Lives of the fellows

Roderick John Kilner Brown

b.3 October 1918 d.3 August 2008
MB BChir Cantab(1942) MRCS LRCP(1942) MRCP(1948) DCH(1951) FRCP(1967) FRCPCH(1997)

Roderick Brown was a consultant paediatrician in Hackney, London. He was born in Bankura, Bengal, India, the son of Arthur Ernest Brown, the principal of the Christian College, Bankura, and Emily Gertrude née Parsons. His uncle, Sir Leonard Parsons [Munk’s Roll, Vol.IV, p.588], was professor of paediatrics at Birmingham Children’s Hospital. Roderick Brown was educated at Kingswood School, Bath, and then studied medicine at Cambridge, qualifying in 1942. He represented Cambridge against Oxford in athletics, and obtained a half blue for the high jump in 1939, but he preferred cricket and played regularly for Trinity Hall first XI and afterwards in club cricket.

He was a house physician at Burntwood Hospital in the Emergency Medical Service (EMS) and then, in January 1943, joined the RAMC, serving for much of the time as a company commander in a field ambulance in India and Burma.

Following his demobilisation in June 1946, he was a house physician and then a medical registrar at the General Hospital, Birmingham. He was subsequently a paediatric registrar at Dudley Road Hospital, Birmingham, and then at the Royal Infirmary, Cardiff. In February 1952 he became a senior registrar at the children’s department, King’s College Hospital, and in April 1955 he was appointed as a senior lecturer with consultant status at the department of child health in Cardiff. In June 1959 he became a consultant paediatrician to the Queen Elizabeth Hospital for Children, the Hackney Hospital and the Mothers’ Hospital, Clapton. He resigned from the Mothers’ Hospital on his appointment to the Middlesex Hospital in February 1964.

His first paper as a registrar was on cystinosis in two siblings, at a time that the recessive inheritance of this condition had not yet been recognised (Arch Dis Child. 1952 Oct;27[135]:428-33). He was also one of the first to recognise the dangers of hypoglycaemia and dehydration in premature newborns denied fluids for 24-48 hours after birth to prevent aspiration of feeds (Lancet 1:404, 1959). This was one of the most important advances in the care of the preterm infant and was gradually accepted throughout the world.

He went to Canada on a sabbatical to study cardiology at the Hospital for Sick Children, Toronto. While he was there he was summoned to the adjacent maternity hospital, where a mother wanted to breast feed her baby, but none of the medical or nursing staff knew how to advise her. He became convinced that breast feeding was best for nutritional and emotional reasons, and he emphasised the close bond in the reciprocal relationship between the breast feeding mother and baby. In the 1960s, paediatricians were impressed by studies showing that formula-fed babies gained weight faster than breast-fed babies. Roderick Brown considered that similar weight gains would occur if breast milk could be given in larger than conventional volumes. The only way that this could be achieved was by giving continuous intragastric tube feeds starting at the age of six hours and increasing the volumes daily for 10 days. He started a study which showed that neonatal hypoglycaemia and dehydration were abolished, weight gain improved and the babies went home earlier, reducing cross infection to a very low level. These findings were published in 1972 (Br Med J 1972;3:547) and the method was adopted by many units throughout the world for feeding the newborn, and later for the rehydration of older infants with gastroenteritis.

At that time Hackney Hospital had a maternity unit delivering about 3,000 babies a year and a large room designated as the neonatal unit. There were no resident paediatric staff and resuscitation of the newborn and regular care of all the babies was in the care of the obstetric house surgeons, who had no specific education in the care of the newborn. Roderick Brown realised a simple manual was needed, which we decided to write together. He arranged for us to meet Per Saugman, the managing director of Blackwell Publications, who had published the book Congenital abnormalities in infancy (Oxford, Blackwell Scientific, 1971), to which Roderick had contributed a chapter on abnormalities of the cardiothoracic system. We met him at the Royal Automobile Club in St James. During the first course a list of the chapter headings was shown, and he agreed immediately to publish the book, which was entitled Practical management of the newborn (Oxford, Blackwell Scientific). It was popular among obstetric and later paediatric resident staff, who eventually took over the care of the newborn, and was published in several languages. New editions were needed every two or three years, and at one time Saugman wrote saying it was a best-seller.

All the junior staff at the Queen Elizabeth Hospital wanted to work with Roderick Brown because he listened attentively to the worries of the children and their families, at a time when good communication was not common. He taught staff to observe a sick child and to obtain as much information as possible before the physical examination, which often provoked crying. His astute clinical judgement could be relied upon to provide a logical plan of management, but he always asked the house physician and registrar to give their opinions before he gave his own. This allowed staff to develop confidence in their own assessment of problems and to advance their clinical abilities. If he disagreed with their opinions he gently gave the reasons why he thought his own were preferable, but he respected the approaches of all.

He was predeceased by his wife, Jean née Reade, and a son, but was survived by two daughters and a granddaughter.

Bernard Valman

[Brit.med.J., 2008 337 2071]

(Volume XII, page web)

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