Lives of the fellows

Donald Albert Heath

b.4 May 1928 d.10 February 1997
MRCS LRCP( 1952) MB ChB Sheffield( 1952) MD(1956) PhD Birm(1959) MRCP(1963) MRCPath(1963) FRCPath(1972) FRCP(1973) DSc Sheffield(1980) FRCP Edin(1991)

Donald Heath was one of the last of the line of great classical pathologists. His name will always be associated with the pulmonary circulation, the pathology of which was his life’s work. After qualifying in medicine at the University of Sheffield in 1952, Heath joined the cardiovascular centre directed by James Brown [Munk’s Roll, Vol.V, p.54]. It was here that he and William Whitaker first demonstrated the importance of pathological changes in the pulmonary circulation in patients with congenital heart disease. They submitted a paper on ‘hypertensive pulmonary vascular disease’ to a British journal but had it rejected on the grounds that the subject was of little medical interest or importance. Fortunately Circulation gave it a kinder reception. Soon after Heath was awarded a Rockefeller travelling fellowship to continue his research in the department of Jesse Edwards at the Mayo Clinic. There, in the space of a year, he elucidated the sequence of events which comprise the pathology of hypertensive pulmonary vascular disease. It was a remarkable achievement; until that moment the pathology of the pulmonary circulation was virtually unknown. Now Heath, with his rare intellectual skill at deducing a coherent story from the randomly acquired snap shots of histological sections, had shown not just the descriptive results of the disease but how it all came about.

Returning to England, Heath joined the department of pathology at the University of Birmingham. Chronic bronchitis was a common and devastating disease in the Midlands at that time, and he began to study the pulmonary circulation in this condition, using sophisticated morphometric and statistical techniques.

It was not certain to what extent the disability of patients with chronic bronchitis was due to a lack of oxygen. It seemed logical to investigate people with normal lungs who lived permanently at high altitude. This led to an interest in high altitude biology and medicine which Heath pursued, together with David Williams and Peter Harris, for the rest of his life, and which was gathered together in the monograph Man at high altitude: the pathophysiology of acclimatization and adaptation, Edinburgh, Churchill Livingstone, second edition, 1981.

A particular interest at high altitude was the carotid body. Heath made a detailed study of this tiny and neglected organ at both high and low altitude. It was a source of wry amusement to him that he had introduced into pathology textbooks an organ which was never before previously mentioned.

One remembers him particularly in the Andes or the Himalayas alongside the llamas or yaks which his studies had shown were genetically adapted to high altitude. His unusually large girth was not, as he once put it "intended by nature for a mountaineer"; and yet his resilience, energy and good humour under conditions of hardship, low oxygen and cold were remarkable. In such remote places he was a striking figure, dressed always uncompromisingly in a threadbare suit, collar and tie and hat even after a night sleeping on the ground.

In the early 1990s he became interested in a group of alkaloids derived from plants of the genus Crotalaria. He showed that feeding rats with seeds of Crotalaris spectabilis, used as cover crop in the southern states of the USA, caused severe and fatal pulmonary hypertension. Several other members of the genus had the same effect, including the common English ragwort, extracts of which he was delighted to find on sale at the local health food shop accompanied by literature entitled How to live a 100 years. He reviewed this great volume of meticulously documented work with Michael Kay in 1969. What had started as a purely academic exercise became important in 1967 when an epidemic of pulmonary hypertension, attributed to a weight-reducing pill, occurred in Europe.

In these ways the pathology of the pulmonary circulation as we now know it has been largely written by Donald Heath. He summarized his wide knowledge of it in the monograph The human pulmonary circulation: its form and function in health and disease, Edinburgh, Churchill Livingstone, 1962, written with Peter Harris, which became the authoritative text for a quarter of a century.

In his earlier academic years he would teach brilliantly ad hoc in the post mortem room. In his lectures to students he had the alarming habit of descending from the podium and striding up and down the aisles firing questions.

In 1968 he was appointed to the George Holt chair of pathology at the University of Liverpool. He took up his duties on April 1st, a point he did not allow to go unobserved. He held the chair until his retirement. Almost immediately afterwards he was afflicted with increasing blindness and cardiac failure. Characteristically he derived a great deal of amusement out of his hospital experiences and refused to allow these disabilities to prevent him continue lecturing to slides he could no longer see. He was unmarried, lived alone, darned his own socks and was only recently persuaded to have the telephone. He was found sitting at his desk with a cup of cold tea beside him.

Peter Harris

[The Times, 10 Mar 1997; The Independent, 25 Feb 1997]

(Volume X, page 207)

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