Emeritus Professor Teresa (Tess) Rita O’Rourke Cramond AO OBE (1926-2015)

Professor Tess Cramond was a pioneering anaesthetist and pain specialist who touched many lives, both directly and indirectly through her dedication to medicine.

When Professor Tess Cramond realised her own health was failing she decided to make arrangements for her own funeral as there had been some organisational diffi culties following the sudden and unexpected death of her husband of 27 years, Humphry. I was stunned when she asked me to deliver a eulogy – one of three.

We had affectionately called her the Godmother as she was prone to making you an offer you could not refuse. This usually involved a task that you would consider to be beyond your level of expertise or to which you felt you were totally unsuited. To make the task easier, she gave me seven handwritten foolscap pages with what I had to say. Her writing looks neat but is almost illegible. On the next visit she produced two typed written sheets with details she had not included in the initial text.

Tess was a devout Catholic and had forged a friendship with the priest at the local church, Father Peter Gillam. Although retired, he still performed some duties at the church and visited her regularly at “Viridian” where she was in monitored care. It had been recently built in the grounds of Nudgee College and housed many members of similar faith. The funeral was to have been held at her local church but it was decided that it had insufficient capacity to cope with the estimated numbers attending. The final arrangements were completed by Elizabeth Carrigan, her niece and daughter of her only surviving sister Joan. The service was to be held at St Stephen’s Cathedral.

The requiem mass commenced with a procession of six priests headed by Peter Gillam through a packed cathedral with some people in the congregation dressed to show their group membership. The Knights of Malta were particularly well represented.

After the welcome, a message of condolence from Archbishop Mark Coleridge was read prior to the placing of symbols on the coffin. There had been so many requests for items to be placed that these had to be limited to six. The first was a white robe as a reminder of baptism into the church and this was followed by a crucifix, a gown from the Order of Malta, a graduation certificate and stethoscope, an MD gown and citation, decorations and awards and Surf Life Saving memorabilia. The last of these was placed by an aged Alan Doig, one of the four lifesavers who volunteered for the demonstration of new lifesaving techniques in the early ’60s. The mass continued with prayers of the faithful being read by younger members of both families, Brophy and Cramond. Following communion, three speakers delivered refl ections and remembrances. The first was Robert Ritchie, a nephew, who spoke of family heritage and the generosity and support Tess had given to nieces and nephews who were treated like her own children.

Next I spoke of her professional life, my personal experience including some of the stories she related during interviews we had prepared prior to a formal presentation for the College. The fi nal speaker was supposed to be Jack Truelove, another of the four lifesavers, but he was hospitalised with a chest infection and his place was taken by Ron Rankin. He outlined her contribution to resuscitation in Surf Life Saving, the electricity industry and with the Resuscitation Council. She was quietly buried at the Nudgee cemetery next to her husband of 27 years.

My first contact with Tess was as an anaesthetic registrar in the neurosurgical unit – 4B – at the Brisbane General Hospital in 1966. I was told she was difficult to work with as she required you to be on time, be well dressed and do things her way.

She had developed a well-balanced and safe technique which she had acquired during her two years at the London Hospital. As a result, she recommended many trainees spend time overseas and 16 local anaesthetists have spent time at the London. We were also involved with evaluation of new drugs (fentanyl and droperidol) as well as the management of severe pain.

Tess purchased her own ventilator and had the engineers make a gas bypass which would inflate the blood pressure cuff and patients were monitored by an ECG. She battled with the nursing hierarchy to establish a training program for anaesthetic technicians and have them under the control of the department.

Even at this stage she was being recognised as a force within the anaesthesia community. Her attitude was “if you do a job, do it well”. If you do a job well it is more than likely you will be asked to complete more tasks.

She became federal secretary of the Australian Society of Anaesthetists (ASA) from 1960-1964 at a time when her general practitioner in Emerald as a young girl, Roger Bennet, was president. The ASA took legal advice and mounted a challenge to the Faculty of Anaesthetists, Royal Australasian College of Surgeons, who wanted to take charge of financial affairs relating to anaesthetists. Their opinion was that the Faculty would lose its tax-free status if it indulged in these matters.

The dean of the Faculty at the time was her good friend Mary Burnell and she was reluctant to talk about this incident until much later. Roger had a significant infl uence on her career, not only with medical politics, but he was instrumental in arousing her interest in resuscitation. When he developed intractable pain from Hodgkin sarcoma Tess determined there was a need to improve treatment in this area.

In 1964 she resigned her position with the ASA and accepted a position in Dallas, primarily to set up a neuroanaesthesia unit. She witnessed racial and sexual discrimination as well as extreme violence and described the experience as “awful”. She returned home and was elected to the board of the Faculty at her second attempt in 1965. Her attitude was that even if you don’t get elected it is important to keep your name where it can be recognised.

As well as developing a busy private practice, her Faculty commitment meant she was involved not only with teaching but also the setting of standards of practice and recognition of the examination process. She negotiated the rotational training program in this state and had been impressed with her Victorian colleagues who kept places at their hospitals for registrars from other states.

Tess became dean of the Faculty in 1972, having filled the positions as assessor and vice-dean. She said some people thought if you were polite, small and female that you were weak. This was not the case with Tess as she steadfastly maintained her position in negotiations with the college of surgeons, increased their representation to two and commenced the movement to achieve fi nancial separation from the College.

At the 21st anniversary of the founding of the Faculty, the Orton Medal was conferred on Jim McCulloch and Geoffrey Kaye. Geoffrey was one of the earliest anaesthetists in Australia and had previously fallen foul of the administration but this had brought him back to the fold. The vice-dean at the time was Brian Dwyer and his pain unit was the example followed in setting up the multidisciplinary pain unit that now bears her name at the Royal Brisbane & Women’s Hospital.

Her interests were now extremely wide and recognition began to fl ow. She was awarded an Order of the British Empire in 1977 and became a foundation professor of anaesthetics the following year, a position she filled until 1993. Her teaching activities were widened to include the Red Cross and St John’s Ambulance, Surf Life Saving and the Electricity Authority. She demonstrated in all situations and although the cherry pickers were no obstacle she detested the spiders in the electricity substation pits.

After her retirement from anaesthesia she turned her attention to pain management having already raised the funds necessary to employ pharmacologists and research scientists to investigate the use of drugs used to relieve pain.

The Australian Medical Association had also been part of her life and she was president of the local branch in 1982. The rural representative was Humphry Cramond who had been at medical school with her and had lost his wife several years previously. They were married in 1985 and enjoyed 27 years together. Her comment was “he was worth waiting for”.

Asked if she intended to change her name after the wedding, she said marriage was a sacrament for life with someone you loved and she was happy to change her name.

Humphry was president of the Nudgee Old Boys Association so she broadened her interests and was seen at a rugby match.

Her professional activities associated with medicine were extensive. She was a member of the medical board, Medical Defence Society, Editorial Committee of Anaesthesia and Intensive Care, Selection Committee for the Rhodes scholarship, the National Health and Medical Research Council, the Senate and Academic Board of the University of Queensland and the Catholic University, and the National Anaesthetics Mortality Committee.

The awards that followed included the Robert Orton Medal from the Faculty, the Order of Australia and an honorary fellowship from the College of Anaesthetists of Ireland. As a devoted Catholic she listed audiences with two Popes in the highlights of her career.

Following the sudden death of Humphry in April 2014, her physical condition deteriorated quite rapidly although her mental state remained sharp.

This was an extraordinary life of someone who dedicated herself to improving the health and safety of our current generation, to educate the next generation and to establish a safe and respected community in which we can all exist. 

Dr John Hains, FANZCA Brisbane

Professor Tess Cramond was inspired to establish Australia’s second multidisciplinary pain centre at the Royal Brisbane Hospital after helping a colleague with uncontrolled cancer pain.

The passing of Professor Tess Cramond in December 2015, eight weeks prior to her 90th birthday, marked the end of a remarkable life well lived. Tess was a devoted doctor with an unparalleled sense of caring and commitment to service, a trail-blazing woman, wise teacher, nurturing mentor and tireless advocate of the patient. Tess was a leader by example and an internationally acclaimed pioneer of anaesthesia and pain medicine.

Tess’s primary focus was always a determined attention to high-level patient care. This was evident early in her career as an anaesthetist and later, in 1967, when Tess was called upon to assist a colleague with uncontrolled cancer pain – it was this experience that inspired her to dedicate her career to helping ease the burden of people suffering in pain and to establish the multidisciplinary pain centre (the second in Australia) at the Royal Brisbane Hospital. In 2008, to honour Tess and her many years of service, the centre was renamed the Professor Tess Cramond Multidisciplinary Pain Centre (PTCMPC).

Tess was proud of maintaining a multidisciplinary focus from the beginning and the centre continued to grow under her strong leadership over the next 42 years. Research was an intrinsic component of PTCMPC with involvement in multicentre trials and numerous PhD and Masters degrees. Tess received strong support from the surgeons in the burns and neurosurgery units and it was these relationships that led to her involvement in major burn injury and also to one of the world’s largest series of percutaneous lateral cervical cordotomy procedures for unilateral cancer pain.

Tess promoted teaching and education in pain management long before the establishment of the Faculty of Pain Medicine and was a strong supporter of the Faculty when established. Tess was granted a foundation fellowship of the Faculty in 1999 and served as an examiner for many years. The PTCMPC was one of the inaugural centres accredited for training in pain medicine from 1999 and under Tess’s mentorship, has supported many local and international trainees to successfully complete their training. She encouraged the establishment of the Queensland Regional Committee of the Faculty – the first in Australia.

Tess’s extensive contributions were recognised with multiple awards and honours, including an Order of the British Empire (OBE) and an Officer of the Order of Australia (AO), an Advance Australia Award, a Red Cross Long Service Award and the AMA Women in Medicine Award. She was the first recipient of the Distinguished Member Award of the Australian Pain Society and was awarded an honorary fellowship of the Australian Chapter of Palliative Medicine. The University of Queensland has awarded her the degree of Doctor of Medicine Honoris Causa and the Australian Catholic University admitted her as Doctor of the University. She has also been awarded the Gold Medal, Faculty of Anaesthetists, Royal College of Surgeons and the Robert Orton Medal, Faculty of Anaesthetists, RACS.

Tess was the first female president of the AMAQ in 1981 and served on many state and national committees.

Her high standards of patient care were underpinned by a strong faith. In 1974, Tess became a founding member of the Brisbane branch of the Order of Malta – a lay Catholic Order of Chivalry whose members were committed to helping the poor and the sick.

Tess reflected in her retirement speech, “What do I regard as my contribution to the profession – and directly or indirectly to this hospital (RBWH)?

• Foremost, the care of the individual patient be it in the ward, in theatre or in outpatients – meeting their physical, emotional and spiritual needs.
• The training of medical students, residents and registrars first in anaesthesia and subsequently in pain medicine.
• The introduction of rotational training in anaesthesia – the first in Australia in 1968 and thus ensuring a decentralised specialist anaesthetic service for this state.
• Accreditation of four training posts in pain medicine.
• The introduction of anaesthetic technicians as an integral part of the multidisciplinary anaesthetics team.
• The establishment of the multidisciplinary pain centre (MPC), and,
• Last, but no means least, persuasion of Queensland Health to develop a plan for pain services in Queensland.”

Tess was an inspirational mentor who lived and encouraged dedication and contribution to the medical profession she loved. She truly considered medical practice to be a vocation. Tess regarded it a privilege to be employed in the public hospital system paid for by the community and she delivered tirelessly in return.

She inspired those who learnt under her tutelage and took immense pride in their achievements. Tess taught that there was no greater privilege than to be allowed to enter into the life of a patient as their doctor.

Outside her medical life Tess was a loyal devotee and passionate contributor to Surf Lifesaving in Queensland and Australia. Tess was instrumental in the introduction of mandatory CPR for surf lifesavers. She was an honorary life member of Surf Lifesaving Qld and Surf Lifesaving Australia.

Tess’s greatest devotion was to friends and family and especially to her loving husband Humphry, who very many of her colleagues knew well. Tess continued to attend many anaesthesia and pain medicine meetings even in her frail later years. Humphry was always at her side.

It is fitting to leave the final words to Tess. These were the closing remarks from her retirement celebration in 2009:

“Initially, I will miss the patients, whose courage has so often been inspirational, and the daily contact with my colleagues, but I look forward to having more time with Humphry and our extended family, to supervising the gardener, to enjoying the matinees at QPAC (Queensland Performing Arts Centre), reading the ‘must do’ books that have been neglected, having morning tea or lunch with friends.”

Professor Tess Cramond will be missed.

Dr Paul Gray

Associate Professor Brendan Moore
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