JAMES DEENY's distinguished medical career was shaped by conditions in his native Northern Ireland.
Born in 1906, the son of a Catholic doctor in Lurgan, County Antrim, he was educated by Jesuits at Clongowes and qualified as a doctor at Queen's University, Belfast, at the early age of 21. Within a short time he had accumulated further academic honours and membership of the Royal College of Physicians; had he not been a Catholic he would undoubtedly have risen to the top within the scope of the United Kingdom but in the years after Partition the Protestant Ascendancy formed a closed shop. He was not offered a job as house surgeon in the Royal Victoria Hospital, Belfast, where in those days there was not a single Catholic medical officer on the staff. 'In the North, the system was the system,' Deeny commented in his autobiography.
He returned to his father's practice in Lurgan, where his experiences among the poor country people of Antrim laid the foundations for his later innovations; one childbirth case in which the mother almost died convinced him that no woman's life should be at the mercy of such circumstances of extreme poverty and lack of care. 'It influenced my life,' he wrote.
Diagnosis as well as cure was a scientific passion for Deeny. He became an expert on pellagra, diagnosing it among his patients when it had not been reported in Ireland before. An internationally known expert, Professor Sydenstricker, of the Rockefeller Foundation, read a paper Deeny had written on these cases and came to Lurgan to confirm his diagnosis. When invited by the Belfast establishment to dine at the Reform Club, Sydenstricker refused to go unless Deeny was also invited, and Deeny found himself dining with all his former teachers and the whole Medical Faculty of Queen's, in a place where he would normally never set foot. 'Politics, bigotry, intolerance and being on the wrong side of the fence interfered in everything in those days in the north of Ireland,' he wrote.
Deeny's discovery of ascorbic acid in the successful treatment of the 'blue men' suffering from familial idiopathic metahaemoglobinaemia made him briefly famous but be regarded his next undertaking, an infant mortality survey of Belfast, as far more significant. In 1943 more than one child in every eight died during the first year of life there; little was known about the causes until Deeny highlighted the problem - as he did the other chief killer, tuberculosis, writing a study which showed up the clustering effect of the disease in working- class areas.
In 1944, new horizons opened for him in the direction he was bound to go, to the South. He was offered the post of Chief Medical Officer to the Department of Local Government and Public Health in Dublin and took it without hesitation. 'Coming to Dublin was wonderful,' he wrote. 'For the first time I discovered my country. I suddenly felt a free citizen of a free country and began getting the repression and bitterness of the North out of my system . . .'
On the practical side, it was hardly a brave new world. In Limerick the matron of the City Hospital, an elderly nun, lamented the days when the officers from Deeny's department were 'gentlemen'. Everything was locked up and when opened revealed the chief medical officer's string of yearling racehorses which occupied the ground floor and were exercised by the older inmates. When Deeny attempted to cleanse this Augean stable, the patients told him the horses were 'their lives' and it would break their hearts if they were taken away.
In the postwar era Deeny's Mother and Child Scheme, attacked by the Catholic bishops of Ireland as socialist tampering with the family, caused the break-up of the first inter-party government of John A. Costelloe, in 1951.
Aged 50 Deeny began a new career with the World Health Organisation, carrying out tuberculosis surveys in Sri Lanka and Somalia, and producing a National Health plan for Indonesia. He became Chief of Senior Staff Training at WHO headquarters in Geneva, continuing to work after his retirement, writing the Fourth Report on the World Health Situation and acting as WHO's first ombudsman.
A devout Catholic, Deeny became Scientific Adviser to Pope Paul VI and, one of his proudest honours, a Knight of Malta. In 1971 he 'went home', writing a survey of the people of Fanad, a beautiful part of north Donegal, the ancestral territory of the Deenys.
After a lifetime in medicine his conclusions in his autobiography To Cure and To Care (1989) would not have pleased Conservative health ministers. Lying in hospital after a heart attack, he reflected that a hospital was 'simply a shell in which skilled people work to provide a service and is only good as the people who work there. The service is provided in relation to and to meet the needs of the community. (When) people talk about closing beds or hospitals what they really are talking about is terminating services which sick people need.'