David Weatherall pays tribute to the man who asked him to eat asparagus in the name of research, Cyril Clarke When I obtained my medical degree from Liverpool University in 1956 I was, as cell biologists put it, totally undifferentiated. And because a compulsory year as a houseman and two years' national service were to follow, there was no incentive to think about a future career.
In those days choosing a house physician post involved touting oneself round the local consultants to find one who would offer six months' employment. As a clinical student I had been taught by Cyril Clarke. He had invited us to his beautiful home on the Wirral, where we were shown how to mate tropical butterflies by Mrs Clarke and, to the consternation of the lady students in their best dresses and high heeled shoes, were marched several miles through thick mud to a local island to birdwatch. I was hooked; at least working for Cyril promised to be different.
I was not to be disappointed. Cyril was a caring and conscientious if eccentric clinician whose first act after I joined him was to cross off all the drugs that I had prescribed for his patients. He told me that he was emulating one of his teachers who, later in their career, reduced their pharmacological armamentarium to only two drugs, morphia and bicarbonate. And, he added with his endearing stammer, he wasn't using much b-bicarbonate.
Cyril's other passion was natural history. At the time that I worked with him he was studying the genetics of mimicry in butterflies together with the distinguished geneticist P. M. Sheppard. A year or two earlier he had read a paper suggesting that there was a relationship between particular blood groups and cancer of the stomach and this had stimulated his interest in the genetic aspects of disease. Cyril never did things by half and the working atmosphere he created round him was frenetic. Any trait that could conceivably be inherited was fair game. We were asked to roll our tongues, eat asparagus to see if our urine smelt, and one unsuspecting Liverpudlian was even investigated as the putative product of a virgin birth.
In 1956, hospitals were friendly places. Two or three times a week, after a ward round with Cyril, the sister would give us coffee. I would be updated on the latest research results, grilled as to whether I had read an article in a journal that had been published only that morning, and, in particular, stimulated to think about genetics.
After I left Cyril in 1957 he went on to lead the team that largely eradicated rhesus haemolytic disease, and became professor of medicine in Liverpool and, later, president of the Royal College of physicians. After a year's exemption to take the membership examination of the college, the army finally caught up with me. On arrival in Singapore a few weeks later one of my first patients was a Gurkha child with profound anaemia, whom I discovered later had thalassaemia. This led to my first publication, in the British Medical Journal, a reprint of which I immediately sent to Cyril, who was delighted to read it. The army establishment were not; they told me it was a court martialable offence to publish information about patients in military hospitals, and that it was rubbish to suggest that there were defective genes in their pukka Gurkha regiments. Unrepentant, I spent two happy years scurrying round Singapore and Malaya searching for more genetic diseases and, after I was demobbed, went to train in genetics at Johns Hopkins Hospital in Baltimore.
Soon after I returned to Liverpool from Baltimore I had a letter from Hopkins inviting me to return to continue my research. Everybody told me that this would be a fatal step in my career; I must stay at home and endure the British system of tedious advancement through the junior doctor grades, with little time for science. Naturally, I consulted Cyril for advice and he asked me what I wanted to do. "Go back,'' I said. "Well, b-bugger off then,'' grunted Cyril; the only session of career counselling that I ever had lasted all of ten, invaluable, seconds.
My six months' association with Cyril Clarke as a newly qualified doctor exposed me to that rarest of individuals, a clinician who is also a genuine biologist with an unquenchable curiosity. I suppose a bit must have rubbed off, for which I am eternally grateful.
Sir David Weatherall is regius professor of medicine, Oxford University.