Lives of the fellows

Richard Worthington Smithells

b.4 July 1924 d.13 June 2002
MRCS LRCP(1948) MB BS Lond(1949) DCH(1950) MRCP Edin(1955) MRCP(1956) FRCP Edin(1969) FRCP(1969) MD(1985) FRCOG(1994) FRCPCH(1996)

Dick Smithells was head of the paediatric department at Leeds from 1968 until his retirement in 1988, during which time, largely as a result of his activity, the department achieved a high reputation nationally and internationally. His outstanding achievements in research into disease prevention were linked throughout with his practical concern and care for the individual child in need.

He was born at Bushey, in Hertfordshire, but throughout his life had a close association with Leeds. His great uncle and grandfather had been professors of chemistry at Leeds and his father was a Leeds graduate. He was educated at Rugby School and St Thomas’s Medical School, and after a two year period of National Service with the RAMC in Germany, his middle grade hospital posts were in Leeds and Bradford. After two years as a senior registrar at Guy’s Hospital, he was appointed a lecturer and consultant paediatrician in the department of child health at the University of Liverpool in 1959 and in 1963 became medical superintendent at Alder Hay Hospital.

On his appointment in 1968 to the chair of paediatrics and child health at Leeds, he worked in all the Leeds hospitals, but in the early 1980s the General Infirmary became his centre of activity. He established in his department a range of specialist regional services for children including the first genetic counselling service in Yorkshire.

In his inaugural lecture following his appointment at Leeds, entitled ‘Better babies…’, he outlined his aspirations for the welfare of children. He pointed out that there were three hazards to the life of the newborn baby – being born too soon, being born too dangerously, and being imperfectly formed. The lecture emphasized his research interests, which addressed the question of infant morbidity – making better babies through prevention and diagnosis in the prenatal period, rather than depending on the effects of treatment for disability already established at the time of birth. His concern for children was not restricted to that stage of development, however, as was shown later in his lecture when he stressed the powerful influence of the environment in which a child grows up – notably the family and the school.

Dick’s outstanding research interests into the prevention of disease and in particular congenital malformations, such as those associated with thalidomide, began when he was at Liverpool. While there, he wrote four key papers, on neural tube defects, congenital abnormality registers, genetic counselling, and rubella in pregnancy. By 1962 he had already established a genetic counselling service and a congenital abnormality register in Liverpool. The latter was a remarkable achievement requiring extensive knowledge of paediatrics, drive, determination and planning and an ability to communicate his enthusiasm to others and gain their cooperation. This enthusiasm has been an important feature of every aspect of his life and work.

Dick recognized early the significance of poor nutrition as a factor responsible for congenital malformations and his most notable research was into the possible link between vitamin deficiency and neural tube defects. These studies spanned many years in Leeds and were reported in several publications. It was, however, not until 1991 that the report of the Medical Research Council fully endorsed his findings by recommending that public health measures should be taken to ensure that the diets of all women who bear children should contain an adequate amount of folic acid. Dick also coordinated rubella vaccination in the north of England and demonstrated its value in reducing the incidence of babies born with disabilities as the result of maternal rubella.

The importance of Dick’s work was recognized by many prestigious national and international awards. The most notable were the Harding award (from Action Research for the Crippled Child) in 1985, the James Spence medal (the premier award of the British Paediatric Association) in 1992, and the Kennedy Foundation international award for his work on the role of folic acid in preventing neural tube defects in 2000.

Dick’s concern for children extended far beyond the area of research. He was an outstanding clinician of the old school with a broad knowledge of the whole of paediatrics and a compassion and concern for the wellbeing of all his patients and their families. His involvement in the care and support of children was evidenced by his part in the struggle to secure compensation for children disabled by thalidomide and his crucial role within the Thalidomide Trust. He also served on the executive committee of the NSPCC, as medical adviser to the Family Fund and on the committee involved in the development of Martin House Hospice for Children, to name a few.

In retirement he continued to promote the wellbeing of disabled people, to support research and to teach, examine and advise on child health services in Britain and abroad. His recognition of the special place of children within the field of medicine led to his very active involvement in the creation of the Royal College of Paediatricians and Child Health, ultimately established in 1996.

As a teacher, Dick was outstanding. By his example, through his clinical approach and skills, many students of all levels, as well as senior colleagues, learnt much. He was co-author of Lecture notes on paediatrics (Oxford, Blackwell Scientific, 1973) – a very successful student textbook, which ran to seven editions. He had a masterly ability to communicate both through the spoken and written word and was much in demand as a public speaker, committee member and chairman. He was highly respected as the leader of a team and a great supporter of others. He demanded that those who worked with him followed the same high standards of integrity and commitment he set himself: he would not tolerate dishonesty or laziness.

Dick had an outgoing, sociable personality and was extremely hospitable. He had a keen sense of humour, free from cynicism or sarcasm. His humour and poetic ability were well illustrated by his book of poems for children, the proceeds of which went entirely to the NSPCC.

He had many outside interests, notably walking and enjoying nature and the countryside, particularly in the Lake District where for many years the family had a holiday home. Throughout his life he was a committed member and supporter of the church and in retirement he became an enthusiastic and knowledgeable bellringer. He was above all a family man and placed the highest importance on the family, both in society as a whole but essentially in his own family. He married Joy in 1948 and they had great pride in their five children and 11 grandchildren. Despite his many commitments, he never neglected to give his time and interest to his family.

John Buckler

[Brit.med.J., 2002,325,445; GKTGazette Sept 2002]

(Volume XI, page 532)

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