Lives of the fellows

Norman Maurice Jacoby

b.18 March 1911 d.22 February 1994
MB BS Lond(1934) MRCS LRCP(1934) MRCP(1937) MD(1938) FRCP(1959)

Norman Jacoby was born in Johannesburg, South Africa, where his father, Shabrin Jacoby, was an immigrant from Eastern Europe. His father valued education above most things and was content to deprive himself in order that his son should study medicine. Norman was educated at Parktown, Johannesburg, and, after taking the London matriculation, he left for England at the age of 17. At that time Guy’s welcomed many South African students, but in 1928 this entailed a long sea voyage. Initially Norman seems to have been rather bemused by the teaching at Guy’s but he soon found his feet and proved to be an outstanding student. He described his student years in the first chapters of his book A journey through medicine, Book Guild, 1991. A great friend and contemporary was the surgeon, Sam Wass; when they were on the house together at Guy’s they wrote, directed and acted in two highly successful residents’ plays. Gavin Thurston [Munk’s Roll, Vol.VII, p.578] and Lionel Cosin, one of the first geriatricians, were also friends at Guy’s.

With the advent of the Second World War, when Norman Jacoby was registrar of paediatrics at Guy’s, clinical services were ‘sectorized’ and he became a physician to the emergency medical services; the only paediatrician between London Bridge and the coast of Kent and East Sussex. His practice was centred on the childrens department at Pembury Hospital, Tunbridge Wells, although he held clinics and had some beds at the Kent and Sussex Hospital. Later he was appointed physician to the Queen Elizabeth Hospital for Sick Children in Hackney, which subsequently became part of the Institute of Child Heath. Although he talked about it only with wry amusement, the workload during those years must have been formidable. Tuberculosis, rheumatic fever, meningitis, and periodic poliomyelitis epidemics constituted the bulk of his practice. In addition to his normal clinical work he gave anaesthetics to the war wounded, and taught both general medicine and paediatrics to Guy’s medical students. It was at Pembury that he refined his teaching skills, which were to become a byword for clarity and common sense. Ever since students have continued to come to Pembury for elective paediatric attachments. At the end of the war his contract with Guy’s was discontinued without ceremony, which left a lasting and bitter taste. He never went back to Guy’s until he became a patient there in his seventies.

The paediatric wards at Pembury, which he directed in close collaboration with his outstanding if somewhat eccentric ward sister, Anne Bowley, were renowned for their humane and progressive practices. In 1949 it was the first unit in the country to open its doors to unrestricted visiting by parents. It was also to be one of the first to provide accommodation for mothers to stay with their children overnight.

Jacoby’s treatment of asthma in children was meticulous, unconventional and almost always successful. He ran a very large asthma clinic, prescribing and controlling the doses of oral steroids with an eagle eye. Children who were admitted whilst having an attack received opiates with much relief and never a fatality. His opinions on the treatment of asthma were published in The Lancet, followed by a lively and controversial correspondence. He followed up a large number of children who had suffered post-streptococcal nephritis and was one of the first to show that the prognosis was good. With Payling Wright [Munk’s Roll, Vol.V, p.461 ] he described idiopathic pulmonary haemosiderosis in the lung of a refugee from Hitler’s Germany.

Norman Jacoby was perhaps best know for his very large series of children with congenital hypetrophic pyloric stenosis. These he treated either with atropine methyl nitrate or, uniquely, by operating on them himself under local anaesthetic. To see him perform a Rammsredt’s procedure under lignocaine, in about ten minutes from skin to skin with the baby sucking sister’s finger, was a revelation. The series was published in The Lancet on two occasions and forms one of the largest collection of cases of the condition ever reported. The results of his management have not been bettered.

As a colleague he was fair, courteous and - once convinced - unswervingly loyal and supportive. He had little ‘small talk’ but concentrated on what he considered the essentials of daily professional life, often with a considerable leavening of wit. As a man he could be warm and generous but he cultivated a certain reserve, and his disappointment at never having achieved a major teaching hospital post remained apparent even into old age. He was widely read, especially in English literature where he took a delight in applying paediatric diagnoses to the children he encountered in his reading, particularly in Dickens. At the time of his death he had been working for two or three years on a close study of Dickens’ health. He was convinced that Dickens had been a childhood asthmatic and postulated from contemporary evidence that he suffered from the disease throughout his life. His paper on the subject had been accepted by the Journal of Medical Biography but, unfortunately, he did not live to see its publication.

In his long retirement he took great pride and joy in the achievements of his four sons, three doctors and a solicitor. That he and two of his sons were all Fellows of the College during his lifetime was probably a first in the history of the RCP His marriage to Leslie Oppenheimer was marked by mutual devotion. Her death, two years before his own, left him saddened but alert and active until the end. The final chapter of his book A journey through medicine is an account of his unexpected return to Guy’s for coronary bypass surgery. It is written with the same dry wit, mixed with humility, fortitude and insight into the practice of medicine, that had characterized his life.

R Jacoby

[Brit.med.J., 1994,308,1505]

(Volume X, page 254)

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