Update February 2009
Malcolm Adams TRAILL
Father: Doctor of Philosophy, Cambridge, England, in Chemistry.
After working with Imperial Chemical Industries, became Head of Chemistry Department, Melbourne Technical College, later Royal Melbourne Institute of Technology. He lectured in physical chemistry. He subsequently became a Vice Principal (Sciences). The household was science-aware. – older brother Robert to become Doctor of Philosophy, and publishing monographs “Physics and Philosophy of the Mind,” “Mind and Micro-Mechanism,” and others in a series “Mechanisms of the Mind.”
Personal: Born: 21/9/1939, middle of 3 offspring
Married: 1969. Three children (one a medical doctor)
Education: Schooling: Carey Grammar (to 1950)
Secondary Schooling: Scotch College (1950-1956)
Won intermediate prizes over three years in the Science Talent Search
Obtained limited Amateur Wireless Licence
Royal Melbourne Institute of Technology (1957)
Applied Science. Matriculated with 1st class Honour in Chemistry. Obtained Commonwealth Scholarship
Obtained full Amateur Wireless Licence
Melbourne University (1958-1963) Studied Medicine
2nd year – 3rd class Honour in Physiology
3rd year - 3rd class Honour in Anatomy (equal 5th)
Trained at the Royal Melbourne Hospital.
Junior Residency: Footscray and District General Hospital (1964). (Now Western General Hospital)
Presented two studies on the hospital notice board – the circulation time with external cardiac massage and the accuracy of Albustix (see list of publications).
Post Graduate: Medical Officer, Pathology, Repatriation General Hospital, Heidelberg, (1965-1969). During that time :
a) Passed 3 topics in the General course for the Royal College of Pathologists of Australia (later Australasia)
b) Wrote medical-scientific papers alone, and in association with Dr Roy Bean (see list). There was an oncology emphasis, including examination of the effects of neonatal thymectomy in mice upon immune tolerance and cancer (see list).
c) Effectively ran Haematology for several years
d) Attended the Haematology/Oncology Outpatients of Dr John (“Jake”) Bolton and Dr Roy Bean (Consultants)
e) Attended the Gastroenterology clinical meetings run by Dr (Sir) Ian Woods
f) Attended and participated in Haematology Slide Meetings
g) Attended and participated in Histopathology Slide Meetings
h) Secretary for the Clinical Meetings Subcommittee
i) Federal Secretary for the Repatriation Department Medical Officers Association, and engaged in arbitration hearings
j) Tutor to Pathology Department, University of Melbourne
k) Tutor in Microbiology at Ormond College, University of Melbourne
Consultant Pathologist, Mental Health Authority at Royal Park, Willsmere and Mont Park (1969-1975) and
Consultant Pathologist to the Coroner at Melbourne and
Consultant Pathologist to the Shepherd Foundation
a) Completed last topic for Royal College of Pathologists of Australasia
b) Became Fellow of Royal College of Pathologists of Australasia (1971)
c) Published/read papers on varied topics, with some Research Grant assistance (lipids)
d) Continued participation in Histology Slide Meetings
e) Ran a Microbiological Discussion Group
f) Australian Medical Association Victorian Branch Council delegate, representing Salaried Officers
Private Practice – Pathology: Aldor Pathology Service
Private Practice commenced in 1975, taking over a small outpost of the Oakleigh Pathology Service. There was one technician, one laboratory assistant, a microscope that turned out to belong to someone else, a counting chamber, an old incubator and centrifuge and an antique colorimeter. Only basic tests were performed, with the others sent to subcontractors. The billing contained a sprinkling of item numbers that were inappropriate. One of the clerical staff was alleged to have been embezzling and some of the referring doctors seemed to be hanging out for payments.
The organization was cleaned up, a comprehensive range of in-house tests brought in, and competent Medical Scientists employed. The increase in overheads was hit with the impact of Medibank Mark I – under which referring doctors and others, such a Yoland Lim, started to tool-up with Unimeters and the like, with assistants testing in back rooms. The practice started to melt away – one doctor’s last referral was for a patient the pathology practice diagnosed (correctly) as hairy cell leukaemia. Things became so bad that even the Accountant suggested that the only way to beat them was to join them – pay kick backs.
With the Fraser Government, fortunes changed for the better, because the back room laboratories were curbed.
Extra rooms were opened and a mobile collecting suite introduced for the towns in the Dandenongs. There was steady growth, generally about 20% per year for over ten years, with annual turnover in 1987-8 about $3.5M. There were over 20 collection rooms, with servicing of the Berwick Bush Nursing Hospital, Springvale and District Community Hospital, Dandenong Valley Private Hospital with one main laboratory and two satellite laboratories and a staff list of about 100.
The practice was one of the first in the private area offering serum diphenylhydantoin and carbamazepine levels and lymphocyte surface markers. Special tests, such as serum gastrin and methotrexate were available in-house. The practice was truly general : -
FNA Breast Cancer Analysis 1987
In 1987 I analysed the results of my Fine Needle Aspiration results derived from the samplings by a particular surgeon; the results representing the combined input of the surgeon’s sampling skills, and the microscopical interpretation. The assessment comparison was against the subsequent histological diagnosis.
The analysis used the methods of Galen and Gambino (1975) and made comparisons with published, comparable results up until 1987.
Positive Result Negative Result TOTAL
True Positive 17(a) 6(b) 23(c)
True Negative 2(d) 107(e) 109(f)
TOTAL 19(g) 113(h) 132(i)
Prevalence of Cancer in the sample ( c/i x 100) = 17.4%
Sensitivity (a/c x 100) = 74%
Specificity (e/f x 100) = 98.2%
Predictive value of Positive result (a/g x 100) = 89.5%
Predictive value of Negative result (e/h x 100) = 94.7%
Efficiency ([a+e]/i x 100) = 94%
COMPARISONS FROM THE LITERATURE
Number 500 202 263 600 1713 2772 237 132
Prevalence* 51.6% 39.6% 62.7% 69.5% 52.9% 63% 30.4% 17.4%
Sensitivity* 84.1% 76.3% 73.3% 92.6% 86.9% 91.3% 69.4% 74%
Specificity 98.3% 97.5% 95.9% 99.5% 97% 95.6% 98.8% 98.2%
Positive Prediction 98.2% 95.3% 96.8% 99.7% 97.5% 97.3% 96.2% 89.5%
Efficiency 91% 89.1% 81.7% 94.7% 91.7% 92.9% 89.9% 94%
*NOTE: A higher prevalence of True Positives in a study will favour Sensitivity in particular, as a simple statistical phenomenon.
The Conclusion was that the FNA testing outcomes, based upon the sampling by a particular surgeon, compared reasonably favourably with the published results up until that time (given the relatively small patient cohort size and low positive prevalence).
 “Beyond Normality: The Predictive Value and Efficiency of Medical Diagnoses.”
Galen RS & Gambino SR. John Wiley & Sons, Inc. New York, 1975
 Cornillot M & Verhaeghe M. Path. Biol. (Paris)1959; 7(7-8):793-802
 Smith et al. 1959 (Probably quoted by another group)
 Shiller-Volkova NN & Agamova KA. 1974 (Probably quoted by another group)
 Zajdela A. Arch. Anat. Pathol. 1963; 11:85-87
 Franzén S & Zajicek J. Acta Radiologica 1968; 7(4):241-260
 Zajdela A Ghossein NA et al. Cancer1974; 35:499-506
 Furnival CM Hughes HE et al. The Lancet 1975; ii:446-449
For Ethos, staff were instructed that they were part of a medical practice, not a factory; if there had been 2 unsuccessful attempts at venipuncture, staff were instructed to call me in.
In about 1982-3, with the election of the Hawke Government and the likely reintroduction of a revamped Medicare, there appeared a need to have a back-up, one not as exposed to Government interference. Accordingly, a subsidiary company acquired a computerized image analyser, and sent a competent staff member to England for training. This venture was to analysis the shapes and sized of items that could be imaged (as later developed for cytology screening), with the intended use industrial, such as quality control. Many organizations seemed interested, but there was a need for accreditation. The application to the National Association of Testing Authorities (NATA) was delayed because their gods could not agree on secondary standards. Accreditation was granted some three months before the lease on the capital equipment was to expire ! (This delay virtually killed the viability of the venture – there is great difficulty saying anything nice about NATA.)
However, work did come from the Defence Department, studying the sizes and shapes of wear particles in the sump oils of tanks – to see if servicing could be based upon the features of the particles found. This work resulted in us becoming eligible to participate in a trip to the USA to seek high technology grants as part of the Defence Department’s Offsets programme. A representative was sent and came back with a proposal to receive from Lockheed Inc. a high technology grant of software for computer aided design and manufacture. After innumerable trips to the USA, there was received a grant of Cadam software for computer aided design and manufacture, with PRANCE, a programme to design multilayered circuit boards, which had a security classification. We were the only organization outside the USA with it. A site with a mainframe was set up with the name Image Analysing Services (IAS) but we could not start because the Westpac bank did not like high technology (preferring high rise investments, which soured when a glut developed), and held up the financing. In the meantime, Cadam, the supplier of the software, which had a 10% equity in Austcad, a computer bureau in Sydney, released to Austcad the details of our marketing proposals and plans – confidential information we were required to provide under the granting process because of the security restrictions. Austcad hurriedly came to Melbourne and signed up our proposed client base at bargain discount rates. The proprietor probably believed that we would collapse and he could take us over. However, our operation was supported by the Pathology practice, so it was the overstretched Austcad which ultimately went under first ! When we opened, our mainstay business, remote connections, had been lost. We performed in-house work both with the Software and the image analyser, which now had a scanning electron microscope for metallurgical studies.
Following this act of corporate bastardry by Cadam, we complained to Canberra and an emissary was sent to talk to us. We took him out to lunch, but it did no good – the response from Canberra was essentially “stiff.” For Canberra to do anything would probably have involved taking on Lockheed in the USA courts – a daunting task, and anyway, if we collapsed, the software would go to someone else in Australia – so the thinking probably went. Sadly, for Australia, things would not work out like that.
For any future, the USA trained staff had to remain with the software. This all required the substantial subsidy from the pathology wing. We set about restructuring, eliminating the mainframe and joining a consortium in Sydney, providing the Software in return for equity. After interminable, protracted negotiations, the consortium Digital D-Sign commenced in early 1988. However, there was the Stock Exchange crash of October 1987. The bank to which we had changed, the National Australia Bank, decided to pull the pin, but not let us know. So they forced the sale of assets, with a decision for us to make whether to sell the pathology practice or the Image Analysing Service. In that the future for pathology practice as had been seen up till then seemed to be limited, the decision was to sell the pathology practice, because there would be new openings in pathology in the future: to lose IAS would be forever. The sale of the pathology practice was crucial.
With the bank cutting credit and limiting marketing of the practice, we were forced with proddings, to sell to Glendon Diagnostics (Aust) Pty Ltd. The sale of the practice and the ramifications will be dealt with later.
Digital D-Sign never performed according to projections. Effectively, the Managing Director was forced upon all the participants by a powerful partner. There was no evidence that the Managing Director had ever run a business, had any idea of management or interpersonal skills. He irritated the USA-trained staff we had kept with the software, particularly since he did not encourage remote connections, a policy we told them would be disastrous. An extra Equity partner was admitted, but the legals were defective (as usual), in that the quorum stayed the same, so the all-NSW quorum seized its opportunity and voted us off the Board. Skilled staff became disgruntled and left. One partner questioned why they needed to remain in the consortium, given that the staff were becoming less skilled and the projections were not being met. So a loophole was found in the legals (defective, as usual), the partner left, and the consortium collapsed. The liquidator found and took possession of the Software, but did not notify the next of kin (us), and sent it back to the USA ! We found about this, and chased the Software to America, providing legal advice that the assignment of the Software to Digital D-Sign was defective (legals again !). The Licensor was not prepared to argue, so we could reclaim it if we could pay the US$50,000 owed by Digital D-Sign. We were not in a position to produce that money and there were security problems with others being involved. In 1999 there was a last ditch appeal to the HIC to pay the money still owing from the Glendon Fraud, in the hope that the Software could be claimed. The HIC did not pay, and the Software is, as far as can be ascertained, lost from us and Australia for ever. It was worth off the shelf about Aust$1M in 1987, estimated to be worth about Aust$10M in 1999. Actually, it was worth much more because, coming through the Defence Department, it came with infinite remote connections and infinite up-dates. The Liquidator, probably, had no right to send a grant made to Australia via the public sector (to be developed by an applicant) back to America without clearance from the Defence (or other) Department. However, no bureaucrat can be involved now without admitting the existence of the Glendon Fraud. The HIC is, in respect of its maladministration affecting this grant, anti-Australian.
LIST OF PUBLICATIONS AND PAPERS READ
Bean R and Traill MA, (1966), in Proceedings of the third Asian-Pacific Congress of Gastroenterology, Vol. III, p. 19
Bean, RHD and Traill M. The Lancet, i; 364 (1967)
Traill MA, Acta Haematol., 39; 174 (1968)
Bean R and Traill MA, Annual Meeting of the Haematological Society of Australia, (1968)
Traill MA, Med. J. Aust., ii; 809 (1967)
Traill MA, Laboratory Practice, 17; 709 (1968)
Traill MA, Med. J. Aust., ii; 67 (1968)
Traill MA, Laboratory Practice, 17; 1013 (1968)
Traill MA, Paper read to the Australian Cancer Society Annual Scientific Meeting, November 1968
Traill MA, Winthrop, 9  (1970)
Traill MA, Laboratory Practice, 18; 154 (1969)
Traill MA, Laboratory Practice, 18; 425 (1969)
Traill MA, The Age Correspondence (1969)
12. “Mucoid bone marrow without carcinoma deposits”
Traill MA, Postgrad, Med. J., 45; 773 (1969)
Traill MA, Med. J. Aust., ii; 777 (1969)
Traill MA, Aust. N. Z. J. Obstet. Gynaecol. 10;119 (1970)
Francis RI and Traill MA, The Lancet, ii; 523 (1970)
Traill MA, Laboratory Practice, 19; 909 (1970)
Bean RHD and Traill MA, Paper read at the Asian and Pacific conference on Haematology, 1971
Traill MA, Med. J. Aust., 66;168 (1971)
Traill MA, Paper read at the Annual Meeting of the Royal College of Pathologists of Australia 1971.
Traill MA, Hospital and Health Administration, May 1`972, p. 10.
Traill MA, Hospital and Health Administration, June 1972, p. 5.
Traill MA, Med. J. Aust., ii; 142 (1973)
Traill MA, Laboratory Practice, 22(7); 527 (1973)
Traill MA, Hospital and Health Care Administration, Sept. 1973, p.12
Traill MA and Urban R, Med. J. Aust., i; 987 (1974)
Traill MA, Paper read at the Royal College of Pathologists of Australia Annual Meeting, August 1973.
Traill MA, Marzorini P and Urban R, Paper read at the Royal College of Pathologists Annual Meeting, August 1973
Traill MA and McFarlane A, Paper read at the Royal College of Pathologists of Australia Annual Meeting, August 1973.
Gaetano A and Traill MA, International Research Communication System, (73-11) 11-21-4
Gaetano A and Traill MA, International Research Communications System, 2; 1000 (1974)
Traill MA, International Research Communications System, 2; 1055 (1974)
Traill MA, Med. J. Aust., i; 114 (1974)
Traill MA, Hospital and Health Care Administration, January (1974) p. 12
Gaetano A and Traill MA, International Research Communications System, 2; 1313 (1974)
Traill MA, International Research Communications System, 2; 1226 (1974)
Traill MA, Paper read at the Royal College of Pathologists of Australia Annual Meeting, August 1974
Traill MA, Paper read at the Royal College of Pathologists of Australia Annual Meeting, August 1974
Traill MA, International Research Communications System, 2; 1721 (1974)
Traill MA, International Research Communications System, 3; 21 (1975)
Traill MA, International Research Communications System, 3; 22 (1975)
Traill MA, The Age, Sept. 18 (1975) p. 8
Traill MA, The Age, Nov. 1 (1975) p. 14
Traill MA, The Age, June 27 (1980) p. 12
Traill MA, Med. J. Aust. i; 230 (1979)
Edited submission to the joint Committee of Public Accounts (Federal) published in the Medical Letter No. 371, august 26, 1982, p. 2 (drawn from MA Traill’s submission)
Traill MA, Clin. Chem. 29; 209 (1983)
Traill MA, Paper read at the Second Australia symposium or Stereology, Image Analysis and Mathematical Morphology, Monash university, May 1983
Traill MA, Practice Computing i; 124 (1985)
Traill MA, Medical Science Research, 16(15); 799 (1988)
Traill MA, Medical Observer, 13th October 2000, p. 32
Su Y-Z, Spall D, Traill MA, Kollin C, Chow C, Sommers B, Harper S, Horlick D, Evans S and Nagourney R, 93rd Annual Meeting, AACO, April 2002, San Francisco
Traill MA, Letter in Australian Doctor, 9th May 2003, p. 29
Traill MA, Letter in Medical Observer, 16th May 2003, p. 30
This is currently being transferred to an enlarged site at http://www.malsmusings.info
Submission for the National Health and Medical Research Council, November 2004.
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