Lives of the fellows

George Jeffrey Green

b.4 September 1947 d.6 April 2013
BSc Liverp(1969) MB ChB(1973) MRCP(1976) MD(1979) FRCP(1991)

Jeff Green was a consultant physician and cardiologist at Glan Clwyd Hospital, north Wales. He was born in Loughborough, Leicestershire, the son of George Alfred Hallam and Stella Green. He lived on a farm, where his father was the manager, and it was here, with his identical twin Jim, that he developed his lifelong love of horses and hunting. He attended King Edward VII Grammar School in Coalville, Leicestershire.

While reading life sciences at Liverpool University, where he graduated with a BSc with distinction, he met his future wife Susan Jane Hotston. They both then read medicine and he graduated MB ChB with honours, with prizes in surgery and orthopaedics.

His first appointment was as a house physician to the professorial medical unit at Broadgreen Hospital. Following junior posts in Liverpool, he was awarded a British Heart Foundation junior research fellowship to work in Alasdair Breckenridge’s department of pharmacology and therapeutics at the University of Liverpool. In 1979 he was awarded an MD for his thesis on clonidine and the nervous control of salivation.

In 1980, following a senior registrar post in medicine at Clatterbridge Hospital, Wirral, he trained in cardiology in Norman Coulshed [Munk’s Roll, Vol.XII, web] and Ellis Epstein’s [Munk’s Roll, Vol.XII, web] department at the regional cardiac centre, Sefton General Hospital, Liverpool.

In 1982 he was appointed as a consultant physician and cardiologist at Glan Clwyd Hospital, where he stayed until his retirement in 2006. On his appointment he started a programme of modernisation, developing a coronary care unit, a pacemaker theatre and a cardiac department providing treadmill electrocardiography, ambulatory tests and echocardiography. In 1984 he established Wales’ first district general hospital pacemaker follow-up service, with local implantation following in 1991.

All these developments were achieved by careful selection of key members of his team. He had the ability to spot qualities in people that he knew would produce a harmonious and efficient cardiology department that could provide high quality care to his patients.

Although he was a single-handed cardiologist for 12 years, he took a full part in acute general medicine.

He realised cardiology services in Wales were inadequate and so, with Andrew Henderson and others, he lobbied for an increase in consultant cardiologists in Wales. This resulted in a Welsh Office review and the subsequent appointment of several more consultant cardiologists in Wales during 1994 to 1995.

His clear and decisive mind was much in demand in the hospital, within Wales and nationally. At the hospital he was chairman of several committees, including the hospital medical staff committee and medical division and, in 1997, he became clinical director for medicine. He was the lead cardiologist for the North Wales Cardiac Network. He was a founder member and long serving president of the Clwyd North branch of British Heart Foundation and founded the patients’ Heart Support Group.

Within Wales he held several offices. He was honorary secretary to the Society of Physicians in Wales, and secretary and subsequently chairman of the Welsh Cardiovascular Society (WCS). During his time as chairman of WCS he again noticed inadequate provision of cardiac services in Wales and led the lobbying of the Welsh government for improvements, which resulted in the building of six new cardiac catheterisation laboratories. He was chairman of the Welsh specialist training committee in cardiology and served on the council of the British Cardiovascular Society. He was an examiner for the RCP.

He continued to take part in research and at retirement was the local lead investigator for the SEARCH clinical trial, coordinated by Oxford University, looking at ways of lowering cholesterol and homocysteine in people who have had a heart attack. He published in excess of 26 papers on diverse clinical subjects.

Despite his onerous committee work, he was at heart a clinician whose skills were much in demand from his patients, who often included his colleagues and former colleagues. He was well read, had excellent clinical acumen, and had a humane bed-side manner. He knew and remembered minute details of his patients’ lives. His note-taking was exemplary, a master-class on how to elicit and then record a comprehensive but concise clinical history on one page of A4.

As well as an excellent physician, he was a supportive and kind colleague and a good teacher and mentor. He maintained high clinical standards and could not stand sloppiness or laziness. This was to the detriment of one underperforming registrar, who was dismissed on the spot. On rare occasions he could get very angry when simple courtesies were ignored or when management decisions were made without full exploration of their potential adverse effects on patient care. Ward rounds were usually efficiently conducted, but during the Cheltenham Gold Cup and the Derby they would be interrupted while the team assembled around the television to watch the next race before the ward round could resume.

Despite his colleagues’ discouragement (because of a fear he might injure himself and require time off work) and his wife’s concern for his safety, he was a courageous horseman and a keen member of the Flint and Denbigh Hunt. Witnesses observed that he would ‘just go for it’, and jump high fences and hedges without knowledge of what was on the other side. This resulted in many injuries, including the surgical reconstruction of his orbital floor with titanium.

Above all, Jeff was a family man. He was immensely proud of his children Elizabeth and William. The last 18 months of his life were difficult for Jeff and his family. Metastatic malignant melanoma required major operations, radio and chemotherapy, and on occasions he suffered severe pain and discomfort. His limited mobility in his last year of life eventually prevented horse riding, although, just before this, despite his surgeon’s strong discouragement following a major knee reconstruction, he had resumed ‘gentle’ riding. His optimism that a new therapy might make a difference to his illness was an inspiration.

Christopher Bellamy

[Brit.med.J., 2013 347 5029]

(Volume XII, page web)

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