Michael Espir had a varied career as a consultant neurologist in Leicester, Derby and Nottingham, then in occupational health as a principal medical officer with the Civil Service Medical Advisory Service, and subsequently as a consultant neurologist in private practice in London.
He was born in Hampstead, London, into a secular Jewish family, and educated at Aldenham School, where he obtained an entrance scholarship. There were no other doctors in his family. His father, Louis Espir, was first in business, manufacturing copper wire, and then became a manager in the Canada Life Assurance Company in London. In 1940, when invasion threatened, he was, at the age of 14, evacuated with his mother, Doris Rosalind Espir née Davis, and sister to Canada at the invitation of Canada Life. He returned to England in 1941 and resumed his studies. In 1944 he went up to Trinity Hall, Cambridge University, his father’s old college, for his preclinical medical studies, and then to the Middlesex Hospital for clinical studies in 1947. He qualified in 1950 with a first class honours degree in biochemistry. He obtained his MRCP in 1957 and was elected as a fellow of the Royal College of Physicians in 1971.
In 1947, after he finished the tripos exams, he stayed up at Cambridge to take the entrance scholarship to the Middlesex Hospital, and in the summer developed polio. His legs and intercostal muscles were affected, and he was taken down from Cambridge in an ambulance to his parent’s home in Wimbledon, where the local GP did a lumbar puncture and he was admitted to Atkinson Morley Hospital under the care of Denis Williams [Munk’s Roll, Vol.IX, p.587]. He wasn’t able to take the scholarship to the Middlesex, but made a good recovery and started there in November 1947, a couple of months late.
His early career was in general medicine, as a house physician and registrar at the Middlesex Hospital, rotating through the neurological departments under Douglas McAlpine [Munk’s Roll, Vol.VII, p.349] and Michael Kremer [Munk’s Roll, Vol.VIII, p.265].
He then did his National Service in the RAMC as a clinical officer to the Army tuberculous meningitis unit at Wheatley Military Hospital and the head injuries centre in Oxford under Ritchie Russell [Munk’s Roll, Vol.VII, p.514] and Honor Smith [Munk’s Roll, Vol.X, p.452]. He soon developed a consuming interest in clinical neurology, and worked as a house physician to the neurological department as a trainee at Wheatley Military Hospital. Wheatley was initially an American military hospital before being taken over by the RAMC. He also spent time at Stoke Mandeville Hospital, which was the premiere military spinal injuries unit during the war, run by the fabled Sir Ludwig Guttmann [Munk’s Roll, Vol.VII, p.233], and worked there with patients with multiple sclerosis, spinal injury and poliomyelitis, and gained a career-long interest in rehabilitation medicine. He then spent six months as a house surgeon to Joe Pennybacker in Oxford. His younger brother, Peter, had died aged 13 from subacute sclerosing panencephalitis, a disease which, at the time, was unknown; while he was working in Oxford he searched out his brother’s notes and found the characteristic EEG.
He was then appointed as a senior registrar in neurology at the National Hospital, Queen Square (‘the registrar to the outpatients’) and at King’s College Hospital under Macdonald Critchley [Munk’s Roll, Vol.X, p.83] and Sam Nevin [Munk’s Roll, Vol.VII, p.428]. At Queen Square he worked under Roger Gilliatt [Munk’s Roll, Vol.IX, p.195], who held the first professorial chair in neurology in the country, and learned the basics of neurophysiology.
In those days there was a severe shortage of consultant positions in neurology and many brilliant trainees spent years in senior registrar posts; some, being unable to find a post, left the country. He was amongst the brightest of this cohort and, in 1960, was appointed as the first consultant neurologist in Leicester. Initially he was responsible for 20 general medical beds, but after 18 months devoted his entire time to neurology. He had a huge practice, being one of only a handful of neurologists in the Midlands.
In 1968, Bryan Matthews [Munk’s Roll, Vol.XI, p.383] left Derby to take up the chair in Oxford, and he succeeded him as the consultant neurologist to the regional department of neurology and neurosurgery. In 1970, a medical school opened in Nottingham and he took on responsibility for the development of a neurological service at Nottingham as well as Derby, and also for the undergraduate teaching in neurology. He helped with the planning of a neurological unit at Nottingham General Hospital, an associated department of neurophysiology, a stroke unit and a unit for the young chronic sick.
In 1979, he resigned his appointment in Nottingham and Derby for family reasons and moved to London. In January 1979, he was appointed as a medical officer to the Civil Service Medical Advisory Service and trained in occupational medicine. In June 1979, he was promoted to the grade of senior medical officer and, in February 1981, to principal medical officer, a post he held until 1987. In this role, he advised Government departments on occupational, epidemiological, administrative and clinical medical problems and on working hazards, and was medical adviser to the Criminal Injuries Compensation Board. He also advised the Lord Chancellor on the medical fitness of judges. He maintained his links with clinical neurology, with honorary consultant appointments at the Charing Cross and Northwick Park hospitals, and as an honorary lecturer at the Institute of Neurology and the National Hospital, Queen Square (from 1980 to 1987). In 1987, he returned to private neurological practice at the Cromwell, Wellington, Devonshire, Lister and St John and St Elizabeth hospitals.
He had a long-standing interest in epilepsy and during 1983 was a member of a DHSS working group on services for people with epilepsy. The ‘Winterton Report’ was published in 1986 (Report of the working group on services for people with epilepsy: a report to the Department of Health and Social Security, the Department of Education and the Welsh Office. London, HMSO). This was an influential document, which resulted in improvements in the care of the condition nationally. He also carried out a study of factors influencing the health, safety and performance at work of civil servants with epilepsy, in collaboration with Mike Floyd from the City University (‘Occupational aspects of epilepsy in the civil service.’ Br J Ind Med. 1991 Oct;48[10]:665-9). He served as honorary treasurer (from 1969 to 1979) and then honorary president (from 1987 to 1990) of the British branch of the International League Against Epilepsy.
He served on various hospital and regional committees, lectured extensively and carried out research in the fields of epilepsy, motor neurone disease, multiple sclerosis, vitamin B12 deficiency and tremor. He published a well-received book with Ritchie Russell on traumatic aphasia in 1961 (Traumatic aphasia. A study of aphasia in war wounds of the brain. London, Oxford University Press) and a second book on the basic neurology of speech in 1970, which went into three editions (The basic neurology of speech Oxford, Blackwell Scientific).
He was a brilliant neurologist and one of the band of extremely talented trainees who were the products of the superb clinical training in neurology afforded in the post-war years. He was a meticulous and careful clinician who paid attention to all aspects of a patient’s needs. He was wise, compassionate, modest and kind. He was a loyal colleague and friend to many, but also a dedicated family man for whom family life was important above all else.
He was a gifted sportsman as a student, before contracting polio, but the polio left him with slight weakness of one leg which ended his sporting ambitions. He met Patricia Smouha, his wife, in 1957 and they were married in January 1958. She was from an orthodox Jewish family and theirs was a very happy marriage. Patricia died in 1999 from cancer. He remarried in 2003, and, with his wife Valerie (née Van Straten), lived a happy retirement in London. He was survived by four children, one of whom was a national middle distance athlete, 12 grandchildren, and 13 great-grandchildren. He had a stroke in 2011, and died after a third stroke.
Simon Shorvon
[The Telegraph 11 August 2015 www.telegraph.co.uk/news/obituaries/11796745/Dr-Michael-Espir-neurologist-obituary.html – accessed 20 August 2015]