Lives of the fellows

Michael John Francis McArdle

b.13 October 1909 d.27 January 1989
MRCS LRCP(1932) MB BS Lond(1934) MRCP(1935)FRCP(1948)

‘Sean’ McArdle entered the medical school at Guy’s Hospital from Wimbledon College with a scholarship in Arts, a fact which he would recall with a hint of pride even in his last years. He qualified at first, as so often happened in those days, with the Conjoint Diploma and later passed the London MB with honours. He held resident appointments at Guy’s and was a medical registrar there. During his years at Guy’s he came under the powerful influence of three extraordinarily capable physicians - Hurst [Munk's Roll, Vol.IV, p.509], Ryle [Munk's Roll, Vol.IV, p.595] and Symonds, later Sir Charles [Munk's Roll, Vol.VII, p.563] - and he often spoke with gratitude for what they taught him by their example and inspiration.

After Guy’s he spent some time at the Maudsley Hospital and was always convinced of the importance of this experience of psychiatry in his subsequent career in neurology. Having decided on a career in neurology he became a house physician at the National Hospital, Queen Square, where again he came under the influence of great men. He used to reminisce especially about his memories of one firm at the National Hospital - Holmes [Munk's Roll, Vol.V, p.195], Riddoch [Munk's Roll, Vol. IV, p.600] and Symonds - and it would be hard to imagine a more formidable trio. While at Queen Square he was awarded a Rockefeller travelling scholarship and chose to spend a year in France, providing himself with a grounding in neuropathology with Bertrand. A colleague there was Garcin [Munk's Roll, Vol.VI, p.189] who later became one of the chiefs of service at the Salpêtrière and they remained good friends.

Sean McArdle retained his affection for France and French neurology and was very well versed in French neurological literature. He spoke French very well and loved to use it when the occasion demanded. He returned to Britain just before the war, joined the RAMC as a neurologist and served in Edinburgh, at St Hugh’s in Oxford, and later in western Europe after ‘D-Day’. It was said that the records of his findings in cases of head wounds - written on small cards - had to be seen to be believed, replete as they were with his detailed observations legibly recorded in his beautifully neat and microscopic handwriting. He left the Army with the rank of lieutenant colonel.

He returned to Guy's after the war and was very soon appointed to the consultant staff there and at the National Hospital, Queen Square. He was subsequently appointed visiting neurologist to Kingston Hospital, where he did a clinic on Saturday morning and a ward round on Saturday afternoon.

It would be difficult to imagine that anyone could be more devoted to his work with patients and, while sometimes impatient with administrative chores, he served them and their needs unstintingly and to the utmost of his great ability. He was an unusual and popular teacher and one could really gain most from his great gifts by working with him, a privilege which many residents and registrars at Guy’s and Queen Square enjoyed. It has been said, and with truth, that he had more neurology in his head learned from his own experience than most of us have ever learned from books. He was an acute, quick and at the same time patient observer and stored his clinical experience in an extraordinary way. It was as a result of his truly remarkable clinical precision in thought and practice that he correctly came to the conclusion that the very common painful, persistent and mysterious syndrome of nocturnal acroparaesthesiae was due to compression of the median nerve at the wrist. Such compression at the wrist had been described before but not its relationship to the common syndrome of acroparaesthesiae and McArdle’s ideas were greeted at first with considerable scepticism.

It is interesting to speculate - although perhaps McArdle would have regarded it as idle - by how much the sum of human pain and misery has been diminished in the last 40 years as a result of his elegant clinical reasoning. If it were possible to measure such a thing, one might suspect that the gain from his observations and conclusions would be rather more in total than has been achieved by some of the more spectacular medical advances of our time. In his general clinical work he was at his best with the difficult problem - and perhaps the more difficult the patient with the difficult problem the more he relished the challenge. He would pick his way patiently and laboriously from one landmark to another to reach ms destination. His particular gift was his ability to elicit and assess the details of physical examination in a way that could be relied on absolutely. He was a great physician and there are many who have had the benefit of his skill, wisdom, sympathy and compassion.

His last years were saddened by his wife’s death and then the trials of failing health. Particularly sad was the partial blindness which robbed him of the joys of reading.

He was very proud of his Irish ancestry and very fond of Ireland. He regularly took his summer holidays on the west coast in County Clare and it was obvious to his colleagues, when he returned, that he was quite transformed - restored and ready for another year’s neurological toil.

C J Earl

[, 1989, 299,511;Guy’s Hosp. Gazette, Sept 1989,356-9]

(Volume IX, page 326)

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