Lives of the fellows

Bernard Isaacs

b.20 July 1924 d.24 March 1995
CBE(1989) MB ChB Glasg(1947) Dobst RCOG(1951) FRFPS(1952) MD(1957) MRCP Glasg(1962) FRCP Glasg(1964) MRCP Edin(1973) FRCP Edin(1979) MRCP(1984) FRCP(1985)

Bernard Isaacs was born and educated in Glasgow, where his father was a shopkeeper and his mother a schoolteacher. He and his elder brother Alick, who was to discover interferon, decided on a medical career. Bernard qualified in 1947 and began his early clinical career in Glasgow, working with Ferguson Anderson in the 1950s, the father of British geriatrics. His MD thesis on ‘the action of antiemetic drugs’ was completed in 1957 with high commendation. He was appointed consultant in 1961 at Foresthall Hospital, moving on to the Glasgow Royal Infirmary in 1964.

In 1975 he made a major move from Glasgow to Birmingham when he was appointed as the first professor to the Charles Hayward chair of geriatric medicine at Birmingham University. No sooner had he arrived when all the promises made to him earlier were withdrawn. Having been offered beds at the main teaching hospital he arrived to a portakabin in the car park behind the department of psychiatry and no beds. It says much for his continuing good humour and his ability to win friends that he became a professor with rather more clinical beds than might have been compatible with academic achievement. He accepted responsibility for the little Jaffray Hospital, but turned down an offer of four beds at the Queen Elizabeth Hospital as wholly inadequate for the practice of geriatrics. Instead he accepted an invitation to join the existing team at Selly Oak and Moseley Hall Hospitals. His clinical services were supported by junior staff in training and part time general practitioners. Because of his strong sense of obligation he continued single-handedly to give geriatric consultant advice to the Queen Elizabeth and General Hospitals.

Bernard published widely throughout his career. He was a brilliant communicator and a teacher of high quality. One of his most notable books was Survival of the unfittest (London/Boston, Mass.,Routledge and Kegan Paul, 1972) in which he described the terrible medical problems of elderly people in the east end of Glasgow. In his first ‘appearance’ in Birmingham in 1972, during a lecture on mental illness in old age, he used the term ‘homo dissipiens’ as an early description of a person with dementia, which he preferred to describe as brain failure. In his unavoidable absence the lecture was presented on tape but still held his audience spellbound. At his inaugural lecture in 1975 he reminded us of one of his favourite concepts - ‘the giants of geriatrics’, the symptom complexes of instability, immobility, intellectual impairment and incontinence. His interest in elderly people with mental illness led him to design a mental test score, the Set Test, and to publish Care of the elderly mentally infirm (London, Tavistock, 1979). He was a prime mover behind the development of the specialty of psychiatry of old age in the West Midlands and chaired the regional advisory committee on the subject for many years.

Bernard also came to Birmingham with an interest in stroke and rehabilitation. He provided one of the early descriptions of perceptual disorders and maintained a deep interest in the language disorders of patients. His ward rounds could sometimes be completely disrupted because he would spend the whole time on the particularity of one individual’s loss of speech with an unequalled depth of understanding.

When he first went to Birmingham he decided that the main research activity of his department would be an investigation into the problem of falling and persuaded a bioengineer, Laxman Nayak, to join him from New Zealand and work in his gait laboratory and video studio. This unit attracted people from all over the world and generated yet more alliterative concepts such as females with ‘fear of falling’ and ‘patients with precocious parking’. Arguably Bernard’s most lasting achievement was to found the Centre for Applied Gerontology based on the concept that equipment designed for disabled elderly people would be suitable for all. The successful idea was used to enlist the support of manufacturers and test their equipment by a committee of one thousand elders, with the award of an ‘owl mark’ for good design.

One of Bernard’s last major lectures was given to the British Geriatrics Society in Birmingham in 1988. This exemplified his ability to hold an audience entirely without notes, because he had decided to abandon his prepared lecture a short time before entering the auditorium. Other lectures could be dramatic, for example when he produced a catheter bag from inside his clothes in a talk on incontinence. He was always able to adjust his lectures to the occasion, whether in an old peoples home or in a major international meeting, and produce insights new to his audience.

He was asked to edit Recent advances in geriatric medicine (Edinburgh, Churchill Livingstone, 1978), and in retirement published The challenge of geriatric medicine (Oxford/New York, Oxford University Press, 1992), from which his devotees continue to quote. Up to his death he was still contributing to geriatrics, through the Brookdale Institute in Jerusalem, and had been helping to organize an international conference.

Bernard married Dorothy Beulah Berman, a schoolteacher, in 1957, and had a great love for his family. They had four sons, Lionel, Aubrey, Michael and Alick. He remained a religious man throughout his life, and not only were the weekends for his family, Saturdays were for his religion. When he first came to Birmingham he had to move house to ensure that he was close enough to an appropriate synagogue. On retirement he and his wife went to live in Israel where their sons had already settled.

Alistair Main, who became his senior lecturer in 1985, summed him up in terms he would have understood: "a giant of geriatric medicine who was iconoclastic, incurably innovative, immensely likeable and irreplaceable."

P P Mayer

[Brit.med.J., 1995, 311,868-69; The Independent, 12 May 1995; Times, 12 April 1995]

(Volume X, page 248)

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