Emeritus Professor Saxon White

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 Boys 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 on Commonwealth Scholarship in Medicine at the University of Sydney and on Bursary 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, cricket and rugby club member, I played 7 rugby tests and 22 other tour games in the Australian colours, and my cricket career as an opening batsman NSW State Colts selection lapsed. I retired from all representative sport at age 24 in 1958 to concentrate on medicine.

After graduation in medicine 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 doctorate in medicine supervised by Professor Paul Korner at the University of NSW 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. This was mainly on the coronary circulation in primate and canine species in behaviour and exercise. The third year of the Fellowship was in the Cardiology Department of the University of Sydney. 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. My basic science research was in nervous control of the coronary and bronchial circulations using new ultrasonic techiniques. I also developed exercise stress testing in clinical cardiology at the Royal Newcastle Hospital and later at the new John Hunter Hospital at New Lambton. But a major innovation was our link with the Hunter Valley community in education and human research via my separate Human Performance Laboratory. We especially educated the community in the value of exercise for the maintenance of health, e.g. the HUFPUF Club of Merewether, and in endocrine research using ballet schools as a source of the female athlete. I also moved to create the Hunter Academy of Sport (1988- ) with its provision for sporting service, education and research.

In 2014 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.

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 Journal papers, Reviews and Book Chapters, and 122 Abstracts since 1970 (as at 22/1/2013)

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.

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.

Collaborations
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 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 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. 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. 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. 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.