Obituaries

Andrew Herxheimer

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1556 (Published 16 March 2016) Cite this as: BMJ 2016;352:i1556
  1. Anne Gulland
  1. London
  1. annecgulland{at}yahoo.co.uk

Clinical pharmacologist, founding editor of Drug and Therapeutics Bulletin, and veteran of the Cochrane Collaboration

It was during a two year sabbatical in the United States that Andrew Herxheimer got the idea for a journal giving impartial and independent advice on drugs and therapeutics. He was impressed by the US journal Medical Letter, and on his return to the UK in 1962 he approached the Consumers’ Association, publishers of Which magazine, who agreed to go into partnership with him.

He published a UK version of the American magazine for a year before launching the Drug and Therapeutics Bulletin with the Consumers’ Association. Herxheimer edited the DTB for the next 30 years, stamping his voice and personality on the journal.

The production of an article followed a unique process: Herxheimer and his editorial colleagues would come up with an idea, commission an author, and then go through a long process of editing. The article, which was always anonymous, would be shown to at least 25 people, including the manufacturers of the product in question and those of its competitors. At the end of this process the article would often bear little resemblance to the original piece. Sometimes authors would be upset at the changes, but Herxheimer was resolute that “articles had to reflect the best knowledge available, and if this ruffled feathers so be it.”1

The fact that manufacturers would see an article before publication should not suggest that they had any editorial control. On one occasion the manufacturers of a preparation to soften earwax demanded to see Herxheimer in person to complain about a forthcoming article. After the meeting—where they showed what they thought was evidence of the product’s efficacy—Herxheimer increased his criticism.

Independence and impartiality were the bulletin’s hallmark, and manufacturers were not allowed to use any DTB material in their advertising. Evidence was king, and Herxheimer was not critical for the sake of it. He did not pull his punches, however, as this extract from a review of phenylbutazone and oxyphenbutazone illustrates: “Between them they are likely to have caused well over 1000 deaths in Britain. Over a million prescriptions are still written every year for phenylbutazone, and about 150 000 for oxyphenbutazone. We believe that these drugs should not be prescribed to new patients.”2

Herxheimer was a great lover of language, prizing clarity and short sentences. He was involved at every stage of the editing process and was a master at cutting copy. His love of language extended to wordplay, particularly puns, and not only in English or German, which was his first language, but also in French and Dutch, both of which he spoke well. As a keen internationalist—he set up the International Society of Drugs Bulletins to encourage other countries to set up similar journals—he loved to pick up words and phrases in the many countries he visited.

His love of internationalism and his antipathy to nationalism, fascism, or any other negative kind of -ism was largely due to his childhood experiences. Herxheimer was born into a middle class, secular Jewish family in Berlin, and led a comfortable, happy life until the rise of the Nazis. In 1938 his father Herbert, known as Hx, took the family to London where he had a job as the doctor for Highgate School through the Council for Academic Refugees. Andrew enrolled at the school and found that, while he was no longer bullied for being Jewish, he was now bullied for being German. However, he thrived at school, quickly picking up English, and was naturalised in 1946.

He trained at St Thomas’ medical school, qualifying in 1949. After graduating he went back to Germany for his national service and then did various house jobs, training as a clinical pharmacologist.

He married his first wife, the textile designer Susan Collier, in 1961, and the couple had two daughters, Charlotte and Sophie. They were married for 12 years, separating in 1973. He married his second wife, Christine, a psychiatrist and psychoanalyst whom he met in Germany, in 1983.

Herxheimer had many medical passions, but the thread running through all of them was the patient’s best interest. Chatting with GP Ann McPherson [read obituary, doi:10.1136/bmj.d3424] about their recent experiences as patients—Herxheimer had recently had a knee replacement and McPherson had been treated for breast cancer—they agreed that they wanted to hear the experiences of other patients with similar conditions and the Database of Individual Patient Experiences (DIPEx) was born.

It was initially a filing cabinet next to the Cochrane Collaboration, of which Herxheimer was a founding member. The charity soon realised that the cabinet was overflowing, and the database grew into a website, www.healthtalk.org. Again, Herxheimer was keen for DIPEx to be a global organisation and donated his own money to establish DIPEx International in order to compare patient experiences around the world.

He also became involved with a charity called April—the Adverse Psychiatric Reactions Information Link. He attended the charity’s first conference in 2001 and campaigned to highlight the adverse reactions of patients to antidepressants such as paroxetine (Seroxat). Herxheimer acted as an unpaid adviser and consultant, helping its founder, Millie Kieve, who set up the charity after the death of her daughter. This generous sharing of his time and knowledge was typical.

Herxheimer, whose lively, creative mind was legendary, made contributions in many spheres. He contributed to Social Inventions, a journal of ideas to improve life. He once regaled a friend with his plans to persuade the designers of public buildings to increase the number of sit down toilets for men and had even been in discussions with architects about this. He also had an ambitious plan to create a database of language stories, which he named Autobiolingos. The idea was that people would record stories of their language, history, learning, and use. It would be particularly relevant for people who had had to learn a new language.

This fund of ideas continued right up until the end of his life, with a series of sessions he had planned for the University of the Third Age, teaching people about their medicines. The sessions would have begun at the beginning of this month if he had lived.

He leaves his two daughters and his wife.

Andrew Herxheimer, professor of clinical pharmacology (b 1925; q University of London 1949) died after complications of a stroke on 21 February 2016.

References

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