Lives of the fellows

Charles Douglas Needham

b.2 July 1915 d.7 June 2003
MRCS LRCP(1939) MB BS Lond(1939) MRCP(1940) MD(1942) FRCP(1957)

Douglas Needham was a consultant physician in Aberdeen for 28 years, where he was much respected by patients, students and colleagues. Born and brought up on a farm in Lincolnshire, he retained a keen interest in farming, and often returned to visit his family. Douglas trained at Middlesex Hospital in London, where he graduated in 1939. He first worked in Aberdeen as a medical registrar in the early 1940s, and then served in the RAMC in north west Europe after D-Day and in India.

Douglas had good memories of Aberdeen, so when it was suggested that he should apply for the post of physician to the North East Regional Hospital Board, he readily responded. This was just as the NHS was coming into being. He quickly settled into the wide-ranging life of a general physician. Needham's approach was full of common sense, coupled with enthusiasm, energy and humour. This sparked a lively response among his students. They soon learned the value of close observation at the bedside, how essential information was to be obtained by using ears and eyes as one talked with the patient, and all the senses during examination. Investigations could be helpful, but could never replace the first personal contact. His house physicians learned that all request to the X-ray department or to laboratories had to be justified, but applications for his house job were always oversubscribed.

This approach was particularly fruitful among patients with alimentary tract disorders. Gastric and duodenal ulceration was still very common in the mid-twentieth century, and advice to these patients could range from adherence to a sensible diet and lifestyle, up to consideration of major surgery. Working as a surgeon in an adjacent ward, I found Douglas an ideal colleague, and we often met to debate a patient's need for an operation. This would lead to a rewarding discussion as Douglas dug into his experience, and I often benefited from his wise judgement and knowledge of his patients. Over the years Needham assembled a substantial practice in gastroenterology, and this led to the appointment in 1969 of a specialist colleague and the emergence of the present four-consultant gastrointestinal unit.

He was one of the first to recognize the unusual investigative opportunities offered by the geographical situation of north east Scotland: all hospitals services for 450,000 people were situated on a single site. The first of these reports on a population was a retrospective study of every patient admitted with haematemesis or melaena from 1942 to 1948. This recorded outcome while there was active use of blood transfusion, and was published in 1950. During the year 1967 to 1968, Needham initiated a prospective study of 817 consecutive admissions for major gastrointestinal haemorrhage when there was active use of emergency surgery. This study was made by a group, including Shirley Johnston, that produced three papers during 1973. These became standard references. Another survey recorded the details of every patient admitted with large bowel cancer during 1967 to 1968, with outcome followed over a seven-year period. One has good memories of our team sitting around the Needhams' kitchen table on many evenings, analyzing the wealth of data entered on punch cards, while Douglas brandished aloft his slide rule and patiently sought the true significance of the figures which emerged.

The NHS has always relied on the forbearance of consultants' families for secretarial and other assistance, and his wife Margaret gave Douglas valiant support in this area. In 1976, after 28 years, they laid down these responsibilities and retired to the Borders. Near Duns, they created a remarkable house and garden, which was much visited under the Scottish Gardens Scheme. This home has been a welcome retreat for their three children and four grandchildren.

Peter F Jones

[Brit.medJ., 2003,327,229; The Scotsman 7 Aug 2003]

(Volume XI, page 417)

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