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Tony Jackson

 
Paediatrician who became a pioneer in the management of cystic fibrosis

Anthony Derek Maurice Jackson, consultant paediatrician Royal London Hospital and Queen Elizabeth Hospital for Children 1959-83 (b Dublin, Eire, 1918; q Middlesex Hospital 1943; MD, FRCP, FRCPCH), died from pneumonia and peritonitis related to chronic ambulatory peritoneal dialysis on 24 December 2005.

Tony had a natural flair for organisation and attention to detail. This was evident throughout his life—both in his work and leisure activities. In the days long before rotating registrar appointments were usual he set up a rotation spanning district general hospital paediatrics (Dr Brian Webb, Taunton), research in neonatal physiology (Prof Kenneth Cross) as well as teaching hospital paediatrics. In 1970 he was appointed postgraduate dean at The London Hospital Medical College, a post he held for 12 years. At the request of the dean, his friend, Sir John Ellis, he established a new computerised system of preregistration house appointments between The London and district general hospitals in the south of England. At Tony’s insistence this system gave equal weight to the choices of candidates and consultants—a change that gained considerably more approval from the former than from the latter.

During his time at The London he was a strong supporter of student extracurricular activities and this combined with his paediatric teaching led the students to elect him staff president of the London Hospital Clubs Union. His especially strong support of the students was most evident with the London Hospital Drama Society, of which he became staff president until his retirement. In the early 1980s Tony’s strong support of this activity encouraged medical and dental students to have the self belief to take annual shows to the Edinburgh Fringe Festival.

Having studied Latin and modern languages to Higher School Certificate level at school, a decision to study medicine meant the need to pass the first MB BS examinations. Although his prowess on the rugby field led to a scholarship to St Mary’s Hospital, he chose to go to the Middlesex Hospital Medical School, graduating during the second world war. As treasurer of the rugby club he made sure the players all received their train fares to Aylesbury. After a shortened preregistration period at the Middlesex and Harrow hospitals, he joined the RAMC and served in Holland, Germany, and north Africa, where he saw an epidemic of smallpox.

Whilst stationed in Tripoli he met Jess Wilkes, a physiotherapist, whom he later married in 1946. Following demobilisation and a year in general practice, he embarked on a career in paediatrics. He began his training in the children’s department at the Middlesex before moving to the Hospital for Sick Children, Great Ormond Street, under the direction of Sir Wilfred Sheldon. As a senior paediatric registrar he worked with Dr Winifred Young in her cystic fibrosis (CF) clinic at the Queen Elizabeth Hospital for Children. He returned to Great Ormond Street as lecturer and first assistant to Prof Sir Alan Moncrieff at the Institute of Child Health in 1956 before being appointed to the staff of the London Hospital and St Margaret’s Hospital, Epping, in 1959. In those days there were only two paediatricians on the staff of the London Hospital—his senior and trusted colleague was Dr Richard Dobbs. In 1965 he transferred his St Margaret’s sessions to the Queen Elizabeth Hospital for Children, taking on the care of the younger children in the cystic fibrosis clinic. His first case of Munchausen’s syndrome by proxy was diagnosed in the early 1960s, 13 years before Roy Meadow gave the syndrome its name. The toddler had been repeatedly poisoned with barbiturates.

He was elected to the council of the Royal College of Physicians and subsequently became chairman of the paediatric committee, an appointment he held for 10 years. When the joint paediatric committee between the three royal colleges and the BPA was set up in 1978 he was invited by Sir Douglas Black to be one of the two representatives of the London College and served on this committee until its dissolution in 1987. He was made a censor in 1980 and was a member of the part 2 MRCP examining board for 10 years, three of them as paediatric secretary.

He was responsible for encouraging the Royal College of Physicians of London to take over the French course, which until 1975 had been run by the Institut Français at Barts. He continued to attend the course for 21 years under the tuition of M. Henri Orteu until it closed. Although acknowledged by others as an excellent speaker of French, his autobiographical notes describe him "acquiring a sound knowledge of French grammar but not, unfortunately, the ability to speak the language fluently." His European paediatric colleagues heaped praise upon him not only for his willingness to address meetings in French (and several other languages) but also for the language skills evident within his lectures.

Educating and developing students was a lifelong interest. For a quarter of a century London Hospital graduates remembered Tony’s impressions of a variety of paediatric conditions, most spectacularly that of croup.

In 1981 Tony became president of the section of paediatrics of the Royal Society of Medicine and over a period of some 20 years contributed to the running of the British Paediatric Association (BPA). He held the posts of secretary of the academic board and honorary treasurer of the BPA. He was joint author with Prof Donald Court of the BPA’s blueprint for the future of paediatrics, Paediatrics in the Seventies, and joint author with Prof John Forfar and Dr Bernard Laurance of the diamond jubilee edition of the History of the BPA. His interest in the history of paediatrics led to a contribution to a Royal College of Paediatrics and Child Health (RCPCH) witness seminar at the spring meeting of 2003. His skill as a photographer led to him being regarded as almost the official photographer at BPA meetings. In 1978, the then president of the BPA, Prof Otto Wolff, asked Tony to propose a toast to the health of the BPA at its 50th anniversary dinner. He was proud to have been awarded an honorary fellowship of the RCPCH at its inception in 1996, 13 years after his retirement.

In 1986 he was elected president of the Association for Paediatric Education in Europe, having been a member since 1974. In retirement he held the post of medical adviser to the Variety Club of Great Britain for 11 years. In addition he took on the chairmanship of the research and medical advisory committee (RMAC) of the Cystic Fibrosis Trust and was awarded the John Panchaud Medal of the trust. His contribution to the transformation of cystic fibrosis from a fatal disease of infancy to a chronic disease of adults was considerable. His application of the developing technology and pharmaceutical developments into everyday practice, his support of families and patients, and, after retirement, his strategic direction of the Cystic Fibrosis Trust RMAC played major roles. His desk at home at the time of his death still contained the photos of cystic fibrosis patients sent to him by grateful parents.

Following a sporting career as a rower and second row rugby forward, he developed a new sporting interest in retirement in the local bowling club. He won trophies from time to time but true to form described himself as a very ordinary bowler. Also true to form he made a major contribution to the administration of the club over many years.

He leaves a wife, Jess; three children; and four grandchildren. Although he developed chronic renal failure four years before he died, he very successfully managed his own peritoneal dialysis, not allowing himself to be restricted in any way. He died from pneumonia and peritonitis complicating chronic ambulatory peritoneal dialysis. [Stephen Jackson, Mark Caulfield]