Lives of the fellows

John Moore Tweed

b.27 September 1920 d.19 February 2013
MBE(1991) MB ChB NZ(1944) MRCP(1951) MRACP(1955) FRACP(1962) FRCP(1971)

Moore Tweed was a pioneering New Zealand rheumatologist – the first rheumatologist appointed to the Wellington Hospital Board and only the second consultant trained in rheumatology to practise in New Zealand (after Tommy Highton [Munk’s Roll, Vol.VII, p.260], based in Rotorua).

Moore was born in Carterton, New Zealand, the son of Martin Baird Moore Tweed, a doctor and international rugby player, and May Marjorie Moss Elvery, an artistic member of a well-known family from Dublin. As a child of the Depression and from a relatively privileged background, Moore developed an early understanding of the need to care for other people and the importance of health.

He was educated at Wellington College. Despite enlisting in the Army at the start of the Second World War, his ambition to study medicine meant he was never called up. He spent the war years studying medicine at Otago. He played provincial rugby in 1943 and qualified in 1944.

After house surgeon and house physician posts at Wellington, Moore went to the UK, where he studied the still emerging specialty of rheumatology, assisted by a Dan Mason fellowship. He developed a clear definition for the uninitiated: ‘Rheumatic diseases can be defined as medical conditions of the locomotor system or alternatively as anything that hurts being not obviously in the head, chest or belly’.

He first worked as a house officer at Hammersmith Hospital with Russell Fraser [Munk’s Roll, Vol.XII, web] and was then (from 1950 to 1952) a clinical assistant at Hammersmith Hospital (working with Will Copeman [Munk’s Roll, Vol.VI, p.120], Oswald Savage [Munk’s Roll, Vol.X, p.432] and Eric Bywaters [Munk’s Roll, XI, p.86]) and at West London Hospital (with Dan Mason and Philip Gray).

He was the first recipient of the Philip Gray fellowship from the Empire Rheumatism Council. During his fellowship, he was involved in early clinical trials examining the effectiveness of corticosteroids such as cortisone as a treatment for rheumatoid arthritis. These studies were carried out at West London Hospital and were run by the committee members of the Empire Rheumatism Council, including Will Copeman (who was also chairman of the Medical Research Council’s steroid committee). At that time cortisone was seen as a major breakthrough in the treatment of rheumatoid arthritis and similar conditions.

He also carried out research with George R Fearnley [Munk’s Roll, Vol.IX, p.168] at Hammersmith Hospital on fibrinolysis, a process that prevents blood clots from growing and becoming problematic. This could be altered by factors such as bacterial infection and was potentially important in the treatment of rheumatic fever and inflammation.

Moore returned to New Zealand and, in 1954, was appointed by the Wellington Hospital Board as the first rheumatologist. He held this post for ten years and was then (from 1964 to 1988) visiting physician and rheumatologist at both Wellington and Hutt hospitals. On his return to New Zealand he also established a general practice in central Wellington, working in particular with the Greek community.

In the 1950s hospital posts for rheumatologists were established in Rotorua, Wellington and Christchurch, followed by other sites in succeeding years. For years, however, there was a shortage of inpatient beds, and patients with rheumatological conditions had to be treated on general medical wards. A lack of direct access to beds was increasingly keenly felt when Moore was joined by Blair Treadwell in 1968. Eventually, a rheumatology unit was set up at Hutt Hospital with 12 designated beds. Outpatients continued to be seen at both hospitals, and also later at Kenepuru.

In 1976 Hugh Burry joined as Wellington's third rheumatologist, allowing a close link with the Wellington clinical school of medicine to be forged. In 1979 the post of senior registrar was established, and in 1981 the British Arthritis Research Campaign contributed funds for a rheumatology training fellow post.

Nursing staff and physiotherapists were also central to the unit, making invaluable contributions to patient education. The unit also maintained close contact with the Hutt orthopaedic surgeons. Regular, combined consultation clinics and seminars were held, and the two departments also worked closely together in the teaching of students.

The unit also developed links with the local division of the Arthritis Foundation, and a field worker post was established. However, the unit still lacked house officers and laboratory and research facilities. It was clear a new site was needed, and, in May 1982 the unit moved into a new, more permanent home at Hutt Hospital.

Moore was active in the Royal Australasian College of Physicians. He was a member of the New Zealand committee (from 1966 to 1980) and served as treasurer, chair and New Zealand vice president (from 1978 to 1980). He was also chairman of the New Zealand Rheumatism Association (from 1964 to 1965) and was vice president and honorary life member of the Arthritis Foundation of New Zealand. During his career he helped forged links between the British and New Zealand rheumatism organisations.

While Moore was achieving professional success and establishing a career as a pioneering rheumatologist, he also had to deal with great sorrow at home. His wife, Margaret Helen (née Watson), whom he had married in 1946, died tragically young from cancer, aged just 42. Moore’s world collapsed. He was left to look after their son, Malcolm. How he managed to hold everything together is testimony to his courage and character, and to the love and support of a network of family and friends.

He did find happiness again and, in 1967, married Nora Margaret White. They had 28 years together, full of love, happiness and joint endeavour. They were inseparable. One of the innumerable anecdotes he loved to recount concerned their honeymoon. They arrived in the Middle East in the midst of the Six-Day War and had to take refuge in the British embassy in Damascus. Eventually they escaped separately hidden in trucks, to Lebanon. They never reached Petra. Whatever they did, whether travelling, socialising, playing golf (he was a life member of the Royal Wellington Golf Club), tennis or bridge, or door-to-door fundraising for the Arthritis Foundation, they did with total dedication. If Moore was the meticulous planner, Margie was the consummate administrator, making sure it got done.

With Margie's death from cancer in 1995 Moore's world was again rocked, but he managed to get up once again. He needed little encouragement to enjoy social, intellectual and artistic times with a tight, and perhaps shrinking, group of friends. He was a well-read man, with considered opinions and with a quirky sense of humour.

Moore was his own last patient. Aged 92, while lying in bed attempting an accurate neurological diagnosis of what was causing his symptoms of nausea, diplopia and disequilibrium, combined with exhaustion from lack of sleep, he asked for three things – a diagnosis, to be put into a therapeutic coma for two days (if doctors could not find another way to give him a good sleep) and to be treated with dignity. When these were provided, he died peacefully.

New Zealand rheumatology owes much to Moore Tweed.

Malcolm Tweed

(Volume XII, page web)

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