Dr David Pugsley often answers the door wearing just his underpants. Today he is sporting the leopard skin high cut variety. He’s recovering from prostate cancer and feeling rather good. Around six-foot, with pale English skin, a large paunch, and thin, veiny legs, he makes a somewhat disturbing figure to the uninitiated. But over the years, friends and family have become used to his eccentric choice of clothing (or lack thereof). He also likes to wear a bemused smile on his face, like he knows something you don’t. And that’s the thing. There is a secret about Dr Pugsley. Something even he didn’t even know for a long time. And unwittingly it has shaped his destiny.

A physician and educator, Dr Pugsley was born and brought up in the West of England. He completed his first degree in Arts at the University of Bristol. As a Quaker, he undertook an alternative national service, working as an orderly and a porter in a hospital. This experience changed his life. As a young man surrounded by the sick and the old “I realised how naive and callow I was.” He decided to train as a physician, which led him to Oxford and London, and then two years at medical school in Uganda. Following further research and clinical training in the UK in the areas of hypertension and renal disease, he immigrated with his wife and two daughters in 1976 to Adelaide, South Australia. He was committed to delivering healthcare in the public system and was appointed Deputy Director of the Renal Unit at the Queen Elizabeth Hospital, and subsequently Director of Hypertension. He retired in 2005.

The father of lifelong friends of mine, as a child I would buy him Christmas presents of spectacularly ugly ties from vintage clothing stores, which he liked to wear to work at the hospital – relishing in the knowledge that each new tie was more garish than the last. You would hear him coming down the ward before you saw him, whistling loudly a classical piece of music, something complicated and obscure by Dvorak or Shostakovich — his doctor’s white coat offset beautifully by a fat brown and orange paisley patterned tie from the 1970s. It was the late 1980s. He loved the hospital. But his wife and two daughters didn’t. They would complain that he spent all his time there – that he was a workaholic. That to get some attention they would need to be dying of kidney failure. That he would bring his work home with him. Literally. You would go to the freezer and find bags of urine or kidneys stored there among the ice cream and frozen vegetables.

His passion for kidneys coupled with a commitment to social justice and equality resulted in him working in the area of kidney disease and diabetes in minority ethnic groups and the world’s developing nations. His ability to take a broad perspective on issues and problem solve saw him pioneer the provision of outreach services by staff physicians, in the firm belief that it was more efficient for one doctor to travel to distant areas than a large number of patients attempting to make the reverse journey.

In this context, he has visited a number of countries, including China, Baghdad and Nigeria to gain first-hand experience of chronic renal disease as well as to give lectures and offer opportunities to those whose research and clinical practice would benefit from the development of neurology. But he is humble about his achievements, referring instead to the dedication of a gynaecologist working in remote Pakistan — “I’ve never felt that sort of commitment.”

In the 1980s and 1990s, he was integral to the discovery of higher rates of kidney disease and diabetes among Aboriginal Australians in comparison to the wider population. Further research revealed similar health problems in New Zealand’s Maori population and the American Indians. Poor diet and a sedentary lifestyle were contributing factors. He believes real improvements to Aboriginal health is at least two, if not three generations away, and will require a lot of money. And “what is needed is not so much talk but action”.

As a person, Dr Pugsley is a devoted father and grandfather. He plays classical piano and sings. He also cooks fabulous curries and preserves. I recall one night during a sleepover he caught me in the cupboard at midnight stuffing my face with his home-made dried apricots, much to his amusement.

As a doctor, however, it’s true to say that he is only really passionate about kidneys. I remember hurting my arm as a child while playing with his daughters in the local park. He took a cursory look at it, strapped it up with one of his hideous scratchy ties, and sent me off, saying it was just sprained. It wasn’t. I had a green-stick fracture and had to go to the hospital.

Whilst immensely talented and skilled in most facets of life he is completely useless when it comes to being the home handyman. When he arrived in Australia he couldn’t change a washer on a tap. And he’s no saint. When I first met the family there was bitter talk of ”Rosemary”. A letter from her was pinned to a notice board hanging in the hall for everyone to see. I was never sure who Rosemary was – not being family I didn’t like to ask – and I still don’t. I don’t know if it was ever a full-blown affair, or perhaps just a distraction for a man who might have been lonely and adrift in a new country.

A year ago Dr Pugsley’s life changed. He was about to visit Sally, one of his daughters, a mother of three living in Tasmania. Her husband is a federal politician who spends most of his time in Canberra. Sally had lost her driver’s licence “she’s always had too much lead in her boots,” and he was going to help her out with driving the children about. Before heading to Tasmania however, he had to go into hospital to have his haemorrhoids removed. While it was “a horrible, very uncomfortable procedure” it was to be the least of his problems.

Two days after the haemorrhoids operation he stopped passing urine. ”Trust a doctor to have complications”, laughed the other doctors. They ran some blood tests and during the weekend of the Victorian fires of 2009, with his air-conditioner on the blink, he sat in his lounge room during the desperate heat, hooked up to a catheter. He still didn’t pass any urine. The following week he was to have a Transurethral Resection of the Prostate (TURP) operation to remove some of the enlarged prostate glands so that the urine could flow more freely. As he and the nurse were studying his blood test results he recognised a moderate degree of renal failure. The TURP was postponed. An ultrasound and a nuclear medicine test of the kidney area revealed a somewhat large left kidney but nothing happening on the right. It was either not working or had never been there at all. The surgeon allowed him to look up into his bladder to see for himself. The left kidney had expanded to compensate for the fact that there was only one. This was a source of great amusement among the nephrologists. What a strange twist of fate for a man who has donated his entire life to the maintenance and preservation of the human kidney that he should be born with only one. His family laugh over the irony of it. Fancy, one man journeys into the world of saving kidneys, without knowing that he only ever had one himself. “Seventy-two years I’d been alive it had done the job,” he says.

The transurethral operation was performed three days later and the results were evident of cancer. Dr Pugsley underwent initial hormone treatment to suppress testosterone production, which was then followed by radiotherapy. Today he is still undergoing hormone treatment, but things are looking positive.

He still made the trip to Tasmania to help Sally. Perhaps it was an effort to make up for all that time spent at the hospital when she was growing up. And that’s why she loves him — his commitment to his wider family over the years. And what does she hate? “Dad’s petty attitude to money — he will always look for ways to save money and avoid any costs – what mum calls a ‘working class attitude.’” What else? “I hate how he always picks his nose in public and wears his underpants two days in a row before washing them.” Despite these eccentricities, Dr Pugsley is a man who’s always been comfortable with himself. He is admired for his commitment to deliver healthcare in the public system and his significant contributions to the scientific community. But he is loved for his courage, his compassion and his penchant for leopard skin jocks.