David Baum was one of Britain’s most distinctive twentieth century paediatricians. He was born into a Polish immigrant family and was educated at George Dickson Grammar School in Birmingham. He went on to the University of Birmingham medical school. After house appointments he started his paediatric training at Birmingham Children’s Hospital. He then spent a brief period at the Middlesex Hospital as RMO before joining the department of paediatrics at the Hammersmith Hospital as senior house officer and then research fellow.
At Hammersmith he came under the influence of Peter Tizard [Munk’s Roll, Vol.IX, p.518] who was developing the specialty of neonatal medicine. Here David’s scientific and research interests flourished. He studied biochemistry, a subject fundamental to clinical paediatrics and which he was later to apply to disorders of carbohydrate metabolism. During this period he also spent some time at the University of Colarado in Denver as a visiting professor, carrying out a follow-up study of teenagers with visual impairment associated with oxygen toxicity in infancy. His later interest in whole population epidemiological studies had its roots here.
He recognised the importance of thermal control of the new-born and invented a heat preserving foil sheet ‘the silver swaddler’ which is still used to protect vulnerable infants immediately after birth.
The core of the Hammersmith team moved in 1972 to the new academic department of paediatrics at the University of Oxford where Tizard had taken up the chair. The John Radcliffe Maternity Hospital was adjacent to the Nuffield Institute for Medical research and it was here that David carried out further neonatal research and clinical work. He turned his attentions to nutrition and particularly to maternal breast milk. He worked with medical physicists and bioengineers to develop instruments that would measure breast flow during feeding and a ‘human milk pasteurizer’ which extended the benefits of breast milk to pre-term infants.
His interests also turned to physiology and to carbohydrate disorders. At that time many children with diabetes were seen by general paediatricians. Late 20th century integrated care was scarcely thought of. He went on to establish a multi-disciplinary service for children with diabetes.
The final visionary phase of his Oxford career came from his concern for families of children with terminal illness. He promoted the foundation of Helen House, the first of many children’s hospices in the UK, and later became the founding chairman of the National Association for Care of Children with Life Threatening Diseases and Their Families. He was patron of the Bristol Jessie May Trust which provides domiciliary support for such families.
In 1985 he was appointed to the chair of child health at the University of Bristol. The department had great epidemiological strengths, but he understood the need to develop a corresponding clinical academic base. Through the appointment of university and NHS consultants with promising teaching and research potential, he led the development of a comprehensive tertiary care service for Bristol and the south west, to be based at the newly constructed Bristol Children’s Hospital. He also recognised the importance of cross disciplinary academic activity and made space available in the Institute of Child Health, his academic headquarters, for specialists who were employed either by the NHS or by the university.
He insisted on carrying a similar clinical work load to his colleagues, with regular nights and weekends on take and a spirited and enquiring post-take ward round. At the time of his death he was throwing his weight behind efforts to unify general paediatrics - which he commended as the cornerstone of secondary and tertiary care paediatrics - in Bristol. He knew that community and general paediatricians (not to mention child psychiatrists) had more in common than they sometimes recognised.
David led the life of a busy academic. He gave numerous guest lectures on the subjects close to his heart - diabetes, hospice services and breast feeding. Latterly, however, he had taken a more visionary view of child health services, families, children and their place in society. One sensed that he was becoming less drawn to technique-based medicine and more to the humanity of clinical practice. He championed child human rights and argued persuasively for the establishment of a children’s ombudsman in the UK.
David had a long association with the British Paediatric Association (BPA), latterly the Royal College of Paediatrics and Child Health (RCPCH). In 1976 he was awarded the BPA Guthrie medal (a rare distinction) for his contributions to paediatric research. He held office in the BPA as secretary and then chairman of the academic board. Early on he developed a belief that the medical interests of children would be furthered by the establishment of a medical Royal College and he campaigned unremittingly to achieve that purpose. He regretted the collegiate parting of ways, but saw it simply as inevitable. For this reason he bore no ill will to those of us who campaigned for paediatrics to stay within the Royal Colleges of Physicians and was swift to use their talents to develop the new College. He was the second president of the RCPCH, and embarked immediately on a programme of strategic thinking concerning the training, registration and continuing education of paediatricians at home and abroad. To many his leadership was dazzling, multi-hued and ambitious.
With his family’s origins it was inevitable that David would have an international outlook. Early in his career he developed links with Thailand and studied infant nutrition there. He was audacious enough to go to the top when he was convinced a topic was worth backing - hence his contacts with Gorbachev, leading to a Bristol/Moscow hospital link and with the UK overseas development minister to develop a project for neonatal services in Brazil.
His particular concern was for the welfare of children caught up in conflict or other humanitarian or natural disasters. With the support of the patron of the RCPCH, HRH The Princess Royal, he established an international task force to supply paediatricians to non-governmental and other organisations working with children in conflict situations. The task force has already placed doctors in the field and will be a lasting memorial to his work. At the time of his death he was particularly distressed by the plight of children in the war torn Balkans. The continuing friction in the Middle East troubled him and he strove to support efforts in peace and reconciliation. He made a strong link between the RPCH and the charity Medical Aid for Palestinians and was planning an ambitious project to aid the education and training of Palestinian paediatricians.
To many David was a contained man: discreet, with warmth, charm and wit. Short in stature with wiry grey hair, bow tie, waistcoat and blazer, he was instantly recognisable in a crowd. Neatness was one if his hallmarks - his handwriting was well formed, as was his prose and diction. He must have been one of the few paediatricians to wear a white coat in consulting practice. When relaxed he became anything but contained. Twinkling eyes, a ready laugh and appreciation of a good joke were his characteristics. He liked good food, wine and cigars, hosting parties and participating in crazy cricket games. He had a punishing work routine, but made himself readily available to colleagues, trainees and, indeed, anybody who sought his wise advice. Shortly before his death he had been elected to the General Medical Council and it was clear that he still had much to contribute to British medicine.
He died before deserved, but unsought, academic and public honours could be conferred. He would have preferred recognition to come from the accomplishment of the numerous projects which he set into action. His hallmark was to develop the idea, find the funding and the people to implement it, then move on, taking little personal credit.
The backdrop of David’s life was his Jewish faith. He disliked being away on the Sabbath and he was a regular worshipper at the Bristol Hebrew congregation. He made time to involve himself in synagogue and regional Jewish affairs, where his wisdom was valued.
David married Angela Goschalk, a painter, in 1967. They had four sons. Family life was important to him. He preferred commuting from Bristol during his College presidency, rather than staying in London overnight. He took great pride in the artistic and academic achievements of his wife and sons, all of whom have inherited his strong sense of Jewish religious and cultural identity. He died suddenly from a myocardial infarction whilst taking part in a charity bicycle ride to raise funds for children affected by war and natural disasters. He was buried at Rosh Pinna near the sea of Galilee, where he had hoped to end his days.
Timothy Lachlan Chambers
[The Guardian 15 Sept 1999; The Independent 17 Sept 1999; The Times 29 Sept 1999; Brit.med.J.,1999,319,923; Proc.R.Coll.Physicians.Edinb.200,30,91; The Hospital Doctor 7 Oct 1999]