Lives of the fellows

Ronald Finn

b.12 June 1930 d.21 May 2004
MB ChB Liverpool(1954) MRCP(1958) MD(1961) FRCP(1972) Hon FRCPCH(1996)

Ronald Finn’s research into the prevention of rhesus-induced haemolytic disease of the newborn resulted in the saving of hundreds of thousands of young lives the world over. For this work he was awarded the prestigious Lasker clinical research award in 1980, together with Sir Cyril Clarke [Munk’s Roll, Vol. XI, web] and an American group of researchers.

Ronnie Finn was born in Liverpool and received his school and medical education on Merseyside. His outstanding ability received early recognition in the form of city and state scholarships, as well as distinctions in his final medical examinations. Before entering university, he completed his National Service as an RAMC private.

Initially, as one of Clarke’s students and later as his house physician and registrar, he began to share the former’s interest in genetics. At that time, the Liverpool academic department of medicine was one of the most productive in the country. Original studies in pharmacogenetics and the relation between ABO blood groups and gastric cancer were followed, at Clarke’s suggestion, by Finn’s studies on rhesus (Rh) induced haemolytic disease of the newborn.

It became known that during normal labour a small number of foetal red cells were transplacentally squeezed into the maternal circulation. In Rh-negative mothers carrying an Rh-positive baby these foetal cells were then capable of eliciting an Rh antibody response in the mother, with resulting haemolysis and probable death of subsequent Rh-positive babies. Yet Finn was puzzled that Rh sensitisation took place in only a fraction of potentially affected pregnancies. Whilst studying a series of pregnancies in Liverpool, he realised that Rh sensitisation only occurred where the mother’s and baby’s ABO blood groups were compatible. He therefore argued that in ABO incompatible pregnancies any foetal red cells in the maternal circulation might be destroyed before they had time to induce rhesus sensitisation. It should therefore prove possible to mimic artificially the protection afforded by ABO incompatibility by destroying spilt rhesus positive foetal red cells by intramuscular administration of the rhesus antibody to the mother early after labour, thus destroying these cells before they could evoke an antigenic response. In a seminal 1961 paper, he described the practical success of his theory. This treatment, subsequently known as ‘the Liverpool shot’, was soon adopted worldwide. It must be regarded as one the great medical advances of the 20th century.

For all his varied research interests, Finn remained primarily a general physician of a type currently in danger of extinction. Locally, he was widely respected and consulted by the families of his fellow doctors, which, like his other clinical encounters, gave him great satisfaction.

Subsequent to his rhesus work, Finn’s interests in immunology began to extend to the study of the various interactions between man and his environment. Since such interests were shared by only a minority of physicians at that time, he founded the British Society for Allergy and Environmental Medicine to encourage discussion and propagation of his ideas. His interests in environmental medicine were nourished by his belief that the vast majority of human disease would ultimately be shown to be environmentally determined, though of course he acknowledged the interaction with genetic factors. He disseminated his somewhat avant-garde ideas through his writings, his extensive and popular lectures to medical and other societies, and especially through his student teaching. Subjects of foremost interest to him were food intolerance (on which subject he contributed to a College publication), atopy, hay fever, asthma, hypertension, myocardial infarction and Crohn’s disease. His theory that the incidence of cancer might be increased by excessive and varied long-term medication, presumably through iatrogenically induced impairment of immune defence mechanisms, remains, however, to be confirmed.

In his retirement he kept in close touch with his academic and clinical colleagues with a view to shedding light on the puzzling aetiology of chronic fatigue syndrome and also to study a possible link between aluminium intoxication and dementia. For many years he was an annual speaker at the Environmental Health Center in Dallas, USA. Until recent times, Liverpool NHS consultants were not granted personal chairs. Finn, in spite of his eminence, received his only during his retirement. However, he derived great pleasure from this belated recognition.

What of the man? Though popular and highly esteemed, he was essentially modest and reserved. His family life was happy (in spite of his being ensconced in his study until late most week nights and his proclaimed complete uselessness in the domestic sphere). This, and being very focused on his work to the exclusion of uncongenial tasks, enabled him to remain productive. It was a waste of effort to try to persuade him to undertake an activity foreign to his main endeavours and it took some time before the writer realised that his response “I’ll let you know” to such requests invariably meant, “No thank you”. Although most of his interests were academic, his Saturday afternoon attendances at St Helens rugby club were inviolate. He was a voracious reader, of catholic tastes, which included especially war, mysteries and philosophy. These interests were reflected in the many addresses he gave to various societies.

The interaction between a specific type of intelligence combined with hard work and serendipity forms the basis of many major discoveries. The fact that Finn was a first cousin once removed of Lord Cohen of Birkenhead [Munk’s Roll, Vol.VII, p.106], no doubt contributed to their happy inheritance from a common gene-bank. Finn has left a wife, Joan (née Singer), two children and two grandchildren. He will be greatly missed by them, as well as by his many colleagues and friends the world over.

John Goldsmith

[Brit.med.J,2004,328,1501; The Times 29 June 2004]

(Volume XI, page 195)

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