Lives of the fellows

Robert Manoah Kark

b.29 August 1911 d.24 September 2002
MRCS LRCP(1935) DCH(1937) MRCP(1937) FRCP(1953)

Robert ('Googoo') Kark, rugby centre and diagnostician extraordinaire, was an officer in military counter-intelligence whose cover as professor of medicine earned him international distinction for teaching and research.

Googoo was educated in Cape Town, at Perse School, Cambridge, in Vienna, and at the University of Cape Town. The interview for Guy's Hospital Medical School presaged Doctor in the House: "How is your rugger playing?" When 'Two-Step Kark's' team won the championship, his wife Julia danced on tables in a Piccadilly pub and kicked off a Bobbie's hat, getting Googoo arrested. He pleaded to drop charges: his father would have stopped the money for his medical career if Googoo was sentenced.

After being Sir Arthur Hurst's [Munk's Roll, Vol.IV, p.509] registrar, Googoo was sent off to learn research. A Rockefeller fellowship supported him at the Boston City Hospital, where he helped fortify bread with B vitamins and helped discover vitamin K. When the Second World War started, he joined the Royal Canadian Armed Forces, installed oxygen tanks in US fighter planes, and invented the single-pane goggle (now used for scuba and skiling) because First World War double lens goggles limited fighter pilots' peripheral vision. He was in charge of security for airplanes that were to fly Churchill to meet Roosevelt and, early one morning, found the oxygen lines to passenger compartments destroyed. He repaired them, and ensured that the German agent, an RCAF pilot, did not return from his next mission.

A general claimed pemmican to be the best field ration. Googoo and Dr Kelley devised a better one, though unpalatable. To test it, 100 recruits from Miami parachuted into the Arctic in a blizzard. None had seen snow - their survival depended on following manuals. Three days later, Googoo's team could find no metabolic differences between groups of recruits. Photographs depicted the first group huddled around a campfire in the wind chewing pemmican next to piles of large branches. The second group, miles away, had built the frame of a shelter from branches and had piled pine brush nearby. They, too, huddled by a fire in the wind eating 'in-between rations'. The third group was comfortable in a wind-proof shelter enjoying a fire at its mouth, eating the 'best' ration. The Pentagon adopted 'Kark-Kelley rations'. The two researchers were irate: would generations of soldiers curse the family names? The compromise was 'K-rations', now with a chocolate bar for taste and extra calories.

Seeking battle, Googoo became chief medical officer to Lord Mountbatten's Allied Land Forces in Southeast Asia: to go behind Japanese lines in the Burmese jungle and identify enemy units unable to fight because of beriberi. Googoo's priority was too low to fly quickly from Cairo to India. A shipment of kangaroo rates had to reach Burma to identify trails of scrub typhus - the jungle version of canaries in a mine. Rat-keeper Googoo left on the next flight.

Before he and a detachment of Gurkha Rifles could get into the jungle, the entire regiment stopped eating (canned) meat. The prior shipment had been labelled 'goat meat, male', the recent one, merely 'goat meat'. The Gurkhas thought it was a mix of male and female meat. Gurkhas could only eat goat; eating female goat when at war would destroy their fighting spirit. Googoo rushed an ink sketch to his cousin Bernard in Bombay and a few days later, when 1,000 new labels arrived with the image of a priapic goat, Googoo and another officer spent the night affixing them to the cans.

On returning after the war, there was concern lest the Soviets invade North America across the Arctic ice. To assess this, Googoo led a brigade of tanks through the Arctic from Labrador to the Yukon in the winter of 1945-6, after growing vegetables for the trip by hydroponics on the shore of Goose Bay in autumn. One tank was lost crossing an all-but-frozen lake. The groups spent 18 hours a day caring for tanks, whose metal became brittle, grease sticky glue, and rubber cracked in the extreme cold. They spent three hours cooking and eating, three hours sleeping: no time to fight. Throughout the Cold War the area was defended with radar installations, not tanks or troop-carriers.

Googoo joined the metabolism and nutrition unit at the University of Illinois, Chicago, in 1947, and became full professor in 1950. Meharry Medical College, an Afro-American medical school in Nashville Tennessee, asked him to spend six months improving their courses. He convinced Vanderbilt to help teach at Meharry, and their faculty still does. In Chicago, Googoo studied liver disease by posterior biopsy and got a pathology report of 'normal glomeruli'. Professor Borg of Copenhagen showed him a better approach, and his group did some 3,000 kidney biopsies at Illnois and the new renal and nutrition unit of Rush-Presbyterian-St Luke's medical center in Chicago. They discovered various types of glomerulonephritis, including lupus nephritis, and other, distinct renal diseases, many with specific treatments. Googoo trained fellows from the United Kingdom, the British Commonwealth, Western Europe, and Asia and for several decades headed courses in history and physical examination at both medical schools. The fellows contributed greatly to the work on kidneys, including biopsies of the response of kidneys to high altitude: the result of an expedition to the Peruvian Andes in the 1960s. Many fellows and students remember him particularly for teaching about fine wines and illustrating this at dinner parties he and Julia gave regularly.

Googoo became a governor of the American College of Physicians and instigated a bond between it and the London Royal College. Accordingly, Lord Brain gave the American College a sterling replica of the College's mace. Googoo got it through customs as a 'medical instrument' lest thousands of dollars of duty be paid. He founded the American Association for the Study of Liver Disease, served in state and national societies for medical research, and helped edit The American Journal of Medicine, the Journal of Laboratory and Clinical Medicine, the Journal of Clinical Nutrition and Nephron. He was a member of US Army, NIH and private foundations' panels to review research, and, in 1976, became a regent of the American College of Physicians, chairing its first committee on medical ethics and earning mastership.

All the while, Googoo worked on counter-espionage with the US Army. He remained closed-mouthed about that to his death, but identified at least one Soviet spy in Chicago. An expedition in 1957 to evaluate nutrition and health in the Libyan Army was cover for a mission to identify and remove a Soviet agent there.

Retiring from the renal unit in 1973, Googoo started the geriatrics division. The Commonwealth Fund helped him and Julia study the life of Sir Richard Bright [Munk's Roll, Vol.III, p.155]. They found that Bright's drawings of neurological pathology foreshadowed Charcot, and that Bright, Addison and Hodgkin together at Guy's devised in the 1840s our current method of recording data about patients: chief complaint, history of present illness, past history, social history, family history, review of symptoms system by system, vital signs (first measured scientifically), description of the patient's unique appearance in one sentence, and examination systematically from head to toe. There was confusion between Richard Bright proper ('the Greater') and a namesake who cashed in for quackery: 'the lesser'. On a trip for the purpose to Bright-the-Greater's descendents in Melbourne, Googoo and Julia discovered numerous letters and papers. These have stimulated doctoral theses about medical history, 19th century West Indian trade, and similar topics.

Googoo went to Guy's for a year on a Guggenheim fellowship. He gave the Harveian Lecture, the Fitzpatrick Lecture, and other named lectureships in the Commonwealth, Japan and the United States. On obligatory retirement in 1982, he became distinguished emeritus professor of medicine at Rush and section chief of geriatrics at the Hines Veterans Administration Medical Center where he continued to teach until age 85.

Googoo remained a gourmet, wine connoisseur, and an avid swimmer and athlete to the end, catching a ten pound salmon with a barbless hook in the Canadian Pacific on his 89th birthday and celebrating with a superb dinner and excellent Bordeaux at the Union Club of Victoria.

Pieter Kark

(Volume XI, page 305)

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