Professor Sir ‘Malcolm’ Keith Sykes 1925–2019

He began his professional life with a medical post at the University College and his surgical house job at Norfolk and Norwich. He undertook national service in Germany, where in addition to Regimental Medical Officer duties he also learnt to administer some anaesthetics. On his return to the UK he decided to sit for the Diploma of Anaesthesia (DA). He started his training at UCH where he met Michelle whom he married, but not until after returning from Boston, USA and Canada under the aegis of the Rickman Goodlee Travelling Scholarship. At Boston, he was surprised by the unpopularity of the use of neuromuscular blockers and was persuaded to set up a randomised trial of patients undergoing major abdominal surgery with either ether or thiopentone and neuromuscular blockade given as a suxamethonium infusion. The findings showed no difference between the two techniques in terms of mortality, but the experience taught him much about the research process, and gained him many opportunities to give talks to professional groups. He returned to UCH as a Senior Registrar in 1955 where he now believed he had started ‘thinking’. His first application for a consultant post (at UCH) failed, but he persevered and was appointed to the Hammersmith Hospital in March 1958 as a clinical lecturer. There he studied the management of tetanus, spending a period of time in Durban, South Africa, where he reduced the mortality of neonatal and adult tetanus from 80% to 21% in 6 months. In the course of this work, he developed his ongoing interest in mechanical ventilators, and on his return to the UK, tried to develop neonatal ventilation with some success, but found his time was largely taken up with the development of the open-heart surgery programme, his interest in respiratory physiology and starting a resuscitation programme. He started to train the nurses and physiotherapists in resuscitation when closed chest cardiac massage was becoming accepted; he believed that the in-hospital survival rate came up to nearly 20%. He became an advocate of mouth-to-mouth artificial respiration and had many battles with the emergency and first aid services when he tried to persuade them of its efficacy. His research interest in the cardiac theatre took off when he acquired O2 and CO2 electrodes which allowed measurements to be rapidly made, and he developed a post-cardiac ITU which then started to treat all patients whether medical or surgical. By 1967, he was appointed Reader and then given a personal Chair, having published his studies on the effects of anaesthetic drugs on lung perfusion. He took up the Nuffield Chair in Oxford in 1980. He had to organise a department over multiple sites and the new John Radcliffe Hospital which had just opened, and he went on to build a successful academic unit there, even though it meant being more an organiser and motivator, rather than an experimenter himself. By 1990, the department had in the region of 20 research fellows, half of whom were basic scientists (physicists, mathematicians, engineers, chemists, physiologists and pharmacologists). He retired from the Nuffield Chair in 1991 but he continued to be involved in several projects and kept up old friendships. Keith Sykes' name is familiar to most anaesthetists through his clear textbooks on the subject of the treatment of respiratory failure, and principles of measurement for anaesthetists which have been used by two generations of anaesthetists to prepare for the Fellowship examination. In recognition of his considerable contributions to academic anaesthesia, he received Honorary Fellowships from the Colleges of Anaesthesia in Australia and New Zealand (FFARACS, now FANZCA; 1979) and South Africa (FFA (SA), now FCA (SA); 1989), as well as Honorary Memberships of several National European Societies of Anaesthesia and Intensive Care, including the Association of Anaesthetists of which he was Vice-President from 1990 to 1992. Partly for his contributions to the clinical and research aspects of anaesthesia, but additionally for his role as Consultant Advisor in Anaesthetics to the Chief Medical Officer at the Department of Health (l986–1992), his eminence was recognised by the decoration of Knight Bachelor in 1991, the year that he retired. In 2009, he was made an Honorary Member of the History of Anaesthesia Society and was also honoured to receive the Hickman Medal from the Section of Anaesthesia of the Royal Society of Medicine. His wife, Michelle, was also an inspirational person; she made a huge contribution to the Ashmolean Museum in Oxford. She died in 2016 and his eldest son and daughter also passed away in 2013 and 2014. He is survived by his two remaining daughters Virginia and Susie, and three grandchildren, Timothy, Alexander and Lydia.

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