b.25 January 1918 d.25 February 2001
BM BCh Oxon(1943) MRCP(1948) FRCP(1970)
Donald Garrow was a paediatrician whose interests in the care of infants and children were much wider than the identification, prevention and cure of disease. In particular, his determination that newborn infants should not be separated from their mothers led to the design of the special care baby unit at Wycombe Hospital, where mothers are routinely admitted to the unit itself with their ill newborn. The unique atmosphere created in this unit in turn led to a deeper understanding both of the distress of families when infants die, and the feelings surroundings the birth of a disabled infant where the quality of survival is uncertain.
Donald trained at Oxford and the London Hospital. After house jobs he saw wartime service in the navy in the far east. After demobilization he worked at Oxford, Great Ormond Street and Hammersmith hospitals. While at the Hammersmith he witnessed the very early exchange transfusions, and used to delight in describing this great advance, and the very long time it took to isolate and catheterise the umbilical vein, now a procedure done in less than a minute in the emergency situation. He always did his own exchanges, ensuring, of course, that the parents knew what was going on, and hoping that they would be present.
He was senior registrar at St George's Hospital Tite Street. It was there that he developed his interest in respiratory diseases, writing a number of review articles. He recognized the frequency of mycoplasma pneumonia, developing a single rapid bedside test for cold agglutinins.
He was consultant paediatrician at Amersham hospital, and later Wycombe, when the paediatric department opened, from 1962 until his retirement in 1983. Initially single-handed he developed the South Bucks paediatric service. It was at Amersham that Dermod MacCarthy's [Munk's Roll, Vol.VIII, p.300] liberal visiting policy had led to the concept of mothers living in hospital with their children. Donald was of a like mind, and the whole department developed round the concept that ill children should not be taken from their families: mothers should stay in hospital; dying children should be at home; children having anaesthetics or practical procedures in hospital should have a parent with them. To establish practices such as these, surgical, anaesthetic, general practitioner and midwife (among other) boundaries had to be crossed. Donald was passionately convinced that he was right. He needed this conviction together with his great charm and perseverance to change the practice of others particularly in the conservative sixties and seventies.
The design of the special care baby unit at Wycombe hospital was his most important innovation. Purpose built mothers' rooms are integral to the unit, enabling the mothers to be involved with their babies from the moment of birth, regardless of the degree of intensive care needed. It was in the special atmosphere thus created that a nurse, Jenni Thomas, observed the feelings of mothers who had lost their babies, and went to found the Child Bereavement Trust. It was here that Donald formulated his ideas that, when life threatening congenital anomalies might best remain untreated, that the family should be totally involved both in the decision making process and the care of their infant.
He strongly believed that clinicians should undertake research. As a single-handed paediatrician he did not just employ research assistants. He was interested in the importance of toxocara infestations in childhood illnesses. He looked down his own microscope for larvae. He studied breathing patterns in the newborn, and was often in the baby unit attaching thermistors to infant nostrils. Throughout his life he was always interested in new ideas and new techniques.
He had a great respect for the natural history of disease, suspecting surgical or medical interventions unless there was evidence of efficacy. He trenchantly opposed most tonsillectomies and circumcisions, was suspicious of the increasing trend for induction of labour and thought that most childhood urinary infections were over investigated. He delighted in arranging meetings where the exponents of new techniques were exposed to impartial analysis.
As a young man he had been an outstanding sportsman, representing Oxford at golf and skiing. He was in the British Olympic ski team in 1948. He was keen all his life, playing golf into his eighties and defeating his younger colleagues (including the writer of this memoir) at tennis into his seventies. A keen musician he played the flute in the Misboume orchestra, to his patients, and at musical parties at his home.
A gregarious man, full of energy and fun, he and his wife Ros entertained widely. Colleagues, patients and staff were often invited to dinner, games and garden parties, and all enjoyed the experience.
His final illness was acute myeloid leukaemia. He fully understood what was happening, discussing it openly with his doctors, accepting his end with great dignity. He was a man who understood that medical science has a limited place in the way that we order our lives.
C H Cheetham
[Brit.med.J., 322,2001,1548; TheTimes 3 May 2001]
(Volume XI, page 214)
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