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John Pemberton 12 April 2010 – Royal College of Physicians Obituary

Royal College of Physicians

Munk’s Roll
John Pemberton

b. 18/11/1912 d.07/02/2010

LRCP, MRCS (1936), MB., BS (London), UCH, 1936, MD (London), FFPH (1974), FRCP (1964), DPH (Leeds) (1957), Milroy Lecturer (1976) 

Founding one scientific society is usually considered a major achievement. John was, however, responsible for the birth of three, a remarkable achievement, testimony of his interest in epidemiology, his concerns and the respect in which he was held. As a Rockefeller Travelling Fellow at the Harvard School of Public Health in 1954 he met Harold Willard, from Yale. They felt they were handicapped in the development of their interests in social and preventive medicine, because of their ignorance of research and teaching in this field in other countries. As a result they decided to establish an informal corresponding club (ICC) “to facilitate the communication between physicians working for the most part in university departments of preventive and social medicine, or in research institutes devoted to these aspects of medicine, throughout the world”. The ICC grew into the major international association, the International Epidemiology Association. At the founding meeting, at the CIBA Foundation in London in 1956, John was also able to persuade the British and Irish participants to accept the need for an independent scientific society and thus created the Society for Social Medicine which rapidly became the major multidisciplinary academic society with more than 1000 members in the UK and Ireland. John’s friend, Professor WJE Jessop of Trinity College,

Dublin was its first chairman. Not content with conceiving two societies, in 1967 John’s powers of persuasion were so great that Geigy supported the creation of an All-Ireland Society of Social Medicine, which has met regularly alternately in Eire or Northern Ireland and eliminated all communication barriers between the North and the South in the fields of public health, social and preventive medicine and epidemiology for those working in the service and academic fields.

John was born in Romford, Essex. His father had been a Steward at Christ’s Hospital, Horsham and he was a pupil there from 1922 to 1930 when he went to University College and Hospital to study medicine, qualifying in June 1936, being the Proxime Accessit in the Roberts Prize in Obstetrics and Gynaecology.

As a student he was influenced by left wing politics and the relationship between social conditions and health. While a third year student he published an article “Malnutrition in England” published in the UCH Magazine. This was re-published in the International Journal of Epidemiology, with his commentary, in 2003. His radical instincts were profoundly affected by the Jarrow marches in 1936. He, and some of his fellow students, met the marchers when they reached London, helped to feed them and tended their feet. His contacts with Jerry Morris FRCP (later Professor, who died in 2009) Philip D’Arcy Hart FRCP, Dr Somerville Hastings FRCP (Chairman of the Socialist Medical Association) and FAE Crew (later Professor of Social Medicine, Edinburgh) reinforced his views of the importance of social and environmental factors in the aetiology of many diseases. It is worth noting that Archie Cochrane (later Professor, and Director of the MRC Epidemiological Research Unit in Cardiff) was a near contemporary. Both the latter and Richard Doll (later Sir Richard), a medical student at St Thomas’ Hospital, mention, in their biographies, the effect of social conditions (and the Jarrow marches) at the time on their effect on choice of career and research.

After qualifying John was House Surgeon to Mr Wilfred Trotter and then Obstetric House Surgeon to Mr Clifford White at UCH. Following these appointments he was recruited to lead a mobile nutritional research team which undertook a major survey in England and Scotland by Sir John (later Lord) Boyd Orr. This showed the effects of poverty on nutrition (and health) and was acknowledged by Lord Woolton (Minister of Food during WWII) to be the foundation for the successful nutritional policy during the War, which has been considered by some to be the major reason for the improvement of health of the UK population after 1939. One of the “control” schools in this study was Gordonstoun, where John says he examined the chest of the current Prince Philip, the “nearest I ever got to a “Royal”. One of his team was Gwen, who had become his wife in 1936 (died 1989).

Following this research appointment he became Casualty Officer at the Miller General Hospital 1939-1940. He was called up in 1940, but was found unfit having had the symptoms of tuberculosis

At the end of this appointment in 1940 he became First Assistant at the Sheffield Royal Hospital and in 1941, Medical Tutor. Between 1942 and 1945 he worked with Sir Hans Krebs on experiments on conscientious objectors, who were allowed to volunteer for this as an alternative to serving in the Armed Forces. The research involved human vitamin deficiency experiments (reported in MRC Special Reports 264 and 280). This work helped to determine policy for shipwrecked sailors. He was appointed Senior Lecturer in Medicine (Social Aspects) in the Department of Medicine at the University of Sheffield and also part-time, the first Student Health Officer. In 1949 he became Senior Lecturer in Social and Industrial Medicine in the University of Sheffield and Hon. Consultant in Social and Industrial Medicine to the United Sheffield Hospitals. In 1955 he was promoted to a readership.

While in Sheffield his research encompassed the study of the health of the elderly at home, for which, together with Prof. W. Hobson, he was awarded a £100 prize from the CIBA Foundation for original work in geriatrics. He probably did the first comprehensive study of illness in general practice and several socio-medical studies of hospital patients and student health. He also undertook a series of investigations on respiratory disease and air pollution which was recognised by the award of funds by the MRC to create a research group on epidemiological research in respiratory disease in Sheffield, later taken on by Professor Charles Stuart Harris, FRCP.

While in Sheffield, he and his family spent many vacation periods in Wensleydale, Yorkshire, where he acted as a locum tenens in the practice of Dr Will Pickles, Pickles was one of the earliest general practitioner-epidemiologistsand became Founder-President of the RCGP. He kept meticulous records and published many seminal papers on the epidemiology of such conditions as measles and infectious hepatitis. John was entranced by Pickles and his work and published an outstanding biography “Will Pickles of Wensleydale” which is still in great demand today.

Between 1953 and 1954 he visited the USA on a 3 month Rockefeller travel grant, later extended to a one year Rockefeller Travelling Fellowship, awarded by the MRC, to spend at the Harvard School of Public Health. It was there that he met Dr Harold Willard and conceived the need for the International Corresponding Club (see above).

He was Professor and Head of the Department of Social and Preventive Medicine at Queen’s University, Belfast from 1958 until his retirement in 1976. While in Belfast, he continued to work on respiratory disease, being the first to show that flax (an important local product), in addition to cotton, caused byssinosis. As a result, the law was changed to include compensation for exposure to flax fibre. His research interests expanded to include coronary artery disease – and the establishment in Belfast of a WHO-Monica Centre. His work in Belfast has been described by Professor Peter Elwoodin the Ulster Medical Journal in 2003.

John was greatly interested in making epidemiology an important tool in global health, and through the IEA, promoted the strengthening of this capacity in developing countries. He served on several WHO committees and in particular, in 1956, on an expert committee in the Public Health Training of the General Practitioner. He was a temporary consultant on several visits to India, to the USSR, to Sri Lanka and to Indonesia, in some of which he was joined by other members of the IEA, such as Professor John Last (from Canada). In 1976, he was appointed Milroy Lecturer of the Royal College of Physicians and was the first Robert Cruickshank Lecturer of the International Epidemiological Association. He served on many important national committees, such as the MRC Committee on the Aetiology of Chronic Bronchitis, the General Health Services Board of Northern Ireland, the Hunter Advisory Committee on Postgraduate Training in Community Medicine in England and Wales, the Health Education Council for England and Wales and Northern Ireland, the Examination Committee of the newly formed Faculty of Community Medicine and was Chairman of the Examiners Board. He was a member of the EEC Panel on Epidemiology, member and rapporteur of the Adhoc Committee on Community Alternatives to Hospital Care of the Council of Europe in 1980. In 1984 he wrote an important report to the EEC on upgrading education in epidemiology.

Following retirement from the Chair in Belfast, he and his family lived in Hathersage near Sheffield; a picturesque part of the Peak District in the centre of England and location of his early career. He continued to remain active in academic life. For the first seven years he was involved in organising the postgraduate training of doctors in public health in the UK. He continued to do research by work on the high death rates attributed to osteoporosis in some parts of England, due to fracture neck and femur. He also pursued his interests in what he called “phoney diseases”, questioning the validity regarding “hypotension” as a disease commonly diagnosed in some European countries.

His abiding interests in literature and in painting now took a much greater part of his life than while he was a full time academic and he contributed a great deal to local activities in these two fields. He was greatly appreciated by the local community. He hiked for recreation and the interior walls of his home were decorated with a fascinating and varied array of paintings and drawings, some of them (like his collection of Indian miniature paintings) related to his international travels. Apart from his academic writing, he contributed to the correspondence in the Guardian, the Independent and other newspapers on matters related to his interests and his radical views such as the Iraq war, advertising of tobacco products and poverty and health. Although he was always interested in political ideas, he was never extreme in his views and his reaction to the disturbances in Northern Ireland, while he was a Professor there, was to support the Alliance Party which worked for a non-sectarian solution. He regarded the introduction of the internal market in the British National Health Service with apprehension.

This account cannot do justice to a remarkable man who has been a contributor and driver of many of the improvements in the lives of the UK population, as well as in the development of epidemiology and in medical education. He has enriched the lives of all those with whom he came in contact. His hobbies of painting, literature and walking epitomised his approach to life. He was kind, gentle as well as stimulating and never said an unkind word about anybody.

John married Gwen in 1936. She died in 1989. They had three sons, Adam (born194O ) a solicitor and mediator, Patrick (born 1942), a consultant paediatricianat the Princess Margaret Hospital, Perth, Western Australia and Robert (born 1948), initially a biologist. He had seven grand-daughters and seven great-grandchildren . He is survived by his partner, since 1990, Dr. Maureen Maybin.

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