The shoulders upon which we stand - geriatric medicine’s pioneers
Mike Denham, past President of the BGS, BGS archivist and historian returns with our regular feature on the history of geriatric medicine and the events which led up to the introduction of the welfare state and the National Health Service. Here he provides a mini-biographies of some of the geriatricians who practised at a time when geriatric medicine did not enjoy the status and recognition that it does today.
Dr Thomas Newton Rudd (1906-1995) qualified from London Hospital in 1930. Initially he entered general practice in Cornwall and joined 128 Field Ambulance in Exeter in 1934. At the outbreak of the war, he joined the RAMC, was a medical specialist at the Royal Herbert Hospital, Greenwich before commanding a medical division in Algeria and Normandy. After demobilisation in 1945, he continued as an active territorial, commanding 128 Field Ambulance for several years and as a full colonel, he commanded a general hospital in the Army Emergency Reserve. After the war, he joined an experimental group practice, which operated at Tiverton and Belmont Hospitals. The poor standards of care in the latter unit caused him to institute regular ward rounds, keep notes, send elderly men with untreated hernias for surgery and remobilised them for discharge. His nursing lectures were published in the Nursing Mirror.
In 1957, he was appointed consultant geriatrician at Southampton with responsibility for 300 beds, taking over from Eric Brooke who had recently died. He developed an excellent geriatric service at Moorgreen hospital with a psychogeriatric service at Knowle hospital. He was active in the BGS and energetically championed the creation of the Medical School at Southampton. In retirement, he wrote a report for the WHO on geriatric services in Cyprus and was a guide at Winchester Cathedral.
Dr Richard Stevens (1912-1998) qualified in 1937 from Cambridge University and St. Thomas’ hospital. In 1940, he joined the RAMC serving in the Middle East, Italy and Austria and was mentioned in dispatches. After demobilisation, he worked in general practice but returned to hospital medicine in 1960 as consultant physician to the Brighton Women’s Hospital: an appointment rapidly terminated when he was discovered to be a man! Nil desperandum, he was appointed consultant geriatrician at Ashford Kent, having ‘learnt the ropes’ from Trevor Howell. He developed a major interest in stroke management and worked for many years with the Chest, Heart and Stroke Association. He assisted in the commissioning of the new William Harvey Hospital at Ashford and was medical administrator of the Canterbury Postgraduate Centre. In 1997, he was awarded the BGS President’s medal.
Dr Raphael Tepper (1916-1990) graduated from Manchester University in 1943. He worked in hospital medicine until 1950 before moving into general practice. In 1963, he switched to geriatric medicine becoming senior registrar in the geriatric department of Crumpsall Hospital, Manchester, and in 1966 became a consultant geriatrician in the Ashton, Hyde and Glossop group of hospitals before moving Bolton 18 months later. He retired in 1981. He wrote several papers, served on hospital committees, the Health Advisory Service and the council of the BGS. He enjoyed golf and had a keen appreciation of music.
Dr William Tod Thom (1917-2006) graduated from Edinburgh University in 1940 and joined the RAMC serving in Africa and India, leaving in 1946 with the rank of Lt. Colonel. He then joined the Colonial Service working as a medical officer in Tanganyika, Somaliland, and latterly Sarawak.
On his return to the United Kingdom in 1964, he was a medical officer in Birmingham before returning to Scotland in 1966. There he joined the Scottish Home and Health Department becoming a principal medical officer. His principal concern was the medical services for older people and carried out pioneering work in exposing the appalling conditions in many long-stay hospitals in Scotland. Between 1977 and 1982, he was director of the Scottish Health Advisory Service.
Dr Peter Thomas Tweedy (1920-2002) qualified from St. Bartholomew’s Hospital in 1942, undertook fire-watching during the London Blitz, served with the RAMC and landed in Normandy on D+3. He advanced with the British troops to Nijmegen, where he met a young girl who later became his wife.
He was appointed consultant geriatrician to the Stockport hospitals in 1959 where he had responsibility for several hundred patients in four hospitals. He developed a thriving service, which expanded to three consultants. In retirement, he helped to raise funds for a rehabilitation centre for head injury patients and served on the local St. Ann’s hospice.
Dr Marjory Warren (1897-1960), the mother of British geriatric medicine, has been the subject of innumerable articles. For those who wish to go back to the beginning, try the Oxford Dictionary of National Biography.
Dr John Wedgwood (1919–2007), was born into the world famous pottery family and was a non-executive director for some twenty years. He qualified from Trinity College, Cambridge and Guy’s Hospital in 1943. In 1944, he joined the RNVR serving in the Mediterranean and in the Far East on the minesweeper HMS Squirrel. He was wounded when the ship was mined and sunk. These injuries caused such increasing discomfort that he gave up his intention to be a surgeon and become a physician. He decided on geriatric medicine following his experiences when he surveyed 200 neglected chronic sick patients in a local workhouse in Cambridge.
His first consultant post was in 1960 at Bury St Edmunds, where he had no medical, rehabilitation, or secretarial staffs. He was responsible for 243 patients in old overcrowded infirmaries, one of which still had gas lighting. In 1968, he became consultant geriatrician at the Middlesex Hospital but in 1980, he moved to the Royal Hospital for Incurables in Putney, as medical director and chairman of the board of management, and stayed there until he retired in 1986.
He was very active in the BGS, serving as treasurer, chairman of the executive committee, and chairman of the editorial board of Age and Ageing (1969–86). While treasurer he placed the Society on a firm business footing and established it as a registered charity. In 1987, he was appointed CBE, and in 1994, he was awarded the BGS presidential medal.
Dr Terence Charles Picton Williams (1919-1996) qualified from St Mary’s Hospital in 1943 and served in the RNVR from 1944 to 1947. He was encouraged to enter geriatric medicine by Sir Ferguson Anderson and following training posts, he became consultant physician at St Thomas’s Hospital in 1963.
He created a thriving unit in the South Western Hospital, Stockwell, set up 2 day hospitals, established an acute assessment geriatric ward in St Thomas’ Hospital and integrated general medicine with geriatric medicine. He retired in 1984 but was soon appointed associate professor in the division of medicine (section of clinical gerontology) at the University of Saskatchewan to advise on strategic planning and clinical care.
Michael Denham