Alexander Paton

Six weeks before Alex Paton died on 12th September 2015,he received an advance copy from Wiley Blackwell of the 5th Edition of the BMJ's ABC of Alcohol’, now edited by the Bristol hepatologist Anne McCune. Alex had first created this ABC in 1982 from BMJ articles. He edited three subsequent editions over the next twenty-three years. He was the best of word-masters’ with an easy-to-read style, and a diplomatic but firm editorial hand.

Alex’s health had been deteriorating since the death of his wife Ann in 2008. Despite intermittent pain, creasing immobility and a longing to meet up with Ann once again ‘in a better place’ Alex hung on for the arrival of this new Edition. Why? Alex was a self-effacing, humble man. He was pragmatic about life at 91, knowing that he and Ann’s genes lived on in their ten grandchildren, and two great grandchildren.

To answer this one must understand Alex’s attitude to alcohol, his humanity, and his concern that society had failed over alcohol. Alex enjoyed a drink, as he was the first to say, but advocated balance and perspective. Above all he advocated sympathetic management of people with alcohol problems, which with early detection this could be a rewarding experience.

Alex felt for ‘the drinker’ because of all of society’s pressures to encourage the drinking of yet more and more alcohol, a legal drug. The genetically vulnerable would be at particular risk of dependency. He understood that every dependent drinker was once a binge or hazardous drinker an that people born with this susceptibility were not being adequately protected by society. And, further, doctors were sorely lacking in knowledge about alcohol, and how to help patients early on with their problem of excess – which they might not perceive as such - before true dependency set in.

Alex judged that the profession dismissed the problems of alcohol-misuse to being the sole preserve of psychiatry. Some doctors did not even appreciate that alcohol was a drug, feeling that it was a unique substance, the ‘fifth element’ after earth, fire, wind and water. Alex judged that this
self-delusion was partly because of doctors’ own alcohol-culture, and their resultant acceptance of their patients’ misuse.

The first ABC was a simple straight forward primer on alcohol, pitched primarily at general practitioners, who Alex felt had no resources to improve their knowledge of alcohol and had been taught little at medical school.

Alex increasingly despaired of the stupidity, even duplicity, of politicians and the malignancy of the drinks industry. Both refused to acknowledge that the amount drunk depends primarily on the twin pillars of availability and price. The seduction of the Blair Government to widen alcohol availability under the auspices of 'inner-city regeneration ’ troubled him.

However Alex was heartened by the medical and nursing professions’ recent increased realisation that alcohol-misuse was the responsibility of all specialties and disciplines. These professionals were increasingly questioning their own drinking habits. He applauded the development of
brief Interventions and the development of a cadre of frontline specialist alcohol nurse specialists.

Alex felt heartened by the 5th edition f the ABC. He felt his work had a new momentum and therefore live on. Now with 24 chapters, it has chapters aimed at doctors and nurses from different specialties. provides specific specialty chapters to interest relevant trainees. An even wider readership will thereby be attracted, to counter the spring tide of alcohol misuse facilitated by politicians and society, funded by the drinks industry.

Alex noted the updated presentation with the continuance of his style and his humanity. He was surprised and thrilled that he remains author of three chapters, such is the depth of Alex’s knowledge and the clarity of his writing. For Alex, the wait had been worthwhile.

Reference: ABC of Alcohol. Editor, Anne McCune. 5th Edition, 2015, Wiley Blackwell.