Lives of the fellows

Joseph Jacobs

b.9 September 1917 d.28 May 2001
MRCS LRCP(1940) MB BS Lond(1940) DCH(1947) MD(1947) MRCP(1947) FRCP(1970) FRCPC

Joseph Jacobs was emeritus professor of paediatrics at McMaster University, Hamilton, Ontario. He was a gifted academician, superb clinician, children's advocate and also a stalwart member of the local synagogue.

The acquirements of knowledge, experience and wisdom, in that order, were essential targets for Joseph Jacobs in his quest for social justice and health worldwide. He held these objectives from childhood, which was deeply influenced by the First World War and seeing the widespread unemployment in the economically deprived community of south Wales, where he was born. This experience of injustice encouraged him in his academic work at Lewis School, Pengan. At his matriculation he was 'first in Wales' and was awarded the prestigious Macloghlin scholarship, covering five years of medical studies at Bart's. Here he further distinguished himself, qualifying in 1940 and working at Highgate Hospital (Bart's sector) from 1940 to 1942, with attachments in cardiology, neurology, dermatology and endocrinology.

In 1942, wartime Britain was again a crisis and Jacobs joined the RAF, doing service in UK, Africa and India as a medical specialist. He was demobilized after four years, with the rank of squadron leader. During this period he married Margaret, who was an officer in the WRAF. Together, they decided to settle in south Wales, where they started their family.

Joe was preparing himself for a career in paediatrics and spent the next two years (from 1946 to 1947) in various ex-service hospitals, acquiring the DCH, MD and MRCP, prior to being appointed to the NHS as consultant paediatrician at Llandough and the United Cardiff Hospitals, where we met for the first time. He became my tutor, adviser and friend. We kept regular contact for the next 50 years.

His early years in Cardiff demonstrated wide interest in neonatology, asthma, primary tuberculosis and child psychiatry; each having special concern for family. The rising incidence of psychosomatic problems, and the emergence of child abuse and divorce, suggested there was great need for 'intervention treatments' in primary care. He set about this by developing a premature baby unit at St David's Hospital (Cardiff), where nursing staff, social workers and undergraduate medical students could be taught. In 1949, polythene tube-feeding and the first expressed breast-milk bank in Wales, must have saved many lives - exporting excess milk production to London at two pence an ounce made it profitable!

By 1950, he had a reputation of being a 'whiz kid', 'walking encyclopedia' and a teacher who considered that 'questions were often more valuable than answers'. His avid reading and quoting of journals usually added spice to departmental debates. Often, the arguments were controversial. He tackled moralistic and politically explosive issues, to emphasize various forms of social disadvantage, which had followed the progressive closure of coal and steel industries in south Wales. These were rarely challenged. Family breakdown and poor parental control were undoubtedly two of the consequences.

Discussions with his junior colleagues balanced the new trend of introducing technology into clinical medicine. He often stated 'we are training technocrats'! Our talks usually ended with a few aphorisms, e.g. 'Sick people only want to know people who know', or 'Understanding is a composite of knowledge, experience and wisdom - the latter often being acquired late in life and linked with religion.'

After 20 years at Cardiff, he had already travelled as visiting professor to USA, Israel and twice as WHO professor to India. He was becoming restless for change, and in spite of his roots and family relations being in south Wales, he emigrated to Canada in July 1969 to become a professor of paediatrics and head of department at the newly established McMaster University in Hamilton, Ontario. He and his family settled in a mainly Jewish community, just two minutes walk from the hospital. His son David became a lawyer in Toronto, and his daughter Sara a community physician in Atlanta, USA. Both followed their father with careers consistent with his beliefs - human rights and health law. Joe's wife, Margaret, graduated in Edmonton, and became a counsellor.

McMaster's 'novel' teaching techniques, using actors in lieu of 'real patients', viewed by student groups through 'one way glass', appealed to Joe. Case presentations and all papers to be delivered by junior staff to learned societies were carefully researched beforehand. His friendly comments were considered praise indeed. But during the 15 years as head of department, his interests slowly shifted from neonatology and 'organic' problems, to more socio-political, behavioural and psychosomatic areas of paediatrics. He regarded the role-modelling functions of parents and grandparents as being highly significant. Holistic views about all health matters were finally able to be applied by this wise physician, now aged 84 years, living in a small community, by setting up a 'private' clinic in Hamilton, where families could attend and where counselling with advice could be dispensed. Here he maintained that 'nobody is unimportant' and that 'learning never ends'.

Joe's main aspiration was to continue working for as long as possible. His recent 'satisfactory' validation made him confident that his primary care work was worthy of the two mornings weekly spent in the hospital library. In fact, he had just completed reviewing two volumes (over 1,000 pages) of multi-authored paediatric neurology before his death.

His own health was evidently failing in the last six months. He diagnosed himself as having 'silent myocardial infarctions with chronic cardiac failure'. Successful by-pass coronary arteries and valve replacement, performed at McMaster, gave optimism, but a few months later, following a head injury with unsuspected subdural haematoma, he died, driving alone at night.

E G Gerald Roberts

[Brit.med.J., 2001,323,456]

(Volume XI, page 294)

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