Alan Worsley Holmes à Court was the product of an interesting family and had a distinguished and effective medical career. He was one of a small band of well read, broadly educated and widely competent physicians who moulded Australian medicine between the wars and guided it for more than a decade thereafter.

He was born in Brisbane, the son of Charles George Holmes à Court (fourth son of the 2nd Baron Heytesbury) and his second wife Mary West. His father was clerk of the Legislative Assembly. He was educated at Brisbane Grammar School and proceeded to Sydney University (St Andrew’s College) in 1906, graduating MB in 1910, ChM 1911. He joined Sydney Hospital as a resident medical officer in 1911 and as registrar in 1912. His association with that institution lasted until the end of his life. He entered general practice in Manly in 1913 and was appointed honorary assistant physician to Sydney Hospital in 1914.

Holmes à Court joined the Australian Army Medical Corps early in 1916. His first posting was to the hospital ship Karoola. This was followed by assignment to 2 Australian General Hospital in France. In January 1918 he was promoted major and in May transferred to 4 Australian Field Ambulance where he was prominent in the training of forward resuscitation teams. For his work in the field he was promoted lieutenant-colonel, mentioned in dispatches and awarded the Medaille des Epidemies (en argent). After the end of hostilities he proceeded to London where he qualified for Membership of the Royal College of Physicians.

He returned to Australia in August 1919 and began consulting practice in Macquarie Street. His career burgeoned, his eminent pragmatism, quiet determination and clinical skills were rapidly recognised and he involved himself in many medical activities. He received the degree of MD (Sydney) for a thesis entitled Intravenous Injections in the Treatment of Haemorrhage and Shock, based on his wartime work in France. He was involved in the first blood transfusion given at Sydney Hospital. He was responsible for the formation of the Sydney Hospital Clinical Society. He was an active and highly skilful teacher and his rounds were elegant and memorable clinical occasions. He had a prodigious memory and delighted his students with quotations from many authors inside and outside medicine.

Holmes à Court was elected to the council of the NSW branch of the BMA in 1925 and was its president in 1933. He took an active part in the Association of Physicians of Australasia, the body from which the RACP arose. At the formation of the College in 1938 he was a foundation Fellow and a member of its first council. He served the College as councillor (1938-54), a member of the board of censors (1938-45) and as censor-in-chief (1945-50). He had a reputation as a fair if hard examiner, most disgruntlement coming from candidates who could not equate his apparent kindness and smiling politeness with their failure to satisfy. He was president of the College from 1952 to 1954 and was chairman of the editorial committee of the Australasian Annals of Medicine from its foundation until his death.

I initially encountered Holmes as a junior resident in 1945. He was close to the top of his powers. Initial awe was quickly replaced by respect and affection. He was of middle height, well built and in his mature years impressively bald. He had a knowing, amused, faintly tolerant smile and distinctly humorous blue eyes. He was a dignified, somewhat reserved person with considerable presence but withal easily approachable. He was always impeccably dressed, moved and spoke quietly, choosing his words carefully and economically. He rarely spoke at length and could sum up a clinical situation or a person in a sentence. Even when bored he was polite, but lengthy uninspiring bedside presentations would cause his eyes to glaze in characteristic fashion. He treated all patients rather formally with the same unfailing politeness. His colleagues and friends however knew him to be a master of pithy, direct and indeed expletive language, all the more arresting because of its urbane delivery. Misguided flights of medical fancy would be brought sharply to earth and stories amongst Sydney Hospital graduates of his various informal remarks and clinical asides are many, ribald and affectionate. He was frequently accused of cynicism but was simply honest and realistic.

Holmes à Court loved Sydney Hospital in a controlled, objective way and gently demonstrated to successive waves of young doctors, the broad concepts of good medical practice, the need for wide reading, the value of commonsense and basic knowledge, rather than directing them to specific research areas. He was busy without doubt but never appeared to be hurried. He commonly addressed his young house staff as ‘Master’ and this was his own affectionate name within the board of censors.

Holmes à Court’s chief pursuits outside medicine were literature, especially poetry, dry fly fishing for trout and sailing. He was fond of all animals, dogs in particular. He was one of a band that regularly fished the waters of the southern alps and was reckoned a great companion. In 1913 he married Eileen Rouse, a Sydney Hospital nurse. His elder son was killed on active service in the RAAF in 1943 and he felt this deeply. However he continued working actively until his sudden death in 1957 from myocardial infarction. He died in the hospital where he had worked a lifetime. He was survived by his widow, a son and a daughter.