It is unusual in medicine for an eminent physician to have a distinguished reputation in two diverse areas. First and foremost, Robin Eady was a world-renowned dermatologist and professor of dermatology at St John’s Institute of Dermatology, London. He was also the world’s longest surviving patient with renal failure; in 1963, he was one of the earliest patients to receive chronic haemodialysis and then, in 1987, after 24 years, he was given a kidney transplant. He lectured widely to the renal community.
Robin was born in Cairo, the second child of English parents, who ran a business importing medical journals and books to the Middle East. From an early age, Robin became a regular international traveller, something that became very much part of his life, travelling back and forth to school in England. It was at the age of nine that he was found to have proteinuria, thought to be postural rather than related to renal disease. It was only when he was at medical school at Guy’s, whilst playing hockey, that he developed chest pain, shortness of breath and headaches, that he was noted to have severe hypertension. A subsequent diagnosis of nephritis was made, confirmed by renal biopsy.
Having lost his older sister, Diana, in an air accident seven years before, his parents were devastated to hear of this diagnosis and resolved to do anything possible to ensure the survival of their remaining offspring. At about that time an article appeared in Life magazine, seen by his mother, about a doctor in Seattle, Belding Scribner [Munk’s Roll, Vol.XI, p.506], who had developed a new technique for continuous dialysis, a procedure not previously easily performed for extended periods and with a high mortality, to be used with his eponymous Scribner shunt. His father, William Jeffery Eady, read the same story in Paris Match, and they contacted him, via a friend in Seattle. Robin was then flown on one of the first Pan Am flights over the pole, where ‘Scrib’ met the flight at the airport, carried him down the steps to his car, transported him to the University of Washington, inserted his shunt and treated him with a Kill dialyser. He was the fifth person to be treated this way in the US.
Over the course of four months his symptoms improved and Scrib organised with Lionel McLeod, then in charge of the renal service at the University of Alberta, Edmonton, Canada, for Robin to move to Edmonton as a dialysis technician. This was all a little close to his own mortality, and so McLeod arranged for him to work instead as an assistant to a neurophysiology postdoc, and he started attending lectures once more. This was the kicking off point for Robin’s lifetime interest in academia.
After 18 months he returned to the UK, where two renal units had been setup, one by Stanley Shaldon [Munk’s Roll, Vol.XII, web] at the Royal Free, who accepted him on to his programme and Robin was able to return to Guy’s. His mentor, as with many after him, was Robert Stuart (‘Charlie’) Wells [Munk’s Roll, Vol.XI, p.612], who inspired him to a career in dermatology. It was on dialysis that he met his future wife, his haemodialysis nurse, Ann (née Green), and together they established home dialysis for him.
He qualified in medicine in 1967, did his house jobs at Guy’s Hospital and moved through the career path, obtaining his MRCP. His interest in dermatology led him to seek a fellowship with George Odland in Seattle, where he learnt about electron microscopy in skin disease.
On his return to the UK he set up an erythema multiforme unit at the Institute of Dermatology, based at Homerton, funded by the Dunhill family. Initially studying mast cell disease and oculocutaneous albinism, Robin became interested in epidermolysis bullosa (EB), setting up a diagnostic service, prenatal diagnosis and several research programmes. Like his mentor, he inspired new fellows in dermatology, supported by the Medical Research Council, Remedi and DEBRA (the Dystrophic Epidermolysis Bullosa Research Association). All to this day remember him fondly, from the exciting work they did in the laboratory, to the trips both at home and abroad that they took with him, sometimes shepherding him to dialysis or being entertained by him.
Aside from being a clinical dermatologist, electron microscopist, scientist and friend to many in dermatology as well as in the nephrology realm, he revolutionised the understanding of the complex group of disorders collectively described as epidermolysis bullosa. He is regarded as perhaps the driving force in EB research over the past 40 years, beginning with the application of electron microscopy to diagnosis, both postnatally and prenatally, followed by monoclonal antibody driven classification of patients, with collaboration with colleagues in the UK and abroad. Once target genes were identified on the basis of monoclonal antibody abnormalities in EB skin, his laboratory then moved to molecular diagnosis and studies of pathogenesis of a variety of genodermatoses. At every stage his laboratory made seminal contributions. He was instrumental in establishing peer review of grant applications to the patient support group, DEBRA, both in the UK and internationally, helping to develop the careers of many who are now leaders in the field. Finally, he trained several investigative dermatologists, who now provide state of the art care and research on EB patients.
Following his retirement from dermatology in 2010, Robin continued to lecture to the renal community, receiving many awards, including the Northwest Kidney Centers’ Clyde Shields service award.
He was elected as a fellow of the Academy of Medical Sciences (FMedSci) in 2002 and received an MBE in 2014 for services to dermatology and voluntary service to governance in the charitable sector.
Robin’s health deteriorated, surprisingly unrelated to his renal disease, necessitating aortic then mitral valve replacements. It was as a complication of the latter that he sadly succumbed. He will be remembered by all for his joy, scientific insights, wonderful sense of humour and friendship, inspiring many in their careers in dermatology and science. We shall miss him greatly. He was survived by his wife Ann, son Tom and grandchildren, Kane and Frankie.
Adrian Heagerty
[The Times 1 September 2017 www.thetimes.co.uk/article/obituary-robin-eady-72vx772gj – accessed 30 October 2017; DEBRA Remembering Professor Robin Eady (1940-2017) www.debra.org.uk/news/debra-news/post/149-remembering-professor-robin-eady-1940-2017 – accessed 30 October 2017; EdRen (renal unit at the Royal Infirmary of Edinburgh, Scotland) The dawn of dialysis – reminiscences of a patient www.edren.org/pages/history/contemporary-accounts.php – accessed 30 October 2017]