Lives of the fellows

Herbert Barrie

b.9 October 1927 d.20 March 2017
MB BS Lond(1950) MD(1952) MRCP(1957) FRCP(1972) FRCPCH(1997)

Herbert Barrie was a consultant paediatrician at Charing Cross Hospital, London and a leading figure in neonatology. He was born Herbert Bihari in Berlin. His parents were Jewish: his mother, Ida, was from Lwów, Galicia, then part of the Austro-Hungarian Empire and his father, Emil Bihari, was from Budapest, Hungary. In the early stages of the First World War, Lwów was captured by the Russians; Emil was a soldier in the Austro-Hungarian Army, which had been sent, in 1915, from Budapest to recapture Galicia.

In 1936 the family fled Nazi Germany and went to England (the family did not practise Judaism and Herbert was a non-believer). The family’s first home was in a block of flats built around a tennis court. This started a lifelong passion for tennis. Herbert won a scholarship to Wallington County Grammar School, and from there went on to University College Hospital Medical School, London, where he qualified in 1950. In his final year at medical school he changed his surname to Barrie.

House appointments at University College Hospital were followed by a paediatric registrar post at Great Ormond Street, and then a year as a research fellow at Harvard University and the Boston Children’s Medical Center.

In 1959 he was appointed as a senior registrar, then five years later as a senior lecturer, at St Thomas’ Hospital, London. Here he worked with Dennis Cottom [Munk’s Roll, Vol.VI, p.122] and Brian Wilson [Munk’s Roll, Vol.VIII, p.542]; Cottom was at the forefront of the emerging specialty of neonatal care and it was at St Thomas’ that Herbert first developed a profound interest in the care of premature infants. This was a time of rapid medical advances, particularly in respiratory support, that were at last making the survival of premature newborn babies a reality. Very few babies born before 32 weeks survived and those who did often suffered neurological impairment. He pioneered advances in resuscitation of the newborn, publishing his seminal paper on the subject in The Lancet in 1963 (‘Resuscitation of the newborn.’ Lancet. 1963 Mar 23;1[7282]:650-5). A film showing the practicalities of resuscitating a preterm infant was shown around the country.

His time at St Thomas’ was probably the happiest time of his professional life. It was during his seven years there that he met, and then married, Dinah Castle, who was also a doctor.

In 1966 Herbert was appointed as a consultant paediatrician to the new Charing Cross Hospital in Fulham (the hospital was in the process of moving from the Strand). The incumbent paediatrician at Charing Cross was Hugh Jolly [Munk’s Roll, Vol.VIII, p.246], a larger than life character with boundless enthusiasm who espoused the rights of parents and the ‘whole child’. Innovative, certainly, but Jolly was not always an easy man to work with. The resultant bouts of departmental divisiveness was a contrast to Herbert’s antecedent years at St Thomas’, where he had enjoyed being part of a superbly cohesive and tight-knit department.

Herbert continued his ground-breaking and pioneering work in the care of the preterm infant. He ran a renowned department, which accepted referrals from not just the local community but also from other hospitals afar. It was here that he built his special care baby unit (SCBU) – a ‘baby’ of its own right of his own making – and this became a hot bed of innovation and expertise. Herbert saw the need to further the success already borne out by his unit, and others like it, and, with the help of funds raised by the grateful parents of premature babies saved by his SCBU, he built a paediatric research laboratory. The hospital trustees gave him a small patch of land in the front of the hospital on which to construct this project, and he was proud of the laboratory, which in time employed a full-time technician and carried out cutting-edge research into neonatal respiratory physiology and intensive care.

One of the concerns at this time was the worry that using high pressures of oxygen could be damaging to newborn lungs. To counter this Herbert developed an underwater safety valve in the oxygen circuit. The tubes were originally made of rubber, but these had the potential to cause irritation to sensitive newborn tracheas: Herbert thus switched to plastic, which was fashioned from a pre-cut roll and so had an inherent curvature. This plastic tube, based on his design, was known as the ‘St Thomas’ tube’.

Herbert was a keen and inspirational teacher, especially on ward rounds and case presentations. He would follow his juniors’ careers with pride; they in turn remained devoted to him. He was a champion of the weak or poor and showed considerable obstinacy in furthering their cause both publicly and, too, in smaller ways in his work.

Once on a family holiday to Rome, Herbert was smitten by a porcelain tondo hanging in the hotel bedroom. It was of the Virgin mother and child, and he was adamant that something like this should adorn the wall above the bank of incubators in his SCBU back in London. It was important, he said, for the mothers to know that love was very much a part of the ethos of the unit and for the junior doctors not to lose sight of humanity. The hotel manager was not, to Herbert’s dismay, prepared to sell the tondo and so the family embarked on a search of the city for a pottery where one might be able to purchase such a thing. They struck lucky on the third day and Herbert returned to London with not one but two beautiful glazed tondos – one being a spare in case of breakage!

He was an early member of the British Paediatric Association, which was to become the Royal College of Paediatrics and Child Health. He was a founder member of the Neonatal Society and the British Association of Perinatal Medicine.

Herbert was the author of over 100 scientific papers on general and neonatal paediatrics, especially in connection with resuscitation of the newborn.

With Jolly’s retirement in 1983, Herbert became physician in charge of the department of paediatrics. At last he felt able to run the department with autonomy and it thrived as a centre of excellence at both undergraduate and postgraduate levels. However, the reorganisation of London’s hospitals in the late 1980s forced a merger of Charing Cross Hospital Medical School with that of Westminster Hospital: indeed already work had begun on the construction of a new hospital in Chelsea. The powers that be declared that the separate departments of child health at Charing Cross Hospital and Westminster Children’s Hospital would unite as one and move into the new hospital (to be called the Chelsea and Westminster Hospital). Herbert envisaged a resultant struggle between his fellow paediatricians as to who would take the helm of the newly-created department. He resigned from NHS paediatrics and immersed himself into a busy schedule of private paediatrics, examining for the MB BS finals and for the Royal College of Physicians, sitting on the Vaccine Damage Tribunal and conducting medico-legal work.

He loved playing tennis; in retirement he continued to play doubles twice weekly until in his mid-eighties. He joined Victim Support and became a volunteer at the local police station. Even in retirement he wanted to reach out to those in need.

He will be remembered, above all, as a paediatrician and a superb exponent of the principles of medicine to generations of students, who eagerly attended his ward rounds, lectures and seminars. He took the trouble to get to know both students and his juniors alike, and delighted in their subsequent careers. Witness to his influence is borne by the number of young paediatricians coming from his department at Charing Cross Hospital.

His patients received his unremitting care and were loyal to him: many parents became personal friends. He was a person who genuinely seemed to like everyone that he met. He always looked for the best in people and he invariably found it – even where others may have failed! He was compassionate, kind to children and their parents alike, and a sensitive, cultured man.

Herbert was survived by his wife, Dinah, his son (Michael, a doctor), a daughter (Caroline) and two grandsons. He will be remembered as a leading paediatrician and neonatologist of the 20th century.

Michael Barrie

[The Telegraph 28 April 2017 – accessed 30 May 2017; The Times 8 May 2017 – accessed 30 May 2017; BMJ 2017 357 2187 – accessed 30 May 2017]

(Volume XII, page web)

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