Friday, 13 February 2015

The growth of the Department of Surgical Neurology

In 1960 a new Department of Surgical Neurology was opened at the Western General Hospital, Edinburgh (WGH) under Professor Norman Dott. This new department brought together the facilities for the diagnosis, treatment and rehabilitation of surgical neurology patients that Dott had been working towards throughout his career. 
Image showing the new Department at Surgical Neurology at WGH (LHB11/7/2)
When he started out in the 1920s there were no dedicated facilities for surgical neurology patients and Dott worked in private practice, treating patients in rooms in a private nursing home and moving his surgical equipment across Edinburgh in a taxi. In 1931, Dott was appointed Associate Neurological Surgeon at the Royal Infirmary of Edinburgh (RIE) and was and given access to four post-operative beds for his patients in Wards 13 and 14 and use of the operating theatre. This was the beginning of the Department of Surgical Neurology at RIE, which was the first of its kind in Scotland.  This move was followed in 1936 with the allocation of Ward 20, which was located in the clock tower at RIE, to Dott to set up his own department. However it wasn’t until 1938 that the new department received its first patients, as the Ward had to be extended and made fit for purpose, this included adding an operating theatre (with a special steel elliptical lighting dome imported from Paris and a sound-proof viewing room which featured one-way glass for students to view operations), twenty beds, an ophthalmic room, staff-room and out-patient facilities. Further accommodation was made available to Dott and his team in 1939 at Bangour General Emergency Service Hospital at Broxburn in West Lothian, where he established the Brain Injuries Unit providing treatment to military and civilian cases. The Department of Surgical Neurology, now firmly established as a specialist unit, operated over two sites providing different services at each location throughout the 1940s and 1950s. Although the department was extended in the 1950s, the growing number of patients (in 1959/1960 Ward 20 dealt with 1,100 patients, performed 900 operations and saw 6,000 out-patients – still with only twenty beds) and the demands on the expertise of Dott and his team meant that more space was needed. A major contributing factor to the growth in patient numbers was the increase in head injuries sustained in road accidents due to the rise in car use.

Roof of operating theatre at Ward 20, RIE (P/PL1/B/l/080)

So, to the Western General were a six- storey block was built, at a cost of £500,000, to accommodate the expanded Department of Surgical Neurology.  The new building housed twin operating theatres; sixty beds; physiotherapy, hydrotherapy and occupational therapy rooms; and staff accommodation.  The theatres, which were specially designed by Norman Dott and described by fellow surgeons as ‘Utopian’, were an ovid shape designed to limit infection and had domed roofs which featured shadowless lamps.
Plan of operating theatre, WGH (LHB13/11/5)
Ward 20 at RIE became a specialist unit for head and spinal injuries and for out-patient services, while the new department at WGH was mainly for elective surgery, with patients transferring between the two sites. The sites were even more equipped to work together when, in 1962 a television link was set up. Norman Dott retired in 1963, but the department that he established continued to grow and lead the way in research and treatment, finally merging in 1986 with the Department of Medical Neurology to form the Department of Clinical Neurosciences.

Television link between Department of Surgical Neurology at WGH and Ward 20 at RIE (P/PL1/l/006)

More images relating to Norman Dott can now be viewed on the Scottish Cultural Resources Access Network (SCRAN) by following this link:


The Royal Infirmary of Edinburgh (1929-1979), Catford, E F
A History of the Western General Hospital Edinburgh, Eastwood, M and Jenkinson, A

With Sharp Compassion: Norman Dott Freeman Surgeon of Edinburgh, Rush, Christopher and Shaw, John F


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