Tony Dornhorst was one of the outstanding academic clinician-scientists of his generation. He was also outspoken, engendering love and admiration in some, and anger and resentment in others. Through his understanding and reasoning, he changed minds; an enlightening experience for those closest to him, but less attractive to others when he challenged the values and traditions of the old order.
It was at St Thomas’s hospital medical school, London, where he became a reader in medicine in 1949 and consultant in 1951, that Tony was at his most active as a traditional researcher, publishing papers in respected journals, and working closely with E P Sharpey-Schafer [Munk’s Roll, Vol.V, p.372]. Characteristically, the topics ranged widely, with papers on red blood cell survival, the behaviour of the oesophagus, lung function, blood pressure and arterial resistance. Typically, they all bridged normal physiology and disease states. During this period, Tony also began to do experiments on himself, and more specifically, mastered techniques – including mercury-in-rubber, strain-gauge plethysmography with brachial arterial infusion of test drugs – for studying the factors controlling arterioles in the forearm.
In these respects, he was an essential link in the study of human physiology and pharmacology stretching from Thomas Lewis [Munk’s Roll, Vol.IV, p.531] in the early twentieth century, to outstanding current researchers, such as Patrick Vallance and Nigel Benjamin in London, and David Webb in Edinburgh.
From 1959 until 1980, Tony held the foundation chair of medicine at St George’s hospital medical school. He was appointed in a late response to the 1944 Goodenough report suggestion that all medical schools should establish professorial units in, amongst other topics, medicine. Most others in this position raised income, built up large departments, published voluminously (even on research in which they had played little part) and lectured widely. Tony did none of these.
For the most part, he concentrated on teaching – mainly at the bedside – and theorising. Nevertheless, his influence was immense. We learned the importance of honesty, integrity and fairness, of challenging authority (and ourselves), of attention to detail, of the sin of ignoring evidence, of the value of using novel, sometimes multidisciplinary, approaches to solve problems, of the importance of listening to and trusting the evidence of patients, and of recognising the need to keep up to date.
We were also reminded of the value of the NHS, and of the need to be wary of the Harley Street brigade.
Tony was born in Woodford, Essex, the son of a company director of Dutch origin and a mother who was a musician. He attended St Clement Danes in London – not, he made clear, a public school – but he did not actually go to school between the ages of 12 and 14, and later took evening classes to cover the subjects he needed to study medicine.
At 17, he went to St Thomas’s Hospital medical school, where he was very much a loner – although he did establish a lifelong friendship with his fellow student Richard Doll, later the eminent cancer researcher. Tony was quiet and withdrawn; he had a bad stammer, and rarely shone in exams – he refused to write anything more than the minimum needed to answer the question.
Yet it was in these early years that the basis for his self-taught, encyclopaedic knowledge was laid down. In his adult years, apart from his insights into matters clinical, he was renowned for his detailed knowledge of physiology, anatomy, pathology and biochemistry. He was also entirely at home with mathematics, law, philosophy, literature and music.
He passed his finals at the age of 22 and, failing to get a house job, studied for membership of the College. A year later, and at his first attempt, he became, at 23, the youngest member in the College’s history. He returned to St Thomas’s as a house officer, one of the very few at that time not educated at Oxford or Cambridge.
During the Second World War, he served with the Royal Army Medical Corps (RAMC) in Palestine, north Africa, Italy, and finally, as a lieutenant colonel, as the senior physician in Berlin. For Tony, as for others, the experience gave him unparalleled exposure to clinical practice and offered an opportunity to puzzle over societal values and how they might function when peace was restored.
The war also offered Tony other benefits. He found time to read and broaden his education – one evening in north Africa he was found chuckling in his tent over a treatise by Albert Einstein. He gained a good enough knowledge of Italian and German to understand his beloved opera and to read scientific articles in their original text. And in Berlin in 1946 he met his future wife Helen, who was serving in the RAMC in the early days of her career as a radiologist. After the war, he returned to St Thomas’s.
Tony served on several national bodies, including the 1969 Himsworth committee on matters relating to Northern Ireland – his inhalation of CS gas to assess its effects caused some consternation among colleagues. He was a member of the medical research council panel (1973 to 1977), a civilian consultant in aviation to the RAF (from 1973 to 1983), and an advisory council member of the Drug and Therapeutics Bulletin. He was awarded a CBE in 1977.
After leaving St George’s, he taught at the Middlesex and the London medical schools, fully retiring only in 1990. His influence was expressed through teaching and example. Many of his pupils became teachers, writers and opinion formers, and thus his ideas have spread further afield and down the generations.
His wife was with him when he died, of exhaustion, having been housebound for months with intractable pain from severe arthritis of his knees and hips. She survives him, as do three daughters.
Joe Collier
[The Times 26 March 2003; The Guardian, 26 March 2003; GKT Gazette, April 2003,916-918]