Lives of the fellows

Philip William Hutton

b.12 July 1908 d.20 April 2010
BA Cantab BChir(1932) MB(1935) MRCP(1936) DTM&H(1937) MD(1948) FRCP(1960)

Philip Hutton made a significant contribution to the development of medical services and medical education in Uganda, as a senior physician at Mulago Hospital and as a founding lecturer in physiology at Makerere Medical School, Kampala. He subsequently pioneered geriatric services as a consultant geriatrician at New Cross Hospital, Wolverhampton.

He was born in the foothills of the Himalayas in Nainital, British India, the eldest of the three children of Charles Herbert Hutton, who was to become chief irrigation engineer in the United Province (Uttar Pradesh), and his wife, Mabel née Garman. Through his father he was a cousin of General Sir Thomas Hutton. On his mother’s side, he was a grandson of William Chancellor Garman and cousin to the Bohemian socialites known as the ‘Garman sisters’ (but known within the family as ‘the naughty nine’). From his mother, he inherited a passion for gardening and artistic gifts. His brother, Bernard Hutton, who saw war service as a major in the Australian Army, taught at Geelong Grammar School, Australia. His sister, Daphne, trained as a psychiatric social worker and married Kenneth Ottaway, the sociologist of education.

Memories of his childhood in the late Raj remained vivid throughout his life. (Who could forget the elephant hired for a Christmas camp to give rides to the children or the adults’ consternation when a stray dog ran off with the Stilton cheese sent over specially from England by his grandfather, the rector of Stilton?) After a relatively peripatetic existence dictated by his father’s occupation as inspector of canals and dams, the family resided in Meerut for a period, followed by four years in pre-partition Kashmir. Here, in the spring and autumn, they lived on a houseboat on Dal Lake. This charmed interlude was followed by less than happy years at boarding school, at prep school and then at Haileybury, after his parents returned to England to live at Great Witley, Worcestershire.

In 1929, he was admitted to Gonville and Caius College, Cambridge, to read natural sciences and physiology, with a view to qualifying as a doctor. He completed his medical training at the London Hospital, initially specialising in tuberculosis. One of his stories dating from this period was how, on the strength of his first driving lesson, he gave a driving lesson to a friend in a borrowed car, which they abandoned when it lost one of its wheels. He was a member of the London Hospital rugby team and enjoyed sailing.

In view of his colonial background, it is not surprising that he considered working abroad. He claimed that it was a lecture by Julian Huxley which inspired his interest in Africa. But there were other motivations, one being the poor prospects for professional advancement in those days for young doctors who did not have the financial means to obtain a Harley Street practice. He also, jokingly, claimed that it was the generous pension scheme which attracted him to the Colonial Service. In 1937, he joined the Uganda Medical Service as a physician specialist, probably not realising that he would remain in Uganda for 24 years, apart from a brief spell in Cape Town during the Second World War. Even before apartheid was officially adopted there, he found racial attitudes in South Africa compared very unfavourably with those of Europeans in Uganda. He did not volunteer for war service, and was probably glad that his medical status meant he could avoid conscription. He was not, as far as is known, a pacifist, but a visit to the Flanders war cemeteries with his father left a deep impression, not of patriotic fervour, but of the appalling scale of loss of lives in warfare.

His first position of responsibility in Uganda was being put in charge of medical services in Eastern Province based at the hospital in Mbale. One problem with which he had to deal was an outbreak of sleeping sickness in an area near Lake Victoria. In 1950, he was appointed as senior physician at Mulago Hospital, Kampala, the national referral hospital serving the African population. Gradually, after 1945, new appointments were made to develop a medical school. Government personnel were employed, as well as personnel newly appointed to Makerere University College, which planned to be the university serving the whole of East Africa. Philip Hutton was appointed as the first lecturer in physiology, one of a dedicated constellation of British expatriate colleagues, among whom his friends and neighbours included Arthur Williams [Munk’s Roll, Vol.XII, web] (first professor of medicine and pro-vice chancellor of Makerere College), Hermann Lehmann [Munk’s Roll, Vol.VIII, p.274] (the haematologist), the surgeon Ian McAdam (later Sir Ian), A G Shaper and Denis Burkitt (of Burkitt’s lymphoma fame). The Mulago Medical School flourished and obtained recognition by the GMC.

In 1955, in cooperation with the Medical Research Council’s tuberculosis unit led by Wallace Fox [Munk’s Roll, Vol.XII, web], Philip Hutton organised the tuberculosis therapy trials instituted in countries throughout East Africa. These trials resulted in cheaper and more effective treatment of the disease. His own contribution to this and further research was published in three papers in Tubercule and the Postgraduate Medical Journal between 1956 and 1962.

While in Uganda he acquired a reputation for his understanding of African attitudes to disease – what might now be called cultural understanding of medicine. This resulted from genuine curiosity about indigenous therapeutics, although he attempted to explain them in European scientific terms. This was exemplified by a visit he made to a local healer (whom Europeans tend to call ‘witch doctors’) among the Jopadhola people, whom he questioned in an attempt to discover how the man was chosen for the role, and the nature and extent of the efficacy of his healing powers.

At one time, he acquired a cheetah as a pet, but he had to give it up because of difficulties in the food supply (condemned livers from the Kampala abattoir, which were being sold on for human consumption). A less exotic, but equally famous, pet was Sam, his white Staffordshire bull terrier, who appears in one of the hospital staff photographs from the 1950s. Sam accompanied him everywhere, except into the wards (the hospital consisted of a set of discrete single-storey buildings, without interconnecting corridors). Renowned for his ferocious addiction to dog fights, Sam sustained an injury to one of his hind legs. This festered to the point where the leg had to be amputated. To the consternation of the medical superintendent and the muslim members of staff, the operation was performed in the Mulago operating theatre. Reduction to three legs did not impair Sam’s mobility or his propensity to be caught up in canine broils.

In 1961 Philip Hutton resigned in order to make way for Ugandan colleagues in the run up to the country’s independence. He returned to England to take up a post as overseas liaison officer with the RCP. However, he soon realised that he was at heart a clinician and a desk job did not suit him. At that time, since there was no demand in Britain for his areas of specialism (tropical medicine and tuberculosis), he found an opening in the new but distinctly unglamorous specialty of geriatrics. In 1963, he was appointed as a consultant geriatrician at New Cross Hospital, Wolverhampton, and the Manor Hospital, Walsall, where the state of care for the elderly was considered ‘desperate and irremediable’. The contrast with his previous clinical post in verdant tropical African could not have been greater: bearing the stigma of being a former workhouse, New Cross Hospital was set in the drab industrial Black Country, where the local population was unaccustomed to the darker skin colour of Asian and West Indian immigrants then being brought in to service Britain’s sclerotic post-war manufacturing industries and shore up the NHS. Wolverhampton soon became notorious for racial attitudes utterly alien to the newly appointed geriatrician. In this period his published papers and letters to The Lancet grapple with the issues faced by the NHS at this time, such as its reliance on junior doctors from the Commonwealth and the problem of waiting lists. These were all problems for which he offered practical solutions borne of experience as a dedicated clinician. He was, however, not comfortable with medical politics. By the time he retired in 1973, the state of geriatric medicine in Wolverhampton and Walsall had been transformed out of all recognition, with purpose-built hospital wards and an efficient domiciliary service.

Having experienced the state of medicine in pre-war Britain, Philip Hutton was a loyal supporter of NHS medicine, firmly believing that, for all its shortcomings, the NHS had brought about huge improvements in standards and undeniable benefits for patients. He therefore followed President Obama’s efforts to reform American healthcare with intense interest, even in the last few months of his life.

In Kampala he was a member of the Uganda Society, the Victoria Nyanza Sailing Club, the Uganda Music Society and the first multiracial social club. He was a passionate gardener and gifted amateur artist. Family friends included the musicologist Klaus Wachsmann, curator of the Uganda Museum. His passion for plants led to his habit of disappearing during family outings and picnics, only to return with his shirt bulging with secreted cuttings to embellish the floral splendours of his garden. The Botanical Gardens at Entebbe were not exempt from this horticultural foraging. He also belonged to the Makerere Art Club, where one of his friends was Margaret Trowell, after whom the Makerere School of Art is now named. Another was the distinguished Tanzanian artist, Sam Ntiro. His home was decorated with some of his many paintings of Ugandan landscapes and people. In retirement, he was able to give more time to these activities. He exhibited at the RCP annual art exhibition and only gave up attending life drawing classes after his first heart attack at 99.

Tall, dark and handsome in his youth, Philip Hutton’s manner was sometimes mistaken as arrogant. In fact he was a deeply humane and tolerant person, with a mischievous sense of humour, although this was dampened by family tragedy (especially the untimely deaths of two of his daughters). In the words of his sometime junior Mulago colleague, Krishna Somers, he was ‘an astute physician, a very practical clinician, an artist in his own time and a quaker of conscience’ (he wasn’t actually a Quaker). He married twice. His first wife was Katherine Elizabeth née Howard, the daughter of a medical practitioner, whom he married in 1938 when he first went out to Africa. It was on account of her illness that he went to South Africa, in the hope of obtaining treatment for her. In 1947, he married Winifred née Abery, a Cambridge-educated botanist, who had been working as an education officer in Uganda since 1944, and who was subsequently a botany demonstrator at Makerere. Three of their four children were born in Uganda. His wife and two of his daughters (Rebecca and Philippa) predeceased him. He was survived by his son, Charles Hutton (a consultant rheumatologist at Derriford Hospital, Plymouth), his daughter, Sarah Hutton (professor of English at Aberystwyth University) and five grandchildren (Katherine, Rachel and James Hutton, and Alexander and Stefan Marianski). He died in the foothills of the Cambrian Mountains in Wales, aged 101, from congestive heart failure, at the home he shared with his daughter, Sarah.

Sarah Hutton

[Brit.med.J., 2010 341 5085]

(Volume XII, page web)

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