Lives of the fellows

Jack Tinker

b.20 January 1936 d.14 April 2010
BSc Manchester MB ChB(1960) FRCPS Glasg(1966) MRCP(1969) DIC(1971) FRCP(1980) FRSA(1998)

Jack Tinker was a pioneer of modern intensive care therapy who reformed the structure of postgraduate medical education, was dean of the Royal Society of Medicine (RSM) and on the editorial board of several important medical journals.

Born in Chorley, Lancashire, he was the only child of Lawrence Schofield Tinker, a police detective and his wife Jessie, who was a teacher. His mother suffered constant ill health throughout his childhood as a result of the effects of rheumatic fever on her heart. From a working class mining family, she was a scholarly woman, and he won numerous prizes at school and university in order to please her. Educated at Eccles Grammar School, he studied medicine at Manchester University and the Manchester Royal Infirmary (MRI). He had initially chosen pharmacology as a cheaper option but moved to medicine when his parents assured him they could afford it.

Qualifying in 1960, he did house jobs at the MRI, working initially as a cardiothoracic surgeon but moving to cardiology and general medicine when he discovered that he had a slight hand tremor. In 1966 he passed the fellowship of the Royal College of Physicians and Surgeons of Glasgow and, later that year, caught hepatitis B from a patient on dialysis. It was during the now notorious Manchester outbreak which killed nine people and was eventually to provide evidence that dialysis should take place in dedicated units. He was in a coma for 48 hours and he probably owed his life to a visit by Dame Sheila Sherlock [Munk’s Roll, Vol.XI, p.514] who advised on his treatment.

After lengthy sick leave, he battled with depression and switched from clinical medicine to research. From 1967 to 1969 he joined James Black [Munk’s Roll, Vol.XII, web] at ICI Pharmaceuticals working on the development of beta blockers. He then moved to London as a lecturer at the Royal Postgraduate Medical School and senior registrar and clinical physiologist at the Hammersmith Hospital. In return for accommodation above the practice, he worked at weekends for a GP in Roehampton and this rekindled his interest in clinical medicine.

In 1974 he was appointed director of the intensive therapy unit (ITU) at the Middlesex Hospital and there created one of the first dedicated intensive care units in the country, personally training a group of doctors and nurses to staff it. Up to that time intensive care had not been particularly recognised as a formal discipline and critically ill patients were managed on side wards with little continuity of care, usually provided by junior staff. An expert on ventilation, he developed a new breed of computer driven ventilators in his unit, which eventually extended to nine beds, and was to provide a model of best practice. He also introduced the Swan-Ganz catheter to measure pulmonary artery pressure and the cardiac output of critically ill patients. One of his senior registrars at the time, David Bihari, recalled that ‘Jack was a great leader: he could bring people together, identify a common goal, inspire them, delegate, and make them do stuff. He brought the best out in his staff’.

Five years after his appointment as director of the ITU, he also became postgraduate sub-dean at the Middlesex Hospital Medical School. During his time there he was also unit general manager and helped to organise the visit of Princess Diana to open a new HIV ward. He is credited with arranging for her photograph to be taken shaking the hand of an AIDS patient – an iconic image which did much to improve the public’s perception of the disease.

Just after his fiftieth birthday, in 1986, he decided to switch entirely to management as he regarded intensive care medicine as ‘a young man’s game’. At the North East Thames Regional Health Authority he became dean of postgraduate medicine in 1988 and, in this post, his initiative of instituting proper training programmes for house officers and junior medical staff provided a model for other institutions to adopt.

After his ‘retirement’ he continued to work at the RSM and was dean from 1998 to 2002. His social skills were a great asset in this role – one of his first registrars said of him that ‘he was the most approachable and relaxed consultant I had ever met’ and his networking skills were reputedly legendary. Here he vastly expanded the academic conference programme which went from 11 major meetings in 1998 to more than 150 in 2002. He instigated various courses instructing the profession in medical advances and others which helped to explain the legal responsibilities of doctors. For the company which examined performance information about NHS hospitals, Dr Foster, he listened to complaints and helped regulate the structure of the organisation. Other part time posts included medical consultancy for Sun Life of Canada and Rio Tinto plc and planning the intensive care unit at the London Clinic, where he was medical advisor.

He maintained his interest in medical publishing all his life. In 1975 he was founding editor of the European journal of intensive care medicine and, nine years later, he took on the task of editing the British journal of hospital medicine which he continued for the rest of his life. A prolific author, one of his key papers (co-written with three others) describing how disturbances in microcirculatory blood flow lead to organ failure and death in some intensive care patients was published as ‘The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients’ (N Engl J Med, 1987, 317, 397-403). He also wrote several important textbooks on intensive care, including, with Simon Jones, A pocket book for intensive care: data, drugs and procedures (London, Edward Arnold, 1986).

Outside medicine, he enjoyed marathon running and watching cricket and football. A member of the MCC and the RAC clubs, he was also a season ticket holder for Chelsea Football Club. In 1985 he had founded the Scarborough Club for friends who shared his passion for the game to get together to attend the Scarborough cricket festival.

In 1961 he married Maureen Ann née Crawford, whose father, Wilfred, was an Army officer. They met at a student dance and she became a health visitor and counsellor. When he died of prostate cancer, Maureen survived him, together with their two sons (one of whom, Andrew, is now professor of molecular medicine at University College, London) and seven grandchildren.

RCP editor

[UCL news www.ucl.ac.uk/slms/news/2010-30-04; BMJ 2010 340 2920 www.bmj.com/content/340/bmj.c2920 - both accessed 3 June 2015]

(Volume XII, page web)

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