Lives of the fellows

Ian Charles Lodge Patch

b.7 August 1923 d.1 July 1996
MB BS Lond( 1946) MRCP(1948) MD(1949) DPM(1956) MRCPsych(1971) FRCPsych(1974) FRCP(1978)

Ian Lodge Patch was a consultant psychiatrist at the Springfield Hospital. He was born in the North Indian hill station of Dalhousie. His grandfather had a distinguished career with the Indian Medical Service and retired and died out in India. His father, also born in India, was a prizeman from the Edinburgh Medical School and trained as a psychiatrist in Scotland before serving with the RAMC in France. Subsequently he too joined the Indian Medical Service where as physician in charge of the mental hospital in Lahore he established psychiatric services in the Punjab.

Ian's early experiences therefore were of being brought up in a spacious house on the estate of a large mental hospital in exotic surroundings which he described as "idyllic for a child". The idyll was broken at the age of seven when he was send ‘home’ to school. This, along with the early death of his mother and premature retirement of his father due to a near fatal coronary thrombosis, clouded his schooldays and perhaps contributed to a reserve of manner. He entered Epsom College on a classics scholarship and in 1941, having won a further scholarship, he went to the London Hospital which he chose on the advice of William Evans [Munk’s Roll, Vol.VIII, p.146], his father’s cardiologist. He qualified in 1946 having acquired prizes in anatomy and surgery, unusual in a prospective psychiatrist, and then became house physician to Lord Evans [Munk’s Roll, Vol.V, p.123] under whom he passed his MRCP and gained his MD within three years. National Service in Nigeria gave him experience of local customs and language which subsequently came to his aid with some Nigerian psychiatric patients referred to him at Hammersmith later in his career. Although very much the physician, he chose to follow his father by specializing in psychiatry in spite of the publication of several papers and a further two years at the London as a registrar in cardiology.

The next six years were spent at the Bethlem Royal and Maudsley Hospitals where Sir Aubrey Lewis [Munk’s Roll, Vol.VI, p.284] was the dominant figure. It was an experience which he recalled with gratitude for the rigorous training which he received, but also with pain as he recounted the effects of Sir Aubrey’s frequently abrasive and occasionally destructive comments to his junior colleagues. He soon decided that his niche was in clinical rather than academic psychiatry and in 1959 was appointed consultant psychiatrist at Springfield Hospital and honorary consultant psychiatrist at the Hammersmith Hospital. Springfield at that time was a Victorian asylum with two thousand patients which he himself described as "preserving most of the worst characteristics of inactive, laissez-faire psychiatry…with a handful of doctors, some of whom themselves were seriously disabled." His appointment meant that there were now four consultants to care for the patients "in wards of huge collections of miscellaneous inadequately treated patients, many of whom had been there with little reason for much of their adult lives. The fixed ritual of each day was lunch, where the four consultants met around a huge table spread with a crisp white cloth, in the middle of which stood a large silver cup, awarded to the hospital farm for pig breeding." He took pride in describing the work of the next 25 years as he and his colleagues saw the transformation of the hospital with an energetic postgraduate programme for junior doctors, the recruitment of able younger colleagues, the improvement of patient care and the reduction of patient numbers. His publications during this time reflected his being a physician but also focused upon the philosophy, motivation and provision of care of the most needy patients. His papers on the founding of Springfield and its history were authoritative and written in elegant prose. In 1985 he and his younger colleague Gerald Woolfson were able to transfer their work and service entirely to an excellent unit at St Charles’s Hospital, Paddington. The transfer had not been without difficulty but he bore no resentment and was glad to work there for the last three years before he retired from the NHS in 1988. Thereafter he continued with his Harley Street practice, but now had time to pursue and develop his considerable skill as a watercolourist.

During his undergraduate days he was introduced to the Reverend Maurice Wood, subsequently the Bishop of Norwich, and became a committed Christian. His new faith became the most powerful influence in his life thereafter. He was active in the Christian Medical Fellowship and eventually on its council of reference, yet he was equally at home worshipping with and preaching to small groups of Christians. Throughout their 37 years of happy marriage he and his wife Pauline made their home and cottage open to friends and associates from very different walks of life where their sense of fun made them most excellent and generous hosts. Part of his enduring legacy will be the number of young people to whom he was a great mentor. This included trainees from overseas, but especially those who sought his advice and support as they pursued a career in psychiatry and struggled with the ethical and philosophical challenges which the practice of psychiatry presents to those who would seek to contribute to the healing of the body, mind and spirit. In the 1960s and 70s he had organized informal colloquia on the subject of religion and psychiatry when such topics were shunned by the psychiatric establishment. In the mid 1980s he contributed to and identified with the founding of the Association of Christians in Psychiatry which now has several hundred on its mailing list and a regular slot during the annual meeting of the Royal College of Psychiatrists.

Having had successful cardiac surgery at the age of 60, he ruefully commented that he had been told that his ‘bypass and refit’ would last him twelve years as he waited for a further operation at his old hospital, the Hammersmith. During his last weeks there was a peace and serenity as he settled his affairs and received old friends. He was able to spend special times with each of his three children and quite unselfconsciously spoke about his faith. He never lost the twinkle in his eye and quizzical smile. His heart did not restart after the operation. In John Bunyan’s terms he would be a combination of Mr Stand-fast and Greatheart.

M G Barker

(Volume X, page 305)

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