Lives of the fellows

John Brereton Barlow

b.24 October 1924 d.10 December 2008
MB BCh Wits(1951) MRCP(1955) MD(1968) FRCP(1971) DSc

John Barlow was head of cardiology at Johannesburg Hospital. He described mitral valve prolapse (‘Barlow’s syndrome’), though would probably have preferred the term ‘billowing posterior mitral leaflet syndrome’. His father, Lancelot White Barlow, was born in South Africa and studied medicine at Cambridge and St Bartholomew’s Hospital, London. Having married an Englishwoman, Madeline Dicks, he returned to practice medicine as a pathologist in Johannesburg. John Barlow matriculated at St John’s College and then started his medical studies at the University of Witwatersrand. When South Africa entered the Second World War in 1940, he interrupted a faltering first year to enlist with the South African forces attached to the British Eighth Army in North Africa and then the American Fifth Army in Italy. Returning to medical school in 1946, he graduated in 1951.

Having served his internships and registrar posts at Baragwanath Hospital near Soweto, he sailed to England to sit his MRCP examination in 1955. Thereafter, he worked as a medical registrar to John (later Sir John) McMichael [Munk’s Roll, Vol.IX, p.341] at Hammersmith Hospital and the Royal Postgraduate Medical School in London. It was with McMichael that his interest in auscultation and phonocardiology began.

He returned to South Africa in the late 1950s, first as a medical registrar at Johannesburg Hospital. In 1960 he became a consultant physician and in 1970 he became director of the cardio-vascular research unit. He became professor of cardiology in the newly created department of cardiology in 1980, continuing as such until his retirement ten years later. At this time he was awarded an honorary doctorate of science in medicine by Witwatersrand.

Barlow became a world authority on cardiology and was perhaps best known for his work on the pathogenesis and mechanism of late systolic murmurs and mitral non-ejection clicks. He showed that these were usually due to billowing of the mitral valve and also described associated features such as mild mitral regurgitation, arrhythmias and other ECG changes. Barlow’s paper of 1968 [Br Heart J., 1968 Mar 30(2):203-18], co-authored with Wendy Pocock, is now the second most cited paper ever published in the British Heart Journal and in 1983 was identified as a citation classic by the Institute for Scientific Information.

In the early 1970s and at the height of apartheid, Barlow (with Margaret McLaren) performed a major epidemiological study of the (high) prevalence of rheumatic heart disease in Sowetan schoolchildren. Publication in the international literature of this poor reflection of the socio-economic conditions of the South African black population was not achieved without criticism from the government of the day.

Barlow was widely regarded as an excellent clinician, a view he shared, and put great store on the value of careful history taking and clinical examination. He did not take investigative reports at face value and questioned orthodoxy in general. In the decade before his retirement, it became increasingly difficult to maintain clinical and academic standards as consultants left the hospital service for the private sector or to emigrate. This was no easier a task after his retirement and as South Africa became a democracy. He served as acting head of department on two occasions and maintained his involvement thereafter. He continued to see patients, advise colleagues and supervise registrars until a few months before he died.

John Barlow married Shelagh Cox in 1949 and was predeceased by her. Their sons, Richard John and Clifford William, are respectively a dermatologist at St John’s Institute of Dermatology, St Thomas’ Hospital in London, and a cardiac surgeon at Southampton General.

Richard Barlow
Clifford Barlow

(Volume XII, page web)

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