b.14 March 1922 d.30 January 2008
BM BCh Oxon(1946) MRCP(1947) DM(1959) FRCP(1971)
Brian McConkey was a consultant physician and a specialist in rheumatology at Dudley Road and St Chad’s hospitals, Birmingham. He was born in Simla, India, the son of Alan Ivor Gray McConkey, who was in the Army, and Norah née Coolican. He was educated at Cheltenham College and then Oxford University, where he was president of the Oxford Union Judo Club. Following house officer appointments in Oxford, he served in the RAMC for four years, including a period in Suez. He was subsequently a medical registrar at the Royal Masonic Hospital and then a senior registrar in Cardiff.
His MD had been in renal medicine and he had planned to make a career in this specialty, but once he arrived in Birmingham, he was encouraged to take up an interest in rheumatology and trained after appointment at the Queen Elizabeth Hospital with Clifford Hawkins [Munk’s Roll, Vol.IX, p.227]. This serendipitous switch resulted in some quite remarkable contributions to the scientific basis of his newly adopted specialty. Much to his credit, whilst working from a small shared office and taking full part in the medical acute take, he mentored several rheumatology research fellows and registrars, some of whom were inspired to progress to professorial and consultant posts. His team made observations which are still today key to the practice of clinical rheumatology.
Brian was first to describe the use of C-reactive protein (CRP) and other acute phase proteins to monitor disease activity in rheumatoid arthritis and correlated changes with the rate of radiological progression. CRP was thought a better marker than erythrocyte sedimentation rate (ESR) as it was not influenced by age, sex or anaemia and samples could be transported and stored more easily.
He developed a system for self-scoring of rheumatoid disease activity by patients, believing that, even if blood tests and X-rays improved, little was gained if the patients felt no better. He systematically and methodically applied this to his practice for all his patients, providing a resource of wonderful benefit for subsequent studies of outcome, going on to show that patients can improve after aspirin-type drugs which do not improve CRP and ESR. This can only be achieved by what were then called ‘second line’ drugs such as sulphasalazine.
Brian became known internationally for his work establishing sulphasalazine in rheumatoid and psoriatic arthritis. After leading clinical trials in Birmingham and Leeds, he was invited to advise the American Rheumatism Association, which confirmed his findings. Brian also studied acute phase proteins in upper gastrointestinal malignancy, high dose intravenous methylprednisolone in rheumatoid arthritis, dapsone in rheumatoid arthritis and reasons why ‘second-line’ drugs are stopped early in diseases which often need treatment for ten years or more.
He took a particular interest in postgraduate education and was College adviser, and for six years postgraduate tutor at Dudley Road (later to become City Hospital), also chairing the research committee. All of these achievements were in addition to his superb skills as a clinician, frequently reflected in the feedback from his trainees and from the many surviving patients whose chronic disease he managed with good humour and humility.
He married Sheila Edmonds in 1948. They had a son (Christopher) and a daughter.
(Volume XII, page web)
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