John Norman Agate (1919-1998)

John Norman Agate (1919–1998), geriatrician and racing car driver!  

by Michael John Denham 

© Oxford University Press 2004–13 All rights reserved

Agate, John Norman (1919–1998), geriatrician, was born on 20 February 1919 at 40 Dingwall Road, Croydon, Surrey, the son of Charlton Stanford Agate (1892–1966), wireless engineer, and his wife, Gwendoline May, née Chappell (1892–1982). He was educated at Aldenham School, Hertfordshire. Attracted to a career in medicine, as several uncles were eminent in the field, he gained an open scholarship to Trinity Hall, Cambridge, to study natural sciences and achieved first-class honours in 1939. During his subsequent clinical studies at the London Hospital he was put in charge of chronically sick patients in wards of north-east London hospitals. He qualified in 1942, passed the MRCP examination in 1944, and completed his general medical training at the London Hospital as senior registrar to Donald Hunter. Between 1945 and 1949 he worked as a research physician for the Medical Research Council's industrial diseases unit, publishing more than twenty papers and completing his MD (in 1948) on the relationship between vibrating tools and Raynaud's phenomenon. On 26 July 1946, at the parish church of Spetisbury, Dorset, he married (Rosemary) Hester Preedy (b. 1924), a musician, and daughter of Frank Preedy, a lieutenant-colonel in the Royal Engineers. They had a son and a daughter. 

Critical to Agate's future career prospects was the need to increase his medical experience. Therefore he took a short-service commission in the Royal Air Force in 1949 as a specialist in medicine in the Central Medical Establishment, leaving the service in 1953 as a squadron leader. However, this additional experience proved insufficient for general medical consultant appointments. Agate now remembered his work with chronically sick patients, who were kept in bed with little treatment until they died, and he decided to become a geriatrician. In 1953 he was appointed consultant in Bradford, where he had sole responsibility for 730 beds in seven hospitals. With characteristic energy he investigated and treated the patients, discharging many and increasing admissions. 

In 1958 Agate was recruited for a new consultant geriatric post in Ipswich. This time he had responsibility for 530 beds with a catchment area of 1000 square miles. All but a handful of beds were in outlying hospitals: three of these were large eighteenth-century former workhouses, which were totally unsuited for modern purposes. He improved the quality of ward accommodation and introduced colour-coding of floors and doors to help patients navigate around the ward. He reduced the waiting time for admission from fifty-three to two days. A new assessment ward was opened in 1963 and new rehabilitation wards followed in 1977. His unit became a centre of excellence attracting many visitors. 

Agate became known as the patients' advocate for dignity and privacy, firmly believing that the illnesses afflicting old people needed proper investigation and treatment. This advocacy led to many confrontations with hospital managements. Thus, when a house physician threatened to certify the cause of death of a patient as neglect due to leaky roofs and lack of ward heating resulting in a ward temperature of 35° F, Agate ‘blackmailed’ the authorities to put matters right. Although he possessed a ‘short fuse’ he was a kind man, given to gentle teasing. He used a shooting stick on ward rounds because of chronic back pain and had to kneel when examining patients. 

Agate served on local and national committees, including the Department of Health and Social Security's standing medical advisory committee, the Central Health Services Council, and the geriatric subcommittee of the Royal College of Physicians of London. In 1963 he was elected FRCP and two years later he organized the college's first two-day seminar on old age. He was treasurer of the British Geriatrics Society from 1958 to 1968, and chairman of its executive committee for three years. At the society's behest he negotiated with publishing houses to find one willing to publish its journal. Karger agreed to publish Gerontologia Clinica in 1959 but the society really wanted a British firm and Agate achieved success in 1972 when Baillière Tindall began publishing Age and Ageing. He himself published many articles, chapters in large textbooks, wrote four books (including The Practice of Geriatrics, 1963, for many years the standard textbook in this field), edited others, and contributed to television documentaries. For several years he edited the bi-monthly Modern Geriatrics. In 1978 he was appointed CBE for services to geriatric medicine. 

Outside medicine Agate had many interests. He and his wife sang together in choirs, including the London Bach Choir, enjoyed their proximity to Aldeburgh, and gave splendid parties to which amateur and professional musicians, such as George Malcolm, were invited. He tuned his wife's harpsichord, and enjoyed pottery using his own kiln; was a keen photographer and used this skill to illustrate a book about Suffolk churches. He loved driving cars, took part in a rally in which he and his co-driver beat Stirling Moss, and was once a co-driver in the Monte Carlo rally. His latter years were dogged by ill-health and he died of left ventricular failure and coronary heart disease on 31 October 1998 at Ipswich Hospital. He was survived by his wife and their two children. 

MICHAEL JOHN DENHAM 

Sources  

J. N. Agate, ‘The geriatric physician's viewpoint’, Medicine in old age, ed. J. N. Agate (1966), 120–31 • The Independent (20 Nov 1998) • The Times (26 Nov 1998) • BMJ, 318 (6 Feb 1999), 401 • munksroll.rcplondon.ac.uk/Biography/Details/4959, accessed on 12 Aug 2010 • J. Agate, ‘Geriatrics as a medical specialty’, BL NSA, F3272 • b. cert. • m. cert. • d. cert.