Lives of the fellows

John Norman Agate

b.20 February 1919 d.31 October 1998
CBE(1979) MB BChir Cantab(1942) MA(1942) MRCS LRCP(1942) MRCP(1944) MD(1948) FRCP(1963)

John Agate was one of the pioneers of British geriatric medicine. He was a consultant at Bradford and then in the Ipswich and East Suffolk area. His services to geriatric medicine were justly rewarded by a CBE in 1979.

He was educated at Aldenham School. He went on to gain an open scholarship to Trinity Hall, Cambridge, where he took first class honours in the natural sciences tripos in 1939. He completed his clinical studies at the London Hospital, qualifying in 1942. He obtained his MRCP in 1944 and his MD in 1948.

He finished his training in general medicine at the London Hospital, as first assistant to Donald Hunter [Munk’s Roll, Vol.VII, p.288]. In 1945 he became a research physician in industrial medicine for the MRC at the London Hospital, identifying the relationship between Raynaud’s phenomenon and the use of vibrating tools. Agate was then called up for national service in the Royal Air Force from 1949 to 1953, becoming a squadron leader and a specialist in medicine, based in London.

To the consternation of some of his erstwhile chiefs, his hitherto straightforward career in medicine underwent what was considered in 1953 a remarkable sea change. John had, as a medical student in the war, been put in charge of wards for the ‘chronic sick’ in the North East London Sector Hospitals. He was shocked by what he found. Accordingly, on leaving the Royal Air Force, he opted to join the embryonic specialty of geriatric medicine. Few would then have forecast that it would, within 45 years, become the largest single medical specialty.

His consultant career began in Bradford, where he single-handedly looked after the needs of 730 in-patients. These needs included proper warmth and shelter from the rain. John had to threaten the authorities with press disclosure of the appalling conditions before the roofs were rendered watertight and the heating made adequate.

Five years later, in 1958, he moved to Suffolk. Here he found 520 in-patients, the vast majority in peripheral workhouses, three of them impressive Georgian buildings, and all unsuited to modern treatment and rehabilitation. He was allocated six beds in the acute hospital in Ipswich and 20 beds in a nearby chest unit. With his customary energy he set about upgrading and refurbishing the peripheral units and introducing active rehabilitation - achieving a six-fold increase in bed usage. He identified the importance of full examination, investigation and assessment of elderly people and, despite not inconsiderable opposition, planned, argued for funding, and opened 50 acute beds at the new district general hospital site in 1967. Ten years later, and as a result of Agate’s persuasion, the charity Help the Aged funded the capital cost of a 50 bed rehabilitation and outpatient unit at the site - the Hayward unit.

All this was achieved by skilful championing of his beliefs. He wrote, broadcasted and was a member of several committees, including the DHSS standing medical advisory committee and the Central Health Services Council. He served on the latter’s liasion committee with the Social Service Council for four years. He was a foundation member of the geriatrics committee at the College and in 1965 organized its first two day seminar on medicine in old age.

He was treasurer of the British Geriatrics Society for ten years from 1956 and chairman of the executive committee for three years immediately thereafter. He started the East Anglian branch.

He wrote three medical books, the first of which The practice of geriatrics (London, William Heinemann Medical Books, 1963) went to two editions and became the definitive textbook of the time. Geriatrics for nurses and social workers (London, William Heinemann Medical Books, London, 1972) arose out of his interest in multidisciplinary working. Taking care of old people at home (London, Unwin Paperbacks, 1979) followed. He contributed to some eight multi-author texts and went on to edit four others. He also wrote articles, original papers and numerous reviews in various journals. He edited Modern geriatrics (later Geriatric medicine) for four years and was a board member and book review editor for Age and Ageing from its inception.

John Agate would have had a successful career in any specialty he had chosen. Geriatric medicine’s gain was industrial medicine’s loss. He had high standards and expected them of others. The patients, their history and physical findings came first and woe betide junior colleagues who relied too heavily upon laboratory results or imaging techniques. He had a short fuse, but was essentially a kind man with a nice sense of humour. He did not spare himself and was a martyr to back pain which necessitated a shooting stick for ward rounds. Examinations of patients often had to be performed kneeling.

Outside medicine his interests were wide. He particularly liked music, especially choral singing. He also enjoyed pottery (he had his own kiln) and cars (he once competed in the Monte Carlo rally). He used his interests in writing, church furnishing and photography to write a book on benches and stalls in Suffolk churches. He married Hester in 1946. They had a son and daughter.

Bryan Moore-Smith

[The Independent 20 Nov 1998;The Times 26 Nov 1998;Brit.med.J.,1999,318,401]

(Volume XI, page 3)

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