Obituary: Professor Leonard Strang
Wednesday 02 July 1997
The term "paediatrician- scientist" may come close to encompassing the scope of a professional life devoted to research into the problems of the newborn infant and to the care of sick children; but it fails to identify Strang's unique ability to fuse these too often disparate disciplines of research and practice - bringing his understanding of physiological science to bear on clinical problems long before the term "translational research" had had been invented. Nor can a professional label convey the idea of the whole man - the strength of his personality, his love of literature, his passionate interest in politics - all of which made him such a wonderful friend and colleague.
Leonard Strang was born in 1925 in East Kilbride, outside Glasgow, of Scottish parents - his father from a local farming family and his mother from a family long established in Donside, near Aberdeen. When he was five, the family moved to Newcastle, where Leonard was to remain more or less continuously until the age of 29.
It was in Newcastle, at the age of eight and before the advent of antibiotics, that he suffered an illness which nearly killed him and was to have a profound influence on the rest of his life. An infection of the mastoid spread to the bloodstream and subsequently destroyed both hips - leaving his legs weakened and wasted in a manner which many later mistook for the effects of polio.
Months of illness were followed by prolonged convalescence, during which he read (and was read to) a great deal. Later, he was to identify this time with the awakening of his love of literature. It also marked the beginning of his fight to re-establish his life and to succeed in spite of his disability. Although he was left able to "walk" only with the aid of shoulder crutches, such was his resolve that he was playing cricket by the age of 10, albeit with another boy as his runner (it was a great personal triumph when, 19 years later, he was able to walk down the aisle aided only by a pair of walking sticks on the occasion of his marriage).
Schooling at the Royal Grammar School, Newcastle, was followed by a medical education at Durham and Newcastle, graduating in 1949. At Newcastle Strang undertook his postgraduate training in paediatrics in the department founded by James Spence, a supreme clinician who, coincidentally, had helped to save Strang's sight when he had been so ill some 20 years earlier. During the seven years he spent in that invigorating environment he learnt to observe the natural history of disease and to respect the instincts of the mother in relation to her child's well-being ("Ask the mother" was Spence's advice) and it was there that he developed the ability to apply basic scientific principles to the management of disease - the hallmark of his future clinical practice.
After Newcastle came a move to the Royal Postgraduate Medical School at Hammersmith and the development of a research interest in the function of the lungs - initially in normal and asthmatic children and subsequently in newborn infants. A year at Harvard as a Research Fellow sparked an interest in the control of the lung circulation in the newborn - work which he continued on return to the Hammersmith.
Although the precise focus was to change later, he was now working in the area which was to dominate his research career and was later to be his major contribution to knowledge - how the lungs of the baby, which are liquid-filled and inactive as they develop in the womb, adapt to the requirements of breathing at birth.
It was at University College Medical Hospital, then separate from University College London, that Leonard Strang carried out this programme of work which established his international reputation; appointed Reader in Paediatrics in 1963, he was in 1967 the first Professor of Paediatrics to be appointed at a London undergraduate medical school.
Great advances in understanding which result from research are rarely the work of one person but they can be the result of the inspiration of one person. And so it was with Strang, who led a research team which, over a period spanning two decades, systematically studied the mechanisms responsible for liquid movement across the internal cellular lining of the infant lung; describing how it is formed within the lung during development (acting as a template for lung growth) and later demonstrating how adrenaline, secreted by the baby in response to the stress of being born, stimulates the absorption of liquid via specialised molecular channels to make way for air at the start of breathing.
This work opened up an entirely new area of lung research and, fittingly, he was awarded the James Spence Medal in 1990 by the British Paediatric Association (now the Royal College of Paediatrics and Child Health) for "outstanding contributions to the advancement of paediatric knowledge".
Just as important as the work itself was the role Strang played in training a series of young paediatricians - to be paediatrician-scientists in their own right. It is no accident that of those that worked with him over the years no fewer than eight have gone on to head departments of their own.
A lifetime's fascination with the physiological mechanisms of the foetal and newborn lung did not preclude a genuine commitment to the care of his patients and great skill in the delivery of that care - in this respect he was a true disciple of James Spence. Infinite patience and concern characterised Strang's relationships with parents and children alike. With friends and colleagues he could be irascible, but his outbursts were rarely irrational or random.
Strang cared deeply, particularly where injustice, ignorance or incompetence were concerned, and he was not slow to make these feelings known. This side of his character was not infrequently displayed in committee and, for those who may have used Strang as a role model, the example of how far he could go to achieve what he thought right has always provided considerable leeway.
A liberal Francophile, among whose greatest pleasures was to read Proust and Stendhal in the original, Leonard Strang moved to France when he retired in 1989 - settling happily in the village of Volx in Haute Provence with Susan, whom he had married six years earlier following the tragic death of his first wife, Madeleine.
Leonard Birnie Strang, paediatrician, physiologist, teacher: born East Kilbride, Renfrewshire 13 May 1925; Registrar and First Assistant, Department of Child Health, Durham University 1953-59; Medical Research Council Clinical Research Fellow, Royal Postgraduate Medical School, Hammersmith 1959-61, Senior Lecturer and Consultant in Paediatrics 1962-63; Research Fellow, Harvard Medical School 1961-62; Reader in Paediatrics, University College Hospital Medical School (University College London) 1963-67, Professor of Paediatrics 1967-89 (Emeritus); married 1954 Madeleine Allen (died 1981; one son, three daughters), 1983 Susan Plant; died Volx, France 24 June 1997.
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