When Ian Munro took over the editorship, The Lancet was at its nadir. His predecessor had abandoned editorial peer review, and however cogent the arguments in favour, the academic community had looked askance at the abandonment of a process going back to the start of scientific journals. Ian spent much of his twelve years as editor restoring this and other traditional editorial processes. His reward was that by the time he died, seven years after retirement, The Lancet was once again the world’s pre-eminent medical journal.
On the face of it, Ian was an unlikely candidate as an influential editor. His main interest was in sport and his career after qualification unremarkable. Yet he was open minded, a liberal in outlook, with a wide circle of friends, and crucially could write quickly and clearly on virtually any topic. In the opinion of Sir Theodore Fox [Munk’s Roll, Vol.IX, p. 178], his great predecessor on The Lancet (and arguably the greatest medical editor of all time), Ian was the best medical journalist he had ever known. And Munro justified his appointment in following The Lancet’s tradition of influential support for unpopular causes that were later self-evidently justified: womans right to contraception and abortion; the perils of nuclear stockpiling; and support for the radical feminist obstetrician Wendy Savage in her battles at the London Hospital.
After qualifying at Guy's, Ian did the usual house jobs and National Service in the RAMC and then had a brief spell in radiology. He was offered a job on The Lancet, Fox recalled, on the strength of a letter he had written to his host thanking him for lunch at the Athenaeum. "Whoever can write a really good letter", Fox was to say in a retirement tribute to Ian, "must be able to recognize a bad one and therefore has the makings of an editor." Ian was to stay at The Lancet for the rest of his working life, becoming probably the longest serving full-time medical editor of all time.
Like so many of his judgements, Fox’s feelings about Ian were justified by events. Throughout his time he shouldered a vast amount of work, facing Ian Douglas-Wilson, Fox’s successor and Ian’s predecessor as editor, at a small desk in the cramped open plan office in the elegant Adam building in the Adelphi. To this room the international medical world beat a path, trying to get articles published or views given some editorial publicity. Here a vast number of papers submitted for publication were assessed and those accepted shortened and rewritten in taut common-sense English, a process known in Lancetese as ‘filleting’. Here too editorials were written, obituaries solicited and culled, and news paragraphs prepared and constructed.
Given the debates on health, the profound changes in medical research produced by the post-war scientific revolution, and the novel intrusion of politics into what until a short time beforehand had been a professionally closed enclave, Britain needed a journal in which to record and debate such happenings. The BMJ at that time was certainly no place to do it, but fortunately with Fox and The Lancet the country (and the international community) had the greatest medical editor and the journal in the world - and Ian was certainly up to the demands made on him as a subordinate. Paradoxically perhaps, apart from his ability to see all sides of an argument, the aspect that stood him in best stead was his relative lack of formal medical knowledge; like Fox, who had done only one house job and then a short spell as a ship’s doctor before turning to editing, Ian had the humility to back up his own judgement with expert advice on most topics where this was clearly needed. And, in any case, given a correspondence column open for corrections or other points of view, he could argue that anything incorrect would ultimately be ousted by the correct - and surely any person or institution had the right to be wrong.
In some people such openness might be taken for weakness. Not so with Ian, whether with the mundane or the more exalted aspects of life, though he might achieve his objectives in an undemonstrative way. Early on at The Lancet he reluctantly concluded that he would have difficulty supporting his large family. Not only did the pay compare badly with elsewhere but it was unlikely, he thought, to get better. Without telling anybody, he decided to apply for an editorial post with the World Health Organization, and after a successful interview spent the rest of the weekend in Geneva sunbathing. He arrived back in the office with a heavily burnt face, whereas in London there had been three days of continuous rain. In true Lancet fashion no comment was ever made, but that Friday all the editorial staff was given a substantial pay rise - and Ian stayed. Editorially too he could be as firm as the next man in defending a decision or in coming to the attack against assaults on his beloved National Health Service. And, particularly in the years after retirement, Ian was able to throw his weight behind other causes dear to his heart: Physicians for Human Rights UK (of which he was the first president), Anglo-Soviet medical links and the campaign against nuclear weapons.
A tall gangly man, when disturbed Ian would emit a continual loud hum, similar to a hive full of active bees. Outside The Lancet his two main interests were cricket and his family. As a Yorkshireman born in Bradford Ian had played cricket since school (where he had also been a footballer) and Guy’s, continuing in village clubs in Kent even up to his retirement. He commuted from his adopted county, Kent, to The Lancet office every day, and his house in Sevenoaks, presided over by Olive (his community physician wife), was full of the happy sounds first of his five children and then of his grandchildren, making it a warm and relaxing home.
All of these attributes were to be commemorated in a Festschrift which the BMJ presented to Ian at a special dinner to mark his retirement. For years relations between the two journals had verged between the cool and the tepid, being downright frosty when Fox and Hugh Anthony Clegg [Munk’s Roll, Vol.VII, p.103] were editors, particularly with their oppposing attitudes over the introduction of the NHS. But Ian mediated a new and warm relationship, as he had done among the international group of editors of important medical journals when he became an enthusiastic founder member of the Vancouver group - though at the end of his life he was in despair at the American-led chauvinism that had precluded this body from achieving further advances. Another source of unhappiness in his last few months was at The Lancet itself. He had kept to its editor’s traditional role of not interfering in management and found himself outmanoeuvred when the editorial office was moved to Bedford Square without his consent and an inexperienced successor from outside imposed on the journal. It was to take some years before these debacles were resolved.
The title of the Festschrift Swerving neither to the right nor to the left, has sometimes been misinterpreted as indicating that Ian always occupied the middle ground rather than the traditional ‘demi-semi-Quaker’ stance of The Lancet, always more to the left than anywhere else. In fact, it was taken from a speech by Lord Curzon (hardly the most conformist of politicians) to indicate that, once his mind was made up, Ian could be relied upon to stick to his guns.
Stephen Lock
[Guy's Gazette, July/Aug 1997; The Daily Telegraph, 8 Mar 1997; The Times, 7 Feb 1997; The Independent, 27 Jan 1997; Brit.med.J., 1997,314,447; The Lancet, 1997,349,300]