Lives of the fellows

John Duncan Hay

b.6 February 1909 d.5 December 2003
MRCS LRCP(1933) MB ChB Liverpool(1933) MA Cantab(1934) MB Cantab(1935) MD Liverpool(1936) MRCP(1939) DCH(1939) FRCP(1951)

John Hay was professor of child health at the University of Liverpool and built the reputation of his department on the study of congenital heart disease. His father was John Hay [Munk's Roll, Vol. V, p.178], professor of medicine also in Liverpool. 'Little John' decided to follow his father in taking a special interest in disorders of the heart, but his love of children led him into the paediatric rather than the adult field.

When he was appointed as physician to the Royal Liverpool Children's Hospital in 1939, there was little that could be done for babies born with malformed hearts. Diagnosis was based on clinical skill with the stethoscope and unsophisticated chest X-rays. After war service, Hay returned to Liverpool determined to find better ways of investigating and treating such unfortunate babies, who often died very quickly. He pioneered the new technique of cardiac catheterisation. He was also able to measure pressures in the different chambers of the heart. He was one of the first to employ this new technique, which had been developed in adults, to children and babies. Having improved diagnostic techniques, he brought together a team of enthusiastic surgeons and skilled anaesthetists, and survival rates rapidly improved. But many heart defects remained resistant to treatment and babies still died.

Hay, a quiet, obsessional man, decided that these 'failures' should be studied in great detail and in 1948 he started a collection of hearts taken from babies at post-mortem. This collection was to play a leading role in improving cardiac services for children. Doctors from all over the UK and elsewhere came to Liverpool to study this valuable collection. It is no exaggeration to say that this collection had an enormous part to play in the increasing success of surgery in children. By October 1999 there were over 2,000 hearts. The Alder Hey controversy over the retention of body parts, precipitated by an apparently errant pathologist, brought huge and unjustified opprobrium on the hospital and its dedicated staff, casting a dark shadow that has not yet lifted. John Hay was invited to appear before the Redfern enquiry, which investigated what had gone wrong at Alder Hey, but thankfully he was too frail to attend. To have seen his life's work disparaged in such a tragic and unnecessary way would have been an unjust end for him.

Hay was born in Liverpool. His grandfather had been a commercial artist and lowland Scot who fell out of work in the latter part of the nineteenth century. He heard that there was work in Liverpool, so walked to that city and found a job. Grandfather later designed his own magnificent house with views over the Dee, which the family lived in for many years. At one stage it was sold, but the family bought it back. This dogged determination was a feature of both big and little Johns. Little John excelled at sport at his school and university, playing scrum half for Sidney Sussex College and subsequently Liverpool Rugby Club. Having a famous father can make it difficult to establish yourself in your own right. John the younger began this process by undertaking his pre-clinical training in Cambridge, but in the early 1930s there was no clinical training in that city. He therefore returned to Liverpool to begin a distinguished student and then postgraduate career, eventually leading to his appointment as professor of child health in 1957. Like many of the time, his progress was interrupted by war service between 1942 and 1945. He spent much of this time with the RAMC in India, in charge of medical divisions of British and Indian hospitals. He rose to the rank of lieutenant colonel.

He was a quiet, modest man, who was an excellent teacher and leader. For many years he held a multi-disciplinary cardiac meeting late on a Tuesday afternoon and this always finished in time for him to cross the road to the Philharmonic Hall and take his same customary seat in the upper stalls at the weekly concert. He was a good administrator and committee man, and was a stalwart of both the Liverpool Medical Institute (president in 1972) and at a national level with the British Paediatric Association (BPA). For seven years he was treasurer of the BPA, before becoming its president in 1972 to 1973. The BPA held its annual meetings in the Lake District, and during these events he would marshal stalwarts for an assault on Langdale Pike. He would also take a daily cold bath, which caused ashamed shivers in his less robust colleagues.

He and his wife Netta, a consultant dermatologist, were superb hosts and medical students and junior staff were often welcomed to their home. His letters were always signed 'J D Hay, Physician'. When asked why not 'professor' or 'paediatrician', he declared that he was appointed as physician to the Children's Hospital and that was that!

The family home on the Wirral at Heswell served the early years of his long retirement, but later years were spent near Abingdon in Oxford, where he died at the age of 94. His wife pre-deceased him. He left three children, 13 grandchildren, of whom one is a GP, and 12 great grandchildren.

Alan Craft

[The Times 2 Jan 2004; Brit.med.J., 2004,328,527]

(Volume XI, page 258)

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