Lives of the fellows

Owen Lyndon Wade

b.17 May 1921 d.10 December 2008
CBE(1983) MB BChir Cantab(1945) MRCS LRCP(1945) MRCP(1948) MD(1951) FRCP(1964) Hon FRCPI(1970) Hon FFPM (1989) Hon MD Belfast(1989)

Owen Wade was one of the founding fathers of clinical pharmacology and therapeutics in the UK. He created two new departments in Belfast and Birmingham and played a key role in the training of many medical students. However, his greatest legacy is the British National Formulary (BNF) (London, British Medical Association and the Pharmaceutical Society of Great Britain), which is regarded as the ‘bible’ by dispensers and prescribers, and is now used by virtually all doctors, pharmacists, and those training to be the prescribers of tomorrow. From 1948 to 1978 the BNF was a dull, hardback publication providing guidance on how to make up a number of old fashioned and largely ineffective remedies. It was published about every three years and used many Latin terms and nineteenth century measures. In 1978 Owen became chairman of the Formulary Committee, and led the team which, by 1981, had transformed the BNF into its modern, paperback format, published every six months and used by thousands in the UK and in many other countries.

Owen Wade was born in Penarth, South Wales. His mother was Katie Jones. His father, James Owen David Wade, was a surgeon and his three brothers also qualified in medicine. Two of his brothers became surgeons, one in Cardiff and one in Edinburgh, the other became a general practitioner working in London. When Owen became a professor in Belfast, they had the UK well covered.

As a teenager, Owen would help his father giving the anaesthetics (cloth and bottle) and began learning to do the operations. Well before starting his clinical course he had removed an appendix, repaired a hernia and enucleated a prostate – all performed rapidly before the anaesthetic wore off.

He went to Emmanuel College, Cambridge, and obtained first class honours. In 1942 he started his clinical course at University College, London. There was a shortage of clinical senior medical staff, and he recalled that students had to look after themselves and take clinical responsibility at a very early stage. On one occasion, he had to deliver a baby on the platform of Warren Street tube station. Coping with the spectators was a challenge, but he used the old trick of sending them off to find boiling water.

The war provided lots of excitement and he and the staff often had to take cover. In his obstetrics exam in January 1945, he was trying to talk about placenta praevia with Hilda Lloyd whilst conscious of the sound of an approaching V-1 bomb. Sensing her increasing concern, he asked if they should both get under the table, which they did. They were not hit, and he passed the exam.

He married Margaret Burton, a dentist, in 1948, which he said was the best thing he ever did. They went on to have three daughters.

The next step was to the Pneumoconiosis Research Unit in South Wales: research, lung function studies, statistics, an MD – a happy time. Then he went to Birmingham as a lecturer on the professorial unit and a move to cardiac catheter studies. Owen was the first person to catheterise a normal subject at rest and during exercise. It was his team leader who kindly left a letter absolving his colleagues if anything went wrong, like sudden death. Nothing did go wrong, and Owen was catheterised by him at the next session. In total 12 subjects were studied, including the ward sister and the catheter team nurse – both willing volunteers. There was no ethics committee and no defibrillator.

In 1957 Belfast Medical School wanted to establish an active clinical pharmacology unit and appointed Owen. He was just 36, and had only been a senior lecturer for five months, had had no special training in clinical pharmacology and no specific interest in therapeutics. The department had one senior technician, who was a great asset, but no other staff and he was offered a few beds on someone else’s ward. He was there from 1957 to 1971.

Owen set about devising a course, putting together a lecture programme and planning practical classes, having never done anything like this before. He gave all the lectures and ran all the practicals. He soon complemented the lectures with interactive road shows, discussing the management of specific patients with a panel of students whilst the rest of the class listened, learned and joined in. These were very clinically relevant and became very popular. Over the early years his clinical work prospered and he became the first consultant to have beds in both teaching hospitals.

In 1961 it became clear that thalidomide taken during pregnancy caused very severe, often fatal, abnormalities in the foetus. Many babies were born with no arms and no legs (phocomelia). His response was positive. He tried to find out how much thalidomide had been prescribed in Northern Ireland and by whom. This proved impossible, but he was able prospectively to quantify all the drugs prescribed by each GP in Northern Ireland, and subsequently worked with colleagues to obtain comparable data for Norway, Sweden, Czechoslovakia and West Germany.

He used the computer-based system used in Northern Ireland to pay the pharmacists, and became the first person to use computers in this type of research, and the first to produce numerical data on drug utilisation. These tools fed his interest in adverse drug reactions and he wrote some of the earliest papers and books on this subject.

The nation was horrified by the thalidomide disaster. At that time there was no legal framework for assessing new drugs, no system for monitoring the safety of drugs already on the market and no means of communicating rapidly with prescribers about safety concerns. In 1963 the Government set up the Committee on Safety of Drugs, the so-called ‘Dunlop Committee’, named after the chairman, Sir Derrick Dunlop [Munk’s Roll, Vol.VII, p.170]. Owen was a founder member and subsequently went on to chair the Committee on the Review of Medicines, the adverse drugs reaction subcommittee and became a member of the Medicines Commission, which set up and oversaw the regulatory committee structure.

Owen Wade was dean of Birmingham Medical School from 1978 to 1984. Technically his deanship started at a minute past midnight on 1 September; by midday, he had had to shut half the medical school and his professor of virology had cut his own throat and was dying. The problem was smallpox. Some research was being undertaken in the medical school and a photographer in the anatomy department became ill in August. She was diagnosed with smallpox on the 24th, and died from the disease soon after – the last person in the world to die of this disease. Trade union power in 1978 was at its peak and the Association of Scientific, Technical and Managerial Staffs (ASTMS) made life very difficult. However, Owen did well. He took command, learnt all about smallpox, took expert advice, kept the relevant documents in good order, looked after his staff and they gave him a lot of support. The medical school was battered but unbowed and lived to fight another day. Four of his professors became presidents of their respective colleges.

Owen Wade achieved a lot. He ascribed this to being cheerful and optimistic, his wife, his ability to sleep well, his strong stomach and his capacity to get on well with colleagues. His colleagues would say that he was very able, worked hard, was well organised and was “able to keep lots of balls in the air at the same time”.

Martin Kendall

(Volume XII, page web)

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