Lives of the fellows

John Stuart Garrow

b.19 April 1929 d.22 June 2016
MB ChB St And(1952) MD(1957) PhD(1961) MRCP Edin(1961) FRCP Edin(1976) FRCP(1992)

John Garrow was professor of human nutrition at the University of London and an honorary consultant physician at St Bartholomew’s Hospital, London. He was born in Dundee to two doctor parents, his mother, Janet Helen Garrow née Hodge, being among the first women to qualify in Scotland. His father was Robert Philip Garrow. The family moved to London, where John was educated at Highgate School. He was briefly evacuated with his elder brother David during the war to Dollar Academy, Scotland. He did not enjoy this experience of boarding school.

He studied medicine at St Andrews University and Dundee, representing the university at tennis. Reluctant to compete with returning servicemen from the war for jobs in the UK, he took an internship in the British Colony of Jamaica, working with John Waterlow [Munk’s Roll, Vol.XII, web], whom he much admired. He quickly became interested in the problems of malnutrition in infants brought into the hospital who died when given food. He published papers relating to protein and electrolyte metabolism, which led to safer feeding regimes, saving numerous children’s lives.

He met his future wife Katharine Thicknesse in Jamaica, where she had secured a paediatric post. At the time John was using himself as human trial material for his study on the use of Evans blue as a tracer for human plasma albumin and was an unusual blue colour. Despite this, the relationship blossomed and they returned to the UK in 1957 to marry, and for John to do his National Service at RAF Farnborough. Whilst there he studied the effects of acceleration on the secretion of antidiuretic hormone, resulting in a PhD from St Andrews in 1961.

On returning to Jamaica, John Waterlow recruited him for an expedition to the Andes to investigate the relationship between altitude sickness and serum potassium and albumin due to his inventive skills in designing and operating a portable centrifuge to spin down blood for analysis at high altitude before it froze.

In 1969 he was appointed as head of the Medical Research Council’s nutrition research unit at Northwick Park Hospital. Here he developed his international reputation in the study of energy balance, designing and building both an indirect and direct calorimeter. He spent the next 18 years devoted to the study of human obesity, resulting in numerous scientific publications. The most popularly known outcome of this period being the development of the BMI (body mass index) charts. When asked years later by an earnest practice nurse during a health check if he understood about BMIs, he pointed out that his name was on the chart above her head.

When working at Northwick Park, the family moved to Pinner, to a house which he rewired himself and a garden in which he built arches and water features, along with lots of creative games and activities for family and guests to enjoy. He was a kind, witty and warm parent. Meal times were often punctuated by experiments on himself, for example weighing portions of food and then, having overeaten to become obese, he subsequently took muscle biopsies to investigate the effects of weight loss.

He was a strong believer in the external regulation of food intake, experimenting with jaw wiring and nylon cords fastened around the waist. His monograph Treat obesity seriously: a clinical manual (Edinburgh, Churchill Livingstone), published in 1981, presaged the concept of obesity as a disease.

John’s work was characterised by integrity and intellectual rigour. This was evident in his private as well as public life. Irritated by graffito which appeared at Northwick Park Underground ‘Acid frees the mind’, he got out of his car one dark night and changed it to ‘Acid fries the mind’. Friends and colleagues recall him as being extremely generous with his time in helping with problems or funding their research. Peter Wilmshurst remembers John refusing to put his name to a study which Peter was researching, despite having designed and sourced funding for the project, because he thought he had not contributed enough. Later, when Wilmshurst was sued by a pharmaceutical firm for flagging up misleading reporting of the results of a clinical trial, John set up a whistleblowers’ fund through the organisation Healthwatch, priming the fund with a large personal donation and attending the High Court hearings to give moral support.

John recalled the excitement his father had displayed when the National Health Service came into being and was a passionate believer in the NHS and the principle of evidence-based care delivered free at the point of need.

In 1987 he was appointed inaugural professor of human nutrition at the University of London and St Bartholomew's Hospital. For a decade he was chief editor for the European Journal of Clinical Nutrition. He became chairman and a founding member of Healthwatch, a charity set up to promote integrity in medicine and campaign against health fraud.

John had previously had problems with libel issues when he challenged the nutrition guru Gillian McKeith to subject her ‘living food powder’ to a simple controlled trial of efficacy, to which he added a gentlemanly wager of £1,000. When the response to this was a telephone call from her lawyer husband threatening to sue, he shrugged it off and said ‘Sue me’. Later she did sue The Sun when it exposed her lack of credentials, and he relished the opportunity to appear as an expert witness at the trial. McKeith eventually dropped her claim. John was also one of the first people to raise questions about the effectiveness of England’s breast screening programme and the information supplied to women.

John's wife Katharine died in 2008, a year after their 50th wedding anniversary. Initially he stayed in their lovely home in Rickmansworth on the river, where he had designed and built many of the garden features. Four years before his death he moved to South Cave to live near his medical daughter. He had an expressive dysphasia, and charted his decline in cognitive capabilities by recording his difficulty in beating his chess computer at progressively lower levels. He maintained his complete independence until the very last weeks of his life. He died at home and was survived by his four children – Jen, Meg, Diana and Alan.

Jen Gilchrist
Diana Greene

[BMJ 2016 354 4290 – accessed 1 February 2017; Medical Journalists’ Association John Garrow: an obituary – accessed 1 February 2017]

(Volume XII, page web)

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