Lives of the fellows

Sheila Patricia Violet Sherlock

b.13 March 1918 d.30 Dec 2001
DBE(1978) FRS(2001) MB ChB Edin(1941) MRCP(1943) MD(1945) FRCP(1951) MRCP Edin(1957) FRCP Edin(1958) Hon FACP(1966) Hon FRCPC(1972) Hon DSc City Univ NY(1977) Hon FRCPI(1978) Hon MD Lisbon(1981) Hon MD Oslo(1981) Hon LLD Aberdeen(1982) Hon DSc Yale(1983) Hon FRACP(1984) Hon MD Leuven(1984) Hon DSc Edin(1985) Hon FRCPS Glasg(1986) Hon FRCS(1989) Hon DSc Lond(1989) Hon MD Mainz(1991) Hon MD Barcelona(1991) Hon MD TCD(1992) Hon MD Valladolid(1994) Hon MD Wisconsin(1995) Hon MD Santiago de Chile(1995) Hon DSc Cantab(1995) Hon MD Padua(1996) Hon MD Toronto(1996) Hon MD Oriedo(1998)

Sheila Sherlock was the world's foremost authority on the diseases of the liver and Britain's first female professor of medicine. Born in Dublin, she was brought up in Folkstone and attended its County School for Girls, where she decided to study medicine. All her applications to medical schools were rejected, but in August 1936 she had a late offer from Edinburgh and started there in October. Being dependent on grants and scholarships, she spent holidays working - as a waitress and as a tutor in a 'crammer'. She enjoyed the social life of a student and played tennis for the University; even so, in 1941, she graduated MB BCh (summa cum laude) - top of her class and the Ettles scholar.

As a woman a house job at the Royal Infirmary was denied her. Instead she became clinical assistant to James Learmouth (later Sir James), professor of surgery, who taught her about medical research. Years later 'Poppa', as she called him, travelled to London overnight to inspect (and approve) her fiancé at breakfast, returning later the same day to Edinburgh. When their first child was born he turned up again - with a grouse's foot for good luck!

In 1942 she went to Hammersmith Hospital and the postgraduate medical school as house physician to John McMichael [Munk's Roll, Vol.IX, p.341] (later Sir John, also an Ettles scholar). He taught her liver biopsy (using the technique of Iversen and Roholm). Their paper on the pathology of acute hepatitis (The Lancet, 2 October 1943), with the pathologist John Dible, effectively demolished the theory of 'catarrhal jaundice' attributed to ampullary obstruction by a plug of mucus.

In 1945 she won a gold medal for her MD thesis based on this work. Supported by the MRC, then by the Beit memorial fund, she studied the biochemistry of the liver and its disorders, although biochemistry was never her forte. After the war she investigated the effects on the liver of the malnutrition still to be found in Germany.

A Rockefeller travelling fellowship took her in 1947 to the department of physiological chemistry at Yale, headed by C N H Long, best known for his work on the isolation of ACTH. She returned to Hammersmith a year later as lecturer and honorary consultant physician. She was only 30.

She set up a liver unit. Within a few years she was famous. Research fellows came from far and wide, particularly the USA and the Commonwealth. The output from the unit was prodigious, with papers on many aspects of liver disease. Her major interests then were hepatic handling of glucose, the patho-physiology of the portal circulation, hepatic encephalopathy (she coined the term 'portal-systemic encephalopathy') and the treatment of fluid retention in liver disease.

In 1959 she was the first woman appointed to the chair of a British department of medicine - appropriately at the Royal Free Hospital School of Medicine, which had pioneered medical education of women in Britain. To help in her new unit she took some of her Hammersmith group to the Free including Barbara Billing, Tony Dawson [Munk's Roll, Vol.X, p.101] (later Sir Anthony, treasurer of the College), Stanley Shaldon (who pioneered home dialysis for renal failure while in her department), Roger Williams and Mike Turner, who soon left for the USA.

For 15 years her main unit (offices and laboratories) was at the hospital in Gray's Inn Road - a rooftop wooden hut reachable only via steep ladders open to the elements. The ladders had to be climbed not only by staff, but also by visitors and patients consulting her there. Lectures and seminars were held in another hut accessed across a set of duckboards that protected shoes from the puddles after rain. Excellent work was produced in this rickety and crowded accommodation. The unit grew and other huts were erected - at Gray's Inn Road and at the Lawn Road branch of the hospital in Hampstead. In 1974 the new Royal Free Hospital was opened in Hampstead; the group moved into relatively palatial, purpose-built accommodation that Sheila helped to design - its offices, laboratories and wards occupied most of the tenth floor.

When she first arrived at the Royal Free she was strongly supported by Kenneth Hill [Munk's Roll, Vol.VI, p.239], professor of pathology who was already interested in liver disease (and working on the paper which introduced the term 'acute alcoholic hepatitis'). Other departments started to specialize in liver disease. Peter Scheuer, who became a leading liver histopathologist, started as lecturer in pathology the same day; supervised by Hill, whom he succeeded, he had written an MD thesis on veno-occlusive disease. Sheila's move stimulated other Royal Free colleagues to work on the liver. Liver surgery was performed initially by Phyllis George, later by Ken Hobbs. Good radiology was essential and was provided first by Bill Young, and then by Bob Dick and his colleagues, who made the Royal Free a major centre for hepatic radiology.

Space does not permit mention of more than a few of her many important contributions to hepatology while at the Royal Free. She and her colleagues linked the hepatitis B virus (when it was still the 'Australian antigen') to the development of cirrhosis and hepatocellular carcinoma, and studied the role of sexual intercourse and male homosexuality in its transmission. With Deborah Doniach they introduced the anti-mitochondrial antibody as a test for primary biliary cirrhosis; many papers were produced on this condition and its treatment. They first recognised (in 1971) the benefit of immunosuppression with prednisolone for autoimmune hepatitis. Classic papers were produced on the circulatory changes in the lungs, kidneys and peripheries, on unconjugated hyperbilirubinaemias, on Wilson's disease, haemochromatosis, the Budd-Chiari syndrome, extrahepatic portal vein block, partial nodular transformation of the liver, and primary sclerosing cholangitis.

Sheila wrote, edited and contributed to many books. The one which will always be remembered is Diseases of the liver and biliary system (Oxford, Blackwell Scientific Publications, 1955) which, for eight editions, she wrote herself. It remains a classic, and is translated into at least six other languages. Two or three weeks before she died James Dooley, her co-author since 1993, presented her with a rushed copy of the eleventh edition.

She had an immense impact on the hospital and the medical school over and above the research done in her unit. Leading clinicians and basic scientists from far and wide visited regularly, and participated in the department's educational programme. Her juniors, and other colleagues, interacted with them and were encouraged to meet them socially - either over sherry after a lecture, or over lunch or dinner.

She influenced new appointments at the Royal Free, always insisting that the successful applicant had a strong academic background. She revitalized the hospital's library, supported the medical illustration department, and took a great interest in many aspects of school and hospital life, including the sporting activities of the students. Every Christmas she gave presents to groups providing key services, including the telephonists, post room, porters and medical records staff. In 1990 she was elected president of the Royal Free Hospital School of Medicine.

She was an honorary fellow or member of other colleges, associations and societies world-wide - including the Physiological Society, a rare honour for a physician. She received honorary degrees, prizes and medals from universities and academic organisations in many countries, including the Gold Medal of the BMA. She was president of the British Society of Gastroenterology and edited Gut. She was a founding member of the European Association of the Study of the Liver (EASL), its second president (for the meeting in Gothenburg in 1967), and the first editor of its journal from 1974 to 1979. In 1950 she was one of the first members of the American Association for the Study of Liver Disease (AASLD) and - according to Hans Popper - in July of that year she ran the first international meeting devoted solely to liver disease, a symposium held in London.

The International Association for the Study of the Liver (IASL) was founded in Washington in 1958, during the first World Congress of Gastroenterology. Although absent, waiting the birth of her first daughter, Sheila was elected its first president; Hans Popper became secretary. The first meeting of IASL was held at the Royal Free in 1960.

The two awards that pleased her most were her appointment as Dame Commander of the British Empire (DBE) in 1978, and her somewhat belated election as a fellow of the Royal Society in 2001.

She 'retired' in 1983. This simply meant that she moved her office and her loyal secretary, Aileen Duggan, to the department of surgery and went on working. She regularly attended international meetings. She was a superb speaker, and a spirited contributor to discussions - often as a critic, but never failing to praise a worthy presentation. She continued to travel the world until a few months before her death, although these trips began to take their toll.

Her home life was a rich one. She married Gerry James, also a Fellow of the College, in 1951. She later described him as 'a perfect consort for an academic wife'. It was a wonderful marriage; they celebrated their golden wedding about two weeks before she died with their two daughters, Mandy and Auriole.

Sheila liked the theatre, opera and literature. But she loved sport. She regularly won her unit's annual tennis tournament. A life member of the Kent County Cricket Club, she could, when asked, name the team. Married to a Welshman she understood rugby, but her loyalty in the winter was to Arsenal.

The love, affection, and great loyalty she inspired in those who worked with her were obvious to everyone. She was a mother figure; she maintained discipline but protected her young from the criticisms of others. She fed them a healthy intellectual diet. She and Gerry invited them home, to dine with friends and overseas visitors. Their hospitality was legendary - initially at Willesden, later at Regent's Park and their house at Hythe. She helped when the offspring left 'home' - to run and work at liver units all over the world. And they were always welcomed back at the Free as part of her extended family. At dinners her toast was always 'the internationalization of medicine'; she did more than anyone to promote that concept. For years a large informal group, nicknamed the 'Sherlock Society', has held a dinner to honour her at the annual American liver meeting. The dinners, I am sure, will continue.

She will long be remembered by her fellow hepatologists. She will certainly be remembered at the Royal Free where there is a Sheila Sherlock Postgraduate Centre, and a Sheila Sherlock professor of medicine. Her portrait, by Ruskin Spear RA, commissioned by fellows and friends, hangs in the postgraduate centre; there is a bust of her in the library; and her spirit still pervades the building.

Sheila had a great affection for the College. She and Gerry lived within walking distance at York Terrace East; they often invited people back to the house after meetings. In 1951 she became the youngest woman elected a fellow of the Royal College of Physicians. She spoke there many times and gave the Bradshaw (1961), Humphrey Davy Rolleston (1968) and Lumleian (1978) lectures and the Harveian Oration in 1985. She was a councillor (1964 to 1966), censor (1970 to 1971) and examiner (1962 to 1985). She was later the first woman to be senior censor and vice-president (1976 to 1977), and in 1983 was narrowly defeated in the Presidential election. But Sheila was also proud that she was the first person to have given birth as an FRCP!

Neil McIntyre

[References:The Independent 8 Jan 2002; The New York Times 10 Jan 2002; The Times 18 Jan 2002; The Guardian 19 Jan 2002; The Daily Telegraph 20 Feb 2002;The College Commentary Jan/Feb 2002; Brit.med.J.,324,2002, 174,367]

(Volume XI, page 514)

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