John Dickinson was chair of the department of medicine at St Bartholomew’s Hospital Medical College, London. He was born in Sydney, Australia, where his father, Reginald Ernest Dickinson, was working as a production engineer. His mother was Margaret Dickinson née Petty. Early in his boyhood the family returned to England and he was educated at Berkhamsted School. He obtained a scholarship to Magdalen College, Oxford, initially intending to study physiology. He gained his BA in 1947 and stayed on to obtain a BSc (in 1950) whilst acting as a university demonstrator in physiology. However, wishing to put his interest in physiology to practical use, he continued to pursue a career in medicine, qualifying as a doctor in 1952 after clinical studies at University College Hospital (UCH).
There followed in 1953 pre-registration house officer posts at UCH. He was a house surgeon to Julian Taylor, Bernard Harries and F J F Barrington, and then a house physician on Max Rosenheim’s [Munk’s Roll, Vol.VI, p.394] medical unit. Working for Rosenheim confirmed he had made the correct career choice and Max was to remain a lifelong friend and mentor. Here too he became aware of the major research interest of the unit in hypertension, which was to become his own major field of research. Having achieved full registration, he then became a resident medical officer at UCH (in 1954). He gained his MRCP in 1955.
From January 1955 to December 1956, he carried out his National Service in the RAMC. He held the rank of captain and worked as a junior medical specialist at various military hospitals in the UK.
On demobilisation, he was appointed as a medical registrar on the medical unit at Middlesex Hospital working under Alan Kekwick [Munk’s Roll, Vol.VI, p.264] from 1957 to 1958. He was then awarded a Leverhulme research scholarship (from 1959 to 1960) at Middlesex Hospital Medical School, which enabled him to begin his lifelong search for the cause of essential hypertension. He devised an unusual approach using post mortem studies, where he would perfuse the vertebrobasilar brain stem arteries of cadavers to establish a correlation between flow rates and the recorded blood pressure measurements made during the patients’ lives. His hypothesis, which he continued to pursue in subsequent years using live animal (rabbit) experiments, was that the mechanism by which essential hypertension (BP) arose was related to disordered blood flow to brain stem centres which control BP. The authentication of the neurogenic hypertension hypothesis continues, with the work of, for example, Julian Paton in Bristol. The award of a Rockefeller travelling fellowship (from 1960 to 1961) enabled him to visit the Cleveland Clinic, USA under Irvine Page.
In 1961, on his return, he was appointed as a lecturer in medicine (later promoted in 1969 to part time senior lecturer and consultant physician) at UCH. His approach to medicine was always to seek out the underlying pathophysiology of disease, which might lead to its treatment. This was epitomised in the classic book Clinical pathology (Blackwell Scientific, 1960) co-edited with Jeremy Slater [Munk’s Roll, Vol.IX, p.477] and Moran Campbell [Munk’s Roll, Vol.IX, p.95], likeminded colleagues at the Middlesex.
When Moran Campbell subsequently moved to Canada as foundation professor of medicine at the new, innovative McMaster Medical School, John was on several occasions a visiting professor. This coincided with the hitherto unheard of domain of medical computing. When meeting David Ingram, a young graduate commencing a PhD in engineering at University College London, he persuaded him to focus his studies on computer simulations of the clinical physiology of circulation, respiration, body fluids and electrolytes, and drug kinetics, work he had begun with colleagues at McMaster. The possibility was that these might be used as tools to support patient management.
His generosity and support in spotting ‘winners’, somewhat in the Rosenheim mould, helped other young investigators to establish themselves, among them Michael de Swiet, whose studies on placental blood flow helped to promote obstetric medicine.
In 1974 he was appointed to the chair of medicine at St Bartholomew’s Hospital Medical College. Together with the first female dean of the medical school, Lesley Rees, they created a modern medical school. One of his first actions was to create a department of medical informatics and appoint Ingram as its head and subsequently the first UK professor of medical informatics.
He was always open to new ideas, which might unexpectedly lead in new directions. Whilst attending the annual Harveian Oration and dinner at the Royal College of Physicians, he was asked to deputise for a colleague who was to ‘chaperone’ one of the invited VIPs – Lord Wolfson [Munk’s Roll, Vol.XII, web]. Over dinner Wolfson was so impressed by the plans to create a department of preventive medicine that next day one of his team was dispatched to progress it. Nicholas Wald was then appointed as chair of the splendid new building.
In his career at the Royal College of Physicians, he later became senior censor and vice president at the time of the creation of the new MRCP (UK) practical assessment of clinical skills (PACES) examination. His contribution to it was typically serendipitous: a lifelong interest in organ music had led to him repeatedly sit the examination of the Royal College of Organists, which he eventually passed. The only consolation of failure was that the candidate received a very detailed mark sheet and advice for future exam attempts. This mark sheet became the template for the one used in PACES!
He had many interests outside medicine, but foremost was his family. He married his childhood sweetheart, Elizabeth (née Farrell), in 1953 and they had two daughters and two sons. The marriage became overshadowed by her developing progressive multiple sclerosis, ultimately rendering her quadriplegic (she died shortly after him). The coping mechanisms he practically instituted and the caring support were quite remarkable as the ever increasing challenges were met. A family tradition of Friday night suppers was one which long continued, having started before disability took its toll. In addition to opera, the organ was his dominant musical instrument and he had a pipe organ built in his own living room. He was frequently asked to play at church services, especially when colleagues were involved.
John Dickinson was a man of many parts, never known to have lost his temper, who could see the good in everyone.
Eric Beck
[St Bart’s Hosp. J Spring 1976 p.43; The Lancet 10 August 1974]