b.1 May 1921 d.11 November 2011
MB BChir Cantab(1946) MRCP(1951) FRCP(1970)
Malcolm Kinsey Towers was a cardiologist at Harefield Hospital, Middlesex. He was born in Wallsend, Northumberland, the son of Arthur Kinsey Towers, a general practitioner, and Marion Towers née Malcolm, the daughter of a wheelwright. As a child he was fascinated by mechanical and electrical devices, together with physics, and he never lost this interest. He gained a scholarship to Durham School and then went on to Cambridge, where he studied medicine. He achieved a first class degree and then, funded by scholarships, entered the London Hospital.
He qualified in 1946 and undertook house jobs at the London. This was followed by National Service, treating tuberculosis in servicemen at Baguley Sanatorium outside Manchester, where he witnessed the introduction of streptomycin and its dramatic effects. Returning to the London Hospital, he passed the MRCP examination.
His interest in electronics was instrumental in him turning to cardiology, and in 1955 he completed his training under Paul Wood [Munk’s Roll, Vol.V, p.456] at the National Heart Hospital. He was appointed as a consultant at Brompton Hospital in 1962 and then, with the support of Walter Somerville [Munk’s Roll, Vol.XII, web], he started to work, albeit part-time, at Harefield Hospital in 1964.
Harefield at that time was essentially a TB sanatorium, and Malcolm needed to make wholesale changes to develop cardiology to the level he had experienced in central London. This required acquiring or modifying equipment from very limited resources, and here his practical skills and knowledge of physics came into their own. He needed to find and train technicians and radiographic staff in the techniques of cardiac catheterisations and pacemakers, as well as developing his own skills in the evolving coronary angiography of the 1960s. He ensured that the hospital provided investigative services that were highly efficient and had an excellent safety record. He attracted specialist cardiac radiologists and, as surrounding hospitals appointed specialist cardiologists, so he invited them to use the Harefield facilities to extend services to a wide population of northwest London and the Home Counties. This very successful ‘hub and spoke’ system also formed a nucleus for education, quality control and the exchange of ideas.
Towards the end of the 1960s he felt the hospital could now attract a full-time, dedicated cardiac surgeon – a highly progressive concept for any hospital at that time. The surgeon appointed was Magdi Yacoub (later Professor Sir Magdi) and, with Malcolm Towers providing the cardiology and Yacoub the surgery, they achieved a highly efficient, high-volume service the equal of anywhere. Increasingly Harefield Hospital became recognised for its high quality and innovative cardiac services, both nationally and internationally.
Over the next 20 years he encompassed the evolving management of valve disease, cardiac pacing and ischaemic heart disease and, in 1980, was highly supportive of the new and at the time very controversial heart transplantation programme. Clinically he was an astute diagnostician and his opinion using a stethoscope was rarely proved wrong. For most of his time at Harefield he was the only cardiologist, and so it was a regular sight for him to be reviewing investigations at the end of each day and personally discussing with the patient their management. He taught by example using his enormous experience. A succession of cardiology registrars and senior registrars owe much to his teaching, with many moving on to both national and international posts. He shunned the limelight, downplaying his own contributions and was eager to give appropriate credit to others. Not only did he help train his own cardiac technicians, but he supported the development of their professional bodies, and was a lifelong supporter of the British Cardiac Society.
In trying to develop the cardiology service he inevitably encountered difficulties. The fabric of the 1937 TB sanatorium had to be adapted to develop the cardiology unit, with angiography suites, new cardiac theatres, and intensive care facilities for both adults and children. Funding to make the changes was limited and difficult to access. The very success of the hospital brought in so many referrals that waiting lists became unacceptable. He was forever distressed by the inability to provide the service to all who could benefit, and recognised that he was being forced against his will to ration. In spite of the obvious clinical success of Harefield Hospital, there were repeated challenges to its existence and, as the senior clinician, much of his time and energy was needed opposing these threats. He continued to work well past retirement, both as a clinician and in advisory capacities, where his experience was invaluable.
He spent his spare time in his workshop, creating model engines. Throughout his career he benefitted from the essential support of his wife Margaret (née Williams) who, along with his son and two daughters, survived him.
(Volume XII, page web)
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