Obituary: Dr Kit Ounsted
Tuesday 13 October 1992
IN 1948, when there was no specialty of paediatric neurology in Britain, Dr Victoria Smallpiece, the distinguished paediatrican, launched it in Oxford in the shape of Kit Ounsted.
Despite his distaste for self-promotion, the divergent eccentricity of his scientific viewpoint, and the prejudice inherent in the various subjects of his interest, his work won international recognition in each of its phases.
Ounsted's core concept of Developmental Medicine as the science of biographies still remains ahead of its time, but through it he altered the thinking and the lives of many people who worked with him and later achieved success in many of its component fields - psychology, social work, occupational therapy, learning difficulties, paediatrics and psychiatry.
He had been an outstanding scholar at Christ's Hospital and University College, Oxford, and had made distinguished contributions to the study of the meningitides, in particular Haemophilus meningitis, through remarking its curious epidemiology.
Ounsted's study of childhood epilepsy in the Oxford region provided the foundation of his lifetime study of temporal lobe epilepsy with Janet Lindsay and others. It was the basis of his famous study of the hyperkinetic syndrome in epileptic children. In that remarkable paper he revealed his command of an ethological method in medicine. He had realised that the indivisible element in behavioural studies was the person. Ethological work was later developed by John and Corinne Hutt, in an entirely novel laboratory setting in which the behaviour of children was minutely observed and filmed while an early form of telemetrised electro-encephalography was made.
By 1958 he had also trained in psychiatry and founded the Park Hospital for Children which became the regional child psychiatry centre, a focus for neuropsychiatric research and later the National Centre for Children with Epilepsy.
Working with Issy Kolvin produced a notable sequence of papers on childhood psychoses as well as important work on forensic child psychiatry. In the late 1960s he realised the potential value of surgical treatment of childhood epilepsy and, with the meticulous records kept by Lindsay, was later able to publish a definitive study. The epilepsies also provided the stimulus for a study of sex differences in disease which allowed him to formulate his brilliant hypothesis on the function of the human Y chromosome years ahead of the structural evidence and a measure of his astonishing biological grasp. At the same time he was assisting his wife, Margaret, with her studies of foetal growth and early childhood development following various sorts of difficult beginnings.
Routine clinical work brought him the burden of child abuse and he was early among those drawing attention to it. He used the Mother's House, which he had had built adjacent to the hospital to provide accommodation for mothers of patients, to investigate the many tragedies of human bonding failure which appeared but always in the spirit of therapy. Even his brilliance in giving evidence in court he saw as a potential basis for reconciliation. He launched several research endeavours and it was Ounsted who described 'gaze aversion' as a symptom in the children and as a response by authorities.
Ounsted returned to his study of temporal lobe epilepsy and completed, with Lindsay and Richards, the follow-up of patients, whom he had cared for beginning in the late 1940s, never losing sight even of one of those 100 biographies.
He always insisted on describing himself as a 'physician'. He saw further specialisation as essentially divisive in medicine. His role as one of the most important investigators and teachers of his generation he regarded as merely contained within his obligations as a doctor. He was apt to appear brusque with those who thought otherwise. This, together with a general disinclination to join in the rituals of medical life and an unwillingness to explain himself beyond a certain limit of simplification, kept him from the honours that his worth commanded.
He was intensely private, shy, with poor skills in trite discourse. His communications were allegorical, lateral, derived from a vast knowledge of literature. Indeed he regarded the serious study of a decent novel as a better preparation for a psychiatrist than learning the contents of a textbook.
Only those who were Kit Ounsted's students or patients truly understood his worth, recognised his endless capacity to perceive their human needs, to realise their strengths and release their potential.
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