Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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So much for not speaking ill of the dead!
- Ellen Goudsmit (18 April 2003)
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Obituary of David Horrobin
- John R Kemm (18 April 2003)
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The Horrobin Phenomenon
- Joseph .C. Obi (18 April 2003)
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Why a negative obituary is the ultimate tribute
- Richard Smith (18 April 2003)
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Not a suitable obituary
- Dr Charles Bernard Shepherd (18 April 2003)
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Re: Why a negative obituary is the ultimate tribute
- Serena Jones (19 April 2003)
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Disgraceful obituitary to a great man
- Ewan D Millar (19 April 2003)
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David Horrobin Obituary
- Colin DR Borland (19 April 2003)
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David Horrobin obituary
- Jamie Cunliffe (19 April 2003)
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graceless and unkind
- John Hopkins (19 April 2003)
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Ill-informed venom
- Peter G W Lapinskas (19 April 2003)
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Re: Why a negative obituary is the ultimate tribute
- Ellen Goudsmit (19 April 2003)
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Other David Horrobin obituaries
- Jamie Cunliffe (19 April 2003)
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David Horrobin, Obituary
- Barry E Monk (19 April 2003)
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David Horrobin, Semmelweis and an Aesop's fable
- Dr Agnes K Ayton (20 April 2003)
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An interesting life. And... years before ...?
- Adrian K Midgley (20 April 2003)
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Fair's fair
- David Carvel (20 April 2003)
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Dead ringers
- Harvey Marcovitch (20 April 2003)
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Spin
- David R Davies (20 April 2003)
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Was it necessary?
- David Roberts (20 April 2003)
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Re: Why a negative obituary is the ultimate tribute
- Dr Charles Shepherd (20 April 2003)
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David Horrobin obituary
- John A. Dodge (21 April 2003)
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Re: Was it necessary?
- David Roberts (21 April 2003)
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Snake oil, COX-2 inhibition, and Dr. Horrobin
- Eddie Vos (22 April 2003)
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A tribute to Dr. David Horrobin
- A. Chaudhuri (22 April 2003)
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Horrobin obituary reveals more of the writer than the deceased
- Ahmed N. Ghanem (22 April 2003)
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Re: Ill-informed venom
- Leslie O. Simpson (22 April 2003)
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David: Maverick, Yes; Rogue, Perhaps?
- Denys N Wheatley (22 April 2003)
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BMJ vitriol is journalistic sensationalism
- Erling Refsum (22 April 2003)
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Let's make all the BMJ obituaries vituperative vindictive vendettas
- Jeremy G Jones (22 April 2003)
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David Horrobin Obituary: further thoughts
- Dr Agnes K Ayton (22 April 2003)
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Evidence based Obituaries?
- Eamonn J Clarke (22 April 2003)
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David Horrobin Obituary
- Peter J Horrobin (22 April 2003)
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At Least He Publicly Challenged Racism...
- Joseph .C. Obi (22 April 2003)
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In Defence Of Editorial Freedom
- Rob Poole (23 April 2003)
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Poor editorial judgement
- William Carey (23 April 2003)
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Time to change
- David Seddon (23 April 2003)
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A hornet's nest!
- Jamie Cunliffe (23 April 2003)
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Caroline Richmond and obituaries don't go together.
- Amanda Sherlock James (23 April 2003)
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Who needs the snake oil?
- Adam Kelliher (23 April 2003)
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Offensive obituaries
- Peter Gooderham (23 April 2003)
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This obituary refers to?
- Philip A Johnson (23 April 2003)
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Shame on you, BMJ
- Janine Hunter (24 April 2003)
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David Horrobin
- Eileen A. Soosai (24 April 2003)
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Corrected Obituary for Dr. Horrobin
- Dr. Patricia C. Kane (24 April 2003)
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Snake oil is good for you?
- Liam Farrell (24 April 2003)
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Re: In Defence Of Editorial Freedom
- Michael D Innis (24 April 2003)
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Re: Why a negative obituary is the ultimate tribute: A simple solution?
- Rudolph A Riemersma (24 April 2003)
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Caroline Richmond’s obituary of my husband
- Sherri Clarkson (24 April 2003)
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Reason for negativity
- Charles Stewart (25 April 2003)
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Further Proof of How Medical Journals Stunt Creative Research
- A. Wes Siegner, Jr. (25 April 2003)
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Alternative obituary for David Horrobin
- John A. Dodge (25 April 2003)
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The right of reply
- John Hopkins (25 April 2003)
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Set the record straight.
- Paul K Stockman (25 April 2003)
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Re: Re: In Defence Of Editorial Freedom
- Serena Jones (25 April 2003)
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In response to David Horrobin's Obituary
- Susan McGoldrick (25 April 2003)
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Re: Caroline Richmond’s obituary of my husband
- janet whittington (25 April 2003)
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The Richmond Vendetta
- Woody R McGinnis M.D. (25 April 2003)
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THE ENRICHED AND THE IMPOVERISHED
- Peter Fitt (26 April 2003)
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In defence of my father
- Cathra Horrobin (26 April 2003)
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Did the editor have a conflict of interest?
- Richard G Fiddian-Green (28 April 2003)
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Vendetta
- Melvyn H Brooks (28 April 2003)
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BMJ has finally lost the plot
- L Hughes-davies (28 April 2003)
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Re: BMJ has finally lost the plot
- Alastair C. A. Glen (29 April 2003)
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An unfortunate obituary
- Nigel P Willis, Nigel Willis (29 April 2003)
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David Horrobin's Obituary
- Amanda Green (29 April 2003)
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BMJ or Sunday Sport?
- Dr Michael John Atkins (29 April 2003)
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Obituary of David F Horrobin - originally submitted to BMJ on 15 April 2003
- Bruce G Charlton (30 April 2003)
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Academic chairman: asset or liability?
- Richard G Fiddian-Green (30 April 2003)
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Press Complaints Commission
- Luke Hughes-Davies (30 April 2003)
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Response to Dr Horrobin obituary
- Catherine C Aitken (30 April 2003)
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David Horrobin Obituary
- robert b zurier (30 April 2003)
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29 points about the obituary
- Adam Kelliher (1 May 2003)
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David Horrobin Obituary Br.Med J 2003;326:885
- Rivita M. Rodrigues (1 May 2003)
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What is the intent?
- Zachary Dutton (1 May 2003)
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David as I knew him
- Håvard Bentsen (1 May 2003)
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David Horrobin obituary
- Victoria S.E. Macdonald (3 May 2003)
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Remembering David Horrobin in Nova Scotia
- Paul S MacDougall (3 May 2003)
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David Horrobin
- Geoffrey A Machin (3 May 2003)
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Is this a covert apology?
- Agnes K Ayton (3 May 2003)
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Author's reply
- Caroline Richmond (3 May 2003)
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Re: Author's reply
- Stephanie Boyd (4 May 2003)
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Put away childish things
- John Hopkins (4 May 2003)
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David Horrobin's obituary
- David Walliker (4 May 2003)
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Dr. Horrobin – why was the innovative maligned?
- John H. Lange (4 May 2003)
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Re: Author's reply
- Peter G W Lapinskas (4 May 2003)
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Re: Author's reply
- Robert B Zurier (4 May 2003)
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Author's response
- Jamie Cunliffe (5 May 2003)
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Does anyone else agree?
- Jamie Cunliffe (5 May 2003)
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Lay of Horobin
- Bo Norberg, SE-901 85 Umeå, Sweden (5 May 2003)
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Insults and Injuries
- Nancy L Morse (5 May 2003)
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BMJ response to protests over the obituary of David Horrobin
- Richard Smith (5 May 2003)
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Reflections on the function of obituaries
- Richard Smith (5 May 2003)
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Oh! Bitchery!
- Dianne C LeFevre (5 May 2003)
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Re: Reflections on the function of obituaries
- noemi levine (6 May 2003)
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Re: BMJ response to protests over the obituary of David Horrobin
- eamonn clarke (6 May 2003)
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Re: Author's reply
- Peter G W Lapinskas (6 May 2003)
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"But where is the bounday between a fact and an opinion?"
- Jamie Cunliffe (6 May 2003)
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Re: Reflections on the function of obituaries
- Ellen Goudsmit (7 May 2003)
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Campaign Against Health Fraud
- Ewan D Millar (7 May 2003)
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David Horrobin - Recollections by a Former Student
- Stephen C. Cunnane (7 May 2003)
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Re: "But where is the bounday between a fact and an opinion?"
- Jamie Cunliffe (7 May 2003)
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Press Commission Complaint
- Anthony W. Fox (7 May 2003)
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David Horrobin
- Sebastian Faulks (7 May 2003)
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Re: Author's reply
- Eddie Vos (7 May 2003)
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Why a free-for-all editorial policy is an abdication of responsibility
- Christopher Somes-Charlton (7 May 2003)
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Typical Smithness!
- David Curtis (7 May 2003)
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Trivial story about Evening Primrose Oil
- H Anne Leaver (8 May 2003)
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A teacher, a friend
- Alessandra Bordoni (9 May 2003)
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Re: David Horrobin obituary
- Morris Karmazyn (9 May 2003)
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Things are improving around here (a bit)
- Geoffrey A Machin (9 May 2003)
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Re: Reflections on the function of obituaries
- David Roberts (9 May 2003)
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David's obituary.
- LINDA FORSYTH (NEE FISHER) (9 May 2003)
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David Horrobin's Obituary
- Keith R. Farwell (9 May 2003)
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A memory from Italy
- Silvana Hrelia (10 May 2003)
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A teacher, Professor, Colleague and a Friend
- Mehar S Manku (10 May 2003)
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Editorial comments
- Iain TR Kennedy (11 May 2003)
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re DAVID HORROBIN Obituary 19 April 2003
- Gillian M Craig, P Colme Malone (11 May 2003)
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David Horrobin
- Paul R Martin (12 May 2003)
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Dr David Horrobin
- Gwynneth P Hemmings (12 May 2003)
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deliberate provocation
- Bob Bury (13 May 2003)
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The best obituary possible?
- Malcolm E Kendrick (14 May 2003)
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More Caroline Richmond
- Vance A Spence (14 May 2003)
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Re BMJ Response to Protests over the Obituary of David Horrobin
- Charles Stewart (14 May 2003)
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Shame on you, Richard Smith
- paul walker (16 May 2003)
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That Times article ...
- Caroline Richmond (17 May 2003)
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Thank you Dr. Horrobin, you will be greatly missed
- Gary R. Lynch, na (18 May 2003)
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Good journal, sickening obituary
- Grace Marshall (19 May 2003)
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Richard Smith must apologise
- Kevin Perrett (23 May 2003)
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Was the Jamal case relevant?
- Agnes K Ayton (30 May 2003)
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Bibliography of David Horrobin's work
- Peter Lapinskas (10 July 2003)
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David Horrobin
- Mike E Robbins (22 July 2003)
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Just a Reader of Redflag
- Fern Baumgartner (27 July 2003)
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Re: Typical Smithness!
- Gordon B Drummond (15 August 2003)
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It was an honour to meet you David
- Linda Whitaker (Jones) (8 March 2004)
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The last word (I hope)
- Caroline Richmond (2 August 2004)
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The need for evening primrose oil.
- Ellen C G Grant (3 August 2004)
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Re: The last word (I hope) -- Oops she did it again
- Eddie Vos (3 August 2004)
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The last word ? We can only all hope!
- Dr. Herbert H. Nehrlich (3 August 2004)
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Ellen Goudsmit, Chartered Health Psychologist London TW11 9QX
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I do hope that I outlive Ms Richmond! In the late eighties, I headed a small medical charity. We needed a photocopier, so I wrote off to various companies, including the forerunner of Scotia. Within days of writing, one of Dr. Horrobin's assistants was on the phone. I could have any photocopier I wanted; they'd foot the bill. And they did! They demanded nothing in return. And the copier still works! Most of us have a less attractive side. The point is, is an obituary the appropriate place to throw brickbats? So he tried to sell a product which wasn't a major breakthrough. He might even have accentuated the positive a little. Shock! Horror! I don't think that his activities will stand out in the annals of the modern drugs industry. And he did not mistreat and abuse his patients! David, rest in peace. And thank you for helping a small charity, when no one else would. Ellen Competing interests: Director of a charity helped by Dr. Horrobin. |
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John R Kemm, Consultant in public health medicine Birmingham
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Editor I am sad that you chose to publish an obituary of David Horrobin that could only be described as bitchy. I did not know David well but briefly worked in the same department as him in Newcastle. His most obvious characteristics were kindness and consideration to junior staff and an outstanding brain. I regret that Caroline Richmond feels such bitterness.I do not know if her snide remarks have any foundation. I do know that it was very ill judged to ask anyone who feels as she did to write an obituary and even more foolish of you to publish it. As doctors I hope we are compassionate and good mannered. This obituary did not display either quality. Yours truly, Competing interests: None declared |
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Joseph .C. Obi, Chief Consultant WellnessClinics.co.uk
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Professor Horrobin was indeed an exceptionally great man ... warm ... kind ... honest ... thoughtful ... generous... decent ... witty and diplomatic. As a medically qualified businessman , one has to often take countless risks ... and one's decisions may not indeed go down exceedingly well with the majority of people; especially those within the traditional clinical establishment (Most of whom may actually even be many times more fraudulent than one is ... verdicts on 'Serious Professional Misconduct' inclusive). What I liked most about David Horrobin was the fact that he regularly knew exactly what he wanted...and didn't care less whether he found it in either Persia or Hebrides. His absolutely charming ability to irrepressibly 'rise above' almost every single cataclysmic setback shall eternally endure him to fellow mavericks like me. May he gracefully continue to successfully market his Essential Fatty Acids from the heavens above... PS*:I am quite sure that he has probably almost nearly convinced those ageless seraphs (up there) to start taking EFA supplements too. Competing interests: Dr Joseph .C. Obi MBBS MD MPH DSc FRIPH has formally requested that the Charity Commission fully investigate the GMC's spending ethics. |
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Richard Smith, Editor BMJ
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Obituaries in medical journals are usually a great disappointment because they describe only the positive side of the dead person. As such, they are unbelievable, incomplete, and dull. Real people, including real doctors, have a dark side as well as a light side-and this is often what makes them interesting. If you want to understand somebody you must understand the good and the bad. The two are often closely linked: our strengths are also our weaknesses. A novel that included only good people doing virtuous things would be assumed to be a parody-and would almost certainly be unreadable. Unfortunately medical journals have fallen into the trap of publishing only positive obituaries. You may never meet a living doctor who is a saint, but they all are by the time they reach the obituary pages, where they lie forever garlanded by cliches. "Loved by all his patients... this natural teacher... a man of unequalled kindness... a first class diagnostician... the funniest after dinner speaker in the West Midlands... a lover of fine wines... a true scholar, widely admired for his knowledge of Plato... sought out by everybody as he walked tall down Chislehurst High Street... we will not see his like again." The national newspapers have been much more successful than medical journals at giving all round pictures of the dead. I find it odd that doctors, who encounter death constantly, should be so squeamish about anything negative in obituaries. Perhaps it's true that people become doctors because they can't cope with death. But the main reason that newspapers publish better obituaries may be simply because they publish obituaries of the famous, or at least the more famous. It's easy to be negative about Winston Churchill or John Lennon because nobody questions the magnitude of their achievement. I'm reading Roy Jenkins's biography of Churchill, and he makes clear that Churchill's faults of rodomontade (a great word that means "extravagant boasting"), recklessness, self- publicity, and pushiness were all important parts of a great man. I've long been keen to try and break the deadening mould of medical obituaries, but it isn't easy. The obvious place to start is with high achievers, and so it is a tribute to have negative things said about you in an obituary. We did it with Sheila Sherlock and now with David Horrobin. The obituary does point out that he was charming, intelligent, straightforward, handsome, well read, effortlessly prolific, and had thousands of friends and followers. Isn't that enough that's positive? Richard Smith, Editor, BMJ Competing interests: I'm the editor of the journal and accountable for all it contains. |
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Dr Charles Bernard Shepherd, private practitioner Friars Cottage Surgery, Queens Square, Chalford Hill, Gloucestershire GL6 8EH
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Editor I was astonished to read some of the extremely offensive remarks - eg '..David Horrobin, Scotia's former chief executive, may prove to be the greatest snake oil salesman of his age' - in the obituary that was written by Caroline Richmond. And I would therefore question the ethical policy of the British Medical Journal in agreeing to publish this obituary if it had not met with the approval of David Horrobin's family. The therapeutic potential of evening primrose oil certainly has many questions hanging over it, as do the results of some of the clinical trials that have been published, but I do not believe that Caroline Richmond's comments and conclusions are an appropriate epitaph for a physician who was so keen to question conventional medical thinking on the cause and treatment of a wide range of illnesses. Yes, David Horrobin was a charming and intelligent physician. He was also very generous man, and I will declare a personal interest in that he helped to fund a trip abroad to allow me to speak at a medical meeting - even though he hardly knew me at the time. I cannot recall ever reading an obituary in this style in the British Medical Journal before. I do not wish to do so again. Yours sincerely Charles Shepherd Competing interests: As mentioned in my letter |
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Serena Jones, housewife London
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In his response to the criticisms of David Horrobin's obituary, Richard Smith writes: "I find it odd that doctors, who encounter death constantly, should be so squeamish about anything negative in obituaries." I don't think that the critics were squeamish; I think they were just pointing out that certain comments were unfair and undeserved. If negativity is the 'ultimate tribute?' will I be permitted to point out in miss Richmond's obituary that she could be very subjective and downright hostile, not to say biased and prejudiced. Somehow I don't think so. I think we should try to be fair. The obituary of Dr Horrobin was not. PS. This is the BMJ, Dr Smith. If we want the dirt on people, we'll read the Sun! Competing interests: None declared |
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Ewan D Millar, Pharmaceutical Physician 48 Kettilstoun Mains,Linlithgow,West Lothian,EH49 6SL
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Sir, Having read the obituiary of David Horrobin written by Caroline Richmond I was appalled at her venomous comments on a great and decent human being who was an incredibly gifted doctor and academic. Having worked with David for a number of years I can testify to his brilliance and the reference to snake oil medicine is an absolute disgrace. Evening primrose oil as a pharmaceutical did indeed work as witnessed by the comment that the Medicines Control Agency stated when they withdrew the license in the UK that patients could obtain it over the counter in pharmacies etc. The world opinion leader in the field of treatment of mastalgia certainly does not agree with its lack of efficacy and indeed has been one of its main advocates. I would not have expected that a journal such as the BMJ could sanction an obituiary from a non medically qualified individual who clearly had an axe to grind. May I point your readers to the obitiuaries published in the Scotsman and the Times which give a far clearer overview of David's accomplishments. It may interest Richmond to know that the clinical trials that Laxdale are currently conducting in Huntingtons disease are showing excellent promise if she would care to look at current press releases relating to FDA opinion. Regards Dr Ewan D Millar 48 Kettilstoun Mains Linlithgow West Lothian emillar@doctors.org.uk Competing interests: Previously medical director at Scotia Pharmaceuticals. I do not give details of my current employers out of confidentiality.This is a personal e-mail independent of my current employers |
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Colin DR Borland, Consultant Physician Hinchingbrooke Hospital Huntingdon Cambs PE28 4TW
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Sadly the evening primrose oil imbroglio has obscured what to those taking 2nd MB around 1970 may be David Horrobin's most lasting legacy; his textbook Medical Physiology and Biochemistry.Published in 1968,a paperback volume containing all the physiology and biochemistry a medical student needed to know for just 40 shillings was bound to be popular.His iconoclastic style and model exam answers help preserve sanity while revising.There are other little gems however which have made this textbook the best thumbed volume on my bookshelf: the statistics chapter contains a brilliant paragraph on the statistics of small numbers and the Poisson distribution which those comparing colleagues' complication rates or doctors faced with possible new infections would be well advised to read. As a newly appointed Clinical Manager I was confronted by the nurses and manager of a medical ward who were overwhelmed by the needs of three young adults diagnosed with acute haematological dosorders in the space of a few months.A quick look at Horrobin's textbook, together with knowledge of the incidence and survival of adult leukaemia helped me give reassurance that a similar crisis would only happen once in ten years at the most.It seems sadly ironic that just such an illness led to Professor Horrobin's premature death. Competing interests: Medical Physiology and Biochemistry DF Horrobin 1968 Arnold was essential in my passing 2nd MB |
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Jamie Cunliffe, Retired from medical practice SO45 4PB
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I took particular interest in this obituary as I had been notified by David’s secretary, a short time earlier, of his death. As editor of Medical Hypotheses it was he that was, at least partly, responsible for publishing three of my papers. These three MH articles take a very different and heretic view of the “immune system” and time seems to be vindicating many of the deductions made in them. Along the way, in formulating these ideas, I have come to realise that much that is written in an absolute fashion, and that admits of no other possible explanation or opinion, needs to be looked at sideways. It is not that the opinion is necessarily wrong but that there is usually some obscuring emotional/animal veneer that is distorting the writing. I would, therefore, advocate a distrust of all absolute or highly polarised opinion and recommend a side step into exploring what it is about the writer that has led them to adopt this absolute/polarised approach. In other words, look for the reasons behind the message rather than listen to the message; it may eventually prove right but you cannot yet trust it. I did not know enough of David Horrobin to make a valued judgement of his character but an article (let alone an obituary) that focuses so strongly on his failings seems very polarised and absolute. These include: his being a “snake oil salesman”; implied unprofessionalism in installing his wife in a key position; many of his arguments and many of his “facts” being typically debatable of wrong; his dubious research ethics; his many enemies who described him as a “rotter”; his cavalier (implied) use of depressed areas to tap into development funds. These are polarised views indeed and should it prove that there is a universal agreement that he is “guilty as charged” then I will have to question my generally favourable opinion about both his professionalism and insight. Three things worry me though. Other BMJ obituaries talk in soft terms of a “Graham” or of a “David” and etcetera but here it was a stark “Horrobin”. Second, even this author admits to having been seduced by his charm at one moment in her life. And last, was this obituary published in this vein with full editorial knowledge or has it slipped through the net without being viewed critically? I would dearly like to know if this is a deserved epitaph or just another absolute opinion to distrust – where we should ignore the words before we seek out the author’s motivation for writing them. Perhaps others who knew him can enlighten us. Finally, I make one request of the BMJ. When (and if) I get my obituary, please don’t show it to my family should it be written in a similar vein. Competing interests: I have three papers published in Medical Hypotheses (DH was the main editor) |
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John Hopkins, GP Stockton on Tees
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Dear Dr Smith, There is all the difference in the world between an honest obituary and a spiteful one. This article which, under any other circumstances would be defamatory, says far more about Caroline Richmond than it does about David Horrobin. Yours sincerely, John Hopkins Competing interests: None declared |
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Peter G W Lapinskas, Independent consultant 26 Deepdene Wood, Dorking, Surrey, RH5 4BQ, UK
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Richard Smith (BMJ editor) justifies publishing the piece which passed for David Horrobin's obituary, on the grounds that negative as well as positive aspects of character should be included. That is a fair point, but the comment should at least be well informed. Horrobin's life work was on essential fatty acids, their metabolism, and potential use as therapeutic agents. It would seem reasonable therefore to choose a writer for his obituary who had at least some understanding of the subject. Richmond however, confuses linoleic acid (18:2 n-6) with gamma-linolenic acid (18:3 n-6) which is about as basic an error as it is possible to make. She also suggests that Horrobin chose the evening primrose plant (Oenothera spp.) as his source of raw material because it looks attractive and has a nice name. Can this be serious? It was chosen because it was the best available source of GLA known at the time; to base a commercial pharmaceutical research programme on any other criteria would be bizarre. Richmond states that Horrobin published 800 papers 'many, it must be said, in his own journals'. I am preparing a bibliography of his work and, of the 835 references I have accumulated so far, there are 39 from Medical Hypotheses and 34 from Prostaglandins, Leukotrienes and Essential Fatty Acids. The balance of 762 references were therefore by definition published elsewhere, the overwhelming majority in peer-reviewed journals. He was also, in addition, the named inventor on 87 patents. Taken as whole, this is equivalent of publishing a paper, letter, book or patent every 15.4 days for 39 years. This was not 'effortless' - Horrobin was one of the hardest working individuals I have ever met. Is this not a remarkable record of a productive life? Others have dwelt on the venomous nature of the obituary, so I will only note that the man I worked with closely for 15 years is unrecognisable from the description given. What is of interest however is why the author wrote in such negative terms. Perhaps it is significant that Ms. Richmond felt it necessary to mention that Horrobin relocated the company where she worked all those years ago, that he didn't recognise her later, and that this 'handsome, charming, straightforward and intelligent' man who sought her out and bought her dinner was only interested in talking to her about fatty acids. Hell hath no fury....! Competing interests: Previously Seed Production Director at Scotia Pharmaceuticals. |
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Ellen Goudsmit, Health Psychologist London TW11 9QX
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Having read Dr Smith's defence of Dr Horrobin's obituary, two thoughts occurred to me. 1. Surely the issue here is not negativity but the fact that some comments were probably unfair and undeserved. Indeed, one or two could be construed as defamatory. The law permits us to libel the dead but we are supposed to be learned and wise men and women. May I suggest that most of us do not wish to read defamatory comments about the deceased? In a sense, this is also about value judgements. I consider rudeness and writing inaccurate reports as major failings but I'm not bothered if someone gives his wife a job. So who will decide which flaws are to be included and which are not? What Miss Richmond offered us were not so much facts as personal opinions and insinuations. If you are going to put the boot in someone, let us at least stick to facts. Personally, I think we should discuss someone's failings while they are still alive and able to defend themselves. The only justification for revealing someone's inadequacies after death is where people were engaged in illegal, immoral or unprofessional activities which were not generally known during their lifetime, and as a result of which they enjoyed a reputation which they did not deserve. In such cases, knowledge of those activities after death would give people a more accurate view. And I think the revelations should be in the public interest. (Knowing a doctor had affairs probably isn't). 2. If the editor wants to jazz things up so the BMJ is more like the newspapers, why doesn't he introduce a page three lovely? We can study their bone structure and musculature over our cups of coffee. Ellen Goudsmit PS. Those who want to know more about Dr Horrobin should read the obit in the Lancet this week. Competing interests: Worked for a charity which received a grant from Dr Horrobin and heard him speak at a conference. |
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Jamie Cunliffe, Retired from medical practice SO45 4PB
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Here are the web addresses of a three more DH obituaries. The independant ran a much softened version of Caroline Richmond's obituary (though I strongly suspect that there are similar jibes in this though they are much more veiled). http://news.independent.co.uk/people/obituaries/ story.jsp?story=397891 http://news.scotsman.com/index.cfm?id=414342003 (in particular see the third and second to last paragraphs) http://www.thelancet.com/journal/vol361/iss9366 /full/llan.361.9366.editorial_and_review.25368.1 Competing interests: I have articles publishe in Medical Hypotheses |
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Barry E Monk, Consultant Dermatologist Manor Hospital, Biddenham, Bedford MK40 4AW
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Richard Smith accuses medical obituarists of producing anodyn obituaries, which he himself publishes week in week out. Then out of the blue he allows the publication of an obituary which is pure vitriolic character assasination, and allowed considerably greater length than the normal BMJ obit. Evening primrose oil doesn`t work, and was over-promoted; but so have many other treatments of modest efficacy, and their proponents were never posthumously pilloried in this disgraceful way. If Smith has evidence that Horrobin was af raud or a crook, he should publish it; otyerwise he should apologize Competing interests: None declared |
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Dr Agnes K Ayton, Consultant Child and Adolescent Psychiatrist 2062-68 Hessle Rd, Hessle, Hull, East Yorkshire, HU13 9NW
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When I learnt that David Horrobin had died in hospital from pneumonia, which had not responded to antibiotics, Ignacz Semmelweis came to my mind. A nineteenth-century Hungarian doctor, he was the first to recognise that poor hospital hygiene was responsible for many deaths1. Would David Horrobin have lived longer in a different environment? He had been responding to treatment until the infection struck. A few months ago, I lost a friend suffering from bowel cancer under similar circumstances. Following a 'successful operation', she died for the same reason: hospital infection. I wonder whether Semmelweis's message is still relevant today. After 150 years, how many health professionals move from one patient to the next, without washing their hands and using the same instruments? How many premature deaths still occur in hospitals as a consequence? Caroline Richmond's spiteful obituary2, makes the parallel between Horrobin and Semmelweis even more poignant. Semmelweis was also ridiculed by his contemporaries for his 'unorthodox' ideas. How could a respectable scientist believe that it was a matter of life and death whether doctors washed their hands? The establishment regarded him as at best, an eccentric, or at worst, a charlatan. Like Semmelweis's contemporaries, Caroline Richmond was confident in her own infinite wisdom to dismiss David Horrobin as 'the greatest snake oil salesman of his age'. Her bravery is similar to that of Aesop's ass who kicked the dying lion when it could not defend itself3. Her piece is full of distortions, factual errors, omissions, and it amounts to a systematic character assassination. This is not the first inaccurate and offensive obituary she has written for the journal4 (with editorial endorsement). David Horrobin devoted his life to lipid research, and he achieved many others things besides. Although he chose an unorthodox path, he remained a medical scientist until his dying day. He stimulated and supported hundreds of researchers across the world, proposed original theories about a range of disorders and dared to question mainstream opinions. He devoted time and money to several important charities. He was an extraordinary human being, and like the rest of us, he had flaws. For example, he did not remember Ms Richmond (a former employee). Posterity will judge David Horrobin, but for the moment his life and work has been grossly misrepresented in the BMJ, but fortunately not in the Lancet5. Reference List 1. Newsom SWB. Pioneers in infection control. Ignaz Philipp Semmelweis. Journal of Hospital Infection 1993;23:175-87. 2. Richmond C. David Horrobin. BMJ 2003;326:885. 3. Aesop, Hanford SA. Aesop's fables. London: Penguin Books, 1996. 4. Richmond C. Dame Sheila Sherlock. BMJ 2002;324:174. http://bmj.com/cgi/eletters/324/7330/174#18979 5. Oransky I. David F Horrobin. Lancet 2003;361:1395. Competing interests: David Horrobin remembered me when I last met him |
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Adrian K Midgley, GP Exeter EX1 2QS
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He seems to have had an interesting life. And I am sure that there is a story behind the absent memories of years before. Perhaps we will hear it one day. Competing interests: None declared |
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David Carvel, GP Biggar ML12 6BE
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I have already received the assurance that Dr Smith will not write my obituary* and I hope to receive the same from Caroline Richmond. I am sorry if Dr Smith is bored or disappointed with obituaries portraying the subjects as saints but I don't believe their purpose is to entertain. Undertakers are not moved by every funeral service and are not expected to be. Of course some obituaries are gushing and don't tell the whole story, but I doubt many late colleagues would have wished a warts and all account from someone they only met a few times. Is Dr Smith suggesting obituaries include anecdotes such as "he had the habit of picking his nose during meetings", "latterly she became incontinent" or even "he died in a skiing accident but never was very good"? His example of Jenkins' biography of Churchill may detail his faults and failings, but is exactly that, a biography not an obituary (which in that case runs to 912 pages). No, let the great, the good and the ordinary be remembered as they ought to be, in the fairest way and in a way their family would feel is fair. The "dark side" that Dr Smith seems to want to know about and publish should be left to unofficial biographies. * Rapid response 13/7/02 Competing interests: My obituary is still to be written (I think!) |
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Harvey Marcovitch, Editor, Archives of Disease in Childhood London WC1H 9JR
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This issue contains 8 obituaries. Seven are brief: nonetheless their subjects are described with such approbations as active and influential, installeer of his country's first whole body scanner, accomplished and even 'a small giant of neuropaediatrics.' One is very long and appears to describe its subject as some sort of medical Jeffrey Archer. What's wrong with celebrating virtue? I suggest redesigning the obituary section along the lines of ELPS, as used for scientific papers. It could be labelled HLVS - heroes long, villains short. Competing interests: Harvey Marcovitch is employed by BMJ Journals but doubts whether he will even gain the advantage of a longer obituary when the time comes. |
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David R Davies, Consultant Psychiatrist Rydon House, Cheddon Road, TAUNTON TA2 7AZ
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The opening statement about Dr Goran Jamal is a travesty of the actual GMC verdict. The impression is given that Dr Jamal acted for personal gain, whilst the GMC expressly found that this was not the case. At the very least, a clarification of this fact is required. Competing interests: None declared |
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David Roberts, Non-principal GP Kettering NN14 1ND
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The obituary by Richmond on David Horobin was the most nauseating I have ever read. It is doubtful whether even the Sun could sink lower. A number of questions arise. Who is M/s Richmond? How did Horobin offend her? Did she enjoy writing her item? Did she feel better for getting it off her chest? And who helped her rush it through? Is anybody really interested in her self-opinionated remark when she writes "I dismissed..."? Questions have also to be asked about the BMJ Editor's part in all this. Was it really necessary to prioritise this item? Scarcely a fortnight has passed before Richmond, with Smith's agreement, is dancing on Horobin's grave. And a whole page of scarce space is allowed to the demolition of this man's character and career. Horobin died on April 1st. Were readers to turn the page (to 886) of the same edition of the BMJ they would find obituaries to colleagues who died: 5/2/03, 8/1/03, 16/9/02. 27/12/02, 2/2/03, 20/12/02 and 25/12/02 and all of these are mini-obits crowded on to one page. Yet Horobin, as I have said, died on 1/4/03. Allowing for messages between Smith and Richmond, Richmond was preparing her merry jig within a week of Horobin's death and Smith cleared space for it. BMA members and BMJ readers will want to know whether Smith commissioned/chose Richmond to write the obit and, if so, why? They may also be interested to learn why Smith felt it necessary to publish such an unedifying item? And should there not now be declaration of competing interests in the obits column? Who comes out of this best, Richmond, Smith, the BMJ or Horobin? Maybe some of the other fast responses give a clue. David Roberts Council member Competing interests: None declared |
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Dr Charles Shepherd, private practitioner Friars Cottage Surgery, Queens Square, Chalford Hill, Gloucestershire GL6 8EH
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In his justification for publishing this disgraceful obituary on David Horrobin, Richard Smith states: '..it is a tribute to have negative things said about you in an obituary. We did it with (Dame) Sheila Sherlock and now with David Horrobin'. This is part of what the Rev Amanda Sherlock had to say about Caroline Richmond's BMJ obituary on her mum after pointing out a number of factual inaccuracies: 'To say that I am upset about this obituary is an understatement. At a time when I am grieving for the loss of my mum, to read such an obituary enrages me and has done a number of my mother's colleagues'. [source: bmj.com/cgi/eletters/324/7330/174#18979] The BMJ has now got it wrong twice. But it doesn't sound as though anyone is taking any notice. Dr Charles Shepherd Competing interests: None declared |
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John A. Dodge, Hon. Prof. of Child Health University of Wales, Swansea SA2 8QA
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When I read in the lay press of David Horrobin's death, I felt (as one sometimes does) that the world had become a little smaller and poorer. My reaction to Ms.Richmond's offending, and offensive, obituary was that it has also become nastier. Your instructions for Rapid responses include a request that written consent should be obtained from identifiable patients. You also encourage self-written obituaries, and David had signalled the likelihood of his impending demise in his recent Lancet paper. Did he, or his family, consent to this piece, and if not, should we not extend the same courtesies to our colleagues as to our patients? Would many of the BMJ's editorial staff commission Ms.Richmond to write their own obituaries? Editors often have to make difficult decisions and cannot always get things right, but this article is so much at variance with the other published obituaries of David, and the recollections of your subsequent correspondents, including myself, that I think a rare apology would be appropriate. Competing interests: None declared |
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David Roberts, Non-principal GP Kettering NN14 1ND
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I can now answer one of my own questions. If readers enter <caroline richmond gmc> into Google a number of references pop up. M/s Richmnond is a well-known (except, apparently, to me) medical journalist who has had personal involvement in a GMC case. I have two final questions for the Editor. Did he pay this journalist for this rapid contribution which seems to have brought so much disapprobation onto the BMJ and consequently the BMA? And, was it worth it? Competing interests: None declared |
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Eddie Vos, maintains: http://www.health-heart.org Sutton (Qc) Canada J0E 2K0
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The obituary (1) in BMJ of Dr. Horrobin, one of the worlds foremost fatty acid experts, contained several inaccuracies. Gamma-linolenic (GLA, not "linoleic" without the "n") acid is not an essential fatty acid and not all prostaglandins are synthesized from it, only those of series 1 are. They have series 2 prostaglandin balancing roles that are not fully understood. Series 2 prostaglandins can also be controlled by COX-2 inhibitors and indeed by the series 3 precursor, EPA, the focus of Dr. Horrobin's last decade of research. I tried but never met him yet I guess he would not have objected to being labeled, as did the obituary, as possibly the greatest snake oil salesman of all time, since snake oil may well be the original COX-2 inhibitor. No one denigrates doctors who prescribe other COX-2 inhibitors, like Celebrex and Vioxx, and it is time to revisit the EPA issue, possibly the most powerful of the omega-3 polyunsaturates. Dr. Horrobin proposed EPA as an underlying unifying factor in schizophrenia, depression, bipolar disorder, cancers, cardiovascular diseases, osteoporosis and inflammatory conditions through its role in phospholipid metabolism, post receptor signal transduction and cell signaling. There are near universal deficiencies in omega-3 fish-oil type fatty acids and of which snake oil would probably be the best land-based source. I don't propose snakes be used for their oil but it is time to face the fact that their high omega-3 content can have benefits in people. The denigrating term "snake oil salesmen" is clearly used only by those not aware of their fatty acid composition. Finally, the obituary links Dr. Horrobin with unethical trial behavior (patient selection) through a scientist performing research for a firm he started. Regarding this second scientist BMJ however reports (2): "The committee accept that he subverted the protocol neither for his own personal financial benefit nor to obtain funds for research projects." It appears that the most severe patients were preferentially enrolled in the evening primrose oil (GLA) treatment arm, to their assumed benefit, but at the cost of lowering the probability of finding benefit from the tested oil. Compared with small scale fatty acid trials that for various reasons fail to show statistical benefit, how about the ethical issue facing doctors with (or without) financial conflict who, while also assuming drug benefit enrolled thousands of patients into the placebo controlled statin trials of the last 6 months (PROSPER, ALLHAT, ASCOT) that failed to show overall mortality benefit? Unsuccessful trails, conflicts and ethical issues are everywhere, and what does this all have to do with Dr. Horrobin anyhow. What is certain is that the world and fatty acid science prematurely lost one of its great thinkers; he will be missed, and instead of pondering ethics in his obituary, his scientific legacy will continue to benefit and inspire many. Eddie Vos vos@health-heart.org No conflict of interest. (1) Obituary: http://bmj.com/cgi/content/full/326/7394/885 [April 19 2003] (2) Reprimand: http://bmj.com/cgi/content/full/326/7392/730/a [April 5 2003] Competing interests: None declared |
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A. Chaudhuri, Senior Lecturer in Clinical Neurosciences University of Glasgow
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I met Dr. David Horrobin only twice and both the meetings were after he had the diagnosis of mantle cell lymphoma. A third meeting never materialised and a promise that he could not keep was to write a contribution for a special theme issue of a journal that I was co-editing. This theme issue on recent advances in neurochemistry and neuroimmunity has now been dedicated to his memory and will be published later this year. Dr. Horrobin was one of the most accomplished medical physiologists I came to know personally. His main research interest was on the essential fatty acids. Because of the critical role of unsaturated fatty acids in the lipid structure of the cell membranes, this area was considered to be of major importance in human diseases characterised by altered cell signalling or oxidative injury to cell membranes. It was only in the last few years that this hypothesis was beginning to gain support by the results in the clinical trials of essential hypertension, coronary heart disease, schizophrenia and Huntington’s disease. When I had met Dr. Horrobin, he was very keen for a pilot trial of essential fatty acids in motor neurone disease. This study has only just begun and it was sad that he could not live to see it. For those of us who were able to grasp only a fragment of Dr. Horrobin’s knowledge on membrane physiology, the thought of using essential fatty acids in complex and difficult human diseases was certainly appealing. Clearly, this is something that will not be appreciated by those who are non-clinicians or non-scientists and are of rather modest intellectual portent. Dr. Horrobin had also suggested a possible role of colchicine in multiple sclerosis. Although my reasons for using colchicine in multiple sclerosis was somewhat different, in terms of efficacy, a combination of colchicine and essential fatty acids is certainly no worse than the vastly expensive, hyped up and toxic therapies that are in use today. No large- scale randomised trial of colchicine in combination with essential fatty acids has been undertaken in multiple sclerosis or will ever be. Such a trial is not an attractive proposition to the pharmaceutical industry because of the extremely low manufacturing cost of colchicine. However, we shared the view that large trials and complex statistical analysis for outcome in life threatening diseases are usually necessary only when the therapeutic effects are at best borderline or doubtful; that no trials for benzylpenicillin was ever required in pneumonia or meningitis was a case in point. Last year, he wrote in the pages of the Lancet on this issue. His views were certainly debatable but only a poorly educated mind will interpret his arguments to be wrong. Dr. Horrobin was the editor of the Medical Hypotheses, an important journal for the untested, new and challenging ideas that are based on facts and still waiting to be shaped by science. During our second, and the last meeting, we had wide ranging discussions on the future of medical science, research and publications. I remember him mentioning during our lunchtime conversation that the only page worth reading in the BMJ was Minerva. I am glad that from where he now rests in peace, Dr. Horrobin would not be reading an insulting obituary full of innuendos written by a non-entity and abetted by a person with an equally narrow mind. At his death, I am reminded of a response made by my favourite poet, story-teller and philosopher, Rabindranath Tagore at the funeral of his American admirer Dorothy Elmhirst: “Science recognises atoms, all of which can be weighed and measured, but never recognises personality, the one thing that lies at the basis of reality. All creation is that, for apart from personality, there is no meaning in creation. Water is water to me, because I am I. And so I have felt that in this great infinite, in this ocean of personality, from which my own little personal self has sprung, lies the completion of the cycle, like those jets off water from a fountain which rise and fall and come back home again”. I shall miss your personality, David. In fond remembrance, Abhijit Postscript: The most unkind act of human nature is to humiliate a dead person, directly or indirectly. The published obituary in the BMJ makes a sad reading more because of its tone rather than its contents. For example, it begins with a reference to a recent GMC proceeding, the relevance of which I find hard to comprehend in the overall context of Dr.Horrobin’s life and his contribution to medical science. The criticisms of the published obituary in the bmj.com clearly indicate that the issue merits a review of the journalistic ethics in the BMJ by a formal referral to the Ombudsman. However, despite repeated suggestions in the past, the BMJ has been very reluctant in accepting an independent Ombudsman because of an unfounded “fear of losing editorial freedom” despite this freedom being misused now and again. Other editorial members of the BMJ should consider issuing an immediate apology to Dr. Horrobin’s family perhaps only to show that the BMJ is suitable for circulation in a civilised and cultured society that respects its dead. Competing interests: I published a paper in the Medical Hypotheses. I have received support from the Laxdale Ltd for an ongoing pilot trial in motor neurone disease. |
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Ahmed N. Ghanem, Consultant Urologiost Mansoura, Egypt
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Sir, The obituary written by Miss Caroline Richmond on Dr David Horrobin was so disappointing and twisted that it has left me with a disturbing feeling of disgust. I do not know Horrobin in person and do not know at all the author but I believe one make an impression of a man or woman by reading a representative page or letter he/she had written, hence I write this response. I went to read the obituary in order to learn more about the deceased's achievements as great doctor, researcher, author, editor and human being and pray for his sole to rest in peace but what I found was obituary of an author full of personal vindictive frustrations. I believe that we should only speak well of the dead unless there are proven facts on illegal acts harmful to society. This piece of cheep journalism, however, had left me with one impression that the writer had admired the man but failed to make a lasting relationship or even a one night stand! The author may correct me on this issue or declare it as conflict of interest with apology should it proved true. Speaking of that, I do have a conflict of interest. I corresponded with Dr Horrobin as author of pioneering articles on peer review while writing a piece on the subject [1], and also as Editor of Medical Hypotheses where an article of mine was published [1]. He waived all extra pages' charges of $800 in full when I explained that all my research efforts and expenses are self-financed, done for the love of science and medicine, donated to the betterment of present and future human society and do not benefit or further my career at all. Hence I refuse to pay and would not consider sending my material to a journal that charges publication fees. Based on assessing my material, he accepted publications for free awarding and addressing me with the title of Professor that I do cherish but never used. The only positive impact that came out of this horrible piece is the many Rapid Responses it generated that spoke well of the deceased and told the author what she truly deserved. Ironically, the many positive responses may seem to strengthen Editor's arguments on the negative obituary but the clear objectives of all writers were in defense of Horrobin against undeserved assault and defamation rather than encouraging a misguided act. This is a rather similar situation to the split feeling of refusing the war on Iraq while wanting the demise of Saddam! If Dr Smith truly wishes to continue with such obituaries in BMJ in order to compete with the weekend tabloids he should try to get the negative one (Anti-obituary) written during the last decade of an expected deceased's life and give him the chance to view and defend it leaving the positive one (Obituary) for after death. Should the editor like the idea, granted for free, and have the guts to implement it and publish this letter may I suggest a start with him-self asking Richmond or alike to do it- by definition he should know some alike around him! Yours Truly, Dr Ahmed N. Ghanem, MD, FRCS Conflict of Interest: Declared in the letter. References: 1. Ghanem AN. Guidelines and Code of Ethics. Saudi Medical Journal 2000; 21 (7): 149. 2. Ghanem AN. Magnetic field-like fluid circulation of a porous orifice tube and its relevance to the capillary-interstitial fluid circulation: preliminary report. Medical Hypotheses 2001; 56(3): 325-334. Competing interests: Declared in letter |
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Leslie O. Simpson, Director Red Blood Cell Research Limited, 31 Bath Street, Dunedin, New Zealand. 9001
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Editor, While many have challenged the nature of Ms.Richmond's writing, it seems that apart from Dr.Lapinskas none have challenged her accuracy The statement "...evening primrose oil, which may go down in history as the remedy for which there is no disease" is simply non-factual. There are many chronic disorders which share the common feature of abnormal blood rheology manifested as reduced red cell deformability and increased blood viscosity. Such changes are usually associated with a defective delta-6-desaturase which means that dietary cis-linolenic acid cannot be elongated to gammalinolenic acid (GLA). This means that in the human being there will be a deficiency of Prostaglandin E1 (PGE1). As early as 1974 it was shown that PGE1 increased the fluidity of the lipid bilayer of the red cell membrane, and the beneficial effects on deformability were reported in the following year. There are several studies which show the beneficial effects on blood flow of infusions of PGE1. So the reason for taking evening primrose oil is to incrase the blood levels of PGE1 - with the objective of making red cells more deformable to improve the rate of capillary blood flow. It has been shown by Horrobin that taking at least 4000mg daily of Efamol significantly raised the blood levels of PGE1. Many people have had dramatic improvements in wellbeing from such a regimen. My personal experiences with David Horrobin are mirrored in the opinions of others. Might I suggest that Ms Richmond would get a better appreciation of Dr.Horrobin's contribution if she became knowlegeable about blood rheology. Competing interests: No competing interests |
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Denys N Wheatley, Head of Cell Pathology, University of Aberdeen University of Aberdeen, AB24 5UA
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David was a lovable maverick, a highly intelligent and gentle person, perhaps a rogue in Ms Richmond's eyes, and possibly at times in some others of us. He may have made some poor judgements, even mistakes, at times. Then So do I. But so has Ms Richmond, and Richard Smith. Fortunately we can correct ours. Competing interests: None declared |
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Erling Refsum, Equity analyst Nomura International plc. Nomura House, 1 St Martin's le Grand London EC1A 4NP
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I blame Richard Smith for the traversty of the obituary on David Horrobin's life rather than the author. But hey, journalism is like that. What more do you expect from people without principles who just think of circulation figures. In the imortal words of Kipling and so loved by David, IF says it all. Read and remember, David Horrobin has finished his race. I think it was a race well run. If you can keep your head when all about you
To serve your turn long after they are gone,
Competing interests: Friend and business advisor |
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Jeremy G Jones, Consultant Rheumatologist Ysbyty Gywnedd, Bangor, LL572PW
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I am an inveterate obituary reader who makes a point of reading the Times obituaries each day. I also usually read those in the BMJ which, as Editor Smith tells us, are much less revealing. I have read several other obits of Horrobin which achieve a more comfortable balance between the dark and the light. They, and almost all other people's obits in the national press, are also without the vindictive and spiteful comments made by Richmond. One wonders what has gone before. No doubt the new look BMJ with it critical obits can produce a serialised account of the whole story when their soap opera feature closes. To liven up the obits section I suggest that instead of family or friendly colleagues writing positive understated comments, you should only commission obits from all those enemies doctors leave behind. For example on a passing in the teaching hospital where the professor and senior consultant haven't spoken for thirty years, you could commission a really negative account of the late doctor's life from the survivor. Other people who will be keen to write include first, second and/or third wives, rejected lovers, crossed practice partners, aggrieved unit managers, wounded theatre nurses, hurt outpatient receptionists, slighted patient self help groups not to mention wronged patients and their relatives. Wouldn't it be so much more fun. I for one would spend more of my BMJ reading time on the obits. It may well lead to improved doctor behaviour in the hospital, in the theatre and in the practice. It would also have the benefit that the need to outlive one's rival would lead to the adoption of a more temperate life style and so improve the health of doctors. I can't wait
Competing interests: David Horrobin and I were medical students together at St Mary's Hospital. He was in a different intellectual league to his contemporaries and almost all of his teachers, although he made no show of this. |
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Dr Agnes K Ayton, Consultant Child and Adolescent Psychiatrist 2062-68 Hessle Rd, Hessle, Hull, East Yorkshire, HU13 9NW
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The more I think about Caroline Richmond's obituary, the more astonished I am. First, I need to declare my conflict of interest: I was privileged to know David Horrobin, and his death affected me personally (although I was not a close acquaintance). He approached me a few years ago, after I published a letter in one of the medical journals. It had nothing to do with evening primrose oil. He sent me some of his work, in case it would interest me. It did, and we exchanged some letters, but he became ill soon afterwards. Eventually, after he recovered and visited Hull, we had dinner together, and had a pleasant chat about evolution and the idea of "phospholipid spectrum disorders" in psychiatry. I talked about a potential project, and although he was initially sceptical, he was polite and supportive. He did not try to sell me anything. After this meeting, I started working on a pilot study using ethyl-EPA, (which has been investigated by Laxdale in several disorders). When I needed advice about methodology or literature, David was always prompt to help. I don't know how he found the time, as he had much bigger fish to fry. He supported many other projects, several at prestigious institutions, including Harvard. He was also searching for a more effective treatment of mantle cell lymphoma at this time. I simply thought that he was an extraordinary person, who was passionately interested in the potential role of poly-unsaturated fatty acids in health and disease, and determined not to allow his illness paralyse him. Looking at his publications, it seems to me that he was a pioneer: he started working on an area, which was small and initially unfashionable. Over the last 20 years, the literature has exponentially grown, and David contributed to this significantly. It is difficult to read anything on the subject without finding a reference to his work. Sadly, I had to cancel my last scheduled meeting with him, and I could only attend his funeral, which was on the Isle of Harris (too depressed an area for Ms Richmond's liking). People flew in from over the world to pay their respects, despite the major difficulties getting there. Everyone there shared the tremendous loss of his early death. It was nice to see that besides his family, the islanders, employees and colleagues knew him as a good, honest, and pleasant person, with an astonishing range of interests and knowledge. He loved this remote island and chose to be buried there. His ninety year old mother and the rest of his family were somewhat consoled by the affection of so many people. How do they feel now? I was hoping that there would be an obituary in the BMJ, but was not sure whether David would be accepted by the establishment in his death. The answer is a loud 'no'. On the contrary, his death was celebrated on the front cover with the words: "The remedy for no disease"- which is the most distasteful thing I have ever seen (and I doubt that this has ever happened before). I am outraged for David, and outraged as a member of the BMA. Caroline Richmond's obituary is factually incorrect, spiteful and defamatory, as others have already said. What did he do to deserve this treatment? If she or the journal had evidence that David Horrobin was a fraud, they should have exposed him when he was alive. My suspicion is that they did not because there was no case. The GMC never implicated David in the Jamal case. He was one of hundreds of researchers collaborating with David over the decades, and it was Scotia who discovered that there was a problem. The fact that Caroline Richmond was presumably paid twice for the two versions of her obituary (in the BMJ and the Independent) is even more nauseating. She implies inside knowledge, but gets her basic facts wrong. She knows little about David's research or current developments in PUFA research. He did not write a book about British cars. The guidebook to Kenya was not published by MTP. The photographs were taken by David and his father. His first wife was the mother of the two children. Ms Richmond clearly does not like David's second wife (sour grapes, from Aesop comes to mind). The madness of Adam and Eve was not written to promote Laxdale, but to promote a theory that David had developed over several years (and by the way, it was shortlisted for the Aventis science book prize in 2002, only to be beaten by Stephen Hawking). David had been interested in evolution since he had lived in Kenya, and he had been interested in schizophrenia since the seventies. As for the collapse of Scotia, it is worth remembering that many companies go bust, and only a fraction of drug developments are successful. Ultimately, he was not a businessman, but a medical scientist. He deserves the respect of his colleagues in the BMJ as a prominent member of the British medical profession (I imagine, that his colleagues over the pond are somewhat bewildered by all of this). The only acceptable solution is to issue a full apology and a full- page correction of all the mistakes and innuendoes. That would certainly break the tradition of obituaries in the BMJ. With best wishes Dr. Agnes Ayton
(Posted on behalf of Dr Ayton by Crispin Bennett, cbennett@laxdale.co.uk) Competing interests: As detailed in my response |
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Eamonn J Clarke, GP Cambs PE14 9BT
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This is a very controversial obituary, which seems certain to cause offence to Dr Horrobin’s family. Having read the article and the responses to date two thoughts occur to me: Firstly, I am concerned that a journal, which prides itself on an evidence-based approach, can print negative comments about someone without any evidence to back them up. Ms Richmond says that many of Dr Horrobin's arguments and facts "were debatable or wrong" and that "his - or his company's research ethics were considered dubious". Fairly serious allegations without any supporting references. In what way were his facts "wrong, who considered his ethics "dubious" and why? I am not suggesting that all obituaries should include supporting evidence that he/she was "loved by all patients" but if we are to speak ill of the dead then surely some level of proof is required? Secondly, shouldn't Ms Richmond's previous article on evening primrose oil be declared as a competing interest? Particularly if she received payment for that article. I am sure it would have been possible to write a balanced obituary of Dr Horrobin that satisfied Dr Smith's quest for "interest" without descending to the level of unsupported insults. Competing interests: None declared |
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Peter J Horrobin, not applicable - David Horrobin's brother not applicable
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"As your obituary writer has proved herself incapable of even getting her own "facts" right, BMJ readers can safely dismiss the opinions and innuendoes expressed in her inaccurate and, in places, offensive obituary of my brother David Horrobin. David would have been amused to hear that authorship of my own book, "The Complete Catalogue of British Cars", had been attributed to him. And the outstanding photographs in David's "Guide to Kenya and Northern Tanzania" were not taken by Nafisa (correct spelling), but by my father, Frederick Horrobin and David himself, as is clearly stated on the title page of the book. I am dismayed that the Editor should further damage his own reputation and the image of the BMJ by attempting to defend the indefensible in Rapid Responses. It is clear that neither he nor Caroline Richmond understood or knew the man that David was. It seems that other correspondents to Rapid Responses knew him rather better than they did. Is it possible that the Editor will have the humility and courage to issue a substantial correction by someone who really knew David for a more substantial portion of his career? If not, the only printed assessment of David's life within the pages of the BMJ will be a serious and damaging distortion of the truth." Competing interests: None declared |
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Joseph .C. Obi, Chief Consultant WellnessClinics.co.uk
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My recent article titled 'The Horrobin Phenomenon' warmly refers. One other thing which I fondly admire about Professor David Horrobin; is the simple fact that he was one of the very few 'Caucasian Clinical Heavyweights' who publicly spoke out about unacceptable levels of 'Ethnic Cleansing' of the medical profession ; going on at both NHS and GMC level. But he did not stop there...He actually went out of his way to help foreign doctors contribute their own due quota to to the highly respectable annals of contemporary medical science. Someone who puts his whole career on the line ,for a bunch of impoverished, over-abused and powerless colleagues; cannot really be all that bad afterall. May he eternally rest in peace. Competing interests: Dr Joseph .C. Obi MBBS MD MPH DSc FRIPH has formally requested that the Charity Commission fully investigate the GMC's spending ethics. |
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Rob Poole, Consultant Psychiatrist Windsor House, Liverpool, L8 7LF
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I am absolutely astonished by this unattractive correspondance, with its taint of outraged pomposity. I have never heard of David Horrobin before. Having read these rapid responses I now know quite a lot about his life and work, but the issues raised are of very limited interest to me. I am undecided as to his qualities, though his supporters have rather put me off him. The BMJ obituary doesn't seem to me to be vindictive, indeed it is quite warm. However, it does have a clear stance with regard to its subject. I entirely agree with Richard Smith's points, and fully support the publication of obituaries which embrace uncomfortable opinions about controversial doctors. Personally, I would be very pleased to posthumously generate so much interest. What really matters here is editorial freedom. Richard Smith's independent mindedness has made the BMJ a truly great general medical journal; not always right, but invariably thought provoking. To maintain this he has to have the freedom to offend vested interests, and even to speak ill of the dead. Surely I'm not the only reader to think so? Competing interests: The author went to the same school as Richard Smith, but hardly knew him, being several years younger. He has had two articles published in the BMJ. |
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William Carey, Clinical Pharmacologist Hammersmith Medicines Research, Park Royal, London NW10 7NS, UK.
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Editor, I, too, was sickened by the obituary of Dr Horrobin. Dr Smith does not understand what an obituary is, namely to inform people of someone's death. It is not meant to be a balanced account of someone's life, bearing in mind that the deceased's family and friends are likely to read it. It is therefore courteous and apposite to recall that person in the best possible light in order to proffer comforting thoughts to the bereaved. If someone was so appalling as to find it impossible to say any nice things about them (surely very rare), then no obituary should be written, or merely a statement announcing their death, perhaps with some comments such as "he held some controversial views, and could be prickly at times." A biography is the place where a balanced appraisal of a person's life should be presented. I have also been irritated by the complete lack of balance in the leading features in the BMJ concerning the war in Iraq - everything I read was against the war, or neutral at best. That I could just about stomach, but the poisonous attack on Dr Horrobin is reprehensible. Dr Smith should resign. Yours faithfully William D H Carey Competing interests: None declared |
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David Seddon, Consultant Physician University Hospital Nottingham, NG7 1BB
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Dear sir Is it not now time to abandon the traditional style of obituary notice, at least in the paper BMJ. The national press carries perfectly adequate obituaries of those few of us who are truly eminent and some of the Colleges supplement this record with their own publications.Would an electronic only obituary suffice for the rest of us? There would thus be no limit whatsoever on the number of obituaries that could be accepted although it would still be necessary to impose a limit on their size. They would need to be courteous, record fact rather than opinion, and would almost inevitably supplied by a colleague or colleagues. David Seddon Competing interests: None declared |
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Jamie Cunliffe, Retired from medical practice SO45 4PB
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A hornet’s nest! And so it should be. I suggested in an earlier response that the words of an absolute and polarised response like the one authored by Caroline Richmond are best ignored until we discover the agenda behind them - and the agenda behind accepting it for publication. It seems that this HAS stirred up a hornet’s nest (37 responses so far and still going strong). Rather than just concentrating on the words (which I am increasingly confident we can ignore), I propose that we respondents should now demand to know the background agenda. The possible reasons for publishing this obituary range from a crude attempt at discrediting David Horrobin (the author and the editor could have different goals) through to David himself being complicit in its publication. He would, I suspect, be pleased to know that he has provoked a substantial disturbance in a cosy set of institutions – even though the likelihood is that he had no directive part in this. Whatever, I propose that Richard Smith and Caroline Richmond should now give us clear, unambiguous and believable reasons why this obituary was published in the style of a “character assassination”. I should also like the editor to discuss what has been learnt from this episode and how this will translate into policies for publishing future obituaries. And finally, we haven’t yet seen one reply that supports this cascade of innuendos that has been boldly paraded as an obituary. Competing interests: He supported me with my publications and through a lot of pressure |
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Amanda Sherlock James, Asst Minister at Enfield Baptist Church Enfield BAptist Church EN2 8DX
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I ask a very simple question - how much longer is the BMJ going to allow Caroline Richmond to write obituaries? She upset me with her unpleasant comments about my late mother (Sheila Sherlock) and it appears little was done. Certainly my family did not receive an apology for her poorly researched inaccurate obituary. And yet again I see she has been allowed to write unkind words about David Horrobin. Surely an obituary is not an occasion for slatting the dead? Come on BMJ you need to rethink. Amanda Sherlock James (Rev) Competing interests: None declared |
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Adam Kelliher, Managing Director 105 Ladbroke Grove, London W11 1PG
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Dear Sirs If David Horrobin was alive today, I am sure that the BMJ would be facing a serious libel suit for the tendentious obituary printed in volume 326. But as the dead cannot defend themselves, I would like to make some comments on both a personal and professional basis. On a personal basis, David was my father-in-law, and I can faithfully state that the account delivered by Caroline Richmond bears no resemblance to the man. Anybody who did not know David, would assume from the obituary that he was a charlatan businessman, who made money based on dubious science. Nothing could be further from the truth. David was a man of the highest integrity, who had great vision about the role of lipids for human health, and managed to turn this vision into a commercial success. Certainly, being successful as a researcher and a businessman made him the target of a lot of petty jealousy. But David never shied from healthy debate, and often challenged established orthodoxy. In reply, few critics could tackle his intellect head on. Unable to refute his findings, they sniped from the sidelines, and branded him as eccentric. I think this sneering obituary encapsulates that point of view. On a professional basis, I must also question this obituary on the basis of being a journalist, which was my profession for 16 years. I know that Ms Richmond contacted many of David’s contacts, but it seems that the views of his supporters were not to be reported. The article is also riddled with various inaccuracies, which it would take a lot of time to list, but do not reflect well on Ms Richmond’s capabilities as checker of basic facts. But on the serious allegations that EPO does not work, and by inference that David’s lifework was flawed, she may want to ponder that thousands of tons of EPO are annually sold around the world, some £32 million worth in the UK alone. Now if Ms Richmond is right, this is really worth reporting: one of history’s great commercial delusions, in which thousands of people keep on repetitively purchasing a product that gives them no benefit. The alternative, of course, is that EPO does give plenty of people benefit: I have witnessed my son’s infant dermatitis clear within days by taking ‘the remedy for which there is no disease.’ So was David ‘the greatest snake oil salesman of his age’? As Ms Richmond is obviously not aware of, snake oil is one of the highest natural sources of EPA, the omega-3 fatty acid that David was mainly using for his research into neurological disorders. Snake oil is ridiculed as a false cure-all, but it seems that the Chinese labourers who introduced it into America for its anti-inflammatory qualities were really onto something. David always said that all science starts with a basic observation. I am certain that we will see in the coming years a recognition that David was a true visionary, and that the world will eventually catch up. Yours sincerely Adam Kelliher Competing interests: None declared |
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Peter Gooderham, Student Cardiff University
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This matter degrades the integrity of the BMJ. Please think again, Dr. Smith. Competing interests: None declared |
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Philip A Johnson, Independent Specialist Occupational Physician London/Hampshire
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There are occasions when an obituary gives a clearer picture of the writer and their personal position than it does about the deceased. This, I suggest, is one of those occasions, and the picture of the writer is not one that is flattering. If the deceased was bad, it must have been possible to say so in an objective and uncluttered fashion. Motto: Always be suspicious of an obituary that contains the word "I" too many times, unless it is self-written. Competing interests: None declared |
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Janine Hunter, Publishing Manager e-MED, c/o 7 Rosebank Cottages, Edinburgh EH3 8DA, or PO Box 29761, London NW3 7ZS, UK
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Shame on you, BMJ, for publishing such a biased and cruel obituary of one who, though flawed, achieved so much. My thoughts are with David Horrobin's family - you owe them, at least, an apology, and at best, another obituary written with some respect. Competing interests: I previously worked for the publisher of PLEFA and Medical Hypotheses, though never on these journals or with D Horrobin. |
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Eileen A. Soosai, Research Assistant Monash Medical Centre 246 Clayton Road Clayton 3168 Victoria Australia
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I was shocked to read the so called Obituary (a resume of the life of a person at their death) on David Horrobin by Caroline Richmond. It was in keeping with poorly researched tabloid journalism and while it says more about the writer than David, it also says much about the BMJ. Having worked in research supported by David Horrobin first at Scotia and now Laxdale I can tell Ms. Richmond that many many people, who have very definite diseases have had life changing benefits from essential fatty acids. Very few people can leave this life having touched the lives of as many people as David Horrobin. I think the greatest sadness is that David's family has to see this rubbish printed in a journal supposedly representing the views of his peers. I hope they take comfort in the many responses. Competing interests: My salary had been paid by David Horrobin's firstly through Scotia and now Laxdale |
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Dr. Patricia C. Kane, Clinical Practice 45 Reese Road, Millville, NJ 08332 USA
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DR.DAVID HORROBIN In April 2003 the scientific community lost one of our greatest treasures, Dr. David Horrobin. Born in England on October 6,1939 David was a scholar of Oxford where he obtained a First Class Honours medical degree. To this he added a clinical medical degree and a doctorate in neuroscience. David was a fellow of Magdalen College where he taught medicine to students alongside the father of the field of essential fatty acids, Dr. Hugh Sinclair. David began his odyssey into the research of essential fatty acids in 1972 at the University of Newcastle Medical school and continued his work on essential fatty acids (EFAs) and prostaglandins at the University of Montreal. He became increasingly fascinated in the development of novel therapeutic agents based on lipid biochemistry and its application to human disease. David set up a small pharmaceutical company, Efamol in 1979 which several years later became a public company, Scotia Pharmaceuticals Ltd. Over the course of 18 years, Dr. Horrobin's innovative approach to research led to the discovery of many lipid products for the treatment of disease. In 1997 set up a new company, Laxdale Ltd. for the exclusive development of novel lipid pharmaceuticals for psychiatric and neurodegenerative disorders such as schizophrenia, bipolar depression and Huntingtons Disease. Laxdale's work will continue and is dedicated to providing a lasting tribute to his memory. David's principle lipid focus was originally on the physiological function of omega 6 EFAs. His research on the medical benefits of gamma linolenic acid opened a doorway into the profound influence of lipids towards health, sparking a minor revolution of lipid studies and research around the world. I first met Dr. Horrobin in 1979 whereby my fascination with lipid therapy and its impact upon the brain was further ignited. Working at first with Dr. Carlton Fredericks and Dr. Carl Pfeiffer, and much later with Dr. John Foster and Dr. Annette Cartaxo we began to integrate the clinical use of omega 6 and omega 3 lipid therapy for our patients with neuropsychiatric, neurodevelopmental and neurodegenerative disorders. Today, EFA research in the USA has evolved to gold standard analysis of lipids at Johns Hopkins Kennedy Krieger Institute and is now the focus of a many NIH studies. David's work inspired and continues to nurture positive clinical outcomes in our patients with MS, Autism, ALS, Parkinsons Disease, PDD, Bipolar, epilepsy, OCD, Schizophrenia and Depression by respecting the critical balance of targeted EFA application. David was the founder and editor of two journals - Medical Hypothesis and Prostaglandins, Leukotrienes and Essential Fatty Acids. David was a prolific writer who wrote and edited numerous books and over 800 scientific publications. One of his main interests was schizophrenia and he was medical advisor for the International Society for Orthomolecular Medicine and President of the Schizophrenia Association of Great Britain. David inspired a multitude of people whose lives he touched. He had a unique combination of enthusiasm and tenacity, humility and friendliness with remarkable creativity, a huge depth of knowledge and striking analytical power. David was an outstanding communicator in speech as well as in the written word. He will be greatly missed. Dr. Horrobin's legacy will continue as our research continues to unfold on the application of balanced lipid therapy and its impact upon the cell membrane, the brain and the body human. Dr. Patricia Kane
Competing interests: None declared |
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Liam Farrell, GP Crossmaglen Health Centre, N Ireland
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Just as the obituary may have told us more about the author than the subject, so the responses tell much about their authors as well. I'd never heard of David Horrobin before, but I thought the obituary showed David Horrobin as a most interesting man. So he had flaws, so what, who doesn't? Great men have great faults; what would Attila have been without his courage? It's also a surprise to hear that snake oil is good for you, and that because countless millions buy evening primrose oil that that means it's good for you too. Competing interests: None declared |
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Michael D Innis, Director Medisets International Home 4575
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Editor, “What really matters here is editorial freedom. Richard Smith's independent mindedness has made the BMJ a truly great general medical journal; not always right, but invariably thought provoking” Well said Rob. Stick with it Richard. I’m sure you’ll make it even greater even though you reject some of the great stuff I send you! Ignore Carey and those ankle biters. Remember – EAGLES RISE AGAINST THE WIND. Michael Innis Competing interests: None declared |
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Rudolph A Riemersma, Senior Lecturer Cardiovascular Research, University of Edinburgh, George Square, Edinburgh EH8 9XF
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If Caroline Richmond's obituary of David Horrobin was disgraceful, Richard Smith's defense of it made it even worse. Obviously he found that it was very easy to "break the deadening mould of medical obituaries", that he was looking for for such a long time. May I suggest that the BMJ restricts itself to publishing simple announcements or submit obituaries to a peer-review? A sincere apology would not go amiss. Competing interests: Sponsorship of international meeting on essential fatty acids and eicosanoids in 1997 |
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Sherri Clarkson, Managing Director Laxdale Ltd, Stirling, FK7 9JQ
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Caroline Richmond’s obituary of my husband, David Horrobin, is the most malicious and spiteful obituary I have ever read. It is so outrageously wrong as to be beneath contempt. I cannot understand why the BMJ would stoop to publish such a mean-spirited piece, knowing the hurt and offense it would cause to David’s family. It is only in the many, many outraged replies from friends, colleagues and total strangers that I can recognize the real David Horrobin. The Editor’s breezy defense of it is a complete travesty of editorial judgement. Even David’s enemies (and everyone has some) are unlikely to support such a scurrilous mix of distortion and innuendo. Publication of this obituary by the BMJ is an injustice of which the BMJ should be ashamed. The BMJ should apologize and publish a more balanced and fitting statement in correction. Sherri Clarkson Competing interests: Wife of David Horrobin |
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Charles Stewart, formerly Medical Director Scotia Pharmaceuticals Home :Rose Villa Hermongers lane , Rudgwick,W Sussex.RH12 3AH
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It’s heart-warming to see so many criticisms of your obituary of David Horrobin. Different people had different takes on David, and there is no doubt that the very name Horrobin conjured up negative feelings in a few. Caroline Richmond seems to represent the extreme end of this minority. What caused such negativism in some people? It certainly wasn’t the wealth, charm, intellect, coherence or articulacy of this apolitical man. It was just one thing I believe – his creativity and vision. Clever creative people got on well with David, unclever creative people got on well with David. However clever people who wished to be creative (but were not) were often reduced to apoplexy by him, especially when David picked up their observations and developed a theme of thought – as he often did – that they themselves could not develop. This apoplectic reaction was often most pronounced in women. I do not know who Caroline Richmond is; but in orchestral terms she comes across as neither composer, conductor, nor player, but as a tabloid critic . Others have pointed to many inaccuracies in the obituary already. She also seems to have no real understanding of the important role of essential fatty acids in normal physiology, judging by her dismissive remarks. Essential fatty acids are powerful antioxidants, and act as the primary trap for free radicals, thus reducing their harmful potential. This in part explains their therapeutic anti-inflammatory action in atopic eczema. Recent work has also shown that essential fatty acids supplementation can reduce the length of ventilatory support, and stay in intensive care unit by 30 % for patients with adult respiratory distress syndrome ARDS (1), and, (with minerals), reduce the reoffending rate of prisoners by 26% (2). No No Ms Richmond the essential fatty acid story has a long way to run, like it or not. Widely used in therapeutic and dietary supplementation these properties would have enormous impact onto day’s social and medical problems. Perhaps David’s problem was that he was too visionary, too far ahead of his time for Caroline Richmond and her ilk to stomach. The obituary also raises questions about Richard Smith’s role in its publication. Smith knew Horrobin personally, I understand, and certainly knew well his ability as a fellow editor. So why did he let such a negative item through. Rather recently Smith issued a grovelling apology to Rob Dow, Horrobins successor at Scotia, for uncertain reasons. It is now time that he apologised again –this time for the very real reason that he has caused the immense and lasting hurt to Horrobin’s family and colleagues. I hope the BMA will investigate his role in letting this obituary through. Finally we are all supposed to declare any conflict of interest. I have none, but I worked with David for some 16 years at Scotia. He inspires even his absence, not least to seek the truth. It would be nice to see Richmond and Smith declaring any conflict of interest they may have. They omitted to do so. Quis custodiet ipsos custodies 1)Crit Care Med 1999 Aug;27(8):1409-20 2) British Journal of Psychiatry 2002;181:22-8) Competing interests: None declared |
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A. Wes Siegner, Jr., Director, Hyman, Phelps & McNamara Washington, DC 20005
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Further Proof of How Medical Journals Stunt Creative Research The Richmond obituary of Dr. David Horrobin is surprising in its inaccuracy and accusations, but understandable on one level. Dr. Horrobin was often controversial. Dr. Richmond has shown, if nothing else, that she has a very sharp axe to grind, and she saw an opportunity to finish the edge on Dr. Horrobin’s reputation through his obituary. However, the acts of printing the Richmond obituary and the defense of this obituary by the editor, Dr. Smith, are more stunning and much more damaging to the objectivity that science requires than Dr. Richmond’s act of writing. These former acts are the responsibility of BMJ and should be addressed by the journal as a whole. An obituary that begins and ends with an implied but unsupported accusation that Dr. Horrobin encouraged research fraud and was unethical, and then goes on to directly (and incorrectly as others have detailed) accuse him of defrauding consumers by marketing useless products with attractive names, setting up publications to publish his own papers, and practicing nepotism to the detriment of his company is not a “tribute” as Dr. Smith claims in his defense. (The repeated observation that Dr. Horrobin established businesses in depressed areas appears to be an implication that he was unethically using government funds to further his business interests, rather than creating business opportunities in depressed areas, which was his intent.) This obituary, to any objective person who knows the facts, is a small-minded and false attack on a scientist who constantly challenged the strictures of major medicine and traditional medical research. Drs. Richmond and Smith, not able to stifle perceived deviations from accepted norms of scientific thinking while Dr. Horrobin was alive, have attempted to diminish him in death by claiming he was a fraud. Dr. Smith would have us believe the obituary is balanced – he says “The obituary does point out that he was charming, intelligent, straightforward, handsome, well read, effortlessly prolific, and had thousands of friends and followers. Isn't that enough that's positive?” This ignores the object of Dr. Richmond’s writing. What the obituary attacks, through unsupported allegations of fraud, self-promotion and ethical failings, is Dr. Horrobin’s scientific legacy – the goal is to establish through innuendo that all his work is suspect and should be disregarded. As one response pointed out, one appropriate remedy to this fundamental breach of scientific conduct would be for BMJ to print an article from someone who knows Dr. Horrobin’s research contributions, detailing the medical discoveries and breakthroughs that are directly or indirectly traceable to him. The publication and defense of this obituary were meant to poison the well of creative ideas that was the mind of Dr. Horrobin – as we know, such practices are unfortunately entrenched policy at journals like BMJ, not accidental negligence, and require skepticism by readers and careful and objective oversight by editors. Regardless of whether BMJ takes any action, the “rapid responses” to date show that the effort to silence Dr. Horrobin has backfired. Competing interests: Friend and attorney |
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John A. Dodge, Hon Prof of Child Health, University of Wales, Swansea Singleton Hospital, Swansea SA2 8QA
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Patricia Kane has written an alternative to the piece of gutter journalism by Caroline Richmond which was published in the BMJ.Almost all the correspondents referring to the original have been condemnatory, because it did not describe the man they knew. The exceptions have been people who by their own admission had never heard of David Horrobin and could therefore not be expected to empathise with the "outraged pomposity" of his family and friends. One of these writers ("of whom I had never heard") is, surprisingly, a consultant psychiatrist -- surprising because David had not only well known research and popular publications about neuropsychiatric disorders, but he was also president of the Schizophrenia Society. The Kane version gives the Editor and the BMJ a chance to get off the hook. I urge Richard Smith to publish it in full,with as much prominence as the offending Richmond article was accorded, as a way of giving the balance to which the - our- Journal aspires. If anyone is in doubt about its aspirations, read the advice to would-be authors given at this website. Please restore the integrity of the journal. Competing interests: None declared |
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John Hopkins, GP Stockton TS17 6EY
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Dear Dr Smith, The arguments of some contributors about editorial freedom are strong but flawed. It's in all our interests to have a free press, to have newspapers and journals in which people are free to speak their minds. It's in all our interests to be reminded that great men and women have feet of clay and sometimes may have peculiar habits . But, the flip side of free speech is natural justice. And that means giving people the right of reply. This week another national editor has made it his business to drag someone's name through the mud. The individual in question is certainly outspoken, some might consider him a complete fool although they may also find it hard to believe he is a crook. In any event, the truth of the matter will come out because, unlike David Horrobin, the individual is in a position to defend his reputation in a court. In the absence of such a right to reply, the BMJ is indulging in what amounts to bullying of Horrobin and his recently bereaved family. Yours sincerely, John Hopkins Competing interests: None declared |
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Paul K Stockman, Specialist Registrar Haematology Western General Hospital Edinburgh EH4 2XU
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Editor I was sickened to read Caroline Richmond's obituary of David Horrobin. It was an unfair assination of his character which bore no resemblance to the man I knew. Most of the other repondents appear to share this view. I do not think the readers of the BMJ should be left with this false impression of him. I urge you to publish a balanced obituary, written by someone who knew him well. An apology to his family would also be appropriate. Competing interests: None declared |
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Serena Jones, housewife London
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I was wondering when someone would invoke the 'freedom of expression' excuse to justify being nasty and unpleasant. If doctors insulted a helpless patient in their clinic, would the GMC accept that excuse? Competing interests: None declared |
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Susan McGoldrick, Finance Director Laxdale Ltd, Kings Park House, Laurelhill Business Park, Stirling FK7 9JQ.
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How eloquently David Horrobin would have replied to Caroline Richmond’s vicious obituary. He would probably first have apologised profusely for appearing to have forgotten her, such was the gentlemanly nature of the man. It now turns to those who are left to find the words to reply to this epistle. Firstly, the factual inaccuracies, of which there are many: in fact, there is barely a correct “fact” in the obituary. In particular it should be noted that David and his company’s research ethics are not dubious. David held and Laxdale Ltd holds the ethical imperative of medical research at its very heart. Laxdale conducts its research to the highest standards. Secondly, to turn to the opinions expressed by the author on David. With my colleagues at Laxdale, I have had the pleasure and privilege of working for David for a number of years. We do not recognise David from the opinions expressed. His family, friends, people who have worked with and for David, say that David is unrecognisable from Caroline Richmond’s description. It is a consolation that total strangers have replied to this obituary in defence of David whom they did not know, but felt did not justify this assault on his memory 3 weeks after his death. There has been much discussion in the replies to the BMJ as to what an obituary should try to achieve. At the very least an obituary should be accurate, balanced and fair. This piece contains none of these qualities. Finally, as to the tone, we can only speculate why David has had this effect on both Caroline and the editor of the BMJ. Perhaps Caroline’s motive is betrayed by her confession that “Horrobin who didn’t remember me from years earlier….”. One can only assume this is factually correct as David is not here to tell any other version. As to the motivation of the BMJ, again, we can only speculate but for the editor to say in his defence that a negative obituary is the ultimate tribute would be laughable if it was not so hurtful. At a time when his family and his many friends and colleagues are mourning his passing, to have to deal with this outrageous and stupid obituary is disgraceful. The editorial board of the BMJ should be ashamed of itself. An apology is overdue. On behalf of all the staff at Laxdale we wish to submit the following more recognisable view of David Horrobin. David Horrobin was one of the most original scientific minds of his generation. His study of human physiology and the basis of disease lead him to investigate the role of fatty acids and their derivatives in human disease. David applied his knowledge and understanding of lipids to investigate their possible role as therapeutics in many fields of medicine. Born in Bolton, England, he was a scholar of Balliol College, Oxford, where he obtained a First Class Honours medical degree. To this he added a clinical medical degree and a doctorate in neuroscience. He was a fellow of Magdalen College, where he taught medicine to students alongside Dr Hugh Sinclair, one of the pioneers in the field of essential fatty acids. Hugh Sinclair was someone who heavily influenced the future of David’s research. Whilst a medical student he worked for the Flying Doctor Service in East Africa. This led to an interest in Kenya and an appointment in 1969 as Professor of Medical Physiology at its new medical school. David travelled widely in Eastern Africa culminating in his publication of an illustrated guide entitled ‘A guide to Kenya and Northern Tanzania”, in 1971. This became a classic volume that has played a large part in developing the tourist industry of the area. Throughout these travels he developed the kernel of thoughts about fatty acids, schizophrenia and its role in evolution which he elaborated on later in the publication of his book in 2001 entitled “The Madness of Adam and Eve”. This was short- listed in 2002 for the Aventis Science Book of the Year. In 1972 David returned to the UK to the position of Reader in Medical Physiology at the University of Newcastle Medical School, where an interest in essential fatty acids, prostaglandins and the endocrine system developed. In 1975 he took up the position of Professor of Medicine at the University of Montreal which he held for four years. He became increasingly interested in the development of novel therapeutic agents based on lipid biochemistry, and in the application of this field to human diseases. In 1979 David left the University to set up a small pharmaceutical company, Efamol, which changed its name to Scotia several years later. Scotia became one of the first biotech companies to be listed on the London Stock Exchange. Over the course of some 18 years, his innovative approach to research led to the discovery and eventual commercialisation of products within two technologies namely lipids and photodynamic therapy, in the fields of cancer, dermatology and diabetes. Scotia was built up to a company with 450 employees and a market capitalisation of over £400 million at the time of Dr Horrobin’s departure at the end of 1997. In order to concentrate on research in psychiatry David, along with his wife Sherri, set up a new company, Laxdale Limited at the end of 1997. Based in Stirling, Laxdale is developing novel pharmaceuticals for psychiatric and neurodegenerative disorders. Laxdale is working on products for diseases such as Huntington’s disease, depression and schizophrenia. David instilled in his team a passion for the science, an open minded approach to research, and a positive and enthusiastic attitude to clinical research and development. Laxdale’s work will continue and aims to provide a lasting tribute to his memory. David was the founder and Editor of Medical Hypotheses, a forum for the dissemination of new ideas in medicine. He was also the founder and Editor of the journal Prostaglandins, Leukotrienes, and Essential Fatty Acids. He was a prolific writer himself who wrote and edited numerous books on a wide range of subjects, as well as contributing to over 800 scientific publications. One of his main interests was in schizophrenia and he was Medical Adviser and then President for the Schizophrenia Association of Great Britain. Much of his research was devoted to finding a treatment for this condition. David inspired a multitude of people whose lives he touched. He had a unique combination of enthusiasm and tenacity, humility and friendliness, open minded creativity, huge breadth and depth of knowledge and outstanding analytical power. He was a mentor and regarded as an inspiration to many people. David was an outstanding communicator and it has been said by his peers that his ability to express his ideas with such clarity and conviction led them to change the way they thought. There is no greater lasting legacy to him than that. He treated everyone with kindness and respect and his optimistic outlook on life never left him. Some two years ago he fell ill with mantle cell lymphoma, and recently wrote movingly an account of his illness in an article in the Lancet arguing passionately that cancer drug development as presently practised with large scale clinical trials is not ethical. David Horrobin could trace his family origins to a small Yorkshire village called Horrobin, which was wiped out except for a few families in the plague of 1348. He is survived by his wife Sherri, his mother Betty, his brother Peter, his children Cathra and Steven, and his grandchildren Jake, Oscar and Luke. David’s final resting place is on Harris where, for many years, he spent time fishing, thinking, walking and reading. He will be greatly missed. Competing interests: Finance Director of Laxdale Ltd and friend of David Horrobin |
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janet whittington, businesswoman lancrigg, grasmere, LA22 9QL
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Pioneering spirits always attract these bully type responses, perhaps by somehow causing fear in those who feel they are in the gang holding power. More care should be taken by these powers that be when they pour ridicule on people like David Horrobin, if they themselves do not want to look ridiculous and lose peoples trust. With the world wide web people can now readily access excellent information for themselves which enables them to distinguish between genuine debate and bias. Many people have recovered their health, (documented etc) by using EFAs as an essential part of their dietary treatment. The research of scientists like David Horrobin adds to our knowledge of the essential roles of fats in the body and like others in this field he has been attacked in this pathetic piece of journalism. However, due to the controversy and response it is generating, again thanks to the web, more people will become aware of the work of this obviously well respected and dedicated scientist. With sympathy to David Horrobin's wife and family. Competing interests: None declared |
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Woody R McGinnis M.D., private practice 944 Pinecrest Terrace, Ashland OR 97520, USA
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Sirs: David Horrobin took an ethical stance against a major pharmaceutical company early in his career, and fostered creative thinking alternative to mainstream dogma throughout his life. These were the real sins which Richmond was punishing in her black-hearted, venomous, and off-handed dismissal of this great thinker. The BMJ has trivialized itself with publication of a truly tasteless piece. There exists now a huge question about editorial bias and lack of grace. Sincerely, Woody McGinnis M.D. Competing interests: None declared |
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Peter Fitt, Conservationist PO Box 78209, Sandton, 2146, South Africa
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Perhaps the redeeming feature of Caroline Richmond’s poisonous paean and the shoddy editorial talents of Richard Smith lies in the wonderful response their efforts evoked. I learned a deal more about a great man I was lucky enough to call a dear friend. It is a reflection of David’s humility that one should discover after his death and from people whose lives he touched so many illustrations of his extraordinary achievements and acts of generosity untainted by even the smallest suggestion of self- interest. Those who loved David, and have now lost him, have been immeasurably enriched by the privilege of knowing him. Their warm tributes stand in stark contrast to the shrivelled utterances of Richmond, Smith and their solitary supporter. Competing interests: None declared |
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Cathra Horrobin, Equazen Director Equazen, 105 Ladbroke Grove. London W11 1PG
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I wonder what Caroline Richmond and Richard Smith had to fear from my father, David Horrobin. Could it be that, beside the enormity and breadth of his courage, vision, intellect, his great humanity and endless generosity, they felt small and unaccomplished? I don’t know either of them but can only assume that, judging by the pettiness, cowardice and unbelievable distortion of the facts displayed in his obituary in these pages, they have some grudge against him or ‘axe to grind’ that they felt unable to confront while he still lived. If you are going to attempt to write and print obituaries, you had better try to get the facts right and do so in the spirit of what is being written; a summary of the life of someone who can no longer speak for themselves, not a one-sided forum for character assassination. My family and father’s close friends are the first to acknowledge that he was a controversial figure. I can’t think of anyone who ever challenged mainstream thinking who was not. But this goes far beyond controversy. If my father could read his own obituary he would laugh at the weakness shown by it’s author and editor. For anyone who might think this is the biased opinion of a grieving daughter, you might like to turn to the pages of this month’s Lancet for an overview of a rather different David Horrobin. While devastated by the original article, I am comforted by the overwhelming response on this website in support of my father. My family and I have been touched and heartened by the messages. I only hope that Richard Smith has the professionalism to print a TRUE reflection of this outpouring in the next issue of the BMJ. Apart from the almost unbearable sorrow I personally feel at my father’s untimely death and at the loss to my three small sons and new baby – due in three weeks- of a most loving and dedicated grandfather and friend, I also cannot help feeling the great weight of missed opportunity for a world that could well have benefited from a few more years of his visionary challenge. As has been said before, my father was a man far ahead of his time. I have absolutely no doubt that the years will prove this right and look rather more kindly and courageously on his memory. Cathra Horrobin (Kelliher) Daughter Competing interests: David's daughter |
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Richard G Fiddian-Green, None None
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If the Editor believes that publishing a long and odious obituary was the "ultimate tribute" to David what does he think it has done for the company and its stock holders and/or beneficiaries, one of whom must be Sherri Clarkson? Might he have had an undisclosed intent be it personal, investigative, political or commercial? If not did he give any thought to whether the obituary might do interested parties good or harm? If not should he have? More importantly did anyone in government instruct him to publish the obituary and does he really believe that an editor, author or reviewer (grant-funded or not)can ever have less of a conflict of interest than someone with a commerical interest? Putting it another way is it ever possible to give a complete and full disclosure of conflicts of interest? I submit that the academic impartiality of some with commerical interests can be just as great than those without commerical interests. In which case declarations about conflicts of interest in journals are meaningless. Competing interests: A firm belief that patients' interests are best served by a close collaboration between business and academia. An contemporary of David's with an interest in Laxdale's fortunes. |
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Melvyn H Brooks, General Practitioner Karkur, Israel 37000
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Dear Sir I have never been more struck by such a biased obituary notice as that of Caroline Richmond for Dr David Horrobin. A glaring Vendetta. My mind boggles at the possible reasons. I think I will confine my own obituary to the pages of the Hackney Gazette. Sadly I did not have the honour to meet Dr Horrobin but hope to maintain my distance from Ms Richmond. Sincerely Melvyn H.Brooks Competing interests: None declared |
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L Hughes-davies, oncologist Cambridge
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The BMJ seems to have slithered into some awful ignorant swamp. Can Richard Smith really think that it is a good idea to run McCarthyite obituaries viciously slandering talented scientists? Caroline Richmond uses the entire first paragraph of her obituary to describe someone else, who was struck off from the GMC; then insinuates David Horrobin's name into the end of this paragraph. I didnt know anything about this case, but it took me two minutes on Google this evening to find out that the reason the case came before the GMC is because the clinical trials staff at Horrobin's company noticed discrepancies between Jamal's data and that from other participating centres. This was flagged up when they submitted it to the licensing authorities. It doesnt sound like the action of an unethical company to me. Later on in the obituary, Caroline Richmond tells us that "In February this year he [Horrobin] published a personal paper in the Lancet, "Are large clinical trials in rapidly lethal diseases usually unethical?" Typically, much of the argument and many of the "facts" were debatable or wrong. He often wrote about ethics, but his - or his company's - research ethics were considered dubious." I read this paper when it appeared and have just carefully re-read it this evening. I can see no facts that are "wrong" nor arguments that are "debatable". It is a very reasonable and moderate account of the problems of running ethical trials for lethal illness in which there are no effective treatments; I am an oncologist who has looked after patients with advanced mantle cell lymphoma and I can understand exactly why David Horrobin wrote this personal opinion paper. It would be very helpful if Caroline Richmond could tell us which of parts of the argument and which facts she considers inaccurate? Also, while she is doing this, perhaps she could tell us what possible justification she has for the the weasel words that conclude the paragraph "his - or his company's - research ethics were considered dubious". By whom? What evidence is there for this? The GMC may have said that the funding arrangements for Scotia's clinical research were unusual, but they weren't unethical. I would be interested to see if Caroline Richmond can show me a company run clinical trial which doesn't involve an element of payment to participating clinicians. I only met David Horribin once, in the summer of 1980. he was in town for the day to give a talk at my medical school. He was the eminent guest lecturer; I was the first year physiology undergraduate sitting at the back of the lecture hall. After his lecture, I approached him with some questions about lipid metabolism. It must have been obvous to him that my questions were motivated primarily by the examinations that awaited me at the end of term. But he answered my questions, and effectively gave me an hour-long impromptu tutorial on the front bench of a deserted lecture hall. I have never forgotten his care and courtesy. Competing interests: None declared |
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Alastair C. A. Glen, Hon Senior Research Fellow, Glasgow University Glasgow G41 5LP
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In libraries and press cutting rooms all over the world whether in electronic or paper form, the false impression created by David Horrobin's BMJ obituary is being recorded for future reference. It is imperative that the editor of the BMJ makes some attempt at retraction now by publishing an apology to David's family and providing a balanced and sensible obituary. It is the very least he can do. Competing interests: Biochemical Research has been supported by Laxdale |
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Nigel P Willis, Judge of the High Court Johannesburg, Nigel Willis
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I got to know David Horrobin in a field not directly connected with medicine: wildlife conservation. I knew him as a man of integrity and decency. I cannot help thinking that Caroline Richmond's obituary was most unfortunate. Judge Nigel Willis
Competing interests: None declared |
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Amanda Green, P. A. to Dr. David Horrobin and Ms. Sherri Clarkson Laxdale Ltd, Kings Park House, Laurelhill Business Park, Stirling FK7 9JQ
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Caroline Richmond contacted me to thank me for my assistance in providing information to her for David's obituary. I was stunned to receive this email, as it was quite clear from reading David's obituary in the BMJ that Ms. Richmond had completely disregarded any information I passed to her. I worked for David as his P.A. for seven years and I did not recognise David from the venomous picture painted by Ms. Richmond. I am amazed at how David's obituary, which was forwarded to both local and national newspapers by Laxdale Ltd, became unrecognisable in Ms. Richmond's hands. Ms. Richmond certainly managed to ensure that her tribute to David stood out from the crowd - although not for all the right reasons! As far as I am aware, Ms. Richmond did not contact any of David's long-term friends and colleagues that I had recommended, as she had led me to believe she would in her initial contact email. I can only surmise it was because her own little work of spiteful fiction was more entertaining to her and certainly easier than actually attempting even the most minimal of research. Dr. Smith should be ashamed of himself for publishing such an inaccurate and wicked "obituary" and for not having the courage to apologise to David's family, friends, colleagues and readers of the BMJ in the face of such outrage. It is only fair that the BMJ redress this unbalanced and factually incorrect obituary and publish a proper obituary for David. The BMJ website quite clearly states that "a rapid response is forever". And inaccurate print is not? It saddens me to think that David's obituary will be accessed in libraries for many years to come and that all the wonderful emails of support will most probably be lost as the BMJ website is updated. David does not deserve Ms. Richmond's bitter and twisted obituary to be the final printed word in the BMJ on his innovative and altruistic life and career. Dr. Smith, you could do no better than to look to David Horrobin as an example of a fair and just Editor. Competing interests: P.A. to Dr. David Horrobin for seven years and Editorial Assistant to Dr. Horrobin for four years for Medical Hypotheses and Prostaglandins, Leukotrienes and Essential Fatty Acids. P.A. to Ms. Sherri Clarkson |
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Dr Michael John Atkins, Consultant phramaceutical physicisn Roche AL7 3AY
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I was alerted to this article by a colleague. I worked with David Horrobin at Scotia. His death was a shock and this obituary more so. The author (Ms Richmond) clearly has a personal grudge. The spiteful tone is not something I want to see in the BMJ and certainly not in the the obituaries, where a degree of respect for the dead and kindness for living relatives is appropriate. David was a visionary and, yes, he had his failings. His passion for discovery was blunted by his dislike of the formal processes of project management. However, the REAL issue is that the BMJ should publish such an article in the first place. To descibe anyone in terms of a "snake oil salesman" in the BMJ obituaries drags the BMJ down into an area of "journalism" that is better suited to non-medical tabloids. Not impressed ! Competing interests: None declared |
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Bruce G Charlton, Reader in Evolutionary Psychiatry University of Newcastle upon Tyne, NE2 4HH
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David Frederick Horrobin, Director of Laxdale Ltd (born Bolton, England, 6.10.1939, qualified University of Oxford 1968; MA DPhil BM BCh) died from mantle cell lymphoma on 1 April 2003 David Horrobin was one of the most creative and productive clinical scientists of his generation and a philosophical thinker of incisive brilliance, as well as being probably the most successful doctor- businessman of recent years. His legacy is remarkable, and the full extent of his influence only likely to be recognised over future decades. David's medical and scientific career can be divided into five stages. His intellect immediately made itself apparent during his undergraduate years at Balliol College, Oxford where he was a scholar. After taking the top first class honours degree in physiology, he went on to a DPhil with Professor GW Harris, a prize Fellowship at Magdalen College, and only then completed the clinical part of his medical degree at St Mary's, London. In 1969, immediately after house jobs, David began a precocious academic career as Professor and Chairman of Medical Physiology at Nairobi Medical School, Kenya. He published several physiology texts and numerous papers on his principal scientific interest of lipid biochemistry, began a parallel career as a critic and philosopher of medical science with his book Science is God, and wrote a best selling guide book to the part of Africa where he was living. In 1972 he returned to Newcastle University as a Reader, where he founded Medical Hypotheses: the only medical journal dedicated to the publication of ideas. This second stage was rounded-out by David's appointment in 1975 as a Professor of Medicine at the University of Montreal, Canada; where he consolidated his status as one of the major scientists in his field and wrote Medical Hubris - a polemical reply to Ivan Illich's Medical Nemesis. In 1979, David made another big career shift, when he set up Efamol, a pharmaceutical company that discovered and developed novel therapeutic agents based on lipid biochemistry, and one of the pioneers of the 'biotech’ industry. Under its later name of Scotia, the company grew to employ 450 people at a market capitalisation of over 400 million pounds; in the process making David wealthy enough to feature in the Sunday Times top one hundred 'rich list'. In 1997, having achieved major success as an entrepreneurial businessman, David returned to his first love of clinical science by setting-up a smaller and more research-orientated company called Laxdale, to concentrate on psychiatric and neuro-degenerative disorders. In this final stage of his career, David developed several promising lipid-based therapeutic approaches to the treatment of depression and schizophrenia, and published a major theory concerning the origins of schizophrenia. In 2001 he was diagnosed as suffering from a mantle cell lymphoma, but his creativity and productivity continued un-diminished. A Lancet personal paper just a few weeks before his death was characteristic. He argued the need for greatly increased numbers of well-controlled but small (and relatively cheap) clinical trials as a basis of discovering new classes of drugs with large therapeutic effects. This was poignantly linked to his own experiences of existing chemotherapeutic agents, which offered small benefits at the cost of debilitating side effects. In the 1987 edition of the Oxford Textbook of Medicine, David was probably the first to point out that modern medical research represents a considerable decline when compared with the 'golden age' of therapeutic discovery from 1940-65. He believed that 'Big Science' has become dominated by the career interests of professional researchers rather than the urgent needs of patients for new treatments. The result is that modern research has become complacent: contented with reliable but modest incremental improvements to existing treatments, and unwilling to take the risks involved in aiming for major breakthroughs. A few days before his death, David suggested to me that the unifying theme that underlay all the variations of his career was the desire to prevent premature 'closure', a wish to keep scientific debate open and active in areas where the current consensus was quite possibly unfounded. This was done with a distinctive style. Although a man of vast and focused energy, David had a truly delightful and warm personality. Despite doing so much, in so many fields, he never seemed rushed. Despite being a famous and forceful 'contrarian' he never seemed ill-tempered or pessimistic, but always reasonable and positive. And despite being astonishingly 'well- connected' in the establishment world of High Science, David devoted much of his energy to encouraging a multitude of lesser known scientific enthusiasts and eccentrics who he felt just might generate the next big idea. He leaves a wife and business partner, Sherri, two children and three grandchildren. Competing interests: None declared |
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Richard G Fiddian-Green, None None
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In one of the obituaries I read it was observed that David was forced to leave Scotia in a board coup. The net effect was that the stock value of Scotia fell precipitously. Laxdale could suffer the same fate with or without the odious obituary. In the US great value is placed in the "champion" and high premiums are paid for "keyman insurance". In the UK that value appears to be placed in a chairman and board chosen for their reputations in the busness world. Rewards in the US are accordingly much greater for the "champion", his board normally being composed of people largely chosen by the venture capitalists to complement the "champion's" skills. Greater value is placed in the CEO (chief executive officer) recruited to manage the enterprise if he/she has "done it before" than in the presence or absence of an MBA for personal contacts and know-how are so important. The "champion", CEO and FO(financial officer) are rewarded by the value acquired in their stock and/or stock options. The net effect is that they give their all, small companies tending to be bought by larger companies and fewer growing into independent companies. But the US model has been infintely more successful than the UK or for that matter the European model in terms of creating new jobs and businesses. The heart of the matter lies in the manner in which potential "champions" are nurtured and rewarded and in which start-up companies are financed. Given the competitiveness of industry it makes a huge difference if the "champion" can be supported by his university or work. Therein lies the rub because of the unacceptable conflict of interest some believe that creates for an academic and universities might argue that the academic appointment per se is more valuable than the individual. At the end of the day it is the credibility of the individual that counts most in a start-up and the fall in Scotia's stock after David was relieved of his duties demonstrated very clearly the value his investors had placed in him. Universities and governments have become greedy seeing in enterprises such as Laxdale the potential for revenue. Making a success of a start- ups is difficult enough as it is without the universities sticking their commonly excessiely greedy fingers into the pie. If the objective is to create more jobs and wealth the more support and freedom would-be "champions" are given the better. The UK needs many more Davids. Competing interests: None declared |
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Luke Hughes-Davies, oncologist Cambridge CB1 7UA
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It is now becoming obvious that neither Richard Smith nor Caroline Richmond are going to offer an apology, correction, retraction or an alternative obituary for the litany of errors and slurs in the original publication. I have therefore been in touch with the Press Complaints Commission. I was pleased to find out that this organisation continues to protect individuals and their families from malicious journalists and editors after death, that the BMJ is bound by the PCC's code of conduct and that it would be prepared to investigate complaints on behalf of David Horrobin and his family. I therefore urge correspondents to this page to send a complaint in writing or by email to the PCC at pcc@pcc.org.uk. If the complaint is lodged by email, you need to include a postal address. Their website is www.pcc.org.uk. It would be helpful if you could specify which clauses in the Code of Conduct you believe have been breached. In my view the following clauses within the code were breached by the original obituary and by Richard Smith's lack of action since then. SECTION 1 ACCURACY clause 1.i "Newspapers and periodicals must take care not to publish inaccurate, misleading or distorted material" clause 1.ii "Whenever it is recognised that a significant inaccuracy, misleading statement or distorted report has been published, it must be corrected promptly and with due prominence" clause 1.iii "An apology must be published whenever appropriate." SECTION 5 INTRUSION INTO GRIEF OR SHOCK In cases involving personal grief ....publication must be handled sensitively. Competing interests: None declared |
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Catherine C Aitken, Further Education lecturer Lews Castle College, Stornoway HS1 2LL
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This vitriolic and embittered obituary will have shocked and angered many readers of your publication who have come to expect better taste from the British Medical Journal. We can only assume it was penned in a fit of pique by an individual whose shoulder bears a huge chip and who only feels able to let go of her pent-up bitterness now that Dr Horrobin is no longer in a position to defend himself. Where was the editor of the BMJ when such offensive, inaccurate and prejudicial material was presented for inclusion? David Horrobin, as nearly all who knew him will testify, was a good man. A philanthropist in nature and deed, his main aim in his writings and research was to put people before money. Was this such a crime? Competing interests: None declared |
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robert b zurier, Professor of Medicine,Chief of Rheumatology University of Massachustts Medical School Worcester,MA 01655
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To the Editor: What axe is it that Ms Richmond has to grind, I wonder.Interesting that she comments on Dr Horrobin's personal appearance;not usual in an obituary. Indeed,the entire attack is highly unusual.That the editors published it is more disquieting,even disgusting.(Dr Smith's Commentary does not really apply to Ms Richmond's screed which does not exhibit balance or an understanding of the Subject).That Ms Richmond cannot identify properly the fatty acid discussed speaks to the accuracy of her tirade. Does she really know anything about this kind and gentle man? Dr Horrobin's views were long thought to be out of the "mainstream",but in recent years they have been embraced by that same mainstream,including the National Institute of Mental Health(USA).The whole point of Dr Horrobin's work was to understand how fatty acids might be used to treat several devastating diseases. Gammalinolenic acid(GLA) happens to be in evening primrose oil(EPO). Dr Horrobin was of late purifying GLA so that higher doses could be given easily without resorting to administration of the many capsules of EPO or the large capsules of borage seed oil now used. Dr Horrobin visited me in 1978 after reading about our work with prostaglandin E1. He guided me toward studying its precursor fatty acids.I invite Ms Richmond to read our randomised,double-blind,placebo-controlled studies (Leventhal et.al.Ann Int Med. 119:867-73,1993;Zurier et al. Arthritis Rheum. 39:1808-17,1996),funded by the Food and Drug Administration (USA) not by Dr Horrobin, which show that administration of GLA reduces joint inflammation (active synovitis)significantly in patients with rheumatoid arthritis,and I ask her to tell me if they look like snake oil sales. Dr Horrobin's contributions to our understanding of fatty acids in host defense are huge. Robert B Zurier MD Competing interests: None declared |
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Adam Kelliher, Managing Director Equazen, 105 Ladbroke Grove, London W11 1PG
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This list has just been forwarded to BMJ editor Richard Smith, with a request for a full retraction of the obituary, and a prominent apology to David's family for the distress this mendacious article has caused. By my tally there are 29 – to borrow from Ms Richmond -- ‘debatable or wrong’ items, in an article of 834 words! By any criteria, this is a really lousy piece of journalism. Factual Errors: 20 1. In the very first sentence, the referenced link BMJ 2003; 326:730 takes one to a story about the charity commission: this reference does not support Ms Richmond’s claims against Dr Goran Jamal. This should have been picked up on a final edit. 2. If Ms Richmond (or yourself) had bothered to check the BNF, she would have seen that Efalith remains under license. http://bnf.vhn.net/bnf/documents/bnf.2342.html 3. The products contained evening primrose oil …. There is no EPO in Efalith 4. …The company moved to Lancaster because it was a depressed area and set-up funding was available for new businesses ... The Horrobin brothers were from Lancaster, and that is why they based their company there. 5. …synthesised from an essential fatty acid, gamma linoleic acid (GLA)... Its actually Gamma Linolenic Acid. Basic stuff, I would have thought for Ms Richmond, who holds herself to be an authority on EPO. But why did your subs not pick this up? 6. … with high levels of GLA and an attractive name and appearance. Fleabane or hairy bittercress would scarcely have had the same appeal... the name Evening Primrose had nothing to do with David's choice of GLA. Evening Primrose Oil was the only commercial source of GLA in the 1970s. (Borage and/or blackcurrant oils as alternative available sources of GLA did not come along until later). Fleabane or hairy bittercress do not contain GLA. There was no spin, only science behind the use of EPO. Richmond could make the allegation against Starflower Oil, which is a commercially concocted name for borage. 7. …Horrobin soon learnt that selling (EPO) over the counter was barely profitable….The sales of Efamol evening primrose oil over the counter were highly profitable, even with competition. Efamol grew into a pharmaceutical company because it had done the research sufficient to gain a product license to sell Epogam in the UK and various other EU countries. 8. …set up a "boutique" company called Laxdale Ltd in another depressed area, the Isle of Lewis ... Laxdale is based on Stirling, Scotland. Lewis is an island in the Outer Hebridies. 9. In 1979 he … set up the Efamol Research Centre … Efamol Ltd was actually created in 1979. The laboratory was set up in Nova Scotia in 1981. 10. In 1987, the institute was turned into Scotia Pharmaceuticals. The institute remained the R and D arm of the company. It is wrong to say it became the parent company. 11. In 1987, the institute was turned into Scotia Pharmaceuticals. The company was called Scotia Holdings. 12. …Horrobin persuaded Sir James Black, the Nobel prize winning master of drug design, to address the company's press launch... Not much arm-twisting needed for Sir James to attend, as he was a member of the board. 13. …Horrobin made himself controversial at Scotia by installing his wife Sherri, who had no scientific background, as research manager ... David did not 'install' Sherri. She was a director (not a manager) of the holding company responsible for research, and was appointed by the board of Scotia. David had no power to appoint directors: this had to be the collective decision by the board on the basis of what was good for Scotia. Sherri's position was then ratified at the AGM by Scotia shareholders, and consequently held the position for about four years. All standard activity as part of the scrutiny under which PLC's operate. 14. … In 1997, shortly before Scotia collapsed, he was ousted in a boardroom coup ... Two inaccuracies in one sentence. Firstly, David was not 'ousted.' He voluntarily resigned as Chief Executive effective in Dec 1997 because he planned to set up a new company, Laxdale Ltd. He remained as a non-executive director of Scotia Holdings until May 1998 when he resigned because of a disagreement with the direction of the company under its new chief exec, Rob Dow. 15. Secondly, and this is extremely important: Scotia was worth £500m when David stepped down. It went into administration after three years under the helm of Mr Dow. The death of Scotia cannot be laid at the door of David. 16. To me, the most outrageous inaccuracy in the whole piece is the slander that 'many' of David 's 800 papers 'were published in his own journals. Few of them had enormous impact.' The best response to this is from Peter Lapinskas, who, in preparing a bibliography of David’s work, found ‘835 references, of which 39 were from Medical Hypotheses and 34 from Prostaglandins, Leukotrienes and Essential Fatty Acids. The balance of 762 references were therefore by definition published elsewhere, the overwhelming majority in peer-reviewed journals. He was also, in addition, the named inventor on 87 patents. Taken as whole, this is equivalent of publishing a paper, letter, book or patent every 15.4 days for 39 years. This was not 'effortless' - Horrobin was one of the hardest working individuals I have ever met. Is this not a remarkable record of a productive life?’ If it is true that David's life work was flawed, then it would seem that the whole peer-review system is flawed. 17. He wrote or edited over a dozen books, including The Complete Catalogue of British Cars. This was written by his brother, Peter 18. The spelling of the name of my mother-in-law, David's first wife, is Nafisa 19. Nafisa did not take the 'superb photographs in his East Africa guide book.' These were taken by David's father, Frederick Horrobin 20. Perhaps less an error than just sloppy journalism, the last line reads as if Sherri is the mother of David's children -- Steven and Cathra. Their mother is Nafisa, a point that other publications, such as The Lancet, took the time to get right. Negative Editorialising: a total of 9 1. Opening an account on the life of David with the case of Goran Jamal, as proof of 'Scotia's way of working', infers that all David's research was fraudulent. However, you should be aware that the GMC ruled that there was no financial motive for the actions of Dr Jamal. Also, that when Scotia reviewed the data generated from the multi-centre trial they noticed an unexplained variance in results form Dr Jamal's centre and instituted and cooperated with full audits of the trial data. Thus, the data from Dr Jamal's centre was not included in Scotia's submission to the regulatory authorities for approval to market Tarabetic. There is no evidence of any improper conduct by Scotia. 2. Ms Richmond states that the stuff ‘doesn’t work.’ Epogam and Efamast were approved according to the standards of the time, and it is not clear to me from the statements by the MCA as to what research made them review the efficacy of EPO. Her glib assertion that EPO is the ‘remedy for which there is no disease’ is in complete contradiction to substantial work on the beneficial role of this oil. Be assured that if you or Ms Richmond wish to engage in a dialogue on this subject, there is a lot of solid research on the benefits of EPO in particular and omega-6 generally, that had nothing to do with David Horrobin. 3. Snake oil salesman is clearly a pejorative description 4. This line that David was always looking for 'depressed areas' in which to build companies and exploit public funds is completely fatuous. I don’t know how many people in Lancaster, Lewis and Nova Scotia would regard their locations as depressed, but there were good business reasons for basing each office in each location. Scotia/Efamol also had offices in Guildford, Sydney, and Boston. Or do these not fit Richmond's hypothesis? Certainly, providing high quality technical employment in various locations can only be seen as a positive policy. Ms Richmond seems to be trying to twist this fact to indicate that David unscrupulously chased public money. 5. Laxdale being a 'boutique' company: does this mean that it is a shallow front, with little behind it? Nothing could be further from the truth. Laxdale is involved in serious research into a whole host of neurological disorders. The company’s clinical trials are all performed under GCP and ICH guidelines. Ms Richmond denigrates a company she knows nothing about. 6. Typically, much of the argument and many of the "facts" were debatable or wrong. He often wrote about ethics, but hisor his company'sresearch ethics were considered dubious. How could any editor have left this gratuitous, unsupported smear in? Can the BMJ not tell the difference between fact and opinion? Perhaps Ms Richmond, whose record on reporting 'facts' does not bear much scrutiny, could enlighten us on what she saw as debatable or wrong? The article in The Lancet is worth mentioning, for David’s courage of writing on cancer while looking at death in the face. Certainly, the various replies to The Lancet all recognised it for a well reasoned, sensitive and profound offering. 7. Given the overrall sway of this trash, its almost refreshing to get to the stage where Ms Richmond degenerates into name-calling: rotter, unethical etc. (though I think the term Rotter was last used in the UK in about 1950). But it is interesting that you opine in your reply that placing these gratuitous insults beside handsome, charming etc, in some way gives journalistic balance. In reality, when her outwardly positive descriptions are set in the context of the many smears, she is painting a picture of someone who appears more as a seducer, or a cad. This is linked to point 9 below. 8. This line that of David’s phenomenal accomplishment of publishing more than 800 papers …‘Few of them had enormous impact.' I would dearly like to know how Ms Richmond assesses ‘impact’ and note with some amusement that she takes the time to proudly note her one publication in the BMJ in 1987 as somehow significant. But this is tangible proof of her negative editorialising. By declaring that 'few' of David's papers had impact, the obvious point therefore is that other papers were. But are these worth a mention by Ms Richmond? 9. Others in the online response section have commented on the weird, deeply personal references in the piece, on how Ms Richmond found David to be charming and handsome, and that he took her out for dinner and all he wanted to discuss was fatty acids. I don’t know if Ms Richmond had some unrequited feelings for David. But I think such personally loaded statements would behove any editor to question the motives of the person making the submission. Competing interests: None declared |
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Rivita M. Rodrigues, Medical Affairs Manager Please see statement in competing interests
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I was deeply saddened by the Obituary I read recently about David Horrobin and as we have all seen from the Rapid Responses many people feel the same way. So it is with great personal sadness that I write these few words about David Horrobin for whom I have always had the highest regard and respect. Here are a few personal reflections and memories. I remember back in 1987 going for an interview at Efamol Ltd as it was then known and meeting David to discuss the position of Medical Information Manager and coming away from that interview fired up and hoping to work for this company. I looked back on the personal notes I made after that interview and here are the bullet points I made about David. - This man has a rich and perceptive mind. - Written many papers in peer reviewed publications and books on various topics. - Very positive, full of enthusiasm, strong person, very determined. - Talks of long range goals ( formation of a pharmaceutical company to be called Scotia Pharmaceuticals). - Superb scientist and what a creative mind! - Interested in many areas of clinical research which most big companies are not keen to pursue as these areas are not commercially interesting. - Highly motivated and driven personality. - Very persuasive and charismatic personality. I worked for Scotia for 6.5 years. In that time I came to appreciate how fortunate I was to work for a thoroughly professional and ethical company. My experiences of working with David on many projects were always positive. He had the ability to cut through the nonsense, pick out the best bits of everything and shine a light on what often looked to me as a miserable scenario! Often now when I come across a similar scenario, I say to myself this needs the David Horrobin treatment! He was also an excellent and confident communicator, a generous person, a good listener, energetic, strong willed, determined to succeed type of person but sometimes also very impulsive! On his communication skills - I specifically remember a woman with an atopic eczema child ringing medical information desperate for something to help her scratchy, itchy child and David happened to be in my office. At that time we had to follow the ABPI code of practice about giving medical advice to patients so I told her that she was lucky and could speak to a medical doctor. He listened so patiently as the woman went on and on and reassured her as though she was sitting in my office! A few months later the woman wrote in to thank him and said that he had explained clearly what was happening to her child in such a simple lay person way and as a direct result she was able to cope better. She also said she wished all GPs could explain things like him. What a superb skill to be able to communicate at different levels and so fluently and to give patients hope. A highly disciplined man - I recall one occasion of several when he did over 20 internal flights all over Australia and New Zealand late 1988 and he was in the office as always very early in the morning, I asked him if he was jet lagged and tired and he said such things were all in the mind! What strength and devotion to duty I thought to myself, if the man at the top can cope why can't I. He was also a very humble unpretentious person and never boasted of his many successes. It was discovering and researching that preoccupied his mind looking for medicines for helpless patients. Thus he would make us all focus on that goal and motivate us towards achieving them. I especially admired his ability to brush off criticism which I often found difficult to handle, so the told me to grow a tougher outer layer so that I could shield myself and not take things so personally. What good advice which I have put to great use many times thanks to David. I have always kept a tab on papers and books he published even when I left Scotia - for instance his letter in the Lancet recently and his book the Madness of Adam and Eve which was most interesting and thought provoking. He kindly sent me a personal copy which I will cherish. Another thing he used to write was Best Wishes and Keep in Touch in nearly all his correspondence which we did and if ever he promised to send a paper etc he always delivered it not based on your status but you as a person, so I shall really miss this means of communication with a great man. So you see all in all I am so lucky, so very fortunate and so glad I had the chance to work with David Horrobin and I am deeply saddened by his passing away. There are many many more lovely moments and tough ones too that I will always treasure and store in my memory of this truly great man. Ms Rivita Rodrigues Competing interests: Previously employed at Scotia Pharmaceuticals 1988-1994 (Medical and Marketing Departments). This is a personal e-mail independent of my current employers. I do not give out details of my current employers out of confidentiality. |
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Zachary Dutton, Emerge Pharma Inc. 2080 NW Everett St. Portland, OR USA
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David Horrobin was my step father and I consider myself fortunate to have known him for most of my life. To say I was shocked at the obituary published in the BMJ is an understatement. I was appalled at the tone and the thinly veiled innuendos. The nature of the obituary makes me question its intent. If the intent was to give a fair and balanced view of the man and his life's work, his successes and his failures; as befits a prestigious medical journal, then clearly it failed. If, on the other hand, the intent was to settle a score with David and ensure that Dr. Smith and Ms. Richmond got the last word in, then, I am sorry to say, it succeeded. Congratulations to them both on beating up a dead man.
Competing interests: None declared |
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Håvard Bentsen, Postdoctoral research fellow Aker University Hospital, Dep. of Psychiatry, N-0320 Oslo, Norway
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The grotesque obituary on David F. Horrobin in 19th April BMJ has entailed a lot of upset 'rapid responses'. I still feel it is right to share with you some memories I have of David in order to correct as well as possible the distorted picture given by BMJ. I fully agree with those who ask for an alternative obituary and an apology.
I first met David in 1996. Inspired by his ideas, we started a Norwegian randomised clinical trial on EPA and vitamins E and C treatment of schizophrenia. David and Laxdale Ltd. were willing to support us financially and with EPA supplies. Without their support we could not have run this study, which is still going on. David accepted to be one of the three members of the steering committee. I never felt dictated by David. He gave advices when asked. Rarely, we disagreed, but then he always let me decide.I was never afraid that he would suppress a negative result of the study. David's basic motivation seemed to be finding the truth. Money was the means he needed to pursue this search. Of course being both a top researcher and a 'big business' man might have caused ethical dilemmas, which I think David was fully aware of. In searching the truth, David stated that he was always willing to change his hypotheses if evidence argued against them. When I once objected to his presentations, that he rarely mentionned arguments against his theories, he answered that his obligation was to present his basic visions about the importance of the phospholipid metabolism in mental disorders. Others would certainly take care of contradicting his views. He seemed - like Albert Einstein - primarily to be driven by a strong and genial intuition. In the beginning, evidence in favour of his hypotheses was scant, like his prostaglandin hypothesis of schizophrenia in the late 70's. But he was still convinced that there was something right in them. At that stage, it is often the fate of creative thinkers to be ridiculized. I have several time witnessed how David has been treated derogatorily by peers. This is natural: a man of such exceptional merits will evoke envy and jealousy. He regretted this, but I never heard him talk with disrespect about any other man or woman. David seemed to have a profound sympathy for those who suffered and for the simple, natural way of life. When he visited Oslo in 1997, I brought him to the Norwegian Folk Museum. There was especially one exhibition he would like to see: the one on the Lapps or the Sami. This people native of the Northern parts of the Nordic countries, has been oppressed and despised for hundreds of years by their neighbours. They have lived very close to nature, following nature's own rhythms. This fascinated David. David's life has come to an end. But his image in us who met him will survive. Why did he, as a person, impress me so much? I think it was his unique combination of geniality and generosity, a man of both exceptional merits and humility and fiendliness. He has given hope to many suffering people, patients as well as their relatives. I feel very privileged to have known this very wise and very kind man. Competing interests: Financial support from Laxdale Ltd. |
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Victoria S.E. Macdonald, social affairs correspondent C4 News Channel Four News WC1X8XZ
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Dear Sir I was so sad to hear of David Horrobin's premature death. As a health journalist, I had interviewed him on several occasions and admired him for his vision, his care and above all his desire to tackle diseases and conditions that so many others had neglected. Some time after I met him through work a close friend of mine married his daughter Cathra and I came across him once or twice socially. He was always charming, yes, and fascinating. He had so many passions, he was always full of enthusiasm and full of life. And then I read Caroline Richmond's obituary and I felt sick to my stomach that she could write and you could print something so mealy- mouthed, inaccurate and deeply offensive to his family and friends and legion of admirers. In fact, I do not think I have ever read an obituary quite like it. That it started with a description of a GMC fraud case only served to establish that Caroline Richmond had a bone to pick. It added nothing, it said nothing about his life and his work. That in the next breath she should describe David Horrobin as a snake oil salesman was beneath contempt. I can only add to the numerous responses you have had following this obituary that the BMJ cannot hide behind freedom of expression as a justification. There are libel laws and there is a press complaints commission for the very reason that people cross the boundaries of decency and fairness. I truly believe in this instance you have done just that. Competing interests: None declared |
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Paul S MacDougall, Microbiology Technologist/Instructor University College of Cape Breton
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The piece below was originally published on Friday, April 4, 2003 in The Halifax Herald. It's not even worthing commenting on, or being clever in my derision, or using sarcastic comments and glib off the cuff remarks in describing the way I felt after reading the obituary selected by Richard Smith to remember the passing of David Horrobin. I will defend my home province of Nova Scotia though. It is not, and never was, a "depressed place" as Ms Richmond seems so expertly fit to describe it. The comments below were written by myself two days after David died of cancer,a disease he spent years researching a cure for. ----------------------------------------- Remembering David Horrobin By Paul MacDougall BETWEEN 1994 and 1998, I was fortunate to work with one of the most intelligent, innovative and unique scientists who ever lived in Nova Scotia. I say unique because Dr. David Horrobin, who died of cancer this past week in his native Scotland, never discounted any possibility, hypothesis, crazy theory or homespun anecdotal piece of evidence in his quest to discover novel drug treatments for numerous diseases. I say work with, because for everyone who worked at Efamol Research Inc. (ERI) in Kentville, David made you feel part of the Efamol family. David Horrobin founded Scotia Pharmaceuticals in the 1980s with the inspiration of his wife, Sherri Clarkson. Sherri is owed credit for developing the Nova Scotia component, ERI, which was a large employer in the Annapolis Valley. David was the scientific genius and heart of the company. During its finest period in 1997, ERI employed close to 80 technologists, research scientists, sales, marketing and administrative people, and David knew everyone by name. For many residents of the area, ERI was the biotechnological jewel in the crown of the Valley. In the 20 or so years David ran Scotia Pharmaceuticals, with labs, production plants and administration facilities in the United Kingdom and Nova Scotia, he never tired. He worked effortlessly, read volumes of material and edited his own journal, Medical Hypotheses, dedicated to publishing articles on theories that many scientific periodicals wouldn't run as they were too unproven or holistic in nature. When I worked at ERI, the established procedure was for David to fly into Nova Scotia every eight weeks for two days of meetings with the various research groups. Much of ERI's focus at the time was on cancer research using essential fatty acids derived from evening primrose oil. It was during these meetings David's true vision came through. Educated in both medicine and the sciences, David could speak volumes on any subject related to health. He understood every disease, present treatment, folk remedy and future possibilities for cures. He took into account everything from concentrations of compounds, drug interactions, patients' mental states and even the role of gravity and the moon on cell cycles and testing procedures. When you left a meeting, your head spun in a dozen different directions, but one thing was always clear: David wanted to make sick people better. A major concern of David's was alleviating the devastating effects of mental illnesses. One of the last joint staff meetings he gave at ERI in 1998 dealt with schizophrenia and the role he believed essential fatty acids could have in its treatment and possible cure. Globally, schizophrenia affects one in every 100 people and David was always emphasizing the ripple effect of this disease on family and friends. He considered it one of the most pressing health problems in the world that was under-serviced by most research and pharmaceutical companies, because of the difficulty in understanding the illness and dealing with the patients who suffered from it. Due to a series of administrative power struggles in the late 1990s within Scotia Pharmaceuticals, David lost control of the company. Around the same time, he began to get ill. Not one to give up, even though he'd lost a company valued at £600 million, he went on to start a smaller company in Scotland dealing mainly with mental illnesses. Efamol Research Incorporated no longer exists in Nova Scotia. The building, the last time I drove past, was beginning to show signs of neglect. Layoffs, packages and eventually the whole company closing two years ago sent people off in new directions. Most of the technologists and scientists who had their first jobs at ERI, even though they complained about low starting salaries, have gone on to rewarding careers in universities, government and other research companies. Many companies which owe their own success to the ground-breaking work David Horrobin did to promote science and biotechnology in Nova Scotia. Nova Scotia lost a great deal when David Horrobin left a few years ago. Now the whole scientific and research community has suffered an even bigger loss, with the passing of a scientist of true vision and heart. Paul MacDougall teaches at the University College of Cape Breton in Sydney, Nova Scotia Competing interests: None declared |
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Geoffrey A Machin, Fetal/Genetic Pathologist Department of Pathology, Kaiser Permanente, 280 West MacArthur Blvd, Oakland, CA 94611, USA
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I look forward to reading Richmond's obituary in due course. Who is this person? Am I supposed to know her? Is she qualified for this work? I don't usually read the BMJ, and this obituary reinforces my reading habits. If I ever want to pick up a copy for easy reading on a flight, I will know where to look in the book-store - somewhere between muscle building and girlie magazines. I do not know whether David Horrobin's career was distinguished or not. I can't judge his business practices. But I was contemporary with him in high school and at Oxford, and I graduated in medicine at about the same time. So I knew him in his youth, when he held extraordinary promise. Although we both later worked in Canada, I saw him seldom, though I was aware that he took on giants, which is why he left the Institute in Montreal. It was clear from the earliest stage that David Horrobin had great intelligence of a degree that put him way ahead of anyone else among his contemporaries. He could understand principles of knowledge rapidly and effortlessly. I think his first textbook of physiology shows this well. Seeing things clearly is a rare gift, and it needs to be used wisely. I remember his impatience with the imprecisions and inaccuracies of clinical medicine when he chafed as a clinical medical student at St Mary's. It never seemed likely that he would fit happily into the medical establishment or get closely involved in medical practice. At school, there was an unusually effective group of teachers, particularly in the sciences. David thrived in this atmosphere, and was one of three contemporary students who found their way into the biological sciences. One became a distinguished malariologist, one toils in prenatal diagnosis and medical genetics, and David Horrobin was the third. We would reminisce about those teachers, who remain vividly in my memory. But I think we were also taught to be guardedly critical of the status quo. I have found this essential to my career, though it has made for me enemies with whom I still do battle. It seems that David Horrobin had the same experience. It may be the strong non-conformist, counter-cultural aspects of David's character that have upset some people, including his obituarist, but I think that such people perform a most necessary function in an age when research grants are largely predicated on already knowing the results, and in which there are allegations of old-boy networks controlling research funding. Some people may have the drive and combination of circumstances to be able to work outside the establishment, thereby keeping clear of the managerial treacle that ensnares within institutions so many who are constrained to walk much more slowly than David ever could or would. Why should this provoke peevish and petty sniping? David may have been charming and handsome (I am not a good judge), he may have written a few of his many papers in the journals he founded and edited, and he may have established businesses in depressed areas. But I prefer charming and handsome people to rude and ugly obituaries, and I fail to see why anyone is to be sneered at for bringing employment where it is needed. I don't think it is by accident that David went on a university expedition to Nepal while at Oxford. This may explain his early interest also in East Africa. These aspects of his life, as well as his very wide knowledge and reading in diverse areas ouside medicine, especially in poetry and literature, are not covered by this mean-spirited and spiteful obituary. There is no doubt that David was a most unusual and diversely talented individual, who packed about twenty times as much into his life as any of the rest of us puny mortals. I cannot judge how much of his diverse activity was good, bad or indifferent, but he deserves a more graceful and fitting farewell than he received in the pages of this journal. I am comforted by the thought that I have had such an obscure career in medicine. When my time comes, I run no risk of having my ashes raked over by feline claws. I have no words for the efforts and inadequate justification from the editor. This has been bad and hasty judgement, and I believe an apology and a more balanced and generous obituary should be printed in full in the BMJ. Some drafts of obituaries have already appeared as responses. As for Richmond, maybe she should be hired by one of the tabloids, as other responders have suggested. Whereas I have declared my "competing interests", did Richmond have none? Competing interests: schoolmate; contemporary; author of one article in "Medical Hypotheses"; opponent of slag jounalism |
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Agnes K Ayton, Consultant Child and Adolescent Psychiatrist 2062-68 Hessle Rd, Hessle HU13 9NW
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In the current edition of the BMJ Ms Richmond has written a non- offensive "traditional" obituary (the type that was labelled by Richard Smith as "usually a great disappointment because they describe only the positive side of the dead person… they are unbelievable, incomplete, and dull"). Furthermore, the editor has chosen "Fatty acids and blood pressure - supplementing infant milk may reduce cardiovascular risk" as the headline on the front cover - just two weeks after dismissing David Horrobin as "the greatest snake oil salesman of his age". What does this mean? Although, with regard to Richmond's obituary for David Horrobin, neither apologies nor corrections have yet been issued, it almost appears as if Richard Smith has now attempted to correct his earlier error of editorial judgement. It could not have escaped his attention that Forsyth (1) et al found that dietary LCPUFA supplementation has potential health benefits (as has been shown by other influential studies (2)). This is exactly the area of research to which David Horrobin devoted his career from the outset. He worked on the physiology and potential therapeutic role of LCPUFAs (and not just EPO). He published several dozen articles on the cardiovascular effects of various dietary fatty acids, involving both theoretical (3) and experimental work. Furthermore, one of the references quoted in Forsyth's article was published in Prostaglandins, Leukotrienes and Essential Fatty Acids (4) - edited by David Horrobin. All of which hardly tallies with Ms Richmond's assertion that his work made little impact. I do not understand why the BMJ feels the need to rely on journalists to write obituaries. This is the journal of the British Medical Association, which includes more than 100000 members. An obituary in the BMJ signals the final respect of the British medical community. This is best done by peers, who can place someone's work into context. Other prestigious bodies, like the Royal Historical Society, follow this tradition. Ultimately, an offensive and inaccurate obituary reflects badly not just on the editor, but on the membership, particularly given that the journal is circulated worldwide. References 1. Forsyth JS, Willatts P, Agostoni C, Bissenden J, Casaer P, Boehm G. Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomised controlled trial. BMJ 2003; 326:953. 2. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI- Prevenzione trial. Lancet 1999; 354:447-55. 3. Horrobin DF. Low prevalences of coronary heart disease (CHD), psoriasis, asthma and rheumatoid arthritis in Eskimos: are they caused by high dietary intake of eicosapentaenoic acid (EPA), a genetic variation of essential fatty acid (EFA) metabolism or a combination of both? Medical Hypotheses 1987; 22:421-8. 4. Engler MM, Engler MB, Kroetz DL, Boswell KDB, Neeley E, Krassner SM. The effects of a diet rich in docosahexaenoic acid on organ and vascular fatty acid composition in spontaneously hypertensive rats. Prostaglandins, Leukotrienes and Essential Fatty Acids 1999; 61:289-95. Competing interests: BMA member |
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Caroline Richmond, Obituary writer SW3 5AQ
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AUTHOR’S REPLY: I take issue with the assertion that David published over 800 papers. Many of them were conference talks, and some were single-paragraph rapid responses in the BMJ and therefore it is an exaggeration to call these ‘papers’. Others were “unpublished results” or in obscure periodicals including The Messenger, J Nutr Sci Vitaminol Tokyo, Living Naturally, and Fats for the Future. Of the papers, the majority are about the role or metabolism of evening primrose oil, fish oil or essential fatty acids in a range of over forty conditions ranging from Aids, acne, ageing, aggression and impulsivity, aspirin-induced haemorrhage, alcohol dependence syndrome, atopic eczema and atherosclerosis, to schizophrenia, seborrhoeic dermatitis, Sicca syndrome, Sjogren’s syndrome, tardive dyskinesia and viral infections. I rest my case. Scotia, the company he founded and which made him one of the richest men in England, managed to convince the medicines licensing authorities of the efficacy of evening primrose oil in only two indications, atopic eczema and benign breast pain of the premenstrual syndrome. Both of these licences were later withdrawn, which casts doubt on the quality of the original data. After I had submitted my copy with the BMJ I learned that a systematic review of Efamol in atopic eczema showed that it reduced doctor-assessed itch but not patient- assessed itch. The company then threatened to sue if the data were made public. His review articles and hypotheses were often superbly written and a pleasure to read. He was also a brilliant speaker. David was a man of contradictions. I wrote the obituary without malice, and I didn’t know what I was going to write until I had spoken to people who knew him or knew his work. He had a brilliant career at Oxford, but there wasn’t room to include details. He was a man who could have been great but whose faults made it impossible, and this is the true nature of tragedy. CAROLINE RICHMOND Competing interests: None declared |
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Stephanie Boyd, lecturer London
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Caroline, no-one minds that you criticised David Horrobin's ideas. And certainly no-one really cares exactly how many papers he wrote (although since you gave the figure of 800 in your original obituary, it is a bit odd to see you dispute it in your reply). In fact, ultimately no-one minds if you think his ideas were bonkers. You think he was wrong-headed, that's fine. It was perfectly okay to put all this into the obituary (you could have been far more forceful, and probably wouldnt have heard a cheep out of the readers) You are perfectly entitled to your own views about all of this. That is not what has caused the offence. What everyone cares about is the fact that a reasonable person reading your obituary would conclude that David Horrobin was a fraudulent and dishonest man. This is simply not true. It is a calumny which has already been picked up and amplified in other newspapers. So your obituary has destroyed the reputation of a dead man, within days of his death, for ever. This is why there is outrage in the responses. Perhaps you could focus your mind on this, and reply to it? You must also have noticed that the tone of your piece has caused widespread offence. You may have written it without malice, in which case this was unintentional. But the offence is no less real. Perhaps you might also Competing interests: None declared |
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John Hopkins, GP Stockton TS17 6EY
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Dear Dr Smith, As doctors we are continually be advised, not least by the BMJ, that we should be adult enough to apologise when we get things wrong. Even the most callow teenager would have been able to recognise the offence and hurt caused by Richmond’s obituary. Yet in her reply she is unable to come even close to an apology. I don’t know where the BMJ is heading but, in making the long journey from Brain to Cosmopolitan (1), you seem to have lost your way. Yours sincerely, John Hopkins (1) R Smith The BMJ Moving on BMJ 2002;324:5 January 2002 Competing interests: None declared |
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David Walliker, Medical Research Council Scientist University of Edinburgh, EH9 3JT
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I also have read with distaste Ms Richmond’s vituperative obituary to David Horrobin. Together with Geoff Machin (see his response of May 2nd), I was privileged to have shared a formative part of my education with David in the 1950’s, at King’s College School in Wimbledon. Extremely clever people are often rather strange in other characteristics, but David epitomised the superb all-rounder. Indeed, rather frustratingly for the rest of us lesser mortals, he even excelled at sport as well as academic subjects, as well as being a thoroughly modest and charming person. So it caused little surprise when we saw his career take off in his student days at Oxford, and he was destined to remain an unattainable rôle model for us all. Subsequently we lost touch, but through his son Steven I was fortunately able to renew our acquaintance a few years ago, to find that he was unchanged by his extraordinarily successful career. The pharmaceutical industry is a hard place, but the warm comments and reminiscences of your correspondents are the best testament that his primary motivation in taking up a medical career was simply to do what he could to improve health. Their comments must assuredly be comforting to David’s family, for whose feelings Ms Richmond seems to have had no regard. I can only assume that Richard Smith must have been suffering a brainstorm in deciding that it was fit to be published, and, like your other correspondents here, trust that apologies from both of them will be forthcoming, in print in the BMJ. Competing interests: None declared |
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John H. Lange, Environmental and Occupational Consultant Envirosafe Training and Consultants, Inc., P.O. Box 114022, Pittsburgh, PA 15239
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Upon hearing of the untimely death of Dr. David F. Horrobin via email from Amanda Green I was saddened and then reading the Obituary by Caroline Richmond (1) I was horrified. I personally never met Dr. Horrobin, but feel I got to know him through the journal Medical Hypotheses. Early in my career I published my second journal article in Medical Hypotheses (2), my first was in Lancet, and to my surprise I received hundreds of reprint requests. This impressed me. Subsequently, I have gone on to publish over 100 articles, including a few more in Medical Hypotheses. I felt that Dr. Horrobin gave me, along with many others, an insight to the scientific and medical world through Medical Hypotheses. This was and remains a wonderful journal, especially for those that look into the future and have dreams of innovation, as did Dr. Horrobin. Why someone would write any negative aspects about one’s life as in the Obituary by Ms Richmond is beyond my imagination. None of us in life are perfect, and if we were, what a boring life it would be. The words by Ms. Richmond were unkind to the memory of Dr. Horrobin and his friends and family. It is a sad day to read such an Obituary, especially in the BMJ. Two quotations are worth remembering from authors’ that I do not recall – “Two out ten people will like you, two will hate you and the other six just don’t care” and “The only importance is that your family and friends love you and who really cares about the rest”. I’ll let you guess where I believe Ms. Richmond fits within both of these. References 1. Richmond C. Obituary – David Horrobin. British Medical Journal 2003; 326: 885. 2. Lange JH, Talbott EO, Baffone KM, Weyel DA, Soboslay EG, Koros AMC, and Sykora JL. Anti-cancer activities of selenium. Medical Hypotheses. 1997; 23: 443-447 Competing interests: None declared |
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Peter G W Lapinskas, Independent consultant 26 Deepdene Wood, Dorking, Surrey, RH5 4BQ, UK
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Ms Richmond writes: "I wrote the obituary without malice..." My goodness! What kind of obituary would she write if she had malice? Competing interests: Previously Seed Production Director at Scotia Pharmaceuticals Ltd. |
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Robert B Zurier, Professor of Medicine and Chief of Rheumatology University of Massachusetts Worcester MA 01655 (USA)
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Ms Richmond: You rest your case? On those diseases you mention? You mean Schizophrenia and the other awful conditions listed are not important? C'mon Ms Richmond,'fess up. What is your case? Just what is your motivation for - if not slander - overtly unbalanced,inaccurate,tabloid journalism? Do you know anything about how inspiring and helpful David was to so many colleagues and young investigators? Do you know how their lives were enriched by David's quiet kindness,enormous intellect,energy,and vision? What do you know,Ms Richmond, and what does the BMJ editor know that qualifies you to be the author of Dr Horrobin's Obituary? Bob Zurier Competing interests: None declared |
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Jamie Cunliffe, Fitness instructor now ! SO45 4PB
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Caroline, For me that reply will simply not do. I stand by my previous response. This obituary, that you still seem to be justifying, has all the appearance of being written with malice, packed with innuendo and being a clear attempt at a character assassination. At some stage either you or the editor of the Independent have been aware that the BMJ obituary was far too opinionated and absolute for the Independent. Even though the insinuations and innuendo are still there, it is much watered down. It is this absolute quality - we are to believe without a shadow of a doubt that this man was malign although superficially charming - that is disconcerting. The obituary could easily have been written to put all your doubts about him in such a way that they were seen as your opinion (which may prove wrong) and leaves the reader to begin to question the character of this man. But your article was pure propaganda. Would you like us to chant (five hundred times after you), “this man was a rotter”? If you have no appreciation that the way you have written this obituary was likely to be offensive then you can have little insight. Here, I will paraphrase you and say that to reach your maturity and have little insight is “the true nature of tragedy”. Or you have insight but it was simply malicious. Even in your retort you peddle your innuendo. “I rest my case” – what case? You haven’t defined it; you have simply implied there is something unsavoury or inadequate here. Define and justify it please before you repeat more of this innuendo. “Casts doubt on the quality of the original data”. Do you not mean validity? This is more innuendo. “The company then threatened to sue if the data were made public”. I note, in the Independent that you get closer to implying that when David Horrobin took you out for this meal to convince you of the error of your ways that this threat of being sued was delivered then. That establishes a conflict of interest not declared at any time to the BMJ. “There wasn’t room to include details” but there was room (one fifth of the article) dedicated to setting the scene by associating (with innuendo) David Horrobin with a scandal perpetrated by another person. You are a journalist; you should be very aware that subtle timings and choices of words can leave ambiguous meanings. Each individual innuendo might be excused as a slip of the pen but when we see such a consistent pattern rising out of the noise, many people will, and have, attribute(d) malice to the piece. So what is the agenda? Open up please. To quote Robert Zurier “C'mon Ms Richmond,'fess up. What is your case? Just what is your motivation for - if not slander - overtly unbalanced,inaccurate,tabloid journalism?” Lastly, these folk seem to think that you have other conflicts of interest not declared to the BMJ. http://www.meactionuk.org.uk/Caroline_Richm ond_Deja_vu.htm I ain’t listening to your words until I know your agenda. Competing interests: As before - he got me into print and I like a lot of what he wrote |
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Jamie Cunliffe, Fitness instructor SO45 4PB
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Richard (Smith), I would like to state my great dislike for referring to people by their surname alone. I grew up in a school in which the headmaster maintained his hierarchical authority by referring to his current and ex pupils as, for example “Cunliffe”. I remember one occasion on which an old pupil remembered himself to this head as “Mr So and So”. The response of this headmaster was little short of a tantrum and I remember, in retrospect, being troubled by both his fury and understanding any justification for it. I guess this would have passed without further notice had not one of my bosses, Larry Liversege (MRI in Manchester) asked me my name. With wlling submission to this institutionalised heirachy, I replied “Cunliffe”. Larry neither liked hierarchy nor pomp. He immediately rebuked me by saying that only Lords were entitled to be called by their “Surname” alone. All other people had a title and/or a first name. Intended or not, the use of a surname in isolation carries the potential baggage of arrogance, an implied hierarchy or a distancing from the individual. I believe the BMJ could and should exorcise this pompous habit from the obituary pages. Competing interests: As previous response |
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Bo Norberg, Associate Professor Eepartment of Internal Medicine, University Hospital of Northern Sweden, SE-901 85 Umeå, Sweden
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The necrology about David Horobin by Caroline Richmond appears to have shocked some colleges. However, both Horobin and Richmond are understandable from the football model of human life (1). A star player cannot take ovations for granted in a foreign field. The Richmond elegy of human restrictions and limitations also frames work and splendour of Horobin. The obituary provides an honour for Horobin, for Richmond, and for the broad-minded editors of BMJ. Bo Norberg 1. Norberg B. Chaos Park – a model of the production game [health]. Rondel 2000; 2. URL: http://www.rondellen.net Competing interests: Editor of The Rondel,www.rondellen.net |
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Nancy L Morse, Director of Scientific Affairs Nutricia Canada Inc., 35 Webster Street, Suite 103, Kentville, N.S., B4N 1H4
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I have never been so furious or hurt in my life as I was when I read David Horrobin's obituary as written by Caroline Richmond. For four days I have been trying to formulate an appropriate response from my perspective. I am still unable to finalize something that would adequately convey my disdain for the BMJ for having published such disgusting trash! The English language does not possess sufficient descriptive words to express my emotions in this regard! If I feel such anguish in response to this injustice, I cannot imagine how hurt David's family must be. How could anyone be so cruel! If David were alive today he would dismiss your insults with a shrug of his shoulder and a boisterous laugh. I wish I were able to do the same. I was one of the fortunate people to be employed by David in one of the depressed areas he so ruthlessly exploited! I thank GOD everyday for his decision to locate the Efamol Research Institute in Nova Scotia! I was able to lead a very successful and exciting career without having to move away from my family, friends and the pristine beauty of the valley. My life has been enriched beyond anything that could have been otherwise because of David - and it continues to be so. Perhaps Nova Scotia is "depressed" by your ignorant standards. However, I can tell you that the superior quality of life in this little province has persuaded many researchers who moved here from major research centers to work at the Efamol Research Institute, to remain following its demise. They have gone on to successful careers in our universities, government and the private sector, and have helped to build a successful biotechnology industry here. In fact, I believe the health products industry in Nova Scotia would not be what it is today, if it had not been for David Horrobin. David's use of our local government funding has actually done what it was intended to do. It has improved our local economy and it will continue to have far reaching positive impact. Ms Richmond, I would also like to dispute your empty-headed statement that in Scotia's "ten year existence it obtained medicinal licenses for only three products". Clearly you know very little about pharmaceutical product development and even less about Efamol/Scotia. That record is not a failure, it is a tremendous accomplishment! To set the record straight: David's innovative approach to research led to the discovery and eventual commercialization of a multitude of natural health fatty acid products sold in over 40 countries under the brand name Efamol and a vast array of lipid based pharmaceuticals and photodynamic therapies in various stages of development for treatment of cancer, dermatology, diabetes, cardiovascular disease and brain disorders, etc. This phenomenal track record positioned Scotia as one of the most productive pharmaceutical companies in the world in relation to its size and corporate expenditure. During its fifteen year anniversary celebration, in 1996 it was quoted to have spent $320 million in R&D to bring four pharmaceutical products to market and to develop an additional six to their late stages. Larger pharmaceutical companies had quoted development costs of up to $600 million per product during that time. That same year, Acadia University, Wolfville, Nova Scotia, awarded David an honorary doctorate in recognition of his scientific achievements and to his wife Sherri Clarkson for her contribution to growth and prosperity of the local region. Caroline Richmond, how dare you make a mockery of such a worthy endeavor? You have no idea who David Horrobin was or what he has accomplished in his lifetime. Let me tell you about the David Horrobin that I knew. David left Efamol and Scotia in late 1997, and that was the last time I saw him in person. About a year later I made a decision to leave the company as well. On the evening of my last day, my telephone rang at around 10:00pm. It was David calling from Scotland to see if I was O.K. It was 2:00 am his time. Have you ever shown that degree of care and concern for anyone? Some months later, I rejoined the Efamol business after Scotia sold it. When David, and his wife Sherri were told that I was still trying to follow current lipid research even though my time resources were scarce, they instructed one of their Research Associates at Laxdale Ltd. to supply me every month with abstracts from recently published relevant articles. This was done with no service fee and would achieve no financial gain on their part. It was simply an act of kindness and generosity. Their only reward was knowing that I would use the information to help someone in need. To this day I am still receiving those documents. This was the David Horrobin that I knew. He had a profound sympathy for those who suffered and his primary objective was always to benefit mankind. I'm sure that every person who worked closely with him and really knew him could tell a similar story to mine. David touched many people in a special way, and their lives would not have been the same without him. Indeed the course of global lipid research and the speed within which this field has grown would not have been the same without David Horrobin. He propelled its development twenty years into the future. Proof of this can been seen through scanning some of his earliest publications where he presented hypotheses that were viewed by many at that time as wildly speculative. Now, many of those preliminary ideas are accepted as common knowledge. Would lipid research be where it is today if it had not been for David Horrobin? I think not. I am also certain that in the coming years we will see the true magnitude of his vision. Caroline Richmond, I feel sorry for you. Those of us who have the ability to comprehend the complexity and the enormity of David's acumen will be forever blessed with a desire to search for the truth. You, however, will have to carry the knowledge of your shortcomings with you for the rest of your life. In addition, you will be remembered as the woman who unsuccessfully tried to discredit the contributions of one of the world's greatest pioneers in medical research. And Richard Smith, you will be remembered as her partner-in-crime. Competing interests: I started working with David Horrobin in 1982 and was the Vice President/Deputy Laboratory Director of Efamol Research Inc./Scotia Pharmaceuticals (Canada) Ltd. when he left the company in 1997. My opinions expressed in this correspondence are independent of my current employer. |
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Richard Smith, Editor BMJ
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I'm grateful to all the people who have responded to the obituary we published of David Horrobin. One result is a fascinating archive of tributes to Horrobin. Another result has been an interesting debate on the function of obituaries, a debate that is perhaps overdue in the BMJ We are responding in several ways. 1. We have posted all the rapid responses we have received, even those that were wildly intemperate. 2. We will within days be posting corrections to the original obituary. These will also be published in the paper edition of the BMJ- probably the issue of 17 May. We apologise for these errors. Many respondents argued that the obituary was full of inaccuracies, implying that it was worthless. It did contain some inaccuracies, but the inaccuracies are comparatively minor and not really the cause of the offence that many people felt. We have corrected what is clearly wrong-for example, the spelling of gamma linolenic [not linoleic] acid-but most of what people found objectionable were opinions not facts. But where is the bounday between a fact and an opinion? This is not always clear, and an example is the statement that "many of Horrobin's 800 published papers were published in his own journals." It seems to have been more than 30 out of 800. Is this many? Compared with two or three, it's many. It's also many compared with journals where the editors think it wrong to publish original papers in their own journals. But is it many as a proportion of 800? Probably not. "Some" might have been a better word. 3. We will publish a selection of the responses in the paper edition of the journal, including shortened versions of some of the alternative obituaries posted. We will also summarise all the responses-and a response from me (which will be much shorter than this). These to should appear in the issue of 17 May. 4. We will of course respond to any communication from the Press Complaints Commission, and I'm grateful to respondents for pointing out that the BMJ is regulated by the commission. We pay for the privilege. Several complaints have been made over the years to the commission about the BMJ, but none have so far been upheld. The commission is more familiar with the rough world of tabloid newspapers than it is with the gentlemanly (forgive the sexist word, but it seems right) world of medical journals. 5. I will publish soon an editorial on how to complain about the BMJ. 6. We will publish soon an editorial that discusses the function of obituaries. I've posted another rapid response that includes preliminary ideas. I welcome responses. Finally, I want to make clear my own relation to David Horrobin. I certainly spoke to him on the phone a few times-and we called each other by our first names. I think that I met him (but I'm not sure)-at a meeting on peer review. What he and I had in common is great scepticism about peer review. We also have both exhibited a taste for the controversial and for publicity. I have a suspicion that he might have enjoyed this contretemps- even if his followers haven't. Richard Smith, editor, BMJ Competing interests: I am the editor of the BMJ and accountable for all it contains. |
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Richard Smith, Editor BMJ
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The heated debate over the BMJ's obituary of David Horrobin raises an interesting question about what obituaries are for and how they should be written. Some obituaries, including most of those published in the BMJ, are little more than death notices. They provide rudimentary information on the person who has died, and no attempt is made to judge the person's life. Everything was wonderful. The pieces are dense with cliches and are usually written by colleagues of those who have died. The colleagues are rarely used to writing, and the result is amateur. If I was more courageous than I am I would stop publishing such obituaries, but we have good evidence that many readers like them-- although a lot of readers-particularly those from outside Britain (now the majority)-never read them. A more interesting function of obituaries is to produce a sketch of people's lives. They can only be sketches-rather than definitive statements-because they must be written quickly in a limited number of words. They are journalism. Further, time must pass before any kind of definitive judgement can be attempted, and even biographies of the same people written years after their deaths will often tell very different stories. For most of us there is no definitive judgement. We simply disappear. If I die tonight and a hundred publications were to commission an obituary (which is highly unlikely) then a hundred different views would be produced. Some might flatter me. Some would probably be poisonous. The best would contain a mixture of positive and negative, as was Caroline Richmond's obituary of David Horrobin. All in some sense would be "true." Should editors suppress those that are negative or more negative than positive? We don't do that for book reviews. Why should obituaries be different from book reviews? "Death," wrote Winston Churchill to his wife in 1915, "is only an incident and not the most important which happens to us in this state of being." We are trying to publish at least one obituary a week that is well written and not simply a glorified death notice. We commission most of these pieces, and we usually use a journalist. Caroline Richmond has probably written more than anybody else. She also writes them for the Lancet, the Independent, and other publications. It's a difficult job to produce a sketch very quickly. Interestingly, most people who didn't know Horrobin and who weren't aware of the fuss (in other words, most readers) didn't think of the obituary as completely negative. To them it seemed balanced. Everybody agrees that Horrobin was unusually clever, creative, and charming. The debate is over whether he in some ways wasted his gifts. Many think he didn't, but some think he did. Time may tell, but it may not. Richard Smith, editor, BMJ Competing interests: I am the editor of the BMJ and accountable for all that it contains. |
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Dianne C LeFevre, Consult Psychiatrist in Psychotherapy Mental Health Unit, Basildon Hospital, Basildon Essex SS16 5NL
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Sir, Shaming and humiliating is the sport of bullies who attack those who cannot defend themselves. Bullying is a form of abuse. Abusisng someone who is dead cannot be equated with a balanced account of the good and bad aspects of the individual. ( see Richard Smith's letter). Caroline Richmond's obituary has practically nothing to recommend it. It gave the impression that the author is so troubled with toxic venemous feelings that she was barely able to restrain herself enough to put in some positive points in order to give some semblence of objectivity. However these points sounded like " graft-ons". As many people have pointed out the piece was full of inaccuracies aand asssumptions with nothing to back them up. ( see particularly "Ill informeded venom" and " BMJ has it really lost the plot.") What is most disgraceful and unprofessional is that nobody has given a thought to the effect that this might have on vulnerable and impressionable patients who read it ( doctors are also patients) and the idea that ill informed doctors might pass on the information or treat the inaccurate rantings as fact. I have been treating severe and enduring mental illness as well as various physical disorders for many years and many of my patients have benefitted enormously from treatment with fatty acids. It is clear that Ms Richmond is not a clinician , otherwise an awareness of ethical considerations might have helped her restrain herself a little more effectively. Perhaps Dr Richard Smith might like to change to obituary column to comic format and head it "Oh! Bitchery!" and make it a free for all in which the excesses of envy, destructiveness, sadism and rage might find a home. It might be a helpful cathartic exercise for some. David Horrobin was a brilliant, far sighted, innovative scientist, a thinker, a poetic and humerous personality and a very decent person who had the courage to pursue what he believed in - all qualities that provoke envy. If he were here now I would congratulate him for getting up the noses of the stuffy club members who have long forgotten how to think. As it is I am deeply saddened by the fact that the BMJ has seen fit to print a piece so unworthy of circulation, so hurtful to David's family and so potentially demoralisisng and harmful to patients - a thoroughly destructive act which reflects very badly on Richard Smith as editor. David's death has left a David Horrobin shaped hole in the world. What a great loss for the scientific world and what a painful loss for many, many people, including myself. I have no doubt that in time the value of his work will achieve recognition and appropriate status. I feel strongly that at the very least an apology from Richard Smith might be a step in the direction of healthy reparation as a start to countering the surfiet of destructiveness. To this might be added some explanation of what change in agenda allowed the publication of Ms Richmond's inaccurate and cruel account in the first place. And in addition the BMJ might undertake to publish the " Rapid response " comments as a booklet". Competing interests: Friens of David Horrobin |
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noemi levine, none 94104
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I am a non-British, non-medical reader of BMJ & a devotee of its obits section. I do generally like to read obituaries, but the BMJ's are the only ones I read regularly. I think of them as I think of all obits: mini-history lessons from a personal perspective. Not only have I learned about men & women responsible for great advances in medicine, but I have learned about ordinary doctors from all over the world - or the Commonwealth anyway. Despite the fact that from early childhood on, I have hated many doctors I thought were more interested in studying me than helping me, the obits remind me that most doctors have spent their lives working in the service of others. Many have been teachers too, making them double candidates for canonization, but their obits sre their final points of recognition. The obit is a send-off, it is the equivalent of putting a coin under the tongue to ensure a safe passage to Elysia. I like the self-written ones best, then the ones written by family & close friends. I like to see all these doctors as normal people. I like meeting all these wonderful people I would never have heard of otherwise. I'm sorry, but just once a week I like to think the world is filled with wonderful people. It is good to read about long lives well-spent; it is necessary to read about the ones cut short by cancers, car smashes & suicides. It is through their lives they will be remembered, & this is the only glimpse of their lives I will catch. My only problem with the obits is that I have to click again to get them unabridged. Why bother shortening them? Obviously anyone who's written one has taken care with it & it is almost always worth reading the longer version. Don't worry, we know nobody was loved by all his patients & students - you don't have to consider journalistic ethics before printing something like that. You do have to consider before printing an obit like David Horrobin's. I knew nothing about him or lipids before reading it & I came away thinking he really was the proverbial snake-oil sslesman. The ensuing rapid responses have been quite an education besides being entertaining as all get-out. Thank you for making BMJ free to all on the net; it is even more valuable to me now that JAMA has shut off non-subscribers from most of its features. Keep the obits please. Competing interests: None declared |
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eamonn clarke, gp PE14
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"wildly intemperate" can I be the first to say: "Pot...... Kettle,
Thank you Competing interests: None declared |
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Peter G W Lapinskas, Independent Consultant 26 Deepdene Wood, Dorking, Surrey, RH5 4BQ, UK
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I feel that Ms Richmond has not been entirely open with us. In 1989, Caroline Richmond helped found a pressure group called the Campaign Against Health Fraud (now known as Healthwatch UK and sometimes referred to as the 'Quackbusters') with the laudable aim of exposing health fraud and promoting the use of clinical trials(1). She is still a member of the governing committee, and over the years the group has produced 49 lengthy newsletters detailing action on a vast range of issues(2). It was in 1987 that Ms Richmond confronted Horrobin with her belief that evening primrose oil was a panacea, and came away from her meeting unmoved. It appears therefore that this noble campaigner against health fraud sat on her hands and said nothing for 14 years while the greatest snake oil salesman of the century duped gullible regulatory authorities across the world (not to mention peer-reviewed academic journals) with his fraudulent data. During that time, hundreds of tonnes of evening primrose oil were sold to unsuspecting consumers, but in the index to the 47 newsletters, there is not a single reference to 'Horrobin', 'evening primrose oil', 'GLA' or even 'fatty acids'(3). Yet within two weeks of his funeral, she felt able to denounce him in the strongest possible terms. This raises two issues: 1) If Richmond truly believed that Horrobin was a fraud, why (apart from abject cowardice) did she not challenge him publicly while he was alive? 2) How can she claim an absence of malice, when Horrobin apparently stood for everything she was campaigning against? In order to achieve balance, I should point out that Ms Richmond is quite good at spelling and has nice hair. (1) http://www.healthwatch-uk.org/index.html (2) http://www.healthwatch-uk.org/index.html#fulltext (3) http://www.healthwatch-uk.org/hwindex.html Competing interests: Formerly Seed Production Director for Scotia Pharmaceuticals Ltd. |
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Jamie Cunliffe, Fitness instructor SO45 4PB
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Richard, You ask, "But where is the bounday between a fact and an opinion?" I would simply reply "Where opinion is boldly paraded as fact" or where opinion is paraded in such a way that its prime goal is to indoctrinate those receiving it. It is incumbent on all writers to recognise what is opinion and declare it openly as such. I am used to being authoritatively rubbished where opinion is boldly paraded as fact and have grown to have a passionate zeal for responding to this where ever I recognise it. We are all entitled to our opinions and they might indeed prove to be right but we have no right to try and brainwash others into accepting our opinions as the "truth" or as fact. David Horrobin, I am sure, would laud this viewpoint. He would also, I guess, have been "tickled pink" by the furore that this has stirred up. Let openness conquer! Competing interests: As before and an intense dislike of opinion dressed up as fact |
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Ellen Goudsmit, Psychologist and writer Teddington TW11 9QX
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Dr Smith still seems unable to differentiate between negative but fair criticisms and defamation. The furore here is above all, about the defamatory aspects of the obituary. I think most of us can cope with negative. I find it rather extraordinary that a person who has such problems understanding concepts like defamation, should he be editing a major medical journal. It's not exactly rocket science! Is it? Competing interests: None declared |
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Ewan D Millar, Pharmaceutical Physician 48 Kettilstoun Mains
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If you wish to read about the activities of this organisation in the past there is an excellent book called "Dirty Medicine" by Martin Walker which features Caroline Richmond amongst others prominently. I do not think it is still in print but it was published in 1993. Regards Dr Ewan Millar Competing interests: Formally medical director of Scotia Pharmaceuticals |
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Stephen C. Cunnane, Full Professor University of Toronto M5S 3E2
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David packed a tremendous amount into a life cut tragically short by cancer. Since his death on April 1, 2003, much has been written about his life, character, and scientific ambitions, particularly in response to a bitter obituary in the British Medical Journal. As a former PhD student of David's at McGill University in Montreal, I want to publically record a few thoughts. David was teaching a Physiology course I was taking to qualify for medical school. As was his trademark, he lectured beautifully and simply, so, out of the blue, I asked him what I should do if I wasn't accepted for medical school. He said - come and do a PhD with us. I didn't get into medical school so I joined his lab and started to learn about the confusing effects of prostaglandins on vascular function. Within 6 months, and with David's firm insistence, I had submitted a paper to Nature. That was exhilarating stuff for a student who a few months previously was a medical school wannabe. The paper was rejected but that was almost immaterial. The point is that David could see things in quite ordinary data that made one feel something special had been accomplished; he knew how to motivate. He could write clearly and convincingly about our experiments as if they were all breakthroughs. He could also see a path through the mostly contradictory literature on prostaglandin physiology. He didn't invent but he often oversimplified. This was frustrating for his students and for many others as well. I think it contributed to people being opinionated about him. After two years post-doctoral work learning experimental nutrition methodology in the UK, I returned to Canada to rejoin David at his newly established Efamol Research Institute in Kentville, Nova Scotia. He wanted me to determine whether some nutrients might be limiting for metabolism of polyunsaturated fatty acids in general but especially for effective utilization of gamma-linolenic acid. David had invested considerable energy in the therapeutic potential of evening primrose oil and wanted to leave no stone unturned in securing its clinical applications or financial success. Gradually we began to interpret results differently and I wanted to do more basic and less applied research. I also sought acceptance by my academic colleagues which, for me, was impossible in David's shadow. So, after four years in Kentville, I accepted a faculty position at the University of Toronto. For some time afterwards David and I talked little as I tried to distance myself from his name and research. We had a couple of acrimonious exchanges but more or less left eachother alone. I don't recall what got us back in touch. We had had sporadic contact and having to raise money for the ISSFAL 2002 conference in Montreal was one incentive for me to reach out to him at Laxdale. Whatever it was, after quite a few years on my own feet, I had more confidence about where I was going in my research and was less overwhemed by his enthusiasm and energy. He would politely but mercilessly reinterpret one's data. He had endless references. He could find the money or the right people to do the experiments he thought were crucial. He was tireless and continually focussed, which demoralized some people. We got back to gether over the subject of dietay fats and human brain evolution. I co-organized a little meeting and invited David. He offerred to pay for the dinner for the 8 or 9 speakers presenting the next day. That was quintessential David - generosity while seeking an intimate oppportunity to talk with others; to learn and persuade at the same time. That meeting was about a year ago and brought me full circle with him. I never saw him again but feel that, by then, we had buried our differences. I was no longer in his shadow but richer for having been. Competing interests: former PhD student |
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Jamie Cunliffe, Fitness instructor SO45 4PB
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I didn’t clearly address Richard Smith’s question when responding last time. I think our concept of a “fact” is a bit misleading. We tend to use “fact” where we mean an observation; we regard them as immutable and irrefutable. It is a “fact” (an observation) that the sun rises every morning. Observations need to be entirely empirical and detached from an interpretative paradigm. They should describe carefully what happens and they should be as unprejudiced as possible. Now, we are all quickly tempted into interpreting observations in the light of some preconceived and (quite likely) distorting perspective and it is most often then that we call them ”facts”. In actual practice, nearly all our “facts” are interpretative opinions about observations. So, the most productive distinction is not between a fact and an opinion but between an observation and an opinion. An observation should be made using every effort to avoid interpretation. As soon as an interpretation is added (eg, the sun rises because the earth rotates) we add in an opinion about the reason for that observation and we prejudice any fresh interpretation of it. In the progress of science, conceptual Jack-in-the-Boxes regularly come along that make us reinterpret our (“facts”) observations. Science gets hung up by old paradigms because the reigning cognoscenti act as if “facts” are immutable and irrefutable. But, the only way we can control quality is to ensure that observations are made in the least prejudiced way we can manage. So now, returning to the earlier email, the idea of opinions dressed up as “fact” takes on a clearer meaning. And there were a lot of interpretations (either direct or, more often, by innuendo) in Caroline’s article on DH. None of them were painstakingly unprejudiced observations. I suggest that we need to “catch ourselves out” and “flag it up” whenever we turn an empirical observation into an opinion. (Should you be tempted to fill in a little more detail around this subject then look at http://bmj.com/cgi/eletters/321/7260/0#9560 and the other responses in this earlier debate.) Competing interests: As in earlier responses |
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Anthony W. Fox, President, EBD Group Carlsbad, CA, 92009, USA
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Sir- More or less everything that is going to be said about this obituary probably has been said. I should merely like to record joining the overwhelming majority in expressing distaste at the obituary, disatisfaction with the editorial process that led to it, and disappointment at the editor's and author's responses to very reasoned criticism. A complaint to the Press Complaints Commission has been filed. To me, the code has been breached at seven places: [1(i),1(ii), 1(iii), 1(iv), 2, 3, and 5]. In a nutshell these relate to uncorrected and unacknowledged gross error (with, for many examples, affirmatory evidence of lack of acknowledgment provided by responses from both author and editor), failure of apology, inability of the dead to respond to accusations, violations of privacy, and intrusion into shock or grief. Within some of the code breaches there are numerous individual causes, leading to a larger number of specific complaints. In my view, several opportunities to repair the damage have been missed. Of all the battles to pick, why would Dr.Smith take such a stand over an obituary ? Editors can claim to exercise freedom of speech, etc. But, do people who exercise that freedom in this sort of manner deserve to be editors ? As a member of the BMA, my view is that OUR journal is being abused. If Dr.Smith thinks that stunts like this are needed to enliven the BMJ, then he should think deeply about the rest of the journal, and take his chances in places where personal offence, egregiously administered by a gun hired specifically for the purpose, will not occur. Tony Fox Competing interests: None declared |
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Sebastian Faulks, Novelist Gillon Aitken Associates, 29 Fernshaw Road, London SW10 OTG
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I am not qualified to contribute to the medical discussion about David Horrobin's work. However, as someone who has spent a lifetime in or around newspapers, I was surprised by how badly written and inadequate your obituary was. Horrobin's book The Madness of Adam and Eve is one of the most wide- ranging and suggestive books I have ever read. I asked if I could go and see him to discuss its contents, since they are relevant to the background of a novel I am currently writing. Dr Horrobin's reply, to a complete stranger, was one of exemplary kindness and scholarly generosity. He came to dinner at my house a few weeks before he died, and although in obvious discomfort, he shared with me his thoughts on a huge array of subjects. It is a conversation the memory of which I shall treasure for the rest of my life. It is true that, like everyone else who has ever tried, David Horrobin did not unlock the chemical secrets of schizophrenia; but he suggested ways forward and fruitful possibilities of further research. His attitude to the problem was clearly based on profound human sympathies. I am not, as I sad, qualified as a doctor, but as a writer and human being who had the pleasure of meeting David Horrobin I found the inadequacy of your obituary little short of disgraceful. Yours sincerely
Competing interests: None declared |
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Eddie Vos, maintains http://www.health-heart.org Sutton Qc Canada J0E 2K0
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Ms. Richmond rested her case about Dr. Horrobin publishing about over 40 diseases and their relation to the polyunsaturated fatty acids--which I take as her disbelief that so many diseases might have a fatty acid link. Yet, apart from the water, about half the brain is fatty acids and their combinations and this is not for padding, this is how the brain works. Cell walls without the fatty acids to which Dr. Horrobin devoted his life are unthinkable and would make them as functional as candle wax. Find a disease where fatty acids do NOT play a role and only then can one minimize his contribution to our understanding of the fatty acids. The role of fatty acids in life is as fundamental as genetics and proteins, and understood as little. While I believe that the obituary should not have been published as is, it is fitting that corrections and letters to the editor will be published and BMJ is to be congratulated for the posting of all electronic responses and for an editorial and internet openness and debate that other major journals have not been able to match. I would agree with the Editor that this obituary might help secure his unique stature in the science of fatty acids and membrane lipids. Competing interests: None declared |
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Christopher Somes-Charlton, Unemployed W11 2BW
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As an outsider, with no involvement in the medical field and no knowledge of David Horrobin (until I read Caroline Richmond’s obituary and the lengthy angry response it provoked), I find Richard Smith’s self- justificatory cant of 18 April (Why a negative obituary is the ultimate tribute) quite repugnant. I am quite sure that most of the BMJ’s readership is sufficiently mature and wise to realise that any individual’s ‘achievement’ will be a balance of positives and negatives. We should all have the courage to face death in the knowledge that our contributions will be assessed not merely by our friends and supporters, but also by our peers and our critics. But herein lies the responsibility on the part of any journal or newspaper editor to ensure fair play. Just as an editor should assure himself of the integrity of the processes used and evidence adduced before publication of any new theory or ‘insight’ report, so some critical review of draft obituaries is in order. It is hard not to see Caroline Richmond’s obituary as anything other than a hatchet job. What positive references she does make are under- played, whilst she makes sweeping attacks on Horrobin’s integrity and lifetime’s work. With Richard Smith’s laissez faire approach, I can only wonder about the obituaries which might be written about Ms Richmond, in due course. But then perhaps other BMJ’s readers have a little more respect for the dead. Yours Christopher Somes-Charlton Competing interests: None declared |
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David Curtis, Consultant psychiatrist Royal London Hospital, Whitechapel, London E1 1BB
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Just stumbled across this after being alerted in the Doctors UK forum. Because I mercifully left the BMA a few months ago and no longer receive the BMJ. Neither an unpredicted nor an undesired outcome. I'm afraid what you're all experiencing in typical Smithness. He wants to liven up his nasty little rag and it seems will try practically anything, regardless of considerations of morality, convention, ethics, scientific worth, fairness or any mundane values which we non-journalists might hold dear. Here, it seems he freely admits to publishing a negative, and probably in the broadest sense dishonest, obituary for purely journalistic reasons. How nasty is that! If you want further examples of the kinds of things he gets up to you can probably find some by searching on my name among contributions like this one. This should yield a few references to things I wrote back in the days when I actually cared what the BMJ published. Likewise you may still be able to find online somewhere his lecture justifying his publication of the albumen affair - that should give you an insight into how he operates and what he thinks is important. What he cares about is a "good" story. Note that for a journalist like him this is not the same as a true story or an important story. And the "scientific" papers in the BMJ are treated largely as "stories" from what I can see. And if they weren't he would like them to be. What I did about all this was to resign from the BMA. I'd say Smith and Bogle made about equal contributions to this decision. What I would recommend to others is either to do the same, making clear why, or to agitate within the organisation to make Smith behave himself or, probably better, find employment elsewhere. The former course of action involves the BMA actually losing money, so they may take more notice. I see that Bogle at least is now admitting he was wrong on the consultant contract issue. For myself, I certainly won't be hurrying back. David Curtis MRCPsych MD PhD Competing interests: I have for a long time had a bee in my bonnet about the uselessness of the BMJ and the arrogance of the editor |
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H Anne Leaver, Clinical Scientist National Science Laboratory, Scottish National Blood Transfusion Service, Edinburgh EH17 7QT
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To Dr Smith Editor British Medical Journal Dear Dr Smith, I was shocked by the unbalanced and unjustified opinion expressed by Caroline Richmond in David Horrobins' orbituary which appeared in the 19th April edition of the British Medical Journal. David Horrobin was concerned with essential fatty acid metabolism in a much wider sense than the trivial story about evening primrose oil presented in the obituary. His cancer reviews and his textbook Medical Physiology and Biochemistry are widely quoted and respected. His ideas have opened up new research areas in cell biology and human physiology. In addition to basic research into essential fatty acids, David Horrobin published important original papers on long-term potentiation, lipid metabolism in schizophrenia and delta-6 desaturase. His ability to write in terms of general scientific process is demonstrated by his letters to the British Medical Journal on cancer cell growth, statistics in medical research, new drug discovery techniques and non-financial conflicts of interest. David Horrobins’ legacy will endure in the body of work that he has established in lipid metabolism and his challenging hypotheses will continue to generate research into the basis of human disease processes. One only has to enter any chemist’s shop or supermarket to see the influence of David Horrobins' work on popular demand for essential fatty acids, Yours Sincerely,
Dr HA Leaver
Competing interests: I contributed unpaid work to a glioma project supported by Scotia Pharmaceuticals. Some of my papers on essential fatty acids were published in Prostaglandins, Leucotrienes and Essential Fatty Acids |
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Alessandra Bordoni, researcher Department of Biochemistry
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When I met David Horrobin for the first time I was a very young researcher. He invited me at a Meeting on gamma-linolenic acid, since I was the first author of a biochemical and clinical study on the use of evening primrose oil in very young atopic children. I was very impressed by David, not only from a scientific point of view, but also for his kindness and humanity. In the following years, although we seldom met, we began to write each other quite often about scientific problems. I continued working on PUFA metabolism and fatty acid desaturation, and many times I wrote him to have his opinion and suggestions about my researches. I do say that his ideas and suggestions were always brilliant, and many times he indicated me the right way to solve problems. I never worked "for" him or his Companies, even though working on gamma-linolenic acid, and I know nothing about his bussiness. What I surely know is that he was a great scientist, and I am honoured to say "He was my teacher, he was my friend"! Competing interests: None declared |
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Morris Karmazyn, Professor University of Western Ontario, London, Ontario, Canada, N6A 5C1
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One can only be grateful that this vituperative piece of drivel was written in such a plodding and tedious fashion that even David's detractors will feel daunted to re-read it. I predict, and certainly hope, that the painful piece will soon be relegated to the dustbin where it really belongs and urge the BMJ to publish a truly honest obituary which will do service to an outstanding, compassionate and brilliant human being. David, I hope you rest in peace but am certain you're now chuckling somewhat at the passionate views you continue to generate. Morris Karmazyn Competing interests: Former PhD student of DFH |
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Geoffrey A Machin, Fetal/Genetic Pathologist The Permanente Medical Group, 280 West MacArthur Blvd, Oakland, CA, 94611, USA
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I was glad to see the editor's piece in which he stated that a revised obituary and a summary of responses will be published in hard copy. This is why I wrote because it is what I had hoped for; I approve of his decision. Whereas some of the responses are possibly prejudiced because they are written by people who worked closely with or are related to David Horrobin, for me the obituary just seemed unbalanced and unfair. In my haste to make an early response, I failed to mention that I support the editor's concept that obituaries should reflect as many aspects as possible. It is healthy that they should not represent a sanitised or adulatory view of a career. Perhaps many obituaries err in that direction. But I thought that the tone of the notice made it clear that there were, indeed, "competing interests" here. Whereas we responders are asked to reveal our interests, the tone of the notice implied that the obituarist had a great deal on her agenda that was openly declared neither at the time nor in her subsequent response. Some responses have showed what these "interest" might be, but the obituarists has still not chosen to come clean. When there are such interests, the obituarist has two choices: the superhuman task of putting aside the agenda, or withdrawing. The editor and obituarist did not make a mature decision here. Many of the responders have pointed out the extent to which David bore his intelligence and knowledge so lightly. This was my experience also, and I think it must have required willpower and patience on his part. To have done as much in 63 years still seems amazing, and time will tell how much of the work is of true and lasting value. It is interesting that Sebastian Faulks has made a comment, because I had always thought of David Horrobin as a sort of Fatal Englishman, although he lived longer than most of that genre. For me, at least, his death is a real blow, and I look forward to reading the revised and unbiased summary of his life and times. Competing interests: As stated previously |
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David Roberts, GP non-principal NN14 1ND
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I have carefully read all three of Dr Smith's responses to the furore created by the publication of the Horrobin obituary. Nowhere was there the slightest intimation of regret for the gratuitous offence caused to David Horrobin's wife and family. Nowhere was there any indication that an apology would be forthcoming from the editor of what was considered to be a highly reputable international medical journal. Still less from the author of the item. Smith claims that he is responsible for the total content of the BMJ but that seems to stop when it comes to apologising. Apologising not for the inaccuracies but the needless addition to the grief of relatives. What I did read was even more unedifying self-justification of the type which appears regularly in the Readers Letters columns of the Radio Times. In my initial response I put some questions to the editor. I refer him back to that original response. Now more than ever they need an answer. Amongst other matters I questioned the need to use professional journalists to write obituaries. In Council the other day I also questioned the need to use M/s Richmond who has produced a similar obituary in the past. He will be aware of Council's feeling on the whole matter. I also suggested that it has now become a regrettable necessity for writers of obituaries to declare their own conflicting interests. Surely, if that had been done in this case M/s Richmond would have been short of at least one journalistic fee. Many of the above respondents are awaiting Dr Smith's apology to David Horrobin's family. One wonders for how much longer? Life may not be long enough for an apology from M/s Richmond. Competing interests: A member of the BMA Council |
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LINDA FORSYTH (NEE FISHER), ANALYTICAL PORJECTS MANAGER PROVA, GU15 3BW
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I was very shocked and absolutely disgusted to read that someone could write David's obituary in that disgraceful manner. It was incredibly malicious and extremely hurtful to Sherri and the family and to all those who knew and worked for him. I, like many others who had the privilege to work for him, am very upset to hear of his passing and can't understand why anyone would want to be so cruel. I worked for Scotia Pharmaceuticals in Carlisle for nearly 8 years and was very grateful for the opportunity to work in what was such a fantastic atmosphere of creativity, inspired by David and his colleagues. His vision gave me and many others the opportunity to work and live in our home towns in those "depressed areas" (Do you know your geography, Caroline - have you ever been to these places??!), and gave us an incredible start to our present careers. The "depressing" thing for us and the Company was when he left Scotia!! David was an amazing man, very creative and an inspiration to a great many people. He deserves a far better obituary than Caroline Richmond could ever write. I am amazed that the BMJ could let such a spiteful piece through the editorial net. Competing interests: None declared |
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Keith R. Farwell, Trade Mark Attorney Phillips & Leigh, 5 Pemberton Row, London EC4A 3BA
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Dear Sirs The obituary of Caroline Richmond had factual errors of a very basic nature which could easily have been checked from public record sources (such as the UK Trade Mark Registry online records, or the UK Companies Register) or from generalised knowledge of the commercialised biotech sector. As a new angle to the dialogue, you may wish to note the following, when you publish your promised corrections. 1. The TARABETIC drug was previously known as EFABETIC. The EFAMOL trade mark was (and is) used for a well-regarded range of evening primrose oil supplements, widely available in supermarkets and health food stores. 2. The EPOGAM and EFALITH products were succesfully commercialised under license to GD Searle and marketed in the UK, Republic of Ireland and elsewhere. Clearly a company like Searle was prepared to throw its weight behind the product because it sold. 3. Given the size of Scotia compared to "big pharma", it was in fact a tremendous success to bring even three products through the lengthy and bureaucratic product approval process to market. The comment that Scotia obtained medical licences for "only three products" shows an ignorance of the need for a research pipeline to achieve even one product approval, given the wastage of projects en route and attendant costs. 4. The writer neglects entirely to mention the most significant of Scotia's products, commercialised under the FOSCAN trade mark. This Temoporfin product is a palliative treatment of patients with head and neck squamous cell carcinoma failing prior therapies and unsuitable for radiotherapy, surgery or systemic chemotherapy. Due to the work of David Horrobin's team, FOSCAN received EMEA approval on 24 October 2001 under numbers EU/1/01/197/001 and EU/1/01/197/002. 5. David Horrobin set up Efamol Limited, a company incorporated in England & Wales, to market EFAMOL evening primrose oil products (not Efamol Research Institute, which came later). He did so to raise funds for his research. 6. Efamol Research Institute was not "turned into" Scotia Pharmaceuticals; Scotia Pharmaceuticals Limited was the trading and intellectual property owning company. 7. David Horrobin was not "ousted in a boardroom coup". He was the victim of the short termism of City investors and bankers. After he took Efamol (later renamed Scotia) public, to raise further finance for research, he faced constant sniping from the City. Indeed, much of his time was wasted placating the money-men. The city won, and forced the appointment of a man who broke up the company founded by David Horrobin within three years. 8. Laxdale Limited was not set up to "market essential fatty acids". It was set up as a research vehicle - with many of the people sacked after his removal from Scotia choosing to join him. Yours faithfully Keith Farwell Competing interests: Trade Mark Consultant to Scotia Pharmaceuticals Limited 1996-98 |
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Silvana Hrelia, Professor of Biochemistry Department of Biochemistry, University of Bologna, Bologna (Italy)
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Sir, just a few days ago I received an e-mail message advising me about the obituary in the BMJ about David Horrobin. After I have read the discraceful obituary by Caroline Richmond (who is she?) I was really astonished. First of all, the most unkind act is to humiliate a dead person. David inspired a multitude of people whose lives he touched, and my life, too. My knowledge of David Horrobin dates in the early ‘90s, when, inspired by the great ideas reported in his papers (he was really a pioneer), I asked him to help me in studying the influence of ageing on the polyunsaturated fatty acid metabolism in liver. He introduced me in the “magic” world of fatty acid desaturases. We published the first paper in collaboration in Biochimica et Biophysica Acta in the year 1991. Since 1990 our scientific collaboration continued successfully and his suggestions were always brilliant. I met David Horrobin only twice, the first one in 1992 in Florence at the “Prostaglandins” meeting, the second, and, unfortunately, the last one, 3 years ago, at the same meeting in Florence. Apart of his deep knowledge in lipid research, he gave me the feeling of enthusiasm, humility and friendliness, and I have been immeasurably enriched by the privilege of knowing him. Usually, Italian people are considered to have “no self-control”, but, after having read the obituary by Caroline Richmond, I think that Mrs. Richmond has completely lost her "self-control". With simpathy to David’s wife and family. Silvana Hrelia, Professor of Biochemistry, Department of Biochemistry
Competing interests: None declared |
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Mehar S Manku, Technical and Scientific Director Laxdale Ltd
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I have known David Horrobin for the past 32 years. His passing is also a great loss to me and my family. We still are grieving his passing. I met him in Kenya (1971) when he was newly appointed Professor of Medical Physiology at the University of Nairobi, Kenya. I was one of his first Ph.D. students. I want to join all that have come in support of David and also thank all who have written to complain and object to the maliciously written obituary in the BMJ. David had many strengths many of which have been described here in the responses. David was a very honest and straightforward person and trusted the people he came in contact with. His strengths at times became his own weakness because of his good and trusting nature and some people took advantage of this. He will be remembered for a long time to come. Mehar Competing interests: A friend and colleague |
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Iain TR Kennedy, Academic Convenor For the Faculty of Medicine, Students' Representative Council, Glasgow University Student's Representative Council, John McIntyre Building University of Glasgow,
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Dear Sirs, I wish not to respond to the obituary itself as many have said anything I would wish to say, and said much better, it would also be intemporate (sic). (Although I agree the obituary - and quite possibly its author - was unbalanced) Dr Smith says "1. We have posted all the rapid responses we have received, even those that were wildly intemperate. " I feel that no response, either way, was "intemperate". It was an out pouring of shock and disgust - whether rightly or wrongly - some which coming from close friends and relatives of the deceased who clearly are still in a period of grieving. You as Editor had a duty, not a choice, to post all the responses if you were willing to address the great ethical issues of balance and representation. It would be customary in a "gentlemanly" Society - such as that of peer-reviewed journals - first to cause no offence, and that being impossible, to apologise for the offence caused. Yours Faithfully
Competing interests: None declared |
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Gillian M Craig, Retired n/a, P Colme Malone
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Re David Horrobin. Obituary published in BMJ Vol.326 April 19th 2003. Sir, The obituary notice about David Horrobin (BMJ 19th April) was unduly negative. We have been fortunate to have known David Horrobin, a passionate ‘ideas man’, with a fine intellect, who enthusiastically supported fellow scientists - irrespective of their scientific ideology. His memory should not be left besmirched in the BMJ by a cynical and unbalanced obituary but should to be restored with a full apology in the printed journal. In our opinion, whatever he did, he did from scientific conviction born of undergraduate and postgraduate scientific enthusiasms, and with profitable and enviable panache. Through force of circumstances he did not rely on grant giving agencies, but earned the money he needed to fund his research. He believed that peer review threatens clinical progress and is a harbinger for mediocrity in research (1). Far from evading his responsibilities, as your obituary writer insinuated, Horrobin risked all to speak out when needed, and suffered the consequences. In the 1970s, he was interested in prolactin and excited by its possible interactions with prostaglandins. He was quick to recognise the importance of prostaglandins in neurophysiology, and encouraged others who shared his interest in the field. He explored the role of prolactin and prostaglandins in mental illness, and suggested in 1977 that schizophrenia might be a prostaglandin deficiency disease. His interest in schizophrenia featured in his final scholarly and wide-ranging book The Madness of Adam and Eve, that was short listed for a literary prize in 2002- an honour that went unmentioned in the BMJ obituary. We both acknowledge the committed and enthusiastic support he gave us when needed. He was interested in Dr Craig’s hypothesis that prostaglandins might mediate the effects of oestrogen on luteinising hormone output and published it in Medical Hypotheses in 1976(2). Thanks to Horrobin her experimental work with McCracken in this field in 1975/76 was eventually published (3). In 1976 Horrobin and colleagues in Montreal proposed that prostaglandins are essential for the final expression of the effects of second messengers in most cells. They stated frankly that “We have extrapolated extensively, many would say unjustifiably, from hard information obtained from only a few situations. But we believe that scientific progress is entirely dependent upon speculation which most teachers of scientific methodology would describe as indefensible” (4). Inspired speculation based on wide knowledge and a deep understanding of complex biological processes was a feature of David Horrobin’s life work on essential fatty acids, but sadly the medical establishment proved uninterested in ideas that were not backed by hard data. Horrobin countered this negative approach by founding the journal Medical Hypotheses. Dr Malone benefited from Horrobin’s interest in creative ideas, for in 1970 he corresponded with Horrobin, then Professor of Physiology in Nairobi, about a physiological hypothesis concerning thrombogenesis. This was committed to paper in Medical Hypotheses in 1977 (5) and had been validated by 1984. David Horrobin should be remembered as a brilliant man who encouraged fellow scientists with upbeat and constructive criticism and treated “theoretical physiologists” seriously as “theoretical physicists” are rightly treated. Perhaps in years to come when our understanding of the neuroendocrine basis of hormonal interactions and mental illness is more precise, many of Horrobin’s ideas and those of the scientists he encouraged will be proved right. The world is poorer for his passing. The BMJ must publish a definitive printed retraction of the disgraceful and unscientific obituary of April 19th by Caroline Richmond, which has offended us and many other fair-minded readers, doctors, and scientists who have expressed their rejection on the BMJ web site. Yours faithfully, Dr Gillian Craig FRCP.
Dr P Colm Malone MD FRCS
References 1. Horrobin D.F. Peer review of grant applications: a harbinger for mediocrity in research? The Lancet. 1996; 348: 1293-1295. 2. Craig G.M. Prostaglandins, possible mediators of the effects of oestrogen on luteinising hormone output. Medical Hypotheses 1976; 2:116- 120. 3. Craig G.M. and McCracken J.A. Evidence for involvement of prostaglandins in central alpha adrenergic activity and LH release in sheep. Prostaglandins leukotrienes and essential fatty acids. 1989; 35: 93 -104. 4. Horrobin D.F, Mtabaji J.P, and Manku M.S. Cortisol in physiological concentrations acts within minutes to modify effects of prolactin and growth hormone on prostaglandin secretion: importance of effect in modulating cellular responses to calcium and cyclic nucleotides. Medical Hypotheses 1976; 2: 219-226. 5. Malone P.C. A hypothesis concerning the aetiology of venous thrombosis. Medical Hypotheses. 1977; 3:189-201. Competing interests: None. We respect David Horrobin's memory and share his view that ideas are essential to scientific progress. |
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Paul R Martin, Managing Director, PharmaResource Management ltd Rokehay Farm, Membury, Devon. EX13 7TS
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Forgive the lateness of this response. I was priviledged to work with David Horrobin in the 1990s. My company supported Scotia in the conduct of several clinical trials of it's products. Those studies were conducted to the highest appropriate standards. The implications in Caroline Richmond's obituary of David are scurrilous and the whole piece loathsome. It cannot be said that David ever welcomed regulation and standardised methodology. He did however, in a purely pragmatic way, accept the need for properly controlled studies and gave them his full cooperation. Working with him was always energetic and never dull. He was unfailingly polite, a model professional and fascinating to observe. He accepted unsupportive data with equanimity and moved on. Thank God that there are people of David's nature in this all too standard world of ours. It has long been an observation of mine that those whose conscience troubles them often give those troubles away voluntarily in the very act of trying to conceal them. Quite what bitterness motivates such viciousness from Caroline Richmond one can only imagine, but her apparent attempts to slur David consist of distortion, untruths and outright nasty rhetoric. A real case of 'wrong being in the heart of the accusor' to me. To hope that someone capable of such cruelty to the living and the memory of the dead might find the humility to offer an apology for the very evident hurt she has caused, is probably to hope in vain. I am sure though that those of us who admired and respected David for the complex, courageous, larger-than-life very-human being he was will take some comfort that Caroline Richmond's life has been irrevocably altered by the article she chose to write and that the process of what has gone around coming back around has very obviously started. As someone else said in these columns, I am sure that David, had he read the offending piece, would have smiled one of those enigmatic smiles and would simply have carried on with the work he loved. Paul Martin Competing interests: My former company SMS was contracted by Scotia to manage the conduct of a number of it's clinical trials between 1991 and 1999. |
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Gwynneth P Hemmings, Director Schizophrenia Association of Great Britian Bryn Hyfryd The Crescent BANGOR Gwynedd LL57 2AG
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Response to obituary - Dr David Horrobin
Dear Sir My attention has recently been drawn to the many letters on the BMJ Website in praise of the late David Horrobin. I would like now to add to this correspondence and to praise him both for his humanity and for his scientific awareness. I first wrote to David whilst he was still in Kenya early in his career. My sister had given me a copy of his textbook for medical students on Biochemistry and Physiology. I was quite delighted with this book, because of its clarity and understanding of the whole human body. Many medical students must have blessed David for it. My husband, Bill, was another Oxford Scholar (Queens). He was an immunologist and zoologist in the University of North Wales, Bangor. He developed a schizophrenia illness in 1961 and with his inquiring mind wanted to help to elucidate its pathology. When I received David’s book I wrote to him and asked if he was interested in the pathology of the brain as well as its normal state. He wrote back to say he was interested. This must have been about 1969. From that time on we corresponded, meeting occasionally at conferences both those of the Schizophrenia Association of Great Britain and others round the world. My husband and I had founded the Association in 1970. When David went to Canada he became concerned that families and their patients could, by getting together, share information and work to conquer diseases more rapidly by the exchange of information. Always it was one of David’s prime aims to help families. He was generous with his knowledge and with his time. He kept me informed always of papers he knew would be of help and interest to me. He explained things with clarity if I asked him questions and could not have been kinder or more inspiring. David published a paper written by my husband in Medical Hypotheses, showing interest, as he always did, in new, perhaps provocative ideas, from inquiring minds. My husband died nine years ago from a stroke. David knew we had to conquer schizophrenia and he was devoted to finding solutions to this disease which causes such huge suffering to so many patients and their families world-wide. At the beginning of the 20th Century it was thought that the disease had its origins in the gut. This has been largely forgotten and the brain is all at this time. However, the old ideas seem happily to be becoming increasingly accepted anew. About 3½ years ago we in SAGB decided to make up nutrition packs for our members. We included in our nutrition packs Laxdale’s Kirunal fish oil and a wide range of vitamins and minerals in fairly high strengths. We sent the packs free to those who requested them and at cost to those whose families could afford to pay. The results have been astoundingly helpful and hopeful. Many of our members are reporting a reduction in their psychiatric symptoms and are gradually returning to more normal energy levels with an increased enjoyment of life. The initial results were published in the Association’s Newsletter No 34. A similar programme of nutritional supplementation was reported in the British Journal of Psychiatry (July 2002 : 161 : 22-28 entitled ‘The Influence of Supplementary Vitamins, Minerals and Essential Fatty Acids on the Anti-Social Behaviour of young adult prisoners. Randomised Placebo- Controlled Trial’. The conclusions of the trial were that ‘Anti-social behaviour in prisons including violence are reduced by vitamins, minerals and essential fatty acids with similar implications’ for those eating poor diets in the community.’ Many, many people have reason to be very thankful for David’s productive and inspiring life. He gave freely of his time and knowledge and must have given hope and encouragement all over the world. His passing is a huge loss. His courage in illness was equally great, as was my husband’s. Let us all praise such great men. Yours sincerely Gwynneth Hemmings Competing interests: None declared |
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Bob Bury, Consultant Radiologist Leeds General Infirmary LS1 3EX
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As someone with considerable editing experience, I know how easy it is to make lapses of judgement. When this happens, the only thing to do is to be up front about it, apologise if necessary, and learn from the experience. However, I think Dr Smith's responses to the distress caused by this vindictive obituary have been deliberately disingenuous. The fact is that, at a time when BMJ obituaries have become so truncated as to be almost not worth printing, this one was afforded unlimited space, and was rushed into print just a few weeks after Dr Horrobin's death. The inclusion (and commissioning?)of the obituary was clearly a deliberately provocative act, and it is difficult to see it as anything other than the latest sad example of the BMJ's descent into tabloid journalism. It really is time the BMA arrested this decline, or a once respected journal will become a joke in the medical scientific community. Competing interests: None declared |
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Malcolm E Kendrick, Medical Director Adelphi Lifelong Learning Adelphi Lifelong Learning, Adelphi Mill Bollington SK10 5JB
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If the purpose of an obituary is to gain a full impression of a man, and his impact on his fellow man, or woman. The obituary on David Horrobin certainly achieved this - primarily through the rapid responses sent in. I have never felt that I have come to know a man so well without ever having met him, and I am saddened that I did not. It is funny how some things happen. Competing interests: I have had an article published in medical hypotheses |
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Vance A Spence, Senior research fellow Department of Medicine, University of Dundee Medical School, Dundee DD1 9SY
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BMJ readers concerned about the unjustly venomous nature of Caroline Richmond’s obituary of David Horrobin (BMJ 19 April 2003) might be interested to know that her latest target is Amelia Nathan Hill (founder of Action Against Allergy, whose patron is Professor Jonathan Brostoff), who died two years ago. Richmond, a journalist, takes it upon herself to reclassify allergic phenomena as neuroses and is particularly uncomplimentary about Mrs Hill. It seems that Richmond once again discredits the achievements of the dead and denigrates a well-deserved reputation. Readers can see for themselves what she says, as it was all over the front page of the Times Weekend on 10 May 2003 in the feature “Allergies: don’t they make you sick: 21st Century syndrome, social phobia, wheat intolerance….. John Naish wonders if it’s all in the mind; well, yes, says AC Grayling, but we’ve seen it all before”. The author affords Richmond the opportunity to assert that the symptoms Hill described “are, alas, the classic symptoms of anxiety and depression. Thousands of people who were suffering from the physical effects of neurosis decided they had allergies to food or the environment”. Is journalistic post-mortem diagnosis by distance a new medical discipline? Competing interests: None declared |
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Charles Stewart, formerly Medical director Scotia Home :Rose Villa Hermongers lane , Rudgwick
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Richard Smith is highly revealing when he apologises for using the word gentlemanly because of its sexist overtones (sic)---and then goes on to justify it because it seems the right word. Hurrah Dr Smith; gentlemanly is absolutely the right word in this context so why apologise for using it. How refreshing that would be if you ditched your PC stance and called a spade a spade, or used the words right and wrong, and other non-PC words whenever they were justified. Richmond’s obituary was wrong, plain wrong, and it would bring joy to many people if you said that. You may think it is modern and worthy to stand on a PC pedestal, but those of us who are driven by fundamentals of science, medicine and therapeutics frankly don’t give a damn. If anything we find it irritating because it is so fashion driven and temporal. Think forward please and consider. I suspect your PC policy will in time be viewed as potty as phrenology with nothing whatsoever going for it. But if you want to be a temporal chauvinist, please abide by the politically correct policy of the BMJ completely. Accept evidence-based medicine fully and accept that the evidence from the many responses to Richmond’s article show she was wrong. Accept too, that if the BMJ wants conflicts of interest declared, contributors like Richmond should not have immunity. Her conflicts of interest are very substantial indeed according to the information posted last week on the BMJ. See http://www.meactionuk.org.uk/Caroline_Richmond_Deja_vu.htm Competing interests: None declared |
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paul walker, consultant psychiatrist darlington
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Noone wants to read fantastic eulogies in obituaries but balance and respect for the family of the deceased are required. I never met David Horrobin but I read his latest article in the Lancet. A colleague passed it to me as she was so moved by it, as was I. Caroline Richmonds article is disgraceful and disrespectful but I suspect she genuinely has trouble appreciating this. Richard Smith, however, has no excuse. This poor man recently died of a debilitating malignancy and no doubt leaves a grieving family. Richard, if you are not mature enough to admit you misjudged this one and print an apology your credibility may never recover. Competing interests: fully developed social skills, and respect for the dead. |
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Caroline Richmond, Freelance obituary writer SW3 5AQ
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I am grateful to Vance Spence (above) for pointing out that I was mentioned in the Times on Saturday 10 May; I didn't know about it. I don't think the article reveals anthing sinister about me; but readers who want to decide for themselves can click on http://www.timesonline.co.uk/ and type my name in the search box. Competing interests: None declared |
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Gary R. Lynch, na na - L6L 4Y5, na
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I was shocked to read the obituary of Dr. Horrobin not only about a great man passing on, but about the brutal attack on a concerned scientist's ethics. I have seen first hand the absolute benefits of Dr. Horrobin's research into EFAs and nutrition. His reasons for producing EFAMOL products and patented techniques were proven to me as my girlfriend's diagnoses of chronic progressive MS began to reverse over time baffling her doctors. His insight into what the root causes of many chronic illnesses should be taken to each and every practising physician today. The change into how people preceive medicine would be staggering. The healthcare costs worldwide would drop so far that many of the less fortunate could get a fighting chance to do something positive in their lives rather than be just another statistic for the rising numbers of chronic illnesses. Cell integrity starts with EFAs and would logically lead to a healthy body. Long term use of mordern medicine is not concerned with a healthy body. It would seem they (drug companies) are interested in this but how much money they will stand to make and how delighted shareholders will be with their dividend cheques each quarter. Isn't it a shame that so much about our health concerns someone ele's profit these days. Thank you Dr. Horrobin for all of your insight for the betterment of mankind. Gary R. Lynch PS - I wonder what Linus Pauling and Dr. Horrobin are discussing right know up in the heavens. Competing interests: None declared |
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Grace Marshall, GP Principal Southampton S032 2UG
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The BMJ's style (article layouts, fillers, photos, summaries etc) is excellent, and makes for a much more enjoyable read than many other medical journals. However, the occasional item goes too far and leaves me as the reader feeling nauseated. The obituary on David Horrobin was one such. Good doctors tend to be sensitive to people's feelings, and will mostly dislike reading vicious attacks on anyone, particularly when based on unattributed hearsay and innuendo, rather than fact. I agree with those who called for an apology, at least to David's family, and preferably to the rest of the readership too! Keep up the good work on the journal, but please dump the idea that dishing the dirt will jazz up the obituaries. It won't. Stories are what make an obituary interesting. Competing interests: None declared |
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Kevin Perrett, Consultant in Communicable Disease Control Health Protection Agency
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I'm afraid I'd never heard of Dr Horrobin before, nor of Caroline Richmond, but I do know who Richard Smith is (indeed I used to admire him). He's the one in charge and is the one who should apologise for publishing what was manifestly a horribly unfair obituary of a much loved and admired man. Do the decent thing Dr Smith and say sorry for the offence you've caused. The BMJ is ours as much as it yours so and this issue won't go away, so just get on with it. Competing interests: None declared |
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Agnes K Ayton, Child and Adolescent Psychiatrist West End Child and Adolescent Service, Hessle, HU13 9NW
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It has been a great disappointment that there has been no apology from the BMJ for the derogatory nature of Ms Richmond's obituary, despite the international outcry. She continues to pursue her allegations in the national media (1), knowing that a dead man cannot defend himself. At least, some factual errors have been corrected (2), including the link to the report of the GMC's verdict on Dr Jamal's case. I had not been familiar with this case before, but reading the reference makes the malicious intent of this obituary even clearer. It does not say anything negative about David Horrobin, or Scotia's professionalism or ethics. According to the BMJ's report Dr Jamal used the active treatment in the most severely ill group. If this is so, he was minimising the possibility of any significant finding between the placebo and control group. Clearly, he did not act for financial gain. If anything, he was acting against his own financial interest. The only explanation I can find is an overvalued idea: he must have been convinced that the intervention worked. He must have believed that it would be unethical to withhold a potentially effective treatment from those who needed it most and who had no alternative available to them. Although this proved to be misguided, he harmed no patients. The people who suffered harm were the financial investors, who overestimated the predicted profit from a potential new treatment. Is that the main issue here? References: 1. http://www.observer.co.uk/uk_news/story/0,6903,963125,00.html 2. http://bmj.com/cgi/content/short/326/7398/1091-f Competing interests: as before |
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Peter Lapinskas, Independent Consultant 26 Deepdene Wood, Dorking, Surrey, RH5 4BQ, UK
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The response to the BMJ obituary of David Horrobin has been overwhelming in its condemnation, but no apology has been forthcoming either from the author or from the editor. For those who had not known or worked with David, it must be difficult to know where the balance should lie. I have therefore prepared an on-line bibliography of David's work covering, at the last count, 829 full references (including 332 abstracts), which includes books, research articles, reviews, published letters, posters and lectures, but excludes (for the moment) patents. The bibliography can be accessed at www.lapinskas.com/publications/dfh_bibliography. I hope that this body of work will illustrate why so many of us were upset by the tone and substance of the published obituary. Competing interests: Previously Seed Production Director at Scotia Pharmaceuticals |
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Mike E Robbins, Professor and Section Head, Radiation Biology, Department of Radiation Oncology Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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Today I read not only the David Horrobin obituary published in the BMJ in April but also the responses generated as a result of that disturbing article. Having had the good fortune to collaborate with David I feel compelled to respond with my own thoughts on this incredible individual. In the early 1990s I worked at the CRC Normal Tissue Radiobiology Group based at the Churchill Hospital, Oxford under the directorship of Dr. John Hopewell. When approached by David and his colleagues at Scotia Pharmaceuticals to investigate the ability of GLA to modulate the severity of radiation-induced skin toxicity, we were skeptical. However, studies carried out in the most relevant animal model, the Large White pig, and subsequently published in peer-reviewed journals, demonstrated that GLA did significantly reduce the severity of acute and late radiation-induced skin injury. After I moved to the US in 1993, David generously provided support for my research efforts in PUFAs and glioma therapy that led to my successfully obtaining peer-reviewed funding from the American Institute for Cancer Research and the NCI. When David left Scotia I lost contact with him, but during a literature search for a proposal investigating alterations in PUFA and radiation-induced cognitive impairment (subsequently funded by the NCI) I came across his e-mail address and we established contact again. His response was, as always, one of great enthusiasm and we planned to get together this summer to discuss future collaborative studies. I was aware of his struggle with cancer; my wife has battled breast cancer for several years and we shared our experiences of the toll cancer inflicts on individuals and loved ones. His untimely death came as a total shock and saddened me deeply. I, like many others who have voiced their anger and concern, do not recognize the man portrayed in the BMJ obituary. David was not only an outstanding scientist but also a wonderful human being. I am privileged to have worked with him, and dedicate future research efforts with PUFAs to his memory. Competing interests: Collaborator |
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Fern Baumgartner, NA 77590
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This Dr. Horrobin must have been a great Dr. and a great personality. Competing interests: None declared |
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Gordon B Drummond, Senior Lecturer, Anaesthesia Intensive Care and Pain Medicine Edinburgh Royal Infirmaty Edinburgh EH16 4HA
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I agree with this analysis of the editorial policies of the BMJ: courting controversy rather than level-headed publication. The albumin affair was equivalent: even to the point of failing to publish factual criticism of the data used. Since then I have not read the BMJ and only came upon this sorry story because of a far more balanced report in "Physiology News" which I commend to your readers. Those interested will find this calm and reasoned account at http://www.physoc.org Competing interests: Membetr of the MCA advisotu group on albumin |
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Linda Whitaker (Jones), Management Consultant Geelong Vic 3220 Australia
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I have just become aware of David Horrobin's death via the obituary on the net and I have read all the subsequent responses. I met David once at a conference in 1974 in Nottingham and had a one hour conversation with him - what an honour. I gained a BSc Biochem/Physiol some years later and often came across David's name and publications. When I saw the obituary I was horrified that my impressions of this man could have been so wrong and that I had been "sucked in by a great con- man!" I truly felt dismayed that I was such a poor judge of character - thanks to that obituary!! After reading the responses - I now know my first impression of David Horrobin was correct. The obituary was disgusting. David Horrobin left me, after a one hour conversation, with a lifelong impression of his integrity, love for humanity, his listening and openness to knowledge and learning. I was right - he was a genuine, charming man of integrity and brilliance. Shame on you Richmond and Smith - in all your responses you continued to defend the obituary and in so doing you continued to denigrate this wonderful human being - defending inaccuracies and slander and assassinating the character of this man. Shame on you - shame on your arrogance. After reading the responses, I got to know so much more about David and I am truly honoured and blessed to have met him. Very belated and sincere sympathy to David's family and his many friends. Linda Whitaker (formerly Jones) Competing interests: none |
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Caroline Richmond, Obituary writer SW3 5AQ
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It is over a year since the row broke out over my obituary of David Horrobin. I couldn’t make a detailed response at the time but I read the rapid responses with interest. Now that the dust has settled I want to make the following points. The main complainants, Adam and Cathra Kelliher, run Equazen Ltd (www.equazen.com),which markets evening primrose and fish oils to parents of disturbed children. Horrobon’s widow Sherri Clarkson runs Laxdale Ltd, which is ‘researching new psychiatric treatments’ (evening primrose oil and fish oils for the mentally ill). These interests were not declared in their rapid responses. Several of my critics intimidated that they were medical specialists but do not appear as such on the GMC web site. One of them, I know, has been thrown out of a university for writing anonymous letters. I stand my my assertion that many of Horrobin’s publications were in his own journals. PubMed (the Internet version of Medline) lists 474 publications by Horrobin DF (not 800 as claimed, a number that includes conference posters and articles in Bella magazine). 77 of these were in journals that Horrobin edited. That’s 1 in 6. Mea culpa—I missed linolinic acid with its derivative linoleic acid, I attributed his brother’s book on cars to him, and I was given the wrong spelling for Nafisa, Horrobin’s first wife. Evening primrose oil was never licensed as a medicine in the USA, and is no longer licensed in Britain. Iain Chalmers has described elsewhere (New Scientist 6 March 2004) how he was asked to evaluate EP oil for atopic eczema. It was costing the NHS £7m a year and rising. He recommended that it be removed from the list of prescription medicines. The manufacturers responded by asking the DoH not to disclose or discuss its contents without their agreement; the government agency responsible capitulated, and EP oil remained available on the NHS for another five years. After twenty years evening primrose oil is no longer a prescription medicine for eczema or benign breast pain, and the evidence that it is effective for ME has evaporated. It came and it went. It rarely worked outside Scotia-sponsored trials. It certainly was safe and popular, even if it doesn’t work. And it took the late Dr Horrobin to number 212 in the Sunday Times’s rich list. Inspirational. Competing interests: None declared |
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Ellen C G Grant, physician and medical gynaecologist specialising in Nutritional Medicine 20 Coombe Ridings, Kingston-upon-Thames, Surrey, KT2 7JU, UK
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Editor- Has either Caroline Richmond or Iain Chalmers ever investigated their own or anyone else's essential fatty acid (EFA) status? I doubt it. Over the past 20 years I have been requesting mineral, vitamin and red cell essential fatty acid profiles as necessary and helpful investigations in my patients. Deficiencies usually respond to supplementation with minerals, vitamins and high doses of evening primrose oil and fish oils. Without adequate EFA levels, not a single cell in our bodies works efficiently. Neurones, in particular, need enough EFAs for normal brain function. This is also a vital part of preconception care.1 Thank God for David Horrobin. 1 Grant ECG.Nutritional supplements to prevent pregnancy complications.http://bmj.com/cgi/eletters/329/7458/152#67502, 16 Jul 2004 Competing interests: None declared |
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Eddie Vos, maintains health-heart.org Sutton (Qc) Canada J0E 2K0
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A sad reminder that it is a year already that the world lost Dr. Horrobin, one of the most inspiring fatty acid scientist. About the current "addendum" to the original BMJ obituary, Ms. Richmond misses again with her: "Mea culpa - I missed [sic] linolinic [sic] acid with its derivative linoleic acid, .." Assuming she means "linolenic" acid, there are 2 types [gamma and alpha] neither of which have linoleic acid as derivative. Linoleic acid [18:2-omega-6] can enzymatically generate gamma- linolenic acid [18:3-omega-6], a very rare fatty acid found in evening primrose, borage and a few other seeds. Since the omega-3 and omega-6 pathways are not convertable in humans, linoleic acid is also not derived from alpha-linolenic acid [18:3-omega- 3], commonly found in canola [10%} and flaxseed [55%] oils, and in many green leafy vegetables, such as kale. Competing interests: None declared |
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia 4507
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Could we please close the book on this sorry saga? I do not know what Caroline Richmond's beef is with the late David Horrobin and my initial hope that she would throw some small amount of light on this proved to be wishful thinking. Apart from her apparent confusion or lack of understanding of the basics of what Horrobin's work was all about (and which was ably pointed out by Eddie Vos) she is attacking a man who was universally accepted as an expert in fatty acid matters. Reminds me of someone who would tell old Carl Benz that he certainly didn't create the perfect motorcar; many of his parts and ideas have been discarded by now. I will not go into the life of Dr. Horrobin, I would just like to ask that he be left in peace now, he has had his battles in a lifetime of service to mankind, why would anyone want to return again, after a year, no less, just to bicker? From what I can see in the responses it appears that Richmond's obituary was somewhat inappropriate and even offended some, so perhaps we will be able to look forward to the next anniversary with high hopes . Competing interests: None declared |
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