Archibald Percy Norman was a pioneering paediatrician who started his medical career in 1939, went off to war, where he was taken prisoner, and returned in 1945 to resume his work at Great Ormond Street Hospital, London. He developed an interest in the newly-described condition cystic fibrosis, one of the most commonly inherited genetic diseases, which affects babies from birth, causing severe growth problems as well as devastating lung disease. Until very recently there was no effective treatment for the underlying condition, but with intensive, supportive care a disease which was inevitably fatal in early life has been transformed into one where more than half of those affected will live past the age of 47. Archie Norman played a pivotal role in this revolution, both in establishing the first clinic in the UK for treating such patients and in establishing the charity the Cystic Fibrosis Trust, which has campaigned tirelessly to ensure that there is universal access to the best care and which has raised huge amounts of money to fund research, clinical care and support for patients and their families. Just two weeks before Norman died, the NHS gave the go ahead for a transformational treatment, kalydeco, which can halt the progression of cystic fibrosis for two- to five-year-olds.
Soon after he qualified in medicine at Middlesex Hospital, he was attracted to Great Ormond Street Children’s Hospital as a ‘resident physician’. His job was to look after the children who were admitted to the hospital and twice a week consultants would visit on an honorary basis. In those pre-NHS days, permission had to be obtained from almoners before a patient could be admitted unless the parents could afford to pay. There was also little in the way of effective treatments, especially for infectious diseases, as the antibiotic revolution had not yet begun. When he eventually returned to the hospital, medicine had changed dramatically. Norman described this as an extremely exciting period with so many new advances in medicine. Paediatrics had been accepted as a real and important branch of medicine. There was the discovery of antibiotics that totally changed attitudes to infectious disease and, with the advent of the NHS, antibiotics could be prescribed without having to worry about whether the family could afford them. The NHS was a huge change, especially for children.
Norman utilised these new freedoms and took a special interest in children with respiratory disease, including asthma as well as cystic fibrosis. He pioneered the concept of multidisciplinary care and recognised the importance of including physiotherapists and dietitians in children’s care. Steadily, survival began to improve, but more research and better care for all affected children was needed. In the late 1950s, a Swiss businessman, John Panchaud, who had a daughter with cystic fibrosis under the care of Archie Norman, suggested that he wanted to form a parents’ association. In those days, such associations were not looked upon particularly favourably by many doctors, however Norman felt it was worth pursuing and, with the help of Joe Levy, a very successful business colleague, and David Lawson [Munk’s Roll, Vol.XII, web], a paediatrician at Carshalton, who had a daughter with cystic fibrosis, the Cystic Fibrosis Trust was formed. Archie Norman was the quiet inspiration and driving force behind this initiative, which has grown to be a major funder of research and a huge support to sufferers of the disease and their families. One of the first achievements was to support the setting up of regional treatment units for cystic fibrosis and this has resulted in the standard of care in the UK being amongst the best in the world.
Norman’s vision came to the fore again when the country branch of Great Ormond Street Hospital at Tadworth was no longer required for long-term care of sick children. He helped to transform it into a major rehabilitation centre for brain-injured children and formed the Children’s Trust to support this important work. One of the buildings at Tadworth is named after him.
Norman was the son of an Edinburgh-trained GP, George Percy Norman, and Mary Margaret Murray MacGregor Norman née MacCallum, a nurse from the island of Kerrera, Argyll and Bute. His early years were coloured by mill town life in Lancashire, but at the age of ten the family moved to Eastbourne. He remembered as ‘pretty grim’ his time at Charterhouse School with ‘daily sport and cold baths once a week’. He went up to Emmanuel College, Cambridge, where he earned a boxing blue, which for a gentle, thoughtful man was somewhat out of character. He then went on to the Middlesex Hospital, where he was taught by Alan Moncrieff [Munk’s Roll, Vol.VI, p.343], from whom his inspiration to be a paediatrician came.
In 1940 Norman volunteered for military service and was assigned as a captain in the RAMC to the 4th battalion of the Northumberland Fusiliers. Most of his troops were Northumberland miners and their officers were former territorials, of whom he had a low opinion. In 1941, the unit embarked for North Africa, where on 4 May 1942 they encountered the Germans on the Knightsbridge Escarpment. The next month saw serious conflict and on 4 June he was advised to withdraw his field dressing station as the British troops were retreating. He refused to do so and consolidated his dressing station along with a medical officer from the 5th Indian division. He was given repeated messages to ‘get away while you can’, but refused to do so and was eventually taken prisoner. There then followed almost three years of internment and eventually repatriation via a circuitous route including Poland and Russia. He led a group of 150 men who walked through Russian-held territory, living off the land. When he eventually got his troops on to a ship in the Crimea, his men wrote a testimonial to his leadership in extricating them from Poland and Russia, which led to the award of a military MBE.
Archie Norman was an infuriatingly modest man who attributed any success to his colleagues. He was a superb clinician and a very caring doctor, who was hugely respected by patients and their families. He typically worked 60 hours a week and saw little of his five children as they grew up. He was frugal and kept phone calls to a clipped minimum to avoid cost. He believed strongly in the importance of nurses and expected the ward sister to be in charge. He always wore a clean white coat and expected the same meticulous standards of others. He was very sprightly and would always take the stairs, never a lift.
Retirement from the NHS in 1972 did not mean the end of work: he continued with private practice, with research and teaching, and supporting his two national charities. He was less mobile after his 100th birthday, but remained intellectually as sharp as ever until his death after a short illness.
He married Aleida Elisabeth Mabel May Roosegaarde-Bisschop, a doctor, in 1950 and she, their five sons (Duncan, Archie, Tom, Sandy and Donald) and seven grandchildren survived him. His son, Archie, was chief executive of the supermarket chain Asda and then an MP and chairman of Marks and Spencer.
Sir Alan Craft
[SurreyLive 20 July 2012 www.getsurrey.co.uk/news/local-news/remarkable-man-childrens-doctor-turns-4810026 – accessed 18 December 2018; The Telegraph 7 January 2017 www.telegraph.co.uk/obituaries/2017/01/07/dr-archibald-norman-pioneer-respiratory-diseases-obituary/ – accessed 18 December 2018; The Guardian 15 January 2017 www.theguardian.com/society/2017/jan/15/archie-norman-obituary – accessed 18 December 2018; BMJ 2017 356 312 www.bmj.com/content/356/bmj.j312 – accessed 18 December 2018]