As we mark VJ Day, Britain remembers those who endured unimaginable hardship in the Far East during the Second World War. Yet few realise that some of these survivors went on to fight a different battle—one against sudden cardiac arrest—and their wartime experiences directly shaped the life-saving treatments we rely on today.
The Railway of Death to the Corridors of Life
Frank Pantridge’s story reads like the tale of two extraordinary lives rolled into one. As a young Royal Army Medical Corps doctor, he was captured at the fall of Singapore in February 1942. For three and a half years, he endured the horrors of Japanese prisoner-of-war camps, including forced labour on the Burma Railway. During this time, he contracted cardiac beriberi, a usually fatal heart condition that would affect him for the rest of his life. When liberation finally came in August 1945, Pantridge was emaciated—his experience of watching countless men die from disease and brutality never left him.
This trauma would fundamentally shape his approach to emergency medicine. In the camps, Pantridge had witnessed death on an industrial scale, often when medical intervention might have saved lives if it had arrived in time. The lesson was seared into his memory: time was everything when death threatened.
The Birth of Pre-Hospital Care
Returning to Belfast, Pantridge couldn’t shake what he’d learned in the camps. In the jungle, men died not just from their injuries but from the delay in receiving treatment. He saw the same pattern repeated in Belfast’s coronary care units in the 1960s—patients were dying in the critical minutes before reaching hospital.
His response was revolutionary. In 1965, Pantridge, alongside colleague Dr John Geddes and technician Alfred Mawhinney, converted an ambulance into the world’s first mobile coronary care unit. They installed a portable defibrillator—weighing a hefty 70 kilograms and powered by car batteries—and took cardiac care directly to patients. The “Belfast experiment” proved that pre-hospital defibrillation could dramatically improve survival rates.
By 1968, using a miniature capacitor manufactured for NASA, Pantridge had designed an instrument weighing only 3 kilograms. This device, small enough to be carried by ambulance crews or stored in public places, would eventually evolve into the automated external defibrillators (AEDs) now found in shopping centres, railway stations, and community halls across Britain.
Breaking the Golden Hour
Pantridge’s wartime experience had taught him that the “golden hour”—a concept familiar to military medics—applied equally to cardiac emergencies. In the POW camps, he’d seen how rapid intervention, however basic, could mean the difference between life and death. He applied this battlefield wisdom to civilian cardiac care, arguing that waiting for patients to reach hospital was accepting unnecessary deaths.
His work, published in an influential 1967 article in The Lancet, transformed emergency medicine worldwide. The “Pantridge Plan” became the template for pre-hospital coronary care worldwide. Pantridge believed that “any lay individual who could do CPR is capable of using a defibrillator” and argued that “a defibrillator should be beside every fire extinguisher” because “life is more important than property.”
The Wider Circle of War-Tested Innovators
Pantridge wasn’t alone in channelling wartime experience into medical innovation. Peter Safar, though not a Far East veteran, escaped the Holocaust and later pioneered the ABC (Airway, Breathing, Circulation) protocol that remains fundamental to resuscitation training. Working with James Elam in the 1950s, Safar proved that mouth-to-mouth resuscitation could maintain adequate oxygen levels in non-breathing patients.
James Elam himself had served in the US Naval Hospital during World War II. His military medical experience informed his groundbreaking research, which proved that exhaled air could sustain life—research that underpinned modern CPR techniques. Together with Safar, they perfected the head-tilt manoeuvre and precise method of mouth-to-mouth breathing that replaced ineffective chest-pressure methods.
These pioneers understood viscerally what it meant to be helpless in the face of death. They knew the desperation of watching someone slip away when intervention might save them. This emotional knowledge, combined with their medical expertise, drove them to ensure future generations wouldn’t face the same helplessness.
The Japanese Connection
In a profound historical irony, Japan—the nation whose forces had inflicted such suffering on Pantridge and his fellow prisoners—would become one of the most enthusiastic adopters of his portable defibrillator technology. By the 1970s, Japanese manufacturers were producing advanced versions of his designs, and today Japan has one of the world’s highest densities of public-access defibrillators.
Pantridge himself harboured deep resentment—he once admitted to throwing a pint of beer in the face of the first Japanese man he saw in Belfast. Yet his focus remained fixed on saving lives, regardless of nationality. His technology transcended the hatred born of war, becoming a universal tool for preserving life.
Recognition Long Overdue
Despite revolutionising emergency medicine worldwide, Pantridge received limited recognition in his own country. He was awarded a CBE in 1978, but many felt he deserved a knighthood for his contributions. It wasn’t until 1990—25 years after he installed the first defibrillator in a Belfast ambulance—that all UK frontline ambulances were equipped with the devices. This delay cost countless lives.
Today, Pantridge is honoured with a statue in Lisburn, a blue plaque at the Royal Victoria Hospital, and roads named after him in Hillsborough and Belfast. The Ulster Transport Museum preserves the original ambulance fitted with his first portable defibrillator. His death on 26 December 2004 marked the end of an era, but his legacy lives on in every life saved by a defibrillator.
Learning from Adversity
For cardiac arrest survivors and their families reading this, there’s something profoundly meaningful in understanding this history. The technology and techniques that gave you or your loved one a second chance at life emerged from the experiences of men who themselves survived against overwhelming odds.
The chain of survival—early recognition, early CPR, early defibrillation, and early advanced care—reflects lessons learned in the most hostile conditions imaginable. Veterans who had seen the worst of human cruelty dedicated their lives to preserving human life.
A Living Memorial
Today, every time an AED delivers a life-saving shock, every time a bystander performs CPR, and every time a paramedic races to a cardiac emergency, they’re continuing work begun by veterans of the Far East campaign. It’s a living memorial more meaningful than any statue.
When President Lyndon Johnson suffered a heart attack in Virginia in 1972, he was treated using the Pantridge Plan. The Belfast Protocol, as emergency treatment for out-of-hospital cardiac arrest is now known, honours the city where Pantridge transformed his wartime trauma into life-saving innovation.
The Continuing Battle
The fight against sudden cardiac arrest continues. In the UK, survival rates for those treated remain below 10%, although they can far exceed this when all elements of the chain of survival function perfectly. Every improvement in these statistics honours the memory of pioneers like Pantridge, who refused to accept that sudden death was inevitable.
For those of us touched by cardiac arrest, understanding this history adds depth to our experience. We’re not just patients or survivors; we’re beneficiaries of a remarkable legacy born from adversity. The technology that saved us emerged from humanity’s darkest chapters, transformed by remarkable individuals into instruments of hope.
Honouring the Legacy
This VJ Day, as we remember the 71,000 British and Commonwealth soldiers who died in the Far East, we should also remember those who survived and used their experiences to save countless others. Frank Pantridge’s portable defibrillator has saved hundreds of thousands of lives worldwide. Peter Safar and James Elam’s CPR techniques have saved millions more.
As cardiac arrest survivors and co-survivors, we carry forward this legacy every day. When we advocate for better AED provision, when we teach CPR to others, when we share our stories to raise awareness, we’re part of a tradition that stretches back to those jungle camps and military hospitals of the 1940s.
From the Burma Railway to the Belfast ambulance, from prisoner-of-war camps to public-access defibrillation, the thread of connection runs clear and strong. Those who suffered most became those who saved most.
After our first meet-up in February 2015, I realised I was not alone. It was the first time since my cardiac arrest the previous year that I had spoken face-to-face with someone who had experienced what I had. This was also true for my wife, who also happened to be my lifesaver. From that meet-up, the idea of SCA UK was born. Since then, we have achieved a considerable amount, primarily providing information, resources and support to others in a similar situation but also raising the profile of survivorship and the need for better post-discharge care. We are starting to get traction in this, and with the formation of the charity, I genuinely believe we have a bright future ahead and will make a significant difference in the lives of many who join our ranks.
I loved this article, Paul. One of my assignments as part of my history degree last year was to advocate for an individual who should have more recognition for their achievements and my choice was Frank Pantridge. What a fascinating man! For the impact he has made on so many lives, Frank Pantridge deserves to be a household name and should have a statue in England to encourage more people to learn CPR and remember the brave individuals in World War Two who made the ultimate sacrifice.
My father was also captured at Singapore and worked on the ‘Death Railway’ until the end of the war. Later in life he suffered three heart attacks, two of which would probably have proved fatal without a defibrillator. Well done Frank, a life well lived, why was he not Sir Frank!
My family have reasons to be grateful for the pioneering work of Frank Pantridge .
In 1966 my much loved great uncle Fred had a heart attack at home ( in Belfast at the height of “ The troubles “ ). The GP was called and summoned Professor Pantridge and his team who attended and when Fred had a cardiac arrest they were able to use the 70kg ( not very ) portable defibrillator successfully. Fred was 42 at the time and recovered well and was able to return to work and see his six children grow to adulthood. There were no angiograms, stents , or statins back then but he survived another 28 years.
Fast forward to 2019 when my dad Steve had two cardiac arrests, three months apart. Fortunately both were witnessed by family members who did CPR and were able to deploy modern, lightweight defibrillators. Steve has had bypass surgery and an implanted ICD and remains well ( he documented his cardiac adventures in an article published on the SCA website in 2020 “ lightning strikes twice “ ).
Understandably our family are keen to promote the importance of bystander CPR and availability of defibrillators.