Doctor Ann McPherson: GP and activist who campaigned to change the law on assisted dying
Friday 10 June 2011
When the actor Hugh Grant picked up the British Medical Journal's Lifetime Achievement Award for Medical Communication on behalf of Dr Ann McPherson, he described her as "part doctor, part campaigner, part stalker" for her subtle, persistent, and ultimately successful pursuit of his support, and said it was "a massive honour" for him to help pick up her award (which he did alongside Ann's husband, Klim).
Ann McPherson, who died of pancreatic cancer after a long struggle, did many things in her 65 years: she wrote 20 books, including the best-selling Diary of a Teenage Health Freak; founded the website Health Talk Online, where patients could share their experiences – and, after her pancreatic-cancer diagnosis, founded the pressure group Health Professionals for Assisted Dying. She also worked as a general practitioner, holding a part-time post in Oxford University's Department of Primary Care, as well as bringing up three children. She was admired for her courage, integrity, wisdom, goodness and perseverance.
She was born Ann Egelnick in north London to Russian-born, secular Jewish parents; her father was a tailor and Communist Party official. Being a girl and a card-carrying communist herself – she later left the party and never joined another – did not endear her to the selection boards of most medical schools, but she gained a place at St George's. Her energy was apparent – she enjoyed concerts, theatre and politicking with fellow-lefties – and her student colleagues regarded her as exceptional. One of them, Klim McPherson, married her in 1968, the year she graduated with distinction.
She chose a career in general practice when it was the Cinderella of medical specialties. With young children, she did her GP training part-time at the Caversham practice in north London, where she formed a lifelong friendship with one of her trainers, Dr Rachel Miller, wife of Jonathan. "She had all the ideas and I was just a sounding-board," Dr Miller told me. "She took on extra work, looked after her three children, and juggled them all. Her energy was amazing. She was an attentive and brilliant."
She finished her training atHarvard and Oxford, where shebecame a GP principal. Jean Robinson, a former chairman of The Patients Association and a near-neighbour,said, "General practice in Oxford used to be very male and patriarchal. She changed that, and it soon became known that she was an outstanding doctor. She was outstanding andahead of her time." Dr Miller added: "She would fight her patients' corner – hospital consultants were frightened of her."
She was an inspiration to other doctors. "I first met Ann when I had just joined college council, which was a scary place – mainly men and very senior," Dr Clare Gerada, chairman of the Royal College of General Practitioners, told me. "I was new and didn't know what to do. During a debate up popped a feisty woman – Ann – who defended the rights of young GPs. She said that general practice should be made more accessible for them and the college should do something. She was wonderful and I remember thinking, 'I want to be like her'."
She co-wrote her first book, Mum, I Feel Funny, with the paediatrician Aidan MacFarlane in 1982. Other books followed: with MacFarlane she wrote Diary of a Teenage Health Freak in 1987. It went into three editions, has been translated into 25 languages, became a television series and lives on as the website www.teenagehealthfreak.org. Her other books included, either alone or jointly, Women's Problems in General Practice (1983); Miscarriage (1984 and 1990); Cervical Screening: a practical guide (1985 and 1992); Women's Health in General Practice (2003); Women's Health: by women, for women, about women (1998); I'm a Health Freak Too (1989) which became The Diary of the Other Health Freak (2002); Adolescents: the Agony, the Ecstasy, the Answers: a book for parents (1999); Healthcare of Young People: promotion in primary care (2002); Sex: the facts (2003); Drugs: the facts (2003); Bullying: the facts (2004); Relationships: the facts (2004); and The Truth: a teenager's survival guide (2007). She also wrote 100 academic papers, wrote for newspapers, and broadcast regularly on Radio 4's Woman's Hour.
In 2001 she became a part-timelecturer at Oxford University; in March that year she attended a meetingof the Society for Social Medicine, where the keynote address was given by Dr Kay Dickersin of Baltimore. Dickersin, a breast cancer survivor, had set up a group for others like herself, to find out about patients' needs and priorities. The clinical pharmacologist Dr Andrew Herxheimer recalled, "After the meeting we walked to the station and had to stop at a level crossing. We turned to each other and said to each other, 'We must do the same here [in the UK].'"
They went ahead, with McPherson doing much of the fund-raising. The organisation, originally called DiPEx (Database of Individual Patient Experiences) is now called www.health-talkonline.org. The eminent breast surgeon, Michael Baum said, "I worked with her on the breast cancer and prostate cancer modules of her website. She was extraordinarily sensitive and compassionate to cancer sufferers." Having survived breast cancer in the 1990s, McPherson was diagnosed with pancreatic cancer in 2007 and made an apparent recovery. When she heard that Hugh Grant's mother had died of the same disease she used her persuasive powers to enlist his support, and he sponsored the website's pancreatic cancer module.
McPherson's cancer recurred in 2009; she responded with a BMJ polemic arguing for assisted dyingfor those who want it. Lord Joffe'sbill on assisted dying for the terminally ill had been defeated in 2006, partly because the Royal Colleges of Physicians and GPs had opposed it, despite public opinion being mainly in favour. She wrote that the politicians and legislators dealing with the matter were not facing immediate death themselves. Many doctors regard a dying patient as a failure, and palliative care specialists were not always truthful about pain relief.
Inundated with replies, most supp-ortive, she founded the group Health Professionals for Assisted Dying. It has 400 members, many eminent, including the heart transplant pioneer Sir Roy Calne; the guru of evidence-based medicine, Sir Iain Chalmers; and the former General Medical Council chairman, Sir Graeme Catto.
McPherson retired from general practice in 2007 and had to give up Healthtalkonline last November when her death seemed imminent. She was angry at what she had to go through and that assisting death was a criminal offence; she didn't want to have to drag herself to Switzerland. She was too weak to go to London in March to receive her BMJ Lifetime Achievement Award, and too weak to write her last BMJ blog, which she dictated three weeks before her protracted death. She would not risk the slightest suspicion of assisting a death falling on her family.
Ann McPherson, doctor: born London 22 June 1945; CBE 2000; married 1968 Klim McPherson (one son, two daughters); died 28 May 2011.
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