Australian Dictionary of Biography

David Clarkson Maddison (1927-1981), psychiatrist, was born on 7 January 1927 at Chatswood, Sydney, younger surviving son of New Zealand-born George Edgar Maddison, company manager, and his wife Frances Mary, née Patterson, from Queensland.  John Clarkson Maddison was his brother.  Educated at Sydney Grammar School, David excelled academically, later studying medicine at the University of Sydney (MB, BS, 1948; DPM, 1953).  He also showed musical talent from an early age, giving his first public piano recital at the Forum Club aged 6 and performing as a soloist, when only 9 years old, with the Australian Broadcasting Commission’s Sydney Symphony Orchestra, conducted by (Sir) Bernard Heinze.  In 1938 Artur Rubinstein encouraged him to travel to Europe to train with Artur Schnabel, but the onset of war prevented him from taking up an overseas music scholarship.  Maddison retained a great love of music, giving occasional public recitals and frequently entertaining friends, students and colleagues around the piano with an eclectic repertoire that ranged from Bach to jazz (a particular passion), Gilbert and Sullivan and Tom Lehrer.  He also dabbled in composition.  His rhapsody for clarinet, piano and orchestra was performed (1956) by the Victorian Symphony Orchestra.

In 1950, inspired by Professor William Siegfried Dawson, and against the advice of family and friends, Maddison decided to become a psychiatrist.  He entered the profession just as new psychotropic drugs were appearing, promising relief for patients and increased status for psychiatrists.  At Broughton Hall Psychiatric Clinic, Sydney, he served as a medical officer (1950-53) and deputy medical superintendent (1954-56).  He became senior lecturer in psychiatry at the University of Sydney in 1957 and took up the chair of psychiatry in 1962.

Two years later Maddison went to the United States of America as a visiting professor (1964-65) at Harvard University, where he worked with Gerald Caplan, a pioneering community psychiatrist.  This experience encouraged Maddison to turn more towards preventive psychiatry and community medicine, seeing the patient in a wider social setting and promoting an interdisciplinary teamwork approach to therapy and rehabilitation.  He published a path-breaking book on psychiatric nursing in 1963 (completing revisions on a fifth edition just before his death).  By carrying out the first studies identifying risk factors for later physical and mental health problems for recently bereaved widows, he contributed to the field of preventive psychiatry with distinction.  He also published major research on depressive illness.

On 17 February 1951 Maddison married Norma Pauline Griffiths, a nursing sister, at St Philip’s Church of England, Church Hill.  Granted a divorce on 10 July 1963, on 12 July he married Heather Mary Houen, née Moffitt, a divorcee, in the registrar-general’s office, Sydney.

Maddison developed an intense interest in medical education, seeking to better equip doctors to see patients in a larger social and behavioural context.  As professor of psychiatry he abandoned the university’s postgraduate qualification, the diploma of psychological medicine, in favour of membership of the newly formed Australian and New Zealand College of Psychiatrists as the major national certification to practise psychiatry.  He was censor-in-chief (1961-71) and president (1974-75) of the college.  Wanting to enhance the college’s training program, Maddison encouraged the State government to establish the New South Wales Institute of Psychiatry, on which he served (1965-74).  Through these offices he made a major contribution to the development of the curriculum and examination process for psychiatrists throughout Australia.

At the university Maddison made significant improvements to the curriculum and became involved in nursing training.  He served as sub-dean for clinical training before being appointed dean of the faculty of medicine in 1972.  He instituted a major reform in medical training at the university, introducing new courses in behavioural sciences, social sciences and community medicine.  He oversaw the organisation and implementation of a new five-year medical degree and established a staff-student liaison committee.

Although the pace of reform was by most measures respectable, Maddison was impatient for further progress.  The University of Sydney was a large and complex organisation and sections of the faculty resisted change.  In 1973 the Commonwealth government decided to establish a medical school at the University of Newcastle and Maddison, foundation dean from 1975, said that he found 'pretty irresistible the opportunity to start something from the beginning'.

Maddison’s term coincided with a downturn in Commonwealth support for universities.  He engaged in a vigorous program of hiring staff, insisting on detailed international searches to find the best candidates, and worked through the complex bureaucratic channels required to ensure that the proper clinical and laboratory infrastructure was created for the new faculty.  He also oversaw the process of detailed external accreditation.  The centrepiece of his work, however, was a new medical curriculum based on problem-based learning, seeing the patient as a whole person and more closely integrating clinical and scientific training.  He implemented an examination system geared more to continuous assessment than to annual tests of memory.  A strong advocate for new forms of admission, he used interviews and a range of aptitude and psychological tests rather than relying solely on State-wide school examination results.  The first students were admitted in 1978 but he did not live to see their graduation.

Maddison had a range of other commitments, from acting as a consultant to the World Health Organization to advising prisons and courts on individual cases.  He served on boards and authorities including the Commonwealth Film Board of Review (1971-73) and Newcastle Newspapers Pty Ltd (chairman, 1978-81).  An early member of the Doctors Reform Society of Australia, he was an editorial consultant to its journal New Doctor.  He remained an active researcher and consultant.

On 3 November 1981 Maddison died of myocardial infarction at Waratah, Newcastle, a few weeks before the opening of the new clinical sciences building at Royal Newcastle Hospital, subsequently named in his honour.  He was survived by his wife, their daughter, and his daughter and son from his first marriage.  Colleagues and friends created the David Maddison memorial fund to perpetuate his work.

Of medium stature, with dark receding hair and fine features set off by thick black square glasses, Maddison cut an imposing figure, although he had an endearing habit of wearing odd combinations of shirts and ties.  Described by friends as energetic, warm and witty, with an insatiable appetite for work, he possessed intellectual distinction and artistic sensitivity.  He had a strong commitment to change, but was always open to suggestions from others and alternative options for achieving desired outcomes.  Although a few were discomfited by his reforming zeal, he provided creative, innovative and stimulating intellectual leadership that many found inspiring.

Maddison led the field of change in medical education both within Australia and internationally.  He championed an education designed to produce doctors who understood patients better and who could tackle disease in a wider social and community context.  In 1992 his alma mater, the University of Sydney, decided to introduce an innovative graduate medical program that carried forward many of the principles that Maddison had first espoused.