Obituaries

William Halstead Taylor

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b5475 (Published 18 December 2009) Cite this as: BMJ 2009;339:b5475
  1. C Williams,
  2. A Khaleeli

    William Halstead Taylor (“Bill”) died peacefully at home on 23 February 2008. From 1959 he developed the chemical pathology laboratory services at the Liverpool Royal Infirmary and established the Metabolic Unit, an innovative single roomed ward suited to metabolic “balance” studies. As gauge of his remarkable journey, one of his first jobs was the then audacious move of stopping the practice of “capping” urine collection containers with twists of hemp rope.

    Initially there was a very small number of staff, and, as those familiar with the deeper labyrinths of the old Royal Infirmary in Liverpool will remember, competition from literally thousands of cockroaches, which mercifully were photophobic. Test procedures, though sophisticated, depended predominantly on manual manipulation, and it took more than an hour of careful calibration before blood gas could be measured (approximated) on the apparatus of the day. Modern students of clinical chemistry will have limited familiarity with the noise of flames routinely used at that time to measure analytes such as sodium, potassium, and calcium. In those early days immunological techniques for measuring hormones and steroids were emerging, and radioactive tracers to that end where just entering the general laboratory domain. Bill was instrumental in taking the great step of ending gonadotrophin estimation techniques based on the weight of mouse ovary—a whole live mouse per patient being injected with human urine. This was not a popular move with some clinical staff, but Bill was not a man to court popularity. Thus it was that rabbits took over the animal house from mice and in return for being treated considerately generated a supply of antibodies for analytical use. Unfortunately this friendly transaction was unpredictable in outcome initially and the supply of testosterone antibody ceased abruptly when one rabbit was licensed one jump too far, breaking its back in the process. This was confirmed by the X ray Department (those were the days) and was serious loss to the lab at the time.

    Bill was always a force to be reckoned with, formidable in his wide international contribution to research across the calcium and mineral metabolism field and much sought after for advice, including by the government, in respect of a then hot topic, fluoridation policy. As an expert on fluid balance, he wrote the seminal book of the 1960s on the subject and continued a lifelong research interest with Dr Norman Roberts in gastric proteolysis, the subject of his DM Oxford thesis.

    Bill would never be defeated. Those facing death would be referred to him “so that they might die in electrolyte balance,” the lesson for young clinicians being that a painstaking scientific, “back to first principles” approach to medicine saved life. Tender recollections linger in memory: a retired army major presented to Bill soulfully complaining that he could no longer stand in a salmon stream without risk of being swept away by a modest current. A lesser man might have suggested that even an army major can expect the worst in his mid-80s, but Bill diagnosed and treated the underlying problem, coeliac disease, to eternal appreciation. In the early days, patients travelled from as far as Switzerland to see Bill, this being before budget airlines. Bill was truly international in his understanding and appreciation of medical science, and colleagues from as far afield as Africa and Cuba were made welcome at his family home, Clare House. Bill travelled widely himself, publishing, lecturing, and examining theses in many parts of the world.

    Bill balanced his academic life and with service commitment to perfection. Devoted to both, Bill proposed to his wife at a cricket match. They shared a love of music, and his fine base voice once harmonised with Kathleen Ferrier when he sang in the Bach Choir in Oxford. As a loving father and devoted family man, he instilled the love of music in his children and he himself played the violin in the Liverpool University Orchestra. For an Oxford don he had an unnatural interest in fishing—hence the sympathy for the major—perhaps a product of his roots in Littleborough, Rochdale, where he was born in 1924. His appetite for work was tested early: he was obliged to rise at 5 am each day to take up a scholarship at Manchester Grammar School and later one at Christchurch, Oxford, where he gained a first in animal physiology.

    Certainly in professional life Bill did not carry politics on his sleeve, and it may surprise some to know that he was an officer of the Oxford Union Labour Party and secretary of the Union. Even his presidency of the Christchurch Junior Common Room did not detract from his glittering progress through medicine with qualification in 1948. After this he went to the Hammersmith, where he met June, his future wife, a physiotherapist. Thereafter he was both a lecturer in clinical biochemistry and a fellow in a joint post at St Peter’s College.

    After retirement in 1989 he was welcomed into the department of the late Professor Tony Hart, professor of medical microbiology at Liverpool University. Bill received referrals from all over the Mersey region, and it was typical of him to set up an outreach clinic. This was at Halton General Hospital in Runcorn, which was to become the site of a district general hospital. Dr Ali Khaleeli was then a newly appointed consultant endocrinologist charged with setting up local diabetes/endocrine services. Thus a final and further productive professional stage of Bill’s career commenced as Dr Khaleeli was delighted to have the collaboration of such an experienced physician. The politeness and mildness of Bill’s manner and self deprecatory modesty coupled with his lifelong depth of knowledge and clinical ability was a source of considerable comfort. Their metabolic clinic prospered and expanded with delight from patients and general practitioners, who now received specialist services locally.

    Bill had previously demonstrated at his Royal Liverpool clinic in a large series that there was an increased prevalence of diabetes in patients with primary hyperparathyroidism. With key changes in the definition of diabetes and the importance given to lesser degrees of glucose intolerance, he worked with Dr Khaleeli to show for the first time, using the oral glucose tolerance test, that glucose intolerance and asymptomatic type 2 diabetes could be recognised frequently in patients with primary hyperparathyroidism. Furthermore, they demonstrated by screening patients in the diabetes clinic that the reverse association—that is, the increased prevalence of primary hyperparathyroidism in diabetes—was also true. The mechanism by which these associations occurred was discussed in considerable detail, including the importance of insulin resistance in primary hyperparathyroidism resulting from a rise in intracellular calcium. These ideas were documented in erudite reviews.

    Finally in collaboration with Dr Khaleeli and Mr James Johnson, consultant surgeon, he demonstrated that glucose intolerance was often reversed and type 2 diabetes improved or rarely reversed after successful parathyroidectomy in patients with primary hyperparathyroidism. This was shown in an ongoing series using the glucose tolerance test for the first time. Patients with normal glucose tolerance also showed an improvement in two hour postprandial glucose testing. It is notable that this paper was published just a year before Bill’s death, when his remarkable alertness and attention to detail in its preparation was self evident.

    Bill took an active part in the interests of the department of medicine, supporting his young consultant colleagues and promoting Halton Hospital and its staff regionally in Liverpool. He avidly attended and contributed at the medical grand rounds, where his enquiring encyclopaedic mind was appreciated. He was generous with his time in teaching medical students and young doctors in training, showing old world courtesy. He was much loved by all the postgraduate staff, and there is a touching photograph in the postgraduate centre celebrating his 75th birthday showing him surrounded by his colleagues. His continued interests in fly fishing and especially cricket struck a chord with a new generation of young colleagues, who fielded a respectable team which generally despatched their charming general practitioner colleagues with alacrity.

    His main interest was, however, his lovely and truly gracious wife, June, and his large talented family—one can imagine his house bubbling with lively conversation and kindly humour. Bill is survived by June, four children, and 10 grandchildren. The tradition of practising medicine continues in both younger generations.

    Notes

    Cite this as: BMJ 2009;339:b5475

    Footnotes

    • Former consultant chemical pathologist Liverpool Royal Infirmary (b 26 April 1924; q Oxford 1948; DM, FRCS), d 23 February 2008.

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