle of the long operation, he came out to reassure my father and me that all was going well. He was a gentle surgeon. He never lost interest in his patients. He understood their anxieties and the fears of their families. What a model he was for the best of medical practice that our country can produce. It is wrong that he will not be there, living into old age to offer his example, his instruction and his inspiration.

But in the extended lives of the multitude of his patients, including my mother and thousands like her, is a love for him, and a gratitude, which is enduring and which I, their surrogate, express on their behalf.

I hope that somewhere in this University, which he loved and served so well, a permanent corner will be found for a fitting memorial to Douglas Baird. Let it be a place of instruction in the Medical Faculty to remind young students of the very best in kindness and skill that this great University can produce. Let it be in the University Union, as an encouragement to the future leaders of our country who sharpen their talents and develop their confidence in student affairs. Let it be in the great hospital associated with the University where, despite the frustrations, Douglas Baird worked in surgery and health administration at the very highest level. Let it be somewhere in the Senate room where he played his part in the governance of the University. Or perhaps in this Great Hall which thirty years ago first resounded to the applause of his high achievements, the promise of which he was to sustain and fulfil in full measure as long as he lived.

Or let it be in a garden of flowers that remind passers-by of a good man, a loving husband, son and father. A fine citizen. A true teacher. An exemplar of all that is best in a profession of faithful service to others.

So, we rage against the dying of the light that has seen Doug Baird taken from us prematurely, painfully and so unfairly. But we, his friends, his patients, his colleagues, the nurses and other staff who worked with him, his fellow citizens, and his family raise our voices in praise of him and all his works.

For every precious day of life that has been given to my family and to countless others, we say our humble thanks. Through those days of so many people and their loved ones, Doug Baird lives on. We are here to mourn him, to give thanks for his life, to praise his memory and to say that we will never forget him.

Memories of Doug Baird

By John Hill, patient of Prof. Doug Baird and Baird Institute Donor

Like many people my first introduction to Dr Baird was in an ICU ward. I was 37, waiting for a spot on the operation schedule for an emergency bypass operation. My father had passed away at 51 so my family were beside themselves with worry.

Doug Baird came in and without lessening the gravity of the situation gave such an air of obvious competence and composure. As long as I gave up smoking, he would proceed and everything would be OK!

It was Ok, I recovered fully and returned to family, friends and work a new man.

I came across Doug Baird in groups we both attended on the North Shore and was aware of his huge involvement with Sydney University where I am an alumnus.  His passing at such a young age was a huge shock.

I had no idea of what he had achieved in so many areas until his memorial service. The Great Hall at Sydney University holds 600 people. It was packed. We are not talking here about a media celebrity or a politician, just an outstanding man who had affected so many people’s lives. Everyone had a story. The extraordinary eulogy from The Hon Michael Kirby really summed up the loss we all felt.

Many thousands of people now undergo heart surgery safely due to the pioneering work done by Doug Baird

9th Annual James Wadland Night of Hearts 2022

The 9th Annual James Wadland Night of Hearts event was held at Jbiel Cuisine Restaurant in Kareela. This annual event is held by Natalie Zugec on the 2nd of April – the birthday of her late husband, James Wadland.

James died from an aortic aneurysm 9 years ago and Natalie has worked tirelessly, since that day, to raise money for The Baird Institute’s heart research program, so that others don’t have to endure what she has had to. The event raised in excess of $8,000 bringing her total raised over her 9 years of fundraising for the Baird Institute to around $150,000. Such a tremendous effort and we thank Natalie for her dedication and support to our cause.

The Royal Prince Alfred Hospital Aortic Team

It is fair to say that a Thoracic Aortic Aneurysm is a Great Masquerader. It can destroy any vessel to any organ in the body, with a single stroke. Of course, it can cause aortic rupture and death. This is the reason an ‘aneurysm’ has historically been perceived as the ‘old demon’ in the surgical literature.

The Royal Prince Alfred Hospital (RPAH) is a major referral hospital and is recognised for its excellence and innovation in aortic services.

The RPA aortic surgery program was initially set up by Professor Cliff Hughes, who was one of the first surgeons to do the Bentalls’ procedure in Australia. The aortic program has since been strengthened and expanded under the leadership of Professor Paul Bannon, who is recognized internationally for his surgical expertise in aortic and complex root reconstructive surgery.

Vascular surgeons, Professor Jim May and Dr Jeff White were excellent surgeons and trainers of generations of surgeons in this country, who provided outstanding service at RPAH. They were responsible for the introduction of endovascular surgery in Australia, and both had outstanding international profiles in this discipline.

There has been a tremendous evolution in both cardiac surgery and vascular surgery over the years. There is a greater appreciation now, that when we are talking about treating any complex diseases, we need to get away from defining ourselves by the specialties that we are in, and really direct our focus towards how to treat the patient in the best possible way and to achieve the best patient outcomes.

There has been a trend to subspecialize within both disciplines to focus on “aortic interventions” and the task has fallen on the “Aortic Team” to explore both surgical and endovascular options for our patients in a collegiate multi-disciplinary team (MDT) environment. It really requires this MDT to review these complex cases together. At the MDT meetings, different pathologies such as thoracic or abdominal aortic aneurysms, aortic dissection, aortopathy and graft infection are discussed and various treatment options such as open, hybrid, endovascular and medical therapy are recommended.

With the introduction of endovascular aneurysm repair, using stent grafts has resulted in a major paradigm shift in the field of aortic surgery. It’s true that the technical details and risk profiles vary greatly between the two, but the principles remain the same. A successful aneurysm repair depends on either open replacement or endovascular exclusion, with healthy segments of artery proximal and distal to the repair. In addition, aortic arch and visceral segments and chronic dissections, add layers of technical complexity to aneurysm treatment.

Even though endovascular repair has become the principal way of dealing with most aortic aneurysms, open repair remains an essential treatment in many circumstances. We consider open surgical treatment to be beneficial for those young patients who have good performance status for better long-term outcomes and for treating patients whose aortic disease has genetic causes. Finally, for those patients for whom previous attempts at endovascular repair have failed, surgical approaches to device removal and definitive repair are becoming increasingly necessary.

I had the privilege of learning under the guidance of Professor Aung Oo as his aortic fellow. He is a world-renowned aortic surgeon, particularly known for open thoracoabdominal aortic repair. Prof Oo was originally the head of aortic surgery at the Liverpool Heart and Chest Hospital but he moved to St Bart’s, London to set up a second aortic centre in the UK. One of the most important lessons that I have learned from him is that you can certainly succeed with good colleagues and limited resources, but you cannot succeed with poor colleagues and great resources. You never hear him raise his voice and everyone listens to him attentively when he speaks. He recognises the importance of unified teamwork and that the key is to have a shared vision.

Indeed, a big part of this, is to build a team with a purpose and a shared vision.  For us, this shared vision is to establish a thoraco-abdominal aortic (TAAA) program at RPA.

With that in mind, Dr Raffi Qasabian, Dr Stephen Llewellyn, our senior cardiac anesthetist, and I went to Barts Heart Centre, based at St Bartholomew’s Hospital in the City of London, to see how their aortic service operates and functions.  Over the subsequent two years, we also invited Professor Oo to Sydney to guide our RPA Aortic team, as it was very clear to us that the success of a TAAA program is very much dependent on the overall growth of the team.

We have now formed a strong RPA aortic team. The team consists of 2 cardiac surgeons and 3 vascular surgeons, specializing in aortic surgery; 5 cardiac anesthetists/perfusionists, 2 neuromonitoring anesthesiologists, and 2 cardiologists, specializing in aortotopathy and connective tissue disorders. We have monthly aortic MDTs and Marfan clinics. All aortic tissues are stored in the heart bank and we have the largest aortic database with more than 20-year follow up.

Together, not only do we need to train surgeons to master the craft of aortic surgery, but perhaps more importantly, we need to take one step further and train the future generation of surgeons on how to work together throughout their career.

The Aortic Research Group

The Aortic Research Group, led by Professor Richmond Jeremy, undertakes both clinical and laboratory research into genetic causes of thoracic aortic aneurysms. Approximately 50,000 Australians, of all ages, have a genetic aneurysm, which are typically asymptomatic until the potentially fatal event of aortic dissection. Detection of affected individuals, understanding of clinical features and discovery of the cell mechanisms of aneurysm formation are key challenges.

The Aortic Group collaborates with the international Montalcino Aortic Consortium to discover new genes causing aneurysm, describe the clinical risk features and monitor the outcomes after surgical repair. The group also conducts novel laboratory research, underpinned by aortic tissue donated by patients undergoing surgery at RPAH for aortic aneurysms. This material is part of the comprehensive tissue collection of the Sydney Heart Bank. Currently, tissue from over 200 patients has been collected and cryopreserved, including patients with Marfan Syndrome (MFS), bicuspid aortic valve, Loey’s-Dietz syndrome, familial TAAD and atherosclerosis. Additionally, blood samples from affected patients are included. The Bank is continuing to grow in scope and is key resource for new research studies.

One current research focus is a study of how changes in regulators of reading of the DNA code affect severity of aortic disease. We have found that alteration of DNA coding inflammatory genes correlates with the severity of cardiovascular disorders in Marfan syndrome, and this work is being expanded to other genetic aortopathies. Other discoveries include altered expression of miRNA molecules. In human vascular smooth muscle cells, changes to the levels of these miRNAs have an effect on pathways essential to vascular smooth muscle cell function and therefore may be contributing to aneurysm formation.

Currently, large-scale analysis of aortic aneurysm tissue samples is underway to investigate over 4500 proteins and genome-wide RNA expression. These studies will shed light on the mechanisms of aneurysm formation, potentially identify markers of progression of aortic disease and also identify new targets for effective treatment intervention.
The Aortic Group also plays an important role in training the next generation of clinicians and researchers, with 3 PhD and 2 MPhil graduate research students and undergraduate medical students included in the program.

Gastrointestinal complications following cardiac surgery – A retrospective analysis of Medical Records

A Cohort Study of 7900 Patients

This research was presented by Dr. Smith at the General Surgeon’s Australia Annual Scientific Meeting on Friday 8 October 2021. Gastrointestinal (GI) complications following cardiac surgery are known to lead to significant morbidity and mortality. The objective of Dr Smith’s research project was to examine the incidence of these complications and to identify the associated risk factors from patient data in the RPAH cardiothoracic surgery database. The identification of risk factors will allow for the development of a predictive model and early management algorithm.

Read more

Professor Bannon named Top Researcher in His Field

We are very excited to announce that Professor Paul Bannon, Chair of The Baird Institute, has just been named the top researcher in Australia in the field of cardiology by The Australian Newspaper’s 2021 Research Magazine.

This ranking is based on the number of citations for papers published in the top 20 journals in his field, over the past five years.

The Australian’s annual Research magazine acknowledges the talent and dedication of Australia’s researchers. They do this by teaming with talent discovery and research analytics firm, League of Scholars, to comprehensively scan online data about Australia’s research output. This enables them to identify the best researcher and the best research institution in each field, based on the excellence of their research and the impact it has in discovery and scholarship.

The listing is unique because it zeros in on the particular specialties of individual researchers and research institutions, it provides fine-grained detail and recognises countless areas of excellence which would otherwise go unnoticed in the public arena.

Read more at this link:
The Australian’s Research magazine takes a deep dive into research | The Australian

Research Report – The Year In Review

We continue to focus as always on the areas of research that can be expanded so as to support the different surgical programs we have in the Cardiothoracic Department at Royal Prince Alfred Hospital.  Our pillars of research are outlined below – Professor Paul Bannon

Clinical Trials:

Our clinical trials have been significantly impacted by COVID but the team have worked extremely hard to try to keep the trials going in both the public and the private institutions.  The key areas are on blood transfusion practices (the continuations of the TRICS 3 trial into TRICS 4) as well as the new CLIP 2 trial on cryopreserved liquid platelet transfusions. These two trials will really add significantly to the international literature and the management of transfusion practices in major cardiac surgery around the world.

Bio-banking Program:

Some of the bio-banking has been impacted by COVID but despite that our strategy in this area has really come to maturity this year with the joining of the aortic biobank and the cardiac muscle biobank.  The biobank is already beginning to generate some basic science projects in the Charles Perkins Centre in the area of heart failure in conjunction with Dr Sean Lal and Dr John O’Sullivan.   We have also been able to continue our support for the vascular surgical department at RPAH by helping them to develop their biobanking strategy.

Broken Heart Program:

We have wrapped up all of our experimental work for the Broken Heart Program and chief researcher, Dr Laurencie Brunel, is preparing to submit her thesis and the third and final publication in that area of work. For this program, predict and model individualised surgical corrective techniques. We then test the model in the research theatre by looking at the structural integrity of the repair This research work sets the scene for what we want to do in this area in the future.  We have also put in an application for a collaboration with Stanford University in the USA and we are waiting to hear the result of this.

Surgical Outcomes Program:

The Centre for Health Record Linkage (CHeReL) links multiple sources of data and maintains a record linkage system that protects patient privacy.  Data linkage transforms routinely collected data into a powerful resource for research and evaluation. Our Clinical Trials team has submitted the data for 12,500 patients to the CHeReL system This data on long-term follow-up and reintervention rates, will give us the answers to our questions on comparative surgical strategies and how well we have done over the years.

Innovative Robotics:

This has had to take a back seat during COVID as the lab in the Charles Perkins Centre has been shut down for a large part of the last 6 months.  The lab has just started to re-open in the last few weeks, as a result, planning for further research in this area is now underway.

The Baird Institute is currently providing support for two research staff members; Cassandra in the biobanking program and Dhairya in the cardiothoracic research office.  These two positions provide an excellent link between the surgical outcomes and the biobanking programs, both of which are inextricably linked. In addition, Dhairya will be assisting with clinical governance research and clinical trials in the Cardiothoracic department.

Finally, we have made a decision to commit to the development of a translational research group in The Charles Perkins Centre and we are currently advertising for a candidate to fill a post-doctoral position.  This person will most likely be a biomedical engineer who will support our higher degree research students across the different areas of interest.

Cardiothoracic Surgical Education Webinar

Aortic Surgery Webinar July 2021

In the past 6 months we have held 2 webinars educating ICU, operating theatre and ward nurses, junior doctors and medical students on various forms of cardiothoracic surgery.

Advanced Robotic Surgery for Lung Cancer:
Presenter: Associate Professor Christopher Cao.

This webinar, presented by RPA Institute of Academic Surgery and The Baird Institute, was designed to give an insight into patients undergoing advanced robotic surgery for lung cancer. The featured topics were: Wedge Resection, Sleeve Resection, Segmentectomy and Lobectomy.

Scholarships and Grants Program – An Interview with Dr Charis Tan

What is your research topic?

My Master of Philosophy research topic is titled: “Optimising Medical and Surgical Treatments of Tricuspid Regurgitation”.  The Tricuspid valve is one of 4 heart valves that helps with blood flow. Tricuspid regurgitation (TR) unfortunately is a common disease/manifestation of the tricuspid valve, caused by various factors (Primary or Secondary) and affects 65-85% of the population.

What is the aim of your research?

The main aim of my research is to understand the impact of current management strategies for Tricuspid regurgitation. Therefore, the first study is to look at patients who have been referred late for TR surgery where they’ve been suffering with right heart failure prior to surgery and understanding their outcomes vs those who have not had right heart failure before surgery. The second paper then investigates patients who have Tricuspid regurgitation due to atrial fibrillation (AF; a type of irregular heart rhythm) and outcomes after these patients have TR surgery as AF is the newest and currently under-studied cause of TR. Lastly a systematic review will be performed to understand the various outcomes of TVR for atrial fibrillation induced TR. Ultimately these studies will help us to optimise the timing of surgical treatment strategies for patients with Tricuspid regurgitation before it is too late.

What is the potential impact of your research?

Unfortunately, the Tricuspid valve has been the most neglected valve to treat until recently where TR has been recognized to be associated with deleterious outcomes. But even despite the acknowledgement of its significance, TR remains undertreated— where patients are rarely referred for surgery or often referred late for surgical intervention, and most end up never making it to surgery in time. Current European and American guidelines describe vague treatment strategies and therefore current medical and surgical strategies for Tricuspid regurgitation (TR) remain understandably controversial due to the limited data available.

Recent studies have also shown that isolated TR is independently associated with high mortality, recommending more attention to diagnosis, grading and optimum treatment strategy. However, these guidelines do not address the fact that these patients are usually at an extreme end of their tricuspid valve disease before being referred for surgery.  There is a possibility that their longevity could be improved if surgery was offered earlier. Therefore, the grand plan for my research is to provide cardiologists and cardiothoracic surgeons a better understanding of the natural history of Tricuspid regurgitation and to recommend an optimum time for surgery… before they reach a stage where it’s too late and palliation ensues.

How has your scholarship from The Baird Institute helped you?

It has been a true honour to have had the support of The Baird Institute by means of a scholarship throughout my Master of Philosophy candidature. Not only have I managed to present at local and international conferences but also have managed to gain access to statistical software and undergo training courses to use them. Being around masters in this field by way of Professor Paul Bannon, has certainly opened doors to meet other experts in the field and broadened my vision for this project. Additionally, the scholarship has also allowed me to spread the word on this under-recognised area of cardiac surgery in hopes of raising more interests in research for future students and researchers at Uni presentations and conferences that I would not otherwise have had the opportunity to attend.

Once again, I cannot thank The Baird Institute enough for this huge opportunity to learn and develop as a budding researcher. I look forward to sharing the end results once its completed.

2021 Clinical Trials Update

The cardiovascular research team at Royal Prince Alfred hospital consists of Lisa Turner, Carmel Oostveen, Lorna Beattie and we welcome our new recruit, Dhairya Vayada. Dhairya has extensive knowledge in implementing data science principles to a clinical research setting.

2021 has continued to be a challenge for the Research Department, working within pandemic conditions.  However, despite the difficulties, research has continued and we find ourselves managing many interesting projects.  One of our projects, Vision, is completed.  This has been a lengthy process involving the recruitment and data collection of 500 patients.  The purpose of this project was to provide useful information to help predict who may be at risk of having complications following heart surgery. This information will be an invaluable source as the total worldwide recruitment was 15,000.

The tissue bank projects have continued to run throughout this year and we are excited about the addition of patients from Strathfield Private Hospital for participation in these study projects.  Heart failure represents a leading cause of morbidity and mortality both in Australia and Internationally.  Heart failure is the final common clinical pathway for a number of pathological processes including atherosclerotic disease, cardiomyopathies, valvular disease, myocarditis and infection.  The tissue bank provides an invaluable source for research projects to expand our current understanding of heart failure pathophysiology.

Stay in the loop

Subscribe to our Heart to Heart Newsletter to keep up with the latest developments in heart and lung research from The Baird Institute.

Honour a Loved One

  • Fundraise in memory of someone special to you.

Challenge Yourself

  • Run a marathon
  • Do a long bike ride
  • Walk 10km each day for a month
  • Do 50 sit ups every day for a week
  • Join an organised event such as the City to Surf

Organise a community event

  • Have a backyard sausage sizzle
  • Host a trivia night

Seek sponsorship to help you quit those bad habits

  • Give up smoking
  • Refrain from alcohol for a month or more

Celebrate Through Giving

  • Choose to give on your birthday: Instead of giving you gifts, ask your friends and family to donate to The Baird Institute.
  • Say “I do” to improving the lives of heart and lung patients: Invite guests to donate to The Baird Institute on your wedding day
  • Turn anniversaries or personal milestones into fundraising events.

Create a CrowdRaiser on GiveNow

  1. Go to CrowdRaiser for The Baird Institute.
  2. Click on the button “Fundraise for this cause” – just under the header image.
  3. Create your Crowdraiser. Fill in the requested details.
  4. Customise your campaign. Add images and messages to make your CrowdRaiser unique.
  5. Share the link to your fundraising page via email, social media, or any way you like.
  6. Let us know via [email protected] that you have created a fundraiser so we can say thank you.

Join a community passionate about making a difference. GiveNow provides a dedicated platform for Australian charities, ensuring your efforts directly support our mission.

Start a Facebook Fundraiser

  1. Go to Facebook fundraisers.
  2. Click on the blue button – “Select nonprofit”
  3. Search for and select The Baird Institute
  4. Set your fundraising target
  5. Choose your campaign end date & a title for your Fundraiser
  6. Personalise your fundraiser: Use the existing wording and photos or choose your own.
  7. Click on ‘Create’.
  8. Invite friends and family. Share the link for your fundraiser and encourage others to contribute.
  9. Let us know via [email protected] that you have created a fundraiser so we can say thank you.

Celebrate where your friends and family connect. Leverage your social network to make a real impact.