James Colquhoun PetriePatrick David WallSir William Ferguson AndersonDenys Elwyn HowellsRonald Herbert JonesRubi Alexandra Koyotsu PadiWilliam Patrick Reynish

BMJ 2001; 323 doi: (Published 15 September 2001) Cite this as: BMJ 2001;323:636

James Colquhoun Petrie

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Professor of clinical pharmacology University of Aberdeen and honorary consultant physician Grampian University Hospitals NHS Trust (b Aberdeen 1941; q Aberdeen 1964; CBE, DSc, FRSE), died from a brain tumour on 31 August 2001.

Many might consider it self evident that medical treatment should be delivered according to guidelines developed from the best available research evidence. Jim Petrie coined the phrase “GOBSAT”—“Good Old Boys Sat Around the Table”—to describe the process by which many guidelines are in fact developed. As founding chairman of the Scottish Intercollegiate Guidelines Network (SIGN), and later as president of the Royal College of Physicians of Edinburgh (1997-2001), he fostered the development of more than 50 clinical guidelines of a quite different nature in diverse medical fields. At the time of his death, he was chairing expert groups on best practice for guideline development for both the Council of Europe and the World Health Organization.

He urged doctors and other healthcare professionals to consider services from the user's perspective—“the journey of care”—and to take responsibility for continuous improvement. In his initial approach to a new challenge, he instinctively disregarded the way something had always been done. He was an inspiring teacher, and his students were rather in awe of him. They generally made sure that they bought his textbooks.

Just after graduation in 1964, he married Xanthe, who, recognising his leadership tendencies, made him promise never to become prime minister. He was appointed professor of clinical pharmacology in Aberdeen in 1985 and became head of the merged departments of medicine and therapeutics in 1994. He was codirector of the Scottish Health Services Research Unit from 1986.

At the time of his first senior appointment in clinical pharmacology at Aberdeen Royal Infirmary in 1970, he was, at 29 years, the youngest senior lecturer and honorary consultant physician in Scotland.

He was a champion of problem oriented medical records—a system that benefits patients and staff, although some initially found it arduous—and continued this theme throughout his career by promoting computerised clinical information systems. His work with the British Hypertension Society has been used to train doctors and nurses worldwide. He published more than 200 scientific papers and 20 book chapters, and was on nine editorial boards.

A former ski instructor and racer, who at university won a full blue for skiiing, he especially enjoyed ski holidays in the French Alps with his children and grandchildren.

He leaves Xanthe; four children; and six grandchildren.

[John Petrie Rhona MacDonald]

Patrick David Wall

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Neuroscientist; professor of anatomy and director, Cerebral Functions Group, University College London, 1967-92 (b Nottingham 1925; q Oxford 1958; FRS, FRCP), d 8 August 2001.

Pat Wall was the world's leading expert on pain and a man of many parts. He developed, with the Canadian psychologist Ron Melzack, the gate theory of pain. They published it in Brain; Wall said that about three people read it. So they rewrote it three years later, by which time they had refined it, and published it in Science in 1965. The theory moved ideas about pain away from the brain and peripheries to the spinal cord. It only started to be taken seriously when Wall collaborated with US neurosurgeon Bill Sweet to produce the TENS (transcutaneous electrical nerve stimulation) devices; their efficacy vindicated his theory. His work also contributed to the development of epidural anaesthesia. His other inventions included underpant elastic that gripped clothes, and hearing aids embedded in spectacle arms.

He was the author of Textbook of Pain; Pain: The Science of Suffering; and a successful thriller, Trio: The Revolting Intellectuals' Organizations. He founded the British Medical Students' Association while a student at the Middlesex Hospital, where he campaigned for the introduction of the NHS. He also begat the International Society for the Study of Pain, and the Brain Research Association, forerunner of the British Neuroscience Association.

Wall developed a lifelong distrust of authority when, aged eight, he was told at school that cotton grew in Lancashire. His support for left wing causes brought him enemies, which is why it took him until 1989 to be elected to the Royal Society; by this time, according to reliable sources, he had been nominated several times for a Nobel prize.

He demonstrated pain responses on television by plunging his forearm into a bucket of iced water while he grimaced, shuddered, and hyperventilated.

He was a chain smoker, kippering himself in the fumes of his roll ups, but it was prostate cancer that carried him off. Treatment gave him five years' remission and he joked, worked, lectured and travelled to within days of his death. Even before his own cancer and painful last year, he was angry at the pointlessness of cancer pain. Towards the end of his life he said that the most useful thing he had ever done was to serve on the Gardiner Committee in the 1970s, examining the effects of rubber bullets in Northern Ireland.

He leaves a wife, Mary. They had no children, and he left his body to the London Anatomical Society for dissection.

[Caroline Richmond]

Sir William Ferguson Anderson

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Consultant physician in geriatric medicine Stobhill and Foresthall hospitals 1952-79 (b 1914; q Glasgow 1936; MD, FRCPG, FRCPE, FRCP), d 28 June 2001. A past president of the BMA, Fergie Anderson represented the best of British medicine at home and in his many distinguished roles as visiting professor in North America, Australia, New Zealand, Japan, and many countries in Europe. A native of Glasgow, he was introduced to the problems of chronic disease in older people while working at Stobhill Hospital, Glasgow, and he continued his studies after war service in India and Germany with the Royal Army Medical Corps (1941-46). Appointed physician to Foresthall Hospital and adviser to the Western Regional Hospital Board in diseases of old age and chronic sickness in 1952, he emphasised the importance of good clinical skills in differentiating between physiological changes caused by age and signs and symptoms of disease. Fergie was convinced that the only way to promote the health care of older people was to make geriatric medicine an academic discipline and ensure undergraduate teaching in the subject. In 1965 he was appointed inaugural David Cargill professor of geriatric medicine at the University of Glasgow. He received numerous honours, including the OBE in 1961, and he was knighted in 1974. Fergie was a remarkably modest man, always elegant and at ease equally with aristocrats and hospital domestic workers or car park attendants. He leaves a wife, Margaret, and three children.

[Brian Williams John Dall]

Denys Elwyn Howells

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Former singlehanded general practitioner northwest London (b 1919; q University College Hospital London 1946), died suddenly on 7 April 2001. He began his general practice at the start of the NHS and retired from it some 40 years later. He also undertook extra commitments as a police surgeon, for the Ministry of Health, the former Ministry of Pensions and Industrial Injuries, as a medical officer for British Gas, and as Treasury medical officer. He was honorary secretary of the Brent division of the BMA for many years and enjoyed travelling around the country to attend the annual representative meeting, which he did for more than two decades. During his semi-retirement he was able to indulge his other interests—travel, music, and the theatre. He leaves a wife and two children.

[Huw V Howells]

Ronald Herbert Jones

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Former general practitioner Wirral (b 1925; q Liverpool 1949; TD, MRCGP), d 21 May 2001. He came from a family of very modest means, and depended for his medical training on a senior scholarship. His two years of national service were almost all spent in the Middle East, in the Suez Canal zone, or in Kenya, where he honed his surgical skills at two military hospitals. He also functioned as a regimental medical officer and was always proud of his close association with the Scots Guards. While a general practitioner in the Wirral, his responsibilities in the Territorial Army increased, and from 1971 to 1975 he commanded the largest general hospital in the reserve army. He also secured a post in Clatterbridge Hospital as a senior surgical assistant. He was created a knight of the Order of St John in 1990, a distinction granted for, in particular, the efficiency with which he supervised the first aid and medical cover provided for the papal visit to Liverpool. A few months ago he was found to have an inoperable abdominal tumour. Ron leaves his first wife, Wendy; his second wife, Theresa; and four children.

[Julia A Jones Dick Harrison]

Rubi Alexandra Koyotsu Padi

Former associate specialist in anaesthesia Glan Clwyd District General Hospital (b Ghana 1937; q Dublin 1963), died in Johannesburg, South Africa, on 9 July 2001. She came to Rhyl in 1967 for a year to undertake paediatrics, returning 10 years later as an anaesthetist and making her home in the area. She provided care for the victims of the flood disaster in the Towyn and Kinmel Bay area of North Wales in 1990. In 1995, she provided interim medical help for three months in a refugee camp in Tanzania and on her retirement in 1996 worked in a hospital in Nongoma, South Africa. She escorted a jumbulance—half luxury coach and half ambulance—taking terminally ill and disabled people to Lourdes annually for many years. A past president of the North Wales association of the Medical Women's Federation, and Rhyl and District Soroptomist International—a worldwide organisation for women in management and the professions—she felt her example had helped to raise the status of women in Africa. A committed Anglican, she helped raise awareness of the problems facing sub-Saharan Africa, particularly poverty, famine, disease, and violence.

[Buddug Owen]

William Patrick Reynish

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Clinical researcher Toulouse University Hospital (b 1966; q Manchester 1992), died on 13 May 2001 after a fall while climbing Pic d'Estats, the highest peak in the Catalonian Pyrenees. He did junior posts in northwest England and at St George's Hospital, London. He found time during his undergraduate and early postgraduate years to develop his natural ability in foreign languages, becoming fluent in French, German, and Russian. He also satisfied all his extracurricular interests—jazz and classical music, piano, singing, racquet sports, surfing, skiing, and mountaineering. Will made full use of his medical skills, in particular his holistic and caring approach to patients, only when he moved into gerontology. His passion for language and foreign culture motivated him to seek a clinical research post in Europe. He moved to Toulouse University Hospital in the summer of 2000, where he was coordinating an epidemiological research programme investigating Alzheimer's disease. In the weeks before his death he had secured funding from the European Commission to expand this work into a pan-European collaborative project. He was able to use his linguistic talents to translate colleagues' research papers from French to English and to translate for the Cochrane Collaboration. Will's work at the department of geriatric medicine in Toulouse is to be remembered by the naming of the departmental library in his honour. He leaves a wife, Emma, and a son.

[Barry Appleton David Watkins]

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