Oxford Medicine April 2015

Oxford Medicine THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI OXFORD MEDICINE . MARCH 2015

Contents President’s Piece . . . . . . . . . . . . . . . . .2 People in the News

Oxford Gastroenterology from birth to international adulthood

The Great War: The RAMC and the University of Oxford officers’ training corps Old Age: a Non-medical Approach

Book Review

. . . . . . . .4

. . . . . . . . . . . . . . . .6

Oxford Gastroenterology

. . . .7

Profile: Dr AW Frankland

. . . .8

Officers’ Training Corps . . .11 Old Age: a Non-medical Approach . . . . . . . . . . . . . . . . . .13 With Sadness

. . . . . . . . . . . . .16

Travelling Fellowship

. . . . . .19

OMA Events . . . . . . . . . . . . . . . . .20

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President’s Piece

2014 has been a year of considerable activity for OMA. The new scheme of medical alumni reunions, carefully created by Theo Schofield, has really taken off this year.

In April and August those qualifying in 1990 and in 2004 met in Osler House; those qualifying 30 years ago had a reunion at Queen’s College; those qualifying 40 years ago had a reunion at Nuffield College in the evening after the Osler Lecture by Andrew Dilnot, and those qualifying 50 years ago met and dined at Oriel in December. One notable feature of these reunions is the year book that Jayne Todd compiles from submissions and

which makes fascinating reading. In addition I was able to attend an antipodean reunion in Adelaide. All these served to remind me how far flung and world-wide is the influence of those trained in medicine at Oxford.

This year for the first time we also held a reception immediately after graduation for those qualifying in 2014 in part to congratulate them but also to remind them that they are now also members of OMA. The Medical Sciences Teaching Centre was packed to bursting with qualified students and their proud families celebrating their achievement.

Professor David Paterson spoke to the group saluting their success and reminding them of their medical heritage. A most successful venture that we hope to repeat annually.

2014 also saw the inauguration of a third prestige lecture to be added to the Osler and Weatherall Lectures. This being the 300th

anniversary of the death of John Radcliffe (if you haven’t already seen it the Remembering Radcliffe Exhibition at the Bodleian is well worth a visit) it was decided, with the Head of the Medical Sciences Division at Oxford, to inaugurate an annual Radcliffe Lecture to highlight developments in one particular part of the Division. Who better to deliver the first, than Professor Hugh Watkins, Head of the Radcliffe Department of Cardiovascular Medicine. On November 12th he filled the largest lecture theatre at the new Maths Institute in the Radcliffe Observatory Quarter with an audience of alumni, academics, students and friends; who heard him give a fascinating talk entitled “Genomics — hope or hype?” on the role of genetic analysis in cardiovascular medicine.

John Morris

2015 New Year Honours List

Knight Grand Cross of the Order of the British Empire Professor Sir John Irving Bell, F.R.S.

For services to Medicine, Medical Research and the UK Life Science Industry. Sir John is Regius Professor of Medicine and Student of Christ Church. He has pioneered the development of genomic and genetic research programmes across the UK. He was the founder of the Wellcome Trust Centre for Human Genetics and sits on a wide range of

advisory panels for public and private sector bodies responsible for biomedical research in Canada, Sweden, Denmark, France, Singapore and the UK. He is a founding director of three biotechnology start-up companies, a board member of the UK Clinical Research Collaboration and UK Biobank, and is Chairman of the Oxford Health Alliance, a

private public partnership that sponsors research and advocacy on chronic disease globally.

Sir Marc Feldmann and Sir Ravinder Maini of the Kennedy Institute of Rheumatology have been named 2014 Canada Gairdner Award winners, one of the world's most prestigious awards for medical research Their discovery of an antibody-based treatment, or 'anti-TNF' therapy, for the treatment of rheumatoid arthritis and other inflammatory diseases has transformed the lives of many patients.

Sir Marc Feldmann and Sir Ravinder Maini Professor Feldmann is head of the Kennedy Institute of Rheumatology, now part of Oxford University's Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences. Sir Ravinder is a visiting professor in the Kennedy Institute.

Rheumatoid arthritis is a common, painful and disabling autoimmune disease. In the mid1980s, the team led by Professors Feldmann and Maini began investigating which molecules might be the cause of this disease.

Using tissue from joints of patients and animal models of the disease, they were able to demonstrate that a molecule belonging to the 'cytokine' family, called tumour necrosis factor, was a major driver of inflammation and joint damage in rheumatoid arthritis.

Sir Marc Feldmann and Sir Ravinder Maini The research group then showed an antibodybased treatment could block the action of TNF, and was safe and effective for treating people with rheumatoid arthritis. Anti-TNF therapy works rapidly in most patients to reduce pain, improve mobility, and boost quality of life. And in comparison to conventional drugs, it reduces the risk of heart attacks, strokes and increases life expectancy.

It has a major role in protecting joints from degeneration, reducing the need for joint surgery.

Not only was this a novel treatment, it was the first demonstration of an effective therapy for a long-term autoimmune disease which used a biological molecule as a drug. It led to recognition in the pharmaceutical industry that biological drugs could compete with traditional chemical drugs.

Professors Feldmann and Maini have improved treatment for many patients with rheumatoid arthritis, and their work has led to other successful anti-TNF treatments and encouraged much further work using antibodies for treatment.

Both researchers will receive 100,000 Canadian dollars for their achievement from the Gairdner Foundation. The researchers will be presented with their awards at a dinner in Toronto, Canada, on 30 October.

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NDORMS has a story to tell Now a growing department with more than 400 people spread across three main sites, the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS) owes its existence to Gathorne R. Girdlestone who returned to Oxford during WWI and later became the first Nuffield Professor of Orthopaedic Surgery.

The history of orthopaedics in Oxford is an outstanding example of scholarly excellence,

delivering research from bench to bedside and vice-versa thanks to close collaborations between University, NHS and research institutes worldwide.

Testimonies of this success story are the latest building developments: Phase 2 of the Botnar Research Centre (opened by HRH The Duchess of Cornwall HRH The Princess Royal opening the new building of the Kennedy in May) and the new Institute of Rheumatology, NDORMS (September 2014) building of the Kennedy Institute of Rheumatology (opened by HRH The If so, we would love to hear from you via post NDORMS History, The Botnar Research Princess Royal in September).

Centre, Windmill Road, Headington, Your story of NDORMS Oxford, OX3 7LD or email: Today more than 75 years old, NDORMS has a Ulrike.bilgram@ndorms.ox.ac.uk. lot of stories to tell. And we very much hope we could add yours. Do you have any Also, if you are interested in receiving an documents, photographs, artifacts or NDORMS alumni newsletter, please contact anecdotes you would like to share with us? us.

G. R. Girdlestone (courtesy of NOC Appeal)

OMA Reunion in Adelaide, 7th – 9th of March 2014-03-18

Readers of this report will be disappointed to learn that they missed a most enjoyable gathering of Oxford Medical Alumni held in Adelaide, South Australia at the beginning of March 2014.It was an opportunity to meet old friends and make new ones in a comfortable modern hotel situated in a quiet square close to the city centre. The meeting coincided with the Festival now held annually in one of the most civilised but less well known State Capitals of Australia. And of course it is the home town of such notable medical figures as Howard Florey, Aubrey Lewis, Hugh Cairns and Robin Warren.

Had you been here with us you would have enjoyed the dozen or so brief presentations as diverse as an assessment of Modern Paediatrics (verging on the politically incorrect), an illustrated guide to the Islands of the Thames, a review of Advances in Diabetes, a record of a journey on the Camino (to Santiago de Compostella) and an update on the Treatment of Neoplastic Disease involving knowledge of the timing of the subject’s immune responses. A fascinating paper on Evolutionary Medicine introduced many of us to a completely new field of study.

You might have enjoyed an afternoon excursion which included a visit to the home and studio of one of Australia’s best known artists – Hans Heysen – and of course the almost obligatory visit to a local winery.

All this with some underlying nostalgia for our time spent studying or working in the “Secret Garden” of Oxford’s Colleges or Hospitals.

Perhaps best of all however the nostalgia was blown away by a comprehensive review of changes in buildings and medical training given by the current President of OMA, Emeritus Professor John Morris whom, with his wife Joyce, we were honoured to welcome as participants in the gathering.

Since you missed such a notable occasion Dear Reader perhaps you should make a note that the next Australasian OMA reunion is likely to take place somewhere in W. Australia in 2016. For the date and location (to risk a cliché) – “ Watch this Space”.

Chris Hughes, Chairman of the Organising Committee.

OMA Reunion, Adelaide, South Australia, 2014.

Reunion Organisers: • Drs Chris & Millicent Hughes, • Prof Peter Roberts-Thompson Participants: • Jennifer Barraclough (nee Collins) Somerville, 1970; Bach flowers • Brian Barraclough (MB Otago 1957) • Roger Bodley (Worcester, 1966–73) Imaging • Brendon Coventry (Univ Adelaide) • Timothy Davis (Univ Western Australia) & Wendy Davis

• Don Handley (Adelaide) & Judy Handley • Maciej Henneberg (Univ Adelaide) & Renata Henneberg. Oxford Biological Anthropology; with Bry an Sy kes • Chris Hughes (Trinity & St Thomas’s 1953–59) • Millicent Hughes (Univ Sydney) • John Lourie (Worcester 1962–6; BM,BCh 1973; orthopaedic surgeon) • Graham May rhofer (Univ, 1965, then DPhil Dunn School; Wellcome), Immunology • Jo Rainbow (SEH 1987–93, Orange Hlth Service) Editor Oxford Handbook of Emergencies in Paediatrics and Neonatology.

• Peter Roberts-Thomson (DPhil under Ian McLennan) Flinders, Immunology • Lesley Roberts-Thomson (Research Nurse for Prof Peter Morris) 1992 sabattical at WIMM • Donald Simpson (Adelaide; 1951; Neuroanatomy under LeGros Clark; FRCS Eng; Neurosurgery under Mr Pennybacker) Prof Neurosurgery, Adelaide) • Peter Teddy (St Peters 1967–72; DPhil with Regius; Head Neurosurgery Oxford, then Melbourne since 2004) • E Haydn Walters & Julia Walters (Univ Tasmania) • Richard Watson & Mary Watson (Adelaide; FRCS Eng) Richard was John Morris’s SHO in 1968 • Sanjiva & Chitra Wijesinha (now Monash) GP

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People

Queen's Birthday Honours 2014

scientific knowledge, or conspicuous service to healthcare. The new Fellows were formally admitted to the Academy at a ceremony in July 2014.

Professor Colin Blakemore, FRS, FMedSci, Emeritus Professor of Neuroscience and Emeritus Fellow of Magdalen College, was knighted for services to scientific research, policy and outreach. Sir Colin was Waynflete Professor of Physiology from 1979 to 2007, and Professor of Neuroscience from 2007 to 2012. He is currently Director of the Centre for the Study of the Senses, at the Institute of Philosophy, School of Advanced Study, University of London. He said: 'Life has its ups and downs: this is definitely an up! Being a scientist is a delight, but also a privilege. The progress of science depends on the confidence of the public and politicians, and I’ve always believed that scientists have an obligation to share their excitement, their knowledge and also their concerns with the whole of society. Scientists must be prepared to engage in debate and dialogue, even on difficult and challenging issues, if we are to maintain the trust of society and the support of government. I’m especially pleased, then, that this honour has recognised my efforts to contribute to the dialogue between science and society. I hope that it will be seen as recognition for the efforts of all those scientists who devote time and energy to public communication.'

Professor Richard Cornall is Professor of Immunology, University Lecturer in Renal Medicine and Honorary Consultant Physician at the University of Oxford. His research aims to understand how the immune system is formed and regulated, as well as the causes of autoimmunity.

Dr Damian Jenkins, lecturer in medicine and biomedical sciences at St Hugh's College, was appointed MBE for his service as Major in the Royal Army Medical Corps.

Dr Jenkins has been connected to Oxford since 2000 when he came up as an undergraduate to read medicine. Since qualifying in 2006 Damian has worked as a doctor in the British Army and is presently the Armed Forces Registrar in Neurology. Damian is an advocate of diversity and inclusivity. He has chaired the Army LGBT Forum, promoting its work which has been recognised in nominations for several awards, as well as in a marked improvement in the Stonewall Workplace Equality Index (Top 100 placement).

Academy of Medical Sciences honours

Six medical researchers at Oxford University have been elected as Fellows of the Academy of Medical Sciences. The honour recognises outstanding contribution to the advancement of medical science, innovative application of

Professor Anke Ehlers FBA is Wellcome Trust Principal Research Fellow and Professor of Experimental Psychopathology at the University of Oxford. Her research focuses on anxiety disorders – in particular post-traumatic stress disorder, social anxiety disorder and panic disorder.

Professor Gary A. Ford CBE is Chief Executive Officer, Oxford Academic Health Science Network; Stroke and Cardiovascular Theme Director, NIHR Clinical Research Network; Consultant Stroke Physician, Oxford University Hospitals NHS Trust; and Visiting Professor of Clinical Pharmacology at Oxford University. His research interests include acute stroke therapies and early diagnosis of stroke.

Professor Fiona Powrie FRS is Sidney Truelove Professor of Gastroenterology at the University of Oxford. Her research has included work on the interactions between the bacterial intestinal flora and the immune system.

Professor Paul Riley is British Heart Foundation Professor of Regenerative Medicine and Chair of Development and Reproduction in the Department of Physiology, Anatomy and Genetics at the University of Oxford. His research centres on cardiovascular development, repair and regeneration.

Professor John Stein is Emeritus Professor of Physiology at the University of Oxford. His research focuses on how vision controls movement in animals, patients with movement disorders, dyslexic children and antisocial offenders.

In April 2014 the Difficult Airway Society presented the DAS Macewen Medal to Dr Ronald Sidney Cormack, who graduated BM BCh in 1948, for his contribution to the Society and to airway management.

In 1984, John Robert Lehane and Ronald Sidney Cormack, at this time anaesthetists at the Northwick Park Hospital in Harrow, United Kingdom, published a simple classification system for grading direct laryngoscopy in the journal Anaesthesia. Their landmark contribution to clinical anaesthesia soon

achieved general acceptance and promoted further improvements. Since the publication the two names have become linked, like the two sides of a coin, and it is difficult to mention one without mentioning the other. Such is the significance of their work that it is impossible to read or write a chapter on airway management without referring to these two famous names.

Their work is amongst the most read and quoted in the world and Dr.Lehane with Dr.Cormack are amongst the most famous names in anaesthesia.

Dr Faith Osier has won the Royal Society Pfizer Award for her research on understanding the mechanisms of immunity to malaria infection in humans.

The prize is awarded annually to a young scientist based in Africa. Dr Osier works at the KEMRI Wellcome Trust Research Programme, a partnership between the University of Oxford, the Wellcome Trust and the Kenya Medical Research Institute (KEMRI). Dr Osier leads a team of young researchers at the programme to understand how children living in areas with a high malaria infection rate develop immunity to the disease. This work is important in contributing to the search for malaria vaccines.

Dr Osier is supported by fellowships from the Wellcome Trust and the Medical Research Council (MRC) and is an honorary research fellow at the Nuffield Department of Clinical Medicine of the University, and at the Burnet Institute.

Erlick A C Pereira Feb 2014 Hunterian Professorship, Royal College of Surgeons of England.

Professor David Paterson Associate Head of the Medical Sciences Division (Education) and professor in the Department of Physiology, Anatomy and Genetics, was elected as an Honorary Fellow of the Royal Society of New Zealand in October 2014.

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The Royal Society awards Honorary Fellowships to researchers outside of New Zealand with the aim of encouraging liaison between scientists of different nations and promoting communication and links. New Zealand born Professor Paterson, commented upon receiving this award: “It’s a terrific surprise and honour, and highly valued by me as an expatriate New Zealander, as not too many kiwis abroad have been awarded this Fellowship.”

2014 John Maddox Prize for Standing up for Science.

The judges awarded the prize to early career scientist Dr David Robert Grimes for courage in promoting science and evidence on a matter of public interest, despite facing difficulty and hostility in doing so. David Grimes writes bravely on challenging and controversial issues, including nuclear power and climate change. He has persevered despite hostility and threats, such as on his writing about the evidence in the debate on abortion in Ireland. He does so while sustaining his career as a postdoctoral research associate at the Department of Oncology in Oxford.

2014 Google Impact Challenge Dr Stephen Hicks and a research team in the Nuffield Department of Clinical Neurosciences have won the 2014 Google Impact Challenge.

Their project has been awarded £500,000 to partnership between the Royal National Institute of Blind People, led by, to develop ‘Smart glasses’ for people with sight loss enabling them to make the most of their remaining vision. This project won as the 'People's Choice' following a public vote.

Oxford Medical School Prizes 2013–14 The Medical School announced the following prize winners for the academic year 2013–2014: Meakins McClaran Medal for the outstanding overall performance of a student graduating with the degrees of BM, BCh (Oxon) has been awarded to Emily Brow n, St Catherine’s College.

Geoffrey Hill Spray Prize in Clinical Biochemistry has been awarded to Andrew Gardner, Keble College.

George Pickering Prize has been awarded to Aislinn Brown, Magdalen College.

John Potter Essay Prize (for an essay on a clinical neurosurgical, neurological or neuropathological topic) has been awarded to Gavin Reynolds, Magdalen College.

L.J. Witts Prize in Haematology or Gastroenterology has been awarded to Joe Cross, St Anne's College.

Margaret Harris Memorial Prize has been awarded to Louwai Muhammed, Green Templeton College.

Matilda Tambyraja Prize for Best Written Performance (Obstetrics and Gynaecology) has been awarded to Tom Hine, Worcester College.

Medical Women’s Federation Prize (Obstetrics and Gynaecology) has been awarded to Mike Shea, St Hugh’s College.

Peter Tizard Prize in Paediatrics has been awarded to, Rose Penfold, Green Templeton College. The runner up prize goes to Katherine Mackay, Green Templeton College.

Renwick Vickers Prize in Dermatology has been award to David Gleeson, Oriel College.

Sidney Truelove Prize in Gastroenterology has been awarded to Hannah Rafferty, Green Templeton College.

Sir John Stallw orthy Prize for Best Clinical Performance (Obstetrics and Gynaecology) has been awarded to Kev in Cheng, Brasenose College.

2014 Oxford University Student Union (OUSU) Teaching Awards Biochemistry lecturers did exceptionally well in the recent Oxford University Student Union (OUSU) Teaching Awards. Elspeth Garman, Louis Mahadevan and Mark Wormald picked up three of the five nominations for 'Most Acclaimed Lecturer' in the Medical Sciences Division.

Dr Philip Bejon will take over the role of Director of KEMRI-Wellcome Trust Research Programme in 2014. His appointment follows the decision by outgoing Director Professor Kevin Marsh to leave the programme and work with a range of African and UK-partnered institutions to strengthen scientific capacity in Africa. Dr Bejon is a clinical epidemiologist and has been working with the programme the KEMRI-Wellcome Trust Research Programme since 2002, specialising in vaccine development.

2014 Failla Award Professor Peter O’Neill of the Department of Oncology, University of Oxford, has been awarded the 2014 Failla Award from the Radiation Research Society.

The Failla award was established in 1962–1963 to honour the late Gioacchino Failla, one of the founding fathers of the Radiation Research Society and its second president. The award is given annually to an outstanding member of the scientific community in recognition of a history of significant contributions to radiation research.

European Molecular Biology Organisation Professors Peter Donnelly (Wellcome Trust Centre for Human Genetics), Chris Tang (Dunn School of Pathology), Peter Somogyi (MRC Anatomical Neuropharmacology Unit) and Scott Waddell (Department of Physiology, Anatomy and Genetics) have been as a elected as members of the European Molecular Biology Organisation (EMBO). They join 106 outstanding researchers from Europe and around the world as newly elected members of an organisation that stands for excellence in the life sciences.

Geoffrey Harris Prize Lecture Professor Ashley Grossman, Professor of Endocrinology at the Oxford Centre for Diabetes, Endocrinology and Metabolism, has been awarded the prestigious Geoffrey Harris Prize Lecture from the European Society of Endocrinology. Professor Grossman will deliver the lecture during the first session of the society’s annual meeting in Poland. The prize, worth €12000 and sponsored

by Ipsen, is the first of its kind in Europe and is awarded to established researchers in the field of neuroendocrinology. It is named in honour of Oxford University’s Professor Geoffrey Harris, one of the leading pioneers of neuroendocrinology.

Professor Grossman commented: "I am especially delighted that I work at a university where Geoffrey Harris made his groundbreaking research into the connections between brain and hormones, in the Department of Human Anatomy in South Parks Road (now part of the Department of Physiology, Anatomy and Genetics). If it were not for his premature death, it is highly likely he would have gone on to be awarded the Nobel Prize in association with Andrew Schally and Roget Guillemin who sequenced the first hypothalamic hormones. At the Oxford Centre for Diabetes, Endocrinology and Metabolism, our in-patient ward is named Geoffrey Harris in his honour."

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2014 ESCEO-IOF Servier Pierre D. Delmas Prize Has been awarded to Cyrus Cooper, Professor of Musculoskeletal Science at the University of Oxford and Professor of Rheumatology and Director of the MRC Lifecourse Epidemiology Unit, Vice-Dean of the Faculty of Medicine at the University of Southampton.

Presented at the opening of the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases in Seville, Spain, the prestigious annual Prize honours an outstanding researcher who has made major scientific contributions to the study of bone and mineral diseases. The Prize, granted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis

Dame Kay Davies, Dr Lee’s Professor of Anatomy, was selected as the 2014 recipient of the British Neuroscience Association award for Outstanding Contribution to British Neuroscience.

Anna Gl oy n, Professor of Molecular Genetics and Metabolism, has been awarded the 2014 Minkowski Prize by the European Association for the Study of Diabetes, particularly for her work on the naturally occurring mutations that cause or are associated with increased risk of diabetes.

Book Review John Chassar Moir Kenneth, Jane and Priscilla Moir For Oxford Medical Alumni, published by John Moir, Oxford 2013 This delightful and informative booklet brings to life one of Oxford’s most distinguished clinical Nuffield Professors. John Chassar Moir’s children have composed a lively and vivid sketch of their father, outlining his career and his many achievements whilst remembering him with great affection.

Quiet and thoughtful, Chassar Moir was also a man of action and a skilled innovator. He lead

(ESCEO) and the International Osteoporosis Foundation (IOF) with the support of Servier is valued at 40,000 EUR. Professor Cooper leads an internationally competitive programme of research into the epidemiology of musculoskeletal disorders, most notably osteoporosis. Key research contributions have included the discovery of the developmental influences which contribute to the risk of osteoporosis and hip fracture in late adulthood; demonstration that maternal vitamin D insufficiency is associated with suboptimal bone mineral accrual in childhood; characterization of the definition and incidence rates of vertebral fractures; and leadership of large randomized controlled trials of calcium and vitamin D supplementation in the elderly as immediate preventative strategies against hip fracture. Professor Cooper is Chairman of the IOF Committee of Scientific Advisors; Chair of the MRC Population Health Sciences Research Network; Associate Director of

Peter Rothw ell, Action Research Professor of Neurology, has won the first Senior Science Award of the International Aspirin Foundation for providing compelling evidence for the substantial role of aspirin in the reduction of cancer incidence, metastasis and mortality.

Michael S harpe, Professor of Psychological Medicine and consultant psychiatrist, has been named Psychiatrist of the Year 2014 by the Royal College of Psychiatrists. The award particularly recognises his research integrating medical and psychiatric care for cancer patients with depression.

Research at the University of Southampton Medical School; and Associate Editor of the journal Osteoporosis International. He has published over 630 research papers on osteoporosis and rheumatic disorders.

Principal investigator Professor Ellie Barnes of the Nuffield Department of Medicine and her team have developed a new hepatitis C vaccine which has shown promising results in an early clinical trial. The vaccine was found to be safe and well tolerated in the 15 healthy volunteers who took part. The researchers also showed the vaccine generated strong and broad immune responses against the virus causing the disease. These results have paved the way for a new trial, now under way in the US, to test whether the vaccine offers any protection from hepatitis C to intravenous drug users – a group at high risk of infection. It is the first hepatitis C vaccine to reach this stage of clinical trials.

approaches to studying membrane proteins.

S ir Dav id We atherall, Regius Professor of Medicine Emeritus, has been awarded the Anthony Cerami Award in Translational Medicine by the Feinstein Institute for Medical Research and the journal Molecular Medicine in recognition of his discoveries in inherited disorders of haemoglobin.

Anthony Wat ts, Professor of Biochemistry, is to receive the 2015 Anatrace Membrane Protein Award of the Biophysical Society in recognition of his many innovative

Kathryn Wood, Professor of Immunology, has been awarded the inaugural Woman in Transplantation award of The Transplantation Society. A former president of the society, she founded its Women in Transplantation group.

forwards many vital themes in modern obstetrics, including the use of ergometrine for post-partum haemorrhage, pain relief in labour, the obstetric flying-squad, and the skilled repair of vesico-vaginal fistula. From his Scottish origins he inherited a love of learning, a flair for inventive engineering, and a sober dress code. He was a stickler for professional behaviour and particularly respectful of his collaborators, especially those whose tasks were menial. There are fond memories of his secretary Miss Phil Wolford, his technician Archie, and the African clawed toads used for pregnancy-testing.

His thirty years at Oxford spanned World War II, with stories of navigating Oxfordshire in the blackout by torch, map and compass on

emergency home visits, and organising the inrush of evacuees, both pregnant and professional. His wife ran the household at 11 Chadlington Road on ‘well-oiled wheels’ providing four meals a day, and he entertained guests to dinner in Oriel.

He had a close friendship with Lord Nuffield, with whom he shared many characteristics and a love of cars, though during the war he cycled between home and the Infirmary.

The booklet is short and synoptic, with helpful lists of chronology, topics, and awards. Yet it manages to capture the essence of his gentle effectiveness and warm home life as ‘…. a man who did more than anyone (contemporary) to save the lives and relieve the miseries of women’.

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Oxford Gastroenterology from birth to international adulthood

Derek Jewell

Gastroenterology prior to the 1940s was not a recognised specialty within general medicine.

That recognition was achieved very gradually and largely thanks to Sir Arthur Hurst, a physician at Guy’s Hospital. He wrote about the features and natural history of many GI disorders, especially constipation and ulcerative colitis, and then founded the British Society of Gastroenterology in 1937. In that year Lord Nuffield endowed the establishment of clinical academic departments in Oxford including the Nuffield Department of Medicine. L.J. Witts, a haematologist from St Bartholomew’s Hospital, was appointed as the first Nuffield Professor of Medicine. War time intervened but he was then able to appoint two First Assistants – an Oxford term (now abandoned) for what were otherwise senior lecturers – one of whom was Sidney Truelove.

He was a medical registrar in Norwich at the time of appointment in 1947 but had served in the RAMC during World War 2, predominantly in Italy. During that period he wrote papers on: jaundice during the treatment of syphilis, infectious hepatitis and diphtheria amongst the troops. His subsequent contributions to gastroenterology were ground-breaking and Oxford became an international centre for clinical management, research and teaching. He had spent some time in the War Office working with Lancelot Hogben and was therefore trained in medical statistics. Thus he was already conversant with the concept of randomised trials and using those techniques he will always be remembered for the seminal trials of cortisone in ulcerative colitis (Truelove and Witts, 1954, 1955), the development of topical therapy for ulcerative colitis and the identification of 5amino salicylic acid as the active ingredient of sulphasalazine. With Felicity Edwards he again published the first properly designed study on the course and prognosis of ulcerative colitis (1955) and subsequently a similar study for Crohn’s disease with Salvador Pena. However, his interests were much wider than inflammatory bowel disease and he made novel studies in coeliac disease, management of haematemesis, and in colonic motility: the latter being done by time-lapse cinefluorography on the basis of an NIH grant and which was a technique uniquely available in Oxford within the UK. Sidney was also the first person within the UK to have an Olympus fibre-optic endoscope and, based on his many studies in ulcerative colitis in which clinical, sigmoidoscopic, and histological appearances were correlated, he realised the potential for similar studies in the upper gastro-intestinal tract. The British Society of Gastroenterology

failed to see the academic potential of endoscopy which subsequently led to a splinter group forming – Truelove became the first President of the British Society of Digestive Endoscopy. The diagnostic and therapeutic as well as research opportunities of flexible endoscopy were a major factor in identifying gastroenterology as a distinct specialty.

Chrohn’s disease (microarray)

With such major contributions, research clearly involved many young doctors who came from all round the world for training in both clinical and academic gastroenterology. Ward rounds were often described by others in the Radcliffe Infirmary as ‘the united nations‘. Many of these have made great contributions to gastroenterology and medicine in general during their subsequent careers. It is perhaps invidious to pick out a few names but Ralph Wright (originally from South Africa and became the first Professor of Medicine in Southampton), Keith Taylor (Chair of Medicine at Stanford), Salvador Pena (originally from El Salvador but became Professor in Leuven and subsequently in Amsterdam), Azad Khan (Professor in Dhaka and founder of a new medical school), and Chris Hawkey (Professor of Gastroenterology in Nottingham). I was very fortunate to be offered the opportunity to do a DPhil with Sidney. I had been associated with the NDM as a clinical student, house physician and SHO and was already very interested in gastrointestinal diseases so the offer was readily accepted and my long-standing career in inflammatory diseases and coeliac disease began. Having completed the research period and subsequently general medical training I moved away from Oxford but it was an enormous privilege to be appointed as Sidney’s successor when he retired in 1980 a post that I held until I also retired in 2008.

During those years we tried hard to maintain

the principles that Sidney had established.

Thus, joint management of difficult clinical situations with the surgeons and close liaison with histopathologists and radiologists stayed as the bedrock for clinical care. We continued a research programme, mainly in mucosal immunology and subsequently we were one of the first groups to investigate the genetic basis of ulcerative colitis and Crohn’s disease which has led to major international studies and probably a better understanding of the genetic susceptibility than for any other polygenic disorder. Clinical trials of new drugs have been always been part of the clinic and our patients were keen to participate for which we have forever been grateful. The research was well supported by the major funding bodies (MRC, Wellcome Trust) as well as the Patient Charitable Organisations such as the National Association for Crohn’s and Colitis and Coeliac UK. As a result we continued to attract young gastroenterologists from around the world who came for at least a year and often for 3 years in order to obtain a DPhil from Oxford or an equivalent degree from their own universities. We were also immensely fortunate to work so closely with internationally known and respected surgeons (Emanoel Lee, Michael Kettlewell, and Neil Mortensen), radiologists (Dan Nolan) and histopathologists (Bryan Warren).

While gastro-intestinal disease was making strides both clinically and academically, liver disease also began to develop. Ralph Wright was initially the major instigator and had recruited Joan Trowell to perform studies of hepatitis B (known as the Australia antigen at that time). She was joined by Roger Chapman in 1982 who has subsequently become internationally involved in studying both the pathogenesis and treatment of primary sclerosing cholangitis. Within the last few years academic hepatology has grown under the guidance of Roger, Paul Klenerman and Ellie Barnes and is now heavily involved in clinical trials of new agents for hepatitis C and there is an impressive programme of immunological research in liver disease.

A major development occurred about 6 years ago when the University agreed to establish a professorship to be known as the Sidney Truelove Professor of Gastroenterology.

It was surprisingly difficult to attract the appropriate person but finally, with great foresight and imagination, the University appointed Fiona Powrie to lead the academic department even thought she is not a clinician. She is an international star in the field of mucosal immunology and has brought an immense reputation to the Unit which she

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has named the Translational Gastroenterology Unit. A private donor made a very substantial contribution to the new laboratories on Level 5 of the John Radcliffe Hospital which are impressive for their state of the art facilities. In addition, there are 3 senior academic gastroenterologists – Professor Alison Simmons, (immunology), Holm Uhlig (a paediatrician with an immunology research programme) and Simon Leedham (colorectal cancer immunology and molecular biology).

Thus, academic gastroenterology has never

been as strong and the Unit is highly respected both nationally and internationally.

Clinical gastroenterology continues to be extremely busy with now a cohort of five consultants for gastrointestinal disease plus James East who has been appointed to run the endoscopy unit and to manage endoscopic training as well to find time for an academic programme of research. He has been of enormous benefit not only for clinical service but for adding to the academic stature of the Unit.

The demands made by the Health Service are making it difficult for modern day clinicians to remain active in research. However the current unit in Oxford is a paradigm of a new model whereby scientists, clinical scientists and clinicians working together can achieve a high level of clinical care underpinned by a strong basic and clinical research programme.

Date and place of birth: Sussex 19 March 1912 Education: St Bees School in Cumbria, Oxford, 1930–1934, St Mary’s Hospital, 1934–1938 War serv ice: (RAMC) Sept 1939 – March 1946 Career: Director and consultant of the Allergy Clinic, St Mary’s Hospital, London, 1962–1977 Allergist at Guy’s Hospital 1977–1997 then consultant at the London Allergy Clinic. Former president British Society of Allergy and Clinical Immunology, Honorary Fellow American Academy College of Allergy and President Anaphylaxis Campaign, Honorary Fellow The Queen’s College, Oxford.

Publications: A book and more than 100 articles on allergy.

What he has done up to now is help revolutionise our understanding of allergy, an affliction that the medical establishment did not always take seriously until relatively recently (Professor Fleming, for example, thought it was nonsense) and is still not entirely understood.

It was Frankland who championed the view that an allergic reaction is due to a malfunctioning immune system. In doing so, he and his colleagues opened up the possibility of radical new treatments for lifelong sufferers by using small doses of an allergen to, in effect, retrain the errant immune system.

Dr Frankland is precise, measured and some of his comments decidedly waspish. His manner is reminiscent of that other near-immortal, Prince Philip. A few years ago, when well into his eighties, Frankland appeared on The Richard & Judy Show to talk about the “epidemic” of allergy. It was a grim experience by his account. “I’d never heard of them to be honest,” he says, “I took an instant dislike to Richard, far too bumptious. And they only paid me £50!”

His career straddled the boundary between the antibiotic and pre-antibiotic eras. When he trained as a doctor in the 1930s, medicine was more or less powerless against diseases such as septicaemia and meningitis. Then came penicillin, and suddenly doctors were empowered as never before to save the lives of tens of thousands of their patients.

In the 1950s, Bill Frankland worked with Professor Fleming at St Mary’s Hospital in Paddington, west London. He predicted (correctly) that even the new wonder drug, which began to be widely used in the late Forties, would cause allergic reactions in some patients. He had wanted to say so in a chapter he had written for Professor Fleming’s latest tome on the subject. “He made me change the sentence. He was wrong, but you can’t really argue with a Nobel Prize winner.”

Frankland has treated royalty, stars – and dictators. “I got a call [in 1979] to see the new

president of Iraq, Saddam Hussein.

They told me he had an allergy and he was being treated with various desensitising injections. But he wasn’t allergic at all; his problem was that he was smoking 40 cigarettes a day. I told him to stop and if he wouldn’t I would refuse to come and see him again. I don’t think anyone had spoken to him like that before. I heard some time later that he had had a disagreement with his secretary of state for health, so he took him outside and shot him.

Maybe I was lucky.”

Certainly luck has played some part in his life. He was born in Sussex into a family that was comfortably off. His mother had had no idea she was expecting twins until his arrival closely followed that of his brother Jack. “I was wrapped up and my cot was a chest of drawers,” he says. Born the year the Titanic sunk Dr Frankland grew up in the Lake District.

His was an idyllic childhood in the Lake District, a lost Britain of horses, Model T Fords clattering along unmade lanes, long walks and helping with the harvest. During his childhood he was a good friend of Roger Altounyan and his sister Titty, together they met the writer Arthur Ransome, who named some of the primary characters in his famous book, Swallows and Amazons, after the children. He attended St Bees School, founded in 1583, before studying medicine at Oxford and St Mary’s Hospital Medical School.

When war was declared, he joined the Royal Amy Medical Corps and was sent to Singapore.

On arrival, he tossed a coin with a fellow medic to decide upon the institution where each would work. It was three days before Pearl Harbour on December 7, 1941. Some two months later, on February 15, 1942, the Japanese swept into Singapore. His colleague, who had gone to the Alexandra Hospital to

Derek Jewell, Professor Emeritus of Gastroenterology

Profile — DR A W FRANKLAND, MA DM FRCP

Britain’s – perhaps the world’s – oldest active scientist and medical practitioner — entered medical school when Stanley Baldwin was prime minister and still works as an allergist, in his capacity as an expert witness, broadcaster and private physician. ‘I have my first patient at 9.00am tomorrow morning.’ A brief run through his diary shows a world of international conferences, speeches and official dinners. As perhaps the most eminent and senior practitioner in the management and treatment of allergy, he is much in demand. Last month he was called as an expert witness in a court case involving a careless driver, a wasp sting and an iPhone.

(His evidence secured the conviction after persuading the court that the driver could not have been suffering an allergic reaction, as he had claimed.)

This is the scientist to whom hay fever sufferers have cause to be grateful: it was he who persuaded Britain’s media to include the pollen count in weather forecasts back in 1961. And, some 60 years ago, he worked alongside Sir Alexander Fleming, the Nobel Prize- winning discoverer of penicillin. Today, he has absolutely no intention of stopping work. “What would I do…?”

OXFORD MEDICINE . MARCH 2015 / 9

work, died there along with other staff in an orgy of killing by Japanese soldiers armed with bayonets. Frankland survived the invasion but endured ''three-and-a-half years of hell” in an internment camp on Blakang Mati Island (now Sentosa). The POWs initially saw few Japanese guards, he says. Instead it was Sikhs and Koreans, employed by the Japanese, who mostly ran the camp in the early days. In the gruelling tropical heat everyone was starving – “Food, food! You only thought of food” – and suffering from hideous diseases such as beriberi, dengue fever, and dysentry.

After liberation, the Japanese soldier in charge, nicknamed “Shuffleboots” by inmates, blew himself up in a roadside drain. “We always thought it a very appropriate end,” Frankland says. Five days later and so emaciated that even sitting down was painful – “just bones on a hard seat” – Frankland was flown in a convoy of three Dakotas up to Rangoon for rehabilitation and a ship home.

The aircraft hit a storm over the mountains of southern Burma, and one didn’t make it.

Yet after 42 months of hardship and violence, and watching his friends die, he refuses to hate the Japanese. “If I hated them it would do me harm but it wouldn’t do them harm, and secondly, I am a Christian and Iwas taught not to hate.”

In 1946, Bill Frankland began working in the allergy department of St Mary’s, determined to make his field better understood. To that end, he has even experimented on himself – with near fatal consequences – by allowing a South

From the archives…

Osler House club taken in 1946

Celebrating Dr Bill Frankland’s 100th Birthday in March 2012.

American insect called Rhodnius prolixus to feast on his blood so he could document his own allergic reaction. He survived severe anaphylactic shock: “All I could do was hold up three fingers to indicate the doses of adrenaline the nurse should inject me with,” he says. Even today, allergies remain perplexing. What, for example, can explain the spectacular increase in allergies over the past half-century? Forty years ago, almost no one was allergic to peanuts; now, a severe reaction to the legumes causes a small but significant number of deaths among children.

Dr Frankland thinks there is much to be said for the “hygiene hypothesis”, which argues that failure to expose children to enough pathogens in infancy hinders the development of the immune system. “Allergy is immunity gone

wrong. You are not making antibodies against infection; you are making antibodies against allergens,” he says. His advice is not to worry about dirt too much and, if you want a pet, “get a cat or a dog before the child is born”.

Small doses of potential allergens seem to stop potential problem in their tracks, he points out.

Peanut allergy is, for example, rare in Israel where nuts are a common weaning food.

Dr Frankland is no stranger to allergy himself – he’s a lifelong hay fever sufferer, which is a painful irony for a man whose love for flowers means he can while away hours in Regents Park.

He remains interested in politics and fierce in his support of the NHS, opposing the proposed Coalition reforms which would see control of finances handed over to GPs. “I haven’t met a single person who is in favour,’’ Frankland says.

“GPs cannot be put in charge of these huge sums of money. It’ll lead to private medicine.”

Now he surrounds himself with his four children and 10 grandchildren. Dr Frankland is still looking forward – he is off to yet another conference, in Geneva, shortly – and shows me with pride his paper entitled Lysozyme and Fleming which has just been accepted by The Journal of Allergy and Clinical Immunology. Is he surprised to have reached such a great age intact? “Well, it’s something I have always aimed at.”

There are now about 12,000 centenarians in the UK, extraordinary people each and every one of them, but few as extraordinary as Bill Frankland. And for that we should be grateful.

Unless, of course, we meet him in court.

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Cairns Library Osler Letter to Mrs White, 9th August 1917

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The RAMC and the University of Oxford officers’ training corps.

Jayne Todd

The Oxford University Officers’ Training Corps (OUOTC) was one of 23 such bodies formed at universities in Great Britain following the establishment of the Officers’ Training Corps (OTC) by Royal Warrant in 1908. The formation of the OTC was proposed by a Committee set up in 1907 by Richard Haldane, Secretary of State for War, to investigate the problem of the supply of adequately trained officers for both the regular and reserve forces of the army. The Committee proposed that an OTC should be formed which would have two divisions, the Senior Division in universities and the Junior Division in schools. The hope was that it would attract young men into the Army and provide an efficient system of progressive military instruction for prospective officers. The report of the Committee was published in February 1907 and the OTC came into existence in April 1908.

In 1908, the newly formed OUOTC was based in premises at 9 Alfred Street with the University Delegacy for Military Instruction.

Candidates were expected to gain a BA degree as well as receive military instruction and the practical experience of being attached to a regular army unit. The Delegacy consisted of the Vice-Chancellor, the Proctors, one or more person appointed by the Secretary of State for War and six members of Convocation. The Delegates made an annual report to Convocation, which was published sporadically in the University Gazette, between 1906 and 1939. There were no reports at all between 1917 and 1924. These reports gave financial and administrative details of the Delegacy and statistical information on the number of candidates and commissions received.

An important aspect of the new OTC was the provision of permanent staff from the regular army to provide rigorous training for the cadets. Training during term took the form of short courses (usually about one per week) which took place at a time that did not interfere with University work or sport. Training included parades, attending camp and studying for voluntary examinations.

The First World War broke out in the midst of the Long Vacation in 1914 so most undergraduates and many fellows were away from Oxford during the early rush to enlist. For those who were still in Oxford and for others too, the simplest way to join up was to apply

to the Delegacy for Military Instruction.

However, the process of applying through the Delegacy was deemed too slow and cumbersome, so the OUOTC set up an ad hoc committee to speed up the application process.

By the end of September 1914, the committee had processed around 2000 applications for commissions and of these the great majority received commissions. When the University term started in October the number of undergraduates in residence was reduced to about fourteen hundred, of whom about eight hundred were undergoing an intensive course in the Officers' Training Corps. College Fellows too flooded into the services. There is a key difference between the First World War and the Second — in the First the majority of dons who left their colleges to serve their country joined the army, but in the Second they tended to be drawn to the civil service or home-based intelligence.

Another group of men, most of whom wore no uniform, rendered good service to the cause. The scientific laboratories of the University were put at the disposal of the Government, and worked hard at the problems referred to them. To enumerate their achievements, in Physics, Chemistry, Physiology, and Pathology, would demand a whole volume. All military operations depend for their success on efficiency at the base, and this War more than any earlier war was based on science. The science of killing had made enormous progress during the War, but it is

sometimes forgotten that the science of healing had kept pace with it. To succeed in war a nation must excel in both sciences, and if ever a complete history of the War shall be written the work of Oxford men of science will have an honourable place in it.

Two figures worthy of consideration in this respect are John Scott Haldane, Reader in Physiology from 1907 to 1913, and Georges Dreyer, Oxford's first professor of pathology, appointed in 1907.

Haldane's studies in respiration and the use of oxygen included investigation of the action of carbon monoxide in mines, resulting in

An Australian chaplain wearing a box respirator, 1916.

Credit: Lt. Ernest Brooks

12 / OXFORD MEDICINE . MARCH 2015

improved safety measures. He discovered the role of nitrogen in the 'bends' experienced by divers and devised a scheme of decompression which is essentially the one still in use today, expressed in the 'Haldane Tables'. It has been said, in connection with the war, that he invented the gas mask. It would perhaps be more accurate to say that he made a significant contribution to the production of the box respirator that became standard equipment during the war. In 1915 he was asked to advise the War Office on the poisonous gas being used in the trenches, and its effects. Following a visit to the Western Front, he concluded that satisfactory protection could only be ensured by a box respirator.

Haldane was noted for conducting many of his experiments on himself. His daughter, the writer Naomi Mitchison, recalled being required as a young girl to stand by in the home laboratory at 'Cherwell' on Linton Road (now the site of Wolfson College) while her father entered his sealed chamber and released various gases in order to note their effects. If he lost consciousness she was to free him and give mouth to mouth resuscitation.

In 1915, George Dreyer was commissioned in the Royal Army Medical Corps with responsibility for the laboratory diagnosis of enteric fever and dysentery. He was also attached to the Royal Flying Corps as Honorary Lieutenant-Colonel, and in this role he addressed problems presented by flying at high altitudes, designing a highly successful mask to deliver the right amount of oxygen to compensate for the lowered levels available as altitude increased. He was twice mentioned in despatches and for his war service was appointed CBE. Papers of John Scott Haldane are held at the National Archives of Scotland and the National Library of Scotland. We have no information so far about the papers of Georges Dreyer. More articles on medical care in the First World War can be found here: w w w.o xf or djour nal s.or g/our_jo ur nal s/ jalsci/v irt ualissue.htm l Very early in the War the Examination Schools were converted into the Third Southern General Hospital, and Somerville College was given up by its staff and students to become a branch hospital. Oriel College lent one of its quadrangles for the housing of the dispossessed Somerville students; University College provided additional accommodation for hospital patients; Merton College gave quarters for the nurses.

In 1916 two Officer Cadet Battalions formed at Oxford (these were No.4 Oxford and No.6 Balliol College; Jesus College served as a Garrison Battalion), in which candidates for commissions, many of whom had served in the

ranks, underwent complete course of training for up to seven months.

The strength of each cadet battalion was about 750 men and they were quartered by companies in Keble, Wadham, Hertford, New, Magdalen, Trinity, Balliol, St John’s and Worcester Colleges. For example, C Company of No. 4 Officer Cadet Battalion was quartered at Keble College under the command of Captain FW Matheson. The majority of cadets who passed through Oxford on this scheme were not members of Oxford University.

In February 1916 entrants to an Officer Cadet Battalion had to be aged over 18 and a half and temporary commissions could only be granted if a man had been through an Officer Cadet unit. The training course lasted four and a half months. The Officer Cadet Battalion had an establishment of 400 cadets at any time (although this was raised to 600 in May 1917).

When the University met again in October the number of undergraduates in residence was reduced to about fourteen hundred, of whom about eight hundred were undergoing an intensive course in the Officers' Training Corps. By the end of 1917 there were only three hundred and fifteen students in residence. Of these some fifty were Oriental students, twenty-five were refugees, chiefly Serbians, some thirty were medical students, and about a hundred and twenty were members of the Officers' Training Corps, waiting till their age should qualify them for admission to a Cadet Battalion.

The effect on Oxford — one college perspectiv e: Only 30 freshmen matriculated at Exeter in October 1914, compared with 59 in 1911, 53 in 1912 and 43 in 1913.All colleges were similarly affected by the rush to enlist. So too were their Fellows. During the course of the First War 771 Exeter men saw active service, almost all of them in the army. Of these, 141 were killed: the entire intake for just over 2½ years at pre-1914 rates of entry. At 18% of those serving, Exeter’s losses were exactly in line with the average for all Oxford colleges.

123 of Exeter’s 141 casualties (87%) were second lieutenants, lieutenants or captains;

only four were privates, none were NCOs and only seven were majors or above. Worst hit in Exeter’s case were those who had come up in 1911 and 1912: from the first of these years 23 out of 59 (39%) were killed, and from the second 18 out of 53 (34%), including 4 of the year’s 7 Scholars. Proportionately, and perhaps unexpectedly, the Fellowship suffered equally severely losing colleagues in France and at Gallipoli.

In other respects, however, Exeter’s experience mirrored that of the University as a whole. Much depended here on a college’s social composition, and those with the highest public school entries fared worse than others with a smaller proportion from public schools; Corpus with 25% casualties and St Edmund Hall with 10% represented those two extremes.

The University experience reflected all British communities. Of the great majority of those lost: (80%) died on the western front, in France or in Belgium. Of the remainder, Gallipoli, Mesopotamia and the Near East saw large losses. Casualties were not evenly distributed over the whole period of the war, but peaked at particular times, notably in September 1915, which saw many deaths in the battle of Loos, and in July 1916, the month of the Somme. Throughout Oxford the Roll of Service in college chapels, briefly record those who fell and are full of the evocative names of the places where they fell, familiar to any reader of First World War memoirs: Aubers Ridge, Vimy Ridge, Neuve Chapelle, Bethune, Cuinchy, Warlencourt, Contalmaison, Mametz, High Wood.

Whatever the make-up of the particular college, recruits from Oxford colleges were overwhelmingly public school men who were quickly commissioned as junior officers and whose lives, as leaders in the front line, were generally short. As in all colleges, the most vulnerable were those who had matriculated in the years immediately preceding the war, most of them in their early twenties. Losses for the University were substantially above those for the British forces as a whole, in which about 12% of all who served were killed. The reason for the discrepancies, both within Oxford and between Oxford men and others, should be obvious.

Acknowledgments: Bodleian Library – Saving Oxford Medicine Project, Christ Church College, Exeter College, Wadham College, St Edward’s School Oxford, University Archives, Oxford University Gazette 1906–39, Oxford University Press, University of Oxford Archives.

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'Old Age: a Non-medical Approach'

George Rousseau

The Humanities, Ageing, and Old Age One reason for a non-medical approach is that medical practice is primarily concerned with symptoms and I, as a cultural historian, am interested in concepts and cultures. Practicing doctors of diverse types are ordinarily too busy to delve into concepts and cultures, perhaps increasingly less so now in times of Britain’s NHS slippage. Most physicians do not enjoy the leisure time to discuss old age philosophically, culturally, or historically. Three retired GPs I know in Oxford – very fine GPs – have told me they want to live well but not to think about old age – as if ageing were some type of taboo and they are only seventy. But historians and philosophers, social scientists and social commentators, are paid to think about old age, to disentangle its cultural configurations and historical trajectories, as well as its contemporary developments apart from its bodily symptoms.

The Cultural Historian as ‘Sy mptom Reader’ As a cultural historian I am also – perhaps like many medical doctors – a ‘symptom reader’ of sorts: assessing signs of how people and societies feel about, think about, respond to, and represent ageing. The analogy is ripe. The cultural historian diagnoses societies, often in terms of health and sickness – healthy and sick societies – and explicitly when studying disease clusters such as epidemics and plagues, and broad psychological clusters such as hysteria and nostalgia. The attitudes and behaviors implicit in personal ageing, as well as the collective ageing patterns of diverse societies, are crucial, especially in our era when this new so-called ‘Third Age of Life’ (the phrase was coined by the late brilliant demographic historian Peter Laslett) has descended upon us.

Postmodern ageing, if I may refer to contemporary ageing as such, did not emerge fully developed from Aphrodite’s head but possesses longue durée socio-cultural roots. So too did Renaissance ageing, Enlightenment ageing, Romantic ageing, and – looking further afield – ageing in non-Western societies.

Study the gleam in Swiss-French classical pastellist Jean-Etienne Liotard’s (1702–1789) various self-portraits and you begin to comprehend how energized he feels when over seventy. The portrait of him in possession of his great, greying beard is as masculinist and sexually charged as anything else Liotard painted. The one in his orange cap, eyes gleaming, right-hand vigorously pointing to something unspecified in the direction of the viewer, displays charged energy and potent agency – the opposite of the stereotype of the

elderly as ravished by age. These are not the canvases of an old man depressed by years.

Liotard lived to eighty-six, enjoying god health for the most part and continuing to imagine himself in different guises.

Contrarily, our Sisyphean rock in the early twenty-first century construes postmodern old age as an ailment; as something passively suffered, and as the culmination and natural effect of having enjoyed too much of life. A more balanced, and humane, approach, and one less commercially driven, would conceptualize it as a condition to be embraced. To be proactively chosen for every one lucky enough to possess it, as a gift to be cherished no less than youth or adulthood for its completion of the well-rounded life, even with the prospect of time remaining for reflection about the future. The further context of this type of non-medical view of old age is that the ‘New Old Age’ – to package its paradoxes – is too important a subject to be left to medical doctors – even to gerontologists. Ageing also requires philosophers, historians, critics and commentators, as well as politicians and policy makers, if we are to have a long overdue public dialogue about it.

Historians of Ageing Previous social historians of ageing, such as French Philippe Ariès and George Minois, already mentioned Cambridge historian Peter Laslett, American historian Thomas Cole, and many others, have demonstrated that old age became a discrete category – something bounded by borders and capable of definition – in the nineteenth century. Before then, old age was more or less fixed: static, chronological, almost cosmically preordained, even if no one was certain exactly when old age commenced.

Nuanced discourse about it did not exist. You attained it at a certain age regardless of the condition of your mind and body. It was anchored to chronometrical age even in Eastern and Western cultures, rather than when men could no longer work, women no longer care for the home, or disease ravaged the body’s firmament. These passages coincided instead with dates and birthdays: men, for example, retiring at fixed ages and consequently no longer judged fit to age.

But old age has become more variable and fluid in the last two centuries. That is, until the new longevity (Peter Laslett’s ‘Third Age’) began to appear in the twentieth century, wreaking havoc with prior conceptions and altering its appearances. Put crudely, this shakeup can be encapsulated as ‘eighty is the new sixty, ninety the new seventy, and so forth. How can this

Liotard. Self-portrait in Old Age.

develop historically? How did we arrive at the point we now find ourselves vis-à-vis old age?

Conceptions, not definitions A whole range of definitions has become operative for the new longevity. For example, the cliché that you are old when no longer working and earning. Or, you are old when labeled a pensioner and collecting state and medical benefits. Or old when retired or when characterized by tired stereotypes that die slowly. The new longevity is dissymmetrical to old age and seeks to obliterate it, yet some overlaps are noteworthy. A history of ‘old age’ (whose chronometric years varied enormously in different eras) culled from non-medical sources reveals intriguing insights ranging from its anthropology and psychology to gender differences (the difference between the way men and women perceive old age) and sexual needs (especially the role of active sexual relations). The new longevity is turning many of these notions upside down, especially the new ‘AGEIST MOVEMENT’, reform proactively working to counter prejudice against the elderly.

The crucial 1980s The 1980s was a pivotal decade. Arising new technologies created increasing wealth, coupled to relatively stable Western societies that watched the Cold War gasp its last breath, without too much pressure from emerging economies and without the subsequent Arab spring and worldwide terrorism now threatening the whole terraqueous globe. Pensions were historically generous, still calibrated to the final three years of income, and care was perceived as affordable. Accommodation for the elderly was also plentiful and still affordable, value for money. These optimistic conditions lie outside the medical realm but even then medical contexts could not be omitted from the perception of well-being. All arrangements, even then, depended on the state of one’s health. However, health was a necessary but insufficient condition for the perception of happiness among the elderly.

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Pharmacology then Historians know how drugs of the 1980s enhanced the new longevism. A whole bouquet lengthened life and kept whole swaths of people alive to ages deemed unattainable.

Pharmacology cannot be omitted from this account even in a non-medical approach. Better diagnostic tools, more precise surgical procedures swiftly administered, also buttressed the new pharmacology, enhanced by secure medical insurance then still flourishing in both the public and private domain without daily cries of economic unsustainability. But by century’s turn the economics of the new drugs altered and vigorously divided haves-and-havenots – as if society suddenly decided on a litmus test for who would, or would not, live long. Yet history’s long arm also reveals another story. Long before the new longevity, during the Victorian and Edwardian era, old age after approximately fifty was conceptualized apart from the condition of one’s health. You were old depending on years, not on whether you were healthy, looked glamorous, or sustained good moods. You could not tell a nonagenarian who felt wonderful during the Great War ‘you are not old’. In contrast, the new old age divides along lines of health and sickness: if you feel wonderful at ninety, and continue the activities performed at sixty, no one has the right to tell you “you are old”. Nor will you tell it to yourself in interior monologues. And if others display old-age prejudice they will be taken to task.

Geriatrics and Gerontology Another factor was the maturation of two disciplines: geriatrics and gerontology, both enjoying long pedigrees from ancient times.

Geriatrics is the medicine of the elderly, a subspecialty born among visionaries in the Victorian workhouse who intuited that medicine alone was not the answer to the perils of ageing, and implemented in the mid20th century in England by such figures as Marjory Warren, whose reforms were intercepted by world war. But so far geriatric medicine, especially geriatric psychiatry, has not developed an integrated theory of the elderly.

Gerontology developed slightly later, in America during the Second War, especially along lines of accommodation for the elderly, but soon refined itself into demographics of ageing and the complex mysteries of the ageing process itself. Gerontology is more inclusive and ought to be the narrative that non-medical approaches converge and overlap with, except that most professional gerontologists are trained in medicine, not philosophy, literature, history, the social sciences or the arts; and most gerontologists, however competent in their practices, are by virtue of their status as practicing physicians also subject to the same pressures of nationalized medicine. Needed is a more

philosophical gerontology that stands back and looks at the longue durée of ageing and old age with fresh eyes. Especially at the paradigm shift that divides the haves and have-nots according to good and bad health, and the consequences following from these two first principles, rather than old age symbolized in stereotypes, national policies lumping citizens together according to age, and – now – old age intergenerationally in relation to younger generations behind it. Let me be perfectly clear about the ‘the haves and have-nots according to good and bad health’. Health, not chronological age, is the great leveler of ageing now. In 1900 old age ensued at about sixty. No equivalent to sixty exists today. It is neither correct nor polite to label anyone old at any age. Yet those sick at fifty or sixty often claim to feel old. The nonagenarian who feels wonderful but is compelled to think of herself as ‘old’, is usually regurgitating what society expects her to say. Lurking in the background of the new longevity landscape is the economic grievance of the young, which gathers strength like waves in a storm, and will eventually rear its head when the intergenerational wave crests.

The nuclear family and the perception of time The family in history forms an integral role within this story, as does the phenomenological perception of time among the elderly. The prenuclear family cared for the elderly, not to the degree in the Orient, especially in China and Japan, where elders were invested with almost magical reverence. But the rise of the nuclear family at the end of the nineteenth century altered these domestic arrangements. Families contacted, grew less extended, become more geographically scattered, living separately rather than communally; and by our time the nuclear family has transformed itself to the degree that more than ever households contain fewer than two parents and their children, often just a solitary person. An elderly mother, father, or aunt, may live hundreds of miles – thousands in America or Canada – from sons and daughters. The consequence is that the elderly can be lonelier than ever despite the gadgetry they can surround themselves with which further alters their perception of phenomenological time. That is, the new technology constantly distracts them and provides an illusion that time is accelerating.

Every year it seems to race faster and faster: days, weeks, months fly by, as they did not in prior generations. This perception of time is further deranged according to one’s health: the elderly who are healthy, and not depressed, can find their way, without bigotry, in the new longevism. Even so, another wolf exists at the door, the antagonism of the young just mentioned. It grows apace, especially in political and legislative quarters, and has

profound economic consequences for the end of the life as imagined in the later 21st century.

Riddles of sustainability Sustainability is the recent institutional buzzword capturing reality checks on the economics of old age. It asks questions such as how can the new longevity be sustained? Or, as one camp in the debate argues, that it cannot be sustained for very long. How can we keep millions of people healthy so that they can fit into the best qualities of the new longevism? Furthermore, how sustain them financially, socially, domestically, and of course medically? To do so their pensions must sustain the kind of life they want for twenty, thirty, and even forty years after they retire and how will the young pay for all this? The dominant concerns of sustainability are political, fiscal, and social. But Western society has already made inroads into other more creative forms. In Britain a new plan in Cornwall called Shared Lives places someone with dementia in a family for a respite instead of being moved to a nursing home — the County Council pays the family, even if only for a few months. In America a recent initiative has younger people adopting an elderly person without being patronizing or sentimental. These are small schemes and often involve the young who have neither the time nor largesse to deliver these services, yet it is hard to see how they will sign on if they harbor bitterness toward the elderly who have saddled them with a lifetime of debt. But forget time, forget being too busy, even forget debt: the crunch will eventually center on affect and good will; on how well disposed the young feel towards the old. And it is hard to be optimistic about the later 21st century. Many parents today have abundant resource to give their children. The next generation may not.

Retirement villages everywhere The retirement village was a spin-off of World War Two and sprung up in the American Sun Belt where warm weather attracted arthritic, osteoporotic bones. By the end of the twentieth century these ‘villages’ proliferated and crossed the ocean, the largest no longer ‘villages’ but towns, even cities, like the one called LEISURE WORLD, a conurbation approaching one-hundred thousand people throughout southern California.

I know it well because my parents lived in one of these sanctuaries for the elderly. The philosophical debate about their value focuses on connection versus separation: are ghettos good? The word ghetto is controversial but this is what they are: minority enclaves segregated according to age.

Historians know how comforting ghettos were, ensuring personal safety, guaranteeing freedoms and support systems otherwise impossible to imagine. And why should our fit elderly not move to retirement villages where their lives are enhanced by others of their own type — especially if intergenerational prejudice is as entrenched as the Ageists claim it is? Oases

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where no stigma, or embarrassment, attaches to old age? Embarrassment about being old not to be minimized for the damage it does? A counter argument devalues these ghettoized ‘villages’, showing what is lost when diversity disappears.

But the case is not clear-cut — strong arguments exist both ways. And a further type of segregation has appeared separating the wealthy elderly, who often prefer to live neither among the young nor with the geriatric poor.

The sacraments in secular societies Today secularism penetrates the social fabric deeper than organized religion, nor can it be omitted in this discussion, anymore than social class, because old age is the single stage in the life cycle most proximate to death, and secularism has taken a huge toll on death.

Secularism recently has done its best to marginalize death to the point of existential nonbeing. Death in pre-secularized Judeo-Christian societies was a gift because the soul was delivered to its eternal home presided over by God. No such comfort exists now, in part the result of sacramental disappearance. Sacraments are rituals, repeated words and acts of belief, protocols of shared custom infiltrating the whole belief system; and rituals help us to celebrate life, mark its transitions and even occasionally attain transcendence. In pre-secular Judeo-Christian societies the rituals of death lorded over lives as their (the lives’) inexorable destination. The postmodern way of death, by contrast, entails a fifteen-minute slot at the crematorium. When religion becomes divested of its sacraments and symbols as ours has, old age cannot expect to occupy its former crevices. Memory endures, as do annual visits to the churchyard, token commemorations, but not rituals’ deep-layer meaning. Besides, the contemporary pace of life is too quick, even in retirement villages, to give the healthy deathward-looking old, time to reflect on the vanishing act.

Loss and purpose Loss and purpose are the brick and mortar of old age. Loss is inevitable: live long enough and you will lose more than you gain. Loss is ubiquitous, diverse, and all-encompassing. Purpose is more difficult because more amorphous and so steeped in affect. Purpose endows life with meaning for individuals, whether the purpose is laborious (keep working until you drop), hedonistic (tennis, golf, sailing around the clock), industrious (keep busy no matter what), or familial (those grandchildren). Purpose can be anything: it sustains the elderly far more than the young who have more options, but purpose keeps the elderly from turning their face to the wall and stop breathing. We know little about purpose’s compass because it is so subjective, idiosyncratic and protean: a sky with millions of lights. It doesn’t matter what elderly purpose is provided it is legal and not too self-deluding. The

most piteous are the healthy old who cannot locate their purpose, like the woman in a famous opera by Richard Strauss who could not find her shadow. Ultimately the new old age is too diverse to define. Perhaps we should not try, but it cannot be conceptualized or described apart from loss and purpose.

Memory and psychological connectedness There are no great contemporary philosophers of old age for all sorts of reasons. Recent philosophers deal with selves and personhood rather than cycles of life, a historian’s task; and philosophers of identity and selfhood consider the psychological connectedness intrinsic to selfhood in old age as purpose. This sequence arises in part as a consequence of the weight given to memory and dementia, and within these two categories to consciousness. Loss of memory obliterates the psychological connectedness providing a secure sense of selfhood. You cannot have purpose, or know what purpose is, if you cannot remember what you did yesterday or whom you saw an hour ago. So the consciousness arising in dementia differs from that in the non-demented even if the borders are blurred. In this sense we return to the divide between the healthy old and the sick old. Purpose exists primarily for the healthy old; psychological connectedness a concern for the sick old. The sick old maintain a better quality of life if any degree of psychological connectedness enables them to claim ‘however much I am failing I am still the person I used to be.’ The healthy old need not worry about psychological connectedness because they remember who, where, and what they are. But the riddles of psychological connectedness, sustained over decades in the new longevity, are overtaking purpose as the numbers of demented continue to increase.

Old age and change Definitions of old age in our time are doomed to failure: the territory is too complex. Consider, for example, the argument from change, which a North American gerontologist put forward not long ago. His theory went like this: the old reduce to those who are adverse to change. He was confident he could even quantify adversity to change. The idea was that you are old once no longer capable of coping with a certain threshold of change. In this paradigm you could be old at thirty or forty. Conversely, those who embrace change are not old. But the elderly cannot abide change. The model suggests if you are forty or fifty and allergic to change you are old; or, that all those who embrace change in their lives at whatever age are not old. For example, if you are ninety and relocating to France or Spain, you are not old. The idea is too simplistic to hold water. A paradigm focusing on the healthy old and the sick old appears more promising and worthy of further development.

Fictions of ageing and old age Another talk is needed to describe the literary fiction dealing with the new elderly in our generation: a large and diverse literature holding many surprises. Writers no longer deal tamely or stereotypically with the elderly, who are coming under the lenses of sharp criticism and satire as well as sympathy. Sensibility about an intemperate, and possibly even demented, monarch like King Lear are over, however skillfully Shakespeare described the ravages old age had taken on this sovereign so tragically laid low. More recently, the best AngloAmerican and Continental writers are targeting the inconsistencies and incongruities of old age and excoriating them: Saul Bellow, Martin Amis, and Harold Jacobsen, who are among the most ruthless. But I want to conclude not on the asperities of some recent fiction but on a note about the future; gazing toward a 21st century I see increasingly devoted to dreams of tangible happiness, longevity, and eternal life. These remain lodged in fantasy but have never been closer to reality than they seem today.

It is small wonder the mysteries of the ageing process have assumed larger-than-life profiles in scientific institutions worldwide. If you are lucky, the new longevity can occupy a full third of your life for the first time. My goal today has been to configure old age not in piecemeal fashion – as old age-quality of life, old age- sustainability, old age-economics, old age-accommodation, and so forth – but for what the thing itself is. Ancient philosophers Aristotle, Cicero and Seneca were much more eloquent in their reflections on old age. Yet they knew they were pronouncing about a miniscule part of the population. But now this has altered. Because old age was chronotropic for the Greeks and Romans, as well as for the Georgians and Victorians – primarily determined by age irrespective of other considerations – their aim was the exquisite delineation of the last cycle of life from birth to senescence. Their reflections nevertheless remain crucial. Bright as beacons for elucidating that whatever else it may be, old age is the phase closest to death; the phase at the end, when the totality of a life may be seen for what it really was.

To gaze upon this whole – the complete life – you must almost arrive at the last day. As the wise Solon claimed, count no man happy until the very last day. The Greek philosophers raised profound questions about beginnings and endings. Is it better to be anguished for the first half of life and then enjoy peaceful, happy later years, or better to start brilliantly and suffer reversals near the end? In the last example one will die miserably and unhappily.

But our fast-paced contemporary way of life offers little opportunity to reflect on these matters. And I wonder how many of us wrestle with the riddle of whether old age is a good or bad thing, which can only be pondered with death on the tip of the imagination.1

1. (This article reprints the talk Professor George Rousseau delivered on 30 September 2014 to the Oxford Medical Alumni Club on Osler House.)

16 / OXFORD MEDICINE . MARCH 2015

With sadness…

Anthony Allison Former general practitioner Market Drayton, Shropshire (b 1927; matric.

Merton 1947, q Oxford/St Bartholomew’s Hospital, London, 1951), d 16 July 2013.

I vividly remember the day I learnt about balanced polymorphisms in biology class. The teacher illustrated the concept with the classic textbook example—the case of the carriers of the sickle cell trait, who are protected from malaria.

The lesson stayed with me because of its pleasing symmetry—that beautiful bell curve that describes so many things in nature. The sickle cell mutation—lethal in homozygote individuals before they reach puberty— maintains itself in the gene pool because people with only one copy don’t get the disease, and are less likely to contract malaria too.

Tony Allison saw the distressing tail ends of the curve: the children’s wards in Mombasa on the Kenyan coast, and at Kisumu on Lake Victoria. Here half of the young patients were suffering the agonising crises of sickle cell anaemia—pain that penetrates the bones and brings fever with it. He himself represented the opposite tail, having often been confined to bed with malaria while growing up in Kenya.

It may have been the unhappy memories of those episodes—combined with the bone rattling cold of the British winter of 1947–48—that drove him to take a break from his medical studies in Oxford. In 1949 he joined an expedition to east Africa to look for evidence for ideas that were circulating at the time—that humans have innate immunity, and that disease drives selection for the genes that encode that immunity.

Human evolution fascinated Allison. His Kenyan upbringing had brought him into contact with Louis Leakey—then digging at Olduvai Gorge in Tanzania—and his anatomy teacher at Witwatersrand University in South Africa, Raymond Dart, was among those who discovered the first Australopithecus fossils, in 1924. Rather than look for diversity and selection in fossils, however, Allison intended to search for it in the blood groups of living people. On the eve of his departure a conversation with a haematologist sowed another seed in Allison’s mind—the outstanding mystery of why sickle cell disease hadn’t bred itself out in Africa.

Straight away he noticed a pattern—sickle cell disease was more common on the coast

and around Lake Victoria than in the highlands. It occurred to him that it might not be a coincidence that these low lying areas were also malarial zones, but by then he had run out of time to investigate further. He returned to Oxford and it wasn’t until 1953 that he was able to go back to Africa and test his theory. He travelled through Uganda, Kenya, and Tanzania, comparing the parasite loads in blood samples from those with and without the sickle cell mutation.

The result was a series of papers published—one of them in this journal1—in 1954. There were disagreements about whether Allison deserved the credit for the discovery and this confirmed his sense of standing outside the British scientific establishment. It also goes some way to explaining why he isn’t better known.

In the 1970s, at the Medical Research Council’s Clinical Research Centre in London, he worked on the problem of deficiencies in innate immunity which left some children permanently vulnerable to infection.

Having identified an enzyme, inosine monophosphate dehydrogenase, that is important in those immune pathways, he speculated that a small-molecule antagonist of that enzyme might help to prevent the rejection of organ transplants, and in treating some autoimmune diseases. The molecule was mycophenolate mofetil, better known as the immunosuppressant drug CellCept. Allison and his wife, Argentinian biochemist Elsie Eugui, developed the drug at Syntex Corporation—a pharmaceutical company in Palo Alto, California—and it went on to make a substantial amount of money for Roche after it bought Syntex in 1994.

In the years leading up to his death, despite having interstitial pulmonary fibrosis, which progressively restricted his movements, Allison threw himself into a new project: developing a pharmacological strategy to reduce reperfusion injury to tissues following ischaemia. If it fulfilled what he considered to be its full potential, it would help in the treatment of both malarial and sickle cell crises, bringing his long and productive career full circle.

Allison leaves his second wife, Elsie Eugui, and two sons from his first marriage.

Anthony Clifford Allison (b 1925; q Oxford University 1952), died 20 Februrary 2014. .

Alexander J. Cavenagh b. 14 June 1929, m. Magdalen 1951, q. 1954 London; d. 1 January 2014 ‘Sandy’ Cavenagh MBE, BM, BCh, D Obst, FRCOG. 3 PARA Regiment Medical Officer from 1955–7. Captain Cavenagh jumped at Suez during Operation Musketeer and although wounded in the eye during the jump continued

to treat the casualties throughout. On retirement from military service, after completion of his short service commission, he became a popular and much respected GP in Brecon. He continued to serve Airborne Forces as the local medical officer to the Regiment's Battle School on the outskirts of the Town.

Colin B Cowey m. Exeter 1952 q.

1958; d. 21 February 2014 Michael A Denborough b. 11 August 1929, m. Exeter 1953; DPhil Clinical medicine 1956; d. 1 February 2014.

Awarded honorary fellowship of the Australian and New Zealand College of Anaesthetics for research on malignant hyperthermia which was named eponymously after Dr Denborough at Marseille in 1982.

Hugh Alexander Evans b 1925; matric. Merton 1943, q Oxford/St Bartholomew’s Hospital 1948; MBE, d 9 May 2014. General practitioner Hugh Alexander Evans was born in Brundall, Norfolk, and the son of a local doctor. He went to Epsom College in 1938, from where he won a place to study medicine at Merton College, Oxford, in 1943. During his undergraduate years he became a member of Vincent’s Club and he was a “centipede” in the Oxford University Athletic Club second team in 1944.

He moved to London to St Bartholomew’s Hospital to do his clinical studies. There he met Barbara, a nurse, whom he married in 1950, after which Hugh joined the Royal Army Medical Corps for his national service in Farnham.

The couple moved on to Norwich in 1952, where Hugh was house surgeon at the Norfolk and Norwich Hospital. The following year, he joined the Anderson Practice in Gorleston-onSea, Norfolk. The couple moved into The Grove in 1953, where the surgery was then based, and where they remained for the rest of their lives.

Hugh was a full time GP for 37 years, with a personal list of patients for whom he was always available. For the first seven years he also had responsibility for obstetric care for the

OXFORD MEDICINE . MARCH 2015 / 17

whole area, at a time when most deliveries occurred at home, and he carried out the emergency caesarean sections. He was also clinical assistant at Great Yarmouth General Hospital, covering the paediatric ward and assisting the general surgeon. Hugh became the area commissioner for Broadland and Great Yarmouth St John Ambulance, and in 1981 he was invested as a commander brother of the Order of St John.

Hugh had all the qualities of a truly exceptional family doctor. He knew his patients well, and he understood the impact of illness on them and their families. He combined a scientific rigour in diagnosis and treatment with genuine compassion and care for his patients, and an absolute determination to do his very best for them.

From the mid-1960s, with the emergence of the southern North Sea gas fields, Hugh was one of the doctors who undertook highly specialised training in diving medicine, on call for emergencies anywhere and often giving decompression guidance over the telephone.

He was a founder member of the North Sea Medical Centre in 1974, later its first chairman, and managing director of Oilfield Medical Services International, training and supplying the medical support for offshore oil and gas locations worldwide. These duties were in addition to his role as a GP and eventually senior partner of the Central Surgery Practice, serving 16 000 patients. Hugh was awarded an MBE for services to the community in 1991.

Outside of his professional life, Hugh kept himself unreasonably fit, running on the beach with his dogs or cycling for miles in the early mornings until his mid-80s. Hugh had learned to fish as a small boy in Norfolk; this was a lifelong passion and led him to northern Scotland every year. For many years he also sailed on Oulton Broad in his Brown Boat, Mallard. He was an avid reader and shortly before his death was elected as the first ever honorary life member of the oldest book club in the country, the Monthly Book Club in Great Yarmouth.

The recurring phrase in the tributes that have poured in since his death was that he was “a perfect gentleman.” He was also wise, measured in his counsel, courteous, and considerate, and happy and content within his home.

Denis Dunbar Gibbs b 7/19/1927; m.

Keble 1948; q 1945; d 8 January 2015 Gordon Telford Haysey Former general practitioner Market Drayton, Shropshire (b 8/13/1927; q Oxford/St Bartholomew’s Hospital, London, 1951), d 16 July 2013. Gordon Telford Haysey took up post in Market Drayton in

Barrie S. MacLean b. 14 August 1944 m. Magdalen 1962 q. 1968; d. 2 May 2014

1959. As a GP he held posts as police surgeon, chest physician at the North Stafford Hospital, and dental anaesthetist. Junior colleagues valued his wisdom and support. He was awarded the Order of St John in 1995 and was colonel in charge, 224th Field Ambulance, in the Royal Army Medical Corps. His passion was music, especially opera. He was organist at Christ Church, Market Drayton, for 30 years.

He was a family man and the achievements of his children and grandchildren gave him much pleasure. He also enjoyed the loyal support and companionship of his wife, Alison.

Bryan Moore-Smith b.1930; m. Oriel 1949, q. BM BCh Oxford/St Thomas’ Hospital 1955; MA, FRCP, d. 19 March 2013, aged 83 (Parkinson’s Disease). Consultant Geriatrician, Ipswich Hospital.

Walter Hift Emeritus professor of medicine Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa (b 1921; q Oxford; DM (Oxon), PhD, FCP (SA)), died from coronary artery disease on 5 July 2013.

Walter Hift was born in Austria. He served the department of medicine at the University of KwaZulu-Natal as a consultant in general medicine and haematology for over three decades. He was loyal to the aspirations of the medical school and the university, a dedicated teacher, and an expert clinician. His forte was undergraduate teaching and the formulation of teaching programmes, and he was passionate about the elicitation of physical signs at the bedside. He contributed substantially to research and to the medical literature on nutritional megaloblastic anaemia. The latter was the subject of the thesis for which he was awarded a DM from Oxford University.

He was interested not only in the science of medicine but also in the classics, and in his retirement he revived this great love, which had started in Austria and London. He did a BA in classics at the University of Natal, went on to receive a BA Hons, and then embarked on an MA, which was converted to a PhD because of its great merit. This thesis was entitled “Psychiatry and the plays of Euripides.” As a result of this later academic success, he was appointed honorary research associate in classics at the University of Natal.

Walter met his wife, Cynthia, while serving in the Royal Air Force during the second world war. After the war he settled in Durban and undertook some of his postgraduate training at the metropolitan hospitals in Durban, obtaining the fellowship of the Colleges of Medicine of South Africa.

He retired to Jeffreys Bay, joining one of his sons and his family. Cynthia died about three years before him.

Nilay Patel Consultant urological surgeon Oxford University Hospital Trust (b 1975; q Cambridge 1998; BA, MD, FRCSurol), died from viral myocarditis on 13 May 2014 Nilay Patel began his career as a consultant urological surgeon, with a special interest in renal cancer surgery, in 2012. During his two years as a consultant, he had already made an important contribution to the management of complex tumours in solitary kidneys, by helping to set up the renal auto-transplantation programme in Oxford and obtaining approval from the national specialised commissioning services. The programme involves nephrectomy, cooling, and bench dissection of the tumour and re-transplantation of the kidney. At the time of his death the programme had prevented 25 people from the need to go on to dialysis.

Nilay was born in the United Kingdom and as a schoolboy was chosen on two occasions to read the “Prayer for Peace” on Commonwealth Day in Westminster Abbey before the Queen. He trained at Trinity Hall, Cambridge, and Cambridge University Medical School, where he won a golfing blue and also played cricket and hockey for his college. He came to Oxford in 2000 and carried out postgraduate research, obtaining his MD in 2006, for which he was awarded the European Association of Urology thesis award. The same evening he spent the prize money on a party for his friends. After his specialist training in urology and obtaining his royal college fellowship, he was appointed to a joint consultant post between Oxford and Milton Keynes. He was a wonderful colleague, who loved his patients and treated everyone with equal respect and dignity, regardless of their status or position. He was always fun to be with, a great friend to all, and a great mentor to the trainees. He will be always missed and never too far from our thoughts.

John D. Little b. 3 August 1914 m.

1937 q. 1946; d. 13 June 2014

Brian Pigott Former house physician Guy’s Hospital; private doctor (b 1928; matric 1946 The Queen’s College, q Oxford 1952), d 17 November 2013.

Brian Pigott had a long and distinguished medial career, initially at Guy’s Hospital

Irvine Stewart Lees Loudon (b 8/1/1924; m The Queen’s 1941; q.

1951; d. 11 January 2015)

John Simon G Miller b. 28 September 1936, m. Oriel 1957, q. 1963; d. 13 October 2014 Neurologist

18 / OXFORD MEDICINE . MARCH 2015

before moving into private practice. Having spent most of the war years at Mill Hill School but exiled to St Bee’s Head in Cumberland, in 1946 Brian went up to Oxford to read natural sciences at the Queen’s College before training at Guy’s Hospital. In later years Brian, a keen sportsman, would say with tongue in cheek that he chose Guy’s above all others because the hospital’s rugby club, founded in 1843, was the oldest in the world.

Brian initially became house officer to Douthwaite the hospital’s senior physician and Mann – physician to the household. In 1954 he served a period of national service and enlisted into the Royal Army Medical Corps. Returning to London in 1956, Brian secured the post of junior medical registrar to his old mentor, Dr Douthwaite, and worked in the hospital until September 1957 when he moved across to Guy’s medical school and lectured in physiology. In March 1958 he left Guy’s and went into private practice. In 1973 Brian began in singlehanded practice in Upper Wimpole Street. It was a busy life—morning visits to patients at home and in hospital and afternoon appointments in his consulting rooms. Statistics can covey a picture as much as they can be utterly meaningless and, as he often said, a doctor’s life cannot be measured in figures, but in retirement Brian found time to reflect on the fact that his diaries for the 23 years when he was in sole practice record over 90,000 appointments.

Victor D. Pippett m. Christ Church 1947 q. 1953; d. 11 May 2014 General practitioner David W. Porter b. 1 May 1974 m. Keble 1992, q. London 1998; d. 2 August 2014 Paediatrician. Rowing blue.

Roger Adrian Livingston Sutton FRCP Born Lancashire: 18 April 1937 – Died Vancouver, Canada 10 September 2014 BA (Oxon) 1957; MA (Oxon) 1962; BM BCh (Oxon) 1960; FRCP (London) 1963; DM (Oxon) 1973; FRCP (Canada) 1976; FACP 1998; FCAHS 2005 Roger Sutton was born in Lancashire. He received his undergraduate medical training at Oxford University and his postgraduate training at University College Hospital, London.

Roger, his wife Wendy and their two young daughters emigrated to Canada in the early 1970s, where Roger worked initially at the Royal Victoria Hospital and McGill University in Montreal. In 1976 he moved to Vancouver, where he established a metabolic stone clinic, and a clinical investigation unit focused on disorders of mineral metabolism, renal stone disease, and osteoporosis. Possessing an unusually exacting and curious mind, he became internationally recognized in his speciality of nephrology, with particular expertise in osteoporosis and renal stones, and was widely admired for his clinical, research and administrative abilities.

In 1984 he was appointed the head of the divisions of nephrology at both the Vancouver General Hospital and the University of British Columbia. In 1986 he also became head of Medicine at Vancouver General Hospital, and held all these positions until 1994. Under his leadership this was a period of marked growth in nephrology in Vancouver, including programmes training clinical nephrologists for all of British Columbia and beyond, as well as many research fellows in the laboratory.

In 1978, he was awarded the prestigious Medal in Medicine of the Royal College of Physicians of Canada. He was on the Executive of the Canadian Society of Nephrology as Secretary Treasurer (1981–1983), President elect (1983–1984), and then President (1984–1985).

In 1993 Roger and Wendy travelled to Pakistan where Roger took up a seven-year position as the Head of the Department of Medicine at the Aga Khan University in Karachi and then Dean of Health Sciences, Aga Khan University where he was the central figure in the development of the curriculum for the new medical school, before returning to Vancouver and retirement. He was Professor Emeritus at the University of British Columbia from 2002 Roger had a life-long passion for ornithology, and it is quite likely that he ultimately came to know as much about birds as he did about medicine. His love of birds and bird watching started in childhood. Later in life his bird watching expertise was accompanied by an equal accomplishment in the photography of birds (and the many travels he made to find and photograph particular birds).

His fearless love for travel and adventure has been an inspiration to many. Roger's life-long achievements in medicine and birding were associated with quiet calm, a great sense of humour and enviable modesty. He was passionate about life and took great joy in the company of his family and friends. He was a loving husband and father and caring physician and will be much missed by his family, numerous patients, colleagues, and friends, and his many students and fellows who now hold senior positions in medicine throughout the world.

He is survived in Vancouver by his wife Wendy and two daughters Fiona and Nicola; and in England, by his brother Nigel and his family.

Angus Rae, Adeera Levin, John Feehally

In memory…

• Marie Beesley née Woolf, born 13/03/1925, matriculated 1943, Somerville College. Died 17/03/2014 • John D. Cairns, born 10/02/1925, matriculated 1942, Balliol College. Died 15/01/2014 • Grace E. Capon née Mowll, born 03/09/1931, matriculated 1950. Died 10/03/2014 • William H. Feindel, born 07/12/1918, matriculated 1939, Merton College. Died 12/01/2014 • Charles B. Freeman, born 31/07/1942, matriculated 1960, St Edmund Hall. Died 19/03/2014

• Ian Hadfield, born 16/06/1921, matriculated 1940, New College. Died 03/04/2013 • Leslie G. Kilpatrick, born 12/09/1921, matriculated 1939, New College. Died 01/01/2014 • Henry D. Leggatt, born 31/08/1922, matriculated 1940. Died 02/06/2014 • John E. Moore, born 25/10/1926, matriculated 1944, Magdalen College. Died 21/02/2014 • Wolfram B. Schmitt, born 25/08/1976, matriculated 1999, Jesus College. Died 19/07/2014

• Basil John Shepstone, born 08/04/1935, matric. Exeter 1959, qualified BM BCh1962, died 03/02/2015 aged 79. A full obituary will follow.

• Kathryn A. Tonge b. 15 October 1964 m. Somerville 1982, q. St Mary’s London 1988; d. 1 January 2014 aged 50. Gastroenterologist.

• Arthur K Tyler b. 29 August 1917, m.

Magdalen 1936, q. London 1942; d. 27 March 2014 • John T. Wright, matriculated 1940, Worcester College. Died 03/07/2014

19 OXFORD MEDICINE . MARCH 2015 / 15

2014 Ended on a high for the Medical Sciences Division 2014 ended on a high for the Medical Sciences Division, as we achieved terrific results in the Research Excellence Framework (REF) exercise. The University overall performed excellently, and the Division’s performance has been superb across the board.

We ranked top for the overall quality of our submissions in the following three areas: Clinical Medicine; Public Health, Health Services and

Primary Care; and also in Psychology, Psychiatry and Neuroscience. In Biological Sciences, we submitted the largest volume of world leading and internationally excellent research in the exercise and ranked top for research ‘power’.

There is no doubt that Oxford continues to perform at the highest level and we in the Medical Sciences Division continue to work hard to ensure that you as alumni can be proud to be associated

with one of the foremost intellectual and clinical institutions in the world. The environment in which we carry out teaching, research and clinical activities continues to be amongst the best and the quality of our academic appointments and of those who seek to study here reflects this. See website for full news item: www.medsci.ox.ac.uk/news/oxford-medicalsciences-excels-in-ref-2014-exercise

The John Radcliffe Travelling Fellowship

I am privileged to be a past holder of this scholarship and I am delighted to find that it is continuing and is even more generous than when I held it in 1972 – 4. I had just completed my DPhil and had taken up the post of senior registrar to Drs Grant Lee and John Ledingham who had recently been appointed to run a general medical firm. My research had investigated a number of immunological mechanisms of potential significance for the development of ulcerative colitis and Crohn’s disease. This kindled my interest in academic gastroenterology and I was keen to spend a further period in research, preferably overseas. At that point Dr Keith Taylor (Magdalen, 1942) spent a sabbatical in Oxford with Sidney Truelove. Keith was a gastroenterologist and had been Chief of GI at Stanford before becoming Chairman of Medicine. He had had a notable academic career and, with Deborah Doniach at the Middlesex Hospital, had described the parietal cell antibodies found especially in patients with pernicious anaemia but also in other auto-immune conditions. He was very keen that I should work in his lab at Stanford and the only obstacle, as is usually the case, was funding.

Fortunately Sidney Truelove knew about the Radcliffe Travelling Fellowship and also knew that it was about to be advertised. An application was submitted to University College, I was interviewed and duly awarded the Fellowship.

My first year allowed me to lunch or dine in College and my only regret is that I did not take greater advantage of this generous offer.

Senior registrars had to work very hard in those days with 2 or 3 on-takes each week and an alternate weekend on call, in addition I spent some time in the lab measuring immune complexes in peripheral blood and in portal blood in patients with severe colitis. In addition, to suddenly enter the SCR without knowing anyone was quite intimidating. I guess I would feel the same nowadays but one just needs courage and when I did go in, Fellows were very kind and welcoming. The Bursar at the time, Mr Screaton (Father of our distinguished Alumnus, Gavin Screaton now at the Imperial School of Medicine), was

UNIVERSITY COLLEGE, OXFORD

Radcliffe Travelling Fellowship in Medical Sciences

Further Particulars

University College, Oxford, is inviting applications for a Radcliffe Travelling Fellowship in Medical Sciences, to be held from 1 September 2015 or as soon as possible thereafter.

The Radcliffe Travelling Fellowship is endowed out of the fund bequeathed to University College by Dr John Radcliffe. It is tenable for two years and is designed to assist the Fellow to do research abroad. Applications from those wishing to work in the Developing World would be particularly welcome.

The Fellow must spend at least one year abroad engaged in the study of medical science.

While abroad the Fellow will receive a stipend of up to £37,822 pa at current levels (point 4 on StR grade for Specialty Registrars) plus allowances of up to £10,000 for research expenses and, if appropriate, an additional £10,000 for a spouse and £3,226 for each child.

These payments (which are subject to review) are the total allowances granted for each year of the Fellowship over the two-year period. In certain circumstances these payments may not be subject to tax. No payment will be made to the holder of the Fellowship while he or she is in the UK but the Fellow will be a member of the Senior Common Room of University College and will be entitled to free lunches and dinners in College when the kitchens are open.

Candidates must either have passed all of the examinations required for the Degree of Bachelor of Medicine of the University of Oxford or have passed all the examinations for the Degree of Bachelor of Arts of the University of Oxford and hold the Degree of Bachelor of Medicine of another university. Under the College’s Statutes, candidates must not have exceeded six years from the time of passing the last examination for the Degree of Bachelor of Medicine.

The successful Fellow will be asked to give a presentation at the end of the two years on their research.

Candidates should complete the application form available from the College website (www.univ.ox.ac.uk) and return it to Miss Sally Stubbs, Academic Services Manager, University College, Oxford OX1 4BH (fax +44 (0)1865 276790; e-mail recruitment@univ.ox.ac.uk) not later than 12noon on Friday 17 April 2015. They should ask two referees to send references to Miss Stubbs by the same date. Note that it would be desirable, although not essential, for interested applicants to inform the College of their intention to apply by 31 December 2014, thus allowing the College to answer any questions that may arise. Interviews are expected to take place in May 2015 (subject to confirmation).

Electronic applications are preferred.

University College is an equal opportunities employer. Applications are particularly welcome from women and black and minority ethnic candidates, who are under-represented in academic posts in Oxford.

particularly friendly and made me feel at ease.

The second year was spent at Stanford which was a fantastic experience and provided an unparalled insight into the American academic scene. My task was to isolate the parietal cells from guinea pig stomachs and to determine the major antigens expressed by those cells. My final results appeared to show evidence for the gastrin receptor on parietal cells but by that time it was time to come home. The lab technicians never performed a the promised replication experiment and it was

about 3 years later that definitive evidence for that receptor was published, sadly from UCLA and not Stanford.

Thus I greatly benefitted from the Fellowship which is the oldest medical travelling fellowship in the country and will always be indebted to University College for granting me the honour and, of course, to John Radcliffe for his foresighted philanthropy.

Derek Jewell MA, DPhil, FRCP, FMedSci Professor Emeritus of Gastroenterology, Emeritus Fellow, Green Templeton College

20 / OXFORD MEDICINE . MARCH 2015

Contacting OMA

Oxford Medical Alumni, University of Oxford, Dept of Physiology, Anatomy and Genetics, Le Gros Clark Building, South Parks Road, Oxford OX1 3QS +44 (0)1865 282346 oma@medsci.ox.ac.uk

OMA Events

2015 Weatherall Lecture Thursday 23rd April

BOOK online through the OMA w eb site to attend this lecture.

The 2015 Weatherall Lecture will be given by Professor Adrian Hill on Thursday 23rd April 2015. Professor Hill will lecture on ' “Vaccines for malaria and Ebola”. This lecture will be followed by a dinner at Linacre College — invitations for which will be sent shortly.

2015 Osler Lecture: Professor Andrew Carr, Nuffield Professor of Orthopaedic Surgery and a fellow of Worcester College, will give the 10th Osler Lecture on Saturday 19th September 2015 in the Said Business School as part of the Alumni Weekend.

The 2015 Radcliffe lecture will be given by Professor Douglas Higgs on the work of Sir David Weatherall and the Institute for Molecular Medicine.

Were you a President or committee member of Osler House?

Director or Producer of Tingewick?

An Editor of the Oxford Medical School Gazette?

OMA is keen to make contact with you so please email us or telephone OMA 01865 282346

Reunions

In 2016 a special reunion will be held for everyone who qualified between 1948 and 1963.

Invitations will be sent for this reunion.

Reunions will be held in 2015 for those qualifying as a doctor in: • 1965 and 1966 and 1967 for a joint reunion on 3 December 2015 at Oriel College • 1974 and 1975 on 19 September 2015 at Balliol College • 1977 and 1978 and 1979, date to be confirmed • 1980 and 1981 on 14 November 2015, at Oriel College • 1985 and 1986 on 18 April 2015, at The Queen’s College.

• 1988 and 1989 on 3 October 2015 at Somerville College • 1994 and 1995 on 24 October 2015 at Balliol College • 2000 on 16 May 2015 at Wadham College • 2005 on 6 June 2015 at Osler House

Want to hold your own reunion?

We are always willing to w ork w ith a cohort who want to organise their own reunion. We can help with soliciting opinions on the style and content of a reunion, identifying local correspondents and helping to individualise the occasion to make a reunion profile that most people would enjoy.

Please email us if you want more information or call 01865 282346 To receive your invitation in time to make plans, please make sure we have your contact details by email or by telephone 01865 282346.

Reunions will be held in 2016 for those qualifying as a doctor in: • 1968 and 1969 and 1970 for a joint reunion • 1971 and 1972 and 1973 for a joint reunion • 1976, including those from the 1975 cohort who cannot attend in 2015 • 1986, including those from the 1985 cohort who cannot attend in 2015 • 1996, including those from the 1995 cohort who cannot attend in 2015 • 2006, including those from the 2005 cohort who cannot attend in 2015 Reunions are open to those who are University of Oxford medical alumni, and also to those who have studied in the Oxford Clinical Medical School, whether or not they qualified through the Oxford School.

Reunions are held to mark every 10th anniversary of qualification as a doctor at: 10, 20, 30, 40, 50 and 60+ years out. OMA reunions include your former tutors — and partners are usually most welcome too.

Please note that information and opinions expressed in this publication do not necessarily represent those of the University of Oxford, or of any of its constituent Colleges. Reference to specific commercial products or services should not be taken to imply endorsement or recommendation of such products or services by the University of Oxford or of any of its constituent Colleges. The University of Oxford and its constituent Colleges assumes no legal liability or responsibility for the accuracy, completeness, or usefulness of any information presented.

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

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