Lives of the fellows

Thomas St Martin Norris

b.10 November 1903 d.16 March 2002
MRCS LRCP(1927) MB BChir Cantab(1928) MRCP(1930) DPH(1932) MD(1948) FRCP(1962)

Martin Norris, an astute physician and a gifted organiser, played a leading role in transforming a former ‘poor law hospital’ for the chronic sick into a leading academic institution brimming with modern clinical expertise.

The son of a clergyman, he was born in Tywardreath, Cornwall, and spent his childhood in St Keverne on the Lizard peninsula; hence his lifelong passion for both the countryside and the sea. He attended Truro Cathedral School and in 1921 he went up to Queens’ College, Cambridge, to read natural sciences. After one year he decided to take a medical degree and he completed his clinical studies at the London Hospital. Following house appointments there and in both Oxford and Cambridge, he travelled widely as a medical officer on merchant ships. He returned to London, took the DPH and worked in the North Western Fever Hospital, which was run by the London County Council (LCC).

In 1930 the LCC had taken over the rate maintained hospitals of London. Boards of guardians had previously run these ‘poor law hospitals’. Three such hospitals lay on adjacent sites in north London; Archway Hospital (Holborn board of guardians), Highgate Hospital (St Pancras board of guardians) and St Mary’s Hospital (Islington board of guardians). In 1934 Martin Norris transferred from the fever hospital service to the general medical service, becoming senior assistant medical officer at Archway Hospital. There he particularly respected the work of the medical superintendent, C D Agassiz [Munk’s Roll, Vol.VI, p.8]. The senior assistant medical officer at Highgate Hospital was a surgeon, Norman Tanner, and in spite of being separated by busy roads the two men worked closely together, stimulating each other’s interest in gastroenterology.

In the same year Norris joined the Territorial Army, choosing ‘A’ battery of the Honourable Artillary Company where his knowledge of horses was valuable. At the outbreak of war he was called up, but he was soon released when it was thought that air raids would cause heavy civilian casualties. He was appointed deputy medical superintendent and medical first assistant at Hammersmith Hospital and the Postgraduate Medical School where he remained until 1942 when he joined RNVR. He served as a medical specialist at Massawa on the Red Sea and as naval health officer, Eastern Mediterranean Area.

He expressed forthright views about the quality of the Royal Naval Medical Service and he particularly criticised the competence of the regular medical officers. Unsurprisingly he remained a surgeon lieutenant throughout the war! His impatience with antiquated Royal Naval attitudes shows through in his paper in the British Medical Journal about a smallpox epidemic in 1944 which spread to naval personnel. Operational needs in wartime demanded modification of the usual epidemiological principles. Ships were not put into quarantine and he adopted “a somewhat bold policy of relying almost solely on vaccination”. He insisted that anyone not successfully vaccinated within the previous two years should be revaccinated and to enforce this all leave was stopped and men without appropriate documents about their immune status were not allowed ashore. This craftiness was successful and it made “all naval personnel, and particularly officers, smallpox-conscious and vaccination-minded”.

He returned to Archway Hospital in 1945 as deputy medical superintendent under C D Coyle to whom the LCC had given the task of bringing its three hospitals there together under single control, eventually to become known as the Whittington Hospital. He relished the responsibility involved in expanding the role of the hospitals after the ravages of war. The ‘poor law hospitals’ had been devoted almost entirely to patients with chronic diseases, the acute sector being the responsibility of the voluntary hospitals. However, under the LCC the balance gradually changed and out-patient clinics were developed. In later years, when his firm used to meet informally to discuss patients at the end of busy, hectic clinics he used to describe how he and Arnold Bloom [Munk’s Roll, Vol.IX, p.43] used to sit in a deserted ward on the ground floor waiting for patients to be referred. The Royal Northern (voluntary) Hospital had previously held the local monopoloy and, at first, attendance was sparse. However the excellence of the service at Archway meant that the medical out-patient department quickly expanded. He was appointed physician to the Whittington Hospital in 1947 and, after its integration into the National Health Service the following year, he continued as a full-time consultant until his retirement in 1968.

He was outspoken in his criticism of part-time consultants and he considered that their split loyalty disrupted the smooth running of the service. However, his robust views were softened by his generous, supportive and optimistic outlook and there was no antipathy in personal relations with colleagues which were always conducted with good humour. One of his favourite aphorisms was ‘if doctors fall out with each other the only person to suffer is the patient’.

Evacuation from Central London during the war had encouraged some teaching of medical students in peripheral LCC hospitals. The advent of the National Health Service and the expansion of good acute medical practice in these hospitals led the dean of the Royal Free Medical School to ask Martin Norris to take six students on his wards and this was the beginning of formal undergraduate medical teaching at the Whittington Hospital. Soon Max Rosenheim [Munk’s Roll, Vol.VI, p.394] asked him to take students from UCH Medical School. This developed into a general liaison between the two hospitals and involved all the physicians. Postgraduate education also increased and an innovative medical centre was built with the help of a grant from the King’s Fund. The biannual intensive course for the MRCP examination enhanced the reputation of the Whittington Hospital as an excellent nursery for fledgling physicians and junior posts always attracted a large number of applicants. The medical registrars were integrated into a rotation with UCH.

The Whittington Hospital not only benefited from his organisational skills, but patients there appreciated his clinical acumen. An excellent diagnostician, his apparently intuitive approach was really based on an encyclopaedic knowledge of medical literature. He published several clinical papers, mainly on gastroenterological topics. The account of results achieved by an integrated medical and surgical approach to the management of haemorrhage from the alimentary tract published in Gut in 1964 was particularly important.

His capacity for sustained hard work, his dedication to his patients and his exceptionally detailed memory of their clinical conditions were an example to members of his firm. He inspired huge respect for his clinical ability and great affection for his unfailing kindness and consideration. The banter at his regular Friday lunchtime meetings in the local pub was a source of both relaxation and wisdom.

After compulsory retirement at 65 years of age he filled locum hospital posts, mainly in Cornwall and north Wales. Gradually he moved into geriatric medicine, giving up medical work in 1984 when he realised that he was older than most of his patients.

His family was a very important part of his life. He married Evelyn Wedlock, a nursing sister in Queen Alexandra’s Imperial Military Nursing Service in 1945. They had two sons and a daughter who were taken on sailing holidays and mountain climbing from an early age. He enjoyed growing vegetables and was still digging his garden and climbing apple trees at the age of 94. He also brewed his own beer, giving up only a month before his final short illness.

K R Hunter

[Brit.med.J., 2002,325,168]

(Volume XI, page 422)

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