Chris PallisBMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7496.908 (Published 14 April 2005) Cite this as: BMJ 2005;330:908
Neurologist who defined brainstem death
On 13 October 1980 the BBC current affairs programme Panorama broadcast a report called “Transplants—Are the Donors Really Dead?” It alleged that patients certified as brain dead sometimes recovered, and hence that the supply of transplantable organs was skewed by doctors wanting to remove organs from trauma patients who might have recovered. The programme angered doctors as few programmes have done before or since and engendered massive publicity.
Chris Pallis stepped into the centre of this controversy. As a neurologist with a strong interest in general medicine, and working in a hospital that was a transplant centre, he was accustomed to diagnosing brain death. He was, moreover, an outstanding writer and teacher. He took on the unenviable job of persuading the profession and the public that brainstem death was true death, and, indeed, that it could be diagnosed at the bedside without the need for high-tech imaging. He was the author of the BMJ's ABC of Brainstem Death (1983, second edition 1995), which remains a masterpiece of clear exposition.
Brainstem death was a subject that few physicians had studied in any depth, and its cultural implications were largely ignored. “It was,” wrote Pallis, “not as firmly perceived as it is today that the criteria used to diagnose death on neurological grounds has to be rooted in an explicitly formulated philosophical concept of death and, moreover, one that would be widely accepted in a multicultural society.”
Christopher Agamemnon Pallis was born in Bombay, the son of a merchant banker from a distinguished Anglo-Greek family. From the College Classique Cantonal in Lausanne, Switzerland, he went to Balliol College, Oxford, to study medicine; he did his clinical studies at the Radcliffe Infirmary. While an undergraduate, he met Jeannine Marty, a Frenchwoman, on a train journey from the south of France to Paris; they married a year later, when he qualified. He then spent three years in the Colonial Medical Service in Malaya.
He did his house jobs and registrarship at Maida Vale Hospital for Nervous Diseases and became consultant neurologist at the Postgraduate Medical School, Hammersmith Hospital, London, where he spent the rest of his career. In 1967 he was appointed physician extraordinary to Dr Radhakrishnan, then president of the Indian republic. He was fluent in French, German, and Greek, and he enjoyed travel, chess, and swimming. He was an exemplary and popular teacher of his postgraduate students.
Pallis was also a highly political person. Though regarded by his colleagues as a communist, he was expelled by the Communist Party early on, and supported the Revolutionary Communist Party, which was Trotskyist. After he quit it, it became the Workers' Revolutionary Party. Pallis went on to become the leading spokesman for a libertarian socialist semianarchist Anglo-French group called Solidarity.
He wrote for the New Statesman and other leftist publications under the pseudonym Martin Grainger. When outed by the press as a neurology consultant at Hammersmith Hospital, he changed his pseudonym to Maurice Brinton and carried on. He was outed again at a time when NHS hospitals were troubled by strikes, but the press received short shrift from his boss, Sir Christopher Booth, who told them firmly that Pallis was a fine neurologist and that his politics, like anyone else's politics, were his own business.
Pallis always felt an outsider in the world of academic neurology and of the establishment in general, a fact that he conceded at his 60th birthday party, held at the Athenaeum. He wrote many political pamphlets including one on the iniquities of the nuclear family, which he gave to a recently separated colleague; Pallis himself lived conspicuously happily in a nuclear family with his wife and son.
Pallis's interest in the interface between neurology and general medicine was reflected in his wide range of publications, covering every aspect of nervous system disease, and his book The Neurology of Gastrointestinal Disease (1974). After 1980 he published almost exclusively on brain death, and in his retirement he worked as an expert witness on legal cases involving complex neurological issues.
In later life he had what his colleagues regarded as Parkinson's disease or a related movement disorder, from which he died. He is survived by Jeannine and his son.
Christopher Agamemnon Pallis, consultant neurologist and expert on brainstem death Royal Postgraduate Medical School, London, 1957-88 (b 1923; q Oxford 1947; FRCP), d 10 March 2005.
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