Lives of the fellows

Allvar Orla Bech

b.24 July 1917 d.17 April 1994
BA Cantab(1939) MRCS LRCP(1942) MB Bchir(1942) MRCP(1943) MA(1944) FRCP(1975)

Allvar Bech was a consultant physician in thoracic medicine in Coventry and Warwickshire from 1951 until he retired in 1982. He was born in Rio de Janeiro, Brazil, where his father was a businessman. His mother was Scottish. In 1919 the family left South America for England and settled in London. Allvar was educated at Malvern College, where he represented the school at swimming and boxing. He went on to study medicine at Gonville and Caius, Cambridge, entering the London Hospital for his clinical training. After qualifying he spent his first year at the Miller Hospital in Greenwich and then became a medical registrar at the Middlesex Hospital for two years, gaining his membership of the College in 1943. After a year as resident medical officer at the Royal Masonic Hospital he began his training in thoracic medicine as a senior registrar at the London Chest Hospital, at the Royal Chest Hospital and at the West Middlesex.

He married Frieda Smith, a nurse, in 1945 and they had two daughters and a son.

In 1951 he was appointed as the first consultant in chest diseases to Coventry and Warwickshire. It is difficult today to realize quite how thinly spread specialist medical and surgical services were in much of provincial Britain in the early years of the NHS. Large centres of population had hardly any trained consultants, who were supported by very few junior staff and faced with a workload barely credible by today’s standards. Chest medicine was a special case because the management of tuberculosis had become a statutory responsibility of local authorities. This responsibility was assumed by the NHS which took over chest clinics and sanatoria, and the tuberculosis officers who staffed them. The resources in Coventry and neighbouring Warwickshire were scarce and, with a small team of tuberculosis officers and a mobile X-ray unit, Allvar was originally responsible for tuberculosis and other chest diseases in Rugby, Nuneaton, Coleshill, Sutton Coldfield, Solihull and Tamworth, as well as Coventry, and for sanatoria beds in Malvern and Warwick. With the increasing role of surgery, a regional thoracic unit was established at Hertford Hill, near Warwick. His early years in Coventry were spent rationalizing the service and establishing a new chest clinic in the Coventry and Warwickshire Hospital. He also supervised the domiciliary treatment of pulmonary tuberculosis, an effective but time-consuming form of community care of patients for whom no hospital accommodation was available. As the tide of tuberculosis ebbed, so the scope of thoracic medicine changed and a department dedicated to the diagnosis, epidemiology and treatment of a communicable disease became increasingly concerned with the management of a wide range of other diseases of the bronchopulmonary system.

Working in a heavily industrialized part of the Midlands quite early in his Coventry career, Allvar became consultant to Sterling Metals of Nuneaton. This association fostered his special interest in industrial diseases of the lungs. He became very expert in this field, writing papers concerned with hard metal disease and the pneumoconiosis associated with emery and beryllium. In 1970 he was appointed to the Central Pneumoconiosis Panel. Eventually, when the new Walgrave Hospital was opened in Coventry in 1969, it was possible to integrate thoracic medicine with the other medical specialties. This widened the facilities for training junior medical staff and also made it possible for Allvar to participate in general medicine, from which he had for so long been separated.

Allvar was a tall, good-looking man, quietly spoken and even tempered. He was a helpful colleague and maintained close and fruitful relationships with the thoracic surgeons with whom he worked and with the chest physicians - ex-tuberculosis officers - whose interests he did much to promote. In spite of his dedication to the clinical aspects of his work, Allvar could rarely be prevailed upon to participate in committee work of any kind. His special leisure interest lay in continental travel. Every year, for as many weeks as he could manage, he would depart with his family and tents for Spain or Italy, from whence he would return bronzed and fit, and full of stories about his travels.

At the age of 60 years, Allvar was taken ill with an obscure chest illness which proved to be thymic carcinoma. Too extensive for surgical removal, it was first treated with radiotherapy and only later by operation. While this successfully eradicated the malignancy it ultimately led to pericardial constriction which caused much discomfort and disability during his latter years. He died shortly after sustaining a fractured femur.

I R Gray

(Volume X, page 24)

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