Lives of the fellows

Max Hamilton

b.9 February 1912 d.6 August 1988
MRCS LRCP(1934) MB BS Lond(1937) DPM(1946) MD(1950) MRCP(1963) FRCP(1970) FRCPsych(1971)

Max Hamilton was born near Frankfurt, the son of Henry Himmelschein and his wife Sarah Kleinberg. His family emigrated to England when he was three years old, settling in the east end of London. He was educated at the Central Foundation school, Cowper Street, London, before undertaking medical training at University College Hospital medical school, University of London. After qualification he returned to the east end, working as a physician in one of the most deprived areas of the country. During the second world war he joined the Royal Air Force as a medical officer and saw service from 1939-46. Towards the end of hostilities he took Part 1 of the DPM and after demobilization began his clinical psychiatric training at the Maudsley Hospital, London. There he had sharp differences of opinion with some of his teachers, memories of which remained with him for the rest of his life, and he failed to be appointed to a post which would allow him to continue his studies at the hospital. He continued his psychiatric training at UCH for the next four years, where he came under the influence of Sir Cyril Burt, one of the first clinical psychologists, and became particularly interested in psychology and statistics.

From 1950-51 he worked at King’s College Hospital as senior registrar to Denis Hill, later Sir Denis [Munk's Roll, Vol.VII.p.264]. a man two years his junior. While at King’s he submitted his MD thesis on the personality of dyspeptics. He subsequently worked at Tooting Bee Hospital in the senior hospital medical officer grade; an unusual career step for a future academic but one which gave him experience of mental hospital psychiatry, and of responsiblity for the care of a large number of patients. He remained proud of his unique feat of progressing from SHMO to professor of psychiatry.

He moved to Leeds as a senior lecturer in the department of psychiatry in 1953. After a few years he again took an unusual step in resigning his post at the age of 45 years, to take up a research post locally which would allow him to spend more time in research with fewer demands from routine clinical work. He was visiting scientist at the National Institute of Mental Health, Bethesda, Maryland, USA, in the year 1959-60, and returned to Leeds to work as a member of the external staff of the MRC. Following the unexpected death of G R Hargreaves in 1963, he was appointed to the Nuffield chair of psychiatry at the age of 51.

During Max Hamilton’s tenure of the Nuffield chair the activities of the department were considerably expanded: the diploma in psychological medicine, which had been established shortly after the war, was developed to include a research dissertation; a diploma course in social work was established jointly with the Department of Adult Education and Extra Mural Studies, and later a course in mental health social work leading to an MSc. Max Hamilton believed that social workers made a vital contribution to the care of psychiatric patients and he sought to increase the academic component in their training. Regrettably, both these courses were closed as a consequence of the university economies of 1981-82. In 1965 a course in clinical psychology, leading to an MSc, was established jointly with the department of psychology. Happily, this course is both thriving and expanding and at the time of its 20th anniversary in 1985 it had been responsible for the training of 10% of the clinical psychologists in Britain. All these developments stemmed from Max Hamilton’s belief that the contributions of many disciplines were essential to advances in psychiatry. At the same time the Leeds School of Medicine was expanding, and there was an increasing demand from undergraduates for instruction in psychiatry.

But it was in the fields of teaching and research that Max Hamilton made his most distinctive contributions. He was an excellent lecturer, giving a clear, concise account of many psychiatric topics with a degree of critical appraisal which made them memorable. His Hargreaves lecture to the Yorkshire Regional Psychiatric Association, in which he reviewed established information on the nature of depressive illness and offered new interpretations of the data, was typical. He was in demand as a lecturer, not only in the UK but throughout the English-speaking world. He was also in demand in Europe and frequently delivered lectures in French and German. And he was a frequent visitor to the United States, where he spent long periods after his retirement Many a speaker at conferences had good reason to remember him; he had an ability to ask the most penetrating questions and if he felt he was right, and he usually was, he was prepared to persist with his opinion in the face of overwhelming odds - and even hostility.

As a teacher Max is remembered as being somewhat severe, but he produced a lasting impression on his many pupils. He always stressed the central position of the patient in both clinical work and in research. He had no love for fools but was prepared to argue a point even with the most junior trainee if he or she could hold their ground. In spite of his fearsome reputation as a teacher there are many accounts of his kindness to individual students, and of the help given to people privately. He often held parties at home for a wide range of students both from Britain and abroad. He was particularly concerned to ensure that foreign students should feel at home in Leeds, and in the department.

Max Hamilton’s major achievements in research are likely to form his most enduring memorial. He was a pioneer in the development of rating scales designed for measuring the severity and extent of psychopathology. His first published scale, known as the Hamilton Depression Rating Scale, published in 1960, is now the most widely used of all such scales; so much so that the paper in which it was described has been among the most cited of medical papers on two occasions. Hamilton was one of the first to appreciate the need for objective rating scales of psychiatric psychopathology, and for these to be well designed and critically evaluated. He subsequently developed other rating scales, including one for anxiety. He also had a long standing interest in the methodology of research. A series of lectures on this topic were published in a book, Lectures on the Methodology of clinical research, Edinburgh, Livingstone, 1961. His other books included Psychosomatics, New York, Wiley, 1955, which stemmed from a study of the influence of personality in peptic ulcer sufferers and was the basis of his MD thesis.

Max Hamilton’s lifelong interest in research was marked by the University of Leeds establishing a prize in 1983 for the best dissertation submitted for the M Med Se degree in clinical psychiatry in each year. The award was named the Max Hamilton Prize, the first recipient receiving it from Max Hamilton himself.

Among the many honours bestowed upon Max Hamilton were the presidency of the British Psychological Society in 1972. He was only the second psychiatrist to be appointed to this position. His remarks as president were regarded as controversial by a section of the membership and a protest meeting was arranged to demand a retraction - which Max Hamilton himself attended. He was foundation president of the British Association for Psychopharmacology, and a managing editor of the journal Psychopharmacology. In 1980 he received the Paul Roch Award for contributions to psychiatric research from the American Psychopathological Association.

Outside his professional life one of his great interests was politics, where he always favoured the advancement of the under-privileged and oppressed. He never hesitated to hold an unpopular or minority opinion, indeed he rather relished it. He was also a keen photographer and his subjects included many professional colleagues. He had an interest in gardening, particularly in narcissi and orchids, which he tended in his own garden at his home in Leeds.

After moving north in 1953, he strongly identified with Leeds and was active in local affairs. He was married twice. There were two sons of his first marriage in 1933, and two daughters and a son from his marriage to Doreen Margaret Moody in 1947. He found a central interest in his family and maintained regular contact with all its members throughout changing circumstances. He was survived by his wife Doreen, who was for many years a city councillor, and all five of his children.

RHS Mindham

[Brit.med.J., 1988,297,914-5; Lancet, 1988,2,582]

(Volume VIII, page 205)

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