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Michael Francis Oliver
Courtesy of Paul Oliver
Obituary
Michael Francis Oliver Leading cardiologist and a past President of the Royal College of Physicians of Edinburgh. Born on July 3, 1925, in Aberystwyth, UK, he died of a heart attack on June 7, 2015, in Siena, Italy, aged 89 years. Among the most eminent of British heart researchers of the second half of the last century, from his appointment in 1976 until his retirement in 1989 Michael Oliver held the Duke of Edinburgh Chair of Cardiology at the University of Edinburgh. Professor Peter Weissberg, Medical Director of the British Heart Foundation, describes the department Oliver led as his enduring legacy. “Michael set it up from scratch and laid the foundations for what is arguably the UK’s most prominent and influential clinical research centre in heart disease, spawning a succession of world leading clinical researchers.” One of these is Professor Keith Fox, the current Duke of Edinburgh Professor of Cardiology. In seeking to encapsulate what his predecessor brought to cardiology, Fox identifies a particular talent. “Michael was an original thinker who challenged dogma. He wasn’t afraid to take a robust position when it came to challenging accepted wisdom. He forced people to think.” Equally important was Oliver’s capacity to accept evidence that contradicted his views, and to change those views accordingly. “It’s a tribute to Michael that he would always follow the evidence”, says Fox. Nowhere was this more apparent than in Oliver’s views on the role of cholesterol in heart disease, and what should be done about it. An early enthusiast for clinical trials he did one of the first on a lipid lowering agent, clofibrate. A study done in the days when such investigations were still fairly 130
unsophisticated, it found an excess of non-cardiac deaths among those treated. This made a deep impression on Oliver. “He then drove a wedge of opinion against cholesterol lowering”, says Fox. Later and larger studies would, of course, paint a different picture. “Michael was involved with one of the subsequent trials of lipid lowering and he did a complete U-turn in respect of people at risk through very high levels”, says Fox. Moreover, Oliver then used his authority to champion cholesterol lowering. But the key word is “high”. To the end he remained doubtful about the benefits of tackling more moderate amounts of cholesterol. Oliver qualified in 1947 at the University of Edinburgh, spent a couple of years in general practice, and then returned to Edinburgh to embark on his lifetime preoccupation with the physiology and biochemistry of heart disease. In 1958 he met Desmond Julian, now retired from a chair in cardiology at the University of Newcastle, but then a senior registrar at the Royal Infirmary of Edinburgh. In the early 1960s, Julian began contemplating the new idea of a coronary care unit. By the time he returned to Edinburgh after a 3-year stint in Australia, the idea had already become a reality, but only in the USA. As Julian recalls, “Michael and I together—he as very good at getting money from other people—established the first coronary care unit in Europe.” That was in 1966 at the Royal Infirmary of Edinburgh. The pair encountered resistance but persevered, and in 1967 they organised the first international conference on coronary care in Edinburgh. Fox describes Oliver as “a witty, charming man with a great intellect and great confidence”. He owned an old farmhouse in Umbria: a building that in later years became a summer home for him and his adored second wife Helen, who died last year. An evening of their joint hospitality was an unforgettable experience. Even in rural Italy Oliver never lost interest in cardiology. His last paper, on free fatty acids (FFA) and myocardial ischaemia, was published earlier this year in Clinical Science. He used it to rehearse the arguments underpinning a long held belief in what he described as the “strong case for reducing the risk of early arrhythmic death during acute myocardial ischaemia by controlling raised plasma FFA concentrations”. This might be achieved, he claimed, by the development of a less toxic variant of the nicotinic acid family of drugs. But although riding a hobbyhorse, he never lost his sense of realism about the way the world works. Old-fashioned pathophysiology is not the metier of modern cardiology or of drug companies, he wrote in an email he sent to me just a week before his death, adding that there was no money to be made from the idea. “I am left with an original hypothesis, well supported by others, which may or may not be taken up. I hope that this is one of the stimulating ways that medical science grows.” Oliver is survived by his daughter and two sons from his first marriage.
Geoff Watts www.thelancet.com Vol 386 July 11, 2015
Obituary
Michael Francis Oliver Leading cardiologist and a past President of the Royal College of Physicians of Edinburgh. Born on July 3, 1925, in Aberystwyth, UK, he died of a heart attack on June 7, 2015, in Siena, Italy, aged 89 years. Among the most eminent of British heart researchers of the second half of the last century, from his appointment in 1976 until his retirement in 1989 Michael Oliver held the Duke of Edinburgh Chair of Cardiology at the University of Edinburgh. Professor Peter Weissberg, Medical Director of the British Heart Foundation, describes the department Oliver led as his enduring legacy. “Michael set it up from scratch and laid the foundations for what is arguably the UK’s most prominent and influential clinical research centre in heart disease, spawning a succession of world leading clinical researchers.” One of these is Professor Keith Fox, the current Duke of Edinburgh Professor of Cardiology. In seeking to encapsulate what his predecessor brought to cardiology, Fox identifies a particular talent. “Michael was an original thinker who challenged dogma. He wasn’t afraid to take a robust position when it came to challenging accepted wisdom. He forced people to think.” Equally important was Oliver’s capacity to accept evidence that contradicted his views, and to change those views accordingly. “It’s a tribute to Michael that he would always follow the evidence”, says Fox. Nowhere was this more apparent than in Oliver’s views on the role of cholesterol in heart disease, and what should be done about it. An early enthusiast for clinical trials he did one of the first on a lipid lowering agent, clofibrate. A study done in the days when such investigations were still fairly 130
unsophisticated, it found an excess of non-cardiac deaths among those treated. This made a deep impression on Oliver. “He then drove a wedge of opinion against cholesterol lowering”, says Fox. Later and larger studies would, of course, paint a different picture. “Michael was involved with one of the subsequent trials of lipid lowering and he did a complete U-turn in respect of people at risk through very high levels”, says Fox. Moreover, Oliver then used his authority to champion cholesterol lowering. But the key word is “high”. To the end he remained doubtful about the benefits of tackling more moderate amounts of cholesterol. Oliver qualified in 1947 at the University of Edinburgh, spent a couple of years in general practice, and then returned to Edinburgh to embark on his lifetime preoccupation with the physiology and biochemistry of heart disease. In 1958 he met Desmond Julian, now retired from a chair in cardiology at the University of Newcastle, but then a senior registrar at the Royal Infirmary of Edinburgh. In the early 1960s, Julian began contemplating the new idea of a coronary care unit. By the time he returned to Edinburgh after a 3-year stint in Australia, the idea had already become a reality, but only in the USA. As Julian recalls, “Michael and I together—he as very good at getting money from other people—established the first coronary care unit in Europe.” That was in 1966 at the Royal Infirmary of Edinburgh. The pair encountered resistance but persevered, and in 1967 they organised the first international conference on coronary care in Edinburgh. Fox describes Oliver as “a witty, charming man with a great intellect and great confidence”. He owned an old farmhouse in Umbria: a building that in later years became a summer home for him and his adored second wife Helen, who died last year. An evening of their joint hospitality was an unforgettable experience. Even in rural Italy Oliver never lost interest in cardiology. His last paper, on free fatty acids (FFA) and myocardial ischaemia, was published earlier this year in Clinical Science. He used it to rehearse the arguments underpinning a long held belief in what he described as the “strong case for reducing the risk of early arrhythmic death during acute myocardial ischaemia by controlling raised plasma FFA concentrations”. This might be achieved, he claimed, by the development of a less toxic variant of the nicotinic acid family of drugs. But although riding a hobbyhorse, he never lost his sense of realism about the way the world works. Old-fashioned pathophysiology is not the metier of modern cardiology or of drug companies, he wrote in an email he sent to me just a week before his death, adding that there was no money to be made from the idea. “I am left with an original hypothesis, well supported by others, which may or may not be taken up. I hope that this is one of the stimulating ways that medical science grows.” Oliver is survived by his daughter and two sons from his first marriage.
Geoff Watts www.thelancet.com Vol 386 July 11, 2015