Thomas Cecil Gray CBE (1913–2008) An outstanding Editor of the British Journal of Anaesthesia (1948–1964)
University of Liverpool, Division of Clinical Science (Anaesthesia), Duncan Building, Daulby Street, Liverpool L69 3GA, UK
* Corresponding author. E-mail: bja{at}liverpool.ac.uk
Thomas Cecil Gray was born in Liverpool in 1913, and was educated at Ampleforth College and Liverpool University where he graduated in medicine in 1937. Becoming interested in anaesthetics when a general practitioner in Liverpool, he was trained by R.J. Minnitt who was, and continued to be for many years, a member of the British Journal of Anaesthesia (BJA) Board. After war service in North Africa, where he was attached to a neurosurgical unit, Gray was invalided out in 1944. He later resumed a demanding civilian anaesthetic and general practice. It was at this time that he began investigating the ways in which tubocurarine might be used as an adjunct to general anaesthesia, as others were following the report by Griffith and Johnson in Anesthesiology in 1942.1 The method he and his colleagues developed over the next few years became known as the ‘Liverpool Technique’. Gray was intent on promoting the safe use of tubocurarine and personally demonstrated his methods widely. In this task, he was greatly helped by a friendly and genial personality and unflagging energy. Over the next 30 yr, he was a towering figure in British anaesthesia and a highly influential and effective member of many organizations concerned with educational and health services.2
In 1948, Edward Falkner Hill and Cecil Gray were appointed Joint Editors of the BJA by the Board of Management and Proprietors to fill the vacancy occasioned by the sudden death of the second Editor, Joseph Blomfield. While it might appear strange to have two editors of a struggling journal only slowly emerging from the moribund state that had been its lot during wartime, there were good reasons for this decision. The senior members of the Board were well aware of the need for the infusion of new blood and had already taken steps to remedy the deficiency. They were also aware that the second century of anaesthesia had begun. The success of efforts to explore the possibilities offered by the use of muscle relaxants would lead to fundamental changes in anaesthetic practice, and indeed to the speciality itself. In addition, whole time academic appointments were being made in several medical schools. Gray, a recently appointed member of the Board, had in 1946 already shown his outstanding abilities by presenting the results of his use of tubocurarine in over 1200 patients at the Royal Society of Medicine.3 No senior Board member was readily able to take up the vacant editorial position, so it was decided that a joint appointment would answer best. Falkner Hill was a greatly respected and long-standing senior anaesthetist in Manchester with close connections to the publisher, and Gray had an unrivalled knowledge of the dramatic changes taking place and access to the chief participants. The arrangement worked highly successfully, each holding the other in high regard. For several years, Falkner Hill travelled from Manchester to Liverpool each week to discuss journal matters with Gray at his university department. The latter undertook the processing of manuscripts, often consulting the former on special problems.
Gray was an outstanding editor. He would go to great trouble to help an author if he believed the basic content was worthy of publication. At that time, the principles of manuscript presentation, now regarded as normal, were little understood and there were few able to instruct the aspiring author. Career advancement in the specialty was much less dependent on published work. Gray was remarkably skilled at achieving desired changes to manuscripts without upsetting senior personages unused to constructive criticism. A clear priority for him was to increase the international content of the BJA. This often required much attention to English language style and presentation and again he excelled at the task. Over the years 1948–1958, the BJA gradually improved in coverage, quality, and circulation. During this decade, the calls on Gray's time became much heavier, however, and he felt the need for assistance in editing the expanding Journal. The Board accepted this view and appointed A.R. Hunter of Manchester and J.E. Riding of Liverpool as Assistant Editors. The steady progress continued.
In 1961, Cecil Gray became the Sir Arthur Sims Commonwealth Travelling Professor, elected by three royal colleges: the Royal College of Surgeons of England, the Royal College of Physicians (London), and the Royal College of Obstetricians and Gynaecologists. Under its terms he was enabled to visit Australia with his wife for a period of 3 months to engage in educational activities and interchange ideas across that country. During his absence, Riding was asked to assume the day-to-day running of the Journal with the advice of Falkner Hill. On Gray's return, so great was the number of matters awaiting his urgent attention that he asked Riding to continue, which he did with the approval of the Board until the end of 1972 when A.A. Spence became Editor. Although readily available to advise on editorial matters, Gray's role now was essentially that of the principal figure on the Board.
During the 1960s, many new members representative of the rapidly advancing developments in the science and practice of anaesthesia such as J.F. Nunn, J.P. Payne, R.A. Millar, and J.G. Robson joined the Board as older members retired. There gradually arose a feeling that the desired growth of the journal was being hampered by an insufficiency of money. It was recognized that more editorial, technical, and secretarial help together with office equipment was needed. The much increased work involved in editorial processing now, it was believed, required an improved basis for remuneration.
By the 1970s it became clear that the existing financial arrangements were also unsuited to the extension of facilities viewed by the Board as essential to the enhancement of the Journal's influence and status. Negotiations with the publisher, John Sherratt and Son Ltd, mainly undertaken by A.R. Hunter in 1974, did not yield acceptable results. Cecil Gray was, however, adamantly opposed to a change of publisher, believing firmly that a duty was owed to one who had supported the journal though the dark times during and after the Second World War. But there is no doubt that the existing situation was untenable and was impeding progress. By this time, Gray was Dean of the University of Liverpool Medical School and was frequently unable to attend BJA Board meetings. The pressure for change became compelling. By 1975, new arrangements with MacMillan Journals Limited had been effected. It fell to Riding to convey this momentous decision to Gray at the Dean's office. Gray was deeply unhappy at this news and dissociated himself completely from the Board's view. At a subsequent meeting he appeared to have come to accept the overwhelming strength of feeling in favour of the new arrangement. He felt, however, that the time had come for him to retire. Even two decades later, he still regarded the decision as mistaken. This was an unfortunate departure for one whose devotion, determination, and great ability had virtually single-handedly rescued the Journal from oblivion and had drawn to the Board many of the leading figures of the day. He set the Journal on its course as an international organ of high standing and universal respect.
T. Cecil Gray retired in 1976, but continued to take a deep interest in medical affairs, contributing several papers on historical aspects of anaesthesia. Having attained the age of 90 yr, and despite frailty, he continued to attend professional events. At some of these he was given yet further honours to add to the many he had been awarded over half a century of uniquely distinguished service.
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1 Griffith HR, Johnson GE. The use of curare in general anesthesia. Anesthesiology (1942) 3:418–20.
2 The Times Obituary. www.timesonline.co.uk/tol/comment/obituaries.
3 Gray TC, Halton J. A milestone in anaesthesia? (d-Tubocurarine chloride). Proc Roy Soc Med (1946) 34:400–10.
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