Obituary: Professor Clifford Wilson

Clifford Wilson, physician: born 27 January 1906; Professor of Medicine, London University (at the London Hospital) 1946-71 (Emeritus), Dean of the Faculty of Medicine 1968-71; Director, Medical Unit, London Hospital 1946-71; President, Renal Association 1963-64; married 1936 Kathleen Hebden (one son, one daughter); died 10 November 1997.

Clifford Wilson was Professor of Medicine at the London Hospital Medical College for 25 years from 1946 and played a major role in the post-war period in the conversion of London medical schools into proper university institutes. He also made seminal advances in the understanding of kidney disease and its relation to high blood pressure and to diabetes.

Behind these bare facts lies the history of a highly reserved but profoundly committed individual, whose thinking arose from a life-long interest in political and moral philosophy. Born in 1906 into a Baptist family, his academic potential first manifested itself in classics, but he eventually won the Brackenbury scholarship to Balliol College, Oxford, on the basis of his performance in chemistry, to which he had been attracted whilst working as a laboratory technician in his spare time at the Heath School, Halifax. At Balliol, he was much influenced by his tutor Harold Hartley, who supported him when he decided to change from Chemistry to Medicine.

Wilson remained throughout his life immensely proud of his Balliol connection, and was prone to recall his intellectual origins to those of his juniors less familiar with the academic pre-eminence of that institution. He took a First in Natural Sciences in 1928 and completed his clinical and junior medical training at the London Hospital by 1934. He then obtained a Rockefeller Travelling Fellowship to Harvard. There, in 1934, he met the pathologist Paul Kimmelstiel and with him made the discovery of the unique lesion in the kidneys of long-standing diabetics which has since then borne their joint names.

Academic medicine had been pioneered at the London by Sir Arthur Ellis, and in 1938 Wilson became his Assistant Director. When, at the beginning of the Second World War, the medical school had to be dispersed amongst hospitals outside London, he took charge of the teaching at Billericay Hospital, where he developed a programme designed to introduce new clinical students to patients and to teach them the elements of clinical history- taking and examination. The core of this part of the course has essentially remained unchanged, simply because no-one seems to be able to better it. Wilson was in the Medical Research Section of the RAMC till 1945, where he played an important part in dealing with the outbreaks of infectious hepatitis which were so prevalent in the army.

By the time Wilson returned to the London in 1946, Ellis had moved to Oxford, and Wilson succeeded him as Professor of Medicine. Then began what was to become the political battle of his life. In 1944 the Goodenough Committee had recommended that the medical school course should provide the student with a university education on broad and liberal lines. This meant that the apprenticeship system, by which students imbibed their trade by osmosis from the eminent doctors to whom they were attached, needed to a large extent to be replaced by a system of training in principles, problem-solving, and habits of learning which would equip them for a lifetime of practice in a continually changing scene - rather than simply to train them to become safe house officers on graduation.

There was resistance to these ideas amongst teaching hospital staff, in the royal colleges and, indeed, in some universities. Wilson was a formidable leader in the battle to achieve proper status and influence of the university in medical schools, because he was prepared to fight for what he felt to be the right course, even at the expense of making enemies. The battle was not really won till the late 1960s, with the publication of the report of the Royal Commission on Medical Education. Though all this may seem obvious now, Wilson's successors and the medical students of today have enormous reason for gratitude to him that these matters are no longer issues. As his ideas gained support, he was elected to senior roles in medicine on a wider stage. He was Senior Vice-President and Senior Censor of the Royal College of Physicians of London in 1967-68 and Dean of the Faculty of Medicine in London University from 1968 until 1971.

In the two decades after his appointment to the Chair of Medicine in 1946, Wilson and his junior academic colleagues, Jack Ledingham and Michael Floyer, and the pathologist Frank Byrom, together worked out much of the mechanism of the curious relationship between the kidneys and blood pressure and thereby established many of the principles upon which the modern treatments of hypertension and kidney disease are based. He provided an academic home for many aspiring clinical scientists, of a wide range of interests, and gave them their head, relieving them of the worry of funding their research. He was a brilliant scientific critic and taught us all how to write papers. Furthermore, he inspired a tradition of service and commitment - you stayed with the job till it was done, and especially if it involved patients.

Clifford Wilson looked immensely distinguished - which he was. This and his natural reserve made him appear a little unapproachable, which entirely belied his nature. He was a man of deeply and passionately held convictions, which tended only to be expressed sparsely and apparently by chance. He was, in fact, exceptionally good with both patients and students; there is a famous painting of him by John Ward, holding forth to students on the subject of kidney disease.

Contrary to expectation, on his retirement in 1971, Clifford Wilson played no further role in medical affairs, but retreated to his country home. He probably felt that his family deserved this after his long years of time-consuming medico-academic politics.

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