Sir John Dacie was a founding father and for decades the unchallenged leader and teacher of haematology in Britain. Better known worldwide as 'J V' Dacie, he attracted the most able young graduates in whom he instilled the need for high standards in research and clinical work, and the highest level of technical proficiency in laboratory investigations. The training programme which he directed at the (Royal) Postgraduate Medical School, based at Hammersmith Hospital, was unrivalled, and greatly influenced the practice of haematology in the UK as well as overseas. He demonstrated, with consummate skill, how to solve the most complex problems of diagnosis by critical assessment of laboratory data, and he was able to extract maximum information about a patient's clinical state from the microscopic appearances of a blood film. He also used simple manual laboratory procedures to perform fundamental research that contributed significantly to understanding the pathophysiology of blood.
Born in Putney, London, he was the son of an accountant whose great interest in natural history encouraged John's boyhood hobby of collecting butterflies and moths. He was educated at King's College School, Wimbledon, and graduated from King's College Hospital Medical School, in London, in 1935. As a medical student he particularly enjoyed staining and examining blood film, building up his personal collection of interesting films. He was to become a dedicated collector and classifier.
After a brief period in the wards he obtained his MRCP and joined the clinical pathology laboratory as a postgraduate student under the nutritionist R C McCance [Munk's Roll, Vol.X, p.312]. In 1937, as the recipient of a one-year MRC studentship, he spent six months in (Dame) Janet Vaughan's [Munk's Roll, Vol.IX, p.541] department at the then British Postgraduate Medical School at Hammersmith Hospital, where she stimulated his interest in anaemias, especially haemolytic anaemias, and he undertook his first research project on the significance of the osmotic fragility of red blood cells. He completed his studentship at the Manchester Royal Infirmary in the department of J F Wilkinson, where he investigated a patient with Marchiafava-Micheli disease, or as it became known descriptively, paroxysmal nocturnal haemoglobinuria. This was to be the prelude to one of his later lifelong studies. During the war he served in the RAMC, reaching the rank of lieutenant colonel. On his demobilisation in 1946 he was appointed as senior lecturer in haematology in the department of clinical pathology at the Postgraduate Medical School. In this capacity he organised the first formal training course in haematology in the UK, specifically for the University of London diploma in clinical pathology, and he published a small monograph on laboratory practice which was to become the forerunner of Dacie and Lewis practical haematology (London, Churchill Livingstone) which is now in its ninth edition and has become the standard textbook on the subject.
In 1957 Dacie was appointed by London University to the first chair of haematology to be established in the UK. He built up an academic department with staff (and visiting colleagues) whom he encouraged to pursue their own scientific interests, but always under his critical guidance and remarkable acuity. During discussions he might remark, "Wouldn't it be interesting to find out what would happen if you tried..." and this would frequently be the prelude to a research study.
He investigated a large number of patients with various haemolytic anaemias who were referred to him from all parts of the UK, as well as from overseas. He maintained carefully classified files on all these patients and contacted them regularly to review their progress. This enabled him to make careful notes of the clinical course throughout their illness, as well as to examine changes in their blood films which he filed for future reference.
In 1952 he was awarded his MD from London University with a thesis entitled 'Auto-antibodies in acquired haemolytic anaemia in man'. He published and lectured extensively on the haemolytic anaemias, continuing to do so long after he had formally retired, and his bibliography included 170 scientific papers - many in collaboration with members of his staff. But he was outstanding in his respect of academic freedom for his staff and research fellows. He would guide but would never take over, and he would not have his name attached to any paper if he had not actively participated in the study and been personally responsible for its writing.
In the 1960s most hospital departments in England functioned primarily to provide a laboratory service. Initially, his department was laboratory-based and he enjoyed working in the laboratory, devising simple tests to assist in diagnosis and research. He never came to terms with the advancing development of automated instruments and computers in the laboratory, and time and again he was able to demonstrate his mastery in diagnosis with much simpler manual procedures. Despite his personal interest in laboratory practice, he believed that haematologists should be competent in both diagnostic laboratory investigations and clinical management of patients with blood diseases. He appreciated, however, that in general haematologists could not be expected to be equally skilful in all aspects of the discipline, and as clinical research in haematology almost always requires extensive laboratory data, he urged close cooperation between those with laboratory expertise and their more clinically qualified colleagues, the latter having direct responsibility for supervising inpatients with blood diseases in dedicated haematology beds or wards. When the Royal College of Pathologists was founded in 1962 it seemed to be a natural home for the majority of haematologists, but Dacie encouraged haematologists to obtain both the MRCPath and the MRCP, the importance of which is now well recognised.
With the introduction of intensive chemotherapy and developments in the management of leukaemias in the 1960s the need for direct clinical responsibilities became apparent. He had been a member (and later chairman) of a Medical Research Council working party on the treatment of leukaemia whose first report was published in 1963. In 1966 the Medical Research Council and Department of Health invited him to evaluate the new approaches to treatment. He established the MRC leukaemia unit with David Galton, as director. The Hammersmith unit became a national (and international) reference centre for research into and in the diagnosis and management of leukaemias and lymphomas. He helped create the Leukaemia Research Fund and was the first chairman of its medical and scientific advisory panel. Meanwhile, he expanded his idea of the unified nature of haematology by appointing clinicians and clinical scientists in the general haematology department.
In addition to Practical haematology, Dacie's major undertaking was The haemolytic anaemias (London, J & A Churchill). The first edition of this unique treatise appeared in 1954, whilst the third edition was published in five volumes, the first in 1985, and the final one was completed in 1998, a magnum opus that is a fitting memorial to his intellect and to the breadth of his scientific and technical knowledge of the subject, and also to his scholarly style of writing. Dacie's influence on haematology was further extended by his distinguished editorship of the British Journal of Haematology, which was launched by Blackwells in 1955. His dedication and insistence on an impeccable standard of both scientific content and literary style ensured that the journal quickly acquired an international reputation. When he relinquished the editorship in 1962 he remained as chairman of the editorial board, providing valued advice to the six editors who successively took up the mantle.
His lifelong interest in lepidoptera, and his skill and devotion to collection and classification, led him to become distinguished in that field too. To this hobby he applied the same scholarly and scientific aptitude as he did with his professional work. He was especially pleased to invite selected visitors to inspect his mounted display of various, some unique, species. He was very proud to have become a member of the British Entomological Society, with three papers published in the Entomologists' Record.
In setting the highest standards for himself and others, he did not tolerate sloppy work or sloppy thought, and he tended to be somewhat authoritarian in his role as a committee chairman, but he was always fair-minded and willing to listen to an opposing argument. He was a devoted family man and throughout his career his wife Margaret (Thynne), whom he married in 1938, was a constant support in his endeavours, extending even to accompany him on moth-hunting expeditions at dawn on Wimbledon Common. When, in his retirement, he was deprived of the services of his secretary, she found time to type all his writings on their faithful Remington typewriter as he could not bring himself to rely on the new-fangled word processor. He had a quiet sense of humour and he was shy but very approachable. He preferred home life to outside social activities and he welcomed his colleagues and the many visitors to his department, both junior and senior, to their home in Wimbledon. And at international gatherings he preferred to spend time with his ex-students rather than at the top table.
He was a foundation fellow of the Royal College of Pathologists and president of that College from 1973 to 1975. He was president of the Royal Society of Medicine from 1977 to 1978. He was one of the founders of the British Society for Haematology in 1960, and its president in 1964. He was also president of the European-African division of the International Society of Haematology for its congress in London in 1975. He was awarded honorary degrees by the universities of Uppsala and Marseilles, and he was the recipient of honorary fellowships from a number of British and foreign professional colleges and societies.
Mitchell Lewis
[The Daily Telegraph 19 Feb 2005; The Independent 26 Feb 2005; The Guardian 11 March 2005; The Times 17 March 2005]