John Lennard-Jones was a consultant gastroenterologist at University College and St Mark’s hospitals, and a professor of gastroenterology at the London Hospital. Known to his colleagues as ‘LJ’, he was a gentle but inspiring teacher, a caring physician and a prodigious clinical researcher. Michael Farthing, a fellow gastroenterologist, stated that ‘…he instilled confidence in his patients. I never heard anyone ask for a second opinion after they'd seen LJ’.
John was born in Bristol, the son of John Edward Lennard-Jones, a mathematician and scientist, and Kathleen Mary Lennard. (When the couple married in 1925, the then John Edward Jones added his wife’s surname to his own.) The family moved to Cambridge in 1932 when John’s father was appointed professor of theoretical chemistry. As a child, his main interest was the natural world, a fascination enhanced during the Second World War when he kept rabbits and grew food on an allotment. He originally intended to become a farmer and, after schooling at Gresham’s, which was evacuated to Cornwall, he studied natural sciences at Cambridge.
After the war, he carried out his National Service at a burns unit in Birmingham. There he wrote two papers – one on the use of penicillin in finger injuries (‘Value of systemic penicillin in finger-pulp infection; a controlled trial of 169 cases’ Lancet 1949 Mar 12;1[6550]:425-30) and the other on distinguishing partial and full thickness burns (‘The impairment of sensation in burns and its clinical application as a test of the depth of skin loss’ Clin Sci 1949, 8 [155]) – and decided to study medicine. He returned to Cambridge and then went on to University College Hospital for his clinical studies, winning all the undergraduate prizes. He qualified in 1953 and held professorial house posts with Max Rosenheim and Douglas Black.
In 1955 he met Francis Avery Jones and worked with him as a registrar at the Central Middlesex Hospital. When Avery Jones was appointed as a consultant gastroenterologist at St Mark’s Hospital, then predominantly focused on surgery, he introduced John as his assistant. John also toured gastroenterology departments in the United States on a Bilton Pollard fellowship from University College Hospital.
In 1963 he was invited to join the Medical Research Council’s gastroenterology research unit at the Central Middlesex Hospital, and at the same time increased his clinical commitment at St Mark’s. He had a profound love for St Mark’s Hospital throughout the rest of his career, and much of his productive work was done there, although he also held a post as a consultant gastroenterologist at University College Hospital from 1965 to 1974 and was professor of gastroenterology at the London Hospital from 1974 to 1987.
John was one of the first ‘pure’ gastroenterologists who worked throughout his career in one specialty. Avery Jones described him in 1991 as the leading architect for the organisation of British gastroenterology in the 20th century. Another gastroenterologist, Christopher Williams, noted his intellect and described LJ affectionately as ‘..an egg-head with a total command of the world literature…He was a walking reference base’.
John became one of the world experts on inflammatory bowel disease, leading major clinical trials on its assessment and treatment. These had a major influence on the treatment of the disorder, notably the efficacy of topical therapy in ulcerative colitis, the powerful effect of immunosuppressive therapy in maintenance of remission in Crohn’s disease and, importantly, the lack of efficacy of long-term oral steroids for maintenance of remission in ulcerative colitis. He initiated landmark studies into the importance of the early recognition of cancer in colitis and the role of surveillance in reducing the risk of cancer death.
During his career, John realised the importance of parenteral nutrition for patients with severe inflammatory bowel disease. The unit at St Mark’s attracted many patients with intestinal failure and he could give patients the confidence and the know-how to go home with the kit and to manage the bags and rest of it themselves. This involved close work with the nursing team and very rapidly the idea of nurse specialists having a major role caught on and he established a multidisciplinary team that developed broad expertise in nutritional support.
He also built a research team to investigate irritable bowel syndrome and chronic constipation. He had a deep appreciation of the importance of psychological support in the management of patients with chronic gastroenterology disorders. As a result of his clinical acumen, comprehensive knowledge, high intelligence and an empathic consultation style, he created a cohort of devoted patients who would happily wait hours to see him in his long outpatient clinic.
It seems that John inherited his father’s mathematical genes: his medical papers were permeated by the logic of the mathematician. For a time John worked with Richard Asher, and this too may have contributed to his fine uncluttered style and his remarkable ability to marshal facts and communicate them with such clarity. His long association with St Mark’s enabled him to make the maximum use of the remarkable concentration of clinical problems found in a specialist hospital, achieving the best coordination between positions, surgeons, pathologists, radiologists, endoscopists, nursing staff, social workers and other staff. It has been said that he succeeded on a scale hitherto possible only in a Medical Research Council unit. The numerous publications over his career show a remarkable justification for both specialist personal chairs and specialist hospitals.
John was a leading light in many gastroenterological charities, including the Ileostomy Association and the Digestive Disorders Foundation. He co-founded the National Association for Colitis and Crohn’s disease, which have stated that ‘…without his skill, interventions and dedication, there would not be the same advancement in the understanding and treatments for Crohn’s disease and ulcerative colitis, nor would the charity have been founded 40 years ago and achieved so much in research, information and support for everyone affected by the conditions’. He was also instrumental in the formation of the British Association for Parenteral and Enteral Nutrition. He was the first recipient of their new Lennard-Jones medal, which remains an important appreciation of merit. He served as secretary and also president (in 1983) of the British Society of Gastroenterology.
John cared passionately about the NHS and was keen to make sure it was accessible to everybody. He therefore declined any private practice, reflecting his very strong Christian ethic. He was a medical adviser to and subsequently chair of the Sir Halley Stewart Trust, a Christian charity providing grants for innovative projects aimed at relieving human suffering. Colleagues recall that no one who worked with him ever had a bad word to say about him.
John married Verna Down, a midwife, in 1955. They had four sons, David, Peter, Andrew and Tim, and instilled in them a love of the outdoors, including sailing, walking, golf and birdwatching. He was at his happiest walking around his beloved Cley marshes in Norfolk with his binoculars.
John and Verna retired to Woodbridge, where they became active members of their local church, St John’s. Shortly after their arrival, John was asked to chair the new spire committee and oversaw the fundraising, planning and subsequent construction. At his funeral service, it was commented that the spire will be a permanent epitaph to him, a thought with which he would probably not have been too comfortable, as he was a supremely modest and unassuming man.
In his latter years, John was increasingly immobile, a situation he found very frustrating. However, he coped with his disabilities in his usual phlegmatic, ‘saintly’ and patient way, continuing to show deep interest in anyone visiting him. Verna sadly died in February 2019. John deteriorated sharply after her funeral and died two weeks later. They were survived and greatly missed by their four sons, four daughters in law, and nine grandchildren.
Andrew Lennard-Jones
[East Anglian Daily Times 29 April 2019 www.eadt.co.uk/news/obituary-gastroenterologist-at-central-middlesex-hospital-2571590 – accessed 23 June 2021; The Lancet 2019 393 (10189) 2388 www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31327-3/fulltext – accessed 23 June 2021; Gut 2019;68:1137-1138 https://gut.bmj.com/content/68/7/1137 – accessed 23 June 2021; BMJ 2019 366 4706 www.bmj.com/content/366/bmj.l4706 – accessed 23 June 2021]