Lives of the fellows

John Henry Friend

b.29 August 1921 d.5 February 2004
MB BS Lond(1943) MRCP(1944) MD(1947) FRCP(1969)

John Friend became one of the pioneers of clinical haematology following his appointment as a consultant physician at the North Staffordshire Hospital, Stoke-on-Trent. Educated at University College School, he went on to study medicine at the Middlesex Hospital, graduating MB BS in 1943. A year later, he became the youngest doctor ever to gain an MRCP. In 1947, he gained his MD with work on the measurement of vital capacity. He continued training at the Middlesex Hospital, including a memorable period of a year when he served as casualty officer. His colleagues from that time recall vividly that John expressed himself forcibly to the patients whom he felt did not genuinely need the department's service.

Between 1944 and 1947, he was attached to the RAF Volunteer Reserve and, between 1946 and 1947, served as a squadron leader (medical specialist) in India. In 1950, he became senior registrar on the medical unit of the Middlesex Hospital and between 1952 and 1954 was the Saltwell research scholar of the College, before going on to be an assistant in the medical unit at Middlesex.

He was appointed consultant physician at the North Staffordshire Hospital in 1955 and his colleagues recognised quickly that in John Friend they had someone of excellent clinical skills, of high principle and who was quite prepared to speak his mind forcibly when the occasion demanded, and sometimes when it did not. They looked to him for leadership in the development of the medical services. In his early days, he had continued his interest in respiratory medicine, leading to publications in the field. During the 1960s and 1970s, however, his interest turned to clinical haematology and, in particular, the treatment and management of leukaemia and of Hodgkin's disease. In this field he was ahead of his time. Before multidisciplinary meetings became the fashion, John worked closely with laboratory haematologists and with clinical oncologists to provide a first class service. During this period, he also maintained a large general medical workload: he was probably the last of the true general physicians in north Staffordshire.

John was one of the leaders in ensuring that medical specialties and medical cover across the City General Hospital and the North Staffordshire Royal Infirmary functioned as a single unit, a development possible because the two hospitals were very close together. He was also one of those instrumental in developing the first rotations for senior house officers and medical registrar posts in the country, a model which has now become almost universally accepted.

His organisational skills influenced his clinical practice. He was adamant that patients should not be admitted to hospital for investigations, as was the usual practice. He always arranged diagnostic tests in rapid sequence on an outpatient basis, thus minimising delays while keeping patients out of the hospital, something that is now called modernisation, although one doubts that John would have recognised that term.

His views on management and development were sought increasingly, both by his colleagues and by management, and were always concisely, clearly and forcibly expressed. He became the longest serving chairman of the north Staffordshire medical advisory committee, having been elected by colleagues on no less than three occasions. In this capacity, he had a large influence on the development of medical services in north Staffordshire. This led to major new developments and buildings for medicine and for surgery, to the beginnings of the heart surgery unit and to the wider development of cohesive services for the elderly within the area. Although he had an excellent relationship with management, he did not hesitate to express forceful opposition to any move, which he felt would reduce the quality of clinical patient care. His reputation was such that his opposition was almost always successful.

John Friend would have been successful in any career because of his focus, precision and ability to express himself clearly. He was an excellent and highly regarded teacher, much in demand for those about to take the MRCP because of his ability to concentrate on the important points of knowledge and technique, and his unerring detection of sloppiness or woolly thinking. His strong belief that patients should be treated as individuals and not as cases, allied to his high expectations sometimes made life uncomfortable for his junior staff, but John was always the physician that they remembered and respected as an example to emulate. He believed that laboratory investigations were only of value to back a clinical diagnosis, or if undertaken with a clear purpose. Beneath his forceful and, often, brusque exterior, he was a kind man and his sense of humour often emerged at the most unlikely moments, particularly in discussing matters with management.

Outside medicine, John was a devoted family man. His wife, Jean, and he were both keen gardeners, with complementary interests (John did vegetables and Jean did the flowers) and they developed three large gardens, the last of these in their retirement home at Cambridge. He was also a keen photographer, but gave this up in later years for health reasons.

He married Jean in 1952 and was inordinately proud of his two sons: Peter, who became professor of transplant surgery at Oxford, and Richard, an internationally known physicist who became an FRS and was knighted. It was fortunate that John lived to see their success, although he seldom admitted directly his pride in them.

Keith Prowse

(Volume XI, page 211)

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