b.12 August 1929 d.11 April 2014
MB BS Lond(1952) MRCP(1954) MD(1967) FRCP(1969)
Abraham ‘Abe’ Guz was professor of medicine at Charing Cross and Westminster Medical School in London, and honorary consultant physician to Charing Cross Hospital until his retirement in 1994. He was active in research on cardiovascular and respiratory topics for many years, and worked as a general and respiratory physician in the Fulham and then Charing Cross hospitals for his entire career. He made major contributions to our knowledge of the physiology and neural control of breathing and mechanisms of breathlessness in both health and disease, mentoring young scientists and physicians and collaborating with many research workers until long after his formal retirement.
He was born in London, the son of Akiwa Guz, a radio engineer, and Esther Guz née Silberman, and was educated at Grocer’s Company School. He began his medical career as he meant to go on. Entering Charing Cross Medical School with a state scholarship, he won prizes throughout his training, culminating in the school’s gold medal and honours in medicine and surgery in his final examinations in 1952. Two years later, aged 25, he passed his MRCP at the first attempt.
He then carried out his National Service, which he ended as medical director of the hospital serving the HQ of the British Army of the Rhine, with the rank of acting major. He returned to a senior house officer post at Hammersmith Hospital, and then went to the United States, where he spent two years in Boston, and two years at the newly-opened Cardiovascular Research Institute (CVRI) in San Francisco.
In England meanwhile, the University of London had decreed that all its undergraduate medical schools must have academic departments in the main clinical specialties. There was no room for this on the Charing Cross Hospital site in the Strand, so space was found on the sites of affiliated hospitals: medicine was located at Fulham Hospital in Hammersmith, housed in a series of prefabricated huts. In 1961 Abe returned to this new department of medicine as an assistant lecturer to the inaugural professor of medicine, Hugh de Wardener [Munk’s Roll, Vol.XII, web]. Drawing on what he had learned at the CVRI, he set about modernising the care of patients with respiratory failure (this was still the era of London smogs) with mechanical ventilation and blood gas analysis, and established the first ECG-monitored beds in the UK (where, leaving nothing to chance before performing one of the earliest defibrillations, he was seen praying by the bedside).
He also put enormous energy into research. He raised grants to fund his own salary as a senior lecturer and that of a lecturer and a research fellow, with running costs for studies – initially in cardiovascular physiology, making measurements in conscious animals, which established much of what we know of left ventricular dynamics in exercise, and later in what would prove to be his lifelong interest – the physiology and neural control of breathing and respiratory sensation.
In 1973 the new Charing Cross Hospital opened on the Fulham site, and Abe, initially with the personal title of professor of medicine and later as head of department after de Wardener’s retirement, took responsibility for academic and clinical respiratory medicine. He was by then immersed in respiratory research. In addition to animal studies, he had studied patients with abnormalities of innervation of the respiratory apparatus – surgical denervation of the carotid bodies, laryngectomy, cervical cord transection, diaphragmatic paralysis, and later denervation of the whole lung after heart-lung transplantation. There were also experiments in normal subjects – the effects of lung volume, local anaesthesia of the airways or inhalation of noxious aerosols on breathing patterns and sensation, and, most controversially, the effect of bilateral block of the vagal nerves at the base of the skull on respiratory sensations in conscious subjects. These studies, which called for ingenuity and determination, as well as collaboration with innumerable colleagues in other disciplines, built him an international reputation, which was later enhanced when he set up a research-based sleep laboratory – one of the first in the country – to study respiratory reflexes and disturbances in normal and abnormal sleep. When research funding became difficult, he responded, typically, by setting up his own research charity, which funded work in the laboratory and supported a series of young research workers, many of whom are now carrying on the work in sleep laboratories elsewhere.
Abe ran a department of medicine in the tradition of the times. It included clinical staff from a variety of specialties, and scientists from the physical and well as the biological sciences supervised and took part in the teaching of undergraduate medicine and were involved in the hospital’s acute medical service. Although he had a reputation for investigating patients with almost obsessive thoroughness, often with sophisticated technology, he was actually a very able clinician, with a respect for clinical technique and its history. When, on his way back from a conference in South America, he was asked to see a British journalist in his hotel who had fallen ill, he improvised a Laennec stethoscope from the cardboard core of a toilet roll, used it to diagnose pneumonia, and supplied the sufferer with antibiotics and analgesics. When he arrived home, he found the story in all the newspapers and his office full of toilet rolls.
His company was always stimulating. He was quick-witted, interested in and seeking explanations for everything, and had an encyclopaedic knowledge of the literature. His enthusiasm motivated those around him, generating hard work and ideas, and the department achieved an impressive list of further degrees and subsequent professorial appointments. He published profusely – his papers co-authored with hundreds of collaborators – and widely; in his lifetime he wrote papers in over 60 different physiological and medical journals. He also found time for other activities; he was a founder member and officer of the Medical Research Society, served on the editorial boards of a number of journals, and sat on grants committees of the Medical Research Council and the Wellcome Trust. He was a clinical examiner for London University final exams and the MRCP, and was president of the British Association for Lung Research.
In his retirement he continued with research, and taught for several years on the graduate programme in the department of physiology at Oxford. He died from complications of colon cancer, and was survived by Nita, his wife of over 50 years, three daughters and nine grandchildren.
[Imperial College London News Abe Guz 16 April 2014 –www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/medicine/heartandlunginstitute/newssummary/news_16-4-2014-11-33-27; BMJ 2014 348 3717]
(Volume XII, page web)
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