Pioneer in the cardiac applications of ultrasound – Sydney Morning Herald

Ian Gregory McDonald September 23, 1933-September 24, 2020

Professor Ian McDonald, a cardiologist and world-recognised pioneer in echocardiography, mentor and thinking physician, has died in Melbourne at the age of 87.

Ian was a precocious child who attended ONeill College, Elsternwick, as a primary student and St Kevins College, Toorak, for his secondary schooling. He graduated from medical school at the University of Melbourne in 1957.

He was a medical student, intern and resident at St Vincents Hospital, Melbourne. He became a member of the of the Royal Australasian College of Physicians and became an MD while at St Vincents Hospital in 1961.

Ian McDonald: world-recognised pioneer in echocardiography.

Ian trained in cardiology under Professor Ken McLean at The Alfred hospital and then went to the Cardiovascular Research Institute (CVRI), University of California San Francisco, to further his studies in cardiology and lung physiology.

He returned to St Vincents as the founding director of the Cardiovascular Diagnostic Unit in 1965. This was later known as the Cardiac Investigation Unit (CIU). His return coincided with the establishment of the cardiac surgery at St Vincents.

Ian had been fascinated by the motion of the heart since his time as a medical student. His early research in collaboration with John Clarebrough, described the rotation of the heart during its contraction (cardiac torsion) which explained the paradoxical observation of a palpable outward impulse at the hearts apex during cardiac contraction.

He was best known as a pioneer in the cardiac applications of ultrasound. He took a sabbatical at the Indiana University Medical Centre in Indianapolis, where there was access to early cardiac ultrasound machines (echocardiography).

Ian collaborated with Dr Harvey Feigenbaum to produce the seminal paper on The Analysis of Left Ventricular Wall Motion by Reflected Ultrasound, which established the clinical utility of echocardiography in the assessment of cardiac function.

This was followed by a series of single-author papers published in the leading journal Circulation, describing echocardiographic findings in patients with aortic valve disease, mitral valve disease and abnormalities of cardiac contraction.

He established a standard manner for recording echocardiograms and confirmed the reproducibility and reliability of the technique. These highly recognised papers culminated in his book An Introduction to Echocardiography,which became a standard reference book as echocardiography was established across the world.

This book was written with great clarity and precision that was a hallmark of his work. He also promoted and lectured on his discoveries and enthusiastically trained others in echocardiography which soon provided an invaluable adjunct to cardiac surgery.

As echocardiography developed, he had the first Australian experience with colour flow Doppler mapping and wrote further papers describing its application in assessing valvular heart disease. He combined this research with a passion for teaching and the clinical interpretation of investigational findings. While at St Vincents Ian practised high-class clinical medicine and mentored many cardiologists throughout Australia and New Zealand.

He spent another sabbatical as visiting professor at the Department of Clinical Epidemiology and Biostatistics at McMaster University, Ontario, Canada, in 1983-84. This built on his interest in assessing the value of technology in the clinical care of the patient. Subsequently, he was struck by the limitations of technology including echocardiography in the reassurance of patients who were concerned that they may have cardiac disease.

This led to research at the Department of Sociology and Anthropology, at La Trobe University in 1990. He established the Centre for the Study of Clinical Practice at St Vincents Hospital in 1994, at which time he retired from clinical cardiology.

Ian constantly promoted a patient-focused approach to the practise of cardiology and medicine. He was a warm and compassionate doctor. He was a past president of the Australian Society of Ultrasound in Medicine and an honorary member of the American Institute for Ultrasound in Medicine and Biology, which formally recognised him as a pioneer in echocardiography. He also served on the Australian National Health Technology Advisory Panel.

Ian finally retired from St Vincents Hospital in 1999. In his retirement he wrote The Crisis in Contemporary Medicine and the Rise of the Reflective Physician and another book Doctors and Patients. All you wanted to know and why. These books explored the doctor-patient interactions and the need to include social science and humanities into the medical curriculum.

Ian was married three times: to Moira, to Pat, and then to Jeanne. He is father to Maria, Gregor, Nadia, and Greta. His children all thank him for the love and encouragement he gave them as individuals. He is survived by his children and six grandchildren Casey, Reuben, Saskia, Charlie, Dashiell, Jett.

We are grateful to his sister, Peta Murray, who provided the details of his early life and was his companion after Ian had a severe stroke which required his hospitalisation in a Balwyn nursing home. Petas husband, Owen Murray, found this nursing home where Ian spent the last 11 years of his life and where he wrote two of his books.

Professor McDonald was a mentor to associate professors Dr Andrew MacIsaac and Dr Michael Jelinek. Each succeeded him as head of the cardiac department at St Vincents Hospital, and each was national president of the Cardiac Society of Australia and New Zealand.

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Pioneer in the cardiac applications of ultrasound - Sydney Morning Herald