Lives of the fellows

Jeremy Hugh Baron

b.25 April 1931 d.11 December 2014
BA Oxon(1951) BM BCh(1954) MRCP(1957) DM(1964) FRCP(1974) FRCS(1987) FRCPS(2001)

Hugh Baron was a consultant physician-gastroenterologist at St Mary’s and Hammersmith hospitals, London. Of all his qualities, the foremost was his love of scholarship. He hungered for knowledge in all his many areas of interest, and from his research and ideas he added to most of them. He described his main hobby as ‘looking’, and from his tall, gaunt frame his quizzical gaze would peruse scientific data, paintings, buildings and members of committees alike. Many were found wanting, for his standards were high, and his learning was analytical, not just acquisitive. He was a compulsive writer and publisher: everything (he believed) should be recorded. As well as his many interests within gastroenterology, he had clear views on ethical matters and was always concerned about the ‘political’ aspects of medicine. He was strong on medical history and on art in, and out, of hospitals. In later years he wrote thoughtfully about religious matters in a collection of talks given to seminars at his synagogue in New York.

His father, Edward Baron, was a Tottenham general practitioner: his mother was Lilian Hannah Baron née Silman. Hugh’s academic abilities were demonstrated early by winning a scholarship to University College School, a Styring scholarship to Queen’s College, Oxford, and then becoming the first Broderip scholar at Middlesex Hospital Medical School. When house officer posts at the Middlesex and Royal Northern hospitals ended, National Service claimed him for the RAMC as a captain. Initially at the Royal Herbert Hospital, Woolwich, he passed his MRCP and was sent as a junior specialist to Malaya. He might have ended his life there had his commanding officer not ordered him to stay in Kuala Lumpur rather than flying up country.

His life-time’s interest – indeed fascination – with the stomach was sparked as a student by Sir Francis Avery Jones [Munk’s Roll, Vol.XII, web] and an enthusiasm for epidemiology and clinical trials by Sir Richard Doll [Munk’s Roll, Vol.XII, web]. At the Middlesex as a registrar he developed Sir Andrew Kay’s augmented histamine test of gastric secretion to his own concept of peak acid output (PAO) (often studying his own, as he had no fear of the nasogastric tube). He showed that below 15 mmol/hour PAO duodenal ulcers did not occur, so treatment to induce this lowered acid state would allow an ulcer to heal. This work led to his DM in 1964. In 1970 international recognition of his work and reputation led him to be invited to give one of the few quadrennial reviews at the World Congress of Gastroenterology in Copenhagen. This was magisterial in tone and delivery, and eventually resulted in his 1978 book Clinical tests of gastric secretion: history, methodology and interpretation (London, Macmillan).

From 1961 to 1962 he held a Medical Research Council travelling fellowship at Mount Sinai Hospital, New York, where he studied pancreatic secretion, showing that it correlated with PAO. Declining the offer of a permanent post in the USA, he returned to a lectureship at the Middlesex, and thence made his crucial move to the Postgraduate Medical School of London in Richard Welbourn’s surgical department. This close collaboration with surgical researchers was unusual but productive, and he was also able to work closely with Stephen Bloom and Julia Polak [Munk’s Roll, Vol.XII, web] in investigating regulatory peptides. Much later, when Helicobacter pylori came on the scene, he collaborated with John Calam [Munk’s Roll, Vol.XI, p.89].

Additionally he took an interest in inflammatory bowel disease, writing about observer error in sigmoidoscopic reports of inflammation, and the effectiveness of 5-ASA compounds in colitis.

His medical-surgical collaboration found a name in the 1980s when his friend Wilfred Lorenz of Marburg revived the idea of ‘theoretical surgery’. Baron delighted in this seeming oxymoron and with Lorenz they founded a journal with the title – but it only survived a few years. In 1987 he was made fellow of the Royal College of Surgeons of England, and later became Hunterian professor (1993 to 1994). In 2001 he was elected a fellow of the Royal College of Physicians and Surgeons of Glasgow.

Alongside his part-time academic employment, he continued to practise clinical medicine at Tottenham, then at St Charles Hospital for over 20 years. Merger with St Mary’s Hospital in 1991 established him on the consultant staff there. On retirement he donated his entire library to St Mary’s.

He was gregarious and travelled widely to lecture. He lectured as he wrote – clearly, trenchantly, authoritatively. His tall figure at the lectern (speaking with Received Pronunciation and extravagantly rolled ‘r’s) was a familiar sight world-wide, but he equally enjoyed discussion. Speakers often quailed as they saw him in the audience unfolding himself and, with hands together as in prayer, eyes closed and facing upwards, he might demolish an argument or correct a mistaken fact, but he was never impolite.

His clarity of analysis, thinking and writing made him an ideal member of the British Medical Journal’s ‘hanging committee’ (1983 to 1988), which assisted the editor in making the final choice of papers for publication. Like many scientific writers, he did not always find the practices of publication satisfactory, so when the Society of Authors formed a medical writers group he was an early member and eventually became its chairman.

He was an enthusiastic member of the British Society of Gastroenterology (BSG). He was its archivist for 16 years, was chairman of the golden jubilee committee for 1987, and wrote a history of the Society for a special edition of the journal Gut for that year (History of the British Society of Gastroenterology 1937-1987: [BSG 50th anniversary] Gut 28, Jubilee Suppl. London, British Medical Association, 1987). The biographical vignettes of every Society officer for 50 years, which he composed, were models of compressed detail of character. He was president from 1988 to 1989. He always regretted that he had never been invited to give the Sir Arthur Hurst lecture.

He was a clubbable man and a ‘joiner’ of societies, so he liked being an Apothecary, became a member of the Oxford and Cambridge Club (but not until they agreed to accept women members) and even founded one. In 1972 he created the Prout Club, membership by invitation, for researchers in the stomach and its secretions. This met at the BSG annual meeting for dinner and debate, and still continues.

The Royal Society of Medicine benefited from his attentions and membership. He was on its council for 12 years and held several offices, including president of the clinical section.

He kept an interested but baleful eye on the Royal College of Physicians for many years. After becoming a fellow in 1974, he became a regular attender at its quarterly comitias (general meeting of fellows), periodically asking cogent questions. He was a staunch ally of John Bennett from 1976 to 1985 while he sought to obtain a referendum about reforming the method of electing the president. He remarked to Bennett: ‘I never know whether to dampen your enthusiasm. I always go into these battles knowing I am going to lose. You are of a different temperament and can fight only when you think you might win.’ He was an RCP councillor from 1993 to 1996, and gave a memorable Fitzpatrick lecture in 1994.

He applied to arts and architecture the same clarity of vision and analytical description as he did to science. Undoubtedly these interests were fostered by his marriages, first to Wendy (née Dimson), an expert on Walter Sickert and for many years curator of the Government Art Collection, and then to Carla, professor of the history of art at Kean University, New Jersey. He found most NHS hospitals dreary buildings and advocated their beautification by cleaning and installing art works such as murals. He even persuaded the Department of Health to revise its health building note one in 1988 to emphasise that hospital buildings should be ‘beautiful as well as functional’.

His productivity did not end with retirement in 1996. He spent summers in London and winters in New York, rejoining Mount Sinai Hospital as an honorary professorial lecturer. He co-edited a volume of the history of the gastroenterology and hepatology departments (Gastroenterology and hepatology at the Mount Sinai Hospital, 1852-2000 New York, Mount Sinai journal of medicine, 2002) and compiled a volume on 24 Mount Sinai physicians (Twenty-four notable Mount Sinai physicians and scientists [New York], The Samuel Bronfman Department of Medicine, [Mount Sinai School of Medicine], 2001).

He continued research into the history of dyspepsia, making forays into the ancient medical records of institutions on both side of the Atlantic, revealing the story of 4,000 years of the stomach, published as a book in 2013 (The stomach: a biography: four thousand years of stomach pains: literature, symptoms and epidemiology Createspace/Jeremy Hugh Baron).

He pursued bioethics, too, and in 2007 published an account of racism, nationalism, eugenics and genocide (The Anglo-American biomedical antecedents of Nazi crimes: an historical analysis of racism, nationalism, eugenics and genocide Lewiston, NY, Edwin Mellen Press). He worshipped at the New York Society for the Advancement of Judaism, often led discussion groups, publishing some of his seminar contributions as Fifty synagogue seminars (Hamilton Books, 2010).

He had two children with Wendy, Susannah (a consultant dermatologist) and Richard, sometimes known as ‘Archie’.

He correctly summed himself up as a restless polymath and said ‘I knew from experience how to accept the unchangeable, but still persisted, sometimes successfully, to change the unacceptable.’

John R Bennett

[The Guardian 31 December 2014 – accessed 25 March 2015; BMJ 2015 350 1025 – accessed 25 March 2015]

(Volume XII, page web)

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