Jehoiada John Brown

Jehoiada John Brown (“Joyda”) was a well known and highly respected physician and clinical scientist, who worked in the Medical Research Council Blood Pressure Unit in the Western Infirmary in Glasgow from 1967 until he retired in 1992. He had a high international reputation for his clinical practice, which was informed by research based observations, and, equally importantly, for the warmth and generousity of his nature.

Joyda was born in Croescyceiliog, South Wales. He was intensely proud of his Welsh heritage and upbringing, and his adult persona reflected the values instilled during his formative years. His father was a cabinet maker and prominent in local government. It was this heritage of craftsmanship and public service, set against a background of Welsh non-conformism, that shaped his character, exemplified by hard work, precision of thought and deed, and a wish to serve others.

He attended West Monmouthshire Grammar School, where he excelled in sport, representing Welsh schools at athletics and rugby. On leaving school he matriculated in medicine at Cardiff University, but his passion for rugby led him to transfer after one year to St Mary’s in London, which, at the time, had a high reputation for prowess in hospital rugby competitions. At St Mary’s he gained a first class degree in physiology and graduated in medicine in 1951. As a student he represented United London Hospitals at rugby, and continued to perform at a high level in athletics. He remained an enthusiastic, if somewhat caustic critic, of amateur rugby throughout his life; when he moved to live in Scotland he willingly supported the Scottish national team except when they played Wales.

Joyda spent his national service in the Royal Air Force in the UK, before continuing his medical training in St Mary’s under the patronage of George Pickering, an inspirational (if somewhat eccentric) clinician scientist, who was the leading figure in hypertension research of his era. He encouraged Joyda’s interest in the problems of high blood pressure. Pickering moved, subsequently, to the regius chair of medicine in Oxford while Joyda stayed in St Mary’s to work with Professor Stanley Peart on the regulation of blood pressure, combining laboratory investigations with acquisition of formidable clinical research skills. At that time his partnership with two other outstanding clinical investigators, Anthony Lever and Ian (Bob) Robertson was formed. Together, they established a series of important studies into the regulation of blood pressure by renin, a hormone produced by the kidney, and helped describe the complex cascade of hormonal steps that controlled blood pressure and salt (sodium) balance in humans. Joyda’s particular contribution here, and later in Glasgow, was the development of meticulously performed studies in normal subjects and patients to establish a clear understanding of physiological and pathophysiological mechanisms involved in disease processes.

In 1967 Brown, along with Lever and Robertson, moved to establish the Medical Research Council Blood Pressure Unit in the Western Infirmary in Glasgow; Lever was the director of the unit until 1994. There, they were joined by a laboratory colleague, Robert Fraser, with whom they had worked in St Mary’s Hospital. Together they maintained, for over 20 years, a highly productive research unit that combined high quality research into basic mechanisms of regulation of blood pressure with clinical studies that defined the clinical presentation and management of important (and often quite rare) hormonal causes of high blood pressure.

The particular expertise of the blood pressure unit was in establishing the regulation of the adrenal hormone, aldosterone, and in demonstrating the consequences of its excess on blood pressure. Brown and colleagues carried out meticulous experiments in human subjects to show how aldosterone was controlled by sodium and potassium intake, and by the hormone renin. In patients with high blood pressure they investigated how altered renin and aldosterone accounted for sodium accumulation by the kidney. They played an important role in describing the aetiology of a hypertensive disorder caused by aldosterone excess (Conn’s syndrome). Brown had a particular belief in the importance of careful dissection of rare clinical syndromes to illustrate key research principles; his insistence on meticulous data recording, in an era before electronic information management, permitted important retrospective analyses of material on large patient cohorts.

The work of Brown and colleagues was very much a team effort. This was acknowledged by the practice of including all members of the team involved in research studies as authors on publications. Because they observed strict alphabetical listing, Brown was cited as first author on many of the key studies published by the unit in the 1970s. Over his career he was author on more than 150 papers, many of which remain citation classics. The contribution of Brown, Lever, and Robertson to hypertension research was recognised by the unusual joint award of the highly prestigious Ciba Award by the High Blood Pressure Council of the United States, the highest recognition bestowed for hypertension research at the time. Brown was elected a fellow of the Royal Society of Edinburgh in 1975 in recognition of his contributions to clinical science.

In Glasgow Brown built up his clinical reputation and became an authority on the investigation and management of patients with complex blood pressure related problems. As a result, patients were referred to the blood pressure unit from a wide catchment area in the UK and overseas. His clinical approach was meticulous and precise, and he was unfailingly courteous to patients. With many he built up a close personal rapport and he was held in exceptionally high regard by those under his care. He remained in contact with many of his patients in Scotland and abroad after his formal retirement in 1992.

He provided important mentorship to a series of junior clinical staff, many of whom have gone on to senior academic positions in the UK. The MRC Blood Pressure Unit also provided training for clinicians and scientists from throughout the world, many of whom remained in contact with Brown and colleagues long after they returned to their own countries and have fond memories of their time in Glasgow. He was an enthusiastic and gifted communicator, whose clinical presentations were a model of clarity; he was much in demand as a speaker at local postgraduate meetings.

Joyda retired in 1992 but maintained informal clinical practice for some years afterwards. On retirement he was able to spend more time with his family and took particular pleasure in the arrival of grandchildren. The skills in carpentry that he learnt from his father were resurrected, and he undertook substantial works of home improvement. He became increasingly involved in local charities, where his sage advice and enthusiastic support were much appreciated.

Joyda married Irene Meredith, his childhood sweetheart, in 1954. They had two sons (Andrew and Christopher) and took enormous pride in their achievements. He was devoted to his family and was particularly delighted by the arrival of two grandchildren after he retired.

He will be remembered as a man who was characterised by personal warmth, loyalty to his patients and friends, and great personal integrity. He was, primarily, a physician whose abiding priority was the wellbeing of his patients: he would wish for no more fitting epitaph.

Predeceased by his wife, Irene; he leaves two sons; and two grandchildren.