b.28 March 1920 d.22 July 2000
Kt(1978) OBE(1953) BM BCh Oxon(1945) MRCP(1947) MD Johns Hopkins(1951) DM(1958) FRCP(1961) FACP(1974) MD Cantab(1975) Hon LLD Nottingham(1977) DMedSci Keio Japan(1983) Hon MD Chinese Univ of Hong Kong(1989)
John Butterfield cared as much for individuals as for groups of people. Although he progressed academically from doctor to professor, master of Downing College and eventually to vice-chancellor of Nottingham and Cambridge Universities, and was awarded the ever grander public honours of a knighthood and a life peerage, he remained John to all those who had the good fortune to work with him and get to know him, and he was always accessible for advice and practical help.
He was also, first at Guy's Hospital in London and later at Cambridge University, a role model for the modern multifaceted professor of medicine: committed to patient care, planning clinical research and raising funds for it, refreshing the aims and practices of medical education and nudging the traditional ways of university administration into more contemporary ways. A primary commitment to the welfare of his patients tempered the design of his clinical research experiments so that they were conducted with the patient rather than on the patient. (This was in the days before clinical research ethics committees demanded evidence that the patient had given informed consent to the research procedure.)
His openly stated striving for excellence helped him to promote the good in everybody, and in the non-hierarchical atmosphere of his department, where everybody, from the most senior lecturer to the most junior technician, was free to express his opinion, everybody wanted to do his best at all times in any case.
Excellence was also detectable in his personal career from an early date. In his undergraduate days at Oxford he obtained blues for cricket, rugby and hockey and also gained a scholarship for Johns Hopkins Hospital in the United States. On the way there, the ship in which he was travelling was torpedoed and John spent several hours on a raft in the Atlantic Ocean before being rescued. Having lost all his possessions, he readily accepted the invitation from a bookshop in Baltimore to speak about his experiences for a modest fee. Some years later, when applying for a visitor's visa to the United States, he had an uncomfortable time convincing the American consul that he had no idea that the bookshop had at the time been under surveillance as a suspected communist front organisation.
After a few years' research on burns for the Army and the Medical Research Council, Butterfield was appointed professor of experimental medicine at Guy's Hospital for an experimental period of five years. Guy's had never had a full-time clinical professor before and this was their first tentative step in that direction. It proved a complete success and in 1963 he was appointed to full professorship at the University of London to be held at Guy's Hospital Medical School.
By then his interest had focused on diabetes and the metabolic changes that occurred in muscle and their effects on blood flow. He refined the techniques of measuring blood flow which had been employed by physiologists since the days of William Harvey and brought the measurement of blood glucose up to date by using automatic analysers, sampling blood continuously from the artery that supplied the forearm muscles and fat, and from the vein draining the tissues. To ensure that the patients who volunteered for these investigations were fully informed participants, he conducted all these experiments in full view of every patient in the ward; there were no curtains or screens to hide anything. He never had a refusal when he invited a patient to take part in one of these experiments.
The study of diabetes gave Butterfield not only the opportunity for physiological investigations, but also stimulated his wider interests in the effects of ill health on behavioural and social aspects of populations. An early manifestation of this interest was the Bedford survey in 1962, when all the residents of Bedford were screened for diabetes by testing a specimen of urine which they had been asked to leave on their doorsteps one Sunday morning in a container supplied by the Guy's team. The impetus for this study came from the medical officer of health for Bedford who had come to see Butterfield to enlist his help in screening the people of Bedford for glaucoma. By the time he left a couple of hours later, he had enthusiastically embraced Butterfield's counter proposition to screen the whole population of Bedford for diabetes. (The glaucoma study was eventually carried out a few years later.)
This ability to make individuals feel, after discussion, that what Butterfield wanted was exactly what they themselves wanted, was not the result of steamrollering to impose his own views, but arose from a genuine desire to help. And it was his ability to grasp the essential point of the argument and his gift of being able to explain in a few clear sentences the purpose of the investigation and how to carry it out, that won people over to his point of view. It was also his ability to explain complex concepts in a few sentences and illustrate them with a few simple lines on a piece of paper or on the blackboard which endeared him years later to the House of Lords, when advances in the genome and many other aspects of medicine were leaving some their Lordships floundering.
He was as successful in dealing with groups of people as with individuals. An example of this occurred shortly after his appointment as vice-chancellor of the University of Nottingham in 1971, during a period of student unrest in many universities in the United Kingdom. One day his office was occupied by a group of vociferous students demanding to know what records he kept on who was co-habiting with whom. Butterfield pointed to a couple of filing cabinets in his office, then commented that if he really kept records on students' co-habitation, his office would be so full of files he would not be able to get in. This brought the occupation to a rapid close amongst much laughter. Yet he was seriously concerned about their lifestyle and health, and the VC's residence became known in Nottingham as 'Bedside Manor'. Some years later, as vice-chancellor of Cambridge University, while on a visit to Norway with a medical delegation, he heard that the Falkland conflict had started and a number of Cambridge students were being drafted into the services. He immediately left Norway to return to Cambridge because he felt it was his duty at such a time to be at the side of his students.
When he became vice-chancellor of Nottingham, the university was just introducing a clinical medical school in addition to the three-year pre-clinical course which it had been running for some time. He threw himself into the planning and implementation of this course with great enthusiasm. This experience stood him in good stead when, in 1975, he moved to Cambridge as regius professor of physic, where a clinical school was under consideration by a reluctant university. His negotiating skill and evident striving for excellence has resulted in the creation of one of the best medical schools in the United Kingdom. His interest in the medical school did not wane when his duties enlarged as he became master of Downing College and vice-chancellor at the University of Cambridge. His advice was also sought abroad, notably the Chinese University of Hong Kong. It was inevitable that such an affable, erudite and multitalented individual would be much in demand as member and chairman of a multitude of committees and trusts and be invited do deliver prestigious eponymous lectures all over the world.
John had great style. In 1958 when he began to build his academic team at Guy's he offered me the post of senior lecturer in a brief note which simply read, "see Mathew 11 v3". On checking in the Bible it said, "Art thou he that shall come or do I look for another?" How could one not have accepted such an offer! In London he lived in an elegant Queen Anne house on Richmond Green, where he organized departmental cricket matches and picnics. In Nottingham and Cambridge his wife (Isabel) made the VC's lodgings into centres of cultural and intellectual excellence. Important dates in the calendar, such as the Oxford-Cambridge rugby match, Wimbledon, Henley and of course cricket matches at Lord's, were always occasions when the department went out as a group and this made for coherence and friendship. He spurned the use of a conventional briefcase, carrying bundles of papers and notebooks in fine weather in a wicker flower basket, and in a nylon string bag when it rained. His entry in Who's who reflected his style well. He gave his recreations as "tennis (real, not lawn), cricket (village) and talking (too much)".
John Butterfield remained a warm and constant friend, ever ready to support and encourage. He spotted those who floundered as well as the high fliers and spent much of his time and effort to encourage them and guide them. His office door was always open, and no one hesitated to walk in and ask for advice.
[The Guardian 26 July 2000; The Daily Telegraph 26 July 2000; The Times 27 July 2000; The Independent 1 Aug 2000; Brit.med.J. 2000,321,836]
(Volume XI, page 83)
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