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Obituaries

David Charles Taylor

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n976 (Published 16 April 2021) Cite this as: BMJ 2021;373:n976
  1. Ian M Goodyer

David Charles Taylor was a world renowned psychiatrist who specialised in the connections between severe brain malfunctions and mental illnesses. Originally making his observations in adult patients, his research became increasingly focused on the neurologically vulnerable child. Supported by the eminent neuropathologist John Corsellis, he was the first to describe focal cortical dysplasia (Taylor type cortical dysplasia), a now known important cause of surgically treatable epilepsy. This was a notable discovery, and has had a longlasting impact on the field. Taylor was the first clinician scientist to investigate the behavioural effects of patients who had undergone epilepsy surgery and among the first to suggest a sex difference in how the brain develops. The latter is a topic of considerable interest in today’s field of cognitive neuroscience.

David Charles Taylor was the youngest of five children born to parents who managed newsagent and tobacconist shops in central London. David and his family lived over one of the shops which was situated between Buckingham Palace Gardens and Victoria Station. David was aged 6 when the second world war broke out and, along with his 10 year old brother, was evacuated to mid-Wales and became a Welsh speaking child. His parents and other siblings also evacuated to Wales in 1941, where they farmed. Although the family returned to London in 1944, David was sent back to Wales until the end of the war. In 1946, aged 13 years, he went to boarding school, Allhallows, in Devon. After leaving school David helped in the family business and undertook two years of national service as an officer in the Nigeria Regiment based in Lagos. On return he applied in writing to medical schools in London and was accepted at Charing Cross. After qualifying he completed his house officer posts in surgery, neurology, medicine, and psychiatry. His psychiatry experience was with William Sargeant, who believed that mental illnesses were of the brain and required physical and medication treatments. Sargeant supported David Taylor’s application to the Institute of Psychiatry at the Maudsley Hospital. He entered the institute in 1962, completed his three year training and obtained his Diploma in Psychological Medicine together with an MPhil in psychiatry. At the Maudsley he was introduced to the neurosurgeon Murray Falconer, who operated on patients with epilepsy, particularly temporal lobe epilepsy. In 1965 David obtained a research assistant post with Falconer to undertake a doctoral MD thesis on the psychiatric correlates and consequences of temporal lobe epilepsy. After two further years his work came to the attention of Christopher Ounsted, medical director of the Park Hospital for children, who invited David to apply for a research fellowship associated with a consultant post and treatment of children with neuropsychiatric disorders. The “Park” housed the first national centre for children with epilepsy. David moved to Oxford in 1967 after nearly six years at the Maudsley. He completed his thesis and started his senior career as a clinician scientist and child psychiatrist. In 1980 he was appointed to the foundation chair of child and adolescent psychiatry at the University of Manchester, where he stayed until his retirement in 2001. Between 2001 and 2007 David continued to work with children with epilepsy with Brian Neville’s group at Great Ormond Street Hospital before finally retiring at the age of 74.

The observations by Taylor and colleagues on the mental state of their hospital surgical patients suggested an elevated psychosis risk associated with lesions of the temporal lobe compared with other brain area lesions. From his temporal lobectomy patient cohort, Taylor described a schizophrenia -like psychosis that was almost five times more likely in those temporal lobe patients with focal dysplasia and other “alien” tumours than in those with the more common lesion of mesial temporal sclerosis. Recent systematic reviews of this literature have confirmed these early observations regarding the additional risks for psychoses in patients with temporal lobe lesions. Subsequently and throughout his career David contributed to the psychiatric assessment of children with epilepsy. His contribution to the neuropsychiatric evaluation of children for epilepsy surgery at Great Ormond Street Hospital was especially valued. In 2012 the American Epilepsy Association awarded David Taylor the William G Lennox—Cesare T Lombroso Award for his extraordinary influence and seminal research on the social, economic, and psychological effects of epilepsy surgery on patients with medically refractory seizures.

After his early pioneering epilepsy work at the Institute of Psychiatry, it was in Oxford that David found new areas of interest in the emerging field of child psychiatry. He developed a profound interest in physical presentations of mental illnesses in young people. These included children who presented with an inability to walk, talk, or speak for no apparent physiological reason. David began thinking and writing about these patients as part of the broader concept of somatisation: the presentation of physical symptoms with no known pathophysiology that indexed mental illnesses. He began to reflect deeply on the meaning of being ill but not having any disease to account for the impairments presenting to doctors. These thoughts and reflections were collated in a commentary published in the Lancet in 1979, entitled “The components of sickness: diseases, illnesses, and predicaments.” This essay was to determine in large measure the theoretical framework for his publications throughout the rest of his career. Although diseases of the brain were his grounding, illness was the behavioural level of adaptation as expressed in symptoms, and predicament, perhaps his most original formulation, describes how individuals find themselves in the social world. His very use of the term “predicament” here reflected David’s broad cultural sympathy and impulse to reach out beyond professional jargon to the general public.

In his post at the University of Manchester he focused his energies on building the department and pursuing his clinical and scientific interest in developmental neuropsychiatry. Together with his students and colleagues he continued to publish on somatisation syndromes and mental states, including an important population study showing that childhood somatisation was common in the general population and in many cases a manifestation of mental distress that was unrecognised by others.

David Taylor was deeply proud of his professorial position and honoured to promote the study and practice of child psychiatry. He was generous beyond measure, a wonderful teacher, a charismatic speaker, and a proud promoter of the careers of his students and colleagues. He also had an excellent sense of humour and a fine ability to draw cartoons. He did not want his junior colleagues to be cast in his own image, and as such there are many senior academics in the UK and abroad who learned from him, who were advised by him, but who made their own scientific and clinical agendas with his total support. He was a lifelong advocate for the vulnerable child in society and a pioneer in the field of brain and behaviour. Taylor leaves a remarkable legacy in the subject of epilepsy psychiatry and in the study and care of the mental and physical health of the vulnerable child.

He leaves his wife, Karin; their daughter, Hannah; and four sons from his previous marriage to Evelyn.

Professor of child and adolescent psychiatry Manchester University (b 1933; q Charing Cross Medical School, London, 1960; MD, FRCP, FRCPsych, FRCPCH), died from pneumonia on 13 March 2021

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