Lives of the fellows

John Nigel Carlyle Cooke

b.16 January 1922 d.25 April 2011
CB(1984) OBE(1954) MB BS Lond(1945) MRCS LRCP(1945) MD(1950) MRCP Edin(1950) MRCP(1950) FRCP(1967) FRCP Edin(1968) MFOM RCP(1982)

Air vice-marshal John Cooke had a distinguished career in the Royal Air Force and continued contributing to aviation medicine until his death in his 90th year. He was one of the last great, truly general, physicians whose multidisciplinary training and experience made him not only an outstanding clinician, but also a fountain of knowledge and a man of gravitas.

He was born in Pembroke, south Wales, the son of air marshall Sir Cyril Bertram Cooke, who had served in both the Royal Flying Corps and the Royal Air Force, and Emily Amelia Phyllis née Davies. He inherited his love of flight from his father, but imperfect eyesight ruled out becoming a pilot, and so he turned to medicine. John spent some of his early childhood years on the north-west frontier in India, where his father was a squadron commander, and was educated at Felsted School, where he developed a love of rugby.

John was a medical student in London at St Mary’s Hospital Medical School during the Second World War. He had to assume responsibilities unheard of in peacetime, as many of the qualified young doctors had joined the armed forces. In addition to his clinical duties he drove ambulances during the Blitz, and was involved in fire watching and the Home Guard. During this time he also worked in Sir Alexander Fleming’s [Munk’s Roll, Vol.V, p.132] unit at the dawn of the use of penicillin therapy for the treatment of infections, an experience about which he lectured later in life.

Following house jobs at St Mary’s in 1945, John joined the Royal Air Force. On completion of officer training, he was posted to the mass miniature radiology unit at the Central Medical Establishment. At the time tuberculosis was common in new recruits to the armed forces. He became an accomplished radiologist, and the experience gained in respiratory medicine stood him in good stead for the rest of his career. Over the next few years, he served at all of the RAF hospitals in the UK. In 1952, he became officer in charge of the medical division at RAF Hospital Cosford.

In 1954 he was posted to Germany as a medical specialist at the newly opened RAF Hospital Wegberg, where he was issued with a VW Beetle and was told that his duties extended to covering all other hospitals in the region. He was extremely busy, covered many miles and developed a great deal of respect for German motor cars and autobahns.

It was with great delight that he was posted back to RAF Hospital Cosford in 1957, from where he was sent on study leave as a senior registrar to Sir Ken Robson [Munk’s Roll, VolVII, p.503] at St George’s Hospital in London. It was during this time in London that he met his future wife at a party.

In 1961, John briefly gained fame in the national press for resuscitating a young lady who had nearly drowned in the sea near Plymouth. He was walking with his wife and new-born son when he noticed a commotion on the beach and it became clear that a doctor was required. He sprinted to the scene where revival attempts using the old Holger Nielsen method were making no headway. Always at the forefront of new techniques, he remembered reading of a new ‘mouth-to-mouth’ method. He tried this and, to great applause, the woman coughed and woke up. In the press the next morning the story of a handsome doctor reviving a young lady with a kiss was hard to resist.

A posting to Aden during the troubles in 1963 presented John with the new challenge of tropical medicine, in which he excelled and subsequently became an authority. Until the 1970s, general physicians were also responsible for the treatment of children in Royal Air Force hospitals. Whilst in Aden, he introduced the technique of rehydrating babies who had collapsed with severe fluid loss due to diarrhoea, by using a needle inserted into the marrow cavity of the tibia, thereby saving many lives.

He relaxed, when possible, by sailing his boat, which he had shipped from the Boat Show in London. To get the boat out of customs and into the water required some carefully distributed ‘baksheesh’. At the yacht club, his advice was sought by Major Douglas Lovejoy of the Devon and Dorsets, who was concerned at the number of young men being killed as a result of land mines exploding beneath Land Rovers. Together, they built some dummies and experimented on the best placement for reinforcement of the underside of the vehicle. After field trials in the desert, the prototype went into service. Shortly afterwards, John was woken at 2am be told another Land Rover had been blown up, but that the project had been successful and the men were uninjured.

The mid sixties were spent at RAF Hospital Wroughton, where his interest in metabolic medicine led to him describing in the Lancet the association between calcium and sodium excretion and their importance in the management of kidney stones (Lancet 1967 Jun 24;1[7504]:1354-7). John was also the first to recognise that topical steroids when used to treat skin disease could also cause suppression of the adrenal glands (Lancet 1967 Dec 9;2[7528]:1254).

He returned to RAF Hospital Wegberg as physician in charge in 1969, where he championed the creation of an intensive care unit. Whilst there, he and his wife were able to take up gliding, and John fulfilled his ambition to fly by developing into a competition-level glider pilot. He was posted to Princess Mary’s RAF Hospital Halton in 1972 to command the medical division. Promoted to air commodore in 1975 and subsequently air vice-marshal in 1979, he spent the rest of his service based at Halton. From 1974 to 1979 he held the post of Whittingham professor of aviation medicine. On promotion to air-vice marshal, he became dean of air force medicine and chaired the Defence Medical Service Postgraduate Council until 1982. From 1983 until his retirement in 1985, he was the senior RAF consultant.

His interest in medical education arose from his outstanding abilities as a clinical teacher and many generations of physicians have reason to be grateful for his wise, though often challenging, tuition. It was a rare event for one of his juniors to fail the stringent examinations for membership of the Royal College of Physicians. He often taught by anecdote, and indeed in the late 1970s he and a few close colleagues seriously considered launching ‘The Journal of Anecdotal Medicine’ as a reaction against the trends in mainstream medical journals. As Whittingham professor, he was able to combine both his teaching skills and his experience as a glider pilot. He was instrumental in setting up the diploma in aviation medicine which continues to attract students from all over the world. As part of the original courses, John used to take all the students to RAF Bicester for a day of gliding experience and a lesson in aerodynamics.

His love of flying and his wide experience of aviation medicine made him a natural choice to give evidence to the working party of the Royal College of Physicians on the cardiovascular fitness of airline pilots in 1978. This working party had been set up to examine the standards for the airline industry following the Trident crash at Heathrow in 1972. The report recommended the institution of a medical advisory panel at the Civil Aviation Authority (CAA) and John was appointed as one of its first members by Geoffrey Bennett, chief medical officer of the CAA. Thus began a long association as consultant physician to the CAA, which extended beyond his retirement from the Royal Air Force. He was a member of the medical advisory board of the European Space Agency from 1978 to 1984 and assisted with the selection of the first British astronaut, Helen Sharman. From 1985 to 1991 he was a consultant adviser in medicine to the Royal Air Force of Oman.

He continued to publish important papers on aviation medicine throughout his retirement and analysed much of the historical data from the CAA archives. He published seminal work on the clinical outcome of various noted electrocardiographic findings, and drew attention to the long-term cardiac consequences of the treatment of childhood cancers, in joint authorship with Sally Evans, the present chief medical officer to the CAA (Aviat Space Environ Med 2003 Sep;74[9]:1003-8). At the time of his death, he was revising his chapter on ‘The ageing pilot’ for a fifth edition of Ernsting’s aviation medicine (fourth edition: London, Hodder Arnold, 2006).

Outside medicine, he had an early love of rugby. He recalled that he was accepted at St Mary’s Medical School, ‘for the size of my thighs and my speed on the rugby field’. He played for St Mary’s and continued to play with distinction after joining the RAF. One of his proudest memories was turning out for Wasps when ‘they were short of a man for the day’. John was a keen fly fisherman all his life. During his latter years, he suffered from progressive loss of vision due to macular degeneration and was hampered by poor mobility due to old knee and ankle problems. Despite this, he continued to enjoy fishing for both salmon and trout, and caught his last fish, a beautiful brown trout of over 3lbs, just a week before his death.

A great raconteur, his dictum was ‘do not spoil a good story with the truth’, and he composed a series of stories for his grandchildren about a dragon who befriends a young boy and their adventures together.

John married Elizabeth Helena Murray née Johnstone in 1958. They had three children, Nigel, Iain and Faith, and four grandchildren, who were a source of great joy and pride to him. A wonderful husband, father and friend, his loss will be mourned by all who were privileged to know him.

David Rainford

[Royal College of Physicians of Edinburgh www.rcpe.ac.uk/publications/obituaries/2011/cooke.php – accessed 6 June 2011; Telegraph 19 May 2011 www.telegraph.co.uk/news/obituaries/8524460/Air-Vice-Marshal-John-Cooke.html – accessed 6 June 2011]

(Volume XII, page web)

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