The Dept of Respiratory Medicine at SCGH evolved from the Perth Chest Hospital which was opened to treat patients with tuberculosis (TB) who had previously been cared for at the Woorooloo Sanatorium. Sanatorium treatment for TB had been the standard management since 1900 and promoted isolation to prevent the spread of the infection in the community (TB was common and endemic). It consisted of bed rest, fresh air and sometimes surgical procedures to allow cavities in the lung to be closed thereby promoting healing. More radical surgical procedures such as thoracoplasty (removal of some of the rib cage) were also performed, but quickly ceased once antibiotics to treat the disease were discovered.

With the introduction of anti-TB drugs (initially Streptomycin and PAS) in the 1950s and with advances in thoracic surgery a more active approach to the management of the disease occurred so that prolonged bed rest was no longer prescribed and the Perth Chest Hospital (A Block) was built.

The first hospital superintendent was Dr Bob Elphick who had been a TB physician at Woorooloo and he was accompanied by Dr Janet Elder (a Victorian graduate) and Dr John Smyth from England. Their medical training had included management of non-TB chest diseases so that cases of asthma, COPD, and lung cancer etc. were increasingly admitted to fill the unused beds. (Dr Elphick remained hospital superintendent until 1970 when he reverted to being a clinician and was replaced by Dr Ron Kilgour).

They formed the Department of Respiratory Medicine and they were joined by another chest physician Dr Richard (Dick) Adams and an overseas graduate Dr Arnold Kreives, whose credentials to practice medicine in Australia were not recognized, so that he could only work as a virtual registrar in a hospital!

As the emphasis on bed rest for many chest diseases became less important length of stay was progressively reduced, so that although more patients were admitted they were easily accommodated. At the same time the occurrence of TB in the community declined and so the need for TB care continued to decline and the pressure to admit more and more general patients increased. So in 1958 the University of WA Department of Medicine, led by Professor Eric Saint, set up a general medical unit (Ward 1B) while Dr Bill Smith established a cardiology/general medical unit (Wards 1A) and thoracic surgery for TB and lung cancer grew under the direction of Mr Peter Gibson and Mr Archie Simpson and later Mr Trevor Nichols. Respiratory Medicine became one of the medical teams and Gastroenterology, Neurology and other specialist medical and surgical teams were established.

By the mid-1960s patients referred from general practices were admitted and an “Assessment Area” was set up on the ground floor of A block for sorting patients’ needs out prior to them going into a ward.

As the hospital grew B Block was built across the “paddock” from A block and the chest wards moved there with TB patients downstairs (wards 9 and 10) and general respiratory patients upstairs (ward 11 and 12) until the opening of G block in 1982.

Perth Chest Hospital doctors who were responsible for TB case-finding in the community and for the supervision of anti-TB therapy in patients who had been discharged from hospital also visited inpatients with TB. Dr Joe Cassidy who was Director of PCC also worked as a locum chest physician after Dr Adams resigned until a full-time replacement could be negotiated.

Dr Tony Tribe was appointed in 1976 having done some respiratory training in Edinburgh, Dr Elphick retired in 1977 and Dr Bill Musk was appointed to replace him. Dr Elphick stayed on as a “locum” for a further year while Dr Musk was completing postgraduate training in Wales. Dr Janet Elder became department head but quickly handed this on to Bill when he returned in 1978. Dr Adams resigned and moved to Dunsborough in 1985 and Dr Musk persuaded the hospital to replace him with a full time appointment, so that Dr Gerry Ryan joined the Department until 2014 when he retired and returned to his home state of Victoria. Janet Elder retired in 1990 and was replaced by Dr Martin Phillips who replaced Dr Musk as Department Head in 2005. Dr Musk retired from full-time work in 2013.

Respiratory Medicine has always relied heavily on nursing support provided by Sr Sue Morey who has always made difficult challenges more achievable. This was best exemplified in 1979 when she and Dr Musk successfully established a bronchoscopy service in B Block which continues to thrive!

Unlike most Respiratory Departments around the world, Pulmonary Physiology (department for the assessment of the respiratory function) has always been separate and part of the Diagnostic Division of the hospital, initially with Dr Fred Heymenson, but then under the firm hand of Dr Bill Finucane from 1976, working closely with the respiratory physicians and including sleep medicine.

By Bill Musk
  1943 – 2021