Oxford Medicine February 2007

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Oxford medicine

THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI OX F O R D M E D I C I N E . F E B RUA RY 2 0 0 7

Letter from the President OMA has had a good half year. The September meeting, designed to recognise the great contributions made by the first Nuffield Professor of Surgery, Sir Hugh Cairns, began with a Special Interest Seminar held on the Friday afternoon. This took the form of an excellent series of short papers by members of the Institute of Biomedical Engineering in areas of both diagnosis and therapeutics which preceded the annual reception held this year in the Boardroom of the Radcliffe Infirmary. About 70 members and guests came, there was much reminiscing (Philip Sheldon remembered his interview there when he was appointed senior registrar in radiology in 1950), but there was also concern over the importance of preserving artifacts, furniture, portraits and lists on the walls in gilt of hundreds of benefactors, some humble and some grand, now that the University owns the premises, bearing in mind the building’s listing as Grade 2*.

On the Saturday, Colin Blakemore gave the Oxford Medical Society lecture, Trevor Hughes reviewed three centuries of neuroscience in Oxford from Thomas Willis to Sherrington and then Hugh Cairns, not forgetting Farquar Buzzard, who as Regius and the first clinical neurologist, played a prominent role in persuading Lord Nuffield to endow the medical school in order to provide for the five Nuffield chairs and the two Nuffield readerships. David Smith, recently retired from the Chair of Pharmacology, explained why he believes Alzheimer’s disease to be preventable, and Simon Wessely, who had been asked to advise the Government as to whether WW1 soldiers shot for cowardice should be pardoned, gave a remarkable account of his investigations (his advice was ignored!). Tipu Aziz illustrated why research on primates is so essential to the development of neurosurgical techniques for the control of involuntary movement, and Alistair Buchan and Peter Jezzard told of remarkable advances, underway here in Oxford, in the treatment of thrombotic stroke. In parallel to all this, those more socially minded were treated to a family tea party organised by Anne Ryan at 13

Norham Gardens and in the evening there were two splendid reunion dinners which filled the hall of Magdalen with graduates from1938 to 2005 and the hall at Wadham with graduates from 1981 and 1996, both finishing late.

In November, John Walton very generously and kindly hosted a reception for us at the House of Lords to mark the 70th anniversary of Lord Nuffield’s benefaction.

This provided an opportunity to thank a number of people who are helping Oxford medicine at the present time, financially, personally and through grant giving organisations, and in many other ways in these not easy political times. During the proceedings, Giles Henderson, Master of Pembroke, and Chairman of the Nuffield Medical Trustees gave an encouraging report on the state of the finances. Finally, as an unscheduled bonus, those who had never been inside the place before were treated to a highly entertaining personal tour of the premises by our host himself.

Our well laid plans for 2007 have, I’m afraid, suffered something of a setback. Oxford University Society, (mindful of OMA’s success!), has moved its annual event to September making it impossible for colleges with the bigger halls to host our dinners. We have therefore decided to move our annual event to the Easter vacation in 2008. The annual meeting will now feature the Osler Lecture and the Oxford Medical Society lecture together with a programme of scientific papers, social events and reunion dinners.

Contents Letter from the President .1 Corporate Plan

. . . . . . . . . .2

Divisional Structures . . . . .3 Capital Priorities

. . . . . . . .3

Governance and Workforce Development . . . . . . . . . . . . .4 Awards — Congratulations

. . . . . . . .5

Oxford’s First Textbook of Medicine . . . . . . . . . . . . .8 Recent Acquisition . . . . . .10 Obituaries

. . . . . . . . . . . . . .12

OMA Events Diary 2007–2008 . . . . . . . . . . . .16

By the time you receive this, THE RADCLIFFE INFIRMARY WILL HAVE CLOSED, 24 years after the original intention to do so. As a consequence, the extensive new development at the JR will render the place unrecognizable to those of you last up there before 2001. High quality new buildings to provide for neurology and neurosurgery, eyes and ear nose and throat surgery, a Children’s Hospital, new car parks and new roads to accommodate new bus services, with not much that is

SPECIAL RADCLIFFE INFIRMARY COMMEMORATIVE SUPPLEMENT INSIDE

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green remaining. Development inside too with the excellent new George Pickering Teaching Centre for medical students and postgraduates, the result of the drive, determination and planning skills of Derek Roskill, one time pathology tutor.

But not everything is going well. That great jewel in the Oxford medical scene, the N.O.C., is in trouble, its viability threatened by one of these poorly thought out specialist treatment centres, just as their state of the art and impressive new buildings are being completed.

Yet another Department of Health “great idea”, no doubt thought up by well meaning individuals with good degrees in sociology or economics from the LSE and the like, but with no knowledge at all of needs for surgical training, research and first rate surgical practice.

Let us hope I am wrong and that this great memorial to Lord Nuffield will emerge undamaged.

J.M. Holt

Corporate Plan

Our plan proposes a modest increase in taught graduate students and courses

Probably the most important activity of Hilary Term was the submission of the Division’s 5-year plan to the University Council. While this sounds vaguely Stalinist and may seem a continuation of previous practice, this year the plans of the Divisions were examined in more depth than previously. This greater scrutiny arose for two reasons. First, these plans need to be approved by Council, especially with regard to fit with the University’s Corporate Plan.

Second, Council will use them as the basis for implementation of the overall University Corporate Plan. The main point for the Division is that it is unlikely that we will be able to implement major proposals unless any such proposals have been incorporated in our 5-year plan. As these will be subject to annual update, there will be opportunity for regular modification.

While we are not able publish our 5-year plans on the web yet, Heads of Department have been sent copies and a summary of its many points is as follows.

On the teaching front, we do not intend an increase in under-graduate student numbers. This is pertinent as there are strong rumours that there will soon be a call for bids for yet another large increase in medical student numbers. While we would consider the possibility of a small increase of 20 places in the year 4 admission (to balance with year 1), we wish to remain relatively small. This will maintain one of our strengths, namely a close, personal knowledge of our students, based around colleges and the tutorial system. Another aspect of our plans for under-graduate courses is the implementation of reviews of non-medical physiology and of Philosophy, Politics and Psychology (PPP), the latter under Professor Oliver Braddick. These were recommended by the University Review of last year and will address all components of the courses — numbers, purpose, curriculum, etc. Experimental Psychology is expected to maintain a steady state, or, at most, a modest decrease in student numbers.

In contrast, we do envisage an increase in graduate students. This will be primarily in post-graduate research students (PRS) where we currently have around 700 students. We intend to expand this number (subject to quality requirements) towards 900, recruiting the best of the available students from everywhere in the world.

Indeed, increasing the proportion of overseas students from the current 36% towards 50% has the potential advantages of both maximising the quality of our students and raising our profile and influence. Our plan proposes a modest increase in taught graduate students and courses — we currently have seven courses and around 90 students. This might increase to around 10 courses with about 150 students. However, we would want these courses to be strongly linked to our research agenda — for instance, providing a taught element to each of our large research themes (see later) — and providing a pool from which the best potential PRS can be recruited. Related to this expansion of graduate students, we will continue to build our graduate training programmes, primarily through the Centre for Education, Training and Learning (CETL) which Professor Edith Sim directs. Both the taught Masters courses and the CETL will provide us with links to the national move towards 4-year DPhils and towards implementing the Bologna Process.

A very important matter related to teaching is the necessity of reforming some of the ways in which we teach. This will involve an examination of the options for decreasing the workload for staff and may result in greater use of graduate students and post-docs. Such options have been highlighted in the University’s Corporate Plan and in our own education strategy (http://www.medsci.ox.ac.uk/portal/edustrat ).

On the research front, our previous Research Plan forms the basis of our current proposals. This identifies several key areas where the Division can play a role in fostering research and discusses the principles which should guide this activity. The key areas include: a searchable database,

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fund-raising and alignment with the NHS. The principles include breadth and depth of research, links to the rest of the University and a focus on both basic and translational science. In addition, the plan identifies seven major themes which endeavour to encapsulate the Division’s research activity. To these, we should consider adding Global Health as a major research (and teaching) theme.

The Plan identifies several priorities for investment,

namely posts in developmental/stem cell biology, molecular virology and basic microbiology, cancer cell biology, vascular biology and clinical haematology.

It also commits the Division to fostering interdepartmental research groupings based on the themes and to finding effectives ways to manage the risk associated with large numbers of our key individuals being funded on short-term external money.

Divisional Structures In January 2006, Professor Sir George Radda took up the post of Head of Physiology, Anatomy and Genetics, the merged departments of Human Anatomy and Genetics and University Laboratory of Physiology. In parallel, the University is providing funding for significant refurbishment of the ULP primarily to improve the laboratory facilities. This is part of a series of measures aimed at recruiting the very best staff and students into the merged department. In the long-term, the objective is to co-localise the merged department to maximise the opportunities for academic synergies. Our warmest thanks go to Professors Kay Davies and Clive Ellory for their stewardship of the former departments.

Biochemistry is the major re-building programme which the department has been planning. As originally conceived, this involves demolishing virtually all the Biochemistry buildings and re-providing them in two phases on the Biochemistry site. The first phase (12,000m2) will mainly provide replacement space for the department and has been costed at around £50m.

The plans for this phase envisage it opening in summer of 2008. While many of the details have been finalised, there are still a few issues to be resolved, but it is hoped these will be resolved imminently. The Council will examine the project with a view to giving final approval in Michaelmas Term 2006.

…a “state of the art” complex of the highest quality

The other major event of Hilary Term has been the dissolution of the Life and Environmental Sciences Division, resulting in the transfer of the Department of Biochemistry into the Medical Sciences Division from 1st April 2006. This will increase the size of the Division significantly: 30% increase in under-graduate and postgraduate students; 15% increase in academic staff; 10% increase in space and 10% increase in budget. A major driver in this merger has been the potential research links, resulting from the recent change in direction of the Department of Biochemistry, especially related to the recruitment of Professor Kim Nasmyth as Whiteley Professor. These links range across microbiology (including anti-viral therapy), cancer biology, structural biology and genetics. There are also exciting possibilities for integrating aspects of our teaching courses, especially in the FHS. Discussions on achieving these research and teaching opportunities have been initiated and will develop further over the rest of this academic year. A vitally important aspect of the merge with

The second phase is virtually of identical size and will be integrated with phase 1. However, this building is now envisaged as new space available primarily for the long-term development of the Medical Sciences in South Parks Road, rather than being reserved for Biochemistry. It is early days, but as is well-known, the current Human Anatomy & Genetics and Physiology buildings are unsatisfactory for 21st century science and will need very significant investment either to refurbish or replace in the very near future. Accordingly, we should examine carefully how the phase 2 building might help to address this issue. Indeed, we should examine the best configuration for re-development of the whole site (Anatomy, Biochemistry and Physiology, etc.) using phases 1, 2 and the current buildings, and deciding the optimum combination of refurbishment, re-build and demolition. This will undoubtedly be a long-term and costly project, but will create a “state of the art” complex of the highest quality for integrated biomedical sciences for the 21st century.

Capital Priorities In another example of the increasing organisation of the University’s planning methods, the Division was recently required to identify and prioritise its capital proposals for the next five years. This generated a list of 26 proposals, totalling around £126m. The Division was asked to identify the top three priorities in order.

These are: Clinical and basic neurosciences; expansion

of the biomedical facility on the Churchill site and the Old Road Building (for Cancer). It is important to note, however, that not being in the top three does not mean that a project may not be progressed. It simply means that in any competition for University funding, the University will take into account the order of priority the Division has detailed.

for integrated biomedical sciences for the 21st century.

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Other Issues In keeping with 2005/6 being an important year in University organisation, the White Paper on Governance was published towards the end of Trinity Term. There was widespread discussion on the proposals over the summer and early in Michaelmas Term 2006/7, with a formal debate and vote in Congregation in Michaelmas Term.

The proposals were rejected at both the formal debate and subsequent postal vote in December 2006.

In another important development, the University has set up a taskforce on Workforce Development. Many of the concerns about recruitment and retention of the best staff revolve around workload, salaries, promotion, titles, college-university interactions, etc. and it is hoped that the Taskforce will address these issues (amongst others). Although the formal date for submissions has passed, given the importance of the issues, I am sure late submissions will be considered and I strongly urge everyone to take advantage of the opportunity to submit ideas and opinions to the Taskforce.

…the University has set up a taskforce on Workforce Development

Over the last six months or so, I have been in discussion with members of the Conference of Colleges about the lack of college membership for many of staff of this Division — especially the externally-funded researchers. There is a recognition within many of the Colleges that this is unsatisfactory, especially for the senior researchers. There is also a willingness to attempt to find a solution which will incorporate the staff into important aspects of college life, but will not overwhelm

the college system. To this end, I have provided the interested Colleges with a list of such staff, with the intention that the College will then contact those whose area of interest aligns best with their plans, with a view to exploring ways in which a mutually satisfactory link can be established.

In November 2005, a new Edward Jenner Institute for Vaccine Research was created by the merge of the vaccine programmes of the University of Oxford and the Institute for Animal Health (IAH) and is being led by Professor Adrian Hill. The work of the last ten years of the Jenner Institute will be built upon and linked to leading translational research and development programmes in vaccinology at Oxford and at the IAH. The headquarters will initially be in Oxford and the current Jenner Building at Compton will continue as part of the institute with a new focus on veterinary vaccines. We wish Adrian every success with this challenging and exciting venture.

Recently, the government has issued consultations on two areas of crucial interest to the Division, namely on the use of metrics in the RAE and on the merge of the MRC and NHS R&D funding (Cooksey Review). We are delighted to have been recognised (as the partner of the Oxford Radcliffe Hospitals NHS Trust) as a Comprehensive Biomedical Research Centre, one of only five in the country. For more on this go to page 6.

Ken Fleming Head of Medical Sciences Division

New President of The Academy of Medical Sciences John Bell, Regius Professor of Medicine at Oxford University, has become President of The Academy of Medical Sciences. He took up the new post in November 2006. Professor Bell will be the Academy’s third President, succeeding Sir Keith Peters, Emeritus Regius Professor of Physic at Cambridge University.

Professor Bell said: ‘I am delighted to be taking up the Presidency of the Academy at such an important time for medical science in this country. Under Keith’s leadership the Academy has grown greatly in stature and influence. I look forward to working with the Academy’s strong Fellowship to build on the United Kingdom’s leadership position in many areas of scientific discovery, medical research and healthcare. We also need to continue the Academy’s campaign to raise the status of researchers and to ensure career structures enable our scientists to realise their full potential.’

Professor John Bell

Sir Keith said: ‘John Bell is an outstanding clinician

scientist with a fine record of research in the areas of genetics and genomics. As Academy President he will be a champion of medical science in the United Kingdom. He has already made a major contribution to the future of clinical academic medicine through the Academy report that led to the establishment of the UK Clinical Research Collaboration.’

In 2002, Professor Bell became the Regius Professor of Medicine. He has been extensively involved in the development of research programmes in genetics and genomics and in the development of a clinical research programme across the UK. He was the Founder of the Wellcome Trust Centre for Human Genetics and has led the significant expansion in biomedical research activities in the Clinical School in Oxford. His research programme has contributed to a clearer understanding of Type 1 diabetes and rheumatoid arthritis and also of the molecular interactions associated with immune activation.

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Awards — Congratulations • Professor Sir Richard Peto and Professor Rory Collins, Co-Directors of the Clinical Trial Service Unit on receiving the Queen’s Anniversary Prize 2006.

• Professor Rury Holman on being given the Hellmut Mehnert/ UN/UNESCO/German Diabetes Union Award. This was presented to Rury at the International Diabetes Federation biennial congress in Capetown, South Africa in December 2005. Rury is only the second UK recipient of the award.

• Professor Miles Hewstone from the Department of Experimental Psychology was awarded two prizes for his work on prejudice and social group relations: the Gordon Allport Intergroup Relations Prize, awarded by the Society for the Psychological Study of Social Issues, and the Kurt Lewin Award, for Distinguished

Research Achievement, awarded by the European Association for Experimental Social Psychology.

• Well done too to Professor Valerie Beral, Professor Nick White and Professor Peter Hunter on their election as Fellows of the Royal Society.

This is an amazing achievement for Oxford Medicine to have three out of a total of fortyfour new fellows world-wide.

• Last, but not least, congratulations to Alastair Buchan and Hugh Watkins for successfully securing an Award in Principle from the Clinical Research Infrastructure Initiative (CRI) for the “Establishment of an Acute Vascular Imaging Centre at the John Radcliffe Hospital”.

Congratulations to them all!

Email Forwarding Service for Oxford Medical Alumni As you may be aware Oxford University has for sometime been offering a free email forwarding service for alumni. Now this service is available to alumni of the medical sciences at Oxford. The email forwarding service provides you with a medical ‘Oxford’ email address which will forward email to your current email address. It is a permanent home for your email. If you are starting a new job, setting up professional contacts, or just want to stay in touch with friends, then this is the only address you'll ever need.

In the future, if you change your personal email address, you need only tell the Oxford Alumni Email Forwarding Service to change the address to which it forwards your email. For all your friends and colleagues your Oxford alumni email address will remain the same.

As an alumnus of the medical sciences at Oxford your email address will, for example, take the form: jayne.todd@medsci.oxon.org <firstname>.<lastname>@medsci.oxon.org.

The email forwarding service for Oxford’s alumni is free, and it includes anti-virus checking and spam scoring.

To be eligible for the service you must be a matriculated member of the University, and have a college affiliation. All names, colleges, and years of matriculation are searchable if you are a member of the service; however, an ex-directory option is available for those who wish to remain private.

Please remember: Oxford’s Alumni Email Forwarding Service is simply an email forwarding service. You will need a separate account with an Internet Service Provider (ISP) in order to collect your email, and it cannot be used until you have set up a personal email account with the Internet Service Provider you have decided to use.

@

@

@medsci.oxon.org

…the only address you'll ever need

To register for the service please go to www.oxon.org/alumnus/signup where you will find all the information you need

Development News: Cancer — Oxford leading the way in translational research Building is now moving forward apace on the new Institute of Cancer Medicine which is due to open in early 2008. Dedicated to developing innovative approaches to the diagnosis and treatment of cancer, this Institute will establish Oxford as one of the leading centres in Europe for translational research. It will embrace Clinical Pharmacology, our new Radiation Oncology and Biology Unit (incorporating the Gray Cancer Institute) and the Ludwig Institute of Cancer Research which is moving from London to Oxford.

This magnificent new building on the Old Road Campus will also house our new Vaccine Unit and the HQ for the Jenner Institute and the University’s Institute for Biomedical Engineering. And most importantly, it is

opposite the new NHS Cancer Hospital at the Churchill.

This will be translational research at its very best — at the heart of our Old Road biomedical campus and dedicated to moving new approaches into clinical trials.

Costing £56m, we are now seeking the final £8.5m to complete the capital fundraising and also seeking funding for posts. We would be delighted to hear from members who would like to know more about the Institute and how they might be able to support it — either directly or perhaps by introducing us to friends or colleagues.

Please contact Diana Stent, Head of Development Medical Sciences (email diana.stent@devoff.ox.ac.uk tel 01865 288082).

The Cancer Institute will also feature at the Oxford Weekend — see page 6

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£57.5m NHS funding for clinical research in Oxford Oxford has been recognised one of the country’s five leading centres for medical research, and will receive £57.5m in NHS funding over five years. Oxford Radcliffe Hospitals (which receives the money) and the University of Oxford jointly applied for the funding, which will help to translate research findings into patient care.

‘That partnership helps us to take research on vital areas including

The Secretary of State for Health has announced five new Comprehensive Biomedical Research Centres of excellence across England, of which Oxford is one.

Together with six Specialist Biomedical Research Centres, they will share £450 million over the next five years. The Centres are based within the NHS and run in conjunction with Universities. They were chosen by the new National Institute for Health Research.

Trevor Campbell Davis, Oxford Radcliffe Hospitals Chief Executive, said: ‘We are proud to have been chosen by the National Institute for Health Research to play a leading role in the future of UK biomedical research.

We know that top-quality research will lead to the best in NHS care for the people served by our hospitals.’

vaccines, diabetes, stroke, cancer and heart disease to patients in Oxford, the UK and the world.’

Dr John Hood, Vice-Chancellor of Oxford University, said: ‘One of the University’s research priorities is translating medical research from laboratories to centres of patient care. Winning this funding highlights, and will allow us to build on, the fruitful partnership we have with Oxford Radcliffe Hospitals. That partnership helps us to take research on vital areas including vaccines, diabetes, stroke, cancer and heart disease to patients in Oxford, the UK and the world.’

The investment secured will build on the many millions of pounds already invested by Oxford Radcliffe Hospitals and Oxford University in medical research,

training and treatment. Not only will the initial investment afforded by the new status help consolidate infrastructure, it will also put Oxford in a position to attract some of the billions of translational research funding available worldwide from industry investors and health charities, and enable the hospitals and the University to develop and exploit rapidly-advancing technologies and bring them to patients.

Oxford’s status as a leading centre for medical research will be greatly enhanced by the presence of new hospital buildings in Oxfordshire, including the new West Wing opening at the John Radcliffe in January 2007 and the Cancer Centre at the Churchill Hospital opening in 2008. The University is currently building a £56m centre for medical research based opposite the Churchill hospital, which will include an Institute for Cancer Medicine to interact with the hospital’s Cancer Centre. The addition of these NHS and University buildings to existing clinical facilities will make the Oxford Centre one of the world’s largest experimental medicine research institutes.

Beyond Oxfordshire, the centre will form and improve links with health planners and policy makers, forging strategic alliances within the NHS, academia and industry, and helping the nation set and develop its health research priorities. The Oxford Biomedical Research Centre will also have a global perspective, through, for example, the Oxford Tropical Network and the Clinical Trial Service Unit, with their links in SE Asia, Sub-Saharan Africa, India, China and South America. This will give the Centre greater potential to rise to global health challenges that affect NHS patients, such as the threat of pandemic influenza and multi-resistant pathogens.

Meeting Minds — The Oxford Alumni Weekend 14th –16th September 2007 All Old Members of the University are invited to attend the first ever collegiate University Reunion. The Weekend is the first opportunity for you to return to Oxford to participate in a range of College and University events all in one weekend. Activities will include panel discussions on Oxford’s contribution to global issues, updates on current Oxford research, reunion dinners, concerts, tours and sporting events. The Oxford Alumni Weekend is organised by the Oxford University Society, in conjunction with Colleges.

A full brochure will be available from 1st April 2007 and can be ordered from the event website, or is available from the Oxford University Society (email alumniweekend@ousoc.ox.ac.uk; tel. 01865 288087).

Further details can be found at www.alumni.ox.ac.uk This website www.alumniweekend.ox.ac.uk will be available from 1st March 2007 and you will find all the information you need here. Booking opens on 1st April and will close on 31st July 2007. Early booking is recommended as places are limited.

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Oxford University Society Travel Programme 2007 The Oxford University Society offers an extensive Travel Programme for Oxonians, friends and family. The trips give you the chance to experience new places, enrich your knowledge and enjoy the company of like-minded alumni. The tours are accompanied by expert trip scholars, who will enhance your enjoyment of the destinations you visit.

The OUS travel brochure 2007 is now available. This brochure features a unique trip to Antarctica, which will be a once in a lifetime experience. Other new trips include ‘Exploring the Veneto,’ accompanied by Professor Richard Cooper. There is also the chance to explore the temple and palace towns of North India, accompanied by Dr Misra (Keble College). For those

who enjoy the cruising life, we have arranged special discounts for Oxonians on Queen Mary 2 Transatlantic Crossings, and also on ‘Spirit of Adventure’ cruises.

For each booking, all tour operators make a donation to the OUS. These funds are used to support the work of the OUS on behalf of all Oxford alumni, and also for travel awards and maintenance grants to current students. Your participation in the programme is therefore greatly appreciated.

A copy of the 2007 brochure can be downloaded from our website: http://www.alumni.ox.ac.uk/services/travel/index.shtml. Alternatively, please email travel@ousoc.ox.ac.uk or ring 01865 288087.

Magdalen marks Sherrington Centenary Sir Charles Sherrington (1857–1952), though originally a Cambridge graduate, came to Magdalen from Liverpool where he had been Professor of Physiology to take up the Waynflete Chair in Oxford. His pioneering work on the fundamental mechanisms of the nervous system at the level of the synapse, — a term he himself coined, — eventually earned him a Nobel Prize shared with E.D.Adrian in 1922. His original ideas had first been outlined in his seminal book "The Integrative Action of the Nervous System" published in 1906.

To mark this event, a seminar was held in Magdalen last November, to which Magdalen Medical Alumni were invited, along with a most impressive array of pre-

senters from the UK and North America currently working in related Neuroscience areas. Arguably perhaps the most interesting of these was William Gibson who had come over from The University of British Columbia, now well into his 90s, he had himself been one of Sherrington's last research assistants!

The event was rounded off by a splendid dinner in Magdalen Hall, hosted by John Stein whose brother, he reminded us, "sells fish, — 'very good for the brain, we understand". Maybe Sherrington knew that too, we wondered, as he lived into his 95th year! All in all, a most memorable occasion.

Richard Maxwell, 1966

Download the 2007 brochure from our website: w w w .a l u m n i .o x .a c .u k / services/travel/index.shtml

Oxford Medicine is sent to more than 9,000 alumni of medicine at Oxford.

If you would like to receive a copy then please contact Jayne Todd.

It is vital that OMA has your current contact details to enable you to continue receiving copies. Please check

Stephen Potts — on “time out” I’ve always had an ambivalent relationship with medicine — or at least with the all-or-nothing nature of medical careers. I squeezed a year of philosophy between my preclinical studies (at Corpus Christi, Cambridge) and clinical medicine (at Magdalen, Oxford, 79–82). After house jobs, I took “time out” to study medical ethics at Green College, and then in the USA, via a Harkness Fellowship.

On my return I trained in psychiatry in London and Edinburgh, and for the last ten years I’ve been a consultant in liaison psychiatry at the Royal Infirmary in Edinburgh, where I work part-time (three days per week) to pursue a parallel career as a writer.

In 1999 my first book, Hunting Gumnor, was published. It’s an adventure fantasy for children aged 10–12, and has been followed by two other books, Compass Murphy (2001) and The Ship Thief (2004) to make a set collectively titled The Running Tide. My latest,

Abigail’s Gift, came out in August 2006. None have been best-sellers, but they have been generally well received, and I’ve made a few award nomination lists. Along the way there was a novella for younger children, and I’m now branching out into radio, with a short play broadcast on Radio 4 in June. I’m currently working on a feature film script and a novel for adults, with a medical theme.

Straddling these two worlds is difficult at times, and requires more organisation than falls to my nature: but it is possible. I’ve heard part-time doctors recount tales of marginalisation, though I’ve never met anything less than total acceptance from my colleagues, and flexibility from management. Yet parttime work is still unusual in hospital medicine, and is most often undertaken by women with young families.

For those of you, male or female, who want time to pursue other interests, I’d recommend it.

and update your details at: www.medsci.ox.ac.uk/ contact

Stephen Potts

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Oxford’s First Textbook of Medicine: John of Gaddesdon’s 1314 Rosa Medicinae

Manuscript — Merton College

…he spent some time in Montpellier to gain experience “in order that he might not endanger his family and fellow countrymen by his first practice of medicine”.

Oxford has become well known as the birthplace of the justly popular Oxford Textbook of Medicine by Weatherall, Worrell and Ledingham, first published in 1983. It is less well known that Oxford was also the birthplace of a textbook of medicine some six and a half centuries earlier. Moreover that book was still being re-printed nearly three centuries later and it is believed that Shakespeare was familiar with its contents! Although now in its third edition and having spawned several offspring it seems unlikely that Weatherall et al. will be able to match John of Gaddesdon’s record. (NB other spellings of the name include Gaddesden, Gatesden and Gatisden).

My previously expressed delight (see Oxf Med Sch Gaz 53 (2)) at the beautiful locations where one must go to pursue the study of the history of medicine in Oxford was further strengthened by a recent visit to Merton College library where I was privileged to examine not only three different printed editions of the ‘Rosa’ — Printed in Pavia in 1492 by Joannes Antonius Biretta; edited by Nicolaus Scyllatius Siculus; Printed in Venice in 1502 and Printed in Augsberg in 1595 (in 2 volumes), but also a manuscript copy in its original 14th century binding. Such treasures are a delight to view. Other manuscript versions of the Rosa are known to exist in the Bodleian, in the British Library and in Exeter Cathedral Library (this a generously illuminated version on over 1500 sheets of vellum, and since it requires the skin from one sheep to provide two sheets of top quality vellum this copy would have required the skins of at least 750 sheep to produce!)

Unfortunately my far distant ‘O’ level Latin is not quite up to a fluent reading of the manuscript but help is not far away. In 1912 Henry Cholmeley published a commentary and analysis of the ‘Rosa’ and in 2001 Dr John Griffin published a short article (in the unlikely sounding journal, Drug React Toxicol Rev 20, 185, — published by OUP) entitled “John of Gaddesdon, Royal Physician, Churchman and Warrior”. From these two sources I have plagiarised the following information.

John of Gaddesdon was born around 1280 in Little Gaddesdon in Hertfordshire where a house still bears his name. This was close to a monastery of the Augustine Order, the College of Bonhommes, which was also responsible for two hospitals in Berkhamstead. It is likely that an intelligent local boy would have attracted the attention of the brethren and he to have profited from interaction with them.

John entered Merton College in about 1294 and

began the study of grammar, ie Greek and Latin. He probably obtained a BA in 1300 and an MA in 1303 when he began his medical studies.

On graduating in 1307 he began his ‘6 years of lectures’ when perhaps he spent some time in Montpellier to gain experience “in order that he might not endanger his family and fellow countrymen by his first practice of medicine”. It is likely that at that time Montpellier would have had more medical texts available for study than Oxford.

In Oxford he might have gained some clinical experience at St Bartholomew’s Hospital, founded by Henry I, about 400 metres east of Magdalen bridge and at St John the Baptist Hospital, founded by John or Henry III in 1233 on a site close to where Magdalen College tower now stands. At this time there were probably also hospitals and libraries at St Frideswide’s Priory and Osney Abbey.

In 1314 the Rosa Medicinae first appeared (later better known as the Rosa Anglica). The title is explained in the preface—translated from the Latin by Cholmeley: “As Galen says in the first book of his treatise ‘de Ingenio Sanitatis’ “do not frequent courts and princes’ houses” as indeed I never did until I had acquired a knowledge of books – for Galen in the introduction to the seventh book says that it is impossible to become nearer to God by any other way than by the way of knowledge – therefore I have wished to write this book for the humble to read. Because since no book is without reproach, as Galen says in the second book of his ‘de Crise’, so neither will this one be. But all the same, I implore those who see it not to gnaw it with an envious tooth, but to read it through humbly, for nothing is set down here but what has been proved by personal experience either of myself or others, and I, John of Gaddesden, have compiled the whole in the seventh year of my ‘lecture’. And in regard to the whole book I intend to observe the following order of arrangement; first of all I try to investigate the name of any disease, secondly its definition, thirdly its incidence and cause, As Isaac says in the fourth book of his Fevers and in his section on Jaundice: “we can discuss everything which we wish to investigate in a triple fashion; we can consider its name, which is a matter of

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arbitrary convention; or its definition, which indicates its nature; or its action, which indicates its effect, and in this use its ‘actio’ is equivalent to incidence or cause” In the fourth place I give an account of the signs, both general and special, and what happenings to the patient are signs to the medical man, in accordance with Joanitius in his treatise on the signs of the official members. In the fifth I give the prognosis and in the sixth place the cure, and here following Mesue I give all things which are to be done for the cure of any dangerous disease which is capable of cure.

But before these matters are treated in the first chapter, I wish to give a name to the book, namely, The Rosa Medicinae, and I have so called it on account of five appendages which it, concerning which it is written: Three are bearded and two are not. That is to say, three of the parts surrounding the rose are hairy and two are smooth, and the same is the case with the five parts of my book. The first three are bearded with a long beard, for they treat of many things and about general diseases, and for what constitutes a general or common disease look into the introduction to the second book. The two following books treat of particular diseases, together with some matters omitted in the proceeding books, and they are as without a beard (shorter).

And as the rose overtops all flowers, so this book overtops all treatises on the practice of medicine, and it is written for both poor and rich surgeons and physicians, so that there shall be no need for them to be always running to consult other books, for here they will find plenty about all curable disease both from the special and the general point of view”.

From this introduction it certainly sounds as if the author was no ‘shrinking violet’ and confident in his own abilities. The work was, however, not an original research-based document but a compilation of what was known or believed at that time, supplemented by the personal experience of the author. Cholmeley identified 43 different quoted sources: Hippocrates (c460–410BC) 120 times, and Aristotle (384–322BC) 15 times, via Galen (130–216), 417 times to Avicenna (980–1037) 474 times and the more contemporary Gilbertus Anglicus (late12th– early13thC) and Bernard of Gordon who taught at Montpellier in the late 13th Century.

Although Chaucer (born c1340) probably did not

know him personally, nevertheless John is generally thought to be the model for Chaucer’s ‘Doctour of Phisik’ and the prologue to the Canterbury Tales includes: “Wel knew he the olde Esqulapius And Deyscorides, and eek Rufus Olde Ypocras, Haly and Galyen, Serapion, Razis and Avycan, Averois, Damascian and Constantyn.

Bernard and Gatesden and Gilbrtyn”.

Good company indeed.

On clinical content, it is generally agreed that the Rosa contains a curious mixture of the classical observations of Greek, Arabian and Jewish authors, some astute observations of the author, a comprehensive coverage of the remedies of the time, some eminently sensible but others almost unbelievable, for example powdered roast cuckoo insufflated into the patient’s nostrils for epilepsy, or if a child, the head of a cuckoo suspended from his neck. The sections most often referred to by more recent authors are those on ‘hydrops’, tuberculosis and leprosy, diabetes, epilepsy, smallpox and surgery. The Rosa also contains advice for travellers and a section ‘de decoratione’ on cosmetics, scents and body hygiene.

The end of John’s life seems less certain than the earlier part. Griffin states that he died at the age of 80 in 1360, having returned to Little Gaddesdon, his birthplace, but Capener in 1972 postulated that he died in 1349, thus explaining why he never referred to the black death which was prevalent at that time.

However it is also recorded that John was Marshall of Calais in 1350 (Bell 1977). No consensus has yet emerged. What is not disputed is that John was held in high esteem by his contempories. Griffin wrote: “John was a great man by any standard, he was the foremost English physician of his day, a theologian, an intellectual, a warrior and a classical scholar, but he remains best known for his Rosa medicinae.”

Weatherall and his co-authors can be proud of their literary forebear.

Eric Sidebottom References Bell V (1977) Little Gaddesdon. Faber & Faber, London.

Capener N (1972) Ann Roy Coll Surg Eng 50, 283.

Cholmeley HP (1912) John of Gaddesden and the Rosa Medicinae. Oxford Clarendon Press.

Griffin JP (2001) Drug React Toxicol Rev 20(4) 185.

Augsberg edition —Merton College

The work was, however, not an original researchbased document but a compilation of what was known or believed at that time, supplemented by the personal experience of the author

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Recent Acquisition: an Anonymous medical Manuscript

The 'Mackenzie polygraph' was subsequently produced commercially, and the Museum happens to have a nice example, dating from about 1910.

When the Department of Clinical Biochemistry relocated from the Radcliffe Infirmary last year, Dr Paul Kent transferred to the Museum two manuscript notebooks which had been found there. One is a Minute Book of the University Clinical Club for the years 1930â&#x20AC;&#x201C;36.

This finds an appropriate home in the Museum, which has records of a number of other University scientific societies; they are an important source of grass-roots information about the study of science at Oxford.

The other manuscript is an anonymous young doctor's journal for a brief period in 1905. While at first it seemed less promising, a careful reading in the hope of identifying its author has paid unexpected rewards.

The document is an exercise book, only eighteen leaves of which have been written on (and most of those on one side only). Running from the 12th September to the 28th November, the journal is chiefly concerned with notes and observations of medical cases seen by the writer, who is evidently either an advanced medical student or a newly-qualified junior doctor.

The writer undertakes clinical teaching rounds with the Professor of Medicine, William Osler, with whom he also shares an interest in antiquarian books. The references to Osler and accounts of his early ward rounds are the most obviously interesting feature of the document.

Sir William Osler (1849â&#x20AC;&#x201C;1919) was appointed Regius Professor of Medicine in 1904, but arrived in Oxford from America only in May 1905; so what is recorded here is actually the beginning of his first full university term in Oxford.

Osler's name is revered in medical circles to this day, making references to him which pre-date his establishment as a heroic figure all the more interesting.

Nevertheless, his first mention in the journal, on the 15th September 1905, immediately confirms the reputation he had within teaching circles in Oxford: 'Today I called on Osler who as usual was keen & inspiring; he wants me to take B.Ps [blood pressures] of rowing men during their training as possibly throwing some light on the conditions associated with the transient murmurs they get'.

The writer's eagerness to learn from the great man, both as medic and as bibliophile, is evident from the notes he makes. On the 5th November he 'Saw original edition of Burtons Anatomy at Osler's ... Tegg's edition is the best of recent times which I must get'. On the 8th of the same month he records in some detail, with a diagram, Osler's teaching clinic on abdominal inspection, showing the great care given to teaching (and learning) the difficult art of tactile examination â&#x20AC;&#x201D;

of training one's hands to recognize the body's inner organs and distinguish between their normal and abnormal states.

On another occasion he notes down one of Osler's wise and witty sayings: 'The three qualities of a good medicine "that it be coloured, that it tastes nice and that it does no harm"'.

While the teaching methods and the evident interest in research suggest an enlightened and modern approach, the journal also contains reminders of the more benighted world in which these medical men were operating. In order to gain experience of a wide range of illnesses, the writer visits various institutions, several of which seem to come from the pages of Dickens.

At the workhouse in Cowley, for instance, 'the daily task for able bodied men is to break 8 cwt. of stones to such a size as to go through a seive of a certain mesh; the quickest of them sometimes get it done by 11 a.m. working from 7'. Among the patients he examines at the mental asylum at Littlemore are 'two cases, male & female of Huntingdons Chorea, [and] a case of Lymphadenoma much improved on large doses of arsenic which had to be stopped because of the pigmentation produced'.

The journal also gives insights into the social life of the young doctors of the day, and mentions contemporaries such as Ernest Mallam and Edmund Bevers, who later went on to become well-known in Oxford both as medical practitioners and as university teachers. Along with a student doctor whom he coaches, the writer goes for bicycle rides in the countryside, and also to Woodstock looking at antique furniture.

On a trip to London he studies the original manuscripts of John Ward's diary in the library of the Medical Society, and comments: 'It might be used extensively for the study of the conditions of practice & practitioners in Oxford from 1668 to 1678'. The original is now in Washington, and is recognized as an important source for the history of chemistry and medicine in Oxford in the seventeenth century; microfilms held by the Museum have been studied by a number of students and scholars in recent years.

The most unexpected and the most interesting passage in the journal describes a trip with Osler, on the 20th and 21st September 1905, to visit a general practitioner in Burnley, Lancashire: "Started from Oxford with Osler at 9.5 to Burnley to see Mackenzie.

On the way read a new paper by Mackenzie on Angina ... Reached Burnley at 3 where was Mackenzie to meet us. After tea saw about half a dozen patients in his surgery chiefly hearts: one in whom a slight anginal attack

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was brought on by holding his breath." The writer of the journal goes on to note that he "Saw Mackenzie take tracings some on blackened paper, some by a device of ink made to write on white smooth paper a new method of his. Mackenzie's hypothesis that irregular pulse never occurs with mitral stenosis & a crescendo murmur being disputed by Osler." Later he had "Dinner with the family Osler making merry with one of the girls. After the rest had retired had a talk with M about Respiration & pulse. Suggests finding out type of respirn in various chest complaints some people have slow, some quick respirations: why?

Some peoples pulses quicken others slow down on respirn." The next day there were visits to more of Mackenzie's patients — 'heart cases nearly all' — and after noting their conditions, the writer concludes: 'To have seen this man (M) & the way he does his work amidst busy general practice including consulting medical work & operating, all his material being his own private patients has been both an education & a stimulus for me'.

This Burnley doctor is therefore none other than Sir James Mackenzie (1853–1925). Though several of his papers and his 1902 book on pulse research had been influential (clearly including on Osler and his young follower), Mackenzie did not become well known in mainstream scientific circles until after he moved to London in 1907. He then established himself as an authority on pain and the interpretation of symptoms, his own focus — seen clearly in this account — being on heart disease and especially angina pectoris.

Mackenzie is known to history, however, for his research upon the heart's rhythm and its irregularities, and for the graphical recording instrument he invented, with the assistance of a local watchmaker, to record the heart's pulsations. This is the 'new method of his' that is mentioned in the manuscript.

The 'Mackenzie polygraph' was subsequently produced commercially, and the Museum happens to have a nice example, dating from about 1910. The polygraph was widely used for clinical and diagnostic purposes. It was perhaps the last significant invention in the field of medical recording before the onset of electronic methods in the following decades.

By a fortunate chance, Osler's visit to Burnley is referred to in the biography of him by Harvey Cushing. Cushing quotes Mackenzie's own recollection of the visit: 'One of Osler's great charms was the kindly interest he took in obscure workers in any field of medicine; and in 1905 when I was a general practitioner in a remote town in Lancashire he paid me a visit; and though my work was not that in which he was directly interested, yet his appreciation was in itself a very great encouragement'.

Cushing places the visit in July or August, so our document may be the only accurate record of the actual date. More helpful to the Museum's immediate purpose, however, this event allows the writer of the manuscript to be identified — for we learn from Cushing that Osler's companion on this trip was A. G. Gibson.

Osler's companion, Alexander George Gibson (1875–1950), studied at Christ Church. He graduated in 1900, obtaining his B.M.. in 1904 after studying at St Thomas's Hospital, London. In 1905 he returned to Oxford as a junior house physician at the Radcliffe Infirmary, where simultaneously he became Osler's informal assistant. It is at just this point that he begins to write the diary. Later he also became Osler's personal physician. Their friendship was so close, and Gibson's admiration for his mentor so great, that according to Dr A. H. T. Robb-Smith 'perhaps unknowingly, Gibson assumed some of Osler's mannerisms'.

Gibson went on to become Pathologist to the Radcliffe Infirmary in 1911; University Lecturer in Morbid Anatomy in 1915; Physician to the Infirmary in 1919; Nuffield Reader in Morbid Anatomy and a Fellow of Merton College in 1937. In the 1920s he was a founder member of the British Cardiac Society, and of the Friends of the Old Ashmolean (the original friends organization of the Museum of the History of Science).

His history of the Radcliffe Infirmary was published in 1926, and the new pathological laboratories opened at the Infirmary in 1964 were named in his honour.

Cardiology was Gibson's lifelong interest, and we see it beginning to emerge as such in his journal, not least through Osler's encouragement and through the 'education and stimulus' of the visit to Mackenzie. Gibson was unusual in combining clinical treatment of patients (firstly as a general practitioner and later as a consultant cardiologist) with pathological and post-mortem work, extracting — in the manner of Mackenzie — important research findings from both.

According to Dr Robb-Smith, who was his pupil and has written a more recent history of the Radcliffe hospital, Gibson's teaching was especially stimulating because of this 'balance between clinical The polygraph observations and anatomical findings'. In the same way, at a time of increasing was widely used division between treatment and research, for clinical 'he always brought the humanity of the and diagnostic clinician into the laboratory', and advocated what today would be called a holistic purposes. It was approach to the study and treatment of perhaps the last disease. significant As can be seen, this extremely unprepossessing notebook turns out to invention in the be an archival object of significant field of medical interest. It contains a contemporary recording before record of the important work of Sir James Mackenzie before it received the onset wider recognition, including an early of electronic mention of his newly-invented polymethods in the graph, and provides insights into the Oxford medical world at the time. following decades.

The nature of the clinical teaching and influence of Sir William Osler are illuminated in some detail, as well as the antiquarian interests of Osler and his circle.

These antiquarian interests are also of some interest to the Museum, since they had a part in stimulating the development of the history of science in England (including the foundation of the Museum by its first Curator, another of Osler's admirers, R. T. Gunther).

Not least, the manuscript provides us with an insight into the life of its author, A. G. Gibson himself, an otherwise little-known but nevertheless significant figure in the recent history of Oxford medicine.

Tony Simcock (Reprinted from Sphaera, by kind permission of the Museum of the History of Science, Oxford.)

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Obituaries A Tribute to SIR JOHN PEEL Sir John Peel died on the last day of 2005 aged 101 after a short illness. A most distinguished Obstetrician and Gynaecologist he assisted Sir William Gilliatt at the births of Prince Charles and Princess Anne before succeeding him after his tragic death in a motor accident: Sir John delivered Prince Andrew and Prince Edward and also Princess Margaret’s children.

A son of the Manse, his father was a Methodist minister. Having won a scholarship to Manchester Grammar School he proceeded to The Queen’s College, Oxford in 1924: we know little of his undergraduate career but the College Archivist records that he came up to read Physiology with a view to studying Medicine although his original plan was to read Classics. A hand written entry on his college records reveals that had a weak heart but would be prepared to play cricket: he was also fond of music but did not play an instrument nor did he sing. He gained a First in Physiology and, although his original plan was to go to St Bartholomew’s Hospital, he acted on the advice of his tutor and applied for the Raymond Gooch Scholarship at King’s College Hospital: apparently he was asked only one question — “Do you play Rugby, Peel?” His reply in the affirmative was followed by the award of the scholarship.

Qualifying with the Conjoint Diploma in 1928 he proceeded to BM BCh in 1930 and held House appointments at King’s and The Samaritan.

Returning to King’s in 1932 he gained his FRCS and became a Member of the new College of Obstetricians and Gynaecologists in 1934.

After his appointment to the staff of King’s, which was honorary, it was necessary for him to establish a private practice in Harley Street in addition to the appointments he held at The Princess Beatrice Hospital, The Queen Victoria Hospital, East Grinstead and Pembury Hospital.

King’s had a special place in the management of diabetes under Robin Lawrence, himself a diabetic, who challenged John Peel with the comment that obstetricians knew nothing about the care of the pregnant diabetic: this led to his association with Wilfred Oakley and the establishment of a clinic specializing in the management of diabetes in pregnancy which revolutionized the outlook for diabetic mothers.

John Peel took a great interest in the Royal College of Obstetricians and Gynaecologists, eventually becoming its Treasurer and later President. At this time, together with David Steele, he was involved with Abortion Law Reform which aimed to see the end of women dying unnecessarily as a result of back street abortions. After his presidency he chaired enquiries leading to the Peel report into the use of maternity beds and also Foetal Medicine Research.

John Peel was a conscientious President of The Oxford Graduates Medical Club which was founded in 1884 and was at one time one of the foremost meeting places for medical debate in the country: more recently its activities consisted of a Council meeting in the Spring, a party in London in the winter and a dinner at an Oxford college in the summer and there were also three successful parties with The Cambridge Medical Graduates Club. In spite of John Peel’s tireless campaigning to increase membership, particularly by recruiting newly qualified members, numbers continued to dwindle and, in 1999 members agreed to its dissolution and its relaunch the following year as Oxford Medical Alumni.

Michael and Jennifer Pugh, 1951

PROFESSOR KEITH BREDIN TAYLOR Keith Bredin Taylor (born 1923) was one of those rare people whose talents spread across an amazing breadth of scholarship and yet remain able to communicate so well with anyone in everyday life – perhaps explaining his great clinical qualities as a doctor. He came to Magdalen to read medicine in the early 1940s obtaining a First Class Honours Degree in physiology in 1946 and qualifying in medicine in 1949.

Following early clinical training he rapidly became involved in research activity, initially in tuberculosis influenced by Dr Honor Smith (unique in running a unit devoted to TB meningitis in a single-storey building later to be demolished to build the Ivy Lane apartments), and Dr R L Vollum of the Dunn School. However, working with Professor L J Witts (the first Nuffield Professor of Medicine) he rapidly became interested in the absorption of vitamin B12, (‘Castle’s intrinsic factor’ as it was then called), and pernicious anaemia. His seminal paper in the Lancet in 1959 described the ability of serum from patients with pernicious anaemia to inhibit the absorption of B12 and he provided evidence that this was due to a specific antibody, later to be known as ‘antibody to intrinsic factor’. He continued to publish in this area but became particularly interested in the mucosal immune system and the possible role of immune responses to dietary antigens in mediating many chronic inflammatory diseases of the gastro-intestinal

tract. He left Oxford for the MRC unit for gastroenterological research at the Central Middlesex Hospital but shortly after that joined Deborah Doniach and Ivan Roitt at the Middlesex Hospital to continue investigating the role of auto-antibodies in thyroid disease, gastritis and other immune mediated diseases. In 1966, he was appointed to the Barnet Chair of Medicine at Stanford University which he held until 1989.

There he established a clinical service and research laboratory in gastroenterology of some distinction and developed a keen interest in nutrition.

When the off-shore medical school at St George’s, Grenada, was developed it was no surprise that Keith Taylor was asked to run an annual course in gastro-intestinal physiology and nutrition. This was the beginning of a long association with St George’s which culminated in him being appointed as Vice-Chancellor in 1989. He finally retired from that post in 1998 but continued to travel the world recruiting new students to the highly developed academic programme which he had worked so hard with the Faculty to achieve. Indeed, he had only just returned from Grenada when he succumbed to his final illness from which he died on January 1st 2007.

During his distinguished career he held a series of prestigious fellowships: the Radcliffe Travelling Fellowship (1953), The Rockefeller Foundation Fellowship (1959), Guggenheim Fellowship (1971) and a

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Fogarty Senior Fellowship (1978). From 1981 to 1982, he had leave from Stanford to become the Director General of the Health Education Council in London which he ran with skill and great wisdom. He bitterly regretted the decisions by the politicians of the time to close it, soon after he returned to Stanford, largely occasioned by his very fine house being washed down the hill by a mud-slide.

He was a tremendous source of inspiration to his trainees in the clinic, on the wards, in the laboratory or in more relaxed social settings. His depth of knowledge, his ability to listen and excellent sense of humour made him a wonderful mentor as well as

friend and companion. His love of theatre, literature and music was infectious and it was always a privilege to be invited to the many social functions that he hosted and to meet such talented and interesting people.

In his busy ‘retirement’ from Stanford he came back to the UK and settled in Bury, near Arundel, when he was not travelling as Vice-Chancellor or as International Relations Director.

He is survived by his first wife, Ann, (a renal physiologist and Fellow of St Edmund Hall) and by four of his five children.

Derek Jewell

MARGARET HAIGH (NÉE MITCHELL) 1931–2006 Margaret had an unconventional yet eminent medical career. Her passion for medicine was fired by her mother, who unusually for the 1900’s, was a science graduate, and by the experience of sitting with her father through his last illness.

Margaret spent her formative years in Kent and South Africa. She was educated at Herschel School, Cape Town and Ashford School, Kent. Here she had to adapt to the British syllabus, but still won a place at Lady Margaret Hall to read Medicine, going up in 1949. She loved the full academic and social life and amongst fondly remembered episodes was her achievement, with best friend “Paddy” Fullerton (Le Quesne), in canoeing the Thames from Oxford to Teddington.

Margaret was an outstanding scholar and, to Oxford’s disappointment, won an exhibition to St. Bartholomew’s Hospital, London, for her Clinical student years. She returned to Oxford several times, once to watch fellow medical student, Roger Bannister run the first under 4 minute mile.

Marrying immediately on qualification in 1955, she followed her husband, Alan, to Johannesburg finding work in a township clinic. Here Margaret saw the consequences of apartheid policy and after Alan, a journalist, was questioned by the secret police, they left Johannesburg precipitously in 1961.

She researched into the causes of vascular atheroma in Leeds and worked at the London School of Hygiene and Tropical Medicine before joining the British Heart Foundation, a fledgling charity, as Administrative Medical Director.

Margaret was involved in allocating funds to researchers just as diet and smoking were being recognised as factors in heart disease. She enjoyed editing “Heart” a quarterly broadsheet to inform on cardiac research and to encourage fundraisers.

In 1969 she coordinated, with the ambulance service and GLC, the first survey of Coronary Care provision in London. This uncovered a huge shortage of coronary care beds at that time — only 81 compared to the estimated 240 needed and large areas of East London had no provision at all, yet there were 5 units in Westminster!

In 1973 she became the Medical Officer to the London Ambulance Service. The only doctor at the LAS, she led a new team that would start to change ambulance staff from “people carriers” to paramedics.

Margaret was responsible for training of ambulance personnel in resuscitation, intubation and intravenous infusion. There was opposition from doctors and ambulance staff, but the course proved a success with many relishing their new skills.

Whilst at work on the 28th February 1975, news came of an underground train crash at Moorgate Station. The train had passed the platform at speed and crashed into a short, blind tunnel. Margaret joined her ambulance crews to rescue the injured in horrific, claustrophobic conditions. Passengers alive and dead were trapped in the mangled front carriages. She spent a further 4 days helping coordinate the recovery of the dead, 43 in total. Margaret undoubtedly suffered Post Traumatic Stress Disorder with recurring nightmares, but coped with the support of her family and work colleagues.

Margaret was awarded MBE, “for gallantry” in the Queen’s Birthday honours in 1975. At the autumn investiture she and other Moorgate heroes had a private audience with the Queen, before receiving their honours.

By 1978 the extended training of ambulance personnel was established, so Margaret moved to the British Council as medical officer and subsequently Director of the Medical Department. Margaret liaised

Margaret Haigh

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Obituaries with senior doctors, arranged lecture tours abroad and placed deserving foreign doctors in the UK for training. Her real joy was her chance to travel. Lesotho, India, Nepal, Brazil, Oman, Zambia and Iraq all had their medical education needs scrutinised and reported upon. It was not all work; treated as a diplomat, she was entranced by the Himalayas, wondered at the arch of Ctesiphon and stood atop the Sugarloaf in Rio. On the Editorial Board of the British Medical Bulletin, the last BMB Margaret commisioned in 1988 was on the “new” AIDS pandemic.

In 1987 on a trip to Southern Africa her foot was crushed in a car accident. She took early retirement and became more involved with her village in Kent. She brought energy and intellect to local causes — fighting a landfill site and defeating a proposed mobile phone mast — one of the first successful actions of this type.

Margaret renewed contact with LMH and became a benefactor.

Margaret took great joy in her children’s lives and careers; Ian in banking and insurance, Fiona in medicine and Niall (St Edmund Hall), in the art world. Sadly widowed she returned in 2003, to South Africa, moving next door to Ian and his young family in Johannesburg. Here she rekindled her love of gardening, poetry, literature, art, film and music and enjoyed her South African grand children.

Margaret’s style and energy, her keen intellect and depth of knowledge, her high standards and integrity, her sense of humour and love of family are cherished by all who knew her.

Fiona Clarke

PAUL BRUCE BEESON — OCTOBER 18TH 1908 TO AUGUST 14TH 2006 NUFFIELD PROFESSOR OF CLINICAL MEDICINE 1965—1974 Paul Beeson was one of the last of the great General Physicians. He qualified from McGill (as had William Osler) in 1933 in an era before the discovery even of the sulphonamides and when digitalis leaf, thyroid extract and mercurial diuretics were among the few effective medicines available. Born in Montana, he grew up in Anchorage, Alaska where his GP father had moved to tend to its 2,500 citizens.

The practice extended as far as Nome, 500 miles west, towards the Bering Strait.

After internships at the University of Pennsylvania Paul spent two years with his father and brother in practice in Wooster Ohio before beginning a brilliant career in university hospital medicine. This experience was one factor in his conviction of the real need for bedside clinical ability and of the vital importance of a traditional relationship between doctor and patient. These were then and always afterwards, at the forefront of his priorities. In an interview given to the Annals of Internal Medicine in 2000, he said; "I fear losing sight of the relationship between doctor and patient … and it seems that many trends in the last half century have conspired against it".

Among the reasons he gave for moving from Yale to Oxford in 1965, was to be able to continue as a generalist, to maintain and nurture bedside skills, and to escape from increasingly narrow specialisation in the USA. He was concerned about "the industrialisation of medicine" — for instance ill thought use of investigations and the growth of "cookbook" medicine and rigid protocols that are so prominent now. He quoted Sutton's Law* in his great paper on PUO (Medicine, 1961, 40: 1–30), advocating the need to start with the procedure most likely to provide a diagnosis and deploring the trend to carry out a battery of "routine" tests in conventional sequence.

He came to Oxford to join a medical world that is scarcely recognisable today. Wards housed only the patients of the consultants attached to them — Thomas Willis and Richard Lower wards (surely better names than 7A & 7B) were the territory of the NDM. There was a Matron and

there were ward sisters together with numerous able nurses from the (pre Salmon report) Oxford Nursing School. Mixed-sex wards or nurses who failed to see that their patients were properly fed were unthinkable. Of Oxford he wrote "There I had a firm with 40 beds, a house staff of six, and five full members of the department. I could work again with the young, with patients and could even return to some research activity. It was wonderful". There were total of 29 members of Osler House in 1965 and 113 in 1973, so that firms were ideally small. Students gained plenty of experience with practical procedures and were often genuine pairs of hands in the team.

Geriatric medicine was in its infancy and its relationship to general medicine in dispute. The two geriatricians were based in the Cowley Road Hospital and did not participate then in "On-Take" Medicine at the Radcliffe Infirmary. This was undertaken by two professorial units, Beeson's NDM and Sir George Pickering's RDM (Regius Department of Medicine) together with three NHS firms. There had in the past been some tension and even distrust between the NHS consultants and those of the university. One of Beeson's major contributions was to join and consolidate Pickering's initiative to unite the NHS and university physicians into one team, equally respected for clinical expertise, teaching and research. New NHS consultants were offered and took "A+B" appointments which gave them university-funded research sessions in place of private practice and the title of lecturer. Further it was Beeson who started the remarkably effective monthly meetings of the "ontake" physicians. Each in turn played host to the rest in his own home at evening meetings where discussion reached decision and a close knit group with unity of purpose was formed.

Beeson was deeply interested in teaching. He thought the Oxford course far too long and favoured something more akin to the American system. He would have approved of the current fast-track course for graduates. With Michael Dunnill he set up the bridge course designed to link the pre-clinical sciences with clinical practice with combined

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teaching by physiologists, biochemists, pharmacologists, pathologists and clinicians. This required a new building and it was Beeson who was largely responsible for persuading the Commonwealth Fund to pay for the new Harkness building in the RI. He was passionate too to keep the clinical school small — not more than 60 per year, as more, he felt, would make for impersonal and so uninspired teaching. He led his department by devolving much of the care to junior colleagues; to them he gave his trust and respect, while always being available to render loyal support. His opinion was regularly sought for the difficult or obscure case and his wisdom was greatly respected. He was generous to senior colleagues too and gave space in his department for Sir Hans Krebs' distinguished metabolic research laboratory.

Beeson was a reserved, even shy man of immense integrity. At Magdalen he became known as "the quiet American". Yet he could be moved to tears on occasion.

He once admitted that he was so nervous before lecturing that he would be unable to eat his breakfast. He found that getting things done — or not done — in Oxford was deeply frustrating but managed to achieve by personality and leadership what could not be achieved solely by being the Nuffield Professor. He could, though, be decisive in both word and deed. He once kidnapped into his own ward the post-operatively septicaemic wife of a colleague from a nearby nursing home, leaving the message "You can get in touch with me" for the surgeon involved. He once appropriated too Churchill's language to rebut an unjustified demand with "I wasn't appointed to preside over the dissolution of the Nuffield Department of Medicine “.

Before his time in Oxford, he had been Chief Resident at Harvard and Chairman of Medicine at Emory and then Yale Universities. He made major contributions in the area of infectious disease, notably in the understanding

of the mechanisms of fever, management of cases of pyrexia of unknown origin, endocarditis, urinary tract infection and, latterly in the pathophysiology of the eosinophil and its disorders. He was a co-editor of Harrison's Textbook of Medicine between 1950 and 1954 and of Cecil-Loeb between 1963 and 1979. As well as the many honours and awards that he achieved he became an honorary Knight Commander of the Most Excellent Order of the British Empire in 1973. The Medical Service at Yale is named in his honour and the Paul B Beeson Professorship in Internal Medicine was established at Yale in 1981. Perhaps Beeson Ward at the Radcliffe Infirmary will take its distinguished name with it in the move to Headington.

On return to America as the Veterans Administration Distinguished Professor of Medicine at the University of Washington, Seattle, Paul became a leading figure in the care of the elderly (editor of the Journal of the American Geriatrics Society); perhaps drawing on his experiences in Oxford, and in 1995 began the "Paul B Beeson Career Development Awards in Aging." To date there have been 125 Beeson Scholars from 39 top medical schools in the USA. In 1940 the Harvard American Armed Forces Hospital came to England at Oldstock, near Salisbury. It was there that Paul met a Red Cross nurse, Barbara Neal whom he married in Buffalo, New York in July 1942. Barbara, whose generous hospitality on Boars Hill will be remembered with affection by so many Oxonians, survives Paul together with their children John, Peter and Judith.

John Ledingham

"I fear losing sight of the relationship between doctor and patient … and it seems that many trends in the last half century have conspired

* Sutton's Law. The term derives from Willie Sutton, a hold-up man who, when asked why he always robbed banks said "Why, because that's where the money is".

OMA records with sadness the names of other colleagues and alumni who have recently died: Dr Teresa EA Addenbrooke Mr Roger G Ainley Dr Roger Bryce-Smith Dr Robert Diamond Dr James Irvine Havelock Hadfield Dr Lawrence I Holmes-Smith Dr Bent Juel Jensen Dr Meng Lim Dr Towy OW Myrddin-Evans Dr Pauline O'Neill Professor Edward S Newlands Dr John M Rice-Oxley Dr Martin J Stewart

Professor Paul Beeson

Dr Frank D Stott Dr Antony S (Tim) Till Dr John Tobin Dr Hubert J Trenchard Dr Andrew D Urquhart Dr Edith M Varley Dr John H Wakely Professor William RW Wilson Dr William Wynne Willson

If you would like to contribute an obituary or to write a tribute then please contact Jayne Todd

against it".

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For more information on any of the following events contact Jayne Todd Tel: (+44)1865 221690 Email: jayne.todd@medsci.ox.ac.uk Website: www.medsci.ox.ac.uk/oma

Oxford Medical Alumni Events 2007–2008 November Oxford Medical Alumni Winter Reception, House of Commons

2007 2 March First Frith Photography Prize Awards Grand Reception

December Varsity Rugby Match Twickenham Rugby Ground, London

7 April 153rd Oxford v Cambridge Boat Race Putney Pier, London 25 April 'The Radcliffe Infirmary' — a half day seminar 2.30pm, 13 Norham Gardens, Oxford.

The seminar will focus on the history and achievements of Oxford medicine at the Radcliffe. Those who attend will be also be able to view newly found video footage of significant medical figures taken at the Radcliffe Infirmary in the early 1960s together with a display of Radcliffe memorabilia and an extensive collection of photographs.

Contacting OMA Address: Oxford Medical Alumni Medical Sciences Office John Radcliffe Hospital Oxford OX3 9DU Email: jayne.todd@medsci.ox.ac.uk Website: www.medsci.ox.ac.uk/oma Enquiries: 01865 221690 Fax: 01865 750750

25 April Oxford Osler Lecture 6pm, Medical Sciences Teaching Centre, Oxford.

To be given by Professor Peter Ratcliffe Nuffield Professor of Clinical Medicine “Oxygen metabolism and the cancer phenotype: then and now.”

25 April Osler Dinner to mark the Closure of the Radcliffe Infirmary, 7.30pm, Rhodes House, Oxford A reunion for anyone who worked in medicine, taught medical students or studied medicine at Oxford at the Radcliffe Infirmary.

20 June Encaenia Sheldonian Theatre, Oxford

A Grand Reunion Dinner for Oxford Medical Alumni will be held in 2007 for graduates of 1977, 1982, 1997 and 2002.

Invitations will be sent.

2008 March Frith Photography Prize Awards Grand Reception March Oxford University North America Reunion.

Launch of OMA N. America, to be held in Washington DC 11 – 12 April Oxford Scientific Meeting Including the: Osler Lecture To be given by Professer John Reid, Regius Professor of Medicine and Therapautics, University of Glasgow.

Oxford Medical Society Lecture Speaker TBC. There will also be a programme of supporting papers.

12 April OMA Grand Reunion Dinner Reunion for anyone who has worked or trained in medicine at Oxford.

19 – 21 September Oxford University Alumni Weekend Oxford Medical Alumni Grand Reunion Dinner For graduates of 1978, 1983 and 1998.

7 July Varsity Cricket Match Lord’s Cricket Ground, London 14 – 16 September Meeting Minds — The Oxford Alumni Weekend

University

November Oxford Medical Alumni Winter Reception, House of Lords

of Oxford

The officers of Oxford Medical Alumni and the Head of the Medical Sciences Division Request the pleasure of your company at the

Third Annual Oxford Osler Lecture To be given by Nuffield Professor of Medicine Peter Ratcliffe

“Oxygen metabolism and the cancer phenotype: then and now” Wednesday 25 April 2007 6pm in the Lecture Theatre, Medical Sciences Teaching Centre, South Parks Road, Oxford Admission FREE by pre booked ticket only To be followed by the Annual Osler Dinner to be held at Rhodes House.

7.30pm for 7.45pm. Black tie. Partners welcome. £60 per head to include all drinks.

Tickets for the lecture and the dinner are available from: Jayne Todd, OMA, Medical Sciences Office, John Radcliffe Hospital, Oxford, OX3 9DU Tel: 01865 221690 Email: jayne.todd@medsci.ox.ac.uk

R.S.V.P. by 2 April 2007

Oxford Medicine is produced by the Medical Informatics Unit, NDCLS, University of Oxford. Telephone +44 (0)1865 222746.

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