Lives of the fellows

Richard Herbert Lindenbaum

b.9 July 1933 d.23 April 1991
BM BCh Oxon(1959) MRCP(1963) FRCP(1979)

Richard Lindenbaum was the son of Konrad Lindenbaum, a general practitioner in London. He was educated at St Paul’s School (where he was a foundation scholar), University College, Oxford, and St Mary’s Hospital, London. At school he was closely associated with Oliver Sacks, another foundation scholar who shared the same birth date and whose father was also a general practitioner in London - they were known as ‘the twins’. Both were deeply influenced by their biology teacher, S R B Pask, and by Julian Huxley’s Modern synthesis. Both won scholarships to Oxford and later their interests and friendship were to be shared with Jonathan Miller and Eric Korn. All achieved distinction.

Lindenbaum’s early appointments included being house physician at both Great Ormond Street and the neonatal unit at the Hammersmith Hospital, where he was profoundly influenced by Peter Tizard, later Sir Peter (q.v.). Dick Lindenbaum was already a remarkable linguist, taking extensive walking tours in and around the Balkans. After registrar appointments at the Liverpool Children's Hospital and the Westminster Children's Hospital in London, he joined the staff of the MRC's research unit in human genetics in 1970, near the Churchill Hospital in Oxford, where he continued his clinical association with Peter Tizard, now professor of paediatrics in Oxford. He maintained his expertise in general paediatrics by volunteering to be included on the on-duty rota.

His other colleague of equivalent seniority was Martin Bobrow, later to be professor of paediatric research at Guy's Hospital. Over 10 years they jointly and separately produced a large number of papers relating chromosomal aberrations to the phenotype. Oxford was an ideal place with the expansion of the neonatal services under Tizard and Turnbull - later Sir Alec - who was expanding the obstetric services in the new John Radcliffe Hospital. With their help, Bobrow and Lindenbaum initiated the prenatal diagnostic service for chromosomal variants: Oxford was the first diagnostic laboratory in the UK to use banding procedures as a routine.

Lindenbaum’s most influential discovery was his interpretation of the diagnosis of Duchenne’s muscular dystrophy in a girl referred to Tizard, in whom he found a translocation between the X chromosome and the largest autosome. Although slow to publish - a shorter and earlier report coming from Christine Verellen of Brussels - he pointed out the likely nature of the connection and the opportunities this provided for the decipherment of the gene: a challenge to be taken up by Southern in Edinburgh, and later in Oxford. Contrary to some assertions, linkage analysis was irrelevant to the eventual decipherment of this gene. Research on sequencing the breakpoints was initiated by Worton in Toronto, where Verellen had worked, and later in Edinburgh and elsewhere after Lindenbaum’s publication. A deficiency in the chromosomal band in the ‘boy from Seattle’, who had muscular dystrophy and various other disorders, was studied by Kunkel in Boston USA before the breakpoint had been sequenced.

Lindenbaum visited the Oxford patient at her home on the Norfolk coast several times: her intellect was unimpaired and she appreciated his sending annotated southern blots of her DNA, knowing that she was to make a considerable contribution in her short life. With Verellen he set a welcome example of making all cell lines of such value publically available to all research workers. The join was first sequenced in Toronto on Verellen’s case; his own case was sequenced in Oxford just in time for him to appreciate the confirmation of his predictions.

His many publications were often late, but always thoughtful and generous in their acknowledgement. Nationally and locally he had a major influence at meetings, at joint consultations with consultants, and through his very long and detailed - if somewhat late - letters. He took great care over teaching, with quarterly afternoons devoted to a laboratory tour followed by relevant clinical dissertations supported by his superb slides. His clinical work was marked by thoroughness and extreme attention to detail, with no sign left untested and few questions left unasked, with families contacted by home visits where he was even more welcome on later visits. His carefully annotated pedigrees missed nothing but were not always easy to decipher. His collaboration with Mrs Ann Hunt, the founder of SCAN, the tuberose sclerosis patient group, led to an almost tenfold increase in recognition in ten years, while his advice assisted the development of this efficient and beneficial charity.

He was somewhat criticized for his output exceeding any available secretarial capacity, delays of many weeks and innumerable tapes. But as he was always available day or night and would go anywhere at anytime, this was a minor problem. Blood always came before paper and his administrative accomplishments were, at best, limited - leaving little documentation of the remarkable workload he handled at an enviable standard. Several registrars and one senior registrar appreciated the unique experience of their apprenticeship. He set up the Marfan clinic and over many years established the foundation of the Huntington register. He was an excellent photographer and left a large number of photographs of clinical syndromes, all well annotated and cross referenced. He also left many books to the extensive library which he had built up within the medical genetics unit.

Outside medicine his interests were numerous and included extensive elaborations of the many byways involving the coevolution of tribes and languages, the relationship between art and disease, evolution in general and the scope for quantifying natural phenomena. His mathematical aptitudes were applied to carrier detection from indirect data and had the effective precision of a computer without the failings of rigid prior assumptions. He was one of the few adults to master the Rubik cube. He had surgery for a malignant obstruction in his lower gullet some 16 months before he died and returned briefly to full-time work. Eight months later he travelled to Leuven by boat and train, to his last meeting of the European Society of Human Genetics, where he appeared fully active. During his final year he worked almost entirely at home and was as productive as ever in giving advice by ’phone. The day before his death he was reading a long review of the works of his friend Oliver Sacks, who later flew over from New York to give his funeral oration. Subsequently a small copse of lindenbaums - or lime trees - were bought by his colleagues and planted at the Churchill Hospital, where his work had been based and in whose hospice he died.

He married Susan née Wheatley-Smith, a health visitor and daughter of an RAF officer, in 1977. They had two children, Daniel and Rachel. Daniel is a graduate in microbiology employed by the MRC in the integration of human linkage data as part of the genome project and Rachel graduated in European languages.

J H Edwards

[Brit.med.J., 1992,304,1504]

(Volume IX, page 316)

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