b.25 March 1930 d.14 May 2005
MA Cantab(1955) BM BCh Oxon(1959) MRCP(1963) DPM Lond(1966) MRCPsych(1971) DM Oxon(1973) FRCP(1976) FRCPsych(1977)
When the BMJ arranged an exhibition of photographs of leading British doctors, they chose Dennis Gath to represent psychiatry. He was shown on the bridge outside his Oxford college, symbolic of his achievements in linking psychiatry with other branches of medicine, and medicine with other faculties of the university.
Dennis Gath was born in York and went to school in Ilford, where he excelled in the study of classics and on the cricket field, and where he took the leading part in school plays. He won an open scholarship to read classics at Cambridge but, after National Service, chose to study philosophy and psychology instead. He thrived in Cambridge. He studied hard, rowed and played cricket for his college and was elected president of its debating society. After graduation, he decided to become a doctor and spent a year as a teacher at the International School in Geneva to earn money. In this year he acquired two skills that were to be important throughout his life - he perfected his French and he learnt how to teach effectively.
Dennis studied pre-clinical medicine in Oxford at St Catherine's, and went on to clinical studies at the Radcliffe Infirmary, where he was much influenced by the teaching of Alec Cooke and John Badenoch [Munk's Roll, Vol. X, p.15]. This experience, followed by that as houseman and then registrar, to Leslie Witts [Munk's Roll, Vol. VII, p.618] and Ritchie Russell [Munk's Roll, Vol. VII, p.514], gave him a deep and lasting understanding of medicine and of the responsibilities of a physician. Thinking of a career in hospital medicine, he obtained his membership of the College, but his interest in the personal side of medicine led him to psychiatry, and to the Maudsley Hospital.
At the Maudsley, Dennis Gath trained with Sir Aubrey Lewis [Munk's Roll, Vol. VI, p.284], an eminent and powerful teacher who insisted that his trainees should be as well informed about the lives and personalities of their patients as they had to be about the scientific basis of psychiatric illness and its treatment. The approach fitted Dennis' dual interests in the humanities and in science, and it was to be the basis of all his subsequent practice and teaching. When his postgraduate training was complete, he moved to the Institute of Psychiatry, where he undertook an epidemiological study of child delinquency, research which resulted in a prestigious Maudsley monograph and the award of the Oxford DM.
In 1969, after a brief period as senior research fellow at the University of Birmingham, where he investigated the effectiveness of day-hospital care, Dennis Gath moved to Oxford to join the newly established department of psychiatry. He remained in the department until he retired in 1996 and played a key role in developing its research and teaching, and in forging links between psychiatry and the other departments of the medical school.
His own research had two main themes. The first was the relationship between physical conditions and psychological disorder. At that time, most studies of this relationship had been either inconclusive or misleading because they were inadequate in design and method. Dennis Gath chose to study gynaecological disorders, and used reliable methods of diagnosis and measurement, together with an epidemiological framework. Working in this way, he overturned many previous conclusions, for example that hysterectomy was a cause of depression. Gath showed that the depression seen after the operation had been present before the surgery, although usually it had not been detected by the clinicians. He did not stop with this negative conclusion, but added positive advice about simple but more effective methods of pre-operative assessment. He carried out other important studies of related conditions, for example of depression after childbirth, where he showed how common it is and how it could be better detected and treated.
The second theme in Gath's research concerned the care of psychiatric disorders in the community. He began with the treatment, in primary care, of minor mood disorders. Working closely with general practitioners he and his research team showed that many patients with these disorders recovered without medication, and that most of the rest could be treated with a staightforward form of counselling, which could be provided effectively by general practitioners or their practice nurses. These studies of the care of patients with less severe psychiatric disorders were followed by others of patients with the most severe disorders, including the homeless mentally ill, and those receiving the care programme approach. These studies too led to valuable recommendations about ways to improve practice.
Dennis Gath was respected by physicians and surgeons for his clear and helpful opinions, for his wide knowledge of general medicine, and for his clinical skills. Many of the Oxford medical students who chose psychiatry as a career did so because of his example, and he helped many younger colleagues to develop their careers. He was known and respected throughout the university, and served on several of its most important committees. In the psychiatry department, he took a leading part in developing postgraduate training, and his wide knowledge and the exceptional clarity of his writing were major reasons for the success of the Oxford textbook of psychiatry which reached its fifth edition in the year after his death. Outside the university, his advice on was sought by the MRC, the Department of Health, the Royal College of Psychiatrists and the US National Institute of Mental Health.
Dennis Gath was a cultured, widely read and sociable man who had many friends. He enjoyed music, the theatre, and long walks in the countryside, especially in France. He was good natured and interested in and concerned for others. From 1973, he was a fellow of Wolfson College and he played a full part in the intellectual and social life of the college, despite his many clinical commitments. When he retired from his university post he was looking forward to a greater involvement in college life and in the many musical and other cultural activities of Oxford. Sadly, the onset and relentless progression of Alzheimer's disease prevented him from enjoying these activities. He was cared for until the final few weeks of his life by his second wife, Eileen. He is survived by her, his first wife, Anne, and his three children from their marriage, and two step-children.
[The Daily Telegraph 14 June 2005; The Times 27 June 2005; Brit.med.J., 2005,330,1273]
(Volume XII, page web)
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