Lives of the fellows

Kenneth David Keele

b.23 March 1909 d.3 May 1987
MRCS LRCP(1932) MB BS Lond(1932) MD(1934) MRCP(1934) FRCP(1951)

Kenneth David Keele was born at Highbury, London, into a family with a strong medical tradition; his father, grandfather and eldest brother George being general practitioners and his other brother, Cyril (q.v.), a professor of pharmacology. He was educated at Epsom College and won a scholarship to St Bartholomew’s Hospital medical school where he won the Harvey prize for physiology. After junior appointments he became casualty physician at Bart’s and was elected to the consultant staff of St Pancras Dispensary, the Evelina Hospital for Children and King George Hospital, Ilford. From 1933-39 he was clinical assistant to Sir John Parkinson [Munk's Roll, Vol.VII, p.443] at the National Heart Hospital.

In 1939, at the beginning of the war, he was appointed consultant physician, Emergency Hospital Medical Service, St Bartholomew’s Hospital, St Albans. From 1942-46 he served in the RAMC in India, where he attained the rank of lieutenant colonel. In addition to clinical and administrative responsibilities he was head of the sprue research team in Poona. It was here that he met Mary Thrussell, then in the QAIMNS/R, who became his second wife. She was sister in the sprue research team and worked with Kenneth both before and after they were married.

After the war Kenneth was appointed full time consultant physician to Ashford Hospital, Middlesex, (1946-71), where he developed his great interest in cardiology. It is not perhaps generally known that he was the pioneer in this country of the use of angiocardiography to provide accurate diagnosis of congenital heart disease to the benefit of both cardiac surgeons and their patients. This work was published in 1948. His experience in general medicine led to the publication, with his surgical colleague Norman Mathieson, of a book entitled Intra-abdominal crises, Washington, Butterworth, 1961.

Kenneth was an excellent doctor. He had all the qualities needed by the modern physician, a deep knowledge of the science of medicine combined with a very human rapport with his patients. It was through his empathetic understanding of his patient’s complaints that he became involved in the study of pain, to which he made notable contributions. He appreciated the difficulties of communication and recording of this common symptom due to its subjective nature. However, insofar as pain has a time course and varies in intensity it can be represented objectively and in 1948 this led Kenneth to introduce the Pain Chart in which intensity of pain, as assessed by the patient, is plotted against time. This has proved to be a most valuable tool in clinical and experimental studies of pain, and a modified form of pain chart, the Visual Analogue Scale, is now used the world over.

Kenneth had long been greatly struck by the variations in response of different persons to noxious stimulation. As a cardiologist he noted that some patients with myocardial infarction suffered little or no pain. To study this phenomenon further he developed, in 1954, the pressure algometer, a simple device to measure the mechanical pressure required to evoke pain when applied to the forehead. Patients hyposensitive to the pressure algometer had suffered the least pain at the time of the infarction.

Among other contributions to the study of pain Kenneth and his colleague, P R S Stern, showed that patients with myocardial infarction or renal colic had marked falls in serum beta-lipoproteins and cholesterol concentrations which were closely related to the severity and duration of the pain. Stress per se raised serum lipid levels.

The medical historian in him found expression in Anatomies of pain, Oxford, Blackwell, 1957, a scholarly work in which concepts of pain from prehistoric times to the twentieth century were admirably reviewed. Kenneth was indeed a most distinguished medical historian with wide-ranging interests and an international reputation, especially in the USA where he was visiting professor at Yale University in 1958. At home he was research fellow at the Wellcome Institute for the History of Medicine from 1970-75.

His book William Harvey, the man, the physician and the scientist, London, Thomas Nelson & Sons, 1965, was a masterly work in which he quoted evidence from Harvey’s own writings, snowing that the growth in Harvey’s ideas was very largely shaped by the creative thought of Aristotle both with regard to the subjects which Harvey studied as well as his method of approach. Harvey may be pictured as ‘...having one foot in the ancient Greek library of Aristotle and the other in the operating theatre of the modern cardiac surgeon.’

In 1960-61 Kenneth gave the FitzPatrick Lectures at the College, which were published c.1963 as The Evolution of clinical methods in medicine, Springfield, Ill., Thomas. The subject gave him full scope to reveal his wide knowledge and understanding of medical history. Kenneth’s lifelong study or the anatomical works of Leonardo da Vinci was a passionate commitment which was favoured by the close proximity of his home in Staines to HM The Queen’s collection of Leonardo’s anatomical drawings at Windsor. In spite of steadily deteriorating eyesight he produced his magnum opus in three volumes: Leonardo da Vinci: Corpus of the Anatomical Studies in the collection of HM The Queen at Windsor Castle, Kenneth Keele and Carlos Pedretti, New York, Harcourt Brace Yovanovich, 1978-80, and Leonardo's ‘Elements of the science of man,' New York:London, Academic Press, 1983. Kenneth founded the Leonardo da Vinci Society in 1986 and became its first president shortly before his death. A fuller account of his historical activities appeared in the journal Medical History.

Kenneth was my brother and my best friend. I give here a few of many thoughts about him. He combined great intellectual and artistic gifts with a most lovable nature. Like his mother he was a good pianist and his love of the arts, especially paintings, showed through all his interests in medical history and gave him the insight to interpret the perplexing anatomical works of Leonardo. Though modest and unassuming he was a very good and enthusiastic communicator, in conversation, in lectures and in his writings. His hallmarks were clarity of thought and of expression allied to a determination to make others see his point of view. He was always delighted to give a helping hand to junior colleagues, with whom he was most popular, and in my view he would have been an excellent teacher of clinical medicine to undergraduate medical students. In later years he was much handicapped by failing sight due to glaucoma, and his inability to read the many medical historical books which he had acquired for his retirement was a galling experience which he endured bravely, with solace from playing his beloved Chopin.

His domestic life brought him great happiness and two tragedies. His first wife Dorée, née Doris Berther, inspired his purpose and achievements before her sudden death when eight months pregnant in 1941. His second wife, Mary, helped him to fulfil his life’s aims. They had a daughter Caroline and two sons, Peter and Tony. Peter was killed in a traffic accident. Kenneth and Mary showed great courage in facing this terrible event. Kenneth was survived by Mary, Caroline and Tony and Caroline’s son and daughter.

CA Keele

[Brit.med.J., 1987,295,338; Medical History, No.4,31,Oct 1987]

(Volume VIII, page 253)

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