A shock to the system – An Irishman’s Diary on Frank Pantridge and the portable defibrillator

There is a statue of Frank Pantridge, who was born 100 years ago on October 3rd, outside Lisburn City Hall. How many passing the statue are aware of who he was or of his huge contribution to modern medicine? His invention of the portable defibrillator enormously advanced emergency medicine and the life-saving effectiveness of paramedical services.

He was awarded the Military Cross for gallantry and distinguished services in Singapore during the second World War, and spent from early 1942 to the end of the war working as a slave labourer on the Burma-Siam railway, in the process being one of the few survivors of the Tanabaya death camp.

Pantridge was born in Hillsborough, Co Down, and grew up on a small farm. His father died when he was 10 and he had a troubled school life, being expelled several times. He completed his schooling at Lisburn Friends’ School and went on to Queen’s University, from where he graduated in medicine in 1939, finishing near the top of his class.

Despite getting a much sought-after job in the Royal Victoria infirmary, he joined the Royal Army Medical Corps and was posted to the Far East. His troubled relationship with authority, evident in school and university, continued in the army. His citation for his award of the Military Cross at the fall of Singapore read: “This officer worked unceasingly under the most adverse conditions of continuous bombing and shelling and was an inspiring example to all with whom he came into contact. He was absolutely cool under the heaviest fire.”

During his nearly four years as a prisoner of war in appallingly inhumane conditions, he survived the often-fatal cardiac beriberi, which may have aroused his particular interest in heart disease. He must have possessed extraordinary physical and mental strength but chronic ill-health dogged the rest of his life.

Back in Belfast in 1945, he lectured at Queen’s and did research into cardiac beriberi, which won him a scholarship to Michigan University, where he worked with Frank Wilson, the world expert on electrical measurement of heart disease. When he returned to Belfast in 1949, he became physician at the Royal Victoria Hospital, remaining there until retirement in 1982.

He soon established an internationally known and respected cardiology unit at the hospital. He and his colleague, John Geddes, introduced what we now know as CPR for the early treatment of heart attack. From further study, he concluded that many coronary fatalities resulted from ventricular fibrillation, and that the earlier medical intervention occurred, the greater the chances of survival.

This led him in late 1965 to design, with the help of Geddes and Alfred Mawhinney, a technician, a mains defibrillator, operated by two car batteries in the back of an old ambulance – the world’s first mobile defibrillator. It weighed 70kg but within a few years, Pantridge, using a miniature capacitor manufactured for Nasa, had designed one weighing 3kg.

The new treatment system, often called the “Pantridge plan”, was adopted almost immediately in America but, amazingly, it took up to 16 years for it to be applied comprehensively in his native UK.

He argued that anyone who could administer CPR could also use a defibrillator and that there should be one beside every fire extinguisher, since human life was far more precious than property. To avoid any danger from misuse, he included a fail-safe mechanism that identified a person’s heart rhythm and would administer a shock only if necessary.

He was made a fellow of the Royal College of Physicians in 1957 and awarded a CBE in 1978. He published The Acute Coronary Attack in 1975. The title of his autobiography, An Unquiet Life (1989), was appropriate, given his lifelong quarrels with authority. His obituarist in the London Independent (January 24th, 2005) said he was "an irascible man on a good day, often apoplectic, rode roughshod over his juniors, and was fond, perhaps too fond, of wining and dining. He would monopolise a conversation and walk away when he had said what he wanted". On the other hand, he could be witty, generous and loyal and it has been remarked of him that "for him to like someone, he had to respect them, and he could then be a very loyal friend".

Whatever about his personal failings – and which of us does not have them – the courage he showed during the war was such that few of us would be capable of, and his significant contribution to medicine has saved countless thousands of lives.