b.18 May 1924 d.16 December 2002
MB BS Lond(1948) MRCP(1949) MD(1952) FRCP(1968) DHMSA(1973)
Peter Fleming was one of the generation of young cardiologists of the late 1950s and 1960s who catalysed modern investigative work into heart disease. He was, however, no narrow specialist, and at Westminster Hospital he devoted much effort to the medical curriculum, whilst at the Royal College of Physicians he was chairman of the part I MRCP examining board. He also had a passion for medical history, on which he wrote a fine book and lectured widely.
Peter’s undergraduate career at the Middlesex Hospital from 1942 to 1948 was distinguished by the award of three scholarships. Appointment as house physician at the Middlesex followed, after which he served in the Royal Air Force for two years. He met his future wife, Kathleen Elizabeth Gimlette, at the RAF station in Aden, where she was a nursing sister. There followed registrar jobs in London, most importantly in the cardiac department of Guy's Hospital from 1955 to 1957, where he was at the forefront of the rapidly developing specialties of cardiology and cardiac surgery. Peter was a bold investigator who performed the seemingly (to others) hair-raising technique of passing a very long needle via the sternal notch down into the chest to measure left atrial pressure (Radner technique). Typically, however, he had studied this method carefully in Sweden and knew it was safe for his patients. He was usually in theatre when Sir Russell (later Lord) Brock [Munk’s Roll, Vol.VII, p.62] was operating, and this often irascible but highly innovative cardiac surgeon came to depend on Peter’s sound haemodynamic advice.
Peter's move to Westminster Hospital in 1957, first as senior registrar and then as senior lecturer in the department of medicine under the aegis of Malcolm Milne [Munk’s Roll, Vol.IX, p.367] gave him scope to diversify his interests whilst remaining a cardiologist. Peter liaised with the department of clinical physiology run by Percy Cliffe, who provided all the measuring apparatus for cardiac catheterisation. He worked closely with the cardiac surgeon Charles Drew who had invented the concept of using deep hypothermia instead of cardiopulmonary by-pass.
As senior lecturer, Peter was closely involved in the revision of the undergraduate curriculum, eventually becoming sub-dean of the medical school and gaining an international reputation as an authority on objective methods of assessment within the field of medical education. He was devoted to the medical students whose welfare and education were close to his heart. Even when a new consultants’ dining-room was opened he insisted on eating lunch twice a week in the students' refectory so that he could keep in touch with student concerns. A keen player and follower of various sports (he was a member of Surrey Cricket Club and a regular spectator at the Oval), Peter was also an enthusiastic supporter of the students’ sporting activities, and was often to be found on the touch-line at rugby matches.
Thorough in everything he did, Peter published 11 papers on various aspects of undergraduate teaching and on examinations, becoming a council member of the Association for the Study of Medical Education. He also co-authored four books on these subjects, one having the title 1,200 MCQs in medicine (Edinburgh, Churchill Livingstone, 1980). MRCP papers set nearly a century earlier fascinated the historian in Peter as a guide to what was uppermost in the minds of the examiners of the time. Naturally, his expertise in examinations at the College and at Westminster led to many requests for help, and he was a visiting examiner at the University of the West Indies and a consultant in the Sudan and in Pakistan.
The University of London also claimed his attention and he became chairman of the MCQ sub committee of the board of studies in medicine. In 1984, Peter played an invaluable role in the merger of the medical schools of Westminster and Charing Cross; in particular, he was closely involved in developing the comprehensive undergraduate syllabus and the closed-circuit television system. This latter initiative, which enabled lectures to be seen and heard simultaneously on the two sites, was, for its time, a pioneering enterprise. Although holding a predominantly academic position, Peter did not ignore administrative duties or more practical concerns; he developed methods for the calculation of bed requirements for undergraduate teaching and became both chairman of the division of medicine at Westminster and a member of the district management team.
Peter was extremely well-read; history, particularly the history of London and medical history, were topics that claimed a good deal of his attention. Unlike others who went to the occasional lecture, he took the trouble to attend a long course on Saturday mornings and attain by examination the diploma in the history of medicine of the Society of Apothecaries. Later he lectured for many years on that course on the history of cardiology, in which he was a considerable expert. During his career he made notes on cardiac history and after retirement he was able to write a splendid book on this subject entitled A short history of cardiology (The Wellcome Institute Series in the History of Medicine, Clio Medica 40, 1997). It was typical of Peter that this book contained not only meticulous detail but also pithy and pertinent comments on a whole range of topics. He also wrote a fine chapter for and was co-editor of British cardiology in the twentieth century (London, Springer, 2000).
Only the year before he died he again helped the College by writing sections of an acclaimed volume on the College and its collections. He also gave a collection of his books on medical history to the College so that they would be available to be borrowed, a typically thoughtful gesture.
Another topic which interested him greatly was the relationship between medicine and the graphic arts. He was a frequent visitor to London art galleries, and made a 40 minute video of his lecture on medicine and the arts for the benefit of his students. It contains many illustrations from art galleries all over Europe and from many books, and is a fine testimony to his erudition on this subject. He also had a good collection of medical stamps.
Peter was of medium height and slender. He had a lively face, often smiling in conversation when he made a point. He had a stammer which, however, never seemed to matter much either to him or to his listeners. It disappeared when he lectured. Elizabeth and Peter had four children, though sadly one son, Jeremy, was killed in a car accident in Canada. They were both committed Christians and in the last year of his life Peter wrote a book A powerful composition: a short history of Christ Church, West Wimbledon (2002), about the church where they worshipped and where he was a churchwarden.
Having previously enjoyed good health, in the year 2000 he developed fibrosing alveolitis, cause unknown. In spite of expert advice and treatment, which in itself disabled him, he died quite suddenly. The funeral service in his own church was packed with friends. Sir Richard Bayliss, who had once been his chief at Westminster Hospital, gave the address.
R I S Bayliss A Hollman
(Volume XI, page 197)
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