Lives of the fellows

Laurence Claude Lum

b.24 January 1916 d.2 December 2008
MB BS Adelaide(1939) MRACP(1946) MRCP(1948) FRCP(1970) FRACP(1973) MA Cantab(1977)

Claude Lum was a respiratory physician at Papworth Hospital, Cambridge, known particularly for his studies on hyperventilation. To his patients and colleagues, he was the archetypal caring physician. In his early years as a consultant, his energy and pioneering spirit were paramount. Latterly, his sympathy and patience were hallmarks of his practice, particularly when dealing with psychosomatic disease.

To his closer friends, Claude's admirable self-sufficiency was the striking feature of his long life. Its origins, to judge from his consistent accounts of his early years, had much to do with a perceived discrimination against those of Asian stock in the South Australian society of some 80 years ago. His father, Samuel Lum, a Chinese immigrant who had made a living by importing fruit, never mastered the English language, but his mother, Florence May née Hill, who came from Lancashire artisan stock, ensured that this should prove no handicap to her two sons. Claude's many gifts began to emerge during his preparatory school years and were developed at Adelaide High School by teachers he remembered as enthusiastic and kind. Among those gifts was a facility with languages and a love of Latin particularly. But he shone in the science subjects too and developed a keen interest in philosophy, relishing logical argument to the extent that he inclined towards a career in the law. However, as he used to recall with laughing-eyed faux solemnity, his father steered him towards medicine as the more respectable profession.

His only criticism of the loving home environment which he treasured in memory was of being ‘put to the piano’ at an age when boys have so many other more exciting things pressing upon their time than the discipline of practise. But his love of music made by others sustained him throughout his adult life.

A coveted scholarship saw him through his medical education at the Royal Adelaide Hospital, graduating in 1939. A year of house officer appointments was followed by experience as a singlehanded truly general practitioner in a remote country area before enlistment for military service. Rejected by the Royal Australian Air Force because (so he said) of his Asian blood, and similarly denied overseas service as a medical officer in the Army, he found himself posted first to a new hospital south of Darwin and then to a hospital at Alice Springs. There he was given charge of the white civilian population (totalling 1,200) and undocumented numbers of nomadic Aborigines within a 500 mile radius of his base. He found the experience fascinating, both geographically and clinically, particular satisfactions being the management of trachoma and yaws. Other postings included a spell at a prisoner of war camp, where a Tuscan count helped him to become fluent in Italian and the interned director of the Sydney Opera House imbued in him a love of opera which he never lost. He was selected for specialist training while still in the Army and acquired his membership of the Royal Australasian College of Physicians in 1946.

On demobilisation he became medical superintendent at the Alice Springs base of the Flying Doctor Service. Returning to the Outback, he delighted in resuming his care of the scattered population, and in the raw beauty of the territory. He discovered a talent for painting in watercolours and a flair for improvisation and innovation. In later life, he looked back on that year as one of the most satisfying of his career and recalled his reluctance to leave it when he felt the urge to take part in the exciting developments becoming evident in post-war medicine. He was persuaded to publish an account of the Australian Flying Doctor Service a few years later (Postgrad Med J 1950 Jan; 26 [291]:17-23).

Postgraduate training in the UK, including six months at Harefield Hospital, led to membership of the London College in 1948. That achieved, he returned to his native country to take up the post of assistant superintendent at the Royal Adelaide Hospital. But he found the lure of Europe's antiquities, art galleries, theatres and opera too strong and was back in England, as a consultant chest physician in Nayland, Suffolk, in 1952. It was while he was there that he developed the interest in sailing, which became his main leisure pursuit during his remaining physically active years. As his experience increased, he made ever more adventurous voyages, ranging from Santander to the Baltic, in the two cruisers he had built to his specification.

The conquest of tuberculosis required him to seek new fields of endeavour in which to exercise his skills and pioneering instincts. In 1959 he was recruited to the team developing cardiopulmonary bypass techniques at Papworth Hospital and, those procedures safely under way, he set about establishing a respiratory physiology facility on that site in 1962. It received patients from throughout East Anglia, serving research and clinical management needs in the field of obstructive airways disease, including asthma, as well as the perioperative assessments required locally. From 1965, as Claude's interest in habitual hyperventilation burgeoned, the work of the laboratory turned increasingly towards its diagnosis and follow-up. Under his leadership, an enthusiastic team of physiotherapists developed highly successful techniques for the control of this common and disabling breathing disorder. These proven, Claude spared no effort in his attempts to make recognition and management of this syndrome more widely known through his lectures and writings, sometimes with colleagues, but often on his own. Some of his publications can be found in The Lancet, the Journal of the Royal Society of Medicine and the Journal of Psychosomatic Research between 1975 and 1987.

Claude also published on the physiology of hypnosis and, in The Lancet and British Journal of Hospital Medicine, on the ethics of cardiac transplantation. He was one of the first in the UK to question the diagnosis of death on ‘brain death’ grounds for that purpose, describing it as "a legal fiction based on necessarily fallible medical opinion" (The Lancet 1980 Apr 26;1[8174]:933-4).

While continuing to work as a clinical consultant, with hospital clinics in Suffolk and a private facility in London, Claude took on responsibility for postgraduate medical education in his area. He served on the council of the National Association of Clinical Tutors and on the Council for Postgraduate Medical and Dental Education in England and Wales. His contribution to medical teaching in Cambridge was recognised by the award of an MA in 1977.

During his long retirement, Claude developed his artistic skills and shared, with his friends, his many interests. These included a detailed knowledge of antique furniture and the graphic and performing arts, model railways, archery and, of course, opera. He is survived by a cherished daughter (Claudia) and son (Edward) of his second marriage. Both are now in the USA. His daughter, to his great satisfaction, was about to qualify as a doctor at the time of his death.

David Evans

(Volume XII, page web)

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