Major influence in emergency medicine practice

EDWARD WILLIAM BRENTNALL August 5, 1929-October 1, 2024

On October 1, 2024, Dr Edward Brentnall MBE, OAM, KStJ, one of the architects of emergency medicine in Australasia, took advantage of the Victorian voluntary assisted dying legislation to peacefully and gratefully bring his long, active life of service and caring for others, to a close.

Born in Lancashire, the second son of Charles and Janet Brentnall, Ed followed his father into medicine. After graduating and completing a year’s residency at University College Hospital, London, he was called up for national service and took a short service commission with the Royal Army Medical Corps in Singapore during the Malayan insurgency, marrying Hazel Otridge while there. Awarded the General Service Medal (Malaya) in 1954 and the MBE (Military Division) in 1956, he returned to the UK in 1957, and served out his commission as a medical officer at the Royal Artillery Depot at Woolwich. He then undertook a diploma of obstetrics and entered general practice in Kent before migrating to join his brother and parents in Australia.

Arriving in Melbourne in 1965, Edward worked in general practice in the Melbourne suburb of Box Hill. Two years later, he joined the Order of St John. In this capacity, he attended the Southern Aurora derailment at Violet Town in 1969 and the search for the kidnapped teacher and students of Faraday Primary School in 1972. A member of St John Council for 11 years, he was appointed deputy commissioner in 1980, Officer in 1981, and invested as a Knight of the Order of St John in 2009. The St John specialist volunteer group of healthcare professionals who contributed time to public events was formed as the Edward Brentnall Division.

In a major career shift, Edward gave up general practice in 1975 to become the full-time salaried director of Box Hill Hospital casualty: a shift, he acknowledged, made possible through his experience of working with St John and the precedent of his friend, Dr Peter Bush, the first director of emergency services at Royal Melbourne Hospital. This part of the health system was considered the most difficult and least desirable at the time, but Ed was challenged to improve the quality of emergency care which became his primary goal for the rest of his career.

Edward Brentnall: The people of New Zealand, Western and South Australia were to benefit the most from his contribution to reforming emergency medical care.

He attended courses at Mount Macedon Counter Disaster College to prepare for the hospital’s role in major events and was active in bringing together directors of hospital emergency departments across the state to learn from each other, to improve processes and outcomes for their patients.

In 1975, Ed introduced a triage system to prioritise care in the Box Hill Emergency Department so that people who needed urgent care would get it more quickly. His original system has been modified slightly to become the Australasian Triage Scale which is used today internationally.

A founding fellow of the Australian College for Emergency Medicine, Ed was also a chief protagonist in its formation. His original vision for the national organisation reflected the multidisciplinary Victorian Emergency Departments Association. Some, however, were opposed to this breadth and the formal proposal Ed eventually moved, in some frustration, included only medical professionals.

Ed’s instinct to include nurses in his proposal for the college was typical of his leadership style that created a workplace culture in the Box Hill Emergency Department his colleagues described as “like no other”. Staff of all levels and roles were respected, and egos had to be left at the door. He demonstrated leadership with honesty, integrity, responsibility and accountability. He taught the power of a great team, and that a great team is more than the sum of the individuals within it.

His modesty meant that his contributions were not always appropriately recognised.

He sought no accolades and when he received them, he was surprised, humble and self-deprecating – he tended to attribute his successes to others even when they were solely his. The cause always took precedence over opportunities for his own personal reward.

Following retirement Ed took director roles in numerous Australasian hospitals with struggling emergency departments. The people of New Zealand, Western and South Australia were to benefit the most from Ed’s contribution to reforming emergency medical care in those regions. Taking on these roles and showing people how things could be done better spread his influence through the many key people in those regions who took his lead.

He had a major positive influence on nearly every important leader in every area of emergency medicine practice during the crucial development years of the specialty. We believe no other individual has exerted so much positive influence on the specialty in Australia and New Zealand.

His way of leaving this world was as he lived it: clear-eyed, purposeful and compassionate; his family, colleagues and friends certain of his love, his resolve and his thanks.

A passionate citizen of his adopted country, Ed was a long-term member of the Field Naturalists Club of Victoria, Trust for Nature and Landcare Australia. He is survived by his family: wife Hazel, daughters Jane, Anna and Sara, his sons-in-law Chris and Michael, and grandchildren Laura, Noah, Nick Jake and Ben.

Dr Allan Mawdsley OAM is honorary secretary, St John Museum committee and associate professor Robert Dunn is director, clinical and academic emergency medicine, Royal Adelaide Hospital. They were great friends and close colleagues.