Lives of the fellows

John Apley

b.3 September 1908 d.6 October 1980
CBE(1968) MB BS Lond(1932) MD(1938) MRCP(1942) FRCP(1959) JP(1966 —73)†

John Apley was born in London, son of Samuel, a merchant, and of Marion Hilda (née Tannis) also from a mercantile family. From local schools he won a state scholarship in 1927 to University College and University College Hospital, London. There he was awarded the first Bucknill Exhibition (1928-1929). Soon after qualifying, in 1932, he entered general practice in Eastcote Lane, Pinner, Middlesex. While in this practice he acted as honorary clinical assistant to Eric Pritchard at the Westminster Children’s Hospital and he also set up a children’s clinic in his practice — a pioneer endeavour in the area at the time, and an indication of his leaning to paediatrics.

The outbreak of war took him into the RAF Volunteer Reserve, where he became a medical specialist with the rank of squadron leader. His service duties were entirely in England, largely in Wiltshire, and during this time he became interested in stress in relation to peptic ulcer among airmen. He also made contacts in Bath and Bristol which persuaded him to go into paediatrics after the war in the West Country rather than return to general practice.

After demobilization in 1945 he became registrar at the Royal Hospital for Sick Children, Bristol, and while in this post he became part time consultant in paediatrics to the Royal United Hospital, Bath, from 1946. In 1948 he was co-author, with JM Naish, of his first book The Clinical Apprentice, now in its fifth edition.

From 1948 to 1949 he was fellow in pediatrics at the Children’s Medical Center, Boston, Massachusetts, USA. Soon after his return he was promoted to be consultant in Bristol and Shaw lecturer in diseases of children in the University of Bristol (1950).

He remained in the combined post of NHS consultant at Bath and Bristol and University lecturer until his retirement in 1973, except for a term as visiting professor of pediatrics at Louisville, Kentucky in 1963, and a year in Saigon, 1967-1968, as leader of the British Paediatric Team. During his time there the Tet offensive by the North Vietnamese over-ran his hospital and he kept it going with the greatest difficulty, having to collect supplies himself - accompanied sometimes by his wife. For this magnificent work he was created CBE in 1968 and also given the Dawson Williams Memorial prize.

John was a great raconteur and a most successful lecturer, chatty and persuasive rather than declamatory and dogmatic, spicing his message with sparks of humour. His writing began with short articles in 1944, but he tended later to deeper thinking about the philosophy of paediatrics - psychosomatic disorders, ecology, chronology and violence in the family — before becoming author of a standard text on paediatrics (1973), the editor of Modern Trends in Paediatrics, and then a still larger library of texts on major branches of paediatric practice.

First and foremost he remained a clinician and a generalist. Even so, he was for 15 years the paediatric cardiologist for the South West (recognized by his colleagues if not by his contract), drawing patients from a distance but also visiting Exeter, Taunton and Plymouth to follow his patients and advise local paediatricians. ‘Apley’s sign’ of cardiac pulsation palpable below the xiphoid, indicating a hypertrophied right ventricle (except in the newborn or in acute asthma), is still taught in the South West region.

He was concerned that a view was taken of the whole child, that sound clinical methods were used first, and the minimum of appropriate tests undertaken later to reach a diagnosis. He soon realized that such diagnosis did not always mean organic disease, and his international reputation was based on his original painstaking study which appeared in 1959 as his book The Child with Abdominal Pains, soon widely renamed familiarly as ‘Little Bellyachers’. In similar vein he was co-author with Ronnie (RC) MacKeith of a book The Child and his Symptoms (1962). Both books have been translated into Spanish, German, Swedish and Portuguese.

John had great gifts as a teacher, supremely so at the bedside, and he was a master of the epigram. He could also draw the best out of a candidate, as he would do when he was an examiner at Bristol and in the Diploma of Child Health, where he ended as chairman of the examiners (1969 — 1973).

His performance as lecturer led to repeated appearances on television, and this in turn to his doing two stints as chairman of the South West Region Advisory Council for the BBC. With approaching retirement, and even more after he had retired, he took increasingly to writing, travelling and lecturing. He wrote regular features for ‘Personal View’ in the BMJ, countless reviews of books, and wrote or shared in the authorship of almost 100 articles in medical journals. His own textbook on Paediatrics appeared in 1973, and from 1977 onwards he was editor-in-chief for Butterworth’s Postgraduate Paediatrics series which numbered 16 volumes by 1980, excluding second editions. He also edited two volumes of Modern Trends in Paediatrics. All bear the mark of his great love for the English language and his consummate skill in its use.

He became a member of the British Paediatric Association in 1952, was on its Council from 1958 to 1961, and was elected an honorary member in 1975.

He became president of the paediatric section of the Royal Society of Medicine, and was also president of the Clinical Society of Bath, the Bristol Medico-Chirurgical Society and the Bristol Medico-Legal Society. He was founder member, and secretary for years, of the South West Paediatric Club, of which he later became the president, and he was also a founder member, and secretary for fifteen years, of the Paediatric Visiting Club, promoting friendships amongst paediatricians throughout Europe.

Outside medicine, he was a musical performer both on oboe and clarinet, a first class chess player and a golfer. He was keen on ski-ing. He was prominent in the Bath Preservation Trust, and at his death was chairman of the local Conservation Society.

In 1947 he married Marina Griselda Nora Palmer, always known as Poo, and she helped him maintain a standard of hospitality which could always cope with unexpected visitors, as well as gracious entertaining of their many friends. There were no children.

SDV Weller

† The list of honorary degrees is too lengthy to include in its entirety.

[Brit.med.J., 1980, 281, 1075, 1124, 1150; Lancet, 1980, 2, 869, 928; Times, 10 Oct 1980, Daily Telegraph, 10 Oct 1980]

(Volume VII, page 17)

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