David Stafford-Clark was, in his day, one of the foremost psychiatrists in the country. He was physician in charge of the department of psychological medicine and director of the York clinic at Guy’s, and a consultant at the Institute of Psychiatry, University of London. But this summary sells him short. David brought to psychiatry a lively intelligence, humour, a lack of pomposity, but above all, an exemplary compassion and concern for the individual; a contribution to clinical psychiatry that contrasted with the therapeutic inertia and detachment that pervaded psychiatry at the time.
He qualified in medicine in 1939 at Guy’s. He had been advised to study medicine there by the family doctor, and that was that. He remained a loyal Guy’s person for life.
During the war he served as a doctor in the RAF, attaining the rank of squadron leader. His war-time career included being one of the last members of the BEF to leave France. He returned to Bomber Command, where his work on air crew morale stimulated an interest in psychiatry which had started in student days, when he was appalled by seeing mental hospital patients paraded in front of medical students like freaks in a circus in the name of ‘teaching’. His war-time researches led to a revision of the flawed concept of ‘low moral fibre’, a term that frequently ended the flying careers of air crew, when exhaustion was cruelly mistaken for ‘cowardice’. In addition, he became a medical parachutist, volunteered and flew as a doctor, was mentioned twice in dispatches, and inhaled poison gases at Porton Down. The legacy from this was asthma, from which he suffered for the rest of his life, culminating in a near fatal attack which led to early retirement on health grounds at the summit of his career.
Following demobilization he returned to Guy’s and later started his post-graduate training in psychiatry at the Institute of Psychiatry, where he caught the eye of Sir Aubrey Lewis [Munk’s Roll, Vol.VI, p.284]. After a spell as a teaching fellow at Harvard and the Massachusetts General Hospital, he returned to the Maudsley as chief assistant to the professorial unit. During this period he carried out EEG studies on alleged murderers on remand; work which highlighted the unrecognised incidence of psychiatric disorder and epilepsy in potential candidates for hanging. A career in forensic psychiatry was aborted by his becoming the director of the York clinic at Guy’s.
Sir Aubrey Lewis had long since spotted that David was a populist, and he recommended him to Sir Allen Lane of Penguin as being someone best qualified to write Psychiatry today (London, Pelican Books, 1951). In its time the book was a classic piece of popular writing and was the most widely read of his many publications.
David’s ability to communicate and clarify psychiatry was masterly, and he inspired enthusiasm for the specialty amongst students and doctors deterred by its obscure terminology and vagueness. His interest and influence were founded on simple clinical principles.
For David, psychiatry was a specialty which must never be divorced from medicine. He believed that psychiatry should be practised in the general hospital, away from the isolation of the mental hospital. When psychiatry left medicine, it ceased to be psychiatry. Proper history taking, examination and assessment of the person’s physical and mental status were summarised in a clinical formulation aimed at identifying and relieving the patient’s disorder. Not, it should be noted, the ‘client’. David encouraged students to develop a proper concern for the relief of human suffering. These concerns took precedence over speculation about the relevance of social and obscure psychological factors. Regard for, and empathy with, the individual and their problem and how that person is feeling, was, for David, where psychiatry must start and end.
His ability to communicate this philosophy of medicine and psychiatry found expression in radio and TV, in particular in the TV series Lifeline, which ran from 1957 to 1963. It was a pioneering endeavour in the communication of the problems of psychiatric and allied disorders, and set an example at a time when public presentations were regarded as revolutionary, if not dangerous, by the more conservative members of the profession. The ensuing popular appeal incurred him a degree of ill-feeling amongst certain members of the medical establishment. But David could handle criticism of his public appearances, his exuberant personality, and his espousal of controversial causes. He was a man who cared about human suffering, and about educating people away from the bigotry and stigma that still mires psychiatric disorder.
On his day he could be very funny. In the York clinic he promoted an atmosphere in which everyone felt enthusiastic and ‘up for it...’; a feeling that spread throughout the staff, producing a community atmosphere that will be long remembered.
[The Guardian 10 Sept 1999; The Times 10 Sept 1999; The Independent 14 Sept 1999]