Lives of the fellows

John Galbraith Graham

b.13 February 1933 d.29 August 2014
MB ChB Glasg(1956) MRCP(1963) FRCP Edin(1973) FRCP(1975)

John Galbraith Graham was a consultant neurologist in Cardiff. He was born into a family with a strong medical tradition that had migrated to Canada but originated from the Mull of Kintyre, Argyll and Bute, Scotland. His grandfather worked as a general practitioner in rural Ontario; Graham’s paternal uncles were surgeons in Toronto and Vancouver respectively. His father, Stanley Galbraith Graham, trained in Toronto and, after serving as a medical officer to a British regiment in Mesopotamia during the First World War, was demobilised in the United Kingdom. He stayed, having met and married Grace Hay Anderson. Both parents worked as paediatricians in Glasgow, where Stanley Graham was later Samson Gemmell professor of child health. John Graham was educated at a preparatory school in Dumfriesshire and then Trinity College, Glenalmond. In 1956 he qualified in medicine from Glasgow University with distinctions in zoology, medicine and surgery.

Following junior hospital appointments at the Western Infirmary, Glasgow, with Sir Edward Wayne [Munk’s Roll, Vol.IX, p.565] and Sir Andrew Kay, Graham carried out his National Service with the Royal Army Medical Corps seconded to the British Antarctic Survey. He travelled on the research ship Shackleton, acting as medical officer and transferring, after the ship hit a submerged iceberg and was laid up in South Georgia, to the John Biscoe. As medical officer to Base W, Loubet Coast, Graham Land, living in relative isolation for a period of nine months, Graham’s duties were training and driving sledge dogs. His stay in Antarctica was prolonged by thick ice, which prevented the arrival of relief ships and it was necessary to sledge over the ice to a point where the personnel could board the US Coast Guard cutter North Wind assisted by the ice-breaker Edisto. Base W never reopened, but it was visited and, years later, a deep-frozen orange cake made by Graham was retrieved.

On his return from Antarctica, Graham worked in the Medical Research Council’s department of environmental physiology, in Hampstead, London, analysing observations on skinfold thickness and sleep rhythms made during his National Service. After further clinical training at the Hammersmith Hospital, where his interest in neurology developed with Christopher Pallis [Munk’s Roll, Vol.XII, web], Graham moved to Cardiff, training with John (Jerry) Spillane [Munk’s Roll, Vol.VIII, p.479], as a house physician and lecturer jointly with the department of anatomy, teaching neuroanatomy in the Welsh National School of Medicine. Thereafter, Graham excelled at expounding the anatomical substrate of neurological symptoms and signs.

After a year at the National Hospital, Queen Square (from 1965 to 1966), he returned to Cardiff as a senior research fellow, then a senior lecturer and consultant neurologist at the Cardiff Royal Infirmary and, subsequently, at the University Hospital of Wales. There, in addition to clinical neurology, his responsibilities included clinical neurophysiology, teaching undergraduates and postgraduates, and structuring the training of junior hospital doctors at the three main Cardiff hospitals. Graham was especially pleased to be elected president of the Cardiff Medical and Dental Students’ Club (from 1973 to 1974). He served as a guarantor of Brain and on committees of the South Glamorgan Health Authority and the Association of British Neurologists. Following the family tradition of careers in medicine, John Graham’s older brother, Peter, also worked in Cardiff as a consultant ophthalmologist.

Graham had an enquiring mind and, early in his career, wrote on the efficacy and adverse effects of carbamazepine for the treatment of trigeminal neuralgia, on head injuries, neurological consequences of vitamin deficiency and various miscellaneous clinical topics that attracted his interest. He did not engage systematically in research or publish much after relinquishing his academic post in 1974. This was a loss since Graham had a highly analytical mind and a way with words that captured attention.

As a consultant neurologist in south Wales at a time when clinical practice was changing and academic medicine developing in the Welsh National School of Medicine, Graham provided continuity in the decisive, efficient and wise doctoring needed by his patients. For a while, he was one of three neurologists, based in Cardiff, who covered the area from Chepstow in the east, Brecon in the north and Bridgend to the west – with patients also seen at Rookwood Hospital in Cardiff and occasionally in an old warship, the Hamadryad hospital ship that lay in Butetown south of the city centre. The distribution of work was uneven: Graham covered everything to the east and north-east, including Newport and the pleasant market towns of Chepstow, Monmouth and Abergavenny; Charles Wells [Munk’s Roll, Vol.IX, p.571] worked the west and north-west patch, including most of the more easterly Welsh Valleys; and Spillane rarely strayed from the Cardiff Royal Infirmary. On their retirement, Graham was, for a while, the only neurologist in south-east Wales, but he soon became senior partner in a formidable duo with Iain McQueen [Munk’s Roll, Vol.XII, web] as, together, they developed the neurological services and nurtured fledging activities of academic neurology in Cardiff during the early 1980s.

Even by the standards of the elite clinical community of consultant medicine in Cardiff and surrounding district general hospitals at that time, Graham had an edge, not just through being acquainted with the mysteries of the nervous system with which many doctors appeared timid, but because he excelled in highly efficient decision-making based on experience and common sense. He had seen too many patients to get it wrong. This muted authority was evident on the weekly consultant rounds that rotated through the three Cardiff hospitals each Friday morning at which his contributions, when coaxed forward, were invariably wise and witty. Graham turned phrases that seemed to endow neurological disease with personality: physical signs were ‘reticent’ or ‘eloquent’ and simulated gait disorders ‘athletically ataxic’.

Graham was economical with his schedules and able to complete sessional work without ever appearing hurried since, in his prime, he was a man of prodigious physical and mental energy who knew how to plan the day and relax in the evening. He set high standards of competence in clinical medicine and hoped for the same in those around him, be those nursing sisters, formidable Welsh matrons, secretaries or colleagues in other specialties. If his expectations were not met, Scottish charm and good manners prevented Graham from revealing his inner thoughts, unless very relaxed. Greeting a potential new colleague and his wife who arrived to visit the University Hospital of Wales, Graham happily pushed a baby-buggy around the corridors and amused their young child during the parents’ meetings with other future colleagues; and there were plenty of wisecracks from those who ventured opinions on his apparent new role in the hospital.

Away from the hospitals or his practice in Cathedral Road, Graham played golf and much enjoyed the company and atmosphere of the Royal Porthcawl Club, where he was captain (in 1988) and later a member of the senior golfers’ society. Here were gathered men raised in the Principality or those who moved to south Wales in the post-war era, and who influenced local society through their achievements in all walks of life. At home in Cyncoed, Cardiff, Graham’s friends encountered amusement and intimacy in conversation, and a certain freedom of expression, but never any malice.

John Graham married Rosemary Joan Cleveland Belle in 1962, the daughter of Albert Edward Belle, a businessman. They had three children, Fiona, Paul and Victoria, and there were seven grandchildren, to whom he was devoted. Ill-health affected the later years of Graham’s retirement so that, with reduced mobility, it was no longer possible for him to play golf. He died at home.

Alastair Compston

(Volume XII, page web)

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