Lives of the fellows

Alexander Macdougall Cooke

b.17 October 1899 d.5 January 1999
BA Oxon(1920) BM BCh(1923) MRCS LRCP(1924) MA(1926) MRCP(1926) DM(1933) FRCP(1935)

Alec Cooke was one of the most admired and best loved physicians of his time. This high regard came from his individual qualities rather than public position or research production.

His medical career was divided between Oxford as an undergraduate and consultant and St Thomas’s Hospital as a student and registrar. He was educated at Merchant Taylors’ School and then won an exhibition at Jesus College, Oxford, but before he took it up he joined the Royal Flying Corps. Fortunately the war ended just before he could join the fighting and he was able to go up to university at once.

He did very well as an undergraduate, gaining a first class degree in animal physiology and becoming for a short time demonstrator in the department of the professor, Sir Charles Sherrington [Munk’s Roll, Vol.IV, p.523]. He did equally well as a clinical student at St Thomas’s where he won two prizes. After qualifying BM in 1923 he was appointed to various junior offices, up to resident assistant physician. He worked on the medical unit and showed a particular interest in metabolic medicine. He expected to get on the consultant staff, and was expected by others to do so, but to his surprise did not, instead he was appointed in 1932 May reader in medicine and consultant physician at the Radcliffe Infirmary, Oxford. In retrospect he thought this the luckiest day of his life. Certainly he found the relaxed atmosphere of Oxford medicine more to his taste than the smart, tight competitive air of London consultant life.

The clinical school at Oxford was then rudimentary but when war came in 1939 things changed quickly and Alec Cooke’s responsibilities for teaching and organization enlarged. His marvellous ability for clinical teaching became apparent to all, especially the preclinical students. On Tuesday and Friday afternoons he gave clinical demonstrations that enlivened their pre-clinical work, which, though of the highest level, was apt to seem remote from their chosen careers. Many of the students could remember Alec’s demonstrations decades later.

In those days specialization in clinical medicine was rudimentary compared with its later development. The medical consultants at the Radcliffe consisted of four general physicians who, with the medical unit under L J Witts [Munk’s Roll, Vol.VII, p.618], took their turns on medical emergency ‘take’. Only one, besides Alec, professed a specialty, cardiology (except neurology, clearly a very separate entity). Alec’s interest in metabolic medicine turned him towards diabetes when the hospital decided it needed a specialist service. He gave it his characteristic interest and enthusiasm to the benefit of patients; this was at a time when the long-term hazards of the disorder were coming to be recognised.

Alec Cooke’s qualities were recognised by outside bodies, universities and, particularly, the Royal College of Physicians, where he became in 1943 examiner, Langdon-Brown (1968) and Lumleian lecturer (1955), censor and senior censor in 1959. His Lumelian lecture on orthopaedic aspects of medicine, particularly osteoporosis, was entitled The bare bones of medicine, symbolizing what he felt would be left of medicine after the specialists had had their pick.

Throughout his clinical career he remained a general physician in the best sense. His focus was always on the patient, not the disease. He did not recognise ‘cases’, only sick people. He brought to his work - and to his life - qualities which were not unique in themselves, but together made up a remarkable combination. His sympathy, enthusiasm and wit were intense; the result was a distillation of precepts and witticisms which became widely known. A few examples, to which I know no exceptions - "it takes longer than you think", "it costs more than you think". One of these pithy remarks reveals something of his character as well his brain. He had had a wisdom tooth extracted and his face swelled greatly - "don’t worry" he was told "this is only a minor operation", which led him to make the classic remark, "a minor operation is an operation done on somebody else".

He couldn’t help being interesting and amusing in his conversation and writing. He wrote easily and beautifully. His two short books, one published by the College My first 75 years of medicine [London, Royal College of Physicians, 1994] and the other privately The Cooke’s tale [Oxford, 1991] are a delight - and an astonishment in their span and scope. His experience of medicine was from the introduction of raw liver for pernicious anaemia ("whatever will they think of next" was his reaction) to molecular medicine. It was entirely appropriate that Sir David Weatherall and his colleagues should ask him to write the introduction to their great new textbook The Oxford textbook of medicine [Oxford, Oxford University Press, 1983], the last word in modern medicine being introduced to today’s students by an octogenarian.

Alec Cooke was not one of the modern breed of committee-sitting, world-travelling doctors. He remained an accessible practising clinician all his professional life, yet he was as widely known and admired as any of his colleagues. This was not from any office he held or honour bestowed, but from sheer personal quality. He could have made a success in any branch of medicine. He was certainly bright enough to have succeeded in research if the circumstances of his life had pushed him that way, eg if he had been appointed to the chair at St Thomas’s, or in consulting practice, but I cannot think that he would have been happier or more productive and appreciated. His professional and personal life seemed ideally suited to him, and he to them. He contributed much to others and they knew it. His juniors and his students learnt so much from him that helped them all their lives and loved him so much that all were deeply influenced by this wonderful man - this is written by someone who became his registrar in 1952, knew him for 47 years and never forgot what he learned of life and medicine from him.

Perhaps the secret of his character was his zest for life. At his 90th birthday he said "I don’t deserve it but I do enjoy it - I should have been furious if I hadn’t been born", a typical Cooke remark.

For 27 years he was on the editorial board of the Quarterly Journal of Medicine. He wrote the third volume of this history of the College, covering the period from 1858 to 1948. He was an examiner to several outside bodies, gave many lectures and wrote many medical papers.

Alec Cooke married Vera Lea in 1928. She died in 1984. They had one son and three daughters, one of whom predeceased him.

David Pyke

[Oxford Medical School Gazette, Vol.L, p.28; Brit.med.J., 1999,318,540; The Times 5 Feb 1999; The College Commentary Jan/Feb 1999]

(Volume XI, page 127)

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