John Anderson, professor of medicine at King's College Hospital Medical School, was a highly original man whose ideas were often years ahead of his time. He was essentially an innovator and pioneered developments in metabolic medicine, medical education and medical computing.
His background was in history, having obtained a BA with honours in modern history at Durham University in 1942. He was then called up to the army and served with the Royal Artillery as an officer during the desert war. After the war he took up the opportunity of free education to armed services' survivors to read medicine at Durham, and graduated MB BS with honours in 1950, also obtaining his MA in modern history in the same year. After house officer appointments at the Royal Victoria Infirmary in Newcastle-upon-Tyne, he was awarded an MRC scholarship in physiology and obtained a BSc with honours in 1952.
An MRC research fellowship in Charles Dent's [Munk's Roll, Vol.VII, p.148] department at University College London followed, working on calcium metabolism. They described the now well-known use of steroids in the differential diagnosis of hypercalcaemia. In 1956 he returned to Durham as first assistant in the department of medicine and, in the same year, obtained his MD with a thesis using a new technique of phosphate clearance by the kidney.
In the following year he was awarded a Rockefeller travelling fellowship to Harvard University and carried out studies on sodium transport in the isolated toad bladder at Massachusetts General Hospital, which he continued to research throughout his subsequent career. It was at this time that he became interested in systems of medical record keeping. He was present at Harvard when 'real time' was discovered, a concept which revolutionised the development of computer technology, and which he realised could be applied to medical records with enormous advantage. He returned to Durham in 1957 to assume direction of the artificial kidney unit there.
In 1959 he went to King's as senior lecturer in medicine and consultant in endocrine and metabolic medicine. Here he set up an active metabolic unit conducting calcium balance studies on patients with various conditions such as osteoporosis and sarcoidosis. He was promoted to reader and elected to the Fellowship of the College.
He was a key figure in the development of renal medicine at King's during the 1960s when the first acute dialyses were performed. He established and directed the South East region artificial kidney unit at this time, which subsequently became based at Dulwich Hospital. He also set up the first hypertension clinic in London.
In 1964 he published, with Sidney Osbourne, the results of his noteworthy and courageous research, the world's first in-vivo neutron activation analysis. At the Atomic Energy Establishment (Harwell) they had both undergone neutron bombardment and demonstrated that this could be used to calculate the quantities of key elements such as sodium and calcium present in the whole body during life. Previous measurements had only been able to be obtained from the ash of cadavers. Sadly, John Anderson was not able to exploit this research subsequently in his own unit in the way he had hoped.
In 1965 he was appointed to the newly established chair in medicine at King's College Hospital Medical School. Although he continued to research in sodium transport and other metabolic projects, his main focus shifted to medical education and medical computing.
In medical education, he reorganised the old curriculum, replacing the existing lecture courses with systems-based topic teaching. These integrated clinical subjects with basic medical sciences to illustrate and explain disease. These ideas have now become established throughout the country on the recommendation of the GMC.
Multiple-choice examinations were introduced together with regular student assessments and, with the help of newly-established lectureships in medical education, workshops for training medical teachers were organised.
Between 1967 and 1970, with the support of the Department of Health, he pioneered the development of computerised medical record keeping at King's. Although there were multiple difficulties, a useable record was achieved, together with a system of automated discharge summaries from the record to general practitioners, which eliminated the usual delays. Unfortunately the system was too slow, cumbersome and expensive for wider implementation and was not continued.
In 1969, he became a fellow of the British Computer Society and chairman of its medical specialist group. He continued to publish and lecture on informatics and electronic medical records throughout the rest of his career.
John Anderson was an amiable man, known to all as 'J A', who would greet one with a broad grin and equally broad Geordie accent. He generated energy and enthusiasm and was a stimulating teacher. Generations of students will remember his teaching and the way he said 'compuer'.
He was a family man, enjoying time with his wife Betty and their three sons. He retained his interest in history, and enjoyed travel and DIY. He was not a political animal and did not enjoy the competitiveness of modern academic medicine. He eventually became somewhat disillusioned by the lack of support for his projects.
He was in great demand abroad as a lecturer, particularly in the Far East and USA. When he retired in 1986 he continued to lecture and travel. He died from sepsis after a hip replacement operation. He would be gratified to learn that technological advances have at last enabled his ideas to become a reality at King's, 30 years later. The price of being a visionary is that recognition tends to come too late!
Keith Pettingale
[Brit.med.J.,2002,325,283]