Arnold Carmichael was the son of Edward Carmichael MD, who was born and went to school in Edinburgh, graduated from its University, and practised medicine in the city as a family doctor until his death. Arnold Carmichael’s education followed that of his father at Edinburgh Academy and Ediburgh University, where he obtained the MB with the Annandale Gold Medal in 1921. His University was to award him the DSc hom, causa in 1963, too. He became a Fellow of the Edinburgh College six years before election to the London Fellowship in 1932. All his junior medical and surgical house appointments were, not surprisingly, at the Edinburgh Royal Infirmary.
His medical education was interrupted by combatant service in the infantry in the world war of 1914-1918. What was surprising was that, with a life grounded in Edinburgh and steeped in American medicine, he should, as soon as possible, have migrated to London to study neurology, for there was then in Edinburgh a strong school led by Edwin Bramwell, whom he knew well and respected.
Arriving at the National Hospital for Nervous Diseases, Queen Square, he became one of four residents, the others there being Macdonald Critchley, Hugh Garland and Esmond Rees, all of whom became Fellows. There began his association with Godwin Greenfield also a Fellow, with whom he collaborated in a text book on the Cerebrospinal Fluid and afterwards in several clinico-pathological papers, mainly in Brain. He then became registrar in neurology at St Bartholomew’s Hospital, and during that time was attracted by the methods of Sir Thomas Lewis, who had just founded the journal Clinical Science.
Returning to the National Hospital as honorary assistant physician he became interested in the effects of the autonomic nervous system on blood vessel control. After a short time, he was appointed to the new post of director of the Neurological Research Unit of the Medical Research Council in that hospital, a post which he continued to hold until his retirement at 65.
Carmichael’s major contribution in those years was not so much in the weight or substance of his personal research, but in the influence he had upon the thought and attitudes of the increasing number of young postgraduates in all the neurological specialties who came to Queen Square from the then Empire, the Commonwealth, and the Western World. He was an enthusiastic, evocative teacher with a compelling quirk which appealed especially to those from the New World, his clinical teaching being by lively free discussion. Clinical observation was closely linked to physiological and pathological observations.
His formal ward rounds and seminars became essential parts of each postgraduate student’s week, at a time when Kinnear Wilson, Gordon Holmes, George Riddoch, and Charles Symonds were teaching in the same small postgraduate medical school in Queen Square. His emphasis on the physiological approach to medicine of Sir Thomas Lewis, and the physiologically orientated attitude of the Medical Research Society was, though, rather out of step with his colleagues’ more direct bedside or purely clinical approach. This aspect of his career was admirably described in the obituaries in the Lancet and the British Medical Journal.
After retirement he continued to teach neurology in several medical schools in North America and in the national institutes in Washington, where his old students eagerly welcomed him. He was elected an honorary alumnus of the Neurological Institute of New York in 1966. He was happier there in an atmosphere which suited his personality than at home, in what he seemed to feel a repressive or reactionary environment. Perhaps he was right, but he found difficulty in accepting his clinical colleagues for what they had to give, and gave well, without reservations. It was this restraint which kept him from more widespread recognition at home. He was not, for instance, elected president of the Association of British Neurologists as expected, though he had been its excellent secretary for several years, and whilst he edited the British Medical Association’s Journal of Neurology and Psychiatry he held no post on the journal Brain, which he would have liked.
But when he was 80 a birthday dinner was held in Hove near his home, and eminent research workers from all parts of Britain and from several overseas countries assembled there.
A lasting material monument to him is the Rockefeller Building of the National Hospital, which was erected entirely through his initiative to house his research unit and wards, as well as the neuro-surgical unit, a fact which was forgotten unfortunately in the turmoil of World War II which began shortly afterwards. During those years he worked for the Medical Research Council in personnel research for the fighting services, for which he was awarded the CBE.
DJ Williams
[Brit.med.J., 1978, 1, 513; Lancet, 1978, 1, 398; Times, 11 Feb 1978]