Lives of the fellows

Robert Merttins Bird MacKenna

b.16 November 1903 d.12 November 1984
MRCS LRCP(1926) MA Cantab(1928) MB BChir(1928) MRCP(1928) MD(1931) FRCP(1941)

Robert MacKenna was the only child of Robert William MacKenna and his wife Amelia, née Bird. Both his parents were physicians who graduated from Edinburgh University in 1898 and settled in Liverpool, where ‘Mac’ was born. His father started in general practice but in 1907, after working in several skin departments in Europe, went into partnership with Stopford Taylor, an established dermatologist.

As a boy, Robert became fascinated by ships in the Mersey and he early decided to make his career at sea. In 1917 he entered the Royal Naval College, Osborne, as a Naval cadet but, although Robert enjoyed life in the Navy, his father foresaw that the number of junior officers would be greatly reduced after the war and advised him to consider changing his career. His father was a powerful persuader and Robert selected medicine, entering Clare College, Cambridge, after attending classes at Liverpool University for one year; moving on to St Thomas’s Hospital for clinical training. After qualifying he worked as clinical assistant to S E Dore [Munk's Roll, Vol.IV, p.568] in the dermatology departments of St Thomas’s and of St John’s Hospital for Diseases of the Skin.

In 1927 he married Helen Dora Todrick and in the same year he returned to Liverpool, with his wife, because both his parents were ill. He worked in his father’s dermatological practice, and in the male venereal department of the Liverpool Stanley Hospital - where he later became honorary dermatologist. He always regretted that he had no opportunity to widen his experience at this stage of his career by working in various skin departments in this country and abroad. He resigned from his previous appointments in 1936 when he was appointed honorary dermatologist to the Royal Southern Hospital, Liverpool, where he also had teaching responsibilities. He was an enthusiastic member of the small but active North of England Dermatological Society which met in rotation, six times a year, in Leeds, Liverpool, Manchester and Sheffield.

At the outbreak of war, having previously volunteered for the RAMC, he was mobilized as a lieutenant. Liverpool was considered to be a likely bomb target, so his wife and her two daughters returned to her family home in Scotland. Robert served under rather makeshift conditions at Catterick and in Lincolnshire, and it was at this time that his organizing ability became manifest. In 1941 he was appointed adviser in dermatology to the War Office. He was to take care of dermatology, now separated from venereology, since up to that time the two disciplines had been linked under the control of one senior officer. Although the total number of trained dermatologists in the United Kingdom was small, he was able to select a few of them to form a nucleus, each in charge of a UK Army command. They were reinforced by young medical officers interested in dermatology who, after carefully planned ‘crash courses’, were appointed graded dermatologists. Many of them became successful consultants in the newly formed National Health Service after the war. The system was expanded to cover all the overseas Army groups and when the invasion of Europe began it was stated that MacKenna had organized the best dermatological set-up of any army Britain had ever had. In 1943 he became War Office consultant in dermatology with the rank of acting colonel, local brigadier, an appointment he retained until 1964. With the end of the war in Europe he travelled extensively in India and the Far East, supervising the care of skin disease problems. In December 1945 he was released from military duty, being made an honorary colonel RAMC in 1954.

‘Mac’ had been actively concerned in the many discussions which took place during the war on the future place of dermatology in the anticipated National Health Service, and he became the first chairman of the newly formed dermatological group of the British Medical Association. Together with a small group of like-minded colleagues he ensured the proper recognition of dermatology in the emerging NHS.

Soon after his release from the Army he was invited by A C Roxburgh, [Munk’s Roll, Vol.V, p.361] then past retiring age, to apply for his post as honorary dermatologist to St Bartholomew’s Hospital. This he did, and he was appointed physician in charge of the skin department in 1946. MacKenna was one of a few dermatologists at that time who felt very strongly that when dealing with problems affecting the skin it was essential to consider the patient as a whole. He accordingly built up a department which not only had close links with general medicine but also particularly with psychiatry and biochemistry. His collaboration and friendship with senior dermatologists in other allied medical services, especially with the Americans and Canadians, enabled him to arrange for many of his post-war trainees to spend time in appropriate departments in North America.

His administrative abilities, which had blossomed in the Army, were well utilized when he was appointed to the boards of both St John’s and St Bartholomew’s Hospitals. These were important decision making bodies and it was work which gave him great pleasure. He was involved in re-establishing in London the meetings of the International Congress of dermatology which had been disrupted by the war. He was a successful president of the British Association of Dermatologists in 1967, and of the dermatological section of the Royal Society of Medicine in the same year. He retired in 1968 but he kept an active interest in dermatology - always being ready to help and advise the young, especially those who had been ‘his boys’ in the Army or at Bart’s.

He wrote well and concisely. He edited and revised the last three editions of his father’s book Diseases of the skin..., R W MacKenna, 5th ed.,London, Bailliere,Tindall & Cox, 1952, which ran into five editions. His own book Aids to dermatology... , 2nd ed.,London, Bailliere & Co., 1939 also ran into five editions, the last two being in collaboration with his friend and colleague E L Cohen. He edited Modern trends in dermatology, Series 1 appearing in 1948, Series 2 in 1954 and Series 3 in 1966. From 1944-63 he contributed annually a synopsis of important current articles on dermatology to The Medical Annual. He encouraged his juniors to study problems in depth and to take an active part in dermatological meetings. He was a Councillor of the College 1956-58, Watson-Smith lecturer in 1957 and Examiner 1964-70.

‘Mac’ had a very busy professional life, and he was also a great bibliophile. He had a deep knowledge of historical London, as many of his overseas friends discovered. The value of his contribution to dermatology was recognized by his honorary membership of fourteen overseas dermatological societies, as well as being a special honorary fellow of the American Medical Association, and honorary member of the Alpha Omega Honor Medical Association. It is a matter of regret to British dermatologists that he never received any national recognition in his own country in spite of his outstanding contribution to dermatology both in war and peace. This may have been due to his natural modesty and self-effacement.

His first wife divorced him in 1943, and he then married Margaret Hopkins who became closely associated with all his activities. He found great relaxation at home and tried to live according to his deeply held Christian faith. He was very happy when the two sons of his second marriage were ordained clergymen of the Church of England. There were two daughters of the first marriage.

HR Vickers

[Brit.med.J., 1984,289,1547,1703; Lancet, 1985,1,61; The Times, 16 Nov 1984; J.Amer.Acad.Derm., 1982,6,1,135]

(Volume VIII, page 308)

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