Lives of the fellows

Ronald Charles King

b.8 July 1924 d.4 October 2014
MRCS LRCP(1947) MB BS Lond(1947) MRCP(1949) MD(1952) FRCP(1970)

Ronald Charles King, known as ‘Ronnie’, was a consultant physician at the Kent and Sussex Hospital, Tunbridge Wells, and postgraduate dean for the South East Thames Region. He was born in Southampton, the fourth child of William Charles King and Edith Jane King née Lockyer, both school teachers. He was educated at Peter Symonds School, Winchester, where he fondly recalled being complimented by his teacher as being ‘an oasis in a Latin desert’! After achieving a Hampshire county scholarship, Ronnie entered St Bartholomew’s Hospital Medical School. This was in 1942, at which time Bart’s preclinical students were housed at Queens’ College, Cambridge.

Following two years in Cambridge, he returned to London for clinical studies and, after qualifying in 1947, became house physician to Culling and Black at Bart’s. He then went on to spend two years in the department of physiology with Kenneth James Franklin [Munk’s Roll, Vol.VI, p.184] at Bart's Medical School. It was here that he produced his first publication concerning a new test for assessing adrenaline concentration (‘A sensitive biological test for adrenaline’ J Physiol. 1949 Aug;109[1-2]:Proc, 30). From 1949 to 1951 he carried out his National Service, as a medical specialist at Cambridge Military Hospital, Aldershot. He was awarded his MD in 1952. There followed a series of training appointments, culminating in a year spent as an instructor and research assistant at the University Hospital, Ann Arbor, Michigan. Here he was particularly involved in gastrointestinal medicine and was with Basil Hirschowitz when the interior of the duodenum was visualised by means of a flexible glass gastroscope for the first time. His family accompanied him to the USA and, before returning home, he undertook a road trip of nearly 5,000 miles across the States with his three small children, all sleeping either in the car or in a small two man tent, enduring temperatures of between 30 and 104 degrees Fahrenheit. It was a wonderful, memorable experience.

He returned to England in 1957 as a senior registrar at the Metropolitan Hospital, London, and was later a casualty physician and medical tutor at Bart’s. He had published widely on a range of subjects, particularly in endocrinology and gastrointestinal medicine. Of particular note was his paper, published in Anaesthesia, on the management of diabetic patients undergoing surgery, which became the standard guideline of the time (‘The control of diabetes mellitus in surgical patients’ Anaesthesia. 1957 Jan;12[1]:30-41). Until that time it was common practice to administer half a pint of concentrated glucose solution by mouth two hours prior to anaesthesia. It had been observed that a significant number of patients so treated vomited and aspirated the glucose solution, sometimes with a fatal outcome. Following this paper, this practice was discontinued. Ronnie also co-authored the textbook Clinical therapeutics (London, Lloyd-Luke, 1962), aimed at medical students to bridge the gap between pharmacological theory and clinical practice.

In 1960 he was appointed as a consultant general physician with special interests in diabetes and gastrointestinal medicine to the Kent and Sussex Hospital, Tunbridge Wells. On arrival in Tunbridge Wells, he set about introducing new practices. He introduced the registrar grade (prior to this there were only house officers) and also established an anticoagulation service, a ward-based pharmacy system, a diabetic clinic with dietician and chiropodist, a library and cardiac arrest service. However, his two greatest achievements were the introduction of an intensive care unit and the building of a fine postgraduate centre. These achievements are mentioned in the official history of the Kent and Sussex Hospital, which states: ‘Two major innovations were attributable to the tremendous energy of Dr King; the Intensive Care Unit in 1969 and the Postgraduate Centre in 1973. Strangely there was opposition to them from certain quarters. Many of the nursing staff and some of the consultants were against the idea of the ICU and Dr King needed all his charm and persuasion to overcome this.’ The intensive care unit resulted in a significant fall in mortality in local patients admitted with coronary artery disease, and the newly built postgraduate centre, as well as serving local medical, dental and veterinarian staff, became the base for the general practitioner vocational training scheme, which Ronnie, as the first clinical tutor, ran for general practitioners. This scheme, with four trainees, was only the second in the country.

Widely admired by senior and junior colleagues alike, and much loved by his patients, he had a tremendous sense of humour, admitting that his consultations tended to be rather jolly affairs, as he felt that the introduction of humour, where appropriate, softened the more serious side of medicine. Indeed, always in demand as a speaker, amongst the many presentations he gave over his lifetime was one entitled 'The importance of humour in medicine'. On one memorable occasion, unbeknownst to him, his laughter was secretly recorded by concealing a tape recorder in the notes trolley during a ward round. This was then played back to the audience during the hospital’s annual Christmas show, ensuring a hilarious start to the evening’s entertainment.

With the passage of the time, his clinical commitments changed as new consultants were appointed. He had been elected to the fellowship of the Royal College of Physicians in 1970. He briefly became involved in oncology, but his real interests moved in the direction of hospital and health management, initially with local committees such as the district management team, then on a more regional basis. He was a founder member of the International Society for Technology Assessment in Health Care, where he saw the need for the control, or even rationing, of some medical practices. He was appointed chairman of the regional research committee, the higher awards committee and was, for 10 years, a member of the South East Thames Regional Health Authority (SETRHA). He was also involved in the activities of the Royal College of Physicians, with various committee memberships; he particularly recalled his involvement in the establishment of the RCP committee on general medicine, of which he was honorary secretary. This committee was particularly dear to his heart as, throughout his career, he had continued to champion the importance of the general physician in the district general hospital. He was also appointed regional adviser for the RCP to SETRHA.

In 1983 he was appointed postgraduate dean for the South East Thames Region and assistant director of the British Postgraduate Medical Federation. This was one of the happiest and most rewarding times of his professional life. With Janet Grant, he established the Joint Centre for Educational Research and Development in Medicine, which was officially opened by Princess Anne as a joint venture between the Open University, SETRHA and the British Postgraduate Medical Federation in 1990. This organisation’s chief aim was to bridge the gap between academic education and practising clinicians, and to commission or undertake research embracing the whole spectrum of medical education. His last, and to him most important, venture was the establishment of the pre-registration house officer’s training manual, aimed as much at the consultants as the house officers themselves.

Outside medicine, he led a full life, enjoying hill walking, skiing, canal holidays, collecting Victorian furniture and paintings, and his family. An invitation to compete in his sons’ school’s ‘father and son’ race led to him taking up jogging, which became a lifelong passion and pleasure. Unfortunately the last 15 years of his life were lived under the shadow of Alzheimer’s disease, which he bore as long as he was able, with his characteristic fortitude and humour. In 1949 he married Patricia Jackson. He was survived by his wife, two sons, two daughters, 12 grandchildren and four great grandchildren. Of these, 10 have gone on to pursue careers in medicine, nursing or midwifery, a testament to the high regard in which he was held by his family.

David King

[BMJ 2014 349 7514 www.bmj.com/content/349/bmj.g7514 – accessed 25 March 2015]

(Volume XII, page web)

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