Professor John Brocklehurst: Physician who transformed the discipline of geriatric medicine

 

Increased longevity and the demographic shift towards a higher proportion of elderly people in the population created a need to develop appropriate medical services.

Geriatric medicine developed as a result of the drive and innovation of a number of pioneers responding to the challenge, one of whom was John Brocklehurst, who was instrumental in improving the care of older people in hospitals and in developing sound, evidence-based practice.

Born in Liverpool in 1924, his father a graduate engineer. The family moved to Scotland, where John was educated at Glasgow High School and Ayr Academy. A medical student at Glasgow University from 1942-1947, he was awarded the Christine Hanson research fellowship after one year’s residency and started his career-long research into bladder and bowel incontinence in old age.

His initial research was conducted at Foresthall, a former workhouse; he developed cystometry, the measurement of bladder pressures in order to diagnose the causes of incontinence and plan treatment on a scientific basis, and fondly recalled the crudeness of the apparatus he devised using rubber tambours and smoked drums. The outcome of his fellowship was an MD with honours and the award of the Bellahouston Gold Medal. He published his first book on the topic in 1950.

National Service saw him as a medical officer on a troopship. He returned to a post in the Department of Materia Medica and Therapeutics at Glasgow University. Becoming restless and driven by a strong Christian faith (which he was later to lose), he joined the Grenfell medical and religious mission and was one of only three medical staff on the Labrador coast; he returned from Canada having met his wife, Susan.

He settled to train in geriatrics and general medicine before obtaining a consultant post at Bromley Hospital in 1960. With few staff, and looking after 250 beds, he nevertheless developed an excellent unit with an innovative day hospital, rehabilitation units and a close working relationship with social services. In spite of the workload he continued research and writing and after nine years moved to Guy’s Hospital for a year then became the foundation Professor of Geriatric Medicine at Manchester University.

Establishing the first professorial department of geriatric medicine in England was a massive challenge. Based at Withington Hospital, his was one four professorial appointments in different specialties created in an attempt to revive the fortunes of a decrepit hospital. The conversion of the former workhouse into a teaching hospital required the development of a library, laboratories and teaching programmes from scratch.

Although Brocklehurst had an unorthodox academic background he soon established himself within the University. He had an unmistakable professorial air of authority; immaculately dressed, with a penchant for bow ties, he took a pride in everything he did. He founded the Giegy Unit for Research in Aging and continued his ground-breaking research into the causes and treatment of incontinence and developed a purpose-built day hospital and rehab unit.

Gathering skilled teachers and researchers around him he produced an innovative and comprehensive undergraduate programme and a range of postgraduate lectures and conferences. He catalysed a change in attitude towards older people and the doctors who provided their care. Soon the speciality was growing and attracting the best graduates.

In spite of his success there remained a deeply rooted prejudice against geriatric medicine within the conservative medical establishment. In 1976 John Leonard, a Manchester physician, published an opinion piece in the BMJ, Can Geriatrics Survive? in which he argued that geriatric medicine should be subsumed by general medicine. The article caused a furore, though Brocklehurst remained above the debate; he had already established an international reputation and was a major figure on the medical landscape. History has vindicated him with general medicine becoming the realm of specialists and geriatrics commanding more consultant posts than any other specialty.

Many of his publications remain relevant and frequently cited. His Textbook of Geriatric Medicine and Gerontology, first published in 1973, was a landmark publicationand a definitive statement of geriatric knowledge. It has so far gone through seven editions. While the first edition contained predominantly UK contributors, the current edition is international and illustrates Brocklehurst’s gift for giving talented people a platform.

Establishing a second chair in Geriatric Medicine in Manchester, he initially appointed Roy Fox, who developed the study of immunology and ageing, followed by Raymond Tallis, a geriatrician with a neuroscience background, an outstanding polymath and intellectual.

Brocklehurst, who retired in 1990, received many honours. He was President of the British Geriatrics Society from 1982-1984 and a leading trustee for Age Concern England and the charity Research into Ageing. Perhaps his greatest honour was the universal respect and affection in which he was held by geriatricians round the world.

In his later years he was a perfect example of the successful ageing he sort to promote in others. Retirement allowed him to develop his many cultural talents: he was a gifted painter and musician and wrote a history of the Manchester Graphic Club, of which was a member. He coped with his increasing frailty and illness with the dignity and grace he had always displayed. A caring and dedicated man, he is survived by his wife of over 50 years.

Very few people leave as benign a legacy as Professor John Brocklehurst. His painstaking research over many decades into the previously neglected topic of incontinence has made life tolerable for millions of suffers throughout the would. The standing he gained for geriatric medicine has made the pejorative use of the term “geriatric” an anachronism. He wrote, “Looking back, I cannot imagine any other field of medicine which I would have had greater satisfaction in, nor in which the opportunities for pioneering and development could have been any greater.”

John Charles Brocklehurst, geriatrician: born Liverpool 31 May 1924; Professor of Geriatric Medicine, Manchester University 1970-89, then Emeritus; CBE 1988; married 1956 Susan Engle (two sons and one daughter); died 27 June 2013.

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