Lives of the fellows

Oliver Murray Wrong

b.7 February 1925 d.24 February 2012
BM BCh Oxon(1947) MRCP(1951) DM(1964) FRCP(1967) FRCP Edin(1970)

Oliver Wrong was professor of medicine at University College Hospital Medical School, London and a pioneer of nephrology who greatly increased our understanding of disorders of the kidney and led to greatly improved diagnosis and treatment of conditions ranging from disabling childhood bone diseases to kidney failure in middle age.

Born in Oxford, his father was Edward Murray Wrong, a Canadian historian who was fellow and tutor in history at Magdalen College and his mother, who was also an historian, Rosalind Grace née Smith, was the daughter of Arthur Lionel Smith, the Master of Balliol College. His father died of rheumatic heart fever when he was three and, since his mother was then a penniless widow with six children, he and two of his siblings were sent to Canada to be brought up by their grandfather George Mackinnon Wrong, who was also an historian. Educated initially at the Upper Canada College in Toronto, he won a scholarship to attend Edinburgh Academy. He studied medicine at Magdalen College, Oxford and the Radcliffe Infirmary and qualified in 1947.

After a year doing house jobs at the Radcliffe, he joined the RAMC to do his National Service and was posted to Malaya and Singapore. During his time at the Radcliffe there was a shortage of qualified doctors due to the war and it was customary for students take over the care of patients. While treating a college servant suffering from urine retention, Wrong accidentally infected him with gastroenteritis. The man (Tom) was clearly dying when a locum who had worked in the Far East recommended a saline drip. Wrong later commented, ‘Tom was saved. To me it was a very important lesson of how a simple knowledge of salt and water could save lives’.

Demobilised in 1950, he returned to various house jobs with the United Oxford Hospitals and then, the following year, became senior intern in medicine at the Toronto General Hospital. In 1952 he spent a year as clinical and research fellow at Massachusetts General Hospital in Boston, working with Alex Leaf and Fuller Albright on the metabolism of salt and water which was to become one of his lifelong interests. Back in the UK he was appointed a medical tutor at Manchester University where he stayed for four years from 1954 to 1958. While he was there he embarked on the research at Manchester Royal Infirmary that was to set the course of his future career and, jointly with Howard Davies [Munk’s Roll, Vol.XII, web], published ‘The excretion of acid in renal disease’ (QJM, 1959, 28, 259-313). Cited some 750 times, this paper, by presenting a simple protocol to test the kidney’s ability to excrete acid, gave doctors an important tool to improve patient care which is still in use today.

In 1959 he joined the staff of University College Hospital (UCH) as assistant to the medical unit for two years and there he worked with Charles Dent [Munk’s Roll, Vol.VII, p.148] and Max Rosenheim [Munk’s Roll, Vol.VI, p.394]. This was followed by an appointment as a senior lecturer in what was then the new clinical specialty of nephrology at the Royal Postgraduate Medical School at the Hammersmith Hospital from 1961 to 1969, when he moved to Dundee as chair of medicine at the university. Three years later, in 1972, he returned to UCH as professor of medicine, staying there for the rest of his professional career and continuing after ‘nominal’ retirement in 1982, broken only by periods as a visiting professor at Harvard, USA and Sherbrooke University in Quebec, Canada.

Building on his early research and the test for acid excretion, he worked to expand the knowledge of how the body regulates its fluid, salt and mineral content. Part of understanding the regulatory process involved examining excretory products and he was dismissive of his colleague’s squeamishness, noting ‘there is a curious reluctance of the medical profession to handle faeces’. A paper he wrote with Anne Metcalfgibson, ‘The electrolyte content [of] faeces’ (Proc Roy Soc Med, 1965, 58, 1007-9) began with the comment, ‘Stool is the Cinderella of electrolyte studies’. In the course of this work he even examined the faeces of the camels at London Zoo and devised a method of stool examination which required him and his colleagues (and wife and family) to swallow small cellulose tubing segments filled with low molecular weight dextran. These were dried and inserted into soluble gelatine capsules which could easily be swallowed with a cup of coffee, it was said that they were often produced at family breakfasts in the 1960s. On retrieval the fluid they had absorbed could be examined. Over time he produced some 5000 of these ‘Wrong bags’, as he called them, in his laboratory and swallowed a considerable number himself.

When he returned to UCH he took over many of the patients of his previous mentor, Charles Dent, a pioneer in calcium and bone metabolism. He had a good relationship with his patients, who found him both a patient listener and a compassionate man. Dent had studied two boys suffering from a combination of rickets, hypercalciuria, and renal tubular damage and Wrong and his team later found similar patients. He found that the condition was familial and associated also with kidney stones and renal failure and, after some 30 years of work, long after retirement, he came up with a definition of the syndrome which he called ‘Dent’s disease’, although his colleagues thought it should properly have been ‘Dent-Wrong disease’. The definitive paper, published nearly 20 years after Dent’s death, with Anthony Norden and Terry Feest, was ‘Dent’s disease; a familial proximal real tubular syndrome with low-molecular-weight proteinuria, hypercalciuria, nephrocalcinosis, metabolic bone disease, progressive renal failure and a marked male predominance’ (QJM 1994 87 473-93). It was remarked of him that not only did he define the disease, but that he also found a simple and elegant name for it.

He was the author of over 130 scientific papers (more than 40 of them post-retirement) on topics including renal and intestinal function and electrolyte metabolism. Also, with C J Edmonds and V S Chadwick, he published The large intestine its role in mammalian nutrition and haemostasis (New York, Wiley, 1981), a work which incorporated many of his findings and was to become a classic in its field. He contributed the section on nephrocalcinosis to the Oxford textbook of clinical nephrology (Oxford, University press, 2005), the standard nephrology textbook, and was a member of the editorial board of the journal Clinical Science for many years. No doubt inheriting from his parents the family interest in history, he also wrote an article about the friendship between his father and the most celebrated physician of his day, Sir William Osler [Munk’s Roll, Vol.IV, p.295]. The families were friends and, when Murray Wrong wished to marry Rosalind Smith, Oliver’s mother, Osler was consulted as to the advisability of the marriage as he had a damaged heart, the paper appeared as ‘Osler and my father’ (J Roy Soc Med, 2003, 96, 462-4). An ex-treasurer of the Medical Research Society, he was also a one- time treasurer of the Renal Association.

A staunch supporter of the NHS, he never undertook any private practice. After retirement in 1990 he continued to avidly research and publish – unhampered by what he saw as the irritating bureaucracy of his academic post, he produced some of his best work. The family moved to Bloomsbury so that he could be in walking distance of UCH and all the main libraries. His work had spanned the change in medicine from classification of disease based on clinical observation and biochemical and physiological measurements to the application of molecular genetics. Diagnosed with pulmonary fibrosis seven years before he died, he was dictating amendments to his last published paper – his 135th – from his bed in intensive care.

Outside medicine, he loved music, especially anything composed by Bach, and enjoyed playing the piano at which he was skilful. Travel and gardening were also favourite pastimes.

In 1956 he was touring Germany with two friends when they gave a lift to two young Italian hitchhikers. One of them was Marilda née Musacchio, a primary school teacher from the Val D’Aosta, whose father Angleo was also a teacher. They were married ‘within weeks’ and had three daughters one of whom predeceased him. When he died in his old hospital, Marilda survived him, together with their daughters, Michela, the author and journalist, and Malinka.

RCP editor

[The Lancet www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60886-1/fulltext?rss=yes; The Telegraphwww.telegraph.co.uk/news/obituaries/9198369/Professor-Oliver-Wrong.html; The Guardianwww.theguardian.com/science/2012/apr/26/oliver-wrong; The Independentwww.independent.co.uk/news/obituaries/professor-oliver-wrong-pioneer-in-the-field-of-kidney-disease-7646384.html ;Hektoen International www.hektoeninternational.org/index.php?option=com_content&view=article&id=1906 Kidney International www.nature.com/ki/journal/v82/n2/full/ki2012183a.html; Wikipediahttps://en.wikipedia.org/wiki/Oliver_Wrong – all accessed 1 November 2015]

(Volume XII, page web)

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