John Hinton was a leading psychiatrist who played a key role in the development of the understanding and care of people experiencing terminal illness and death.
Trained at King’s College Hospital Medical School, he first held a series of hospital positions in and around London, including the Maudsley Hospital, before his appointment to the department of psychiatry at the Middlesex Hospital, which he led from 1966 to 1983. He was also closely involved for many years with the development and provision of care at St Christopher’s Hospice, Sydenham.
John was the youngest of three children (he had two sisters), raised in a modest household in south London. His father, Albert George Hinton, was a clerk; his mother was Winifred Alice Hinton née Bray. He gained a scholarship to attend Christ’s Hospital, Horsham and became a life-long supporter of the school, which he regarded as filling an important role in our education system. He was the first in his family to enter an academic profession and in early post-war years at King’s was a meticulous student, won a major prize for pathology and once considered specialising in surgery. Aside from his studies, he participated in the student theatrical shows and from 1948 to 1949 captained the rugby team. Birdwatching was, and remained, his main hobby, and he cherished visits and holidays to the countryside as far north as Scotland.
While a house officer at King’s, John met Pat (née Watkins), a nurse four years his senior. They married in 1950 just prior to his posting to Sierra Leone for two years’ National Service as a captain in the Royal Army Medical Corps. Pat was later able to join him and their experiences of tropical medicine, life and the people of Freetown were often recalled in later years.
Returning to the London area in 1952, John held house officer and registrar positions while studying for higher qualifications. He started pursuing his keen interest in psychiatry at the National Hospital for Nervous Diseases. This led to appointments as a registrar, then a senior registrar, at the Maudsley Hospital and, in 1961, as a senior lecturer in psychiatry at the Middlesex Hospital. He became professor of psychiatry there, aged 40, in 1966.
At the Middlesex, John combined clinical and teaching roles with his research towards better understanding of the emotions and suffering of those with terminal illness, and thereby improvements in care and treatment. As he was later to record in a 2003 review paper, when he started his psychiatric work John found ‘There were practically no factual accounts of what dying patients felt’. He commenced a huge programme of interviewing and data-gathering from patients, their families and carers, culminating in publication of his ground-breaking paper in the Quarterly Journal of Medicine, ‘The physical and mental distress of the dying’ (Q J Med. 1963 Jan;32:1-21).
This changed things. The first hospices were then being set up, and the need for better methods of palliative care was being recognised. John’s paper provided evidence, missing thus far, of both the practical and, equally importantly, the emotional needs of the dying. Cicely (later Dame Cicely) Saunders [Munk’s Roll, Vol.XII, web] invited him to join the project team at St Christopher’s Hospice, where he contributed his medical and psychiatric expertise, a function he came to continue beyond formal retirement. The publishers, Penguin, commissioned a book.
Dying (Harmondsworth, Penguin) was published in 1967, revised in 1972, remained in print for 30 years and formed a readable, substantive text for students, the medical and care professions and others seeking to better understand this inevitable part of life. Translated into many languages, it sowed the seeds for a more understanding and open approach to the terminally ill. Parts are still cited today, and in his own final months John was touched that his personal carers found it useful, one of them independently purchasing a copy for him to sign.
Preparing the book for publication, in common with so many aspects of his life, was a partnership with Pat. She typed up the handwritten drafts, while also looking after the home and children and developing her own interests in archaeology. Away from work, researching their family trees was a shared interest that took John and Pat to record centres, churchyards and villages across London and southern England.
As a professor John continued his own research and contributions to the treatment and needs of dying patients, headed the department of psychiatry, was consultant to patients with a wide range of psychiatric needs at both the Middlesex and at St Luke’s, Woodside, and taught hundreds of students. An earlier lecture tour in America (in 1964) had cemented contacts with colleagues there, and his work contributed to international studies and delivery of terminal care. In total, he published over 50 papers, most, though not all, relating to psychiatric aspects of dealing with terminal illness. ‘Administration’, as John described department and hospital management and politics, was something of a chore, albeit undertaken with diligence and commitment, and he participated fully in duties associated with senior membership of several professional bodies. He was a fellow of both the Royal College of Physicians and the Royal College of Psychiatrists, acted as an examiner for both bodies, was actively engaged with the Royal Society of Medicine and was an expert adviser to the University of London.
In all his work, John’s primary concern was the welfare and interests of people – patients, students, colleagues, close friends and family. He was committed to the founding principles of the NHS. He was modest, unassuming, meticulous and knowledgeable, and quietly proud of his contribution to his specialty. Some friends have indicated that this last might have deserved formal recognition during his lifetime.
On retirement John was awarded the title emeritus professor. He and Pat moved to a village in west Dorset, fulfilling an ambition for space, views, wildlife and relative peace. John continued his research and consultancy role as a research fellow at St Christopher’s, leading tutorials and providing moral and professional support and advice to staff working in challenging roles. He and Pat were proud that their garden contained an ancient orchard and meadow classified as a Dorset Site of Nature Conservation Interest. They managed it diligently, mowing at the right time of year and recording its flora, birdlife and insect life. They were regular visitors to Shetland and particularly enjoyed holidays to northern Norway and Sweden.
John remained active and interested well into old age, enjoying his garden, home and family to the end, and maintaining his commitment and interest in medicine and psychiatry. He never benefited personally from the hospice care he’d done so much to foster, only the last four days of his life, aged 90, being away from home, in hospital in Taunton. He was survived by his much-loved family of Pat, his wife for over 65 years, his daughter Ruth, son Peter and two grandsons.
Ruth Briggs
[BMJ 2016 353 2773 www.bmj.com/content/353/bmj.i2773 – accessed 21 November 2016]