Lives of the fellows

Wilfrid Ingram Card

b.13 April 1908 d.12 January 1985
MB BS Lond(1931) MD(1933) MRCP(1934) FRCP(1944) MRCPE(1951) FRCPE(1953) FRCPG(1967)

The son of Henry Charles Card, Wilfrid was educated at Tonbridge School, leaving with an exhibition in mathematics. His medical training was at St Thomas's Hospital, where he had a distinguished undergraduate career, obtaining the Seymour Graves Toller prize and the Mead medal. He was a house physician at the London Chest Hospital and also to Sir Francis Fraser [Munk's Roll, Vol.V,p. 141] at the Postgraduate Medical School; then he returned to St Thomas’s Hospital as medical registrar to Sir Maurice Cassidy [Munk's Roll, Vol.IV,p.528]. He obtained the Perkins scholarship in 1936 and the Louis Jenner research fellowship in 1938. In 1939 he was appointed physician to outpatients at St Thomas’s and was elected to a Beit research fellowship. He had already studied gastroscopy in Leipzig, and gastrointestinal radiology in Hamburg, and while in Germany also gained an understanding of and bitter loathing for the Nazi movement. This last gave him a sense of justice in a war which he felt, with Churchill, was unnecessary and the result of British unpreparedness. Remembering what he called his ‘wasted years’ he was anxious that Britain should never make this mistake again.

From the outbreak of war until 1942 he was in charge of the medical division at Botley’s Park War Hospital. From 1942-46 he served in the Royal Army Medical Corps as a lieutenant colonel, and saw service in West Africa, India, Burma, Ceylon, Malaya and Siam. In 1945 he was appointed to a research group and organized a field trial of a new scrub typhus vaccine.

After the war he felt that the opportunity for his research at St Thomas’s Hospital was not sufficient and he accepted an invitation to move to Edinburgh where Sir Stanley Davidson [Munk's Roll, Vol.VII, p. 136] was introducing new blood into Edinburgh medicine. As physician in charge of the gastrointestinal unit at the Western General Hospital Wilfrid was able to give full rein to his skills as an innovator despite, at that time, primitive facilities. With Sir John Bruce, later the professor of clinical surgery, he initiated a joint medical and surgical gastrointestinal unit which acquired national and international renown. The medical research building, available to whole and part-time staff alike, was his brain child. He was the moving force behind the establishment of a university department of medicine at the Western General Hospital, and as a true democrat he managed to persuade first his colleagues and then the faculty of medicine that the department should have an elected chairman in charge rather than an appointed professor - an arrangement common in other countries but almost unknown in Britain. He was a natural leader, though he looked on himself rather as primus inter pares, and as his new colleagues became his friends he was able to guide them towards objectives which he recognized, often much earlier than they, to be of merit. He was aware of the importance of social meetings of members of the staff, and he founded a staff dining club where his knowledge of wines and enjoyment of companionship proved catalytic in the achievement of the rapport which he fostered. On leaving Edinburgh he gave his colleagues a magnificent silver loving-cup of modern design which bore William Harvey’s words ‘Concordia res parvae crescuni' and this now serves as a fine memorial to him on occasions when the staff dine together. His colleagues in their turn founded a memorial lecture in his name and, by then in retirement, he was to give the first lecture. He generously described this as the greatest honour of his medical career.

He established a close partnership with his nursing colleagues and was influential in the appointment, as matron, of Estelle Adamson, also from St Thomas’s, where she was later also to be matron. They both warmly subscribed to Florence Nightingale’s aphorism that ‘our patients are our honoured guests’. (He also liked to quote another of Florence Nightingale’s sayings: ‘A nurse should wash her hands every day; if her face too so much the better.’)

While in Edinburgh he and his colleagues published a classic paper on the relationship between the parietal cell mass and the acid output of the stomach, among a constant stream of publications relating mainly to gastrointestinal physiology in man. At an early stage in the development of the GI unit he enlisted the closest support of clinical psychologists and social workers to develop his own version of holistic medicine.

Those who knew Wilfrid Card best were usually impressed most by his vision. This was manifested particularly in his second major interest in what was to prove a classic contribution, in 1967, entitled ‘Towards a Calculus of medicine’, Medical Annual 1967,85,9-21. He often returned to the thesis Ars Longa Vita Brevis; ‘since all doctors, without exception, are mortal, their hardly earned skill and wisdom die with them.’ [ibid.p.9]. His principal aim became to work towards ‘...a clear concept of disease, a rigorous definition of all clinical and laboratory data, an assessment of their discriminatory value, and an analytic process whereby a set of data from the patient can be assigned to a diagnostic, prognostic or treatment class. We need nothing less than a calculus of medicine.’ He quoted George Boole’s observation of 1847: ‘We might justly assign it as the definitive character of a true Calculus, that is a method resting upon the employment of Symbols, whose laws of combination are known and general, and whose results admit of consistent interpretation.’ [ibid.p.9]. As Henrik Wulff said at a Memorial Festschrift held at the RCP London on 17 June 1985: ‘Card proposed a new paradigm of clinical thinking...’ [‘Measuring Gut feelings: The scientific basis for clinical medicine.’].

As these mathematical interests became dominant he was to move in 1966 to a newly created chair of medicine with relation to mathematics and computing at the University of Glasgow. Relieved now of the administrative and committee work for which he had become so much in demand in Edinburgh, this phase of his career became the most productive in research publications. His renewed energy may have derived in part from the atrophy of his social life with the loss of his beloved wife Tilly. After his formal retirement he maintained his active research life right up to the end; on his sudden and unheralded death there was a new manuscript in his brief case.

‘Even those of us who never had the opportunity to work with Professor Card recognize the remarkable diversity of his talents. We recognize him as a scientist who did very important physiological research, we respect him as the statistician and mathematician who applied the ideas of decision theory to clinical problems, we see him as our teacher who had the gift of explaining complex issues in simple terms, and we appreciate that all his activities were carried forward by his ability to inspire his colleagues and by his talents for cooperation, organization and administration. However, Professor Card’s achievements do not only reflect his diversity of talents. They also reflect the fact that he used his talents to serve a single purpose. Wilfrid Card will be remembered as a clinician and a humanist because everything he wrote, including the most theoretical papers, aimed at improving the care of the individual patient.’ (H R Wulff, Memorial Festschrift).

Add to this that he was also physician to the Queen in Scotland; secretary to the Association of Physicians; a skilful navigator and sailor; a talented carpenter - he built the superstructure of his cabin cruiser; that he was blessed with an infectious laugh; that he was a much beloved husband, parent and grandparent, and that as a person of integrity and a privately devout man he was an embodiment of Christian virtues. One can understand the comment of Gerry Crean, a colleague who was to work longer than anyone with him in Edinburgh and in Glasgow: ‘He never knew how much we loved him.’

J Strong

[, 1985,290,474; Lancet, 1985,1,293; Times, 18 Jan 1985; The Scotsman, 21 Mar 1966; Medical News, 1 Apr 1966,2 Apr 1966]

(Volume VIII, page 76)

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