b.20 May 1919 d.21 December 2012
MB BChir Cantab(1942) MRCP(1942) DPM(1951) MD(1955) FRCP(1965) FRCPsych(1971)
John Pippard was a consultant psychiatrist at Claybury Hospital, Essex, where he played a major part in the transformation of a traditional mental hospital into a pioneering therapeutic community.
He was born in London, the eldest son of Olive (Frances Louise Olive née Tucker) and Alfred John Sutton Pippard, who was professor of civil engineering in Cardiff, Bristol and later at Imperial College, London. His younger brother, Brian, became a professor of physics in Cambridge, but John was always more interested in biology – for some years the attic of the family home in the grounds of Claybury Hospital still housed a collection of pots containing marine zoological specimens collected during his teenage years. He went to Clifton College, Bristol, before studying natural sciences at Corpus Christi College, Cambridge, and completing his undergraduate medical training at the London Hospital. He qualified in 1942, gaining his MRCP the same year.
After house jobs at the London Hospital, he served in the Royal Army Medical Corps in North Africa and Italy, and later headed the medical division of the British General Hospital in Klagenfurt, Austria. There he met his future wife, Kathleen Marjorie Fox, also a doctor, and after a short courtship they married in 1947.
On his return to the UK, the focus of his interest moved from medicine to psychiatry. While in training at the London, Maudsley and St George’s hospitals he was also a fellow of Corpus Christi College in Cambridge, where he supervised students in physiology. He was awarded the Copeman medal by Corpus Christi College for the research leading to his MD, a follow-up study which examined factors influencing the likelihood of benefit or harm after modified leucotomy.
He was appointed as a consultant psychiatrist at Claybury Hospital in 1955 at a time of great change in psychiatric care – phenothiazine drugs were just appearing, but tricyclic antidepressants were not yet available and electroconvulsive therapy (ECT) was frequently used. He and his colleague, Denis Martin, with the support of the physician superintendent, Stuart Harris [Munk’s Roll, Vol.VIII, p.209], set about transforming a hospital caring for 2,200 patients into a therapeutic community in which there was a conscious effort to harness the potential of all staff and patients in the overall treatment programme. His approach was eclectic but he saw the community, in which maladaptive behaviour could be explored in terms of ‘what does it mean’ rather than ‘how can we stop it most easily’, as an essential background to other treatments (and sometimes itself making the major contribution). The excitement of this period was captured in Adventure in psychiatry (problems of society) (Oxford, Bruno Cassirer Ltd) by Denis Martin published in 1962, and the work inspired many visitors and trainees who then took their experience all over the world. Talking at Claybury’s centenary celebrations in 1993, John recalled the inevitable anxiety and sometimes hostility amongst staff fearing loss of control. He summed up: ‘A therapeutic community is never actually achieved; if it were it would be static and cease to be. We have to be constantly rebuilding as staff and patients come and go, and because the people change, it is never the same, nor are the methods and structures sacrosanct. The therapeutic value is in the effort to make the vision reality.’
In the last few years of his consultant career part of his time was spent working with patients with intellectual disability at Leytonstone House. After his retirement in 1979 he took up a research fellowship at the Royal College of Psychiatrists, undertaking a survey of ECT, the first comprehensive national assessment of any widely used treatment. He obtained a 95% return from 3,200 doctors while visiting 180 clinics. His report Electroconvulsive treatment in Great Britain 1980: a report to the Royal College of Psychiatrists (London, Gaskell, 1981) highlighted inadequate practice in many places. Over the next 10 years he was in demand to give talks and professional advice to colleagues, and a re-audit in 1991 showed major improvements in practice and education. From 1983 to 1986 he was a commissioner for the Mental Health Act Commission.
He saw himself as a doer rather than a thinker or scholar, and his Quaker outlook underpinned his optimistic, practical and determined approach to his life and work. He took pleasure in devising simple gadgets around his house, and when in his late seventies he fell from his loft, shattering his shoulder, and was told he would never play his cello again, his response was to rig up a pulley over the door frame to enable him to passively raise his arm until he regained full movement. He loved the house and garden he tended with Kathleen until her death in 2005, but he was well aware of the transience of all things, and knew when physical frailty meant that it was time to leave. He chose to spend the last two years of his life at Quaker House, a residential home in New Milton, where he remained cheerful and interested in family, friends and new books to the end. He was survived by his four children (Martin, Andrew, David and Clare), nine grandchildren and four great-grandchildren.
[Brit.med.J. 2013 346 1770; The Guardian 2 April 2013; The Psychiatrist Online May 2013 37 182]
(Volume XII, page web)
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