Lives of the fellows

John Lorber

b.12 October 1915 d.2 July 1996
BA MB BChir Cantab(1944) MRCS LRCP(1944) MRCP(1948) MD(1951) FRCP( 1964)

John Lorber was a distinguished paediatrician and, whilst working at Sheffield Children’s Hospital, made major contributions to the treatment of childhood tuberculosis and the congenital defects of spina bifida and hydrocephalus. When he bravely reversed his views about the treatment of spina bifida he precipitated a major ethical discussion which had, and will continue to have for many years, widespread repercussions.

John was born in Budapest where his father was a hospital superintendent. His medical studies at the Universities of Pécs and Budapest were interrupted in 1938 when he came to England. The move was arranged by his father who gave him some family treasures in lieu of money to finance him in his new country. Not long afterwards his father was sent to a concentration camp where he died, but his mother hid and later reached England.

British Council support enabled John to resume his medical training at Cambridge University and Guy’s Hospital, London. He qualified in 1944 and then held various appointments at Guy’s and in Dartford. It was at the hospital in Dartford that he met and in 1945 married a radiographer, Joan, who became his devoted and supportive wife. In the same year he was to become a naturalized British subject.

In 1948 he gained the MRCP and was appointed lecturer in the department of child health at the University of Sheffield which had been established recently by Ronald Illingworth [Munk’s Roll, Vol.IX, p.259]. John Lorber remained in Sheffield throughout the rest of his professional career, eventually becoming professor of paediatrics in 1979.

John’s early origins remained evident in his speech and autocratic manner. He set himself high standards of hard work and intellectual honesty and expected the same of others. These characteristics sometimes led him to be considered cold and abrasive, but closer awareness revealed a very humane concern for and loyalty towards his patients, which they fully understood and appreciated.

Childhood tuberculosis was a common problem in British cities in the period following the war, but none more so than in Sheffield. Lorber took up the challenge with enthusiasm, and research publications flowed. Within three years of joining the department he earned his MD with a thesis on the streptomycin treatment of tuberculosis. An early introduction of BCG vaccination and a ruthlessly thorough follow up of contacts led to control of the infection in Sheffield earlier than in many other cities.

Meanwhile the paediatric surgeon in Sheffield, Robert Zachary, was concerned with the surgical treatment of babies born with spina bifida and hydrocephalus. The control of tuberculosis enabled Lorber to turn his energies to the treatment of birth defects of the central nervous system. Zachary and Lorber together with an orthopaedic surgical colleague, John Sharrard, combined in a medical-surgical team which became world famous. They showed that a survival rate for affected babies could be changed from one of less than 10% to nearly 90%; that intervention within hours of birth gave the best results; and that the correction of limb defects and renal tract problems were all possible. Lorber’s enthusiasm and meticulous documentation and analysis of the cases underpinned these developments. He was foremost in advocating very early and thorough intervention for all babies born with spina bifida.

Some fifteen years later Lorber began to realize that life for some of the salvaged babies was not so good as they got older. Teenagers who had undergone many operations still had problems and would never be self sufficient. He was profoundly affected by these experiences and he set to work on the huge task of re-analysing all the case material. As a result he was able to present firm criteria to be used in the selection of cases for treatment. These principles are now accepted generally, but only after long and heated debates concerning the ethical issues arising from the advocacy of selective treatment.

In 1975 he gave the Milroy lecture at the Royal College of Physicians when he reviewed the treatment of spina bifida. An earlier Milroy lecture - entitled 'the quality of survival’ - had pointed out the issues met by Lorber.

John Lorber continued to see children with spina bifida until his health deteriorated. Their parents sought his guidance because they appreciated his immense knowledge of the condition and liked the directness with which he advised them. Their appreciation was fully matched by his loyalty to them.

Throughout his work John was supported by his wife Joan and together they worked in and enjoyed their fine garden. They adopted two children, Stephen and Diana.

K S Holt

[The Times, 2 Aug 1996]

(Volume X, page 307)

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