Harold Leeming Sheehan

Harold Leeming Sheehan (Avatar)

1900-1988

Vol VIII

Pg 455

Harold Leeming Sheehan

1900-1988

Vol VIII

Pg 455

b.4 August 1900 d.25 October 1988

TD MB ChB Manch(1921) MD(1931) MSc(1932) DSc(1940) MRCP(1941) FRCP(1947) FRCOG(1949) FRCPath(1964)

Harold Sheehan was born in Carlisle where his father, Patrick Sheehan, was a general practitioner who had built up a large working-class practice with over 4000 panel patients, the largest panel in the city. His mother had been Eliza Leeming before her marriage to Patrick Sheehan and Harold was one of their twelve children. Harold was educated at Carlisle Grammar School and the University of Manchester, graduating with honours in 1921. In the meantime his father had died, and Harold began his career as a doctor by joining his elder brother Gerald, who was now running the family practice in Carlisle. He worked as a general practitioner for the next six years.

The academic phase of his career began in 1927 when he became a demonstrator, and later a lecturer, in the department of pathology in the University of Manchester. At this time the professor of pathology in Manchester was John Shaw Dunn, whose chief interest was in renal disease, and he encouraged the young Harold Sheehan to undertake experimental work on renal function. The result was a thesis on the deposition of dyes in the mammalian kidney for which he was awarded a doctorate, with a gold medal, in 1931; the MSc degree followed a year later for a thesis on the renal elimination of injected urea and creatinine.

In 1934 he married Eve Suzanne Gertrude Potter, who was so dissatisfied with the names that her parents had given her that her real name became a sort of skeleton in the family cupboard. She would introduce herself as Susan Sheehan, while amongst intimates she was always known as ‘Shooz’. Their married life began with a year in America, Harold having been awarded a Rockefeller medical fellowship to continue his studies on renal function in the department of pharmacology at the Johns Hopkins medical school in Baltimore.

The most important phase of Sheehan’s professional career began in 1935 when he attained the post of director of research at the Glasgow Royal Maternity Hospital, for it was during the next five or six years that he began to establish himself as an international expert on the pathology of pregnancy. He analysed the effects of obstetrical shock, he differentiated between the fatty liver of delayed chloroform poisoning and the condition of primary fatty liver of pregnancy, he demonstrated the reactivation of latent rheumatic heart disease that was induced by pregnancy, he clarified the effects of eclampsia upon the liver and kidneys, he identified the encephalopathy of hyperemesis gravidarum as Wernicke’s disease, he recognized the association between concealed accidental haemorrhage and renal cortical necrosis and recognized that obstetrical shock and haemorrhage could induce necrosis of the anterior lobe of the pituitary gland.

The war interrupted his work on the pathology of pregnancy. He sometimes said himself that his most important work in the Army was the contribution that he made towards the solution of the problem of ‘syringe jaundice’. His overseas service was in Italy, and by the end of the war he had been mentioned in despatches and was deputy director of pathology to the allied forces in Italy, with the rank of colonel. In 1946, after demobilization, he was appointed to the chair of pathology in the University of Liverpool.

In Liverpool he had to provide curricula for large classes of medical and dental students many of whom had served for several years in the forces. Such students were conscientious and were very discriminating about the instruction they received. They found Sheehan’s teaching entertaining and memorable, for he had striking mannerisms - his eyes would bulge as he expressed horror at the enormity of some wrong answer. He was highly provocative and challenged much cherished dogma. He was at his best in the informal class on Saturday mornings, when specimens obtained during the previous week were demonstrated and discussed. The give and take of the ‘meat class’ reduced, for the regular attenders, any dread they might have felt for oral exams. Postgraduates also often attended these classes.

Although the students enjoyed his classes they knew that he was a demanding examiner and they suspected him of slyness: his nickname was ‘Crafty Harry’. In his dealings with the juniors in his department, and with his colleagues, he liked to hold his cards close to his chest, and he kept his right hand in strict ignorance of what his left hand was up to. He obtained many advantages for his department by private deals rather than by formal negotiation at the faculty board.

In the post-war expansion of the laboratory services in Merseyside his influence was important but inconspicuous. His success, however, in establishing an endocrine unit within the region was of course something in which his vested interest was obvious.

He acted as a histopathological consultant for the region and his opinion on difficult sections was frequently sought by pathologists in Merseyside, North Wales and beyond. He arranged that he should be informed of any obstetrical death in the region and he would carry out the post mortem himself, even late at night, for he believed firmly that only fresh tissue was worth histological examination. His autopsy technique was chaotic but effective.

In Liverpool he consolidated and developed the work he had begun in Glasgow. In 1949, with V K Summers [Munk's Roll, Vol.VI, p.427] he published an important paper in the Quarterly Journal of Medicine, 1949,NS viii, 277-309, on the syndrome of hypopituitarism. The paper showed convincingly that emaciation and premature senility, previously considered to be essential for the diagnosis of pituitary insufficiency, were not features of the syndrome. This paper, rather than Sheehan’s earlier papers on pituitary necrosis, led to the syndrome of post-partum pituitary necrosis becoming known as Sheehan’s syndrome. He continued to study renal cortical necrosis and his conclusions were published in book form, with H C Moore as co-author, Renal cortical necrosis..., Oxford, Blackwell Scientific, 1952. In addition he initiated much experimental work designed to elucidate the pathogenesis of both pituitary necrosis and renal cortical necrosis. He published, for example, a long series of papers with J C Davis on experimental renal ischaemia, and supervised various studies of the vasculature of the human pituitary gland by members of his staff. He never succeeded, however, in establishing that spasm of critically sized blood vessels, a mechanism that he had postulated to explain his findings in human material, had the importance he attributed to it.

The value of Sheehan’s work appears to have been recognized abroad before it was recognized in Britain. He accepted many invitations to undertake lecture tours in both North and South America and in Europe, including both sides of the iron curtain. His wife always accompanied her husband on his foreign travels. Her linguistic skill was of value, especially in Spanish-speaking countries, but Harold himself could read a paper in French or German. A series of foreign visitors also came to Liverpool to undertake research in Sheehan’s department.

In 1965 he was obliged by his age to retire from the chair of pathology but he continued his researches, first in the Liverpool School of Tropical Medicine and later in the University department of physiology. In 1973 he published a comprehensive book, with J B Lynch as co-author, The Pathology of toxaemia of pregnancy, Edinburgh, Churchill Livingstone. In 1982, with J C Davis, the whole of his work on post-partum hypopituitarism at last appeared as a book, Post-partum hypopituitarism, Springfield, Illinois, C C Thomas. That same year, with K Kovacs, he made an important contribution on the neuro-hypophysis and hypothalamus to the second edition of Bloodworth’s book Endocrine pathology, 2nd ed. Baltimore, Williams and Wilkins,1982,pp.45-100.

The Sheehans had no children. His wife died in 1986 and after her death Harold lived alone in their big, cold house in Liverpool until a fractured hip led, eventually, to his admission to a nursing home in Kendal, where he died at the age of 88. He was a remarkable man and a memorable character, who well deserves the eponymous fame that has been bestowed upon him.

AH Cruickshank

[Independent, 3 Nov 1988]