Lives of the fellows

Robert Alistair Livingston Brewis

b.16 October 1937 d.27 July 2014
MB BS Durh(1960) MD Newcastle(1966) MRCP(1962) MRCP Edin(1963) FRCP(1974) Hon DSc Newcastle

Alistair Brewis, a consultant physician at the Royal Victoria Infirmary (RVI), Newcastle, was widely acknowledged as an outstanding respiratory physician, educator, role model and mentor. Beyond medicine, he was known as a very talented artist and illustrator, an expert on local history and a creator of automata. He was born and bred in Newcastle upon Tyne, where his father, George Brewis [Munk’s Roll, Vol.VI, p.64], was a physician and paediatrician at the RVI. Alistair attended the Royal Grammar School in Newcastle and studied medicine at King’s College, then a college of Durham University. He had a distinguished undergraduate career, winning several prizes.

After qualifying in 1960 and pre-registration house jobs at the RVI, he went to London for further experience at the Hammersmith, Brompton and Charing Cross hospitals. At Charing Cross he wrote an MD thesis on the subject of choriocarcinoma, around the time that it was first becoming curable by chemotherapy. He then spent four years as a senior registrar at Manchester Royal Infirmary, where he was particularly inspired by J B L (‘Jack’) Howell to pursue a career in respiratory medicine. Alistair returned to Newcastle in 1970 as a consultant physician and senior lecturer in medicine at the RVI.

He rapidly established himself as a highly respected clinician and teacher. His clinical opinion on difficult cases was greatly valued and widely sought. Many medical colleagues turned to him for help when they themselves had medical problems; although it has become a cliché to describe an individual as ‘the doctor’s doctor’, such a tribute applies par excellence to Alistair Brewis. He developed particular interests in managing patients with asthma and young adults with cystic fibrosis. Effective management of both these groups of patients demands considerable time and explanation, and Alistair would patiently devote as much time as each individual needed. In asthma, he was a pioneer in the important areas of patient education and individualised plans for self-management. He would spend considerable time writing (and drawing) such plans from scratch for each patient, as he appreciated this had more impact than any standardised, predesigned advice.

As a clinical teacher, Alistair Brewis was second to none: he impressed on his students a classical approach, based on careful observation and history taking, picking up important clues which eluded others. His clinical style was ‘holistic’ long before the term became fashionable. For many years he was virtually singlehandedly responsible for undergraduate teaching in respiratory medicine in Newcastle, and his own lectures and seminars were regularly the most popular.

Brewis’ classic book Lecture notes on respiratory disease (Oxford, Blackwell Scientific) remains the undergraduate bible of the specialty; first published in 1975, it is now in its eighth edition, having been translated into many languages. The text is greatly enhanced by his illustrations and cartoons. Because of their immediate impact, his simple and eloquent caricatures of the physical characteristics of patients with chronic obstructive pulmonary disease (COPD) – ‘pink puffers’ and ‘blue bloaters’ – are widely used by many lecturers on the subject. He also jointly edited the large postgraduate textbook Respiratory medicine (London, Saunders, c.1995) which, again, was illuminated by his brilliant artwork, illustrating the detailed anatomy of the lungs and chest.

Although he possessed, in abundance, the curiosity necessary for successful research, he always regarded clinical work and teaching as his strengths and he never claimed major contributions to research. In the later part of his career he was persuaded to assume the role of medical director at the RVI. His tenure of the post covered a period of considerable expansion of the hospital and demanded a major commitment. He was initially reluctant to take on the role, but, as his colleagues had anticipated, he devoted his considerable energy and diplomatic skills to making it highly successful.

Alistair Brewis made several notable contributions on the national respiratory scene. Because of his interest in self-management of asthma, he was an important participant in the development of the first UK guidelines for asthma. These were published in 1990, long before guidelines became the major industry they are today. He was, at various times, chairman of the research committee of the National Asthma Campaign and specialty adviser on respiratory medicine to the Chief Medical Officer at the Department of Health.

He was a very successful editor of Thorax for six years, a mammoth undertaking in the pre-electronic age, particularly as he was assisted by only two associate editors (compared with 22 today!). During those years he would never be seen with less than two large bulging cases of manuscripts, and holidays were a serious challenge because of the enormous pile which would be awaiting his return.

His contributions were recognised by the British Thoracic Society (BTS), firstly by his election as president and later by the award of the BTS medal for ‘outstanding contributions to respiratory medicine’. After retirement, and to his own considerable surprise and delight, Alistair Brewis’ outstanding career was appropriately recognised by Newcastle University by the award of an honorary doctorate of science.

Alistair Brewis retired with his wife, Mary (née Burdus), a clinical oncologist, to a house overlooking Bassenthwaite Lake in Cumbria. Rather than continue with a reduced medical role, he ‘switched off’ completely from medicine and became immersed in village activities, as well as devoting more time to painting and to his numerous other interests. He had painted regularly during his working life and the walls of many houses in the north of England are adorned by his paintings, particularly landscapes, in which he excelled in the portrayal of light and shade. His talent as a caricaturist was also widely recognised and, on their retirement, many colleagues were delighted to be presented with a ‘Brewis’ of themselves to mark the occasion. After his own retirement, the proceeds from the sales of his paintings were donated to the Calvert Trust, a Lakeland-based organisation dedicated to ‘challenging disability through outdoor adventure’. He became chairman of the Friends of the Calvert Trust and a trustee of the trust itself.

His numerous local activities also involved designing and producing the Bassenthwaite parish map, supervising production of the large village mural, designing permanent display boards at nature reserves and beautifully illustrating local guides, including one on St Bega’s Way, a 36-mile walk through west Cumbria. He became very well versed in local and natural history, giving talks on subjects as diverse as the Newcastle Town Moor, the Lakeland fells and the life history of ants and spiders.

He also developed a particular interest in designing and constructing automata. Initially, these were for the amusement of his grandchildren, but they were also exhibited at local events. They include a life-sized man pedalling a bicycle with a barking dog and squawking crow, a farmer performing gymnastics and a massive duck which laid rugby balls.

Alistair Brewis was survived by his wife Mary, three sons and six grandchildren.

G J Gibson

[The Telegraph 7 October 2014 www.telegraph.co.uk/news/obituaries/11146728/Dr-Alistair-Brewis-obituary.html – accessed 11 December 2014; Newcastle University, citation www.ncl.ac.uk/congregations/assets/documents/AlistairBrewis.pdf – accessed 11 December 2014]

(Volume XII, page web)

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