Lives of the fellows

Harry Fortescue West

b.23 May 1910 d.23 April 2001
MB BS Lond(1936) DTM(1937) MRCP(1947) MD(1948) FRCP(1960)

Harry West was a consultant physician in Sheffield, where he set up a centre for the investigation and treatment of rheumatic diseases. He was the son of a physicist. He was born and grew up in Eltham. Having left school early, he worked for a time in a chemist's shop, and then decided to be a doctor and trained at King's College Hospital where he won the senior scholarship.

After qualification he was house surgeon at King's College Hospital and later at Essex County Hospital in Colchester. At King's he met Elizabeth Honor Western and they married in 1937. After studying together at Liverpool School of Tropical Medicine they set sail for Transjordan where Harry, supported by three large tomes on operative surgery bought with his scholarship money,became surgeon-in-charge of a Church Missionary Society Hospital. Elizabeth was the anaesthetist and paediatrician, and they worked there for three years.

After the outbreak of the Second World War, against the Bishop's wishes, he joined the Arab Legion, and later at his own request was transferred to the RAMC. He served in a Druze regiment, followed by postings as malaria field officer at Tabgha, and than as OC at the Transjordan Frontier Force Hospital at Zerka.

He and Elizabeth returned to England in 1945, and after demobilization in 1946 Harry became honorary clinical assistant at the Bristol hospitals, and from 1946 to 1949 he was physician-in-charge of the student health service, during which time he obtained his membership of the College and his doctorate.

He became interested in rheumatic disease and published evidence for the hereditary nature of ankylosing spondylitis, after which he became known in the emerging field of rheumatology.

In 1950 he was appointed consultant physician in Sheffield with the express purpose of setting up a centre to investigate and treat rheumatic diseases.

At that time the clinical excitement was the remarkable effect of cortisone on the symptoms of rheumatoid arthritis, and Harry West decided that his research should be directed to the possible role of corticosteroids in the course and management of rheumatic diseases. To this end, in addition to clinical services he set up a research laboratory, staffed by chemists, in Netheredge Hospital where the inpatients were treated. In the wards research mainly took the form of therapeutic trials. In the laboratory he and his team soon gained an international reputation for their work on the identification and quantification of corticosteroid metabolites. Their method for the analysis of 17-hydroxycorticosteroids was widely used for assessing the function of the adrenal cortex, permitting relatively safe treatment with adrenocorticotrophic hormone.

Harry West was among the first to emphasise the disastrous effects of overdosage with corticosteriods, and was able to establish the largest possible dose of prednisolone that could be taken without causing significant adrenal suppression, and that a daily dose within that limit was relatively safe.

He was quick to realize the potential of gas chromatography and combined gas chromatography with mass spectrometry for the analysis of steroid hormones. His laboratory was responsible for much of the pioneering work in using these analytical techniques for the trace measurement of corticosteroid metabolites in biological fluids. He became interested in the possibility that cortisol was metabolised to a significant degree in extra-hepatic tissues, and in fact provided evidence that it was so from studies on saliva and synovial fluid.

He was disappointed that his work did not contribute more to our understanding of the cause of rheumatoid disease, but during the twenty years as director of the rheumatism research unit in Sheffield he published over 60 scientific papers, and played a major part in our knowledge of the secretion, disposition and metabolism of corticosteroids in the normal and in patients with rheumatoid disease.

He was a member of the Endocrine Society and of the Heberden Society. He was president-elect of the latter during his last year before retirement and so never held the office. He retired when aged 60 and as is often the case in those who have been totally absorbed in their professional work, he lost interest in the continuing activities of the hospital unit he had established, but he retained a close personal interest in his former staff. For a time horticulture became his ruling passion, and physical exercise was taken first in a large garden at his new home in Axminster, and from 1982 onwards in maintaining a 29 acre estate at Widworthy near Honiton, where he planted over 2000 broad leaf trees.

Devotion to his garden and grounds endured, and he fulfilled his commitments to them up to the day before he died, but a new interest began to fill the spare hours. He read extensively books that many would regard as difficult, and became what he described as an active natural philosopher. His great regret was the extent to which good science was turned to bad ends, and his recurrent example was its misapplication to the cause and prosecution of wars. He sought to rally ordinary people everywhere to take particular care in choosing their representatives in government. He wrote his first paper on these themes in 1976, and subsequently wrote 15 more and distributed them widely, especially to teachers. His last paper was dated March 2001.

Harry West's tolerance to the failings of others may have been partly due to his oft repeated belief that no man was better than he had to be, which is impossible to disprove but the example he set in his own life at least cast doubt on its absolute truth. His personal standards were very high, but he had enough redeeming defects to make him always comfortable to be with, indeed endearing for he was entirely without meanness. He died in his sleep.

G R B Newns

(Volume XI, page 613)

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