Stewart Hunter was born in 1936 in Comrie, Perthshire. He was the son of Margaret (Peggy) and Archibald Hunter who was a minister in the Church of Scotland and later became Professor of New Testament Theology at the University of Aberdeen. Whilst Stewart chose medicine over the Kirk, he still studied at Aberdeen University. Following qualification in 1960, he chose to specialise in Paediatric Cardiology moving his family to London to learn how to treat children born with heart malformations at Great Ormond Street. Subsequently, he and the family moved back north to Edinburgh to continue that speciality at the Sick Children’s Hospital. In 1969, he was appointed as a lecturer in paediatric cardiology in the academic department of Newcastle University. Between 1972 and 1973, he and the family went to a research post in the United States of America in Pennsylvania where he was part of a team researching and publishing on the use of cineangiography in adults, a technique which he then extended with Dr Mike Tynan to children and infants upon his return to Newcastle. He returned to a second consultant post at Newcastle General Hospital, where the North East Clinical Paediatric Cardiology department was sited before moving to the new purpose built department of Paediatric Cardiology at Freeman Hospital, Newcastle upon Tyne in 1977. His career is a list of achievements which is perhaps most notable for the many clinicians of varying backgrounds with whom he collaborated, supported, taught and developed over the years.
At the outset of echocardiography, Stewart was involved together with Carlos Mortera, Tony Goodwin and Michael Tynan in demonstrating what could be achieved with only M-mode including one of the earliest reports of contrast echocardiography. He was subsequently largely responsible, along with Dr Ron Pridie, a radiologist at Harefield, for showing the value of cross-sectional echocardiography as the major diagnostic tool in establishing the phenotypes of the congenitally malformed heart. They set up the first United Kingdom course in echocardiography run biannually between Newcastle and Harefield in 1974 which continued for 25 years. Stewart, along with Michael Tynan, was also involved in the initial promulgation of what is now known as “sequential segmental analysis”. The regular meetings between the two institutions built on this experience and also gave rise to courses in sequential anatomy with Robert Anderson which became essential for those wishing to fully correlate echocardiographic findings with anatomical reality.
There followed a number of firsts, either for the United Kingdom, or for the North East where he made his home. With Michael Tynan and others, he was instrumental in forming the British Paediatric Cardiac Association which became the British Congenital Heart Association which was affiliated with the British Cardiovascular Society. Stewart was the first President (1991–1993) followed by Michael Tynan. With John Burn and Alison Heads-Baister, he set up the tertiary referral fetal echocardiography clinic serving the North East but based in Newcastle. Later, this trio were joined by Paddy Walsh who Stewart was able to appoint as the first paediatric cardiology specialist liaison nurse. He was one of the founders of the Children’s Heart Unit Fund (originally known as the Lesley Ann Scott Fund) which has helped develop and improve children’s heart services throughout the North East. With Chris McGregor, he helped to establish the heart and lung transplant programme at Freeman Hospital, only one of two in the country for children. Again with Alison Heads-Baister, he was one of the founder members of the British Society of Echocardiography in 1991.
From 1987 onwards, Steve Robson and Stewart published more than 14 ground breaking research papers into the maternal haemodynamic changes in pregnancy. This was followed from the early nineties by many papers published with Jon Skinner and Edmund Hey, amongst others, describing haemodynamic changes immediately after birth relevant to neonatal intensive care. In 2000, Stewart produced the first United Kingdom book on “Echocardiography for Neonatologists” co-edited with Jon Skinner and Dale Alverson with many international contributors joining those from the United Kingdom. Throughout his career, he was on the editorial committee of four journals, co-authored 5 books, authored 47 invited articles or book chapters and 124 peer-reviewed papers.
He was involved in many partnerships and projects but these examples demonstrate the collaborative and collegiate, open-minded approach which Stewart had in developing and driving forward care using research and standards. After Michael Tynan left for Guy’s Hospital in 1976, Hugh Bain and later Chris Wren joined further developing the Newcastle department into one which attracted trainees and researchers from cardiology, paediatrics, neonatology, fetal medicine and genetic backgrounds to name a few.
Stewart was an appointed member of seven different independent review panels. In 1992, he was a member of the joint working party of the British Cardiac Society reporting upon “The future of paediatric cardiology in the UK” which defined the first steps in ensuring that the speciality was sustainable. Following the enquiry into Paediatric Cardiac surgery outcomes at Bristol, Stewart with Leslie Hamilton and David Spiegelhalter was commissioned to review paediatric cardiac surgery results at Brompton and Harefield. There was no evidence of any issue at the hospitals, but the review found the Hospital Episode Statistics and the Cardiac Surgical Register provided inadequate data for audit. Therefore, it was recommended that a national system for congenital cardiac operation outcomes should be established. This eventually became the National Congenital Heart Disease Audit, which has been an exemplar for national outcome reporting.
No mention of Stewart Hunter would be complete without mentioning the legendary hospitality which he and his wife Val provided to their wide range of colleagues and friends. Trainees, colleagues and visiting professionals would often be hosted at their house. There were memorable dinner parties which often concluded with singing around their piano into the evening. Those remarkable events would also include, at times, the whole Hunter family (Newcastle branch). There was also Stewart’s love of all sport but especially golf which he was able to enjoy, again with colleagues and family but also as a route to raise funds for Children’s Heart Unit Fund. Together with Hugh Bain, he was a long-time member at Gosforth Park until retiring to Gatehouse of Fleet where he continued to enjoy the sport until quite recently.
Archibald “Stewart” Hunter made a huge impact in the paediatric cardiology world and is one of those who developed and drove forward the speciality. He was a remarkable teacher, and it is perhaps the impact which he had on the development of so many who were fortunate to count him as a mentor which will be his lasting legacy. His loss will be felt by patients, their parents in the North East and the many colleagues and trainees with whom he worked. His vibrant enthusiasm and support has had an effect on the training and careers of so many doctors, nurses and allied professionals both within and without the world of paediatric cardiology. He had a role in the development of at least six professors in specialities outside paediatric cardiology because the Newcastle upon Tyne Children’s Heart Unit with Stewart, Hugh Bain and Chris Wren, had a great “feel” to it and attracted people who wanted to learn and develop. Stewart was able to bring people together and forge them into more effective groups in the delivery of care and research. He was never threatened by the success of others but actually revelled in it, especially if he had been involved or had helped them. Merely listing, his many professional achievements cannot do justice to his working life as he has a much wider clinical family, many still practising, and now grieving, for a man who played an integral part in the people they have become and the care which they continue to deliver.
