Patrick Hamilton was born at Edinburgh, the son of a Presbyterian minister, John Edmund, and his wife Elizabeth Lilias, a medical practitioner. He was educated at Winchester College and Christ’s College, Cambridge, and his life in medicine and public health spanned four continents. His interest in tropical diseases developed in Nepal with the Royal Army Medical Corps, but his work as a teacher and research worker really began in Uganda in 1963 at the Makerere medical school, with studies of splenomegaly, sickle cell disease, tetanus, and a growing interest in epidemiology. From there he moved to the London School of Hygiene and Tropical Medicine under Donald Reid [Munk's Roll, Vol.VII.p.493] and applied himself to the organization of an epidemiological study of heart disease involving 20,000 civil servants, and to an examination of the risks of smoking and the effects of anti-smoking programmes.
His abilities proven, Hamilton was the natural choice to head a newly created tropical epidemiology unit within the School. Then, after establishing the unit in research on onchocerciasis, schistosomiasis and African arvoviruses, he went to Trinidad as director of the Caribbean Epidemiology Centre. Again he started virtually from scratch, building up a large and effective international organization engaged in the control of communicable diseases in the area.
After seven years in Port of Spain he came back to the London School of Hygiene and Tropical Medicine to take up the chair of community health. During recent years the specialty has had to struggle against outsiders casting doubts as to its worth, while many of its own practitioners have sought to defend an increasingly limited territory. In contrast, Patrick saw this as a time to push the case for community medicine all the harder, both in academic and health service spheres. His vision was characterized by the range of potential contributors -clinicians, epidemiologists, economists, statisticians, sociologists - and the breadth of its applications both in industrialized and third world countries. And he was forever seeking to extend these activities still further. One of his last major initiatives was the establishment, with the help of the Nuffield Provincial Hospitals Trust, of a research group to study the social impact of AIDS, a development that included the appointment of a historian to the School’s staff. This reflected his personal delight in history, which he saw as crucial to our understanding of contemporary medicine.
At a time of the increasing emphasis on the scientific and technical aspects of health and health services research, Patrick continued to recognize the importance of the managerial and personal contribution for achieving change. There was probably no country in the world in which he lacked a personal contact - an ex-colleague, a past student, an acquaintance from a previous visit. This unrivalled international network meant that regardless of topic or location he could, by picking up the telephone, help students and colleagues with even their most obscure problems. It was in his capacity as adviser to the WHO programme on onchocerciasis, a disease causing widespread blindness in some tropical areas, that he was visiting Ouagadougou, Burkina Faso, in West Africa, at the time of his death. He had characteristically refused to allow his very active life to be restricted by his diabetes.
Patrick married Fiona Hunter, a financial journalist, in 1972 and they had two children, a son and a daughter. He and his wife filled their London house with unpredictable combinations of overseas visitors, colleagues, students, friends and neighbours. As well as being a fine ambassador for this country, Patrick was an enthusiastic host. He also found time to collect a variety of things. Besides the tribal spears and weavings that decorated his office were antique mahogany medicine chests, packages of historic books on public health, and old medical instruments of obscure purpose.
Patrick's sudden death came as a great shock to all who studied under him or worked with him.
NA Black
C Skinner
[The Times, 17 June 1988; The Guardian, 17 June 1988; The Independent, 20 June 1988; Brit.med.J., 1988,297,550; Lancet, 1988,1,1469]