Lives of the fellows

Brian Victor Payne

b.3 December 1945 d.11 August 2012
MB BChir Cantab(1970) MRCP(1974) FRCP(1989)

Brian Payne was a much-respected consultant geriatrician in Norfolk. He was born in St Albans, Hertfordshire, the son of Victor Albert Payne, a civil engineer, and his wife, Mary Jane née Gibbons, who was an engraver during the Second World War. He was educated at Dulwich College from 1957 to 1964, on a scholarship from a state school. From there he won an open scholarship to Gonville and Caius College, Cambridge, to study invertebrate zoology and physiology. He gained a first in part one of the natural sciences tripos in 1966, but, as Gonville and Caius was more inclined to medicine, Brian decided to change courses. Cramming anatomy and pathology into one year, as well as being immersed in college politics and rowing, resulted in second in the medical sciences tripos in 1967. He went to the Middlesex Hospital Medical School, London, for his clinical studies and gained an MB BChir with a distinction in pharmacology.

He met Margaret Andrea Ayling in a basement of Student Movement House in Gower Street when they were working for the student London Medical Group. They married in 1971 during an off-duty weekend in his pre-registration year, when he was house surgeon at St Albans Hospital. They had twins, a boy and a girl, Tom and Suzie, and at a later date another daughter, Julia. Margaret was a linguist, and after studying at university worked with the World Council of Churches in Geneva.

Brian was fortunate to spend the next six months of his preregistration year at the Central Middlesex Hospital under Sir Francis Avery Jones [Munk’s Roll, Vol.XII, web], then the doyen of British gastroenterologists.

An initial decision to train as a pathologist led him back to Cambridge, via a general senior house officer post at Roehampton. Brian became the last resident pathologist at the old Addenbrooke’s Hospital before taking up a university post as a junior assistant pathologist, a year before all such posts were incorporated within the NHS. A chance meeting at a college dinner in Cambridge led to his appointment as a lecturer in microbiology at St Thomas’ Hospital under Ian Phillips. Whilst in London he pursued clinical training in parallel with laboratory studies and obtained the MRCP.

Eventually deciding to proceed in clinical medicine in East Anglia, he accepted a post in geriatric medicine at Chesterton Hospital, Cambridge, under Bill Davison, at this time envisaging a career in general practice. Towards this end he did several long residential locums in the very rural practice of Freddie Johnstone at Hoxne on the Norfolk/Suffolk border. Finding that the resources and diagnostic uncertainties of mid-1970s in general practice were not to his taste, he discovered the great variety of clinical work with the elderly. He completed senior registrar training, before being appointed as a consultant geriatrician in Norwich in 1978.

Norwich at the time of Brian’s appointment was at a crossroads in its development of geriatrics, with two rigidly demarcated sector services. His brief was to open the first specialty beds at the Norfolk and Norwich Hospital, the pre-1948 voluntary hospital of the city and county, expanded from 1974 by site developments. Prior to this, geriatric services were provided at the West Norwich Hospital in upgraded workhouse accommodation: consultants also had outlying beds in north Norfolk at Aylsham Hospital, where care was provided in old wards alongside the specialty of rheumatology and with orthopaedic patients requiring surgery for rheumatoid arthritis and hip and knee joint replacement. With the appointment of younger colleagues, this fully amalgamated geriatric department was realised by 1985. Further integration was happily achieved at the turn of the century, with the move of all hospital facilities to a green field site at Norfolk and Norwich University Hospital, situated adjacent to the University of East Anglia and associated research institutes.

The 1980s were occupied by a developing private practice and service in the Territorial Army, as a captain in its Norwich detachment of 257(S) General Hospital from 1980 to 1983. Brian enjoyed weekends away and three weeks of manoeuvres in Denmark. Towards the end of the decade, these activities gave way the demands of hospital management, first within the local community trust and then as clinical director at Norfolk and Norwich Hospital, from 1992 to 1997. This latter period involved hospital moves and reorganisation, as well as hosting the national spring meeting of the British Geriatric Association at the University of East Anglia in 1994.

Abandoning medical management with relief, he decided on further career development in clinical work. This first took the form of establishing and building a team to deliver out-patient services in the diagnosis and management of Parkinson’s disease and related movement disorders, the first of its type in Norfolk. With this done, and with an already established interest in orthopaedic surgery in the elderly, he put together a team to open a dedicated ward unit to manage, from admissions to discharge, elderly patients with fractured neck of femur. This proved successful enough for visiting Cabinet Office officials to express an interest, but then, typically, non-clinical management interest waned and resources were cut, but not enough to destroy its effectiveness.

Approaching long-planned retirement at 60, an episode of acute appendicitis revealed an unsuspected carcinoma of the caecum. After the necessary two rounds of surgery and subsequent chemotherapy, Brian returned to work for a final 18 months before retiring in 2006.

Putting aside clinical work completely, Brian began to learn to play the flute from scratch, picking up his younger daughter’s instrument to do so. He and Margaret were also able to pursue their combined love of music by attending the many concerts and recitals taking place throughout Norfolk and further afield. He also assumed chairmanship of the long-established Norfolk and Norwich Benevolent Medical Society, and started work with the Norwich Society website subcommittee.

Margaret and Brian took many holidays together, notably a two-month tour around Australia. Included in this was a north-south Ghan train journey, so named after the Afghan camel trains originally making the arduous journey from Adelaide to the Red Centre, through the Outback to Darwin. They enjoyed some obligatory snorkelling on the Great Barrier Reef. Sadly in 2008 his colon cancer re-asserted itself, resulting in further surgery and more chemotherapy, followed by radiotherapy. During the recuperative period they had memorable train journeys to Vienna, Venice and Paris, where they were re-acquainted with Monet’s beautiful gardens in Giverny. The well preserved house and flower garden in front of it and the Japanese inspired water garden on the opposite side of the road brought back many happy memories.

In the autumn of 2009, a lower limb deep venous thrombosis developed in association with a known metastatic spread. This was very disabling until a stent and thrombolysis proved successful enough to re-establish normal walking ability for a year. He had the great joy of seeing his first grandchild and gained great comfort from his family, reading the works of Rudyard Kipling and continuing his love of poetry.

Brian Payne died from a metastatic brain tumour. He was survived by his wife Margaret, with whom he had such a happy relationship for 41 years, and by his twins, Tom and Suzie, and younger daughter Julia, her husband, Stuart, and grandson Ted.

Margaret Payne
N Alan Green

[Eastern Daily Press 14 September 2012 www.edp24.co.uk/news/obituaries/brian_payne_norwich_consultant_transformed_care_for_the_elderly_1_1516173 – accessed 12 February 2013]

(Volume XII, page web)

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