Oxford Medicine November 2008

Oxford medicine THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI OXFORD MEDICINE . NOVEMBER 2008

The New Oxford Cancer Centre At the inaugural symposium of the new Gray Institute for Radiation Oncology and Biology in early September this year, Professor Herman Suit, the distinguished radiation oncologist from Harvard, clicked on to his next slide: “And when I arrived in Oxford in the early 1950’s, this is where the Radiotherapy Department was based!”

Snorts of incredulous laughter greeted the picture of the shabby brick hut on the screen. I was laughing particularly hard, as the picture was of my current office…

But not for long. Soon the official handover of the new Oxford Cancer Centre will be complete, marking the culmination of eight years of discussion, planning and construction. In a flurry of carefully choreographed moves, cancer services will leave much loved but in some cases leaky buildings to a thoroughly 21st Century venue.

The new Centre will bring together for the first time in Oxford, the main elements of cancer diagnosis, investigation and treatment onto one hospital site.

This will mark a major improvement for patients with cancer, who up until the beginning of 2007 had to negotiate a number of hospital sites in Oxford.

The underlying principle of the development has been to integrate the non-surgical oncology specialties of Medical/ Clinical Oncology and Clinical Haematology into one building with elective cancer surgery in adjacent buildings. In addition to a suite of six new Linear Accelerators providing radiotherapy, there will be new Chemotherapy and Out patient departments, and four new wards.

Surgery will take place in a ten theatre operating suite, while all specialties on site will have the support of an eight bedded Critical Care Unit.

The colorectal, oesophago-gastric and gynaeoncological elective surgical services will relocate from the John Radcliffe to join the hepato-biliary, breast and urological surgical services already based at the Churchill. During 2009, the head and neck cancer specialties– ENT, Maxillo-facial, Plastic and Thyroid surgery will also move, into a refurbished building at the Churchill, to create a head & neck cancer unit.

The Dermatology department and Chest Unit are currently on site, but lung cancer surgery and neuro-surgery will remain within the cardio-thoracic and neuro-surgery centres at the John Radcliffe. The Cancer Centre will maintain close links with the Nuffield Orthopaedic Centre where major surgery for bone cancers will continue to take place.

The increased volume of medical and surgical activity could not take place without major investment in the new Diagnostic and Imaging Centre, equipped with the latest technological tools for diagnosing and staging cancer.

Whilst these plans have been in development for nearly a decade, the overall desire to see a new cancer centre has been strong in the department for over 20 years. The Radiotherapy Improvement Fund was begun in 1989 to raise a million pounds but was quickly constrained by the more advanced plans to fundraise for a new A & E and Children’s Centre. It gradually became clear that a PFI (Private Finance Initiative) would be the only way to support such a large capital project.

Contents Letter from the President .2 Head of MSD Newsletter .4 Achievements and Awards . . . . . . . . . . . . . . . . . . .5 Retirements

. . . . . . . . . . . . . .7

Continuing Education

. . . .7

Development News . . . . . . .9 History of Oxford Medicine . . . . . . . . . . . . . . . .9 Osler House

. . . . . . . . . . . . .11

A Plea From Your Honorary Treasurer . . . . . . . . . . . . . . . .12 Obituaries

. . . . . . . . . . . . . .13

Lives Remembered The £109 million scheme will have taken almost three years to complete and great care has been taken regarding the internal and external environment, to ensure that it is both safe, as well as aesthetically pleasing for patients and staff. The new buildings will include 10,000 sq m of terracotta

. . .17

70th Anniversary Meeting . . . . . . . . . . . . . . . . . . . . . . . . . .19

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

Ref: OxMed0108/7700

2 / OXFORD MEDICINE . NOVEMBER 2008

cladding, 2,600 doors, 1,400 windows and 15,000 sq m of external landscaping. Courtyard design and internal artwork have all received a great deal of attention. A geothermal system will provide heat in winter and cooling in summer by pumping water from 120 metres below the ground.

In separate ventures, Oxford University, the Medical Research Council, the Wolfson Foundation and Cancer Research UK have made major investments in cancer research adjacent to the Cancer Centre, to ensure that breakthroughs in the laboratory bring about clinical benefits as soon as possible. This “Old Road Campus” now houses groups from many disciplines including the Gray Institute for Radiation Oncology and Biology, the Department of Clinical Pharmacology, the Ludwig Institute, the Institute of Biomedical Engineering and the Structural Genomics Consortium.

One of the trends in modern cancer care is the move to much greater integration of the multidisciplinary teams concerned with a particular cancer type. This will be greatly facilitated by being in the same physical space. Every change which enables staff and students to follow a patient from first admission to post treatment follow up is to be welcomed.

Many clinical and managerial staff, along with the Relocation Team and patient representatives have worked extremely hard to bring the Project to fruition.

Oxford will soon be able to boast one of the major Centres of Excellence in the country for cancer research and clinical services. And we won’t have to put buckets out when it rains.

C.J.Alcock and A.J.Salisbury

Letter from the President It seems only weeks ago since I was writing for the last issue of Oxford Medicine which is a good indicator that OMA is active, strong and continuing to evolve. Since that last issue in March of this year it has been gratifying to have received so many favourable comments on the ‘new look’ – very many thanks to all of you who have made those comments. We will stay with a similar format for the time being but any suggestions for further change are always welcome. Much has happened since the Spring and I will try to bring you up to date with the ongoing activity, some of which is elaborated in more detail elsewhere in this issue.

The most obvious events were the two reunions that were held in the Spring. The first was the University North American Reunion weekend in New York. This is held every two years and it has been traditional for OMA to have a brunch on the Sunday morning. I was most grateful to Dr Don Chambers for organising the Princeton Club as a venue for this event and to Dr Phil Schein for inviting Dr Scott Gottlieb to talk to us. Dr Gottlieb has been an advisor to several FDA committees and to Medicare, and has also been a sub-editor for the British Medical Journal. His subject concerned the regulation of medical practitioners and the lessons that the US could learn from the UK. It was a fascinating talk and stimulated a lively discussion. The whole event was very enjoyable although it was sad that there were many who had registered to come who did not appear. It was nevertheless good to meet those Alumni who did come, both to renew acquaintance with old friends and to meet some for the first time.

The second Reunion was, of course, the annual meeting of OMA, held just the week following the New York event. It began with the Osler lecture on the Friday

evening which was given by Professor John Reid on the subject of ‘Essential hypertension – a problem solved?’

It was a superb talk and well up to the standard of the three previous Osler Lectures. The annual symposium took place, as usual, on Saturday and was devoted to cancer to mark the opening of the new cancer research institute and the new cancer hospital (though that is not actually opening now until the Autumn). We listened to an outstanding series of talks which gave great insight into the amazing scope and depth of cancer research in Oxford, from tumour immunology providing new forms of immunotherapy (Professor Cerundolo), to developments in radiobiology (Professor Gillies) and chemotherapy (Dr Vallis) and then to the economics of new therapy.

Professor David Kerr talked about the logistical nightmare of treating cancer in Kenya where the annual health budget is about $10 per head and Professor Mike Richards then addressed the NHS strategies for affording the highly expensive new drugs. The Oxford Medical Society Lecture opened the symposium and was given by Professor Nick Wright who gave a masterly account of cell growth and regulation. Following lunch, two excellent historical talks about Oxford

OXFORD MEDICINE . OCTOBER 2008 / 3

Medicine were given by Dr Mark Harrison (Director to the Wellcome History of Medicine Unit in Oxford) and

by Dr Eric Sidebottom. It was a most stimulating and exciting day which I think everyone enjoyed. The dinners in the evening, held in The Queen’s College and St Edmund Hall, were enjoyable but not as well attended as in previous years. Indeed, many Alumni having registered (and some had even paid) for dinner did not turn up. It is difficult to discern why this happened and the large expanse of unoccupied places at dinner always has a slightly dampening effect. I very much hope that we can avoid this in the future.

Elsewhere in this Issue you will read about the exciting developments that are taking place for the enlargement and refurbishment of Osler House, a matter close to the hearts of all of us. OMA has had a number of meetings with Osler House as we will need to raise some funds for actually furnishing the building.

It is a project which I think we would all want to support and I very much hope that all Alumni will be very generous when you begin to receive details of the plans during the coming months. There has also

been a request from Osler House that members of OMA might form part of a mentoring programme as happens in many American Medical Schools. Details of this are yet to be worked out but I hope that we will be able to provide those by the time the next Issue of Oxford Medicine appears. In the meantime, if any Alumnus has suggestions about developing this scheme, I would be pleased to hear them.

At the annual business meeting in April, an amended constitution was presented and agreed upon. You should all have received a copy prior to the meeting but, if not or it has been mislaid, further copies can be obtained from the Administrator, Mrs Jayne Todd. No revolutionary changes have been made but we now have a constitution that reflects what actually happens in practice. We have agreed that the Council should only meet once a year and that day-to-day running of the organisation should be in the hands of a small executive that meets about every 6 weeks which is actually what has been the pattern over the last few years. I am delighted that we voted in Dr Peggy Frith as Vice-President and I very much look forward to having her involved.

Finally, I would like to say how grateful we have been to Dr Ken Fleming who, as Dean, has promoted and supported OMA over the last 8 years. We would not have been where we are now without his vision and encouragement. We look forward to welcoming Professor Alistair Buchan who takes over from Ken as Dean of the Medical School in October. As an ex-President of Osler House, I know that he is fully committed not only to the new developments but to the continuing activity and health of OMA. We look forward to working with him.

Professor Derek Jewell

4 / OXFORD MEDICINE . NOVEMBER 2008

Newsletter from the Head of the Medical Sciences Division As I come to the end of my tenure as the first Head of the Medical Sciences Division, it is perhaps appropriate to reflect on the achievements of the last 8 years.

Back g ro u n d The Oxford Medical Sciences Division was created in 2000 by unification of the pre-clinical and clinical medical departments of the University of Oxford, jointly with the Department of Experimental Psychology.

The Department of Biochemistry joined in 2006.

On the clinical front, there are three major Oxford NHS acute Trusts (hospitals) with which we interact – one of which is about the fourth largest Trust in England – and around five Primary Care Trusts ( Community and General Practice). The NHS population served is around 700,000 for local clinical services and about 3 million for regional specialty services.

The Division has had an extraordinarily dynamic history in its eight years of existence: • The six years medical course has expanded its student numbers by 50% (from 100 to 150 a year); • We have created a 4-year graduate entry medical course of 30 students a year; • Taught MSc courses have expanded from one course (three students) to twelve courses (177 students); • Research students (DPhil) have expanded from around 500 to over 900; • External grant research funding has increased by over 12% a year, from around £80m to £170m; • The Division now has a budget of around £250m, 2900 staff and around 60% of the University’s external grant income – by external grant income, the Division would be the 6th largest university in the UK. For the last two years running, it has been ranked third in the world by the THES, top for medical and physiological education in the UK by the Guardian and Times newspapers, top-ranked medical school in Europe by the League of European Research Universities (2002) and had all its departments ranked 5 or 5* in the 2001 Research Assessment Exercise. Graduates of the Division have been the most successful of any institution in the UK, in membership exams of the Royal Colleges of Physicians and of General Practitioners.

Ch a l l e n g e s The most important objective has been to recruit and retain the best staff and students from anywhere in the world. To do this, it has been vital to maintain an environment and culture which is permissive, supportive and expectant of academic excellence and of change, with a concomitant sense of energy, enthusiasm and excitement.

To demonstrate our commitment to this, we have: • Radically revised admissions (especially medicine and physiology) to ensure recruitment of the best students, irrespective of background and college, such that the procedure is now regarded as the exemplar for the rest of the University; • Reviewed and revised most of the curricula, with the possibility of a common first year for some courses being investigated; • Through the creation of the Doctoral Training Centre, established the basis of a Graduate School, which eventually will deal, in a unified manner, with all aspects of recruitment, admission, progression and graduation of graduate students. This will allow us to optimise our ability to attract the best students and provide them with the best of Oxford education; • More than doubled our space (40,000m2 to 100,000m2) and have plans for a further £125m of capital building; • Created a network of speciality Clinical Research Facilities, with three in operation and two more due to open by the end of 2008. These facilities are particularly important in achieving one of our key research objectives, namely developing further the links between our strong basic science programmes and the clinical research arena (experimental and translational research); • Developed closer alignment of overall strategy with the NHS organisations in Oxford. This alignment is vital to the future health and strength of both the education and research agenda of the Division. As an example, the Division partnered with the Oxford Radcliffe Hospitals NHS Trust (ORHT) in a successful application in 2006 to be a Comprehensive Biomedical Centre of Excellence (only five in England). As a result of this, we have started a Partnership Board with the ORHT to manage and maximise the benefits of the interface between the Trust and the Division. We are also currently developing proposals with the ORHT and other parts of the NHS in Oxford to establish an Academic Health Sciences Centre.

Separately, we have inaugurated, with the regional NHS, the Oxford University Clinical Academic School to deliver one of our strategic objectives of fostering the clinical academics of the future and to take advantage of the Walport scheme for clinical academic training; • Helped create in 2001 the Oxford Medical Alumni to maintain contact with former students and staff.

There is now a database of over 9000 members and an active programme of events.

• Created a fund-raising operation to deliver substantial income for the Division (£6m in 2006).

The above are some examples of the changes initiated to provide an attractive environment for staff and

OXFORD MEDICINE . NOVEMBER 2008 / 5

students, but there are many other changes which have been implemented, including: An agreed educational and research strategy; greater strategic focus and investment in recruitment, including greater flexibility in terms and conditions of employment; proactive recognition of staff through the creation of Prize Committees for education and research excellence.

As can be seen from the above, Oxford Medicine in 2008 is a dynamic, expansive institution which, taken with the other benefits of Oxford, makes it one of the most academically attractive places anywhere in the world.

Achievements and Awards Ch a n c e l l o r ’s Co u r t o f Be n e f act o rs John Spalding has been admitted to the Chancellor’s Court of Benefactors (CCB) and his name has been inscribed on the Clarendon Arch. The CCB is the University’s foremost forum for acknowledging the generosity of the University’s most munificent Photograph courtesy of Rob Judges supporters, in keeping with Oxford’s ancient tradition of honouring those whose contributions have built the University and its Colleges. Members of the CCB are invited to meet with the Chancellor and senior member of the University twice a year to hear about important developments. The Clarendon Arch, near to the entrance to the Bodleian Library is inscribed with the names of Oxford’s most generous benefactors throughout history including HRH Queen Elizabeth 1, John Radcliffe and Cecil Rhodes. We are delighted to see Professor Spalding’s outstanding contribution to the development of neuroscience at Oxford recognised in this way. The first Spalding Senior Clinical Lecturer in Neurosurgery is Dr Alex Green who is investigating using deep brain stimulation to regulate blood pressure.

Nu f f ie ld D e p ar tm e n t o f S ur g e r y Pr o f e s so r s hi p Freddie Charles Hamdy MB CH.B Alexandria, MD Sheff, Professor and Head of Urology, Academic Urology Unit, University of Sheffield and Head, Section of Oncology, University of Sheffield School of Medicine, has been appointed to the professorship with effect from 1 October 2008.

Ne w He ad o f De p art m e n t Professor Dame Kay Davies takes over as the new Head of the Department of Physiology Anatomy and Genetics and will continue to serve as a Governor of the Wellcome Trust.

For me, the last eight years have been exciting and exhausting in equal measure. The challenge of setting up the division from scratch was ‘interesting’, but by every measure it is now clearly established as amongst the best in the world. This is a testament to the talent, energy and skill of the division’s staff and students and it has been a privilege to have had the opportunity to help this happen. I have been lucky in having lots of colleagues who have contributed greatly to this endeavour. I thank them all. I also wish my successor, Professor Alastair Buchan, my best wishes for the next few years and I look forward to seeing the division becoming even more successful.

Dr. K. A. Fleming

Professor Chris Kennard has become Head of the Department of Clinical Neurology. Professor Kennard moves to us from his position as Deputy Principal of the Imperial Faculty of Medicine responsible for the Charing Cross campus and Head of Neurosciences. Professor Kennard will continue as the Chair of the Neuroscience Board for the MRC and will be working to develop neurosciences in Oxford.

D o ct o r s o f M e d ici ne : OMA congratulates the following alumni on achieving their DM Dr John R. Ingram Dr Edward Seaton Dr Mark J Beresford Gr a d ua t e s o f t h e O x f o r d M e d i ca l S ch o o l ha v e h a d t h e b e s t r e s u l t s c o n s i s t e n t l y s i n c e 1 98 9 — A paper by the Royal College of Physicians London shows how graduates of the Oxford Medical School have had the best results consistently since 1989, compared to most other Medical Schools in the UK, for MRCP (UK) Part One. The authors suggest that around 40% of that performance is due to the experience in the Medical School concerned. Download the paper (PDF) http://www.biomedcentral.com/content/pdf/1741-7015-6-5.pdf In the Q u e e n ’ Bi r t h d a y H o n o u r s …Professor Andrew McMichael, Professor of Molecular Medicine has been knighted. The Director of the Weatherall Institute of Molecular Medicine and Fellow of Corpus Christi College has been honoured for services to medical science.

Professor Anthony Goldstone, an almnus of the Oxford Medical School, has been made a Commander of the British Empire for his services to medicine. Professor Goldstone is consultant haematologist at University College London and Director of the North London Cancer Network.

This year the R o y a l S o c i e t y announced forty four new Fellows of whom seven are Oxford academics, and of these three of whom are working in Oxford medicine. They are:

6 / OXFORD MEDICINE . NOVEMBER 2008

• Sir John Bell FRS, Regius Professor of Medicine. Professor Bell has made major contributions to the development of UK clinical and medical science. He founded the Wellcome Trust Centre for Human Genetics in Oxford, the first to focus on the genetics of common diseases, and then led the creation of four other clinical research institutes in Oxford. Underpinning his strategic planning, his own research on the immunogenetics of HLA, T cell receptors and autoimmune diseases has been sustained and ground breaking.

• Professor Russell Foster FRS, Professor of Circadian Neuroscience and Chair, Nuffield Laboratory of Ophthalmology. Russell Foster has made fundamental contributions to the field of biological clocks (circadian rhythms) and the role of a novel photoreceptor in the retina that is critical for the pathway whereby light signals at dawn and dusk entrain the central circadian clock. His earlier research studied non- retinal photoreceptors in the deep brain of birds which are used to regulate seasonal reproduction.

• Professor Graham Russell FRS, Professor of Musculoskeletal Pharmacology, The Botnar Research Centre, Nuffield Department of Orthopaedic Surgery and Honorary Consultant, Nuffield Orthopaedic Centre. Graham Russell's research on tissue mineralization and pyrophosphate set the scene for the discovery of bisphosphonates as drugs. He was a leader in that discovery process and in research that led to the application and use of the first generation bisphosphonates. He brought novelty to this field at its very beginning, and again almost 30 years later, with his work on the mechanism of action of these drugs, which are now the major drugs used for treating disorders of bone resorption.

The F r a n c i s Cr i c k P r i z e from the Royal Society has been awarded to Dr Simon Fisher in 2008 for his ground breaking research in human language. Dr Fisher’s work combines a number of disciplines such as genetics, neuroscience and psychology to investigate what makes us human. He was co-discoverer of the FOXP2 gene and the revolutionary finding that people with faulty versions of this gene have difficulty developing normal speech and language.

Professor Terence Stephenson has been elected as P r e s i d e n t o f t h e R o y a l Co l l e g e o f Pa e d i a t r i c s a n d Ch i l d H e a l t h . Professor Terence Stephenson is Professor of Child Health and Dean of the Faculty of Medicine and Health Sciences at the University of Nottingham and Vice-President for Research and Science, Royal College of Paediatrics and Child Health. He is also Consultant Paediatrician and NonExecutive Director, Nottingham University Hospitals NHS Trust Each year Oxford medicine recognises and rewards excellence in College and University teaching through the Medical Sciences Teaching Awards. In 2008 awards will be made to: • D r P h i l i p A n s l o w , Consultant Neuroradiologist, Department of Clinical Neurology • P r o f e s s o r J o n A u s t y n , Wolfson College, Professor of Immunobiology, Nuffield Department of Surgery • D r H e l e n Ch a p e l , Professor of Clinical Immunology, Nuffield Department of Clinical Medicine • M i s s J a n e C l a r k e , Consultant Surgeon, Nuffield Department of Surgery • The Clinical Teaching Associate Team led by: D r B r e n d a K e l l y, Clinical Lecturer, Nuffield Department of Obstetrics & Gynaecology;

M i s s J a n e M o o r e , Senior Fellow and Honorary Consultant Gynaecologist, Nuffield Department of Obstetrics & Gynaecology; D r H e l e n S a l i s b u r y, Honorary Senior Clinical Lecturer and General Practitioner, Division of Public Health and Primary Health Care • D r H u w D o r k i n s, St Peter’s College, Fellow and Tutor in Medicine; Consultant Clinical Geneticist • D r Pa u l Fa i r c h i l d , Oriel College, RCUK Fellow, Sir William Dunn School of Pathology • D r E l s p e t h G a r m a n , Linacre College, Reader in Molecular Biophysics, Department of Biochemistry • P r o f e s s o r M i l e s H e w s t o n e , New College, University Lecturer, Department of Experimental Psychology • M i s s S t e l l a H o r n b y , Honorary Clinical Lecturer, Department of Ophthalmology • D r J e n n i f e r L o r t a n , Clinical Tutor and Honorary Consultant Immunologist, Nuffield Department of Clinical Laboratory Sciences • D r G o r d o n M a c P h e r s o n , Oriel College, Senior Tutor; Departmental Lecturer, Sir William Dunn School of Pathology • D r Ja c q u e l i n e M c Cl a r an , Balliol College, Director of the SIFT Faculty Development Programme, Department of Primary Health Care • The Primary Health Care Teaching Team: D r M i c h a e l M o h e r, Teaching Co-ordinator, M r s E m m a Wi l e y , Course Administrator, M s Ca r o l i n e J o r d a n , Assistant Course Administrator, Department of Primary Health Care) • D r Tr e v o r S h a r p , University College, Fellow in Neuroscience; Reader in Pharmacology, Department of Pharmacology • D r P e t e r S u l l i v a n , Magdalen College, Reader in Paediatric Gastroenterology, Honorary Consultant Paediatrician, Head of Department, Department of Paediatrics • D r J e r e m y Ta y l o r, Pembroke College, University Lecturer, Department of Physiology, Anatomy & Genetics • D r D a v i d Va u x , Lincoln College, Reader in Cell Biology, Sir William Dunn School of Pathology F in ally …

Lennard Lee a final year student in the Oxford medical school, and a team of three other Oxford students, successfully swam the entire length of the Straits of Gibraltar, unaided in three hours and 38 minutes on 9 July 2008, setting a new British record. The team of Oxford Blues, Lennard Lee, Harry Fisher and Nicholas Berry faced even more adversity than usual, as they contended with a pod of killer whales following them on the final stage of their swim, whilst they completed this dangerous open water challenge in aid of the Variety Club Children's Charity. For further information see www.justgiving.com/gibstraits.

OXFORD MEDICINE . OCTOBER 2008 / 7

Retirements Recognition and heartfelt thanks also goes to several distinguished senior colleagues who are retiring: Professor George Brownlee (as Abraham Professor of Chemical Pathology)

Professor Richard Moxon (as the Action Research Professor of Paediatrics)

Professor Siamon Gordon (as Professor of Molecular Pathology)

Professor Sir George Radda (as Head of the Department of Physiology, Anatomy and Genetics)

Professor Jonathan Meakins (as Nuffield Professor of Surgery)

Professor Angela Vincent (as Head of Department of Clinical Neurology).

Continuing Education for medical alumni So you qualified BM BCH …alumni who have qualified in medicine at Oxford are eligible to apply for a range of higher degrees from the University either by virtue of further work, or by having worked in their field for a number of years. The higher degrees which you may be eligible to apply for include: M a st e r o f A r t s (M A ) Alumni of the Medical Sciences at Oxford may apply, through their College, to take the degree of MA with the following restrictions: 1. A Bachelor of Arts (other than one covered by the provisions of clause 2 below) may, with the approval of his or her society, supplicate for the Degree of Master of Arts in or after the twenty-first term from his or her matriculation.

2. A Bachelor of Arts whose qualification for admission to a Final Honour School was the successful completion of a Foundation Course at the Department for Continuing Education may, with the approval of his or her society, supplicate for the Degree of Master of Arts in or after the eighteenth term from his or her matriculation.

3. A Bachelor of Arts who has been admitted to the Degree of Doctor of Philosophy may supplicate for admission to the Degree of Master of Arts, provided

that he has satisfied all other necessary conditions, at any time after his admission to the Degree of Doctor of Philosophy.

4. If a Bachelor of Medicine shall first have been admitted to the Degree of Bachelor of Arts, he may supplicate for the Degree of Master of Arts with the approval of his society in or after the nineteenth term from his matriculation, and may retain the Degree of Bachelor Medicine, as the case may be.

Please contact your college if you wish to take your M.A. Do ct o r o f M e d i cin e (D M ) This senior doctorate is open to candidates holding the Oxford BMBCh degree after a period of twelve years from their matriculation, and to candidates who have passed the first BM examination and hold an Oxford MA together with a registrable medical degree from another British university. The DM degree is awarded on the basis of a thesis (or, for senior staff only, published work) on a medical subject previously approved by the Divisional Board. For further information contact: Research Degrees Office, Examination Schools, High Street, Oxford OX1 4BG. Email dm.degree@admin.ox.ac.uk

8 / OXFORD MEDICINE . NOVEMBER 2008

M a s t e r o f S u r g e r y ( M Ch ) This degree is open, under specified conditions, to candidates holding the Oxford BMBCh (ten years from their matriculation) and to those holding both an Oxford MA and a registrable medical degree from another university.

For further information contact: Medical Sciences Office, The John Radcliffe Hospital, Headington, Oxford OX3 9DU. Email dm.degree@admin.ox.ac.uk

…alumni who have qualified in medicine at Oxford are eligible to apply for a range of higher degrees from t he University…

O x f o r d D o c t o r a l Co u r s e i n Cl i n i c a l P s y c h o l o g y ( D Cl i n P s y c h o l ) This three-year full-time course validated by the University confers eligibility for Chartered status as a professionally qualified clinical psychologist. All trainees are currently employed by the Oxfordshire Mental Healthcare NHS Trust and are members of Harris Manchester College. The course is unique in being fully funded and run from within the NHS. The course aims to provide a thorough and integrated academic, clinical and research training in clinical psychology. The philosophy of the course stems from both the scientist-practitioner and the reflective practitioner models, and the course is committed to drawing on a wide variety of theoretical orientations which have been demonstrated as contributing to human well-being or to the relief of suffering.

For further information and applications contact: Clearing House for Postgraduate Courses in Clinical Psychology, 15 Hyde Terrace, Leeds LS2 9LT. Email m.degree@admin.ox.ac.uk The University also offer a wide range of courses of which the following continuing education courses may be of interest to alumni.

D P h i l i n E v i d e n c e - B a s e d H e a l t h Ca r e The part-time DPhil Programme considers applications from those who have already been awarded the MSc in Evidence-Based Health Care. Applications may also be considered from students with a Master's in a related subject. Supervision is arranged to suit the DPhil topic and may involve staff from within the Medical Sciences Division as well as co-supervision with members of the Evidence-Based network.

M S c i n E v i d e n c e - B a s e d H e a l t h Ca r e The MSc in Evidence-Based Health Care is part of the Oxford International Programme in Evidence-Based Health Care, and is offered as a part-time course consisting of six taught modules and a dissertation.

This is a joint Programme with the Department of Primary Health Care and the Department for Continuing Education's Continuing Professional Development Centre and a particular aim of the Programme is to strengthen the natural links with the renowned Centre for Evidence-Based Medicine in Oxford.

M S c i n E x p e r i m e nt a l Th e r a p e u t ics Oxford has made a major contribution to modern molecular medicine and our senior scientists have provided significant insights to our understanding of cancer, diabetes, and cardiac, haematological and infectious diseases. There is now an opportunity to harness these advances and translate them into therapeutic benefits for patients. The Department of Clinical Pharmacology and the Department for Continuing Education’s CPD Centre offer this part-time two-year MSc in Experimental Therapeutics that brings together some of Oxford's leading clinicians and scientists to deliver an advanced modular programme designed for those in full-time employment, both in the UK and overseas.

P o s t g r a d u a t e Ce r t i f i c a t e i n H e a l t h C a r e t o Pe o p l e E x p e r ie n cin g H o m e le s s ne s s This innovative and unique programme brings together health professionals, support workers, volunteers and all people who deal with homelessness in any aspect of their work.

This programme offers professional development courses which address provision of healthcare for people experiencing homelessness by taking a collaborative approach which allows students to learn from one another and gain an understanding of the challenges that workers in other occupations face. The aim is ultimately to greatly improve the quality of help that homeless people receive. Courses aim to provide information both for professionals who are relatively new to the field of healthcare, or who have been working with homeless people for some time and wish to enhance their knowledge and skills. When taken for credit, courses can qualify for the Postgraduate Certificate in the Provision of Health Care to People Experiencing Homelessness.

P o s t g r a d u a t e D i p l o m a i n Pa e d i a t r i c I n f e c t i o u s D is e as e s Our Postgraduate Diploma in Paediatric Infectious Diseases, directed by Dr Andrew Pollard of Oxford University Department of Paediatrics, is designed to provide a variety of different teaching methods (face-to-face and online) directing students through the syllabus required in the EU for clinical training in the subspecialty. The Programme will also be appropriate for those outside the EU. Paediatricians attending modules may claim CPD credits in accordance with the current Royal College of Paediatrics and Child Health CPD guidelines.

If you wish to find out more then you should contact University of Oxford, Department for Continuing Education, Rewley House, 1 Wellington Square, Oxford, OX1 2JA Email enquiries@conted.ox.ac.uk telephone +44 (0)1865 270360

OXFORD MEDICINE . NOVEMBER 2008 / 9

Development News

In late September the University launched an Annual Fund Programme as a pilot project involving a quarter of the Colleges. In medicine it will enable us to offer raise much needed unrestricted funds to support a variety of needs within the Medical Sciences Division, including a financial hardship fund, bursaries and financial support for clinical attachments.

Fu n d r a i si ng I n co m e We are delighted to report the Medical Sciences Division has secured nearly £5M fundraising income during the financial year 2007/2008, from a wide variety of sources including cash gifts, gifts in kind, legacy gifts, new pledges and sponsorship.

Wi l l i a m O s l e r H o u s e Oxford Medicine recently received a very generous donation from a former member of the Oxford Medical School towards the extension and refurbishment of William Osler House at the John Radcliffe Hospital.

Osler House still needs to find the funds for the interior furnishings, fixtures and fittings as well as the on-going costs of running Osler House. This funding will enable Oxford to continue to provide this important, and much loved facility for the clinical students of medicine at Oxford. You can help the students of today by giving online at www.giving.ox.ac.uk/osler Gas tr o e n te r o lo g y at Ox f o r d In well deserved recognition of Professor Jewell’s major contributions to Gastroenterology at Oxford, an anonymous benefactor has recently given a very significant donation to refurbish the Gastroenterology laboratory which, according to the benefactor’s wish, will be named after Professor Derek Jewell.

O x f o r d t h i n k i n g – Ca m p a i g n U p d a t e In May 2008, the University of Oxford launched the biggest fundraising Campaign in European history, Oxford Thinking. This Campaign aims to sustain and develop Oxford’s priceless and distinctive contribution to the lives of people all over the world. The Campaign has three key strategic priorities: • Supporting students and the life of the University • Supporting academic staff and programmes • Supporting new facilities and buildings We are very pleased to report that we have been almost overwhelmed by the supportive response to the launch of the Campaign. There has been a significant increase in unsolicited and spontaneous gifts from many new donors. We are delighted to report over £625M have been raised so far for the Colleges and the University.

Fo r m o r e in f o r m a t io n a b o u t g iv in g t o Ox f o r d m e d i cin e p le a s e co nt a ct : Frewyeni Kidane, Development Officer – Medical Sciences University of Oxford Development Office, University Offices, Wellington Square Oxford OX1 2JD Tel: +44 (0) 1865 611538 Email: frewyeni.kidane@devoff.ox.ac.uk www.campaign.ox.ac.uk/contribute/ways_to_give

Exceptional thinking has always flourished at Oxford…

You can help that tradition to continue.

To g i v e o n l i n e g o t o : www.giving.ox.ac.uk/academic_departments/medical_ sciences

An Archive of Public Health and a history of Oxford Medicine at 13 Norham Gardens

Terence J Ryan (Archivist for OMA) When in the mid 19th century the Public Orator was permitted to have a family home in situ, a well known Victorian architect, Wilkinson, designed the first of the large Norham Gardens buildings. It was this house that William and Grace Osler approved on their arrival in 1905. BUT Grace disapproved of its lack of bathrooms and two more years went by while they were installed into an extension.

To Grace Osler they were important as they entertained 6000 Americans and housed the biggest medical library at that time. In 1919 when Osler died it took 10 years to catalogue this library, before it eventually made its way to Johns Hopkyns in Montreal. The house then had several owners but was intended for the use of the Regius Professors of Medicine at Oxford; although in

practice only Sir George Pickering and Sir Richard Doll actually made use of it.

With the help of an Osler admirer, the Texan paediatrician McGovern, Green College purchased 13 Norham Gardens; part of the ground floor then became the Osler McGovern Centre. The former sitting room became a seminar room but the main room, Osler’s library and study was preserved.

Lord Walton who had used this room as his Oxford office had begun to develop it with Dr Alastair Robb-Smith it as a reminder of Oxford’s most famous physician and they recruited Professor Terence Ryan who, in recent years, has developed it still further. It was enhanced by the recent bequest of the archives of Oxford’s morbid pathologist and medical historian, Alastair Robb-Smith.

Osler memorabilia

10 / OXFORD MEDICINE . NOVEMBER 2008

The material held at 13 Norham Gardens is divided into sections with headings such as: • Osler’s publications, • Medical Publications written from 1890–1930 consulted by or influenced by Osler, • Books about the Oslers, • The Penicillin Story, • Sherrington and his pupils, • Dr Alexander Cooke, • The History of the Hospitals of the United Kingdom, • The History of Medicine, Penicillin plate • Oxford University Much effort has been made to build up all the publications available on the Oxford Medical School when it was based at the Radcliffe Infirmary Emphasizing “Public Health before and after Osler” there are collections on Cholera and other epidemics, as well as the basis for the “Global project on the history of Leprosy”. A public health issue of contemporary medicine is the global interest in “Alternative and Complementary Medicine” and the library holds what is probably the best Oxford collection of “Other Systems of Medicine”. Anyone wishing to explore the early confusion and development of the language of dermatology especially in the field of tropical diseases will find much of interest in this library because Robb-Smith was a great collector as well as writer on nomenclature.

Very recently Dr Rosemary Fitzherbert Jones has helped to catalogue and annotate the Robb Smith Archive and has recently produced two volumes of catalogued photographs from the collection.

The early minutes as well as other ephemera of the Oxford Osler Society, the Oxford Medical Graduates Club, the Oxford Medical Society, the London Osler Club and the American Osler Society are given space. We have some material from student groups such as Osler House and Tynchwyke.

We collect, rather haphazardly, relevant obituaries and interviews with Oxford Medical dignatories, and the Wardens of Green College and their wives. There is also an enlarging collection of Oxford hospital departmental history. Collections of books from the libraries of Kilner and Cooke are recent aquisitions. We have space for Nursing in Oxford, Occupational Therapy and other allied health disciplines. Splendid photographs of Oxford leading medical personages, ‘Deans of the Medical School’ and Regius Professors of Medicine decorate the upper walls.

If we had money we could do better! OMA supports the project by allocating some of the time of the alumni officer, Jayne Todd, and increasingly awareness of the project is providing more donations.

Whilst we are running out of space, we are always happy to receive donations of material which alumni hold but which they cannot find a home for. We are especially keen to receive medical school syllabi and lecture notes, the diaries and obituaries of tutors and students, drawings, cartoons and photographs of the people, places and events associated with Oxford medicine over the years. We also seek anything related to Tyngewyck. We have not had an official opening of this project but plan one for 2009 when labelling and cataloguing is more complete.

Much of this began when Terence Ryan saw the need for Oxford Medical Alumni to record the woefully inadequate history of the successes of Oxfords graduates both in Oxford and world wide.

Something Alasdair Robb- Smith began a half century ago with his publications on Women Graduates. There is now a larger project, in its very early stages, to identify and store more of the archives of Oxford medicine and to get this material cared for in the Bodleian Library.

However all this is still “a work in progress” and with the 70th Anniversary of the Medical School in 2009 we hope to use this to encourage even more people to place their memorabilia in our care for future generations.

Please contact Jayne Todd if you would like to contribute items to the archive.

From the archives ….

To The Right Honourable The Viscount Nuffield The Nuffield Organisation, Cowley My Lord I am writing to Your Lordship in my capacity as President of the Osler House Club which was established in 1946 for the benefit of medical students at the Radcliffe Infirmary. The Club has unanimously decided to invite Your Lordship to become an honorary member, and I have now very great pleasure in formally conveying this invitation to you.

In taking this decision the students are aware that in the past, you would have received many invitations of a similar nature, but they trusted that their own invitation would be regarded by you as implying nothing more than their gratefulness for your generosity to the Radcliffe Infirmary, the results of which they enjoy daily, and their appreciation of your benefactions for the advancement of medicine.

Our wish is above all that Your Lordship will regard this invitation as a manifestation of the great good will of the Radcliffe Infirmary medical students towards you, and that in this light you will accept it.

I have the honour to remain, My Lord, Your Lordship’s obedient servant J.C. Voight December 25th, 1957 Dear Mr Voight, Thank you for your letter of December 25th, and for the invitation you extend to me to become an Honorary Member of the Osler House Club.

As you probably are aware I knew Osler when he was at Oxford, and there is no doubt that he was one of the greatest physicians this country has ever known. It gives me much pleasure to accept this invitation, and I am indeed appreciative of the generous reasons of the students for making it.

Yours sincerely, NUFFIELD December 30th 1957

OXFORD MEDICINE . OCTOBER 2008 / 11

Renovations at William Osler House This year the winds of change look to create quite a stir in the corridors of the old Dower House up on Headington Hill. Known to all as William Osler House, it has served faithfully as a bar, meeting room, nightclub, TV lounge, games room and much-needed retreat for generations of Oxford medical students. This autumn the now time-worn interior looks set to be changed beyond recognition. The tremendous generosity of a medical school alumna will allow a major renovation of William Osler House, expanding its size, facilities, and scope of activities. The current executive committee of Osler House Club want to use this time of change to reconnect with all our alumni and bring you up to speed with the diverse roles played by Osler House Club (OHC) in today’s Oxford Medical School. We hope that you will share our enthusiasm for the club’s expanding position within the Medical Sciences Division and also come forward to help us face the many upcoming challenges.

The current interior of William Osler House

and gatherings that encourage our members to take a break from the stresses of student life. The successful Med-Ed and Osler Parenting programmes create a collegial, supportive environment within the medical school and encourage peer learning. Our Welfare Officers have worked to improve and widen the services provided by Osler House Club.

We now offer free yoga sessions, rape alarms and pregnancy tests, and subsidise the cost of bicycle safety equipment. We have also produced a personal safety guide, which students can access on our website.

An artist's impression of the renovated William Osler House

In an increasingly competitive academic and work environment, Osler House Club has become even more important in helping Oxford Medical School to produce doctors whose talents extend to more than just medicine. By providing a supportive atmosphere for students and working together to represent our common interests, we have made significant contributions to the personal and professional development of our members. OHC represents the interests of medical students on both internal academic committees and external forums like the Oxford Foundation Training Board and the UK Foundation Programme Office.

Our efforts ensure that students’ opinions are heard and that our professional futures are secure. The support provided by OHC is most evident through the activities of our welfare and sports and societies officers. Welfare support is provided in the form of regular welfare teas

Our Sports Teams and Societies continue to flourish and this year the Men’s Football team was particularly successful, reaching the Cuppers Final. Our Sports Officer also trialled free circuits sessions for our members this year with huge success and we hope to continue this scheme into the long term. OHC also funded the Varsity Sports Day away in Cambridge this year where Oxford teams acquitted themselves honourably with wins in volleyball and football.

OHC also provides its members with the funding and support to necessary to raise the national profile of Oxford Medicine. Medsin UK’s Annual Global Health Conference was hosted in Oxford this year and was organised by a dedicated team of Oxford medics. OHC was the largest donor and provided much-appreciated advice and organisational support. Over 450 national and international delegates attended the weekend conference and it ran very smoothly.

Oxford Medical School Varsity Sports Team at Cambridge

12 / OXFORD MEDICINE . NOVEMBER 2008

Ca l l i n g P r e sid e nt s o f Osle r Hou se We a r e a n x i o u s t o t r ac e al l t h o s e w ho ha v e b e e n P r es id ent o f Osle r H o us e o v e r t he l a s t 6 0 y e a r s. I f y o u c an h e l p u s p le a se co n t a ct J ay n e To d d a t O M A o n 01 865 2 216 90

As we reflect on the continuing achievements of OHC and the opportunities afforded to our members, we also recognise that a great unfulfilled potential still remains.

For many years, the interaction between OHC and the medical school alumni has remained erratic and perfunctory at best. With this first letter to you we hope to lay the foundation for a closer, more involved relationship.

While we will keep you more regularly informed of our every day activities through this newsletter, please also take the opportunity to return to William Osler House and see for yourself how it makes a difference in the lives of every medical student. When the newly refurbished building opens next year, OHC will undertake to furnish it in a style that reflects the needs and aspirations of both our current students and our alumni. We hope you will accept our invitation to be involved in that process.

Finally, we aim to make OHC a conduit that allows alumni and current students to interact and learn from each other. A mentorship programme that allows students unique opportunities to learn from and contribute to the

work of alumni mentors is currently being developed in co-operation with OMA. Such a programme will embody our belief that alumni and current students have much to gain from a close and relationship.

This is a tremendously exciting time for Osler House Club. Now, more than ever, we need our alumni to serve as stewards of the Osler legacy; to support, guide and aid us in ensuring we overcome approaching challenges and make the most of future opportunities.

We hope that you will be encouraged to see that Osler House Club remains an active, vibrant and vital part of Oxford Medical School and are motivated to join us in writing a new chapter in its illustrious history. If you would like to help with this project you can contact Jayne Todd at OMA: jayne.todd@medsci.ox.ac.uk telephone 01865 221690, or Frewyeni Kidane at the University Development Office, frewyeni.kidane@ devoff.ox.ac.uk telephone 01865 611538. Or you can give online at http://www.giving.ox.ac.uk/osler

A Plea From Your Honorary Treasurer Generally speaking, it is best to give the good news first. To that end, we estimate there are currently some fifteen thousand lucky souls wandering this planet eligible for OMA Membership. Of these, we have recent contact details for around ten thousand. Whilst there is clearly room for improvement there, the really bad news is that barely two thousand are presently paying the full OMA annual subscription of £30, – ideally Gift-aided, of course! Not only is this situation clearly unfair, but it also represents a huge shortfall in potential income to our organisation. Whilst the whole issue of alumni funding is currently under review within the University, little imagination is required to think what OMA could do with an annual budget of between a quarter and a third of a million pounds rather than the relatively measly £30-£40k which we currently have to scrape by on each year.

So what else could we do if everyone was paying their full whack? Whilst the potential for further developments is clearly vast, here are just a few random ideas in no particular order of merit: First, our current newsletter, Oxford Medicine, is always cramped for space and we regularly receive copious quality copy which sadly we often can't accommodate.

Similarly, we regularly struggle to meet the expenses of our usually excellent speakers and are seldom able to offer an appropriate honorarium commensurate with their status. Furthermore, as OMA's influence grows and spreads, it would be greatly to our advantage if we were able to invite even more prestigious and influential guests to our set-piece dinners and other

functions rather than having to cut our cloth as sparingly as at present. Moreover, from the Medical Students’ perspective OMA could play a much greater part in helping to add value to the whole student experience perhaps by developing mentoring as well as by increasing the current number and scope of prizes and perhaps helping to make the students' life a little more comfortable by possibly even starting up a reserve fund to help alleviate hardship amongst those unfortunate ones who may be experiencing particularly difficult financial circumstances. This is by no means an exhaustive list, but OMA's potential is huge if properly harnessed and that begins by getting our own financial affairs properly addressed, irrespective of any other initiatives.

The first stage in this process then is for us to persuade everyone who should be doing so to pay their full subscription, both promptly and regularly. Those who are not currently doing so know who they are and, of course, so do those of us who work on behalf of OMA. So now is the time both to save any further embarrassment and, for the long-term benefit of OMA, for us all to stump up our due subs.

See inside After all, what back cover is thirty quid for your among friends really subscription these days, I ask you?! form Richard Maxwell, – OMA Hon.Treasurer.

OXFORD MEDICINE . OCTOBER 2008 / 13

Obituaries

DAVID YORK MASON 1941 – 20 08 1960 Matriculated St Johns College 1960, 1966 qualified BM BCh; 1987 elected Fellow of Pembroke College; 1994 Reader; 1997 to 2008 Professor of Cellular Pathology.

Professor David York Mason who died on the 2nd February 2008 from post-operative complications was an internationally renowned authority on the diagnosis and pathology of human lymphoma and leukaemia. As is clearly evident from the wealth of tributes being sent and posted on the web he had an influence far beyond his own laboratory. His work on techniques and reagents has spread to virtually every hospital in the world. He can truly be said to have changed radically the practice of pathology as it relates to haematological malignancy.

David Mason was born on 30th November 1941 and educated at Tonbridge School, St John’s College University of Oxford and St Thomas' Hospital qualifying in 1966. He came from a medical family but was brought up with a life long passion for the arts. He combined these two enthusiasms at University occasionally veering more to the arts than his tutors would have preferred.

This led though to a highly successful and satisfying role in the early development of television satire. Indeed he was a scriptwriter for some of the early pre-Monty Python satirical shows especially “That Was The Week That Was” for which he was still delighted to be receiving some royalties right up until his untimely death.

After qualifying in medicine he turned his back on a literary career and concentrated the rest of his life on the study of human lymphomas, a cancerous tumour of the lymph glands and other tissues that presented considerable problems in diagnosis and classification to clinical haematologists. He was one of the first, with Clive Taylor, to show that antibodies, then studied mainly in test tubes by scientists, could be applied to clinical samples from patients. He immediately realised that the discovery of monoclonal antibodies in 1977 was a great opportunity for this to be developed. In spite of considerable scepticism from many colleagues he persevered with the production of these antibodies specifically developing them for human applications. To enable this he developed and improved many technical methods including the so-called APAAP (alkaline phosphatase – anti-alkaline phosphase) technique whose description has become a citation classic. Today his reagents and methods are applied daily in the routine practice of pathology worldwide.

He was very enthusiastic about international collaboration. Visitors flocked to his laboratory from around the world to study these new reagents and learn their applications. He rarely turned anyone away if there was space and cared not if they were famous or just starting out. An enthusiasm to learn and co-operate was all he desired. Today the leaders in lymphoma pathology and research include many clinicians and scientists who spent periods from weeks to years with him in Oxford. He maintained this welcome to researchers right up to the present time.

He was promoted to Reader (1994) and then in 1997 to Professor of Cellular Pathology at Oxford. The Leukaemia Research Fund was his main source of funding throughout his career and with which he developed a close personal relationship. He founded and was the first director of the Leukaemia Research Fund Immunodiagnostics Unit which has recently been expanded into a national antibody resource for the Charity’s research workers. Within this Unit he built up an incredibly loyal and helpful team that stood by him for over 20 years of whom the key players are Jackie Cordell, Margaret Jones, Karen Pulford and Bridget Watson.

He was a founding member in 1991 of the International Lymphoma Study Group that brought together pathologists and clinicians from around the world to discuss and agree on lymphoma diagnosis and research. At that time there was a great divide between the United States and Europe with many rival and highly complex classification schemes. David alongside Peter Isaacson, Harald Stein, Elaine Jaffe, Nancy Harris and several others brought all of these disparate opinions together and formulated a new clear highly practical scheme for clinical use. Today this is encapsulated as the WHO classification of lymphomas and leukaemias. A tribute to the enormity of this achievement comes from the fact that present day diagnostic pathologists utilising this scheme wonder what the arguments can have been about. Another measure of his success is that over nearly 30 years he was regularly the top cited scientist in Oxford and always in the leader table of UK scientists.

David continued to investigate avenues to improve classification and diagnosis with new reagents and techniques. A recent promising approach was the development of methods of highlighting underlying genetic lesions directly on a patient’s lymphoma samples. This was achieved in a very successful collaboration with his wife Teresa Marafioti who is an experienced haematopathologist in her own right.

14 / OXFORD MEDICINE . NOVEMBER 2008

JOHN MICHAEL NEWSOM-DAVIS

1932 – 20 0 7

1967-69 Lecturer, University Department of Clincial Neurology, National Hospital for Diseases of the Nervous System, 1970-80 Consultant Neurologist; 1969-70 Neurological Research Fellow, Cornell Medical Center, New York Hospital; 1980-87 MRC Clinical Research Professor of Neurology, Royal Free Hospital Medical School and Institute of Neurology; 1987-98 (Emeritus) Professor of Clinical Neurology, Oxford University; 1991 FRS; 1996 CBE; 1997-2004 editor, Brain.

R e s e a r c h a nd Ox f o r d In 1973 Ricardo Miledi in the Biophysics Department at UCL suggested that I, as the medic in the lab, should pick up the first muscle biopsies of patients with the autoimmune disease myasthenia gravis. John came with the highest recommendations from Tom Sears, so it was with some curiosity that I found my way to his rather cramped laboratory opposite the old RFH in the Grays Inn Road. John was hunched over his recording equipment, placing an electrode in a tiny piece of human muscle. He turned slowly round, smiled and said “Hi” in a way that combined friendliness and openness but with a hint of tease or questioning. The quizzical tone or glance was one that we learned to recognize and was most evident when he knew you were talking rubbish but was too polite to say so!

We met frequently after that and in 1977 I moved to the Royal Free to work with him. I remember how excited John was to be starting research into myasthenia – he seemed to know that it was going to be successful and he certainly had strong support from the Head of Neurological Sciences at the RFH, the late Prof PK Thomas, who was very welcoming – and extremely tolerant over the next ten years as the research group expanded. The early days were exhilarating.

With Alastair Compston and Richard Batchelor we stratified the MG patients into groups, and we helped Glennis Scadding (now Pearson) to show that the white blood cells from the thymus gland made the offending antibodies. It was while culturing these cells that I saw another side to John’s abilities. Generally speaking John’s movements were unhurried, and he admitted to being a little dyspraxic. In those days one had to clean the dissecting instruments with alcohol and we often flamed them through a Bunsen burner just to be sure that they were really sterile. One of us managed to set the alcohol on fire and it made an impressive blaze. I was then, and still am, amazed at the rapidity with which John found the appropriate fire extinguisher and put out the fire. Of course, we probably have his RAF training to thank for his speed and decisiveness and for saving the Department from an embarrassing incident!

Perhaps it was that incident that made John determined to recruit a real immunologist and Nick Willcox joined us in 1979, shortly after we had taken on Bethan Lang who like me was a biochemist. Things between the four of us went so well that John was awarded the first MRC Clinical Research Professorship and his first Programme Grant, providing the core support that was essential to keep the team together and allow new developments. And new discoveries did follow as John used his clinical acumen to recognize other autoimmune diseases, the Lambert Eaton myasthenic syndrome, seronegative myasthenia, and then later acquired neuromyotonia. We on our part did our best to keep up with the experiments required to investigate the immunopathology and mechanisms in these conditions, collaborating very fruitfully with Peter Molenaar in Holland, Dennis Wray at the RFH and Andrew Engel at the Mayo Clinic.

One of the early observations was that plasma exchange did not have any effect in those patients who developed the disease from birth or in early childhood. Further investigations convinced us that these patients had a genetic rather than autoimmune condition, and the fifth member of the team, David Beeson, joined to develop the genetic aspects of myasthenia. This project has been loyally supported by the Muscular Dystrophy Campaign ever since and is flourishing with collaborations with Clarke Slater in the UK, Yuji Yamanashi in Tokyo, and many neurologists worldwide.

Meanwhile John had been invited to become the next Action Research Professor of Neurology in Oxford and after ensuring that we would all come with him, he accepted the post. Martin Brydson joined us to coordinate the move. In fact, sixteen of our team moved from London, to become the first group in the newly created Institute of Molecular Medicine (now the Weatherall institute). Here we were able to enjoy daily coffee room chats with immunologists like John Bell, Alain Townsend and Andrew McMichael greatly enhancing our ability to apply molecular techniques to the immunology of our diseases.

But of course John’s life changed considerably at Oxford.

Until then he was the protected protégée of PK Thomas and the MRC, and could concentrate on his research.

But in Oxford, he was thrown into the situation of all university academics – juggling clinical leadership, clinical practice, research and fund-raising with teaching and administration; he also held a Professorial Fellowship at St Edmund’s Hall, “Teddy Hall”, where he helped to secure charitable funds and provided very perceptive and accurate assessments of potential medical students.

But as Berch Griggs, the President Elect of the American

OXFORD MEDICINE . OCTOBER 2008 / 15

Academy of Neurology has written “John had an amazing ability – unique in my experience – to master new areas and to quickly contribute to them”.

and cell biology in the neurological sciences. He was one of the absolutely central figures in linking clinical and basic biomedical research. “

The demands of University life meant that he had relatively few hours in the week which could be spent with us, but John clearly was at his most relaxed when in the lab and his time there was marked by notable habits. Firstly, shortly after arrival, the door to his office would close and after some clanking of wire hangers, John would emerge changed from his immaculate dark suit into navy blue cord jeans and a sweater – both clearly from Marks and Spencer, and subsequently replaced by the Lab one Christmas when even we thought they were becoming too threadbare.

Secondly, John would whistle – often choruses from oratorios or arias from operas. In fact, Nick Willcox recalls how in the early years when John still had time to work late into the night with him, the tunes would start adagio and become more allegro as they came closer to completion of the day’s experiment.

My colleagues and I have spent many hours since last August thinking about John and what was so special about him and how he achieved so much. Others talk about his energy, but in fact he seldom appeared to hurry, and managed to maintain a casual, almost sauntering style in all he did. We wonder at his extraordinary tolerance and ability to devote time to people at every level, making each of them feel that he was their friend and they were his equal. His enviable eloquence meant that he could defuse any situation, however tense. His work was always thorough, never sloppy or rushed – if it needed more time, he would find it – presumably by getting up an hour earlier.

His door was always open and we were often very demanding – little appreciating then the number of other demands on his time. The only time I can remember him drawing attention to – not complaining about – his work load was when, as Chair of the Board, the crate of MRC grant proposals to read through would arrive from Megan Davies at the MRC. And all of this was conducted in a most unpompous manner – not the typical neurologist! Nick puts this down to the good influence of his sisters, Rosemary and his children.

The lab work continued to be strongly supported by the MRC, the Muscular Dystrophy Campaign and increasingly by other charities such as Action Research, the Welton Trust and the Sir Jules Thorne Trust. At its height the group numbered about 35 scientists, including many foreign visitors, some of whom are here to day, and loyal administrative staff such as Jill Ratcliffe, Anne Taylor, and Mary Tinker. But that was not all. When John joined the department in 1987 there was already a strong tradition of clinical research from Charles Warlow and Bryan Matthews and he strengthened it further. His clinic became an MDC-supported myasthenia gravis centre, under the gentle but firm hand of Sister Eve Goodger who had followed him from Queen Square and continued to plasma exchange the patients until very recently. Kerry Mills was appointed as Reader in Neurophysiology, and Margaret Esiri was invited to move to the department as Reader in Neuropathology, both key people for the success of the clinical and academic work. He recruited Peter Rothwell as Clinical lecturer which enabled Peter to establish an internationally-renowned group in Stroke Prevention; and then in the mid 1990s John, with Alan Cowey and Sir George Radda, convinced the MRC to create a new Functional Imaging centre to complement the structural and spectroscopic imaging that George Radda had first developed in Oxford. They brought back Paul Matthews from Montreal to direct it, and the FMRIB as it is known, now directed by Prof Irene Tracey, has flourished. When John retired, the department overall had more than 70 researchers and existed on three different sites. Sir David Weatherall writes “What John achieved was to perpetuate and expand the very high standards in clinical neurology that had been established by his predecessor yet, at the same time, successfully establish and pursue the role of molecular

We are particularly impressed by the gracious way he managed his retirement. The easiest and most tempting thing would have been for him to continue to lead the research – but he made it quite clear in the early 1990s that he would hand over to the rest of us.

Throughout the next years he carefully nurtured external commitments both within and outside the University for himself, and strengthened our positions so that we were ready to take over. After his retirement, he was an extremely welcome guest at our weekly meetings but always took a back seat. In the clinical arena, however, he continued to see the patients, helping Jackie Palace and David Beeson to obtain DoH funding to support the genetic service and the related research, and gradually passing the autoimmune baton to David Hilton Jones and Camilla Buckley. As a result, he has not only left a major mark on Oxford’s clinical science but ensured that the group has stayed together and the work continues.

We were very lucky to have experienced for so long John’s particular blend of intelligence, enthusiasm, consideration and tolerance. I suspect that we don’t realize the full extent of his influence on us but nevertheless subconsciously try to emulate him in our daily lives. He was a truly remarkable person and it was a privilege to have been his colleague and friend.

Angela Vincent, Professor of Neuroimunology and Head of Department of Clinical Neurology, University of Oxford

16 / OXFORD MEDICINE . NOVEMBER 2008

M e n t o r a n d Cl i n i c i a n I have been asked to say a few words about John as a mentor and senior clinician under whose guidance I, and a whole generation of neurologists trained. He inspired, taught and mentored so many of us, in whose place I am honoured to speak here today.

I had the tremendous privilege of sitting in on his myasthenia clinics for three years as a research registrar and more recently of doing joint clinics with him as a fellow consultant. Quite simply, he was the best doctor I have ever worked with. His patients knew this: many of them followed him from London to Oxford and subsequently continued to come and see him in Oxford even after they had moved hundreds of miles away. His colleagues knew it. Several members of the clinical team, namely Laurie Loh, Kerry Mills and Eve Goodger came to Oxford with him, and the reason that so many neurologists agreed to take part in the forbiddingly ambitious and complex MGTX trial was because of the respect they had for John.

GMC booklets apart, it is difficult to put into words what makes a good doctor so I will mention a few of the characteristics in John that I think contributed.

First and foremost, he was kind and thoughtful, and took a genuine interest in patients and colleagues as individuals with a life outside the consulting room. I was always struck by how he remembered not only the pattern of a patient’s disease but also their jobs, families and significant life events. This allowed patients to relax and feel safe in the knowledge that treatment decisions were being made in the context of their life as a whole rather than simply on their disease in isolation.

In part this stemmed from his own pride in his family and his achievements outside of medicine. I can remember to this day sitting in the Thomas Rowney outpatients at the Radcliffe Infirmary with John taking a history when it emerged that the patient had flown in the RAF. There was some hesitation, before John, unable to hold back any longer, succumbed to temptation and admitted that he too had flown Meteors. There followed a lengthy and animated discussion which made me realise that he was at least as proud of his real-life Meteors as he was of his subsequent meteoric career as a scientist and a doctor.

John took particular care about his teaching, and great interest in his students, as I discovered to my embarrassment. As a clinical student, I failed to turn up to our first group teaching session with him as a 5th year medical student. Since there were 10 of us in the group, such an absence would usually go unnoticed, so I was surprised and taken aback when my a colleague phoned later that day to say it had

been noticed, and that John had asked for me by name. I subsequently learnt that he always asked for the names and photographs of each new cohort of students and memorised them so that he could fully involve everyone in his teaching sessions.

John had unflagging energy and capacity for hard work, and total dedication to the care of his patients.

I am sure Gary will remind us of the huge amount of time and effort John devoted to the thymectomy trial over the last 8 years. However despite this, and the fact that he was supposedly retired, he still regularly did his MG clinics with enthusiasm, identifying clinical features worthy of further research, and instituting the use of new treatments in patients with intractable disease.

As a mentor he was everything one could ask for, and more; a superb role model who led by example.

Despite his hectic schedule he always seemed to have time for his charges. He responded to emails promptly no matter where he was in the world or what time of day or night. He would make the time to discuss a clinical case, review a manuscript, or give career advice, and never made one feel rushed or as if it were an imposition on his valuable time. He only delegated tasks to people if he thought it would be useful for them, and if ever he involved one in something that turned out to be more time-consuming than he expected he was always apologetic and readily offered, and gave, assistance.

On his last day at work I recruited the first oxford patient to his beloved thymectomy trial. When I told him the patient had agreed to take part his face lit up with the comment “you have made my week”.

Later that evening I got a call at home from a slightly anxious-sounding John querying the patient’s drug dose. There followed a rustling of papers as he double checked the inclusion criteria, and relief in his voice as he confirmed that yes indeed the patient was eligible.

This was typical of John. He was thorough and careful, paying attention to detail. This attitude in the clinic contributed hugely to the success of the research as it meant that in the lab we could be sure that whatever came from John’s clinic was exactly what it said on the label. In this, as in so much else, he was an instinctive and natural clinician-scientist.

We have heard already about how successfully John mastered the very different worlds of clinical neurology and laboratory science. This is more than most can manage, but his true talent was that he could do this and remain such a warm, generous, humble and kind human being.

Camilla Buckley 31/03/2008 MRC Clinician Scientist, University of Oxford

OXFORD MEDICINE . OCTOBER 2008 / 17

ANTHONY STEADMAN (TIM) TILL

1909-20 0 6

Tim Till was a Consultant General Surgeon at the Radcliffe Infirmary from 1947 until his retirement in 1972.

He was born in London and educated at Marlborough and Gonville and Caius College, Cambridge, where he was scholar before going to the Middlesex Hospital as a University Scholar. His surgical training was at the Middlesex where he was registrar and private assistant to Sir Gordon Gordon Taylor (known to my generation as GT).

Tim enlisted in the RAMC. At the beginning of the war and was stationed in the Middle East before being taken prisoner on the island of Cos. He was flown to Athens and then put on a two week train journey to a Prisoner of war camp at Moosberg. Here he operated not only on fellow prisoners but also on the local population as, following a spell in Heidelberg before the war, he was fluent in German.

As always he kept immaculate and legible notes and, possibly as a thank you for this, he was repatriated in 1944 with a group of sick and wounded, his offer to exchange places with one of the wounded having been refused.

He returned to Germany in 1944 and was with the first Field Ambulance Unit to enter Belsen Concentration Camp. There were over 7000 prisoners in the camp, all starving, and 1000 dead. The prisoners could not be released as typhus was rife in the camp.

Tim (as the only man fluent in German) went to the villages begging blankets, etc.

Following demobilisation Tim came to Oxford where he was appointed Consultant General Surgeon. He specialised in surgery of the thyroid and was the leading authority in the country being elected President of the Section of Surgery of the Royal Society of Medicine and President of the Association of Surgeons of Great Britain and Ireland. He was also on the Court of Examiners of the RCS. He and Joan greatly enjoyed their visits, home and abroad, with the Surgical Travellers.

Outside medicine he was a man of many talents. He rode to hounds with the Heythrop Hunt and when over 80 finally gave up his horse for a bike as he liked to ride out each morning! He was also District Commissioner of the Pony Club for many years. He was an excellent artist in watercolours, a keen fly fisherman, a magistrate and played a role in St Johns Ambulance as well as having a keen interest in military history especially the medical branch.

He was married to Joan for over 60 years and in their retirement in Holwell were generous hosts not only to their family (four daughters, 10 grandchildren and 12 great grandchildren) but also to their numerous friends.

Tim died peacefully a week before his 97th birthday.

Joe Smith

Lives remembered • Norman M Bleehan, Exeter College, m. 1947 d.1 Feb. 2008 Oncology Addenbrookes Hospital A full obituary will follow.

• Geoffrey Bennett, St Edmund Hall, m 1944 d.5 May, 2008 Chief Medical Officer to the Civil Aviation Authority and involved in the process of delegation of examinations which resulted in the establishment of the Aviation Medical Examiners network.

• Thomas JD Cochrane, St Catherine’s College, m 1947 d.7 April 2008 • Derek ML Doran, Pembroke College, m 1933 d.

23 February 2008 One of the first doctors to work for the newly formed NHS, he rose to become a

pioneer in the field of physical medicine and rheumatology. He was later a founder member of the British Association of Physiotherapists. A keen sportsman, he was one of the oldest surviving captains of the Oxford University Boxing Club and won numerous sporting accolades during his student days.

• David W Dove, Trinity College, m.1950 d.11 Dec.2007 • Charles G Elliott, Worcester College, m 1940 d 13 June 2008 Educated at Charterhouse and studied at Worcester College in Oxford, awarded soccer Blue, joined the Royal Army Medical Corps, ran a single-handed general practice for 28 years.

18 / OXFORD MEDICINE . NOVEMBER 2008

• James H Fairley, m 1953 d. 11 May 2008. After two years working in general practice in Corrawa, New South Wales, Australia.

Returning to the United Kingdom, and joined a practice in Caversham, where he spent the rest of his professional life.

• Graham C Fisk, Oriel College, m 1945 d.7 June 2008 Anaesthestist, following BM BCh and MA at Oxford during which time he rowed in the Coxed Four for Great Britain at the 1952 Helsinki Sumer Games, he returned to Australia where he spec aliased in paediatric anaesthesia eventually appointed Director of Paediatric Anaesthesia at Prince of Wales Hospital in Sydney.

• Anthony NT Fletcher, New College, m 1939 d. 19 May 2008 • Frederick J Flint, St Johns College, m 1939 d 24 May 2008. Former consultant physician Northern General Hospital, Sheffield

professional life, becoming reader in physiological biochemistry and fellow and medical/biochemistry tutor at Merton College. His major research contributions were in intestinal absorption, his studies with R B Fischer in the early 1950s paving the way to understanding the cellular basis of active transport of sugars, work which formed the scientific basis for oral rehydration therapy.

• Ronald CA Pearson, Trinity College, m 1971 d. 8 July 2008 Neuroscientist who made a significant contribution to the study of Alzheimer’s disease. Senior lecturer at St Mary’s Hospital Medical School, Professor of Neuroscience at Sheffield Univeristy, later appointed Chair of Neuroscience in Sheffield. Abandoned this role to spend a year teaching undergraduates in Tanzania, then returned to the UK to become a GP working in Sunderland and Newcastle upon Tyne.

• George J Rushton, University College, m1952 d. 28 August 2008

• Marianne E Harling, d. 19 May 2008 A life long advocate of homeopathic medicine and one of the founders of the Wessex Healthy Living Foundation.

• Geoffrey J Russell, Lincoln College, m 1957 d. 12 July 2008 • Margaret N Samson, Somerville College, m 1949 d. 8 July 2008

• Michael E. Harper, Brasenose College m. 1963 d. May 2007 Studied sociology at the London School of Economics in 1956, and realising he had chosen the wrong course left and whilst working as a porter in the Princess Margaret Hospital attended night school to obtain the A levels to train in medicine. Michael retired after 25 years as a general practitioner in Cotham. After retirement graduated with a Masters degree in epidemiology in 2000. He worked in Togo, Ecuador, and the Gambia, where he was instrumental in creating a tuberculosis clinic.

• Quentin JG Hobson, New College, m.1936 d.2008 Endocrinologist, West Middlesex Hospital.

• Philip A King-Lewis, New College, 9 August 2008 Haematologist, St George’s Hospital • Janet M Marks, Lady Margret Hall, m.1946 d. 20 April 2008.

Dermatologist, who discovered coeliac syndrome of dermatitis herpetiformis, received both Parkes-Weber and Archibald Gray medals. Established the Newcastle Psoriasis Treatment Unit.

• Brian McConkey, Hertford College, m.1940 d. 30.01.08 Rheumatologist, Dudley Road Hospital, Birmingham.

• H Christian Nohl-Oser, St Peter’s College, m. 1937 d.13 June 2008 Consultant Chest Physician, Harefield Hospital.

• Ayub K Ommaya, Balliol College, m. 1954 d. 10 July 2008 Rhodes Scholar. Retired Head of neurosurgery at the National Institute of Neurological Disorders and Stroke and professor of neurosurgery at George Washington University. Inventor of the Ommaya reservoir and developer of the centripetal theory of traumatic brain injury.

• Henry H Schmidek, m. Sept. 2008 d. 26 Oct. 2008. Lecturer in neurosurgery, Visiting Fellow, Balliol College. Authored and edited five editions of "Schmidek and Sweet's Operative Neurosurgical Techniques", currently the most widely used text in neurosurgery throughout the world.

• George M Ross Smith, Christchurch College, m 1957 d. August 2008 Consultant Orthopaedic Surgeon, Scarborough. George Smith joined the small 1958 Oxford clinical school intake, coming from one of the London medical schools. He worked very hard and was the epitome of the "dour" Scot, though his upright figure and almost military carriage marked him out, as did his impeccable clinical knowledge, and the fact that he invariably ‘got the answers right’ when it was his turn to present a case on formal ward rounds. The only time he was known to lose his composure slightly (who wouldn't?) was when subjected to some good-humoured rigging by Harold Ellis on one of his surgical rounds.

Irene Bainbridge • David Staig, Trinity College, m. 1940 d. 1 July 2008. Former ophthalmologist Royal Berkshire Hospital, Reading.

• Robert Alexander Harrison Surtees, St Edmund Hall, m. 1974 d. 18 August 2007 Professor of paediatric neurology and honorary consultant, Head of Neurosciences Unit UCL • Sheila Tangye, St Hildas College, m. 1936 d Sept 2007 Researched into development of the BCG vaccine • William H Taylor, Christ Church College, m. 1942 d. 23 February 2008 • Geoffrey W Thompson, Worcester College, m. 1952 d. 13 Sept 2008

• Susan E Openshaw, Somerville College, m 1943 d. 17 January 2008 General Practitioner

• Peter R Wright, The Queens College, m. 1937 d. 10 February 2008

• Dennis S Parsons, Merton College, m 1944 d. 28 July 2008.

Distinguished physiologist who worked in Oxford throughout his

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