Do you know that the first images that correspond to you are taken these days even before you are born? Obstetricians (doctors who practice obstetrics, the field of study that concentrates on pregnancy, childbirth and the post-partum period) use ultrasound to produce pictures of a baby (embryo or foetus) within a pregnant woman.
An imaging test, ultrasound scans use sound waves to create a picture of organs, tissues and other structures inside the body without using radiation, unlike x-rays. The physician who developed ultrasound diagnostics, thereby enabling doctors to detect potentially fatal issues and prevent health problems, was Englishman Ian Donald.
Bridging both worlds
Born in 1910 in Cornwall, England, Ian Donald was the eldest of four children born to Helen Wilson and John Donald. Helen was a concert pianist and John was a doctor and Ian grew up to become someone who tread both the worlds of art and medicine with panache.
After beginning his formal schooling in Scotland, Donald moved with the rest of his family to South Africa in 1925. He studied at the Diocesan College in Cape Town and then the University of Cape Town, majoring in arts and music, with a fine understanding of literature and a number of languages.
Having lost his parents while in South Africa, Donald moved to London with his siblings in 1930 and entered St. Thomas’ Hospital Medical School in London in the same year. After receiving his medical degree in 1937, Donald became a general practice physician in the Obstetrics and Gynaecology Department at St. Thomas’ Hospital.
Wartime learnings
During World War II, Donald was drafted into the Royal Air Force. It was in this period that Donald was drawn towards sonar (sound-based) and radar (based on high-frequency electromagnetic waves) techniques that were used during warfare to navigate, communicate and detect objects underwater.
Returning to St. Thomas’ after the war, Donald found himself in a position where he could spend time on research. Working alongside Maureen Young, who specialised in foetal and neonatal physiology, Donald developed an improved design for a negative pressure respirator to help premature babies with breathing difficulties. As opposed to existing neonatal respirators that had a set rhythm and hence made breathing more difficult for the babies at times, Donald’s device conformed to the infant’s breathing pattern.
Works on respirators
In 1952, Donald moved to Hammersmith Hospital in London and continued his research, developing a positive-pressure respirator. This device, which could be applied to the patient in under a minute, delivered an oxygen mixture to the infant’s face. While the negative-pressure respirator was ideal for long-term treatment, the positive-pressure respirator was more suited for crisis scenarios.
In 1954, Donald met English-born American physician John Wild, who had had success in using pulse-echo ultrasounds to visualise abnormal tissue in the human breast. Based on his wartime sonar, radar experiences and seeing the potential of using ultrasound to obstetrics, Donald sought Wild’s opinion and he suggested using ultrasonic industrial flaw detectors.
In that same year, Donald was appointed to the Regius Chair (a chair endowed by the British Crown) of Midwifery at the Glasgow Maternity Hospital in Scotland. As fate would have it, one of Donald’s patients introduced him to her husband, the director of Babcock and Wilcox, an industrial fabrication company, in 1955.
Three-man team
As a major user of industrial ultrasound, including flaw detectors for checking cracks in welds and steel plates, Babcock and Wilcox was the perfect setting that Donald could have imagined. When invited on a tour to their factory, Donald was all eyes during the demonstration of the ultrasonic flaw detector. When the technician tested the equipment by bouncing off an ultrasonic beam off his thumb, Donald was certain that these could be applied to biological material.
By 1956, Donald started working with Thomas Brown, an engineer at Kelvin and Hughes Ltd. in Glasgow who had a sound understanding of industrial ultrasound technology. Brown had already been dabbling with medical imaging along with Scottish physician John MacVicar and Donald too had been working with MacVicar.
Based on the medical knowledge of Donald and MacVicar and the engineering acumen of Brown, the trio mastered the use of ultrasound as a diagnostic technique and also came up with an ultrasound machine. In 1957, they used their technology to show that a woman, previously diagnosed with an inoperable gastric cancer, actually had an ovarian cyst. Their diagnosis was confirmed by surgical intervention and the cyst was successfully removed.
First ultrasound images
On June 7, 1958, Donald, MacVivar and Brown published their findings in The Lancet in a paper titled “Investigation of abdominal masses by pulsed ultrasound”. The seminal paper contained the first ultrasound images of the foetus and brought global attention to the three men.
Even though the idea was initially greeted with scepticism, it gained widespread acceptance from the medical community and the public with time. Donald, MacVivar and Brown constantly improved their device to build a scanner that could be handled efficiently.
In the years that followed, Donald’s work with ultrasound ensured that the foetus was no longer invisible to doctors and monitoring foetal development became much easier. By the time Donald died in 1987 due to his many heart problems, he had seen his idea grow to become the standard clinical practice world-over.
