Emeritus Prof. Saxon White

Biography

My father left the Australian Navy in 1946 and joined the staff of The King’s School, Parramatta, and we moved home to Parramatta, where we lived close to my father’s cousins, the Benauds, and of course Richie and John. At this time I finished at Woollahra Primary Opportunity Class and commenced at Sydney High School moving after 6 months to Parramatta High School and then to King’s in November 1946. At King’s I became school captain and played combined GPS firsts Cricket and Rugby for 2 years. In 1953 I enrolled in Medicine at the University of Sydney and at St Andrew’s College, but my undergraduate career was interrupted twice each for one year to tour with the Australian Rugby (Wallaby) team first to South Africa (1953) and then the British Isles, France and North America (1957-58). So in 1953 I was touring South Africa with the Wallabies when Richie was touring England simultaneously with the Australian Cricket team. As a Sydney University undergraduate and rugby club member I played 7 tests and 22 other tour games in the Australian colours, and my cricket career as a NSW State Colts selection lapsed. I retired from all representative sport in 1958 to concentrate on medicine. After graduation I became professorial surgical registrar at the University of NSW Prince Henry Hospital and commenced research as a National Heart Foundation Fellow for a higher degree in medicine supervised by Professor Paul Korner in cardiovascular reflex control during hypoxia including haemorrhagic shock. I graduated MD and in 1968 I became Overseas Life Insurance Research Fellow of Australia and New Zealand with tenure in 1968 in the Department of Physiology, University of Goteborg, Sweden working with Professor Bjorn Folkow and Dr Bengt Oberg on microcirculation rheology and reflexes emanating from the heart. In 1969, the Fellowship took me to the Scripps Clinic and Research Foundation, La Jolla, and the Department of Cardiology, University of California, San Diego, where I worked with the Professors Gene Braunwald and Dean Franklin on the behavioural and reflex control of the coronary circulation during rest and exercise in awake baboons and dogs. The third year of the Fellowship was in the Cardiology Department of the University of Sydney where I commenced work on reflex cardiorespiratory control during hypoxic conditions in awake pigtailed monkeys, dogs and rabbits. In 1974 I moved to the new medical school at Flinders University of South Australia, but within 18 months took the Foundation Chair of Human Physiology at the newer medical school at the University of Newcastle. We were 2 years ahead of the first undergraduate student intake and we developed an innovative curriculum, built buildings, and finally set up laboratories and took in postgraduate research students. I helped develop exercise stress testing in clinical cardiology at the Royal Newcastle Hospital, but a special innovation was our link with the Hunter Valley community in education and human research. We especially educated the community in human performance namely in the value of exercise for the maintenance of health, e.g. the HUFPUF Club of Merewether, and in the creation of the Hunter Academy of Sport (1989- ) with its provision for sporting service, education and research. In 2013 we service coached 26 separate sports for selected teenage talent squads. The Academy also provided for educational International Conferences, e.g. in 1989, 'Drugs in Sport, the Socio-Ethical and Medical Issues, [fully published, 1991, see elsewhere]. Its research commitment was through the Human Performance Laboratory at the University of Newcastle. It turns out these initiatives through the medical school and its community are continuing successfully, for which I will be eternally grateful to my wife Julie, my children Matthew, Lisa and Jessica, for their patience and support as we all grew and flourished in the Hunter Valley community.

Qualifications

• Doctor of Medicine, University of New South Wales
• Bachelor of Medicine & Surgery, University of Sydney

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Research

Research keywords

• Neural Control of Cardiopulmonary Systems

Research expertise

My philosophical goal is to help maintain Global Health, that is to say, the research and practice of sustaining health of human and animal populations as they interact with ecosystems on the planet.

My physiological goal is to identify the integrated mechanisms neural and non-neural responsible for survival in the freely operating, natural state.

A special goal is therefore to wherever possible experiment with conscious man and other awake mammalian species. This approach is justified by our knowledge that acute experimental research models using preparatory anaesthetic agents, surgery plus positive pressure ventilation disrupt in a variety of ways, the natural control systems we seek to identify.

My research therefore involves developing appropriate (new) techniques and a large measure of experimental surgery for pre-implantation in, or application to, the recovered awake experimental model (e.g. the application of thermodilution, electromagnetic, ultrasonic and impedance methods for measuring cardiac function, blood flow and airways dimensions). This enables examination of postulates concerning dynamic physiological control in awake man and animal (in my case rat, rabbit, cat, dog, sheep, pig-tailed monkey, and baboon). A special but not only target is the sensory and central nervous control of the coronary and bronchial circulations by efferent autonomic effectors.

One great advantage with this approach in awake species is the enabling of behavioural studies both at rest and when the species is mobile. We have correlated and analysed behaviour in terms of integrated, moment-to-moment autonomic, hormonal, and local autacoid responses, in both immediate and longer term domains. We have targeted emotion and published on Darwin's hypothesis of emotion, facial expression and linked autonomic responses. The biggest ongoing challenge is to analyse during exercise how the brain normally controls the coronary and bronchial (airways) circulations, and the airways themselves. These studies are relevant to the greatest killers of mammalian species on the planet when the normal, natural control systems are modified by disease, e.g. the cardiopulmonary conditions of coronary artery disease, hypertension (systemic and pulmonary), and the multiplicity of asthma syndromes. I have trained higher degree students in these philosophies since 1970 (see Teaching Expertise below).

An understanding of pathological processes are compromised without an understanding of the normal mechanisms underpinning survival. Special environmental influences requiring analysis are different forms of tissue hypoxia, i.e. ischaemia secondary to heart disease, and the arterial hypoxia (acute and chronic) of pulmonary disease, altitude, and the extremes of mammalian (including sporting) performance, e.g. postural change, diving, and the exercise-induced hypoxia and pulmonary haemorrhage in thoroughbred racehorses.

The review of functional correlates between vertebrate species offers fascinating insights into the evolutionary maintenance of cardiopulmonary survival mechanisms, which has been suggested as defence against tissue hypoxia. This has applied to lung barriers preventing inhaled harmful molecules from penetrating across airways into the systemic circulation, and the reasons for reflex autonomic vasoconstriction in the coronary circulation of the heart when this appears physiologically inappropriate.

I have published 101 fully peer-reviewed papers, Reviews and Book Chapters, and 122 Abstracts since 1970 (as at 22/1/2013)

Collaboration

In 1968 my primary collaboration after my higher doctorate in medicine in Australia was with Björn Folkow and Bengt Öberg at the University of Göteborg, Sweden. Here as a medical research fellow I learned a variety of original techniques developed in the Department of Physiology for studies in anaesthetised models of human physiology. We studied rheology and cardiac reflexes. In turn I demonstrated to the Scandinavian Physiological Society the awake rabbit preparation developed by Paul Korner in Australia for analysis of cardiac output control during hypoxia using thermodilution (a new technique not accepted fully at that time).

The next year 1969 I became a cardiology fellow in the novel Seaweed Canyon large animal complex at UC San Diego, La Jolla, California, where a new approach to studies of reflex cardiopulmonary control was used. This was physiological realism. The techniques allowed continuous measurement in awake animals of dynamic coronary blood flow and cardiac dimension changes under natural behavioural and reflex conditions using frequency shifted ultrasound as originally described by Christian Doppler. The techniques foreshadowed clinical echocardiography and like techniques. I worked with Gene Braunwald, and the inventor of the techniques, Dean Franklin. We examined behaviour effects on the coronary circulation in baboons of sleeping, feeding, and extreme excitement. We examined in awake dogs the effects of clinical complete heart block, and simulated and spontaneous arrhythmias when sudden changes in rate evoked large changes arterial pressure and baroreflexes. We then analysed responses in the coronary and other vascular beds during maximal exercise in greyhounds. Finally, we studied in awake rabbits the spectacular, natural changes in the circulation of the smoke reflex as a terrestrial model of nasophayngeal defence against nasally-inhaled molecules (in air or water = in bushfire and diving).

On return to Australia in 1970, I joined foundation science staff at the University of Sydney Cardiology Department, then known as the Hallstrom Institute. Collaboration was commenced between clinicians and basic scientists, and with the Veterinary School, and Pharmacology, through new higher degree students. Studies in primates tested if reflex defence mechanisms in hypoxia published in mammalian species were likely in man, and work was completed on reflex control of the coronary circulation in awake dogs.

In 1976 I accepted the Foundation Chair of Human Physiology at the new medical school, University of Newcastle. Collaborative research commenced with the Depts of Anaesthetics, and of Surgery, at the established Royal Newcastle Hospital. We evaluated Impedance Cardiography for measurement of cardiac function in man. Studies commenced on coronary and bronchial circulations in awake dogs and sheep. We also commenced novel community collaborative studies, on the menstrual cycle of the female athlete in Hunter Ballet Schools, and on G-force adaptation of blood pressure control in RAAF fighter-pilots. I founded the Hunter Academy of Sport in 1989, as a community based, service, education and (university) research company, limited by guarantee. In 1991, I was invited by Respiratory Medicine, University of California, Davis, to commence long term collaboration on asthma, namely, on reflex control of airways and bronchial circulation during rest, behaviour (including sleep), and exercise. In 1999, I developed in conjunction with bioengineer Koullis Pitsillides at UC Davis the airways internal diameter assessment (AIDA) ultrasound technique for online tracking of airway dimensions and blood flow. This international University collaboration foreshadowed new University of Newcastle collaborative policy. It was timely, as the Faculty of Medicine was restructured into a Faculty of Health, and the Hunter Medical Research Institute came on line at the new John Hunter Hospital.

Fields of Research

Code	Description	Percentage
111600	Medical Physiology	60
110300	Clinical Sciences	30
060300	Evolutionary Biology	10

Centres and Groups

Centre

• Hunter Medical Research Institute

Group

• Hunter Medical Research Institute - Cardiovascular

Memberships

Body relevant to professional practice.

• Member - Order of Australia
• Elected Fellow/member - Royal Australasian College of Surgeons
• Elected Member - Fellow of Cardiac Society of Australia and NewZealand, 11 August, 2004

Learned Academy.

• Member - Elected President, University of Newcastle Association of Professors (Collegiate Academic Group )
• Elected Member - American Physiological Society
• Elected Member - Australian Physiological Society

Appointments

Foundation Professor of Human Physiology University of Newcastle (Australia)	01/05/1976 - 01/12/1999
Chairman Hunter Heart-Lung Research Guild (Cardiovascular Research Programme) (Australia)	01/01/2002 - 01/12/2004
Chairman Council of St Andrew's College, University of Sydney (Australia)	01/01/2002 - 01/12/2005
Emeritus Professor University of Newcastle (Australia)	01/01/2000
Honorary Professor University of Sydney (Australia)	01/01/2001

Awards

Honours.

2005	Member Order of Australia Australian Commonwealth Government (Australia) For service to medicine and to medical education, particularly through the planning and development of innovative curriculum, as a researcher in the field of human physiology, and to the Hunter Valley community.

Recognition.

2005	Fellow of St Andrew's College St Andrew's College, University of Sydney (Australia) For distinguished service to St Andrew's College, University of Sydney, as a member of and Chairman of Council.
1988	Life Governor of the Australian Postgraduate Federation in Medicine Australian Postgraduate Federation in Medicine (Australia) For service to co-ordination and development of national programmes of postgraduate medical education in Australia via the Board of the Australian Postgraduate Federation in Medicine

Research Award.

2011	Honorary Member Australian Physiological Society (Australia) For distinguished service and research to Australian physiology
1967	Overseas Fellowship of Life Insurance Fund of Australia and New Zealand Life Officers of Autralia and New Zealand (Australia) Distinction in medical physiological research

Invitations

Once in a Lifetime: An Allegory. The story of the New Medical School at the University of Newcastle, Australia The King's School, Parramatta, Australia (Distinguished Visitor)	1986
Eulogy for a Happy Warrior. The death of Peter Fenwicke, Grazier, King's School Old Boy, and Wallaby Captain. St Andrew's Anglican Church, Walcha, New South Wales, Australia (Invited Presenter)	1987
On Parochialism: the Newcastle Medical School Experiment. Lambie-Dew Oration, The University of Sydney, Australia The University of Sydney Medical School Society, Australia (Distinguished Visitor)	1991
The New Science of Exercise: the Invited Lecture, Australian Physiological Society Australian Physiological Society- The Invited Lecture, Australia (Invited Presenter)	1992
Education for Change; The Surgical University of Australia. General Scientific Meeting, Royal Australasian College of Surgeons, Perth, Australia Royal Australasian College of Surgeons, Australia (Keynote Address)	1995
Get A Life. Achievement from nowhere; the stories of Isaac Newton, Heather Turland, and Greg Cooper (a young tyro with Sarcoma who became a father and an All Black) The King's School, Parramatta, Australia (Distinguished Visitor)	1998
God, Nerves and the Coronary Circulation. The Stengert Memorial Lecture. UC, Davis, USA School of Medicine, University of California, Davis, California, United States (Invited Presenter)	1999
Isaac Newton at the Graduation Ceremony. For Biomedical Science and others, University of Newcastle, Australia, 2007 University of Newcastle, Australia, Australia (Keynote Address)	2007
A Reasonable Man. The death of JHA Stacy, Grazier, Athlete and Family Man, All Saints Church, Singleton, The Hunter Valley, NSW The Stacy Family, Australia (Invited Presenter)	2007
The Life and Times of Dean Franklin. The application of ultrasound to medical science. University of Missouri, USA John M Dalton Cradiovascualr Research Center, University of Missouri, Columbia, USA, United States (Keynote Address)	2008
Reflex controls underpinning asthma syndromes: the Airways Internal Diameter Assessment (AIDA) ultrasonic system for measuring continuous, online changes in airways dimensions and blood flow at rest. John M. Dalton Cardiovascular Research Center, University of Missouri, Columbia, USA, United States (Invited Presenter)	2008
Physiology, University of Tasmania University of Tasmania, Australia (External Examiner.)	1978
Physiology, University of Queensland University of Queensland, Australia (External Examiner.)	1981
Physiology, University of Malaya University of Malaya, Malaysia (External Examiner.)	1981
Physiology, University of Malaya University of Malaya, Australia (External Examiner.)	1983
Anaesthetics, first part College course and exams, Otago University Otago University, New Zealand (External Examiner.)	1984
Physiology, University of Malaya University of Malaya, Australia (External Examiner.)	1985
Physiology, Otago University Otago University, New Zealand (External Examiner.)	1985
Physiology, University of Singapore University of Singapore, Australia (External Examiner.)	1985
Physiology, University of Tasmania University of Tasmania, Australia (External Examiner.)	1989
Physiology, University of Tasmania University of Tasmania, Australia (External Examiner.)	1990
Surgery, University of Western Australia University of Western Australia, Australia (External Examiner.)	1990
Physiology, Otago University Otago University, New Zealand (External Examiner.)	1991
Invited Assessor on Selection Committees for full Professorial Appointments SEE BELOW 1980-2013 (all dated 1980 for confidential reasons) Various Universities (Distinguished Visitor)	2013
External Assessor for Chair. Cardiac Surgery, University of Melbourne University of Melbourne, Australia (Invited External Assessor for Full Professorial Appointments)	1980
External Assessor for Chair. General Surgery, University of Western Australia. University of Western Australia, Australia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Physiology, University of New England , NSW University of New England, Australia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Physiology, University of Tasmania Univerity of Tasmania, Australia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Pathology, Otago University, New Zealand Otago University, Australia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Several Chairs. University of California, Davis, USA : Cardiovascular Medicine, Pulmonary Medicine and Anaesthesiology and Pain Medicine University of California, Davis, California, United States (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Medicine, University of California, Irvine, California University of California, Irvine, United States (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Physiology, University of Sains Malaysia, Pulau Pinang, Malaysia University of Sains Malaysia, Malaysia, Malaysia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions)	1980
External Assessor for Chair. Physiology, University of Malaya, Kuala Lumpur, Malaysia University of Malaya, Malaysia (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions )	1980
External assessor of Chair. Pathology, University of Kuwait, Kuwait University of Kuwait, Kuwait (Invited External Assessor for Full Professorial Appointments, and Professorial Promotions )	1980

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Administrative

Administrative expertise

I was a full-time researcher until I went in 1974 to the new Medical School at Flinders University for my brief tenure of 18 months, where I became Foundation Chairman of the Library Committee. On taking up the Foundation Chair at Newcastle Medical School in May 1976, I repeated this tenure, and also became Foundation Chair of the Research Committee. I also became Chairman of Phase I in the new curriculum responsible for planning and implementing the problem-based course when the students arrived in 1978. During the next 22 years I served on many committees of the medical faculty and the University, and became the elected President of the Association of Professors of the University of Newcastle. Externally I served on the National Heart Foundation Scientific Advisory Committee for some 10 yr, and as mentioned elsewhere, on the Australian Postgraduate Federation of Medicine, and on the (Part 1) Board of Examiners, of the Royal Australasian College of Surgeons.

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Teaching

Teaching keywords

• Medical Education

Teaching expertise

I have worked in 4 new medical schools during the evolution of their clinical and basic science curricula, namely, UNSW (1962-67), UC San Diego (1969), Flinders University of South Australia (1974-76), and as a Foundation Professor at the University of Newcastle, NSW (1976- ). Therefore, I have an evolutionary view of the change in medical school approaches to medical education internationally, and of the evolution within each school. Early in my career, I was a junior teacher, and simply followed the policy laid down by committees. Later I became a committee member and took part in developing policy as well as teaching. At Newcastle, I was responsible for initiating (e.g. Chairman of the initial Phase 1 of the new medical curriculum, ) and establishing policy and participating in new courses using problem-based learning (PBL), e.g. in both medicine and biomedical science courses we linked Group PBL tutorials to Interactive whole year learning sessions). We viewed Problem Based Learning in undergraduate curricula as analogous to the learning process in research

My focus was also on the undergraduate, graduate, and postgraduate domains for research education and process. As a physiologist I trained higher degree students by initially working closely with them in the laboratory and while writing, a process where the variable capacity of students to become potentially independent researchers is efficiently revealed. At the University of Sydney and at the University of Newcastle I have trained 1 higher Doctorate in Medicine by thesis (MD), 9 PhD (6 medical, 1 veterinary, 2 science grads), 4 B Med Sci, and 5 Sci Hons students. I am currently mentoring in 'retirement' PhD and Honours students by invitation in Professor AW Quail's laboratory in the Medical Sciences Building at the University of Newcastle.

I was also a Foundation member (Treasurer) of the Hunter PostGraduate Medical Institute, and represented the Institute on the Australian PostGraduate Federation of Medicine where I recommended policy changes in medical postgraduate learning. I also sat on the Part 1 Board for Basic Surgical Training, Royal Australasian College of Surgeons, and was intimately involved in the change of the College from an Examining Institution alone, to an Educational and Examining Institution. I have not published this experience widely, but encouraged others to do so, mainly because my publishing time was devoted to physiological research writing.