Lives of the fellows

John Alexander Simpson

b.30 March 1922 d.10 May 2009
MB ChB Glasg(1944) MRCP(1949) FRFPS Glasg(1950) MRCP Edin(1958) FRCP Edin(1961) MRCP Glasg(1962) MD Glasg(1964) FRCP(1964) FRCP Glasg(1964) FRSE(1969) DSc Edin(1992) DSc Glasg(1993)

John Alexander Simpson, known as ‘Iain’, was professor of neurology at the University of Glasgow and an international authority on myasthenia gravis. He was one of the last of that breed of physician/scientists who designed and built their own equipment, a breed, which by the very nature of advancing technology, now scarcely exists. He was born in Greenock, the son of Henry Keith Lindsay Simpson, a coal and building trade merchant, and Stewart Macfarlane Simpson (née Rankin). His great grandmother, Elizabeth Gibson, was related to the political caricaturist and printmaker James Gillray. He was educated at Greenock Academy and then had a distinguished undergraduate career at Glasgow University.

After house posts and two years as a surgeon lieutenant in the RNVR, in 1953 he went as a Medical Research Council fellow to the neurological unit at the National Hospital, Queen Square, London. Here he was able to pursue his particular interest in muscle disease from both a clinical and neurophysiological standpoint. It was suggested that he should make an independent assessment of the National Hospital cases of myasthenia gravis and the response to thymectomy, at that time a highly controversial form of treatment. Sir Geoffrey Keynes [Munk’s Roll, Vol.VII, p.319] invited him to extend this survey to include the patients on whom he had performed thymectomies since the 1930s. This was to be the beginning of a lifetime’s study of myasthenia gravis, which resulted in a number of seminal papers. What he described as his most important paper was published in the Scottish Medical Journal in 1960. It was the first paper to describe an autoimmune mechanism for myasthenia gravis. It also contained the first suggestion of a genetic factor with variable expression (later recognised as HLA-BB). It was unfortunate that at the time this was not a widely read journal.

Over the years there were further papers on myasthenia gravis and its relationship to thyroid disease, to hypergammaglobulinaemia, on the nature of the neuro-muscular transmission defect in myasthenia gravis, on the inheritance of the HL-A antigen and immune deficiency. He accumulated a large number of patients with myasthenia, whose care he supervised personally and scrupulously. In 1956 he published the first paper describing the measurement of nerve conduction velocity in local compressive lesions of the human nerve (particularly in the carpal tunnel syndrome), a method of investigation which because standard worldwide.

Iain Simpson was appointed to the newly created chair of neurology at Glasgow University in 1964 and began to develop what eventually became a large and significant department of clinical neurology – a constituent part of the Institute of Neurological Sciences.

In addition to his share of the clinical work, undergraduate teaching, the supervision of research fellows and the administration of the university department, he was on the editorial boards of a number of scientific journals, most notably the Journal of Neurology, Neurosurgery and Psychiatry. He became the assistant editor in 1963 and the editor in chief from 1970 to 1979. He was an extremely diligent reader of submitted material and he had an outstanding ability to recognise relevant and important contributions. He worked on the journal most evenings of the week and he felt that it was important to give an early response to authors who had submitted papers. He also gently corrected grammatical infelicities.

He served on numerous local, national and international advisory bodies, and was a member of many learned societies, both in Britain and abroad. He was president of the Association of British Neurologists from 1985 to 1986, and was elected as a fellow of the Royal Society of Edinburgh. His list of academic distinctions, university appointments, memorial lectureships, memberships of international and national committees and boards of management is remarkable.

Despite his achievements, he acknowledged that his scientific education was poor and he commented on only four undergraduate lectures in ‘physiological chemistry’. His approach to scientific enquiry was not inhibited by longstanding tradition. He had a sceptical mind, wary of accepting received theory and he approached problems from what he referred to as ‘first principles’. Over coffee he would often sketch out his current ideas on the back of an envelope. For his experimental work he was very much ‘hands on’. He built his own equipment from scratch using ex-military surplus, shelving and pieces of Meccano, eventually making a primitive oscilloscope. This equipment was also used for the investigation of clinical problems and many of the techniques which he developed became part of the standard investigative procedures. In the early days even the most routine tests seldom went without a hitch and I have vivid memories of Iain reaching into the innards of a crackling, glowing piece of equipment to push a valve more firmly into place or twisting straying wires together. This was before the days of transistors, computers or health and safety.

Iain applied himself with equal enthusiasm to his extracurricular activities, especially after retirement. He had had a lifelong passion for sailing, starting with a sailing dinghy on summer holidays, progressing through a day racing boat to a large cruising yacht. Apart from weekends sailing in the Firth of Clyde, his annual holidays extended to cruises further a field on the west coast of Scotland and to the Hebrides. He was seldom satisfied with the standard equipment provided on his boat; he sought out cutting edge replacements and sometimes had specially made fittings, designed according to his own favoured ‘first principles’. Some needed repeated modification and after the weekend you could get an idea of the success or otherwise according to the amount of grease and oil engrained in his fingers.

Music was also a continuing source of pleasure. While at school Iain had already achieved a high standard of proficiency on the violin. Later in life, he was able to devote time to practise, and he played in a trio, in the Glasgow Chamber Orchestra and in the traditional Scottish Fiddle Orchestra, of which he was a founder member.

Iain was married to Elizabeth Neill, herself a doctor, and they had two sons, Keith and Neill, both consultants in Glasgow, and a daughter, Guendolen, who works as a nurse in Edinburgh.

Iain was seldom idle. Even towards the end of his life, when he was to some extent physically incapacitated, he retained an enquiring and critical mind, and he was always ready to act the devil’s advocate. His was a busy life, well lived. He had a generous nature, rewarded with significant achievements in his chosen field.

Ivan T Draper

[The Scotsman 23 June 2009; The Royal College of Physicians of Edinburgh; British Society for Clinical Neurophysiology]

(Volume XII, page web)

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