I recently spent a weekend in Martinborough and as many people do spent some time browsing the local bookshop. Here I serendipitously came across Perfection. As a general surgeon, I was aware of the New Zealand connection to the birth of plastic surgery through Sir Harold Gillies and Sir Archibald McIndoe, but not of Sir William Manchester or indeed Rainsford Mowlem or John Barron. Sir William Manchester was one of four “first descendants” of the New Zealand plastic surgical family tree. His career spanned from the 1930s into the 1980s. The legacy Manchester left is simply astonishing and deserved of a biography. Early in WWII, Manchester trained in England under McIndoe and Gillies then transferred to serve in Egypt, providing care to New Zealand soldiers. Due to the increasing repatriation of injured New Zealand soldiers toward the end of the war, Manchester was sent back to New Zealand to work and lead the newly established Burwood plastic surgical unit. In 1947, despite having a reputation as a pioneer and fine plastic surgeon, Manchester did not have his FRCS or FRACS and so returned to the United Kingdom to complete this qualification. In 1950 Manchester was recruited to return to New Zealand to set up and run a stand-alone plastics unit at the newly opened Middlemore Hospital. Here Manchester remained until his retirement from public hospital work in 1979. What comes across as a recurring theme is Manchester’s ability to see the “bigger picture” in creating processes and team-based units that are required for successful complex surgery. Additionally, he had a strong desire to maintain international collaborations (to ensure maintenance of knowledge) and was committed to training the next generation, all so important components to creating an enduring and successful service.

This is a highly interesting story of an exceptional individual who converted experiences from a horrific world event into a legacy that continues to benefit New Zealand citizens decades on. One cannot help but feel that those initial wartime patients who endured such disfiguring injuries would in some small way be proud of the legacy that they, Manchester and his teams were able to create. This story is well told by the authors who both had personal connections with Manchester and have gone to extensive effort to gain anecdotes and images from others who were operated on by or worked with Manchester. Perhaps the only disappointment is that Manchester had previously declined to personally contribute to a biography, and so some of the richness of the stories and personal thoughts are missing. Perhaps Manchester was simply unaware of the magnitude of what he was instrumental in creating, or he was simply of a generation or a culture that didn’t like to re-live past times or overtly celebrates one’s own success.

For current surgeons it should challenge us to think, what will we contribute to the New Zealand health system that leaves it in a better place than when we started? I would suggest that Sir William would challenge us that simply turning up and doing surgery may not be enough. Manchester may well have posed the question “what will you contribute to elevating the team performance?” understanding that to create something long lasting and worthwhile can never be focused on any one given individual.

I recently spent a weekend in Martinborough and as many people do spent some time browsing the local bookshop. Here I serendipitously came across Perfection. As a general surgeon, I was aware of the New Zealand connection to the birth of plastic surgery through Sir Harold Gillies and Sir Archibald McIndoe, but not of Sir William Manchester or indeed Rainsford Mowlem or John Barron. Sir William Manchester was one of four “first descendants” of the New Zealand plastic surgical family tree. His career spanned from the 1930s into the 1980s. The legacy Manchester left is simply astonishing and deserved of a biography. Early in WWII, Manchester trained in England under McIndoe and Gillies then transferred to serve in Egypt, providing care to New Zealand soldiers. Due to the increasing repatriation of injured New Zealand soldiers toward the end of the war, Manchester was sent back to New Zealand to work and lead the newly established Burwood plastic surgical unit. In 1947, despite having a reputation as a pioneer and fine plastic surgeon, Manchester did not have his FRCS or FRACS and so returned to the United Kingdom to complete this qualification. In 1950 Manchester was recruited to return to New Zealand to set up and run a stand-alone plastics unit at the newly opened Middlemore Hospital. Here Manchester remained until his retirement from public hospital work in 1979. What comes across as a recurring theme is Manchester’s ability to see the “bigger picture” in creating processes and team-based units that are required for successful complex surgery. Additionally, he had a strong desire to maintain international collaborations (to ensure maintenance of knowledge) and was committed to training the next generation, all so important components to creating an enduring and successful service.

This is a highly interesting story of an exceptional individual who converted experiences from a horrific world event into a legacy that continues to benefit New Zealand citizens decades on. One cannot help but feel that those initial wartime patients who endured such disfiguring injuries would in some small way be proud of the legacy that they, Manchester and his teams were able to create. This story is well told by the authors who both had personal connections with Manchester and have gone to extensive effort to gain anecdotes and images from others who were operated on by or worked with Manchester. Perhaps the only disappointment is that Manchester had previously declined to personally contribute to a biography, and so some of the richness of the stories and personal thoughts are missing. Perhaps Manchester was simply unaware of the magnitude of what he was instrumental in creating, or he was simply of a generation or a culture that didn’t like to re-live past times or overtly celebrates one’s own success.

For current surgeons it should challenge us to think, what will we contribute to the New Zealand health system that leaves it in a better place than when we started? I would suggest that Sir William would challenge us that simply turning up and doing surgery may not be enough. Manchester may well have posed the question “what will you contribute to elevating the team performance?” understanding that to create something long lasting and worthwhile can never be focused on any one given individual.