OBITUARY

 

Professor David Dent - 1939-2023

 

 

Emeritus Professor David Dent, nationally and internationally recognised for his contributions to surgical oncology and endocrinology, died in Cape Town after a prolonged illness on 27 December 2023, aged 84 years.

He will be remembered by his colleagues, students and friends for his wide-ranging contributions to surgical practice, research, education and university administration. He was an innovator, a critical thinker, supremely knowledgeable and a sharp wit.

David graduated with an MBChB from University of Cape Town in 1962 and did his internship and surgical registrar training at Groote Schuur Hospital (GSH), under the mentorship of Professor Jannie Louw. He qualified as a surgeon in 1969 when he was awarded the Douglas Gold medal as the best graduate of the year. While still a surgical registrar at GSH he participated in highly productive and collaborative laboratory research with a formidable team including John Terblanche, Stuart Saunders, Rosemary Hickman and Chris Barnard that produced key findings and highly cited international publications. These included the early seminal work on baboon-to-human exchange transfusion by cross circulation for fulminant hepatic failure and baboon-to-pig liver and kidney xenotransplantation.

It was evident early on that David was destined for a career in academic surgery, and after a three-year lectureship in Bristol, following in the footsteps of John Terblanche and Ed Immelmann, he returned in 1972 to take up a full-time position on the consultant staff of GSH in the Department of Surgery. In the same year he completed and was awarded a ChM research degree by the University of Cape Town for his thesis entitled "Experimental liver transplantation". In 1978 he was promoted to Associate Professor. After the retirement of Professor Jannie Louw in 1980, David, along with John Terblanche, Raoul de Villiers and Ed Immelman, became head of one of the four eponymous professorial "Firms" that formed the backbone of the Department of General Surgery, a hierarchical structure that still functions in the Surgical Department today.

David established the GSH Breast Clinic, a first on the continent and one of the very first "one-stop" breast diagnostic services in the world. He was an enthusiastic supporter of the weekly "cancer multidisciplinary meeting" format, allowing all specialists involved in the care of patients with cancer to collaborate, share ideas and individualise the treatment plan for women with breast cancer. In addition, he made important contributions to the surgical understanding and treatment of gastric carcinoma, thyroid and parathyroid disorders and haematological disease.

David excelled in all aspects of scholarship and his academic achievements were manifold. He was widely and prominently published and was a sought-after speaker and opinionist at local and international surgical congresses. He was Chairman of the South African Breast Group from 1984 to 1986, President of the Association of Surgeons of South Africa from 1996 to 1998 and Secretary General of the Pan African Association of Surgeons from 1999 to 2004. He was awarded a Personal Chair in Surgery in 1998 and assumed the headship of the Department of Surgery in 2001 until 2004 after John Terblanche retired. He was also Co-Director of the School of Clinical Medicine with Ralph Kirsch from 2001 to 2004. In 2000 his contributions to surgical scholarship were recognised with an Honorary Fellowship from the Royal College of Surgeons and Physicians of Glasgow. From 2004 to 2006 as deputy dean for Health Services he provided wise and thoughtful counsel to Gonda Perez and Marian Jacobs, the incumbent Dean of the Faculty of Health Sciences.

 

 

David had an inherent and visceral dislike for bureaucracy, rigid protocols and "rules". He despised cant, humbug and hypocrisy in all its guises. He valued authenticity and railed against posturing and those who were pretentiously pious. He enjoyed verbal sparring, relishing the thrust and parry of robust debate on ward rounds and the opportunity to refute or debunk surgical dogma and orthodoxy. He rejected untested hypotheses and only accepted advances predicated on carefully conducted randomised controlled trials or new concepts that had passed muster and scrutiny on the editorial pages of the New England Journal of Medicine or The Lancet. Those who had the good fortune to be a coauthor with him benefitted from his acumen and understood implicitly that, as a devotee of Occam's razor, he was a stickler for parsimony and proper syntax and decried the split infinitive.

Teaching was David's métier and he loved to teach in the Socratic style at every level of the teaching pyramid, from medical students to audiences at eponymous lectures. He loved medical students, was amused by interns and was intrigued by registrars. He will be remembered by generations of medical students who benefitted from his legendary tutorials during, which he would effortlessly synthesise and distill complex surgical problems into 20-minute teaching "pearls" that left all enlightened.

David was socially gracious, charming and entertaining. His medical aphorisms, dispensed on ward rounds to an appreciative audience and widely known as "Dentisms" were hilarious, pointed and droll. He could also be acerbic and, as the master of witty repartee, the waspish retort or sharp rebuttal, he did not suffer fools lightly and would skilfully skewer shallow suggestions and deftly dismantle timid or frivolous opinions from startled registrars.

David's legacy will be as one of the first "surgical oncologists" in South Africa. As such he influenced generations of trainees who learned from him the basics of outstanding surgical practice, certainty about the diagnosis, accuracy of staging, knowledge of the biology of the cancer, inclusion of the patient in the decision making and then tailoring the final treatment plan to take all these variables into account.

He was a masterful surgeon - careful, determined, meticulous, realistic, informed, innovative. He knew when to operate, how to operate, and when not to operate. There is no greater praise for a surgeon.

Our condolences go to his sister, Leslie, and his nieces Jane and Clare and his nephew, Martin.

Requiescat in pace, David.

Professor Eugenio Panieri

Emeritus Professor Jake Krige