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Professor Dame Sheila Sherlock (1918–2001)
Journal of Hepatology 36 (2002) 312–314 www.elsevier.com/locate/jhep
Obituary
Professor Dame Sheila Sherlock (1918–2001)
Printed with kind permission of the family.
Dame Sheila Sherlock died, peacefully, on 30 December after a long illness. She was a founding member of the European Association for the Study of the Liver (EASL), its second President (for the meeting in Gothenburg in 1967), and the first editor of this journal, serving from 1974 to 1979. In 1950 she was one of the first members of the American Association for the Study of Liver Diseases (AASLD) and – according to Hans Popper – in July of that year she ran the first international meeting devoted solely to liver disease, a CIBA symposium held in London. The International Association for the Study of the Liver (IASL) was founded in Washington in 1958, during the first World Congress of Gastroenterology. Although absent, awaiting the birth of her first daughter, Sheila was elected its first President; Hans Popper became Secretary. The first meeting of IASL was held at the Royal Free in 1960. Sheila was born in Dublin on 31 March 1918, but brought PII: S01 68- 8278(02)0002 9-6
up from an early age in Folkestone, Kent, where she attended its County School for Girls. She decided to study medicine. All her applications to medical schools were rejected, but in August 1936 she had a late offer from Edinburgh and started there that October. She described her student days in My medical school (1978), a collection of reminiscences edited by Dannie Abse. She and her mother had little money so she depended on grants and scholarships and spent her holidays working – sometimes as a waitress, sometimes as a tutor in a ‘crammer’. She graduated MB, BCh (summa cum laude) in 1941, and won the Ettles Scholarship as top of her class. Even so, as a woman, she could not receive one of the coveted house jobs (internships) at the Royal Infirmary. Instead she became clinical assistant to the Professor of Surgery, James Learmonth (later Sir James), who taught her the rudiments of medical research. She called him ‘Poppa’; years later, when she got engaged, he travelled to London overnight, inspected (and approved) her fiance´ at breakfast, then returned to Edinburgh. In 1942 she was house physician to Professor McMichael (later Sir John, another Ettles scholar) at Hammersmith Hospital and the Postgraduate Medical School. He taught her liver biopsy and, in 1943, with the pathologist John Dible, they published a paper on the pathology of acute hepatitis (Lancet, 2 October); it effectively demolished the theory of ‘catarrhal jaundice’ attributed to obstruction of the ampulla by a plug of mucus. This work was the basis of her thesis for an Edinburgh MD (and gold medal) in 1945. No one could have predicted what was to follow. Supported by the Medical Research Council, then by the Beit Memorial Fund, she studied the biochemistry of the liver and its disorders, although biochemistry was never to be her forte. When the war ended she investigated the effects on the liver of the malnutrition still to be found in Germany. Awarded a Rockefeller travelling fellowship in 1947 she went to the Department of Physiological Chemistry at Yale, headed by C.N.H. Long, best known for his work on the isolation of ACTH. She returned to Hammersmith a year later as Lecturer and Honorary Consultant Physician. She was only thirty. Within a few years her new Liver Unit was famous – and so was she! Research fellows came from far and wide, particularly the USA and the Commonwealth. The research output was prodigious, with publications on many aspects of liver disease. During this time her interests included hepatic handling of glucose, the pathophysiology of the portal circulation, the mechanisms and management of hepatic encephalopathy
Obituary
(she coined the term ‘portal-systemic encephalopathy’), and the treatment of fluid retention in liver disease. Her co-workers included Barbara Billing, of bilirubin conjugation fame, Pete Reynolds, Jan de Groote and Frank Iber. In 1959 she was the first woman appointed to the Chair of a British department of medicine, taking the newly created post at the Royal Free Hospital School of Medicine, which pioneered medical education of women in this country. To help in her new Unit (which was also responsible for gastroenterology, nephrology and general medicine) Dame Sheila brought some of her Hammersmith group to the Free including Barbara Billing, Tony Dawson (later Sir Anthony), who moved to St. Bartholomew’s Hospital in 1966, Stanley Shaldon, who pioneered home dialysis for renal failure while at the Free, Roger Williams, who later started the Liver Unit at King’s College Hospital, and Mike Turner, who soon left for the USA. For 15 years her main unit (offices and laboratories) was at the hospital in Gray’s Inn Road – housed in a rooftop wooden hut reachable only via steep ladders open to the elements. This was the access not only for staff, but also for visitors and patients who consulted her there! Lectures and seminars were held in another hut; to get to it one crossed a series of duckboards that protected shoes from the puddles of water collecting after rain. Despite this rickety and crowded accommodation excellent work was produced. The unit grew and other huts were erected – at Gray’s Inn Road, and at the Lawn Road branch of the hospital in Hampstead. In 1974 the new Royal Free Hospital building in Hampstead was opened; Sheila’s group moved into relatively palatial, purpose-built accommodation that she helped to design – its offices, laboratories and wards occupied most of the tenth floor. When she first arrived at the Royal Free she was strongly supported by Kenneth Hill, Professor of Pathology who was already interested in liver disease (and working on the paper which introduced the term ‘acute alcoholic hepatitis’). Peter Scheuer started as Lecturer in Pathology the same day; supervised by Hill, whom he succeeded, he had written an MD thesis on veno-occlusive disease. Sheila’s move stimulated other Royal Free colleagues to work on the liver. Liver surgery was performed initially by Phyllis George, later by Ken Hobbs. Good radiology was essential and was provided first by Bill Young, and then by Bob Dick and his colleagues, who made the Royal Free a major centre for hepatic radiology. Space does not permit mention of more than a few of the many important contributions which Sheila and her coworkers made to hepatology while she was at the Royal Free. They linked the hepatitis B virus (when it was still the ‘Australia antigen’) to the development of cirrhosis and hepatocellular carcinoma, and studied the role of sexual transmission and male homosexuality. With Deborah Doniach they introduced the anti-mitochondrial antibody as a test for primary biliary cirrhosis; many papers were produced on this condition and its treatment. They were
313
the first to recognize (in 1971) the benefit of immunosuppression with prednisolone for autoimmune hepatitis. Classic papers were produced on the circulatory changes in the lungs, kidneys and peripheries, on unconjugated hyperbilirubinaemias, on Wilson’s disease, haemochromatosis, the Budd–Chiari syndrome, extrahepatic portal vein block, partial nodular transformation of the liver, and primary sclerosing cholangitis. Sheila wrote, edited and contributed to many books. But the one which will always be remembered is Diseases of the liver and biliary system which, for eight editions – the first appearing in 1955 – she wrote herself. It remains a classic, and is translated into at least six other languages. Two or three weeks before she died James Dooley, her co-author since 1993, presented her with a rushed copy of the eleventh edition. She had an immense impact on the hospital and the medical school over and above that resulting from the research done in her unit. Leading clinicians and basic scientists from far and wide visited regularly, and participated in the department’s educational programme. Her juniors, and other colleagues, interacted with them and were encouraged to meet them socially, either over sherry after a lecture or over lunch or dinner. She influenced new appointments at the Royal Free, insisting always that the successful applicant had a strong academic background. She revitalized the hospital’s library, supported the medical illustration department, and took a great interest in many aspects of school and hospital life, including the sporting activities of the students. Each Xmas she gave presents to groups providing key services, like the telephonists, post room, porters and medical records staff. In 1990 she was elected President of the Royal Free Hospital School of Medicine. In 1951 Sheila became the youngest woman elected a fellow of the Royal College of Physicians, later the first woman to be Senior Censor and Vice-President, and in 1983 was narrowly defeated in the Presidential election. She was an honorary fellow or member of other colleges, associations and societies world-wide – including the Physiological Society, a rare honour for a physician. She received honorary degrees, prizes and medals from universities and academic organizations in many counties. She was president of the British Society of Gastroenterology and edited Gut. The two awards that pleased her most were her appointment as Dame Commander of the British Empire (DBE) in 1978, and her somewhat belated election as a Fellow of the Royal Society in 2001. She ‘retired’ in 1983. This simply meant that she moved her office and her loyal secretary, Aileen Duggan, to the Department of Surgery and went on working. She regularly attended EASL, IASL and AASLD meetings, and was in great demand at other meetings as well. She was a superb speaker, and a spirited contributor to discussions – often as a critic, but never failing to praise a worthy presentation. She continued to travel the world until a few months before her death, although these trips began to take their toll.
314
Obituary
Her home life was a rich one. She married Gerry James, also a distinguished physician, in 1951; she later described him as “a perfect consort for an academic wife”. It was a wonderful marriage; they celebrated their golden wedding about two weeks before she died with their two daughters, Mandy and Auriole, and two granddaughters, Alice and Emily. Sheila liked the theatre, opera and literature. But she loved sport. She played tennis for her University; later, with the best male player, she regularly won her unit’s annual tennis tournament. A life member of the Kent County Cricket Club, she could, when asked, name the team. Married to a Welshman, she understood rugby, but her loyalty in the winter was to Arsenal. The love, affection, and great loyalty she inspired in those who worked with her were obvious to everyone. She was a mother figure; she maintained discipline but protected her young from the criticisms of others. She nurtured them, feeding a healthy intellectual diet. She and Gerry invited them home, to dine with friends and overseas visitors. Their hospitality was legendary – initially at Willesden, later at Regent’s Park and their house at
Hythe. She helped when the offspring left ‘home’ – to run and work at liver units all over the world. And they were always welcomed back at the Free as part of her extended family. At dinners her toast was always “the internationalism of medicine”; she did more than anyone to promote that concept. For years a large, informal group, nicknamed the ‘Sherlock Society’, has held a dinner to honour her at the annual American liver meeting. The dinners, I am sure, will continue. She will long be remembered by her fellow hepatologists. She will certainly be remembered at the Royal Free where there is a Sheila Sherlock Postgraduate Centre, and a Sheila Sherlock Professor of Medicine. Her portrait, by Ruskin Spear RA, commissioned by fellows and friends, hangs in the postgraduate centre, there is a bust of her in the library, and her spirit still pervades the building. Neil McIntyre Jean-Pierre Benhamou Gustav Paumgartner Juan Rode´ s
Obituary
Professor Dame Sheila Sherlock (1918–2001)
Printed with kind permission of the family.
Dame Sheila Sherlock died, peacefully, on 30 December after a long illness. She was a founding member of the European Association for the Study of the Liver (EASL), its second President (for the meeting in Gothenburg in 1967), and the first editor of this journal, serving from 1974 to 1979. In 1950 she was one of the first members of the American Association for the Study of Liver Diseases (AASLD) and – according to Hans Popper – in July of that year she ran the first international meeting devoted solely to liver disease, a CIBA symposium held in London. The International Association for the Study of the Liver (IASL) was founded in Washington in 1958, during the first World Congress of Gastroenterology. Although absent, awaiting the birth of her first daughter, Sheila was elected its first President; Hans Popper became Secretary. The first meeting of IASL was held at the Royal Free in 1960. Sheila was born in Dublin on 31 March 1918, but brought PII: S01 68- 8278(02)0002 9-6
up from an early age in Folkestone, Kent, where she attended its County School for Girls. She decided to study medicine. All her applications to medical schools were rejected, but in August 1936 she had a late offer from Edinburgh and started there that October. She described her student days in My medical school (1978), a collection of reminiscences edited by Dannie Abse. She and her mother had little money so she depended on grants and scholarships and spent her holidays working – sometimes as a waitress, sometimes as a tutor in a ‘crammer’. She graduated MB, BCh (summa cum laude) in 1941, and won the Ettles Scholarship as top of her class. Even so, as a woman, she could not receive one of the coveted house jobs (internships) at the Royal Infirmary. Instead she became clinical assistant to the Professor of Surgery, James Learmonth (later Sir James), who taught her the rudiments of medical research. She called him ‘Poppa’; years later, when she got engaged, he travelled to London overnight, inspected (and approved) her fiance´ at breakfast, then returned to Edinburgh. In 1942 she was house physician to Professor McMichael (later Sir John, another Ettles scholar) at Hammersmith Hospital and the Postgraduate Medical School. He taught her liver biopsy and, in 1943, with the pathologist John Dible, they published a paper on the pathology of acute hepatitis (Lancet, 2 October); it effectively demolished the theory of ‘catarrhal jaundice’ attributed to obstruction of the ampulla by a plug of mucus. This work was the basis of her thesis for an Edinburgh MD (and gold medal) in 1945. No one could have predicted what was to follow. Supported by the Medical Research Council, then by the Beit Memorial Fund, she studied the biochemistry of the liver and its disorders, although biochemistry was never to be her forte. When the war ended she investigated the effects on the liver of the malnutrition still to be found in Germany. Awarded a Rockefeller travelling fellowship in 1947 she went to the Department of Physiological Chemistry at Yale, headed by C.N.H. Long, best known for his work on the isolation of ACTH. She returned to Hammersmith a year later as Lecturer and Honorary Consultant Physician. She was only thirty. Within a few years her new Liver Unit was famous – and so was she! Research fellows came from far and wide, particularly the USA and the Commonwealth. The research output was prodigious, with publications on many aspects of liver disease. During this time her interests included hepatic handling of glucose, the pathophysiology of the portal circulation, the mechanisms and management of hepatic encephalopathy
Obituary
(she coined the term ‘portal-systemic encephalopathy’), and the treatment of fluid retention in liver disease. Her co-workers included Barbara Billing, of bilirubin conjugation fame, Pete Reynolds, Jan de Groote and Frank Iber. In 1959 she was the first woman appointed to the Chair of a British department of medicine, taking the newly created post at the Royal Free Hospital School of Medicine, which pioneered medical education of women in this country. To help in her new Unit (which was also responsible for gastroenterology, nephrology and general medicine) Dame Sheila brought some of her Hammersmith group to the Free including Barbara Billing, Tony Dawson (later Sir Anthony), who moved to St. Bartholomew’s Hospital in 1966, Stanley Shaldon, who pioneered home dialysis for renal failure while at the Free, Roger Williams, who later started the Liver Unit at King’s College Hospital, and Mike Turner, who soon left for the USA. For 15 years her main unit (offices and laboratories) was at the hospital in Gray’s Inn Road – housed in a rooftop wooden hut reachable only via steep ladders open to the elements. This was the access not only for staff, but also for visitors and patients who consulted her there! Lectures and seminars were held in another hut; to get to it one crossed a series of duckboards that protected shoes from the puddles of water collecting after rain. Despite this rickety and crowded accommodation excellent work was produced. The unit grew and other huts were erected – at Gray’s Inn Road, and at the Lawn Road branch of the hospital in Hampstead. In 1974 the new Royal Free Hospital building in Hampstead was opened; Sheila’s group moved into relatively palatial, purpose-built accommodation that she helped to design – its offices, laboratories and wards occupied most of the tenth floor. When she first arrived at the Royal Free she was strongly supported by Kenneth Hill, Professor of Pathology who was already interested in liver disease (and working on the paper which introduced the term ‘acute alcoholic hepatitis’). Peter Scheuer started as Lecturer in Pathology the same day; supervised by Hill, whom he succeeded, he had written an MD thesis on veno-occlusive disease. Sheila’s move stimulated other Royal Free colleagues to work on the liver. Liver surgery was performed initially by Phyllis George, later by Ken Hobbs. Good radiology was essential and was provided first by Bill Young, and then by Bob Dick and his colleagues, who made the Royal Free a major centre for hepatic radiology. Space does not permit mention of more than a few of the many important contributions which Sheila and her coworkers made to hepatology while she was at the Royal Free. They linked the hepatitis B virus (when it was still the ‘Australia antigen’) to the development of cirrhosis and hepatocellular carcinoma, and studied the role of sexual transmission and male homosexuality. With Deborah Doniach they introduced the anti-mitochondrial antibody as a test for primary biliary cirrhosis; many papers were produced on this condition and its treatment. They were
313
the first to recognize (in 1971) the benefit of immunosuppression with prednisolone for autoimmune hepatitis. Classic papers were produced on the circulatory changes in the lungs, kidneys and peripheries, on unconjugated hyperbilirubinaemias, on Wilson’s disease, haemochromatosis, the Budd–Chiari syndrome, extrahepatic portal vein block, partial nodular transformation of the liver, and primary sclerosing cholangitis. Sheila wrote, edited and contributed to many books. But the one which will always be remembered is Diseases of the liver and biliary system which, for eight editions – the first appearing in 1955 – she wrote herself. It remains a classic, and is translated into at least six other languages. Two or three weeks before she died James Dooley, her co-author since 1993, presented her with a rushed copy of the eleventh edition. She had an immense impact on the hospital and the medical school over and above that resulting from the research done in her unit. Leading clinicians and basic scientists from far and wide visited regularly, and participated in the department’s educational programme. Her juniors, and other colleagues, interacted with them and were encouraged to meet them socially, either over sherry after a lecture or over lunch or dinner. She influenced new appointments at the Royal Free, insisting always that the successful applicant had a strong academic background. She revitalized the hospital’s library, supported the medical illustration department, and took a great interest in many aspects of school and hospital life, including the sporting activities of the students. Each Xmas she gave presents to groups providing key services, like the telephonists, post room, porters and medical records staff. In 1990 she was elected President of the Royal Free Hospital School of Medicine. In 1951 Sheila became the youngest woman elected a fellow of the Royal College of Physicians, later the first woman to be Senior Censor and Vice-President, and in 1983 was narrowly defeated in the Presidential election. She was an honorary fellow or member of other colleges, associations and societies world-wide – including the Physiological Society, a rare honour for a physician. She received honorary degrees, prizes and medals from universities and academic organizations in many counties. She was president of the British Society of Gastroenterology and edited Gut. The two awards that pleased her most were her appointment as Dame Commander of the British Empire (DBE) in 1978, and her somewhat belated election as a Fellow of the Royal Society in 2001. She ‘retired’ in 1983. This simply meant that she moved her office and her loyal secretary, Aileen Duggan, to the Department of Surgery and went on working. She regularly attended EASL, IASL and AASLD meetings, and was in great demand at other meetings as well. She was a superb speaker, and a spirited contributor to discussions – often as a critic, but never failing to praise a worthy presentation. She continued to travel the world until a few months before her death, although these trips began to take their toll.
314
Obituary
Her home life was a rich one. She married Gerry James, also a distinguished physician, in 1951; she later described him as “a perfect consort for an academic wife”. It was a wonderful marriage; they celebrated their golden wedding about two weeks before she died with their two daughters, Mandy and Auriole, and two granddaughters, Alice and Emily. Sheila liked the theatre, opera and literature. But she loved sport. She played tennis for her University; later, with the best male player, she regularly won her unit’s annual tennis tournament. A life member of the Kent County Cricket Club, she could, when asked, name the team. Married to a Welshman, she understood rugby, but her loyalty in the winter was to Arsenal. The love, affection, and great loyalty she inspired in those who worked with her were obvious to everyone. She was a mother figure; she maintained discipline but protected her young from the criticisms of others. She nurtured them, feeding a healthy intellectual diet. She and Gerry invited them home, to dine with friends and overseas visitors. Their hospitality was legendary – initially at Willesden, later at Regent’s Park and their house at
Hythe. She helped when the offspring left ‘home’ – to run and work at liver units all over the world. And they were always welcomed back at the Free as part of her extended family. At dinners her toast was always “the internationalism of medicine”; she did more than anyone to promote that concept. For years a large, informal group, nicknamed the ‘Sherlock Society’, has held a dinner to honour her at the annual American liver meeting. The dinners, I am sure, will continue. She will long be remembered by her fellow hepatologists. She will certainly be remembered at the Royal Free where there is a Sheila Sherlock Postgraduate Centre, and a Sheila Sherlock Professor of Medicine. Her portrait, by Ruskin Spear RA, commissioned by fellows and friends, hangs in the postgraduate centre, there is a bust of her in the library, and her spirit still pervades the building. Neil McIntyre Jean-Pierre Benhamou Gustav Paumgartner Juan Rode´ s