SWITHIN MEADOWS was for many years one of the most respected and admired of British neurologists.
In manner and appearance he was the antithesis of the public image of a London consultant; he was bluff, outspoken, wasted few words and looked more like a genial and prosperous Yorkshire farmer than an expert in neurological disorders. His background was also a far cry from Harley Street; he was born in Wigan, where his father edited the local newspaper, and he was educated at Wigan Grammar School and Liverpool University.
After graduating in medicine and holding junior posts in Liverpool Royal Infirmary he came south to continue his training and secured, much to his and his fellow-candidates' surprise, a coveted position as Medical Registrar and Tutor to St Thomas's Hospital. Later on he went - as all aspiring neurologists did in those days - to the National Hospital in Queen Square, where he was Resident Medical Officer.
Neurology then was attracting many of the brightest medical graduates, who were drawn by the intellectual stimulus and by the challenge of localising the source of disease by means of skilled physical examination. Even in this company Meadows's outstanding qualities were soon recognised and he was appointed to the honorary consulting staff at the Maida Vale Hospital for Neurology just before the outbreak of war in 1939. He remained in London all the war and was one of the first to be appointed to the staff of the National Hospital when it returned to its peacetime role as one of Europe's leading centres for the study of diseases of the nervous system. Two further important appointments followed - neurologist to the Westminster Hospital and Physician to Moorfields Eye Hospital in City Road.
Meadows's abiding interest was in the diagnosis and treatment of diseases of the brain and in particular of the visual system. This stemmed mainly from his work at Moorfields, where he was referred the many patients whose vision was disturbed not by ocular disease but by impairment of the brain. He became particularly expert in the recognition of disease of the optic nerves, the pituitary gland and the occipital lobes. His published work on cranial arteritis, a vascular disorder affecting elderly patients and an important and preventable cause of blindness, are still quoted today. Other notable contributions were the Doyne Lecture on childhood optic neuritis, a paper with William Blackwood on aneurysms of carotid artery and a paper with CP Symonds on the cause of hand wasting in diseases of the lower brainstem, a point which has long perplexed neurologists.
As his reputation grew Meadows remained totally without affectation or self-esteem. Postgraduate students at Queen Square were captivated by his informality and intellectual honesty - he would frequently admit himself baffled by a case and once assured a startled foreign visitor that it was weeks since he had made a correct diagnosis. In the same way he would never attempt to mislead a patient if he felt that the matter lay outside his field of knowledge, preferring to tell him that he was regretfully not the best person to help and that he should go elsewhere.
Unfailingly courteous, approachable and interested, he was a popular teacher with students at Westminster and the National and was never short of invitations to lecture at home or abroad. He greatly enjoyed his time as visiting professor at the University of San Francisco in 1954. In contrast to his enthusiasm for clinical work, he had little time for committees or public occasions and was a most reluctant chairman or president - usually pleading deafness as his excuse.
He retired from his hospital work at the age of 65 but remained keenly interested in clinical neurology for a further 10 years, continuing in private practice with his son John, who is also a neurologist.
He finally retired from active practice at the age of 75 to devote his time to travel, to his books and to his family - and to his favourite evening occupation of playing the piano. Swithin Meadows may not have matched the literary brilliance of Walshe, the originality of Symonds or the sophistication of Macdonald Critchley, but for many of today's neurologists he was the finest physician of them all.
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