Obituary: Professor Roger Hardisty

Roger Michael Hardisty, haematologist: born London 19 September 1922; Professor of Haematology, Institute of Child Health, London 1969- 87; Emeritus Professor, Royal Free Hospital School of Medicine 1987-97; married 1947 Jytte Jarnum (one son, one daughter); died London 18 September 1997.

When Roger Hardisty was appointed to Great Ormond Street Hospital in 1958 the death rate from childhood leukaemia was 100 per cent. By the time he retired, up to 70 per cent of afflicted children were surviving apparently cured.

This major advance was also due, certainly, to work in other centres, both national and international, but, as the first specialist to be solely concerned with paediatric haematology in Britain, Hardisty's role was pivotal. His other area of research, into how the blood clots, was fundamental and equally productive, with the new knowledge applied to running a world-famous treatment centre for haemophilia and other clotting disorders.

Apart from his National Service in the Army, Hardisty's early medical life was centred on St Thomas's Hospital. Like most London teaching hospitals then, this had its stuffy establishment consultants who saw their only responsibility as patient care at the hospital and in Harley Street. But, unlike many medical schools, St Thomas's had a large body of exceptionally gifted academic doctors committed to research and teaching as well. In the heady intellectual atmosphere of the post-war period the output of new and important results was unique for a British undergraduate hospital. Unusually, moreover, the research was heavily based on the laboratory and, even more unusually, at St Thomas's such doctors were not second- class ancillaries but clinicians expected to see patients in the wards.

Appointed to Great Ormond Street after a short period at Cardiff, Hardisty brought this unique approach with him. Once established, strong individual departments were given formal academic status, so that in 1969 Hardisty became the first professor of paediatric haematology in Britain.

The hospital was a referral centre not only for Britain but also for abroad, and the treatment of leukaemia was a significant problem. Research was indicating that remissions could sometimes be obtained using drugs such as steroids and the "antimetabolites". Nevertheless, after a few weeks or months the leukaemia invariably relapsed, and, though occasionally a second remission might be obtained, inevitably it returned and the child died.

In the early 1960s the suggestion arose that giving the drugs together or in succession might produce longer remissions - and that carefully controlled schedules in expert centres might eventually produce cures. In retrospect such trials sound straightforward ; at the time they were anything but easy. The toxic effects of the drugs added to the miseries of the disease, and even when the leukaemia had been absent for some months it might suddenly return, say, as a lump in the testicle or ovary, or as leukaemia meningitis (which Roger Hardisty was the first to identify).

These recurrences demanded surgical operation or radiotherapy, but some consultants refused to allow their patients to have such major procedures. Given the then inevitable lethal outcome of leukaemia, treatment might be worse than the disease; humane terminal care was thought to be paramount.

Similarly, in the heroic surgery starting around that time, particularly organ transplantation, the results were dismaying. Many now speak of the surgeons who persisted to success as having the "courage to fail". No less courage was shown by those haematologists who persisted in treating childhood and other leukaemias. Among these, Hardisty (as humane as anybody, giving his home telephone number to worried parents) was the foremost in Britain.

Showing that the rarer forms of childhood leukaemia behave differently from the commoner "lymphoblastic" variety, as secretary and then chairman of the Medical Research Council's working party on leukaemia in childhood he was rewarded when a trial disclosed that no fewer than 70 per cent of children with the latter had survived. Another reward was a secretly organised tea party for his retirement, in the boardroom of Great Ormond Street, attended by his many survivors from leukaemia.

Roger Hardisty was an exceptionally modest man (figuring in neither Who's Who nor the Honours List, though the French government made him a Chevalier de l'Ordre Nationale du Merite). He shunned merely adding his name to research papers, but delighted in transmuting those written by colleagues into pellucid prose. The co-author of two notable books, Bleeding Disorders: investigation and management (1965) and Blood and its Disorders (1974), he was an outstanding editor of the British Journal of Haematology, and alone among the contributions to one multi-author textbook his required no alterations at all.

Apart from photography (at which he excelled) his outside interests were mainly intellectual (as befitted somebody who could give medical seminars in French or Danish). These - whether reading, listening to music, or going to the theatre - were reflected in his Hampstead home, where he and his Danish wife, Jytte, created a relaxed and cosy mixture of books, pictures, and antique and modern furniture.

Nor was the company at the frequent dinner parties exclusively medical: the conversation over the food and carefully chosen wine would be livened by an economist, a music critic, or a botanist. And if, during his final illness with stomach cancer, he had been asked to look on the bright side, he would probably have remarked wryly that at least he wouldn't have to experience the full awfulness of John Birt's future BBC.

-