Lives of the fellows

Aubrey Gerald Leatham

b.23 August 1920 d.7 July 2012
BA Cantab(1942) MRCS LRCP(1944) MB BChir(1945) MRCP(1945) FRCP(1957)

Aubrey Gerald Leatham was one of the leading British cardiologists of his time, earning his reputation through three key areas of heart medicine: auscultation, pacemaking and angiography. At St George’s Hospital in London, he headed the team who engineered and fitted the first artificial pacemaker in 1955.

Born in London, he was the son of a medical practitioner, Hugh William Leatham, and his wife Kathleen Ella Pelham née Burn who was the daughter of Henry Pelham Burn, a major in the Rifle Brigade. His father was medical officer at Charterhouse School and, in those pre-NHS days, he treated local people without charge after school. One of his son’s early memories was of listening to the heart sounds of a women with mitral stenosis through his father’s stethoscope which sparked his interest in cardiology.

Educated at Sandroyd Preparatory School and Charterhouse, he studied medicine at Trinity Hall, Cambridge where, since it was during the Second World War, he did an abbreviated two year degree. Continuing his training at St Thomas’ Hospital, he qualified in 1944 and did house jobs there before moving to the National Hospital , Queen’s Square as he briefly considered specialising in neurology. In 1945 he became a junior registrar at the National Heart Hospital on the invitation of Sir John Parkinson [Munk’s Roll, Vol.VII, p.443], the eminent cardiologist. While he was there he developed his interest in auscultation and devised a recording device by connecting a telephone earpiece to a string galvanometer. He gave a Goulstonian lecture to the RCP based on this research and wrote it up afterwards as ‘Auscultation of the heart’ (Lancet, 1958, 2, 703-8). This paper plus his subsequent book (see below) provided, according to one of his colleagues, ‘the final word on the topic’.

In 1946 he enlisted with the RAMC to do his National Service. Demobilised two years later, due to Parkinson’s influence, he was offered a Sherbrook research fellowship at the London Hospital and was then appointed, in 1951, assistant director of the Institute of Cardiology at the National Heart Hospital. There he became assistant to Paul Wood [Munk’s Roll, Vol.V, p. 456], the dynamic Australian cardiologist often credited with making London the world centre for the management of heart disease. Three years later, in 1954, he was appointed a consultant physician at St George’s Hospital and he remained there for over 30 years. During this time he was also dean of the Institute of Cardiology from 1962 to 1969, following Wood’s premature death.

He had not expected to get the consultant post at St George’s because, in the early 1950s, physicians were against the idea of cardiology specialists since they regarded heart disease as part of their general practice. When he arrived he found that his department consisted of himself, one technician and one ECG machine. The new department he assembled consisted of a highly talented multidisciplinary team and the building was constructed by extending underground beneath Knightsbridge. Having seen, in the late 1940s and early 1950s, many cases of atrio-ventricular (AV) block – a normally fatal condition which effected the electric conduction of the heart – he was convinced that it should be possible to use an electrical pulse to stimulate the ventricles and asked his new technician, the bioengineer, Geoffrey Davies, to build a ‘stimulator’. The first equipment they tried in 1955, on a 55 year old woman who suffered frequent heart attacks, used a very high voltage and stimulated the heart through electrodes attached to the chest wall. Although the device worked it caused the patient such pain that it was eventually disconnected and she died. A subsequent device, miniaturised so that it could be implanted in the heart itself, was successfully implanted in a 65 year old man in 1961 and, in four years, they had treated some 1000 patients, all of whom were given a normal life expectancy.

Throughout his career he was fascinated by listening to heart sounds and in 1958 he developed an innovatory stethoscope – the Leatham stethoscope - which became immensely popular among his peers and is still being manufactured. He described it in a paper in the Lancet ‘An improved stethoscope’ (Lancet,1958, 1, 463). Another investigative procedure, coronary arteriography, was pioneered by him after a visit to Cleveland, USA to meet its inventor, Mason Sones, and he was the first physician in Europe to carry it out in 1963. By then he was developing an international reputation and he was sent for by the third King of Bhutan whose doctors had confined him to bed for several months with an undefined heart problem.

The journey to Bhutan, a closed country at the time, was hazardous and involved five flights. On arrival he found nothing wrong with the King and suggested he left his bed. The following night he awakened as the King was in pain, a correct diagnosis of indigestion due to the consumption of fried scorpion’s eggs led to the award of the Order of Bhutan. The King survived for another nine years and Leatham and his family were invited to visit the country which they subsequently did, and went trekking in the Himalayas.

The author of numerous scientific papers in his field, he also published three important textbooks Auscultation of the heart and phonocardiography (London, Churchill, 1970), An introduction to the examination of the cardiovascular system (Oxford, University Press, 1979), both of which ran to two editions, and Lecture notes on cardiology (Oxford, Blackwell, 1991).

He retired from St George’s in 1985 and was amused that three new cardiologists were hired to replace him. It was said of him that he ‘favoured braces, bow ties and blunt talk’ and a fellow cardiologist recalled that he was given to slight eccentricities such as carrying out a ward round at Christmas dressed as Father Christmas and wearing roller skates – the patients were ‘bemused’.

In 2009 he benefited from his own work, as he was fitted with a pacemaker and was thus able to continue his more energetic pursuits of playing tennis, sailing, cross-country skiing and mountaineering. Apparently he once caught a burglar in his London house and chased him down the road with a tennis racket – the man would only come out from his refuge under a car when the police arrived and he emerged with criss-cross marks on his forehead. A less strenuous enthusiasm was photography, a pastime he shared with his wife.

In 1954 he married Judith Savile née Freer whose father, Charles Edward Jesse Freer was a solicitor. Judith was a tennis coach and bilingual guide – all their children were excellent tennis players - and Charlotte was one of the winners of the junior doubles at Wimbledon. When he died, Judith survived him together with their son, Edward, also a cardiologist, and daughters, Julia, a GP, and Charlotte and Louise who are teachers.

RCP editor

[Lancet www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61748-6/fulltext?rss=yes; The Telegraph www.telegraph.co.uk/news/obituaries/medicine-obituaries/9471113/Aubrey-Leatham.html; The Independent www.independent.co.uk/news/obituaries/aubrey-leatham-physician-behind-the-first-pacemaker-8217252.html; Europace 2010 12 1356-9 http://europace.oxfordjournals.org/content/12/10/1356; Clin Card 1999 22 155-7 http://onlinelibrary.wiley.com/doi/10.1002/clc.4960220223/pdf - all accessed 18 November 2015]

(Volume XII, page web)

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