Lives of the fellows

William Walker

b.18 January 1919 d.22 January 1998
MB BS Durh(1942) MD(1950) MRCPath(1963) MRCP(1965) FRCPath(1968) FRCP(1972) DSc Newcastle(1977)

William Walker was a pioneer in the treatment of rhesus haemolytic disease. He was born and educated in County Durham, the youngest of four children. The first from his family to choose medicine as a career, he qualified at Durham University in 1942. The future direction of his career was largely determined during his first post as house physician to Sir James Spence [Munk’s Roll, Vol.V, p.386] and Tom Boon [Munk’s Roll, Vol.X, p.43]. Spence was to become England’s first professor of child health and Boon part-time director of the wartime blood transfusion service. Thus paediatrics and haematology became the main focus of Walker’s career.

Following this appointment, Walker joined the Army and saw service in Europe with a light field ambulance, helping train his section in transfusion techniques. He was later posted to the Army transfusion headquarters in Bristol and then to the Far East, to a field transfusion unit.

After the war he returned to Newcastle to work with Spence as a lecturer and then reader in child health, developing his work in haemolytic disease. At that time in the UK over 500 babies a year were certified as dying from the disease and many more survived suffering severe and permanent brain damage. Early attempts at treatment included premature delivery and simple transfusion to combat the anaemia. However, more was needed and the technology of exchange transfusion, in which blood damaged by the mother’s rhesus antibodies is removed from the baby in small amounts at a time and replaced with healthy blood from a donor, was developed. Walker became an acknowledged expert in this difficult, painstaking technique.

Recognizing the importance of proving the value of the procedure scientifically he embarked, with Pat Mollison, on one of the first multicentre, randomized controlled trials. The meticulously collected results from Newcastle played a major part in the success of this study, which proved that the new technique was indeed superior. Few will now recall the practical difficulties of conducting large scale clinical research to such rigorous standards at that time. Pioneering research of this kind, 30 years before Archibald Cochrane’s [Munk’s Roll, Vol.VIII, p.95] advocacy of randomized controlled trials, often elicited scepticism rather than enthusiasm from medical colleagues.

Having shown that exchange transfusion could save lives and avoid devastating brain damage, Walker went on to refine the technique at the Princess Mary Maternity Hospital in Newcastle. At one time he was personally carrying out over 300 such procedures each year, while at the same time keeping the nursery staff and visiting colleagues entertained with his lively repartee and sparkling wit.

From his research it appeared that the results of exchange transfusion were more satisfactory in Newcastle than elsewhere, and this persuaded the chief medical officer, Sir John Charles [Munk’s Roll, Vol.VI, p.98], to allow him unprecedented access to the death certificates of all babies dying from haemolytic disease. Using his characteristic enthusiasm and drive he obtained access to 809 of the 811 medical records of these babies from all over England and Wales and was able to demonstrate clearly that treatment in special centres, by dedicated individuals, delivered the best results.

Collaborating with George Knox, he went on to unravel the complexities of rhesus haemolytic disease, helping pave the way for Cyril Clarke and his team at Liverpool to develop preventive measures (use of anti D injection for mothers) which have contributed to the dramatic fall in the incidence of the disease in the last 25 years. Walker’s meticulous data collection allowed him to develop algorithms which are still used to forecast the severity of haemolytic disease. This enables the prediction of those babies at risk of dying before birth, determining who will benefit from premature induction of labour.

In 1972 he was encouraged to apply for the newly established post of haematologist to the Royal Victoria Infirmary and over the next 12 years took great pride in establishing a model haematology service for the hospital and in establishing links between haematologists throughout the region.

Willie was essentially a reserved modest person, but most will recall his rather extravagant, but rarely out of place, sense of fun. His two minute introductions of learned speakers were often remembered long after the message of the lecture had been forgotten. He was a brilliant, stimulating and popular teacher who made frequent use of the most unconventional visual and other aids.

Spence had said the ‘the first aim of my department is comradeship, not achievement’, a principle with which Willie Walker entirely agreed. With his friend George Twitchett he organized the legendary Twitchett-Walker tours, whereby members of the department and a wide range of friends would be transported by bus to some far flung corner of his beloved Northumbria. A full evening of activities usually culminated in a visit to a local hostelry and a country dance. An early tour led to a dance at the granary of Linden Hall in Northumberland and this was associated with the inaugural congregation of the fictitious ‘University of Linden’. At subsequent congregations, in equally unusual settings, honorary degrees were awarded to such luminaries as Sir James Spence and Henry Miller [Munk’s Roll, Vol.VII, p.396]. The posts of deputy chancellor were offered to several colleagues who were known to be ‘pro-vice’! With Tom Bird and Alan Sharp he later founded the ‘Haematology Travellers’, an equally social club but with a strong academic content. This club, with its limited membership, continues to thrive.

Whilst enjoying robust health he was a dedicated hypochondriac, often sitting for hours at his microscope with a thermometer in his mouth! Willie had an enormous capacity for selective friendship. He took pleasure and pride in what he regarded as successful talent spotting, furthering the careers of a variety of younger colleagues in paediatrics, haematology and other fields. He also claimed personal success as a matchmaker with at least two successful marriages of colleagues to his credit.

His own marriage to June, one week after her medical graduation, led on to 47 years of very happy life, enriched by Scottish country dancing, gardening, motoring, foreign travel and many less active pursuits. A dedicated family man, he took great pride in his four children, two of whom have followed their parents into medicine.

A W Craft

[Bull.Roy.Coll of Path., 1998,103,11; Brit.med.J., 1998,316,942; The Times 12 Feb 1998]

(Volume XI, page 599)

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