Lives of the fellows

David William Kilbourne Kay

b.31 October 1918 d.11 February 2016
BM BCh Oxon(1943) DPM(1948) DM(1960) MRCP(1964) MRCPsych(1971) FRCPsych(1971) FRCP(1972) MRANZCP(1976)

David Kay’s central achievement was a steady and regular flow of influential scientific papers to the psychiatric literature, of high quality and covering a broad range of topics, over a period of 50 years. His name became entwined with that of Sir Martin Roth [Munk’s Roll, Vol.XII, web] following their ground-breaking studies carried out in the early 1950s on the classification of mental disorders in the elderly.

David Kay was born in Oxford in 1918 into a family in which his paternal grandfather had created the highly successful mail order firm of Kays of Worcester. His father, Jack Kilbourne Kay, who married Winifred Elizabeth Rose, became a regular Army officer in India, was awarded the Distinguished Service Order, and later returned home to run the family business with his brother Edwin. An engaging portrait of Edwin (Uncle Ted) by Sir Stanley Spencer now hangs on permanent loan at the Ferens Art Gallery in Hull, with due acknowledgement to the Kay family. David was sent from India to Summer Fields Preparatory School, from where he gained a scholarship to Eton College. He became a member of the exclusive Pop Club there and also played cricket for the first 11. After Eton he studied medicine at Trinity College, Oxford.

Following house appointments at the Radcliffe Infirmary, Oxford, and the Royal Northern Hospital, London, David Kay became an RAMC trainee and graded psychiatrist for two years, reaching the rank of captain, where his responsibility for assessing recruits and deciding whether they should be appointed to Army units or the Pioneer Corps kindled his interest towards a career in psychiatry. His next move was to the Bethlem and Maudsley Hospital, and Institute of Psychiatry, where as a registrar he trained with Felix Post [Munk’s Roll, Vol.XI, p.458] for three years, the doyen of geriatric psychiatry at that time. In 1952 he moved to become clinical research assistant attached to the Medical Research Council’s (MRC) unit at Graylingwell Hospital, Chichester, which was headed by Martin Roth. Here Roth and Kay studied the mental hospital patients who at that time were generally regarded as suffering from ‘senility’ and who aroused little medical interest. It was their considerable achievement to demonstrate, on the basis of operationally defined clinical groups and their outcome, that there were subdivisions of ‘senility’ into dementia (senile and vascular), confusional states, paranoid psychoses and depressive illnesses. This classification has stood the test of time and gained later validation by correlates with brain pathology.

From 1955 to 1956 David Kay was a senior registrar at Cherry Knowle Hospital, Sunderland and then at All Saints Hospital, Birmingham. From 1956 to 1958 he worked on a Leverhulme research scholarship at the Karolinska Hospital, Stockholm, undertaking studies on outcome and mortality in mental disorders of the elderly; the data were drawn largely from the reliable Swedish medical records. He also learned sufficient of the Swedish language to be able to care for patients in a nearby mental hospital.

In 1959 David Kay was invited by Martin Roth, who then held the chair of psychological medicine in Newcastle upon Tyne, to join him and resume their partnership. After two years as first assistant to Roth, he was appointed as a consultant psychiatrist at the Royal Victoria Infirmary. This post enabled further impetus to be given to his research and writing in a variety of fields. These were often pursued in conjunction with junior colleagues who found participating in projects of impeccable design, method and analysis an invaluable experience and a stimulus to pursue enquiries of their own. Kay’s studies were largely undertaken at the nearby research unit and included: important epidemiological and prevalence enquiries into old age disorders (including the finding that 10% of old age residents in the community suffer from dementia) and their community care provision; genetics of schizophrenia and other mental disorders; mortality (including suicide) in manic depressive and schizophrenic psychoses; head injury and the post-concussional syndrome; syndromes of depression; anorexia nervosa; anxiety and neurosis in old age; pre-senile dementia; Alzheimer’s disease and Down’s syndrome; deafness in paranoid and affective psychoses; the syndrome of stuttering; and reflections on therapeutic abortion. From 1963 to 1964 he was a member of the Irish Committee of Enquiry on Mental Illness and from 1965 to 1969 an adviser on psychogeriatrics to the World Health Organization.

In 1976, at the relatively late age of 57, David Kay moved to Tasmania to take up the chair of psychiatry at Hobart, where he was also appointed clinical commissioner of Mental Health Services in Tasmania. His eight-year tenure there led to greater integration of clinical and research activity, the overhauling of psychiatric education and a renewed surge of research activity and review writing. He also became joint editor of the prestigious Handbook of studies on psychiatry and old age (Amsterdam, Oxford, Elsevier, 1984).

On his return to Newcastle in 1984, David worked for a year at Prudhoe Hospital, Northumberland, for the mentally impaired, before becoming an honorary member of the scientific staff at the MRC neurochemical pathology unit for six years, grant holder with the MRC for a further six years, and finally visiting professor in the department of psychiatry in Newcastle until 2002. During these periods his research output continued undiminished with further studies on genetics, suicide, dementia and the effectiveness of community-based care. He also took part in the European collaborative studies on the elderly.

David Kay married twice. He had three children by his first marriage to Alexandra. From his second marriage to Barbara Hopkins, a clinical and research psychologist with whom he collaborated at Graylingwell Hospital, and who survived him, he had six children. David was highly intelligent, warm and modest, kind, generous and hospitable, and with an exquisite dry sense of humour. He was also consistently supportive to junior colleagues and friends. During his belated retirement he resumed his passionate interest in cricket and the exploration of his family genealogy.

Alan Kerr

(Volume XII, page web)

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