Lives of the fellows

Dan Sylvester Tunstall Pedoe

b.30 December 1939 d.13 February 2015
BA Cantab MB BChir(1965) MRCP(1967) DPhil Oxon(1970) FRCP(1979)

Dan Tunstall Pedoe was a distinguished consultant cardiologist at Hackney, Homerton, St Bartholomew’s and the London hospitals, and the founding chief medical officer of the London Marathon. He was born in Southampton, one of twins. His father, Daniel Pedoe, the English-born son of Polish immigrant parents, was a mathematician. His mother, Mary Pedoe née Tunstall, was a geography lecturer. His twin, Hugh, also became a cardiologist. Dan was educated at Haberdashers’ Aske’s and Dulwich College, and then went on to King’s College, Cambridge, where he gained a BA with first class honours in physiology and psychology, and his MB BChir in 1965.

At Oxford he subsequently carried out research as a registrar at the Radcliffe Infirmary, investigating the velocity and distribution of blood flow in the major arteries of animals and man. He was awarded a DPhil in 1970. From 1972 to 1973 he worked as a physiologist at the Cardiovascular Research Institute, San Francisco.

On his return, he became a senior lecturer, consultant physician and cardiologist at Barts and Hackney hospitals. This was a joint appointment, but he spent the majority of his time at Hackney, a local hospital in a deprived area of London, as he felt the need there was much greater. This was very typical of Dan; he always concerned himself with improving medical, departmental and hospital expertise.

At the Hackney Hospital, Dan began with one technician and an ancient ECG. He converted an old laundry building into a thriving cardiology department, where he carried out innovative research, using Doppler ultrasound techniques, enabling non-invasive cardiac diagnosis. The equipment he designed is now a standard part of echocardiography.

Many people admired the Victorian buildings of the old Hackney Hospital, and felt that the new Homerton Hospital could never live up to them. Dan, however, disagreed, and was very involved in setting up the new Homerton University Hospital – eventually becoming chair of the commissioning team. There was a lot of local opposition to this new hospital, and Dan described abusive letters, threats of violence, even burglary.

The new hospital got off to a bad start with an MRSA epidemic, but it soon became successful, partly due to Dan’s insistence that the Homerton get its own pathology laboratories and teaching areas. Later, he was to chair the Homerton Hospital's art committee, set up to embellish its bare walls. He was so successful that the hospital gained a reputation as the place to see fine art.

There was also quite another side to Dan’s medical life: he was a pioneer in the UK of health-related sport and exercise, and of sports medicine. He was a runner – he competed for Cambridge at athletics and was the London mile champion in 1964 – so, fittingly, he became a world-leading expert on marathon medicine. Chris Brasher and John Disley set up the London marathon in 1981, with Dan as the sole official doctor, with four fellow medic helpers, two physiotherapists, one podiatrist and a handful of St John Ambulance volunteers supporting those first 7,451 runners (of whom 6,255 finished). In legendary ‘Dr Dan’ fashion, he would join in to help in the medical tent on those occasions when he had just completed the race. He also formulated the original detailed marathon medical advice sheet, important in reinforcing the runners’ responsibility for their own wellbeing.

By the time Dan stepped down as medical director in 2006, the race had burgeoned to over 35,000 runners, and now medical cover is provided by 150 doctors, highly experienced in sports medicine, orthopaedics, intensive care, and internal medicine, assisted by 50 physiotherapists, 30 podiatrists and over 1,500 volunteers of St John Ambulance, who organise over 50 first aid posts along the route, seeing some 5,500 ‘contacts’. There are also a large number of nurses and paramedics, and three field hospitals at the finish. In its first 20 years, there were eight deaths, seven of them cardiac, in 650,000 completions, giving odds of 1/80,000 against dying, which, according to Dan, was no higher than people going about their normal activities.

Dan recognised that the marathon is a healthy event for most, but a medical challenge for some. To this end, he set up an annual conference on the science and medicine of marathon running to ensure that the most up-to-date knowledge and best practice was being shared. Beginning at Barts Hospital Medical School in Charterhouse Square, it later moved to the Royal Society of Medicine, and is now the longest-running event of its kind internationally. Normally a day-long event, in 2000 the conference was held over three days and included contributions from 31 world-leading authorities. The proceedings were published as Marathon medicine (London, Royal Society of Medicine Press, 2000), co-edited by Dan and with a preface by Sir Roger Bannister. Dan was also chair of the British Association of Sport and Medicine from 1983 to 1991.

Outside medicine, he loved photography, especially photographing insects, a hobby which burgeoned in his retirement (his work was included in exhibitions at Homerton). Another hobby was astronomy and cosmology, and we had many conversations on the multiverse, dark energy, dark matter, antimatter, the Higgs boson and black hole physics. He played a good game of chess and enjoyed humorous poetry.

Dan was a sceptic in the original sense of the word – a disciple of pyrrhonism, the doctrine that certainty of knowledge is unattainable. He had a wholly delightful sense of humour, including a love of eclectic data. A favourite saying of his was: ‘To every function there is an equal and opposite malfunction’, which he saw as a core truth of medicine. Dan was always very courteous, but he spoke out, and told the truth as he saw it, with an absolute refusal to kowtow to dogma and winds of favour. He could tell people in power what they did not want to hear and, worse, what they did not want others to hear.

In 1968 he married Diana Robin Kennedy, known as ‘Robin’, whose father was a stockbroker. They had a daughter, Nadine, and sons, Simon and Ian. They were a delightful, warm, couple. She predeceased him in 2014. He battled stoically and uncomplainingly with Parkinson’s for 12 years; his ‘dopamine imbalance’, as he called it. He eventually died from a heart attack while in hospital with a badly dislocated shoulder. He was survived by his three children and three granddaughters – Ella, Olivia and Jessica.

To the end, he continued to interest and enthuse those around him, whether in discussion of matters medical or scientific, or through his expertise in photography. He will be enormously missed, but his legacy of improving the safety of all marathon competitors will stand timelessly.

Craig Sharp

[The Times 27 Febraury 2015 www.thetimes.co.uk/tto/opinion/obituaries/article4366724.ece – accessed 4 March 2015; The Guardian 26 March 2015 www.theguardian.com/sport/2015/mar/26/dan-tunstall-pedoe-obituary – accessed 2 June 2016; BMJ 2015 350 2025 www.bmj.com/content/350/bmj.h2025 – accessed 2 June 2016; The Lancet 2015 385 1504 www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)60743-7.pdf – accessed 2 June 2016; Muscles Ligaments Tendons J 2015 Apr-Jun:5(2):142-3 www.ncbi.nlm.nih.gov/pmc/articles/PMC4496016/ – accessed 2 June 2016; The Hackney Society The story of Healthcare in Hackney Dr Dan Tunstall Pedoe, Cardiologist www.health.hackneysociety.org/page_id__226.aspx?path=0p10p – accessed 2 June 2016]

(Volume XII, page web)

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