Lives of the fellows

Nicolas Borrell Malleson

b.30 October 1923 d.3 June 1976
MB BChir Cantab(1945) MA(1950) MRCP(1950) MD(1957) FRCP(1973)

Born in Surrey of the actor Miles Malleson and Joan, his doctor wife, Nic, as he was regularly called in adult life, savoured luxury and was exposed to severe privations from very early years. Indulgent nannies, boarding school by the age of three years, the recurrently agonizing sound of his father’s retreating footsteps after leaving him at school; these belonged to the network of his experience. Henry Walton MD FRCPE FRCPsych writes movingly of Malleson’s early life in Students in Need: a collection of essays in memory of Nicolas Malleson (1978). In the same book is a paper written by Malleson the medical student, more than thirty years earlier. His hopes for his future may well have seemed naive at the time but many of them came to pass: sophisticated group practices in general medicine, highly equipped health centres fully financed by the State.

He did not then foresee the growth of student health services, but it was as physician-in-charge of the Student Health Association of University College London, in 1949, that he began his life’s work in that field, having previously been medical registrar at the Ipswich Group Hospitals, medical officer to RAFVR (UK and India), and house physician at the West Middlesex Hospital. In student health practice he proved himself a natural leader. Impulsive often to the point of rashness, he was nevertheless clear-sighted and far thinking, quickly earning for himself the respect, not only of leading administrators at UCH, but also of the University of London, of London medical schools, and of the vice-chancellor’s committee, thereby extending his influence throughout the country.

This culminated in his appointment to the Social and Preventive Medicine Committee of the Royal College of Physicians, on which he served from 1965-1970. As much as anyone, he was responsible for an ensuing report from a sub-committee on student health in 1966, which became something of a charter in the development of student health services in this country, and was complemented by Malleson’s slim Handbook of Student Health Services (1965), which is a classic. In its 88 pages he succeeds in including sophisticated essays on the influence of emotional factors on achievement in university education, on the treatment of pre-examination strain, and on his ecological concept in student health practice in Britain. The latter was based on his work for his doctorate in 1957. Such was the range of the man.

By that year, 1965, he had already been five years in charge of another health centre, that of the Central Institutions of the University of London. This had freelance beginnings, having been built piecemeal by Malleson after his return from Australia in 1960. Very little is known about his venture into Australian University health practice. He was disappointed, both he and his wife seem to have been unhappy there, and it looks as if he was glad to accept support from university authorities there for the family’s return to this country. He had left UCH in 1959 and was back in this country building another practice in 1960. By autumn that year he was covering the health of students at the School of Slavonic Studies, the School of African and Oriental Studies, and at Birkbeck College. He worked at an address on the west side of Woburn Square.

These were difficult days, for he had to provide any medicines that he used out of his own funds, or by private prescription for which the patient paid, or by relying more than he liked on hospital casualty departments. Naturally, students who were already patients of other doctors could be counselled and referred back. But, as always, most of the needy ones were not registered under the NHS in London; any medical contact they had once had was far removed. Malleson, from the start, had a campaigning interest in catering for waifs and strays of this kind.

Matters improved when he succeeded to a NHS practice vacancy through death of a practitioner located at No 1 Woburn Square, on the east side. From then on he went from strength to strength. His detailed curriculum vitae, lodged at 20 Gower Street, lists seventeen sundry appointments, scholarships and fellowships in this country and in the USA. Few people knew of his work as Borough Councillor for St Pancras from 1946-1949, or of his Senior Fulbright scholarship in the department of mental hygiene at the University of Michigan in 1952. Much better known was his work as founder chairman of the Society for Research into Higher Education, now at the University of Surrey, and his membership of HM Government Standing Advisory Committee on Drug Dependence.

He was a pioneer in the teaching of counselling. He was not schooled in psychoanalysis, but had had some personal experience of it, and consistently geared his short courses in counselling to analytic concepts and to human biological development. Among his professional disappointments were the working parties which he convened from 1962 onwards for the promotion of a School of Medicine and Human Biology, which were abandoned after 1966; also Educational Redeployment Service Limited, which ceased functioning after a few years for lack of funds. His hope had been of a country-wide network of agencies interested in studying young people’s difficulties.

Nicolas Malleson came of highly creative stock. His mother, Joan Graeme, was the daughter of James Bilson, a company director. She became a historic innovator in the field of gynaecological problem solutions, including her own teaching of contraceptive techniques. His father, Miles, was an actor and dramatist of considerable fame. Parents as eccentric as his were not easy to live with, and Nic seems rarely to have been at ease with them or within himself. At the same time he set himself parallel high standards for initiating change.

Anyone who could tolerate his exasperating impatience and a degree of superficiality, which was the inevitable consequence of his having so many irons in the fire at one time, fell under the spell of his lovableness. He was easily hurt, not only by spitefulness but also by discovery of mistakes. Where others learned from mistakes, he tended to withdraw and work his way in a different direction. Sometimes he suffered acutely from finding himself thrust out of a concern which he had worked hard to establish. Malleson could be awkwardly rebellious and committees would be as relieved to see him go as they would be sad to miss the penetration of his thinking, the embrace of his warmheartedness.

In the early 1950s he was in the vanguard of those who were prepared to educate young men and women in methods of contraception and made no secret of the fact. He was hurt by the obscurantism of some of his colleagues, and not easily able to allow for the genuine doubts of others. However, wounds heal and he would almost certainly have persisted had he not been smitten by the death of his elder daughter, Sarah; killed tragically as the carefree pillion passenger on a boyfriend’s motor cycle. Those closest to him knew that he had never really recovered from depression following his mother’s death by drowning at sea, some years previously. The blows were intolerable. Even so, his last message to his colleagues, over the telephone three days before he died was: ‘Tell the Annual Conference that I am not sulking. I am tired. I hope to rejoin you all next year with my wife, for at least part of the conference then’.

His wife had been Jane Mary Owen, daughter of Colonel Owen Tucker OBE, an engineer. She met him first when she was a new girl at Dartington Hall Public School, where he was already a pupil. She survived him with three of their five children: Peter and Stephen had already become doctors, Kate was 13 when their father died. His body was found in his car in Gateforth Street, a little north of Marylebone railway station. At a subsequent inquest, Gavin Thurston FRCP declared an open verdict: death was said to be due to alcohol and barbiturates, self-administered, with insufficient evidence of motivation.

Agnes H Wilkinson

[Times, 19 June 1976; Brit.med.J., 1976, 2, 50]

(Volume VII, page 374)

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