Lives of the fellows

Clifford Wilson

b.27 January 1906 d.10 November 1997
MRCS LRCP(1931) BM BCh Oxon(1933) DM(1936) MRCP(1946) FRCP(1951)

Clifford Wilson played a major role in the establishment of academic medicine in London medical schools in the two decades following the Second World War and made seminal contributions to the understanding of the pathogenesis of hypertension and of renal disease.

He was born into a Yorkshire Baptist family and educated at the Heath School in Halifax. His first talents were manifest in classics, but he switched to chemistry after a period as a lab boy in his spare time. On the basis of his performance in that subject he won the prestigious Brackenbury scholarship to Balliol. However, whilst at Balliol he decided to make another change, this time to medicine. He remained throughout his life immensely proud of his Balliol connection and there was little doubt of the lifelong influence that that environment had on his moral and political outlook. He took a first in natural sciences and moved to the London Hospital for his undergraduate and early postgraduate clinical training.

In 1934 he obtained a Rockefeller travelling scholarship to Harvard where he developed his enduring interest in hypertension and renal disease. Whilst there he met the pathologist Kimmelstiel and with him described the specific glomerular lesions of long-standing diabetes which have been known since by their joint names. Wilson returned to the London, where Sir Arthur Ellis [Munk’s Roll, Vol.VI, p.162] was professor of medicine, and became assistant director of the academic medical unit. With Ellis and Horace Evans [Munk’s Roll, Vol.V, p.123] he produced a classification of glomerulonephritis which attempted to integrate the pathological findings with the very variable clinical course. The classification brought some order into a highly confusing field and held sway until the late 1950s when the advent of renal biopsy caused it to be superseded. He also developed a programme for introducing new clinical students to clinical method which in essence remains unchanged to the present day.

During the war Wilson was in the medical research section of the RAMC and played a major role in dealing with the outbreaks of viral hepatitis prevalent in the services. On his return to the London in 1946 he succeeded Ellis as professor of medicine. The remainder of his career had two main strands. The first was the working out of the relationship between hypertension and renal disease. He gathered around him three colleagues - Michael Floyer, Jack Ledingham [Munk’s Roll, Vol.IX, p.311] and the pathologist Frank Byrom [Munk’s Roll, Vol.VII, p.77] - in a highly productive research team. Together they worked out in rats the idea of a vicious circle in hypertension, whereby renal damage causes hypertension, which in turn produces further renal damage due to arteriolar lesions. Our understanding of the pathogenesis of malignant hypertension and some of the principles of the modern treatment of hypertension have their conceptual origin in this work.

The second strand was a medico-political one. In 1944 the Goodenough committee had recommended that medical students should be provided with a proper university education, with a systematic training in the principles, problem solving and habits of learning, rather than the previous emphasis on a largely apprenticeship based system whereby students imbibed professional expertise from watching senior doctors practice. These principles seem very obvious today but there was at the time much resistance to them at the London and elsewhere, and Clifford Wilson, who was simply not prepared to give up, despite making enemies, fought a battle which lasted more than two decades before it was eventually won with the publication of the report of the Royal Commission on Medical Education in 1968. He deserves the gratitude of generations of medical students for his role in establishing these principles. Because of the time-consuming nature of these struggles he played a less active personal role in research from 1960 onwards, though he remained a brilliant critic and supervisor of the work of his lecturers.

As Clifford Wilson's views gained acceptance he was appointed to wider national and university roles, including Vice-President and Senior Censor of the Royal College of Physicians from 1967 to 1968. He was dean of the faculty of medicine of the University of London from 1968 to 1971.

Wilson’s august appearance and his deep natural reserve belied his actual warmth and his great qualities as a physician who cared deeply for his patients. Beneath this outer shell he was a man of deep and passionately held convictions which only occasionally surfaced, and then when least expected. He was left-wing politically, but only those of his staff who had known him for some years were really able to appreciate the moral and political depths of his personal philosophy. But he inspired an ethos of service and commitment - you stayed with the job until it was done and especially if it involved patients.

In 1936 Clifford Wilson married Kathleen (née Hebden), a long-standing childhood friend. They had two children, a son Jeremy, and a daughter, Felicity. When he retired from the chair of medicine in 1971 all thought he would continue to play a major role in medico-academic politics. Quite deliberately he decided not to do so. It is believed that he felt that his family deserved this after so many years when his position in medicine had required so much single-minded attention.

R D Cohen

[The Independent, 19 Nov 1997]

(Volume X, page 524)

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